{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:19:51Z","timestamp":1788279591688,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Br J Cancer"],"published-print":{"date-parts":[[2026,9,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sentinel node biopsy (SNB) predicts long-term melanoma outcomes and advises referrals for adjuvant systemic therapy (AST). Concerns regarding the impact of treatment delays on clinical outcomes remain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A UK retrospective cohort study at a supra-regional centre was performed, including 1625 patients listed for SNB between 2010-23. Three parameters were investigated: disease progression, micrometastatic burden, and disease-specific survival. Time-to-SNB was stratified as early (\u226490days) or late (&gt;90days), with a subgroup analysis accounting for AST use (2017-23). Sensitivity analyses calculated a wait-time threshold beyond which worsens survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median time-to-SNB was 68 days (IQR\u2009=\u200951\u201395) and follow-up 75 months (IQR\u2009=\u200935\u2013115). Late surgery correlated with disease progression before surgery (0.34% versus 1.54%; OR\u2009=\u20094.31;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022); larger micrometastases (1.40\u2009mm vs. 2.95\u2009mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and increased high-risk micrometastatic deposits &gt;1\u2009mm (55.2% vs. 69.1%; OR\u2009=\u20092.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). For patients post-2016, longer wait-times correlated with poorer DSS (HR\u2009=\u20091.01 (1.00\u20131.02);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011 for diagnosis-to-SNB; and HR\u2009=\u20091.01 (1.00\u20131.02);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016 for primary excision-to-SNB). Sensitivity analyses calculated \u226468-days from diagnosis (HR\u2009=\u20093.17 (1.19\u20138.46);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) and \u226482-days from excision (HR\u2009=\u20092.94 (1.10\u20137.87);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032) as optimal treatment thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical delays correlated with harm: disease progression, increased tumour burden and worse survival. SNB should occur within 68 days from diagnosis and\/or 82 days from excision biopsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41416-026-03497-9","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:20:52Z","timestamp":1781612452000},"page":"909-916","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implications of wait times for sentinel node biopsy on melanoma disease progression, micrometastatic tumour burden and survival outcomes in the modern treatment era"],"prefix":"10.1038","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7780-8942","authenticated-orcid":false,"given":"Sofia O.","family":"Breeze","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Heaton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Snelling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Garioch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny P.","family":"Nobes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-235X","authenticated-orcid":false,"given":"Marc D.","family":"Moncrieff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"3497_CR1","unstructured":"Melanoma Skin Cancer Statistics: Cancer Research UK. 2024. https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/melanoma-skin-cancer#heading-Zero."},{"key":"3497_CR2","first-page":"472","volume":"67","author":"JE Gershenwald","year":"2017","unstructured":"Gershenwald JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, et al. 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All reasonable measures were taken to protect patient anonymity.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Ethics approval from the UK Health Research Authority (IRAS ID: 332188) was obtained prior to starting the study and the protocol was reviewed by the East of England (Essex) Research Ethics Committee (Ref: 23\/EE\/0283). The study was performed in accordance with the Declaration of Helsinki. Specific informed patient consent was not required for this project, in accordance with General Medical Council guidance and GDPR legislation.","order":3,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}]}}