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Related Experiment Video

Updated: Feb 6, 2026

Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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National practice patterns of completion lymph node dissection for sentinel node-positive melanoma.

D Brock Hewitt1,2,3, Ryan P Merkow1,2, John Oliver DeLancey1

  • 1Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Journal of Surgical Oncology
|August 12, 2018
PubMed
Summary

Close observation is a viable alternative to completion lymph node dissection (CLND) for select melanoma patients with minimal sentinel lymph node (SLN) tumor burden. CLND utilization decreased over time, influenced by patient factors and tumor location.

Keywords:
neoplasmsoutcomesregistries

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Area of Science:

  • Melanoma research
  • Surgical oncology
  • Cancer epidemiology

Background:

  • Close observation is an alternative to completion lymph node dissection (CLND) for select melanoma patients with minimal sentinel lymph node (SLN) tumor burden.
  • Understanding practice patterns of CLND utilization is crucial for optimizing melanoma treatment.

Purpose of the Study:

  • To examine the utilization of CLND in clinically node-negative Stage III melanoma patients with a positive SLN biopsy.
  • To identify factors associated with the decision to forgo CLND in favor of observation.

Main Methods:

  • Analysis of the National Cancer Database (2012-2015) for Stage III melanoma patients with positive SLNB.
  • Hierarchical logistic regression models to determine factors influencing observation versus CLND.

Main Results:

  • Of 131,171 patients, 55,688 had SLNB, and 7,200 had metastatic disease in the SLN.
  • CLND was performed in 57.0% of patients with a positive SLNB.
  • Factors favoring observation included lower extremity primary tumor location, older age, multiple comorbidities, and later diagnosis year (2015).

Conclusions:

  • CLND utilization in melanoma varies significantly based on patient characteristics and has decreased over time.
  • Close observation is increasingly recognized for selected patients with low SLN tumor burden.
  • Improved cancer registry data is needed to ensure appropriate CLND use in melanoma management.