A large multicenter prospective blinded MERLIN study enrolled 1761 patients undergoing resection of melanoma with sentinel node biopsy performed per classic clinical criteria. The commercially-available SkylineDx genomic test was performed on resected tumors which classified roughly one-third (n=651) as low-risk for sentinel node metastases. Chance of being classified low-risk precipitously dropped with increasing T-stage: T1 (68%), T2 = (33%), T3 (3%). In the end, there was indeed quite the distinction in realized rates of sentinel node involvement based on blinded genomic score: 46 (7%) of genomically low-risk patients versus 264 (24%) of genomically high-risk. | Hieken, JAMA Surg 2025
