{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:02:37Z","timestamp":1781143357583,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sentinel lymph node biopsy (SLNB) is the standard staging procedure in cutaneous melanoma of the head and neck, but current guidelines are extrapolated from non\u2013head and neck studies. Existing risk models lack specificity for this region. Using the National Cancer Database, we developed and internally validated a nomogram and web\u2010based calculator to estimate SLNB positivity specifically in head and neck cutaneous melanoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the NCDB, including patients with cutaneous melanoma of the head and neck. The inclusion criteria were patients with clinical node\u2010negative, early\u2010stage melanoma who underwent SLNB between 2004 and 2021. Demographic, clinical, and pathologic features were compared using chi\u2010squared testing, and multivariable logistic regression identified independent predictors of SLNB positivity. Significant factors were incorporated into a nomogram and interactive risk calculator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 14,058 clinical N0, M0 cutaneous head and neck melanoma patients who underwent SLNB. Of these, 2182 (15.5%) had a positive SLNB. In multivariable analysis, age, head and neck sublocation, histologic subtype, mitotic rate, Breslow thickness, lymphovascular invasion, and ulceration were identified as independent predictors of SLNB positivity. A nomogram based on these variables was developed. The model demonstrated good discrimination with a C\u2010index of 0.724 (95% CI, 0.712\u20130.735).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides a predictive tool that allows head and neck surgeons to estimate the risk of SLNB positivity in individual patients, enabling more personalized surgical decision\u2010making in early\u2010stage head and neck melanoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70469","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:55:09Z","timestamp":1773114909000},"page":"3002-3012","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting\n                    <scp>SLNB<\/scp>\n                    Positivity in Head and Neck Melanoma: A Nomogram and Online Risk Tool"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-8864","authenticated-orcid":false,"given":"Felipe","family":"Porto\u2010Gutierrez","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2177-9426","authenticated-orcid":false,"given":"Brett","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Montanez\u2010Azcarate","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3787-9897","authenticated-orcid":false,"given":"Zoha","family":"Syed","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3155-7492","authenticated-orcid":false,"given":"Alexa","family":"Kacin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scharukh","family":"Jalisi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology, Department of Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010017\u20106267\u20107"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310460"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613210"},{"issue":"13","key":"e_1_2_10_5_1","article-title":"False\u2010Negative Sentinel Lymph Node Biopsy for Melanoma: A Review","volume":"16","author":"Downey J.","year":"2024","journal-title":"Cancers"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811411878"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02362"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.6904"},{"key":"e_1_2_10_9_1","unstructured":"American College of Surgeons Commission on Cancer \u201cAbout the National Cancer Database (NCDB) \u201daccessed 2025 (Notes ~72% national capture.) 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