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Receipt of sentinel lymph node biopsy for thin melanoma is associated with distance traveled for care
Author(s) -
Kang Ravinder,
Columbo Jesse A.,
Trooboff Spencer W.,
Servos Mariah M.,
Goodney Philip P.,
Wong Sandra L.
Publication year - 2019
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.25314
Subject(s) - medicine , sentinel lymph node , melanoma , biopsy , receipt , surgery , cancer , breast cancer , cancer research , world wide web , computer science
Background Sentinel lymph node biopsy (SLNB) is not routinely recommended for thin melanoma. However, it is considered when high‐risk features, clinicopathological, or sociodemographic, are present. It was our objective to evaluate the impact of travel distance on decision‐making for SLNB in thin melanoma. Methods We used the National Cancer DataBase (1998‐2011) to identified patients with thin melanoma (≤1 mm thickness). The primary exposure was distance traveled for care, categorized as short (<12.5 miles), intermediate (12.5‐49.9 miles), or long (≥50 miles). The primary outcome was receipt of SLNB. Results We identified 21 124 cases of thin melanoma; 48.8%, 38.2%, and 13.0% traveled short, intermediate, and long distances, respectively. Overall, SLNB was performed in 32.8% of patients. Traveling farther was associated with a step‐wise increase in the likelihood of undergoing a SLNB ( P ‐trend < 0.001). Even after adjusting for patient, disease, and facility factors, we found that patients who traveled an intermediate distance were 18% more likely to undergo a SLNB (OR:1.18; 95%CI: 1.10,1.27), and those who traveled a long distance were 24% more likely (OR:1.24; 95%CI: 1.11,1.39) compared with those who traveled a short distance. Conclusions The distance patients travel for surgical care appears to be an independent factor influencing the receipt of SLNB.