Receipt of sentinel lymph node biopsy for thin melanoma is associated with distance traveled for care.
J Surg Oncol
; 119(1): 148-155, 2019 Jan.
Article
em En
| MEDLINE
| ID: mdl-30508289
ABSTRACT
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 (OR1.18; 95%CI 1.10,1.27), and those who traveled a long distance were 24% more likely (OR1.24; 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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cutâneas
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Viagem
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Biópsia de Linfonodo Sentinela
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Tomada de Decisões
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Acessibilidade aos Serviços de Saúde
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Melanoma
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2019
Tipo de documento:
Article