{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:44:38Z","timestamp":1791989078921,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V115C\u2010013"],"award-info":[{"award-number":["V115C\u2010013"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Cutaneous melanoma in Asian populations is characterized by a predominance of acral melanoma and distinct clinicopathologic features. Although sentinel lymph node biopsy (SLNB) is widely used for staging, a subset of SLN\u2010negative patients still develop recurrence, and evidence regarding recurrence patterns and prognostic factors in this group remains limited, particularly in acral\u2010predominant cohorts. We conducted a retrospective cohort study of consecutive patients with cutaneous melanoma evaluated at Taipei Veterans General Hospital between 2005 and 2025. A total of 181 patients were included and categorized into SLN\u2010positive (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200989) and SLN\u2010negative (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200992) groups for survival analysis, with further analyses of recurrence patterns and prognostic factors restricted to the SLN\u2010negative cohort. Kaplan\u2013Meier analysis showed significantly poorer recurrence\u2010free survival (RFS) and overall survival (OS) in the SLN\u2010positive group compared with the SLN\u2010negative group (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Among SLN\u2010negative patients (mean age, 72.3\u2009years; 88.0% acral melanoma), 25.0% developed recurrence during a median follow\u2010up of 28.5\u2009months, corresponding to a 5\u2010year recurrence rate of 30.9%. Nodal recurrence was the most frequent initial pattern and tended to occur earlier than other types of recurrence. Multivariable analysis identified lower body mass index, diabetes mellitus, and ulceration as factors associated with poorer RFS, while older age, lower body mass index, and greater Breslow thickness were associated with poorer OS. These findings suggest that recurrence remains a clinically relevant concern in SLN\u2010negative melanoma in acral\u2010predominant Asian populations. Careful follow\u2010up may be warranted, particularly in patients with unfavorable clinicopathologic features.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.70358","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:30:23Z","timestamp":1781760623000},"page":"1236-1244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrence Patterns and Prognostic Factors in Sentinel Lymph Node\u2010Negative Melanoma in a Taiwanese Cohort With Predominant Acral Melanoma"],"prefix":"10.1111","volume":"53","author":[{"given":"Chih\u2010Yuan","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Medical Education Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien\u2010Hsiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Department of Surgery, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Han","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-8248","authenticated-orcid":false,"given":"Jai\u2010Sing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, China Medical University Hospital China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8065-0876","authenticated-orcid":false,"given":"Yu\u2010Jen","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Department of Surgery, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.0160"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147\u2010025\u201002747\u20109"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.25259\/ijdvl_601_19"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010013\u20103089\u20100"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature22071"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70360"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346\u20108138.17187"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/tox.23450"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346\u20108138.16579"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2014.3689"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0036"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.13074"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010019\u201007369\u2010w"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.13024"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.1335"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.5941"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000001002"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000000586"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201000386\u20104"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000000809"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2014.0172"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.12.002"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.10.060"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27021"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljag097"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19813"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11010\u2010022\u201004630\u2010x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(18)30078\u20100"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010021\u201009773\u20107"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.S477649"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc\u20102024\u2010009769"}],"container-title":["The 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