How Well Are We Taking Care of Melanoma Patients in the USA?
- Vernon K. Sondak MD
- … show all 1 hide
Increasingly, “compliance” with adopted standards of practice is becoming synonymous with the delivery of “quality” medical care to our patients. For our melanoma patients, the guidelines promulgated by the National Cancer Centers Networks (NCCN)1 are one such set of standards, and have been widely disseminated. But to what extent are we complying with the NCCN melanoma guidelines, and to what extent does compliance with them indicate that high-quality medical care is being delivered? Current and recent publications in Annals of Surgical Oncology shed light on these issues, but raise as many questions as they answer.
Earlier this year, Erickson et al.2 reviewed the charts of 252 clinically node-negative melanoma patients treated at a community teaching hospital and found a significant rate of noncompliance with NCCN guidelines. Excision margins conformed to the guideline standards in 87% of in situ and thin (T1) tumors but only 60% of thicker tumors (T2–4). Compliance with the recommend ...
- National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Melanoma 2008. Accessed at www.nccn.org
- Erickson JL, Velasco JM, Hieken TJ. Compliance with melanoma treatment guidelines in a community teaching hospital: time trends and other variables. Ann Surg Oncol 2008; 15:1211–7 CrossRef
- Foster JE, Velasco JM, Hieken TJ. Adverse outcomes associated with non-compliance with melanoma treatment guidelines. Ann Surg Oncol 2008; DOI: 10.1245/s10434-008-0021-0 [ASO-2008-03-0221]
- Bilimoria KY, Balch CM, Bentrem, et al. Complete lymph node dissection for sentinel node-positive melanoma: assessment of practice patterns in the United States. Ann Surg Oncol 2008; 15(6):1566–76 [ASo-2008-01-0011] CrossRef
- Sabel MS, Griffith KA, Arora A, et al. Inguinal node dissection for melanoma in the era of sentinel node biopsy. Surgery 2007; 141:728–35 CrossRef
- Morton DL, Thompson JF, Cochran AJ, et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 2006; 355:1307–17 CrossRef
- Thomas JM. Prognositic false-positivity of the sentinel node in melanoma. Nat Clin Pract Oncol 2008; 5:18–23 CrossRef
- Thomas JM, Hayes AJ. Sentinel lymph node biopsy in melanoma in 2008. PPO Updates 2008; 22:1–9
- Thomas JM. Sentinel lymph node biopsy in malignant melanoma. Brit Med J 2008; 336:902–3
- Van Akkooi ACJ, de Wilt JHW, Verhoef C, et al. Isolated tumor cells and long-term prognosis of patients with melanoma. Ann Surg Oncol 2008; 15(5):1547–8 CrossRef
- Eggermont AM, Suciu S, Santinami M, et al. EORTC 18991: Long-term adjuvant pegylated interferon-alpha2b (PEG-IFN) compared to observation in resected stage III melanoma, final results of a randomized phase III trial. J Clin Oncol 2007; 25:473s
- Anaya DA, Xing Y, Feng L, et al. Adjuvant high-dose interferon for cutaneous melanoma is most beneficial for patients early stage III disease. Cancer 2008; 112:2030–7 CrossRef
- Riker AI, Sondak VK. Complications of soft-tissue tumor surgery. In: Mulholland MW, Doherty GM, eds. Complications in surgery. Philadelphia, PA: Lippincott Williams & Wilkins, 2006, pp 619–27
- Sarnaik AA, Puleo CA, Sondak VK. Limiting the morbidity of inguinal lymphadenectomy for metastatic melanoma. Cancer Control J (in press)
- How Well Are We Taking Care of Melanoma Patients in the USA?
Annals of Surgical Oncology
Volume 15, Issue 9 , pp 2360-2362
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- Vernon K. Sondak MD (1) (2)
- Author Affiliations
- 1. Division of Cutaneous Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
- 2. Departments of Oncologic Sciences and Surgery, University of South Florida College of Medicine, Tampa, FL, USA