I strongly feel that you must have end to end tests while using node because of the dependency hell. Not even knowing if a upgrade of a dependency breaks your system is just hard. Also testing it by hand is just not maintainable.
This is true for any language/platform.
With Clojure, I can think of 2 times ever when a dependency caused an issue. It was extremely obvious since the issue was "won't compile", and the fixes were simple.
With PHP, I expect any change to potentially break something. Bump your AWS SDK which uses a different minor version of guzzle? Fatal error.
There's a world of difference between breakage being an everyday thing and a true rarity.