Stephen Scoville

186 timestamped statements across 3 topics — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Soft Tissue Sarcoma (lymph nodes) · guest expert

Featured statements

▶ Ep 2 · 9:15

before those trials came out, there was a much higher rate of uh completion lymph node dissection even in in kids. And then after those trials, the rate has gone down, but it's still higher than what's done uh typically in adults.

quote · Metastatic Disease

▶ Ep 2 · 12:08

I think the the answer would more likely just be to move forward with systemic therapy. Uh I don't think people would move forward with the completion lymph node at that time. You would just go with advent therapy.

quote · Metastatic Disease

▶ Ep 417 · 9:53

for most children we can, um while the disease is thought to be more severe, you can still observe these patients with sentinel lymph nodes and not uh move forward with um completion lymph node dissection

quote · Pediatric Oncology

▶ Ep 417 · 7:30

Only 21% of patients that underwent completion lymph node dissection had additional nodes discovered and findings of additional nodal disease did not significantly correlate with recurrence.

quote · Pediatric Oncology

▶ Ep 11 · 0:33

Compared to adults, we know that childhood melanoma is associated with delayed diagnosis and therefore, not surprisingly, more frequently has nodal involvement.

quote · Soft Tissue Sarcoma (lymph nodes)

▶ Ep 11 · 4:30

Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease.

quote · Soft Tissue Sarcoma (lymph nodes)

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Stephen's statements about Metastatic Disease 62 statements

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BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD

▶ Ep 2 · 3:01

guideline Tumors less than 8 millimeters thick are largely managed with wide local excision ↗

▶ Ep 2 · 3:01

quote there is no pediatric data to support one versus the other ↗

▶ Ep 2 · 3:01

quote Management of pediatric melanoma is based on adult studies. ↗

▶ Ep 2 · 3:01

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 2 · 3:01

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old ↗

▶ Ep 2 · 3:01

clinical Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults ↗

▶ Ep 2 · 3:01

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection ↗

▶ Ep 2 · 3:01

clinical Two adult trials (Decog SLT and MSLT2) showed no significant difference in outcomes for patients with positive sentinel lymph node biopsies followed with ultrasound observation versus completion lymph node dissections ↗

▶ Ep 2 · 3:01

guideline Tumors greater than or equal to 8 millimeters or less than 8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies ↗

▶ Ep 2 · 3:01

clinical Management of pediatric melanoma is based on adult studies despite differences in disease mechanisms ↗

▶ Ep 2 · 4:10

quote we found nearly equal distribution of age, tumor location, while race was predominantly white, consistent with prior literature ↗

▶ Ep 2 · 4:10

clinical Breslow depth ranged from 2 millimeters to 20 millimeters with a median of 2.55 millimeters ↗

▶ Ep 2 · 4:10

clinical Study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions ↗

▶ Ep 2 · 5:20

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph node biopsies (approximately 51%) ↗

▶ Ep 2 · 6:30

clinical Patients who underwent completion lymph node dissection were significantly older and more likely to receive adjuvant therapy ↗

▶ Ep 2 · 6:30

quote there was no significant differences between recurrence or death from disease between these two groups ↗

▶ Ep 2 · 6:30

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups ↗

▶ Ep 2 · 7:30

quote Only 21% of patients that underwent completion lymph node dissection had additional nodes discovered and findings of additional nodal disease did not significantly correlate with recurrence. ↗

▶ Ep 2 · 7:30

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden ↗

▶ Ep 2 · 7:30

clinical Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease ↗

▶ Ep 2 · 7:30

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group ↗

▶ Ep 2 · 8:00

clinical Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death ↗

▶ Ep 2 · 8:31

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate ↗

▶ Ep 2 · 8:31

quote Recurrence did most strongly associate with positive sentinel lymph node biopsies and deeper Breslow depth. ↗

▶ Ep 2 · 8:31

clinical Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease ↗

▶ Ep 2 · 9:15

quote before those trials came out, there was a much higher rate of uh completion lymph node dissection even in in kids. And then after those trials, the rate has gone down, but it's still higher than what's done uh typically in adults. ↗

▶ Ep 2 · 9:15

opinion For most children with positive sentinel lymph nodes, observation is appropriate without moving forward with completion lymph node dissection ↗

▶ Ep 2 · 9:15

clinical Before the Decog and MSLT2 trials, there was a much higher rate of completion lymph node dissection in children, and after those trials the rate has gone down but is still higher than in adults ↗

▶ Ep 2 · 9:15

quote we didn't find any statistical difference between those that underwent completion lymph node dissection versus uh sentinel lymph node with um ultrasound observation ↗

▶ Ep 2 · 9:53

quote for most children we can, um while the disease is thought to be more severe, you can still observe these patients with sentinel lymph nodes and not uh move forward with um completion lymph node dissection ↗

▶ Ep 2 · 10:45

clinical Not all patients with positive sentinel lymph nodes receive adjuvant therapy; decision depends on genetic makeup of melanoma and overall risk factors including tumor size ↗

▶ Ep 2 · 11:46

opinion If a lymph node becomes clinically positive during ultrasound surveillance, the likely approach would be to move forward with systemic therapy rather than completion lymph node dissection ↗

▶ Ep 2 · 12:08

quote I think the the answer would more likely just be to move forward with systemic therapy. Uh I don't think people would move forward with the completion lymph node at that time. You would just go with advent therapy. ↗

BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation

▶ Ep 3 · 0:26

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 3 · 0:26

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 3 · 0:33

quote Compared to adults, we know that childhood melanoma is associated with delayed diagnosis and therefore, not surprisingly, more frequently has nodal involvement. ↗

▶ Ep 3 · 0:33

clinical Compared to adults, childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement. ↗

▶ Ep 3 · 0:42

clinical Childhood melanoma has unique disease mechanisms compared to adult melanoma. ↗

▶ Ep 3 · 0:44

quote Despite these differences though, management of pediatric melanoma is based on adult studies. ↗

▶ Ep 3 · 0:44

guideline Management of pediatric melanoma is based on adult studies despite differences from adult disease. ↗

▶ Ep 3 · 0:49

guideline Melanoma management is largely based on depth of the tumor and presence of metastatic disease. ↗

▶ Ep 3 · 0:55

guideline Tumors less than 0.8 millimeters thick are largely managed with wide local excision. ↗

▶ Ep 3 · 1:07

guideline Tumors greater than or equal to 0.8 millimeters or less than 0.8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies. ↗

▶ Ep 3 · 1:20

guideline If sentinel lymph node biopsy is positive, patients typically undergo ultrasound observation versus completion lymph node dissection, which has a high risk of morbidity. ↗

▶ Ep 3 · 1:29

clinical Two adult trials (DCOG SLT and MSLT2) showed no significant difference in outcomes for low to intermediate risk patients with positive sentinel lymph node biopsies who were followed with ultrasound observation versus completion lymph node dissections. ↗

▶ Ep 3 · 1:47

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection for positive sentinel lymph node biopsies. ↗

▶ Ep 3 · 1:47

quote However, there is no pediatric data to support one versus the other. ↗

▶ Ep 3 · 2:10

epidemiological In this study of 252 pediatric melanoma patients, race was predominantly white, consistent with prior literature. ↗

▶ Ep 3 · 2:21

clinical Breslow depth ranged from tumor in situ to 20 millimeters with a median of 2.55 millimeters. ↗

▶ Ep 3 · 2:40

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 (approximately 51%) had positive sentinel lymph node biopsies. ↗

▶ Ep 3 · 3:22

clinical Patients who underwent completion lymph node dissection were more likely to receive adjuvant therapy compared to ultrasound observation. ↗

▶ Ep 3 · 3:22

clinical Patients who underwent completion lymph node dissection were significantly older than those who underwent ultrasound observation. ↗

▶ Ep 3 · 3:34

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups. ↗

▶ Ep 3 · 3:41

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group. ↗

▶ Ep 3 · 3:52

clinical Only 21% of patients who underwent completion lymph node dissection had additional positive nodal disease. ↗

▶ Ep 3 · 4:01

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden. ↗

▶ Ep 3 · 4:11

clinical Recurrence was associated with positive sentinel lymph node disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death. ↗

▶ Ep 3 · 4:23

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate. ↗

▶ Ep 3 · 4:30

clinical Management of nodal disease (ultrasound observation vs completion lymph node dissection) had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 3 · 4:30

quote Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 3 · 4:38

clinical Findings of additional nodal disease in completion lymph node dissection did not significantly correlate with recurrence. ↗

▶ Ep 3 · 4:47

clinical Recurrence most strongly associated with positive sentinel lymph node biopsies and deeper Breslow depth. ↗

Stephen's statements about Pediatric Oncology 62 statements

Open the Pediatric Oncology collection →

BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD

▶ Ep 417 · 3:01

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection ↗

▶ Ep 417 · 3:01

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old ↗

▶ Ep 417 · 3:01

clinical Management of pediatric melanoma is based on adult studies despite differences in disease mechanisms ↗

▶ Ep 417 · 3:01

clinical Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults ↗

▶ Ep 417 · 3:01

guideline Tumors less than 8 millimeters thick are largely managed with wide local excision ↗

▶ Ep 417 · 3:01

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 417 · 3:01

quote there is no pediatric data to support one versus the other ↗

▶ Ep 417 · 3:01

quote Management of pediatric melanoma is based on adult studies. ↗

▶ Ep 417 · 4:10

quote we found nearly equal distribution of age, tumor location, while race was predominantly white, consistent with prior literature ↗

▶ Ep 417 · 4:10

clinical Study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions ↗

▶ Ep 417 · 4:10

clinical Breslow depth ranged from 2 millimeters to 20 millimeters with a median of 2.55 millimeters ↗

▶ Ep 417 · 5:20

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph node biopsies (approximately 51%) ↗

▶ Ep 417 · 6:30

clinical Patients who underwent completion lymph node dissection were significantly older and more likely to receive adjuvant therapy ↗

▶ Ep 417 · 6:30

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups ↗

▶ Ep 417 · 6:30

quote there was no significant differences between recurrence or death from disease between these two groups ↗

▶ Ep 417 · 7:30

clinical Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease ↗

▶ Ep 417 · 7:30

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group ↗

▶ Ep 417 · 7:30

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden ↗

▶ Ep 417 · 8:00

clinical Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death ↗

▶ Ep 417 · 8:31

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate ↗

▶ Ep 417 · 8:31

quote Recurrence did most strongly associate with positive sentinel lymph node biopsies and deeper Breslow depth. ↗

▶ Ep 417 · 8:31

clinical Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease ↗

▶ Ep 417 · 9:15

quote we didn't find any statistical difference between those that underwent completion lymph node dissection versus uh sentinel lymph node with um ultrasound observation ↗

▶ Ep 417 · 9:15

opinion For most children with positive sentinel lymph nodes, observation is appropriate without moving forward with completion lymph node dissection ↗

▶ Ep 417 · 9:15

▶ Ep 417 · 9:53

▶ Ep 417 · 10:45

clinical Not all patients with positive sentinel lymph nodes receive adjuvant therapy; decision depends on genetic makeup of melanoma and overall risk factors including tumor size ↗

▶ Ep 417 · 11:46

opinion If a lymph node becomes clinically positive during ultrasound surveillance, the likely approach would be to move forward with systemic therapy rather than completion lymph node dissection ↗

▶ Ep 417 · 12:08

BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation

▶ Ep 419 · 0:26

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 419 · 0:26

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 419 · 0:33

quote Compared to adults, we know that childhood melanoma is associated with delayed diagnosis and therefore, not surprisingly, more frequently has nodal involvement. ↗

▶ Ep 419 · 0:33

clinical Compared to adults, childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement. ↗

▶ Ep 419 · 0:42

clinical Childhood melanoma has unique disease mechanisms compared to adult melanoma. ↗

▶ Ep 419 · 0:44

guideline Management of pediatric melanoma is based on adult studies despite differences from adult disease. ↗

▶ Ep 419 · 0:44

quote Despite these differences though, management of pediatric melanoma is based on adult studies. ↗

▶ Ep 419 · 0:49

guideline Melanoma management is largely based on depth of the tumor and presence of metastatic disease. ↗

▶ Ep 419 · 0:55

guideline Tumors less than 0.8 millimeters thick are largely managed with wide local excision. ↗

▶ Ep 419 · 1:07

▶ Ep 419 · 1:20

guideline If sentinel lymph node biopsy is positive, patients typically undergo ultrasound observation versus completion lymph node dissection, which has a high risk of morbidity. ↗

▶ Ep 419 · 1:29

▶ Ep 419 · 1:47

quote However, there is no pediatric data to support one versus the other. ↗

▶ Ep 419 · 1:47

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection for positive sentinel lymph node biopsies. ↗

▶ Ep 419 · 2:10

epidemiological In this study of 252 pediatric melanoma patients, race was predominantly white, consistent with prior literature. ↗

▶ Ep 419 · 2:21

clinical Breslow depth ranged from tumor in situ to 20 millimeters with a median of 2.55 millimeters. ↗

▶ Ep 419 · 2:40

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 (approximately 51%) had positive sentinel lymph node biopsies. ↗

▶ Ep 419 · 3:22

clinical Patients who underwent completion lymph node dissection were more likely to receive adjuvant therapy compared to ultrasound observation. ↗

▶ Ep 419 · 3:22

clinical Patients who underwent completion lymph node dissection were significantly older than those who underwent ultrasound observation. ↗

▶ Ep 419 · 3:34

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups. ↗

▶ Ep 419 · 3:41

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group. ↗

▶ Ep 419 · 3:52

clinical Only 21% of patients who underwent completion lymph node dissection had additional positive nodal disease. ↗

▶ Ep 419 · 4:01

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden. ↗

▶ Ep 419 · 4:11

clinical Recurrence was associated with positive sentinel lymph node disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death. ↗

▶ Ep 419 · 4:23

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate. ↗

▶ Ep 419 · 4:30

clinical Management of nodal disease (ultrasound observation vs completion lymph node dissection) had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 419 · 4:30

quote Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 419 · 4:38

clinical Findings of additional nodal disease in completion lymph node dissection did not significantly correlate with recurrence. ↗

▶ Ep 419 · 4:47

clinical Recurrence most strongly associated with positive sentinel lymph node biopsies and deeper Breslow depth. ↗

Stephen's statements about Soft Tissue Sarcoma (lymph nodes) 62 statements

Open the Soft Tissue Sarcoma (lymph nodes) collection →

BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD

▶ Ep 10 · 3:01

guideline Tumors less than 8 millimeters thick are largely managed with wide local excision ↗

▶ Ep 10 · 3:01

quote Management of pediatric melanoma is based on adult studies. ↗

▶ Ep 10 · 3:01

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection ↗

▶ Ep 10 · 3:01

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 10 · 3:01

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old ↗

▶ Ep 10 · 3:01

quote there is no pediatric data to support one versus the other ↗

▶ Ep 10 · 3:01

clinical Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults ↗

▶ Ep 10 · 3:01

clinical Management of pediatric melanoma is based on adult studies despite differences in disease mechanisms ↗

▶ Ep 10 · 4:10

quote we found nearly equal distribution of age, tumor location, while race was predominantly white, consistent with prior literature ↗

▶ Ep 10 · 4:10

clinical Study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions ↗

▶ Ep 10 · 4:10

clinical Breslow depth ranged from 2 millimeters to 20 millimeters with a median of 2.55 millimeters ↗

▶ Ep 10 · 5:20

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph node biopsies (approximately 51%) ↗

▶ Ep 10 · 6:30

quote there was no significant differences between recurrence or death from disease between these two groups ↗

▶ Ep 10 · 6:30

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups ↗

▶ Ep 10 · 6:30

clinical Patients who underwent completion lymph node dissection were significantly older and more likely to receive adjuvant therapy ↗

▶ Ep 10 · 7:30

clinical Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease ↗

▶ Ep 10 · 7:30

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group ↗

▶ Ep 10 · 7:30

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden ↗

▶ Ep 10 · 8:00

clinical Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death ↗

▶ Ep 10 · 8:31

quote Recurrence did most strongly associate with positive sentinel lymph node biopsies and deeper Breslow depth. ↗

▶ Ep 10 · 8:31

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate ↗

▶ Ep 10 · 8:31

clinical Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease ↗

▶ Ep 10 · 9:15

quote we didn't find any statistical difference between those that underwent completion lymph node dissection versus uh sentinel lymph node with um ultrasound observation ↗

▶ Ep 10 · 9:15

opinion For most children with positive sentinel lymph nodes, observation is appropriate without moving forward with completion lymph node dissection ↗

▶ Ep 10 · 9:15

▶ Ep 10 · 9:53

▶ Ep 10 · 10:45

clinical Not all patients with positive sentinel lymph nodes receive adjuvant therapy; decision depends on genetic makeup of melanoma and overall risk factors including tumor size ↗

▶ Ep 10 · 11:46

opinion If a lymph node becomes clinically positive during ultrasound surveillance, the likely approach would be to move forward with systemic therapy rather than completion lymph node dissection ↗

▶ Ep 10 · 12:08

BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation

▶ Ep 11 · 0:26

quote Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 11 · 0:26

epidemiological Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old. ↗

▶ Ep 11 · 0:33

clinical Compared to adults, childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement. ↗

▶ Ep 11 · 0:33

quote Compared to adults, we know that childhood melanoma is associated with delayed diagnosis and therefore, not surprisingly, more frequently has nodal involvement. ↗

▶ Ep 11 · 0:42

clinical Childhood melanoma has unique disease mechanisms compared to adult melanoma. ↗

▶ Ep 11 · 0:44

guideline Management of pediatric melanoma is based on adult studies despite differences from adult disease. ↗

▶ Ep 11 · 0:44

quote Despite these differences though, management of pediatric melanoma is based on adult studies. ↗

▶ Ep 11 · 0:49

guideline Melanoma management is largely based on depth of the tumor and presence of metastatic disease. ↗

▶ Ep 11 · 0:55

guideline Tumors less than 0.8 millimeters thick are largely managed with wide local excision. ↗

▶ Ep 11 · 1:07

▶ Ep 11 · 1:20

guideline If sentinel lymph node biopsy is positive, patients typically undergo ultrasound observation versus completion lymph node dissection, which has a high risk of morbidity. ↗

▶ Ep 11 · 1:29

▶ Ep 11 · 1:47

quote However, there is no pediatric data to support one versus the other. ↗

▶ Ep 11 · 1:47

clinical There is no pediatric data to support ultrasound observation versus completion lymph node dissection for positive sentinel lymph node biopsies. ↗

▶ Ep 11 · 2:10

epidemiological In this study of 252 pediatric melanoma patients, race was predominantly white, consistent with prior literature. ↗

▶ Ep 11 · 2:21

clinical Breslow depth ranged from tumor in situ to 20 millimeters with a median of 2.55 millimeters. ↗

▶ Ep 11 · 2:40

clinical Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 (approximately 51%) had positive sentinel lymph node biopsies. ↗

▶ Ep 11 · 3:22

clinical Patients who underwent completion lymph node dissection were significantly older than those who underwent ultrasound observation. ↗

▶ Ep 11 · 3:22

clinical Patients who underwent completion lymph node dissection were more likely to receive adjuvant therapy compared to ultrasound observation. ↗

▶ Ep 11 · 3:34

clinical There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups. ↗

▶ Ep 11 · 3:41

clinical Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group. ↗

▶ Ep 11 · 3:52

clinical Only 21% of patients who underwent completion lymph node dissection had additional positive nodal disease. ↗

▶ Ep 11 · 4:01

clinical Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden. ↗

▶ Ep 11 · 4:11

clinical Recurrence was associated with positive sentinel lymph node disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death. ↗

▶ Ep 11 · 4:23

clinical Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate. ↗

▶ Ep 11 · 4:30

clinical Management of nodal disease (ultrasound observation vs completion lymph node dissection) had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 11 · 4:30

quote Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease. ↗

▶ Ep 11 · 4:38

clinical Findings of additional nodal disease in completion lymph node dissection did not significantly correlate with recurrence. ↗

▶ Ep 11 · 4:47

clinical Recurrence most strongly associated with positive sentinel lymph node biopsies and deeper Breslow depth. ↗