{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:22:33Z","timestamp":1771561353909,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recently, a model to predict 5-year recurrence-free survival (RFS) and melanoma-specific survival (MSS) after sentinel lymph node biopsy (SLNB) was published. The aim of this study was to validate that model in a large independent international cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The database of the Sentinel Lymph Node Working Group (SLNWG) was analysed for patients with malignant melanoma who underwent SLNB. Patients with clinical stage III melanoma, a history of other malignancies, or receiving concomitant systemic therapies during follow-up were excluded. The model\u2019s predictive performance was evaluated using discrimination and calibration metrics in the eligible cohort. Decision curve analysis was performed to assess the clinical value of the model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The external validation cohort consisted of 6174 patients of the SLNWG from the USA, Europe, and Israel. A positive sentinel node was found in 788 patients (12.8%). The area under the time-dependent receiver operating characteristic (ROC) curve of the external validation was 0.76 (95% c.i. 0.74 to 0.77) for RFS and 0.79 (95% c.i. 0.76 to 0.81) for MSS. The model was well calibrated, as the observed 5-year survival rates aligned closely with the predicted survival rates (calibration slope of 0.98 for RFS and calibration slope of 0.99 for MSS). The model provided a net benefit versus the \u2018treat all\u2019 and \u2018treat none\u2019 strategies at the predetermined probability threshold for recurrence of 45%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The model demonstrated good performance in a large heterogeneous independent cohort, emphasizing its robustness. Decision curve analysis revealed a clear net benefit of the model over a treat all strategy, highlighting its potential for clinical use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf037","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T12:18:17Z","timestamp":1744892297000},"source":"Crossref","is-referenced-by-count":1,"title":["External validation of a model to predict recurrence-free and melanoma-specific survival for patients with melanoma after sentinel node biopsy"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-6966","authenticated-orcid":false,"given":"Robert C","family":"Stassen","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolien C H M","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus University Medical Centre , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley P","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Surgery, California Pacific Medical Center and Research Institute , San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Kashani-Sabet","sequence":"additional","affiliation":[{"name":"Department of Surgery, California Pacific Medical Center and Research Institute , San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L","family":"White","sequence":"additional","affiliation":[{"name":"Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Atrium Health , Charlotte, North Carolina ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A","family":"Pockaj","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mayo Clinic , Phoenix, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan S","family":"Zager","sequence":"additional","affiliation":[{"name":"Department of Cutaneous Oncology, Moffitt Cancer Center , Tampa, Florida ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Schlomo","family":"Schneebaum","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tel-Aviv Sourasky Medical Center , Tel Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T","family":"Vetto","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Oregon Health & Science University , Portland, Oregon ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Avisar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology at University of Miami Miller School of Medicine, Miami, Florida ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Harrison Howard","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of South Alabama , Mobile, Alabama ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"O\u2019Donoghue","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rush University Medical Center , Chicago, Illinois ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Kosiorek","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic Arizona , Scottsdale, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander C J","family":"van Akkooi","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia, University of Sydney , Sydney, New South Wales ,","place":["Australia"]},{"name":"Faculty of Medicine and Health, University of Sydney , Sydney, New South Wales ,","place":["Australia"]},{"name":"Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-8613","authenticated-orcid":false,"given":"Cornelis","family":"Verhoef","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"van Klaveren","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus University Medical Centre , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8293-6002","authenticated-orcid":false,"given":"Dirk J","family":"Gr\u00fcnhagen","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-0355","authenticated-orcid":false,"given":"Roger","family":"Olofsson Bagge","sequence":"additional","affiliation":[{"name":"Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Department of Surgery, Sahlgrenska University Hospital , Gothenburg 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