{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:22:02Z","timestamp":1791976922713,"version":"4.4.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Overall survival (OS) of Merkel cell carcinoma (MCC) patients is strongly influenced by health. Sentinel lymph node biopsy (SLNB) is recommended for staging. We evaluated whether SLNB is associated with OS in clinically node-negative MCC and contrasted tumor factors with patient frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>STROBE-compliant cohort across eight centers in Germany (2004\u20132024). We included 271 primary stage I\u2013II MCC; 167 underwent SLNB and 104 did not. The primary outcome was OS; disease-specific survival (DSS) and progression-free probability (PFP) were secondary. Kaplan\u2013Meier and Cox models were used. Confounding by indication was addressed with 1:1 propensity score matching and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients receiving SLNB were younger (median 74 vs 82 years;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and less comorbid (Charlson 4 vs 5). Ten-year OS was 69.5% with SLNB versus 45.2% without (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001); unadjusted HR 0.34 (95% CI 0.20\u20130.59). In the matched cohort, SLNB remained associated with lower all-cause mortality (HR 0.56, 95% CI 0.34\u20130.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024). DSS did not differ (HR 1.09, 95% CI 0.55\u20132.13;\n                      <jats:italic>\u2009p<\/jats:italic>\n                      =\u20090.81). For PFP, unadjusted curves favored SLNB (\n                      <jats:italic>p<\/jats:italic>\n                      =0.0045), but the matched analysis was not significant (HR 0.53, 95% CI 0.23\u20131.26). Sensitivity analyses suggested benefit: overlap weighting HR 0.49 (95% CI 0.33\u20130.73;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00045) and a stage-restricted match HR 0.36 (95% CI 0.13\u20130.99;\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SLNB was associated with improved OS after adjustment, supporting its role in staging and risk stratification. The absence of DSS and matched PFP differences highlights the influence of overall health; residual confounding by indication cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-026-06485-x","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:35:08Z","timestamp":1777401308000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["General health versus tumor stage: determinants of survival in Merkel cell carcinoma assessed by sentinel lymph node biopsy"],"prefix":"10.1007","volume":"152","author":[{"given":"Thilo","family":"Gambichler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Heinzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessr","family":"Abu Rached","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Joachim","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Noah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke C.","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Wesselmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Gutzmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Boms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Susok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sera S.","family":"Weyer-Fahlbusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kreuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina L.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Auer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen C.","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"2","key":"6485_CR1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.jaad.2023.07.1047","volume":"90","author":"NA Alexander","year":"2024","unstructured":"Alexander NA, Schaub SK, Goff PH, Hippe DS, Park SY, Lachance K, Bierma M, Liao JJ, Apisarnthanarax S, Bhatia S, Tseng YD, Nghiem PT, Parvathaneni U (2024) Increased risk of recurrence and disease-specific death following delayed postoperative radiation for Merkel cell carcinoma. J Am Acad Dermatol 90(2):261\u2013268","journal-title":"J Am Acad Dermatol"},{"key":"6485_CR2","volume-title":"AJCC Cancer Staging Handbook","author":"American Joint Committee on Cancer","year":"2017","unstructured":"American Joint Committee on Cancer (2017) AJCC Cancer Staging Handbook. Merkel Cell Carcinoma. Springer, USA"},{"issue":"3","key":"6485_CR3","first-page":"305","volume":"21","author":"JC Becker","year":"2023","unstructured":"Becker JC, Beer AJ, DeTemple VK, Eigentler T, Flaig M, Gambichler T, Grabbe S, H\u00f6ller U, Klumpp B, Lang S, Pf\u00f6hler C, Posch C, Prasad V, Schlattmann P, Schneider-Burrus S, Ter-Nedden J, Terheyden P, Thoms K, Vordermark D, Ugurel S (2023) S2k guideline \u2013 Merkel cell carcinoma (MCC, neuroendocrine carcinoma of the skin) \u2013 update 2022. JDDG 21(3):305\u2013320","journal-title":"JDDG"},{"issue":"24","key":"6485_CR4","doi-asserted-by":"publisher","first-page":"4279","DOI":"10.3390\/cancers16244279","volume":"16","author":"L Borgognoni","year":"2024","unstructured":"Borgognoni L, Susini P, Gerlini G, Brandani P, Giannotti V, Sestini S (2024) Sentinel lymph node biopsy: is there a role in non-melanoma skin cancer? A systematic review. Cancers 16(24):4279","journal-title":"Cancers"},{"issue":"2","key":"6485_CR5","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.jaad.2019.03.027","volume":"81","author":"RRZ Conic","year":"2019","unstructured":"Conic RRZ, Ko J, Saridakis S, Damiani G, Funchain P, Vidimos A, Gastman BR (2019) Sentinel lymph node biopsy in Merkel cell carcinoma: predictors of sentinel lymph node positivity and association with overall survival. J Am Acad Dermatol 81(2):364\u2013372","journal-title":"J Am Acad Dermatol"},{"issue":"16","key":"6485_CR6","doi-asserted-by":"publisher","first-page":"9583","DOI":"10.1200\/JCO.2022.40.16_suppl.9583","volume":"40","author":"ME Delisle","year":"2022","unstructured":"Delisle ME, Dingley B, Apte S et al (2022) Sentinel lymph node biopsy in Merkel cell carcinoma: a multi-institutional study from the Pan-Canadian Merkel Cell Collaborative. J Clini Oncol 40(16):9583\u20139583","journal-title":"J Clini Oncol"},{"issue":"1","key":"6485_CR7","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1245\/s10434-025-18618-6","volume":"33","author":"MM Dugan","year":"2026","unstructured":"Dugan MM, Balsay-Patel C, Chin N, Israeli J, Ward KR, Nichols M, Greenbaum S, Fan W, Cruse CW, Harrington M, Neves RI, Gonzalez RJ, Perez MC, Sarnaik AA, Sondak VK, Messina JL, Tarhini AA, Khushalani N, Brohl AS, Markowitz J, Eroglu Z, Karapetyan L, Tsai KY, Zager JS (2026) Recurrence and survival outcomes in patients with primary Merkel Cell Carcinoma with positive, negative, or not performed sentinel lymph node biopsy. Ann Surg Oncol 33(1):389\u2013396","journal-title":"Ann Surg Oncol"},{"issue":"7","key":"6485_CR8","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1097\/PAS.0000000000001277","volume":"43","author":"EM Erstine","year":"2019","unstructured":"Erstine EM, Tetzlaff MT, Jia X, Aung PP, Prieto VG, Funchain P, Gastman BR, Billings SD, Ko JS (2019) Prognostic significance of \u201cnonsolid\u201d microscopic metastasis in Merkel Cell Carcinoma sentinel lymph nodes. Am J Surg Pathol 43(7):907\u2013919","journal-title":"Am J Surg Pathol"},{"issue":"3","key":"6485_CR9","doi-asserted-by":"publisher","first-page":"E828","DOI":"10.1002\/lary.28866","volume":"131","author":"JA Harounian","year":"2021","unstructured":"Harounian JA, Molin N, Galloway TJ, Ridge D, Bauman J, Farma J, Reddy S, Lango MN (2021) Effect of sentinel lymph node biopsy and LVI on Merkel cell carcinoma prognosis and treatment. Laryngoscope 131(3):E828\u2013E835","journal-title":"Laryngoscope"},{"issue":"6","key":"6485_CR10","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1177\/0194599820967001","volume":"164","author":"D Jacobs","year":"2021","unstructured":"Jacobs D, Olino K, Park HS, Clune J, Cheraghlou S, Girardi M, Burtness B, Kluger H, Judson BL (2021) Primary treatment selection for clinically node-negative Merkel Cell Carcinoma of the head and neck. Otolaryngol Head Neck Surg 164(6):1214\u20131221","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"6485_CR11","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1111\/ans.15228","volume":"89","author":"LN Jenkins","year":"2019","unstructured":"Jenkins LN, Howle JR, Veness MJ (2019) Sentinel lymph node biopsy in clinically node-negative Merkel Cell Carcinoma: the Westmead Hospital experience. ANZ J Surg 89(5):520\u2013523","journal-title":"ANZ J Surg"},{"issue":"6","key":"6485_CR12","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1002\/lary.29835","volume":"132","author":"MA John","year":"2022","unstructured":"John MA (2022) Is radiation, sentinel lymph node biopsy, or neck dissection beneficial for the node negative neck in Merkel cell carcinoma? Laryngoscope 132(6):1142\u20131143","journal-title":"Laryngoscope"},{"issue":"4","key":"6485_CR13","first-page":"e5760","volume":"12","author":"D Kanakopoulos","year":"2024","unstructured":"Kanakopoulos D, Lacey H, Payne A, Houlihan M, Riyat H, Wheelan R, Cubitt J, Totty JP (2024) The role of sentinel lymph node biopsy in the management of Merkel cell carcinoma: A systematic review and meta-analysis. Plast Reconstr Surg 12(4):e5760","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"6485_CR14","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1038\/modpathol.2015.109","volume":"29","author":"JS Ko","year":"2016","unstructured":"Ko JS, Prieto VG, Elson PJ, Vilain RE, Pulitzer MP, Scolyer RA, Reynolds JP, Piliang MP, Ernstoff MS, Gastman BR, Billings SD (2016) Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients. Mod Pathol 29(2):122\u2013130","journal-title":"Mod Pathol"},{"issue":"5","key":"6485_CR15","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1177\/000313481808400507","volume":"84","author":"EP Lamb","year":"2018","unstructured":"Lamb EP, Shaw FR, Fleming MD (2018) Investigation of the diagnostic precision and utility of sentinel lymph node biopsy in the treatment of patients with Merkel Cell Carcinoma. Am Surg 84(5):e173\u2013e175","journal-title":"Am Surg"},{"issue":"4","key":"6485_CR16","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s40271-020-00428-5","volume":"13","author":"J Lambert","year":"2020","unstructured":"Lambert J, Marrel A, D\u2019Angelo SP, Burgess MA, Chmielowski B, Fazio N, Gambichler T, Grob JJ, Lebb\u00e9 C, Robert C, Russell J, G\u00fczel G, Bharmal M (2020) Patient experiences with Avelumab in treatment-na\u00efve metastatic Merkel cell carcinoma: Longitudinal qualitative interview findings from JAVELIN Merkel 200, a registrational clinical trial. Patient 13(4):457\u2013467","journal-title":"Patient"},{"issue":"2","key":"6485_CR17","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jaad.2022.05.054","volume":"88","author":"DJ Lewis","year":"2023","unstructured":"Lewis DJ, Fathy RA, Nugent S, Etzkorn JR, Sobanko JF, Shin TM, Giordano CN, McMurray SL, Walker JL, Zhang J, Miller CJ, Higgins HW 2nd (2023) Sentinel lymph node biopsy in Merkel cell carcinoma: rates and predictors of compliance with the National Comprehensive Cancer Network guidelines. J Am Acad Dermatol 88(2):448\u2013450","journal-title":"J Am Acad Dermatol"},{"key":"6485_CR18","doi-asserted-by":"publisher","first-page":"115406","DOI":"10.1016\/j.ejca.2025.115406","volume":"221","author":"GC Lodde","year":"2025","unstructured":"Lodde GC, Leiter U, Gesierich A, Eigentler T, Hauschild A, Pf\u00f6hler C, Gambichler T, Herbst R, Meier F, Hassel JC, Mei\u00df F, Mohr P, Terheyden P, Nikolakis G, Hecht M, Stang A, Dalkoohi M, Galetzka W, Ugurel S, Becker JC (2025) Clinical course of Merkel cell carcinoma: a DeCOG multicenter study of 1049 patients. Eur J Cancer 221:115406","journal-title":"Eur J Cancer"},{"issue":"5","key":"6485_CR19","doi-asserted-by":"publisher","first-page":"102977","DOI":"10.1016\/j.esmoop.2024.102977","volume":"9","author":"I Lugowska","year":"2024","unstructured":"Lugowska I, Becker JC, Ascierto PA, Veness M, Blom A, Lebbe C, Migliano E, Hamming-Vrieze O, Goebeler M, Kneitz H, Nathan P, Rutkowski P, Slowinska M, Schadendorf D, Piulats JM, Petrelli F, van Akkooi ACJ, Berruti A, ESMO Guidelines Committee (2024) Merkel-cell carcinoma: ESMO-EURACAN clinical practice guideline for diagnosis, treatment and follow-up. ESMO Open 9(5):102977","journal-title":"ESMO Open"},{"issue":"7","key":"6485_CR20","doi-asserted-by":"publisher","first-page":"4345","DOI":"10.1245\/s10434-023-13437-z","volume":"30","author":"KL Ma","year":"2023","unstructured":"Ma KL, Sharon CE, Tortorello GN, Perry NJ, Keele LJ, Lukens JN, Karakousis GC, Miura JT (2023) Radiation, lymph node dissection, or both: Management of lymph node micrometastases from Merkel Cell Carcinoma. Ann Surg Oncol 30(7):4345\u20134355","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"6485_CR21","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1111\/imj.15676","volume":"52","author":"E Nan Tie","year":"2022","unstructured":"Nan Tie E, Kok DL (2022) Merkel cell carcinoma: is sentinel lymph node biopsy crucial? Intern Med J 52(2):330\u2013331","journal-title":"Intern Med J"},{"issue":"34","key":"6485_CR22","doi-asserted-by":"publisher","first-page":"4813","DOI":"10.2217\/fon-2021-0574","volume":"17","author":"R Palencia","year":"2021","unstructured":"Palencia R, Sandhu A, Webb S, Blaikie T, Bharmal M (2021) Systematic literature review of current treatments for stage I-III Merkel cell carcinoma. Future Oncol 17(34):4813\u20134822","journal-title":"Future Oncol"},{"issue":"2","key":"6485_CR23","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1245\/s10434-018-6810-1","volume":"26","author":"MC Perez","year":"2019","unstructured":"Perez MC, Oliver DE, Weitman ES, Boulware D, Messina JL, Torres-Roca J, Cruse CW, Gonzalez RJ, Sarnaik AA, Sondak VK, Wuthrick EJ, Harrison LB, Zager JS (2019) Management of sentinel lymph node metastasis in Merkel cell carcinoma: Completion lymphadenectomy, radiation, or both? Ann Surg Oncol 26(2):379\u2013385","journal-title":"Ann Surg Oncol"},{"key":"6485_CR24","doi-asserted-by":"publisher","first-page":"489536","DOI":"10.1155\/2014\/489536","volume":"2014","author":"R Sadeghi","year":"2014","unstructured":"Sadeghi R, Adinehpoor Z, Maleki M, Fallahi B, Giovanella L, Treglia G (2014) Prognostic significance of sentinel lymph node mapping in Merkel cell carcinoma: systematic review and meta-analysis of prognostic studies. Biomed Res Int 2014:489536","journal-title":"Biomed Res Int"},{"issue":"5","key":"6485_CR25","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1111\/1346-8138.12072","volume":"40","author":"E Sattler","year":"2013","unstructured":"Sattler E, Geimer T, Sick I, Flaig MJ, Ruzicka T, Berking C, Kunte C (2013) Sentinel lymph node in Merkel cell carcinoma: to biopsy or not to biopsy? J Dermatol 40(5):374\u2013379","journal-title":"J Dermatol"},{"issue":"5","key":"6485_CR26","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.3390\/jcm12051813","volume":"12","author":"M Scampa","year":"2023","unstructured":"Scampa M, Kalbermatten DF, Oranges CM (2023) Demographic and clinicopathological factors as predictors of lymph node metastasis in Merkel cell carcinoma: A population-based analysis. J Clin Med 12(5):1813","journal-title":"J Clin Med"},{"issue":"25","key":"6485_CR27","first-page":"00665","volume":"S0190\u20139622","author":"N Shafique","year":"2025","unstructured":"Shafique N, Ertmann E, Vargas GM, Farooq MS, Gimotty PA, Karakousis GC, Miura JT (2025) High rates of sentinel lymph node positivity across all age groups in Merkel cell carcinoma. J Am Acad Dermatol S0190\u20139622(25):00665\u201300666","journal-title":"J Am Acad Dermatol"},{"issue":"18","key":"6485_CR28","doi-asserted-by":"publisher","first-page":"3252","DOI":"10.1002\/cncr.29452","volume":"121","author":"FO Smith","year":"2015","unstructured":"Smith FO, Yue B, Marzban SS, Walls BL, Carr M, Jackson RS, Puleo CA, Padhya T, Cruse CW, Gonzalez RJ, Sarnaik AA, Schell MJ, DeConti RC, Messina JL, Sondak VK, Zager JS (2015) Both tumor depth and diameter are predictive of sentinel lymph node status and survival in Merkel Cell Carcinoma. Cancer 121(18):3252\u20133260. https:\/\/doi.org\/10.1002\/cncr.29452","journal-title":"Cancer"},{"issue":"1","key":"6485_CR29","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1245\/s10434-020-08587-3","volume":"28","author":"Y Song","year":"2021","unstructured":"Song Y, Azari FS, Tang R, Shannon AB, Miura JT, Fraker DL, Karakousis GC (2021) Patterns of metastasis in Merkel Cell Carcinoma. Ann Surg Oncol 28(1):519\u2013529","journal-title":"Ann Surg Oncol"},{"issue":"12","key":"6485_CR30","doi-asserted-by":"publisher","first-page":"7261","DOI":"10.1245\/s10434-022-12174-z","volume":"29","author":"RJ Straker 3rd","year":"2022","unstructured":"Straker RJ 3rd, Sharon CE, Fraker DL, Karakousis GC, Miura JT (2022) Contemporary analysis of sentinel lymph node biopsy performance among patients with clinically localized Merkel cell carcinoma. Ann Surg Oncol 29(12):7261\u20137264","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"6485_CR31","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1067\/mjd.2002.119563","volume":"46","author":"LD Su","year":"2002","unstructured":"Su LD, Lowe L, Bradford CR, Yahanda AI, Johnson TM, Sondak VK (2002) Immunostaining for cytokeratin 20 improves detection of micrometastatic Merkel cell carcinoma in sentinel lymph nodes. J Am Acad Dermatol 46(5):661\u2013666","journal-title":"J Am Acad Dermatol"},{"issue":"5","key":"6485_CR32","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s00066-023-02068-8","volume":"199","author":"D Vordermark","year":"2023","unstructured":"Vordermark D, H\u00f6ller U (2023) The role of radiotherapy in the updated German S2k guideline for management of Merkel cell carcinoma. Strahlenther Onkol 199(5):433\u2013435","journal-title":"Strahlenther Onkol"},{"issue":"23","key":"6485_CR33","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.1200\/JCO.2011.40.3519","volume":"30","author":"SL Wong","year":"2012","unstructured":"Wong SL, Balch CM, Hurley P, Agarwala SS, Akhurst TJ, Cochran A, Cormier JN, Gorman M, Kim TY, McMasters KM, Noyes RD, Schuchter LM, Valsecchi ME, Weaver DL, Lyman GH, American Society of Clinical Oncology, Society of Surgical Oncology (2012) Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline. J Clin Oncol 30(23):2912\u20132918","journal-title":"J Clin Oncol"}],"container-title":["Journal of Cancer Research and Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-026-06485-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00432-026-06485-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-026-06485-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:53:30Z","timestamp":1781650410000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00432-026-06485-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["6485"],"URL":"https:\/\/doi.org\/10.1007\/s00432-026-06485-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8669831\/v1","asserted-by":"object"}]},"ISSN":["1432-1335"],"issn-type":[{"value":"1432-1335","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"assertion":[{"value":"22 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The given and family names of Nessr Abu Rached were incorrectly structured and have been corrected in the original publication.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"T.G. has received speakers and\/or advisory board honoraria from BMS, Sanofi-Genzyme, MSD, Novartis Pharma, Roche, UCB, Abbvie, Almirall, Janssen, Lilly, Pfizer, Pierre Fabre, Merck-Serono, outside the submitted work. N.A. received funding, travel support and\/or personal honoraria for lectures from Novartis Pharma, JanssenCilag GmbH, Recordati Rare Diseases Germany GmbH, UCB Pharma, Almirall Hermal GmbH, Bristol-Myers Squibb (BMS) and Johnson & Johnson that were independent of the work submitted. R.G. has received honoraria for lectures\/advisory boards from BMS, MSD, Novartis, Merck Serono, Almirall Hermal, SUN Pharma, Sanofi\/Regeneron, Pierre Fabre, Immunocore, Janssen, Incyte and Delcath and has received research funding from Amgen, Merck Serono, SUN Pharma, Sanofi\/Regeneron, Almirall Hermal, Kyowa Kirin, and Recordati as well as congress participation supported by SUN Pharma and Pierre Fabre, all outside of the submitted work. J.C.B is receiving speaker\u2019s bureau honoraria from Amgen, Incyte Merck-Serono and Regeneron is a paid consultant\/advisory board member for Merck-Serono, Incyte, 4SC and Regeneron. His group receives research grants from Regeneron, Merck Serono, and Alcedis. L.S. has received speakers and\/or advisory board honoraria from UCB, BMS, Sun-Pharma, MSD, and Novartis. The other authors report no conflicts or competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was conducted according to the declaration of Helsinki and followed a protocol approved by the institutional ethics review board of the Ruhr-University Bochum (#16\u20135985).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"100"}}