{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:50:49Z","timestamp":1785876649050,"version":"3.56.0"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T00:00:00Z","timestamp":1533859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although the role of sentinel lymph node biopsy (<jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content>) as a prognostic factor is well established, its consequences for therapy are controversial. The aim of this study was to analyze if complete lymph node dissection (<jats:styled-content style=\"fixed-case\">CLND<\/jats:styled-content>) in patients with more than one positive sentinel lymph node (<jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content>) significantly improves melanoma\u2010specific survival (<jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>) and progression\u2010free survival (<jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content>). Medical records of patients who underwent <jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content> between 2001 and 2016 at the University Hospital of Cologne were reviewed, and patients with positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content> were identified. Patient and tumor characteristics, patterns of recurrence, progression\u2010free and melanoma\u2010specific survival were analyzed. Seventy\u2010eight patients with multiple positive and 197 patients with one positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content> were included in this study. Patients with multiple positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content> had significantly more positive non\u2010<jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content> compared with patients with only one positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content> (26.9% vs 8.6%, <jats:italic>P<\/jats:italic> = 0.01). However, in the subgroup of patients with multiple positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CLND<\/jats:styled-content> did not significantly improve <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content> (mean <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content> 95 vs 75 months, <jats:italic>P<\/jats:italic> = 0.5) and <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> (mean <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> 59 vs 68 months <jats:italic>P<\/jats:italic> = 0.167). <jats:styled-content style=\"fixed-case\">CLND<\/jats:styled-content> did not result in a significant improvement in <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content> in patients with multiple positive <jats:styled-content style=\"fixed-case\">SLN<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/1346-8138.14577","type":"journal-article","created":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T12:43:35Z","timestamp":1533905015000},"page":"1191-1194","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single\u2010center retrospective analysis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-4464","authenticated-orcid":false,"given":"Oana\u2010Diana","family":"Persa","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Knuever","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Mauch","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Schlaak","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.12.027"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310460"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1992.01420040034005"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.01.045"},{"key":"e_1_2_6_6_1","first-page":"26","article-title":"Timing of completion lymphadenectomy after positive sentinel lymphnode biopsy in patients with melanoma","volume":"104","author":"Oude Ophius CMC","year":"2017","journal-title":"Br J 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