Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital

Background: Cutaneous malignant melanoma (CMM) is a significant cause of skin cancer-related mortality. The time between the diagnostic biopsy and primary surgical excision, the surgical interval (SI), is a modifiable factor that may impact melanoma outcomes. Delays in the SI are attributable to man...

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Autores principales:	Seshini Naidoo, Henriette Burger, Tonya M. Esterhuizen
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	surgical interval melanoma biopsy delay skin cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1f3fb0709f45459dadf158859785f98e
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spelling	oai:doaj.org-article:1f3fb0709f45459dadf158859785f98e2021-11-24T07:48:46ZDelays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital2518-87042523-064610.4102/sajo.v5i0.183https://doaj.org/article/1f3fb0709f45459dadf158859785f98e2021-10-01T00:00:00Zhttps://sajo.org.za/index.php/sajo/article/view/183https://doaj.org/toc/2518-8704https://doaj.org/toc/2523-0646Background: Cutaneous malignant melanoma (CMM) is a significant cause of skin cancer-related mortality. The time between the diagnostic biopsy and primary surgical excision, the surgical interval (SI), is a modifiable factor that may impact melanoma outcomes. Delays in the SI are attributable to many factors. Aim: To determine the SI in patients with resectable CMM treated at Tygerberg Academic Hospital (TAH). Methods: A retrospective review of patients referred to the TAH multidisciplinary melanoma clinic with histologically confirmed CMM between January 2015 and December 2017 was done. Patients 18 years with resectable melanoma (T1b-T4b N0-3 M0-1a) who received definitive surgery were included. Results: The cohort (n = 40) comprised mostly Caucasians referred from the Cape metropolitan (metro) area, with a median age at diagnosis of 59 years. Thirty-one (77.5%) patients had T3 or T4 lesions on diagnostic biopsy. Twenty patients (50%) underwent a sentinel lymph node biopsy (SLNB) which led to an upstaging in 20% of cases. The median length of the SI was 13.5 weeks. Eighteen patients (45%) underwent primary excision within the recommended 12 weeks from diagnostic biopsy. There was a significant association between the SI and patients living in the Cape metro (p = 0.04) as well as the SI and p Stage (p = 0.01). Conclusion: Surgical interval guidelines for cutaneous melanoma are poorly defined. We used 12 weeks as an extrapolation of international guidelines. Even though this target was not met, the study is proposed to be of value in guiding future protocols and ultimately allowing for improved, timely service to patients.Seshini NaidooHenriette BurgerTonya M. EsterhuizenAOSISarticlesurgical intervalmelanomabiopsydelayskin cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENSouth African Journal of Oncology, Vol 5, Iss 0, Pp e1-e7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	surgical interval melanoma biopsy delay skin cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	surgical interval melanoma biopsy delay skin cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Seshini Naidoo Henriette Burger Tonya M. Esterhuizen Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
description	Background: Cutaneous malignant melanoma (CMM) is a significant cause of skin cancer-related mortality. The time between the diagnostic biopsy and primary surgical excision, the surgical interval (SI), is a modifiable factor that may impact melanoma outcomes. Delays in the SI are attributable to many factors. Aim: To determine the SI in patients with resectable CMM treated at Tygerberg Academic Hospital (TAH). Methods: A retrospective review of patients referred to the TAH multidisciplinary melanoma clinic with histologically confirmed CMM between January 2015 and December 2017 was done. Patients 18 years with resectable melanoma (T1b-T4b N0-3 M0-1a) who received definitive surgery were included. Results: The cohort (n = 40) comprised mostly Caucasians referred from the Cape metropolitan (metro) area, with a median age at diagnosis of 59 years. Thirty-one (77.5%) patients had T3 or T4 lesions on diagnostic biopsy. Twenty patients (50%) underwent a sentinel lymph node biopsy (SLNB) which led to an upstaging in 20% of cases. The median length of the SI was 13.5 weeks. Eighteen patients (45%) underwent primary excision within the recommended 12 weeks from diagnostic biopsy. There was a significant association between the SI and patients living in the Cape metro (p = 0.04) as well as the SI and p Stage (p = 0.01). Conclusion: Surgical interval guidelines for cutaneous melanoma are poorly defined. We used 12 weeks as an extrapolation of international guidelines. Even though this target was not met, the study is proposed to be of value in guiding future protocols and ultimately allowing for improved, timely service to patients.
format	article
author	Seshini Naidoo Henriette Burger Tonya M. Esterhuizen
author_facet	Seshini Naidoo Henriette Burger Tonya M. Esterhuizen
author_sort	Seshini Naidoo
title	Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
title_short	Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
title_full	Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
title_fullStr	Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
title_full_unstemmed	Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital
title_sort	delays in the referral and primary management of cutaneous malignant melanoma at tygerberg hospital
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/1f3fb0709f45459dadf158859785f98e
work_keys_str_mv	AT seshininaidoo delaysinthereferralandprimarymanagementofcutaneousmalignantmelanomaattygerberghospital AT henrietteburger delaysinthereferralandprimarymanagementofcutaneousmalignantmelanomaattygerberghospital AT tonyamesterhuizen delaysinthereferralandprimarymanagementofcutaneousmalignantmelanomaattygerberghospital
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Delays in the referral and primary management of cutaneous malignant melanoma at Tygerberg Hospital

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