{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T07:29:55Z","timestamp":1750750195883,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The results of the DeCOG\u2010SLT and MSLT\u2010II studies, published in 2016 and mid\u20102017, indicated no survival benefit from completion lymph node dissection (CLND) in melanoma patients with positive sentinel nodes (SNs). Subsequently, several studies have been published reporting a benefit of adjuvant systemic therapy in patients with stage III melanoma. The current study assessed how these findings influenced management of SN\u2010positive patients in a dedicated melanoma treatment centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>SN\u2010positive patients treated at Melanoma Institute Australia between July 2017 and December 2018 were prospectively identified. Surgeons completed a questionnaire documenting the management of each patient. Information on patients, primary tumours, SNs, further treatment and follow\u2010up was collected from patient files, the institutional research database and pathology reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 18\u2010month study period, 483 patients underwent SN biopsy. A positive SN was found in 61 (13%). Two patients (3%) requested CLND because of anxiety about observation in view of unfavourable primary tumour and SN characteristics. The other 59 patients (97%) were followed with a four\u2010monthly ultrasound examination of the relevant lymph node field(s). Two of them (3%) developed an isolated nodal recurrence after 4 and 11\u2009months of follow\u2010up. Fifty\u2010seven patients (93%) were seen following the publication of the first two adjuvant systemic therapy studies in November 2017; 46 (81%) were referred to a medical oncologist to discuss adjuvant systemic therapy, which 32 (70%) chose to receive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At Melanoma Institute Australia most patients with an involved SN are now managed without CLND. The majority are referred to a medical oncologist and receive adjuvant systemic therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15491","type":"journal-article","created":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T03:57:50Z","timestamp":1572494270000},"page":"491-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Current management of patients with melanoma who are found to be sentinel node\u2010positive"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-5444","authenticated-orcid":false,"given":"Amanda A. 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M.","family":"Saw","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney School of Medicine  Sydney New South Wales Australia"},{"name":"Department of Melanoma and Surgical Oncology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander M.","family":"Menzies","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney School of Medicine  Sydney New South Wales Australia"},{"name":"Department of Medical Oncology Royal North Shore and Mater Hospitals  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger F.","family":"Uren","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney School of Medicine  Sydney New South Wales Australia"},{"name":"Alfred Nuclear Medicine and Ultrasound  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2816-2496","authenticated-orcid":false,"given":"John F.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney School of Medicine  Sydney New South Wales Australia"},{"name":"Department of Melanoma and Surgical Oncology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omgo E.","family":"Nieweg","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney School of Medicine  Sydney New South Wales Australia"},{"name":"Department of Melanoma and Surgical Oncology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310460"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181a77eba"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-9885-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.02.022"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613210"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00141-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1708539"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1802357"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709030"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0538-y"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200309000-00002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21770"},{"key":"e_1_2_7_14_1","unstructured":"Cancer Council Australia.Clinical Practice Guidelines for the Diagnosis and Management of Melanoma. 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