{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:20:17Z","timestamp":1776259217712,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sentinel lymph node biopsy (SLNB) is recommended for patients with &gt;10% risk of metastasis and not for those with &lt;5% risk. The National Comprehensive Cancer Network acknowledges that individualized risk assessment tools, such as the Melanoma Institute of Australia (MIA) sentinel node metastasis risk model, may aid decision-making. We hypothesized that SLNB utilization would not differ substantially between the pre- and post-publication eras of the MIA model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed National Cancer Database data from 2018 to 2022. Patients with thin melanomas (&lt;1.0 mm Breslow depth) were classified into &lt;5% or &gt;10% sentinel node positivity risk groups using the MIA model. Demographic and pathologic characteristics were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 58,119 patients with thin melanomas, 43,551 met inclusion criteria after excluding 14,491 with intermediate (5\u201310%) risk. Among 3949 with &gt;10% risk, 62.9% had SLNB and 37.1% had SLNB omitted. Conversely, among 39,602 with &lt;5% risk, 13.7% received SLNB. Tumor thickness, ulceration, and mitotic rate were significant predictors of SLNB in both groups. Increasing age was associated with lower odds of SLNB only in the low-risk cohort. Notably, SLNB utilization changed minimally following publication of the MIA model, increasing by &lt;1% in the &lt;5% group and 4% in the &gt;10% group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Before and after MIA model publication, SLNB was underutilized in high-risk patients and overutilized in low-risk patients. Utilization was primarily driven by tumor-specific factors. Our findings suggest limited early adoption of the model and highlight the need for improved dissemination of personalized risk stratification tools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-19079-7","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T17:56:50Z","timestamp":1768586210000},"page":"4000-4010","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns and Predictors of Sentinel Lymph Node Biopsy Utilization in High- and Low-Risk Thin Melanomas"],"prefix":"10.1245","volume":"33","author":[{"given":"Mackenzie M.","family":"Mayhew","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily G.","family":"Tocco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret G.","family":"Mercante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidhi","family":"Kuchimanchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengli","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad El","family":"Moheb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Ruff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn T.","family":"Dengel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Craig L.","family":"Slingluff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-8633","authenticated-orcid":false,"given":"Russell G.","family":"Witt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"issue":"1","key":"19079_CR1","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jaad.2022.09.040","volume":"88","author":"AB Shannon","year":"2023","unstructured":"Shannon AB, Sharon CE, Straker RJ 3rd, et al. Sentinel lymph node biopsy in patients with T1a cutaneous malignant melanoma: A multicenter cohort study. J Am Acad Dermatol. 2023;88(1):52\u20139.","journal-title":"J Am Acad Dermatol."},{"key":"19079_CR2","unstructured":"Susan M Swetter, Douglas Johnson, Mark Albertini, et al. NCCN Guidelines Version 2.2025 Melanoma: Cutaneous."},{"issue":"4","key":"19079_CR3","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1245\/s10434-023-14862-w","volume":"31","author":"S Maddineni","year":"2024","unstructured":"Maddineni S, Dizon MP, Muralidharan V, et al. Validation of the Melanoma Institute of Australia\u2019s sentinel lymph node biopsy risk Prediction Tool for cutaneous melanoma. Ann Surg Oncol. 2024;31(4):2737\u201346.","journal-title":"Ann Surg Oncol."},{"key":"19079_CR4","unstructured":"Melanoma Institute Australia. Melanoma risk assessment tool. https:\/\/www.melanomarisk.org.au\/SNLLand. Accessed December 7, 2025."},{"issue":"24","key":"19079_CR5","doi-asserted-by":"publisher","first-page":"2719","DOI":"10.1200\/JCO.19.02362","volume":"38","author":"SN Lo","year":"2020","unstructured":"Lo SN, Ma J, Scolyer RA, et al. Improved risk prediction calculator for sentinel node positivity in patients with melanoma: The Melanoma Institute Australia nomogram. J Clin Oncol. 2020;38(24):2719\u201327.","journal-title":"J Clin Oncol."},{"key":"19079_CR6","unstructured":"National Cancer database. ACS. https:\/\/www.facs.org\/quality-programs\/cancer-programs\/national-cancer-database\/. Accessed December 7, 2025."},{"issue":"12","key":"19079_CR7","doi-asserted-by":"publisher","first-page":"4441","DOI":"10.1016\/j.bjps.2022.08.044","volume":"75","author":"M Hodson","year":"2022","unstructured":"Hodson M, Feustel P, Davis L. Sentinel lymph node biopsy in desmoplastic melanoma - the percent desmoplastic component matters: A systematic review. J Plast Reconstr Aesthet Surg. 2022;75(12):4441\u20139.","journal-title":"J Plast Reconstr Aesthet Surg."},{"issue":"1","key":"19079_CR8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.19697","volume":"3","author":"RM Carey","year":"2020","unstructured":"Carey RM, Fathy R, Shah RR, et al. Association of type of treatment facility with overall survival after a diagnosis of head and neck cancer. JAMA Netw Open. 2020;3(1):e1919697.","journal-title":"JAMA Netw Open."},{"issue":"9","key":"19079_CR9","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1001\/jamadermatol.2020.1729","volume":"156","author":"D Grossman","year":"2020","unstructured":"Grossman D, Okwundu N, Bartlett EK, et al. Prognostic gene expression profiling in cutaneous melanoma: Identifying the knowledge gaps and assessing the clinical benefit: Identifying the knowledge gaps and assessing the clinical benefit. JAMA Dermatol. 2020;156(9):1004\u201311.","journal-title":"JAMA Dermatol."},{"issue":"9","key":"19079_CR10","first-page":"835","volume":"157","author":"JS Crystal","year":"2022","unstructured":"Multicenter Selective Lymphadenectomy Trials Study Group, Crystal JS, Thompson JF, et al. Therapeutic value of sentinel lymph node biopsy in patients with melanoma: A randomized clinical trial. JAMA Surg. 2022;157(9):835\u201342.","journal-title":"JAMA Surg."},{"issue":"4","key":"19079_CR11","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/S0039-6060(03)00275-7","volume":"134","author":"DM Agnese","year":"2003","unstructured":"Agnese DM, Abdessalam SF, Burak WE Jr, Magro CM, Pozderac RV, Walker MJ. Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. Surgery. 2003;134(4):542\u20137 (discussion 547-8).","journal-title":"Surgery."},{"issue":"7","key":"19079_CR12","doi-asserted-by":"publisher","first-page":"3470","DOI":"10.1245\/s10434-021-09998-6","volume":"28","author":"JN Herb","year":"2021","unstructured":"Herb JN, Ollila DW, Stitzenberg KB, Meyers MO. Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: Analysis of a population-based registry. Ann Surg Oncol. 2021;28(7):3470\u20138.","journal-title":"Ann Surg Oncol."},{"issue":"1","key":"19079_CR13","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1002\/jso.26225","volume":"123","author":"TJ Aiken","year":"2021","unstructured":"Aiken TJ, Stahl CC, Schwartz PB, et al. Sentinel lymph node biopsy is associated with increased cost in higher risk thin melanoma. J Surg Oncol. 2021;123(1):104\u20139.","journal-title":"J Surg Oncol."},{"key":"19079_CR14","unstructured":"Risk of sentinel lymph node metastasis. Memorial Sloan Kettering Cancer Center. https:\/\/www.mskcc.org\/nomograms\/melanoma\/sentinel_lymph_node_metastasis. Accessed December 7, 2025."},{"issue":"3","key":"19079_CR15","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1001\/jamasurg.2023.6904","volume":"159","author":"R Olofsson Bagge","year":"2024","unstructured":"Olofsson Bagge R, Mikiver R, Marchetti MA, et al. Population-based validation of the MIA and MSKCC tools for predicting sentinel lymph node status. JAMA Surg. 2024;159(3):260\u20138.","journal-title":"JAMA Surg."},{"issue":"3","key":"19079_CR16","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1245\/s10434-024-16379-2","volume":"32","author":"EK Bartlett","year":"2025","unstructured":"Bartlett EK, O\u2019Donoghue C, Boland G, et al. Society of Surgical Oncology consensus statement: Assessing the evidence for and utility of gene expression profiling of primary cutaneous melanoma. Ann Surg Oncol. 2025;32(3):1429\u201342.","journal-title":"Ann Surg Oncol."},{"issue":"1","key":"19079_CR17","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1097\/XCS.0000000000000886","volume":"238","author":"HM Drebin","year":"2024","unstructured":"Drebin HM, Hosein S, Kurtansky NR, et al. Clinical utility of melanoma sentinel lymph node biopsy nomograms. J Am Coll Surg. 2024;238(1):23\u201331.","journal-title":"J Am Coll Surg."}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-19079-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-025-19079-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-19079-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:26:28Z","timestamp":1776255988000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-025-19079-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["19079"],"URL":"https:\/\/doi.org\/10.1245\/s10434-025-19079-7","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"assertion":[{"value":"11 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors declare that they have no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}