{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T19:48:19Z","timestamp":1747943299286,"version":"3.37.3"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Cameron Family Foundation"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1093017","2008454","2018514"],"award-info":[{"award-number":["1093017","2008454","2018514"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020062","name":"Melanoma Centre of Research Excellence","doi-asserted-by":"publisher","award":["1135285"],"award-info":[{"award-number":["1135285"]}],"id":[{"id":"10.13039\/501100020062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001774","name":"University of Sydney","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Predicting which patients with American Joint Committee on Cancer (AJCC) T1\u2013T2 melanomas will have a positive sentinel lymph node (SLN) is challenging. Melanoma Institute Australia (MIA) developed an internationally validated SLN metastatic risk calculator. This study evaluated the nomogram\u2019s impact on T1\u2013T2 melanoma patient management at MIA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>SLN biopsy (SLNB) rates were compared for the pre- and post-nomogram periods of 1 July 2018\u201330 June 2019 and 1 August 2020\u201331 July 2021, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 850 patients were identified (pre-nomogram, 383; post-nomogram, 467). SLNB was performed in 29.0% of patients in the pre-nomogram group and 34.5% in the post-nomogram group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.091). The overall positivity rate was 16.2% in the pre-nomogram group and 14.9% in the post-nomogram group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.223). SLNB was performed less frequently in T1a melanoma patients in the pre-nomogram group (1.1%, <jats:italic>n<\/jats:italic>\u00a0=\u00a02\/177) than in the post-nomogram group (8.6%, <jats:italic>n<\/jats:italic>\u00a0=\u00a017\/198) [<jats:italic>p<\/jats:italic>\u00a0\u2264\u00a00.001]. This increase was particularly for melanomas with a risk score \u2265\u20095%, with an SLN positivity rate of 11.8% in the post-nomogram group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) compared with zero. For T1b melanomas with a risk score of &gt;\u200910%, the SLNB rate was 40.0% (8\/20) pre-nomogram and 75.0% (12\/16) post-nomogram (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.049).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this specialized center, the SLN risk calculator appears to influence practice for melanomas previously considered low risk for metastasis, with increased use of SLNB for T1a and higher-risk T1b melanomas. Further evaluation is required across broader practice settings. Melanoma management guidelines could be updated to incorporate the availability of nomograms to better select patients for SLNB than previous criteria.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-024-15456-w","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T20:30:09Z","timestamp":1716841809000},"page":"5331-5339","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of an Online Risk Calculator for Sentinel Node Positivity on Management of Patients with T1 and T2 Melanomas"],"prefix":"10.1245","volume":"31","author":[{"given":"Alec A.","family":"Winder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Boyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney","family":"Ch\u2019ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Stretch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn P. 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Scolyer has received fees for professional services from MetaOptima Technology Inc., F. Hoffmann-La Roche Ltd, Evaxion, Provectus Biopharmaceuticals Australia, Qbiotics, Novartis, Merck Sharp & Dohme, NeraCare, AMGEN Inc., Bristol-Myers Squibb, Myriad Genetics, and GlaxoSmithKline. Robyn P.M. Saw has received honoraria for advisory board participation from MSD, Novartis and Qbiotics, and speaking honoraria from BMS and Novartis. Andrew J. Spillane has received an honoraria from Eli Lily Australia. John F. Thompson has received honoraria for advisory board participation from BMS Australia, MSD Australia, GSK and Provectus Inc, and travel and conference support from GSK, Provectus Inc. and Novartis. Alexander H.R. Varey has received an honorarium from Novartis. Serigne N. Lo has received a stipend for editorial services at the British Journal of Dermatology. Alec A. Winder, Zoe Boyer, Sydney Ch\u2019ng, Jonathan R. Stretch, Kerwin F. Shannon, Thomas E. Pennington, Omgo E. Nieweg, Anne E. Cust, and Andrea L. Smith have no disclosures to declare in relation to this manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}