Many Factors Affect Lymph Node Biopsy in Melanoma-- Eric Metcalf
Thursday, March 12, 2009
THURSDAY, Mar. 12 (HealthDay News) -- The use of sentinel lymph node biopsy for clinical stage I and II melanoma is associated with socioeconomic factors, according to research published online Mar. 9 in the Journal of Clinical Oncology.
Karl Y. Bilimoria, M.D., of Northwestern University in Chicago, and colleagues analyzed data from the National Cancer Data Base on 8,073 patients with clinical stage IA and 8,525 patients with clinical stage IB/II melanoma. Guidelines promote sentinel lymph node biopsy (SLNB) for patients with stage IB and II disease.
Of patients with IB/II disease, 48.7 percent underwent SLNB, the researchers report. Patients at this stage were less likely to have SLNB if they were older than 75 or non-white; had lesions on the head, neck or trunk compared to the upper or lower extremities; had non-ulcerated lesions; or were covered by Medicare or Medicaid versus private insurance, the investigators found.
"These data suggest that a substantial percentage of patients who might have benefited from SLNB remained understaged and undertreated. It is unknown whether such individuals will have poorer overall survival, but at the very least, they will live with greater uncertainty in their prognosis and can be expected to be at higher than necessary risk of regional nodal recurrence," the authors write. This study "may point toward an opportunity for improvement in the quality of melanoma care for patients nationwide."
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