Citation: Sant, M.; Magri, M.C.; Maurichi, A.; Lillini, R.; Bento, M.J.; Ardanaz, E.; Guevara, M.; Innos, K.; Marcos-Gragera, R.; Rubio-Casadevall, J.; et al. Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations. Cancers 2022, 14, 4379. https://doi.org/10.3390/ cancers14184379 Academic Editor: Eduardo Nagore Received: 6 July 2022 Accepted: 31 August 2022 Published: 8 September 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). cancers Article Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations Milena Sant 1 , Maria Chiara Magri 1 , Andrea Maurichi 2 , Roberto Lillini 1, *, Maria José Bento 3,4 , Eva Ardanaz 5,6,7 , Marcela Guevara 5,6,7 , Kaire Innos 8 , Rafael Marcos-Gragera 6,9 , Jordi Rubio-Casadevall 9 , Maria-José Sánchez Pérez 6,10,11,12 , Rosario Tumino 13 , Massimo Rugge 14 , Pamela Minicozzi 1,15 and the Melanoma HR Study Working Group † 1 Analytical Epidemiology and Health Impact Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy 2 Melanoma and Sarcoma Surgical Unit, Foundation IRCCS National Cancer Institute, 20133 Milan, Italy 3 North Region Cancer Registry of Portugal (RORENO), Cancer Epidemiology Group, IPO Porto Research Center, 4200-072 Porto, Portugal 4 Department of Population Studies, Institute of Biomedical Sciences Abel Salazar, University of Porto, 4200-465 Porto, Portugal 5 Navarre Public Health Institute, 31006 Pamplona, Spain 6 Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain 7 Navarre Institute for Health Research (IdiSNA), 31006 Pamplona, Spain 8 Department of Epidemiology and Biostatistics, National Institute for Health Development, 11619 Tallinn, Estonia 9 Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology (ICO), Girona Biomedical Research Institute (IdiBGi), 08908 Girona, Spain 10 Andalusian School of Public Health (EASP), Granada Cancer Registry, 18011 Granada, Spain 11 The Biomedical Research Institute (ibs.GRANADA), 18014 Granada, Spain 12 Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain 13 Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), 97100 Ragusa, Italy 14 Department of Medicine—DIMED, Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, 35139 Padova, Italy 15 Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK * Correspondence: roberto.lillini@istitutotumori.mi.it † Membership of the Melanoma HR Study Working Group is provided in the Acknowledgments. Simple Summary: The study was aimed to investigate the frequency of accurate pathology report and sentinel lymph node biopsy for staging clinically node-negative >1 mm melanomas across European countries, which are standard care indicators having relevant consequences for survival. 4245 melanoma cases from in six European countries in 2009–2013 were analyzed by multivariable logistic regression in order to estimate the odds ratio of having such indicators performed. Model- based survival to estimate the five-year relative excess risks of death were computed. Results showed how much accurate pathology profiling and sentinel lymph node biopsy carried survival benefit. Narrowing down between-countries differences in adhesion to guidelines might achieve better outcomes. Abstract: Objectives: Standard care for cutaneous melanoma includes an accurate pathology report (PR) and sentinel lymph node biopsy (SLNB) for staging clinically node-negative >1 mm melanomas. We aimed to investigate the frequency of these indicators across European countries, also assessing consequences for survival. Methods: We analyzed 4245 melanoma cases diagnosed in six European countries in 2009–2013. Multivariable logistic regression was used to estimate the Odds Ratio (OR) of receiving complete PR with eight items or SLNB and model-based survival to estimate the Cancers 2022, 14, 4379. https://doi.org/10.3390/cancers14184379 https://www.mdpi.com/journal/cancers