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Population‐based analysis of lymphatic mapping and sentinel lymphadenectomy utilization for intermediate thickness melanoma
Author(s) -
Stitzenberg Karyn B.,
Thomas Nancy E.,
Beskow Laura M.,
Ollila David W.
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20403
Subject(s) - medicine , melanoma , lymphadenectomy , lymphatic system , head and neck , surgery , population , lymph node , pathology , environmental health , cancer research
Background and Objectives Lymphatic mapping and sentinel lymphadenectomy (LM/SL) is the nodal staging procedure of choice for patients with intermediate thickness melanoma. We hypothesize that a significant portion of these patients are not undergoing LM/SL. We explore factors that influence use of LM/SL. Methods Analysis was performed of all incident cases of invasive cutaneous melanoma in North Carolina between January 1, 1999 and December 31, 2001. Results Three thousand four hundred and thirty‐six cases of melanoma were reported for 1999–2001. Two hundred and seventy‐three cases (8%) were excluded due to metastases. Nine hundred and sixteen cases (29%) were excluded because the T classification was not reported. Of the remaining cases, 1,242 (55%) were intermediate thickness (T2–3); 48% (596/1,242) underwent LM/SL. Subjects ≥60 years old were less likely to receive LM/SL than subjects <60 years (39% vs. 55.4%, P < 0.001). Subjects with head/neck primary tumors were less likely to receive LM/SL than other subjects (33% vs. 51%, P < 0.001). Subjects with T3 tumors were more likely to receive LM/SL than those with T2 tumors (54% vs. 42%, P < 0.001). Conclusions Half of all patients with intermediate thickness melanoma in North Carolina do not receive LM/SL. Use of LM/SL varies by patient age and primary tumor site. Further investigation is warranted to explore these differences.. J. Surg. Oncol. 2006;93: 100–107. © 2006 Wiley‐Liss, Inc.