Prospective study of patterns of surgical management in adults with primary cutaneous melanoma at high risk of spread, in Queensland, Australia

Smithers, B.Mark, Hughes, Maria Celia B., Beesley, Vanessa L., Barbour, Andrew P., Malt, Maryrose K., Weedon, David, Zonta, Mark J., Wood, Dominic J., Triscott, Joseph A., Bayley, Gerard J., Brown, Lee J., Allan, Christopher P., D'Arcy, Justin, Williamson, Richard, Khosrotehrani, Kiarash and Green, Adele C. (2015) Prospective study of patterns of surgical management in adults with primary cutaneous melanoma at high risk of spread, in Queensland, Australia. Journal of Surgical Oncology, 112 4: 359-365. doi:10.1002/jso.24013


Author Smithers, B.Mark
Hughes, Maria Celia B.
Beesley, Vanessa L.
Barbour, Andrew P.
Malt, Maryrose K.
Weedon, David
Zonta, Mark J.
Wood, Dominic J.
Triscott, Joseph A.
Bayley, Gerard J.
Brown, Lee J.
Allan, Christopher P.
D'Arcy, Justin
Williamson, Richard
Khosrotehrani, Kiarash
Green, Adele C.
Title Prospective study of patterns of surgical management in adults with primary cutaneous melanoma at high risk of spread, in Queensland, Australia
Journal name Journal of Surgical Oncology   Check publisher's open access policy
ISSN 1096-9098
0022-4790
Publication date 2015-08-27
Year available 2015
Sub-type Article (original research)
DOI 10.1002/jso.24013
Open Access Status Not Open Access
Volume 112
Issue 4
Start page 359
End page 365
Total pages 7
Place of publication Hoboken, New Jersey, United States
Publisher John Wiley & Sons
Collection year 2016
Language eng
Formatted abstract
Background: Knowledge of variation in diagnosis and surgery in high-risk primary melanoma patients is limited. We assessed frequency and determinants of diagnostic procedures, wide local excision (WLE) and sentinel lymph node biopsy (SLNB).

Methods: People in Queensland newly diagnosed with melanoma, clinical stage 1b or 2, were recruited prospectively. Patient information was collected from questionnaires and pathology records. Differences in surgical procedures in relation to host and tumor characteristics were assessed.

Results: In 787 participants, primary melanoma was diagnosed by surgical excision (74%), shave (14%), punch (12%) or incisional (1%) biopsy. General practitioners (GPs) diagnosed 80%. Diagnostic procedure differed by remoteness of residence, health sector, treating doctor's specialty and melanoma site and thickness. 766 patients had WLE, 86% by surgeons. Of 134 residual melanomas, 13 (10%) were ≤ 1 mm at diagnosis but > 1 mm at WLE, mostly after shave biopsy. SLNB was performed in 261 (33%) patients. SLNB was more common in those under 50, in remoter locations or treated by GP initially, and less common with head and neck melanoma.

Conclusion: Diagnostic and surgical procedures for primary melanoma vary substantially and partial biopsy can influence initial tumor microstaging. Patient, tumor and doctor characteristics influence SLNB practice.
Keyword Excision
Melanoma
Sentinel node
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 2 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 15 Sep 2015, 03:53:36 EST by System User on behalf of Scholarly Communication and Digitisation Service