{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:37:23Z","timestamp":1777448243561,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cutaneous head and neck melanoma (cHNM) has a high rate of false-negative sentinel lymph node biopsy (SLNB) and up to a 25% risk of recurrence despite negative SLNB. The aim of this study was to investigate the pattern of melanoma recurrence in patients with cHNM with negative SLNB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of consecutive cHNM patients at a tertiary care centre from 2014-2022. We included all cHNM patients with negative SLNB. All patients were categorized into Breslow thickness &gt;2\u00a0mm and \u22642\u00a0mm and extracted information pertaining to histopathological characteristics and the presence and type of disease recurrences. We performed multivariable analysis using logistic and cox regression. We used an alpha of 0.05 and all statistical analyses were performed using R software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 167 patients met eligibility criteria and of these, 53.5% patients had cHNM \u22642\u00a0mm thick and 46.7% had lesions &gt;2\u00a0mm thick. The overall recurrence rate was 29.3%. Multivariable analysis demonstrated that Breslow thickness [aOR: 5.89 (95% CI: 1.37, 32.3),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02] was associated with distant recurrence. Multivariable cox regression also identified that pathological ulceration [aHR: 3.17 (95% CI: 1.61, 7.66),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01] predicted time to distant recurrence. The SLNB false omission rate was 3.6% (95% CI: 1.3%, 7.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SLNB-negative cHNM patients with high-risk pathological features may benefit from adjuvant immunotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251323707","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T16:49:44Z","timestamp":1743612584000},"page":"1156-1162","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of Failure in Cutaneous Head and Neck Melanoma Following Negative Sentinel Lymph Node Biopsy: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9095-9543","authenticated-orcid":false,"given":"Phillip","family":"Staibano","sequence":"first","affiliation":[{"name":"McMaster University"},{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Xie","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Abdallah","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Nguyen","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Au","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelvin","family":"Zhou","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailey","family":"Bensky","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Choi","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor A.","family":"Lewis","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.E.M. (Ted)","family":"Young","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Zhang","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-9464-6_37"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.0440"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58111589"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.0076"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/01455613221126327"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2018.1489246"},{"key":"e_1_3_4_8_2","unstructured":"Pembrolizumab (Keytruda). CADTH reimbursement review: therapeutic area: melanoma adjuvant treatment [internet]. Ottawa (ON): Canadian agency for drugs and technologies in Health; 2023 feb. Clinical review. 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