{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:12:27Z","timestamp":1784635947630,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["1R25DC021791\u201001"],"award-info":[{"award-number":["1R25DC021791\u201001"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective(s)<\/jats:title><jats:p>The objective of this study is to evaluate the utilization and outcomes of completion lymph node dissection (CLND) and immunotherapy for sentinel lymph node biopsy (SLNB) positive head and neck cutaneous melanoma (HNCM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with primary HNCM and positive SLNB in the 2020 National Cancer Database (NCDB) Melanoma file were reviewed. The frequency of CLND and immunotherapy was tracked from 2012 to 2019. Clinicodemographic features of patients were evaluated with respect to their post\u2010SLNB treatment choice. Overall survival (OS) was calculated from the time of diagnosis, and the association of therapy choice with survival was determined using a multivariate Cox regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rates of CLND declined from 66% to 18% while adjuvant immunotherapy increased to a peak of approximately 40%, with an inflection point occurring in 2016. Multivariate survival analysis indicated that immunotherapy use alone, though not CLND, was associated with improved prognosis (hazard ratio 0.65, 95% confidence interval 0.45\u20130.93). Patient characteristics associated with immunotherapy administration included age (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), insurance type (<jats:italic>p<\/jats:italic>\u2009=\u20090.002), income (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and healthcare facility type (<jats:italic>p<\/jats:italic>\u2009=\u20090.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this retrospective NCDB\u2010based study, we find that the modern management of SLNB\u2010positive patients has shifted towards greater use of adjuvant immunotherapy and a decline in CLND; the use of immunotherapy is associated with improved OS. Patients treated with immunotherapy were more likely to be younger, of higher income, and with private health insurance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32269","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T07:50:14Z","timestamp":1747381814000},"page":"3670-3679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Survival Correlates With Adjuvant Choice in Sentinel Node Positive Head and Neck Cutaneous Melanoma"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-0419","authenticated-orcid":false,"given":"Sina","family":"Dadafarin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Alvi","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery &amp; Spine Program, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-9855","authenticated-orcid":false,"given":"Sean T.","family":"Massa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Veatch","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division Fred Hutchinson Cancer Center  Seattle Washington USA"},{"name":"Department of Hematology and Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2070-2005","authenticated-orcid":false,"given":"Zain H.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington  Seattle Washington USA"},{"name":"Veterans Affairs Puget Sound Health Care System  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.27.1627"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21964"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07830-w"},{"key":"e_1_2_9_5_1","first-page":"147","article-title":"Regional Lymphatic Drainage in Primary Malignant Melanoma of the Trunk Determined by Colloidal Gold Scanning","volume":"28","author":"Robinson D. 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