{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:04:14Z","timestamp":1784145854358,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with early\u2010stage cutaneous melanoma (CM) have low individual risk but account for most distant recurrences. The utility of gene expression profiling (GEP) in CM risk stratification and clinical management remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 2015 to 2022, CM patients at a single center were universally referred for DecisionDx 31\u2010GEP. Patients with prior recurrence or not undergoing excision were excluded. The Kaplan\u2013Meier method and Cox proportional hazards models were used to evaluate primary outcomes of recurrence\u2010free survival (RFS), distant metastasis\u2010free survival (DMFS), and melanoma\u2010specific survival (MSS). Secondary outcomes were sentinel lymph node biopsy (SLNB) positivity and recurrence subtype events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      689 patients were analyzed: 63% GEP Class 1A, 16.1% Class 1B\/2A, 16.1% Class 2B, and 4.8% unclassified. After staging, 86.6% were stage I\/II and 13.4% stage III. Median follow\u2010up was 4.85 years. On multivariable analysis, GEP remained significantly predictive of RFS (Class 1B\/2A HR\u2009=\u20094.022; Class 2B HR\u2009=\u20093.052), DMFS (Class 1B\/2A HR\u2009=\u20094.403; Class 2B HR\u2009=\u20093.729), and MSS (Class 1B\/2A HR\u2009=\u20096.656; Class 2B HR\u2009=\u200911.583) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for all). Older Class 1A patients with indication for SLNB had lower SLNB positivity (2.8% \u2265\u200965 years, 0% \u2265\u200975 years).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data show GEP remains a robust predictor of recurrence and MSS after adjusting for clinicopathologic factors overall but is not predictive for all outcomes in stage\u2010stratified analyses, particularly Stage II disease. Stage IA patients should forgo GEP altogether testing due to its futility in this population. Older patients with low\u2010risk GEP may be candidates for avoidance of SLNB given lower positivity rates. GEP Class 2B patients represent a relatively high\u2010risk population regardless of SLNB status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70229","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:47:38Z","timestamp":1773035258000},"page":"889-900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Universal Risk Stratification in Stage I\u2013III Cutaneous Melanoma Using 31\u2010gene Expression Profiling: A Single\u2010Center Study"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-7615","authenticated-orcid":false,"given":"Daniel B.","family":"Gehle","sequence":"first","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center Memphis TN USA"},{"name":"Department of Surgery St. Jude Children's Research Hospital Memphis TN 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University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5421-9014","authenticated-orcid":false,"given":"Andrew M.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Pedo","family":"Freitas","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3963-0651","authenticated-orcid":false,"given":"Feng","family":"Liu\u2010Smith","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3461-2406","authenticated-orcid":false,"given":"Simonne S.","family":"Nouer","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6747-0355","authenticated-orcid":false,"given":"Andrew J.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center Memphis TN USA"},{"name":"Department of Surgery St. Jude Children's Research Hospital Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6964-8146","authenticated-orcid":false,"given":"Martin D.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tennessee Health Science Center 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