Table of Contents
ISRN Dermatology
Volume 2013, Article ID 315609, 5 pages
http://dx.doi.org/10.1155/2013/315609
Research Article

Sentinel Lymph Node Biopsy in Patients with Thick Primary Cutaneous Melanoma: Patterns of Use and Underuse Utilizing a Population-Based Model

1Division of Surgical Oncology, Department of Surgery, University of California at Davis, Saeramento, CA 95817, USA
2UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3010, Sacramento, CA 95817, USA
3Department of Dermatology, University of California at Davis, Saeramento, CA 95817, USA
4Department of Veteran Affairs, Northern California Health Care System, Sacramento, CA 95655, USA

Received 2 December 2012; Accepted 20 December 2012

Academic Editors: E. Alpsoy, M. Clelia, and C. Johansen

Copyright © 2013 Steve R. Martinez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Sentinel lymph node biopsy (SLNB) for thick cutaneous melanoma is supported by national guidelines. We report on factors associated with the use and underuse of SLNB for thick primary cutaneous melanoma. Methods. The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgery for thick primary cutaneous melanoma from 2004 to 2008. We used multivariate logistic regression models to predict use of SLNB. Results. Among 1,981 patients, 833 (41.8%) did not undergo SLNB. Patients with primary melanomas of the arm (OR 2.07, CI 1.56–2.75; ), leg (OR 2.40, CI 1.70–3.40; ), and trunk (OR 1.82, CI 1.38–2.40; ) had an increased likelihood of receiving a SLNB, as did those with desmoplastic histology (OR 1.47, CI 1.11–1.96; ). A decreased likelihood of receiving SLNB was noted for advancing age ≥ 60 years (age 60 to 69: OR 0.58, CI 0.33–0.99, ; age 70 to 79: OR 0.32, CI 0.19–0.54, ; age 80 or more: OR 0.10, CI 0.06–0.16, ) and unknown race/ethnicity (OR 0.21, CI 0.07–0.62; ). Conclusions. In particular, elderly patients are less likely to receive SLNB. Further research is needed to assess whether use of SLNB in this population is detrimental or beneficial.