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Factors Influencing the Use of Sentinel Lymph Node Biopsy in the Netherlands

Annals of Surgical Oncology volume 21, pages 3395–3400 (2014)Cite this article

Abstract

Background

In the US, whether a sentinel lymph node biopsy (SLNB) is performed depends on tumor and patient factors, including socioeconomic status (SES) and type of health care insurance. We analyzed which patient and tumor characteristics influenced the use of SLNB in a country where every patient has equal access to healthcare.

Methods

Patients diagnosed with a cutaneous invasive melanoma of ≥1 mm between 2004 and 2011 and living in the northeastern part of the Netherlands were selected from the Netherlands Cancer Registry. Regression analysis was performed to assess the association of patient and tumor characteristics and SLNB use.

Results

SLNB was performed in 42 % of the 2,413 included patients. The frequency of performing SLNB increased between 2004 and 2011 from 24 to 55 % (p < 0.001). Patients were less likely to undergo SLNB if they had a melanoma located in the head and neck area (p < 0.001), when they were over 55 years (p = 0.001), and if they had a low SES (p = 0.03). SLNB use was more likely when the diagnosis of melanoma was made in the university hospital (p = 0.045) or when the Breslow thickness was 2.01–4.0 mm (p = 0.03).

Conclusions

The use of SLNB has increased significantly between 2004 and 2011. However, in 2011 it was still performed in only 55 % of the Dutch patients with a melanoma ≥1 mm. In patients with head and neck melanoma, older patients, and patients with low SES, SLNB was less frequently performed. Patients with T3 melanomas and a diagnosis made in the university hospital more often had an SLNB performed.

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Conflict of interest

No commercial interests to disclose.

Author information

Affiliations

  1. Department of Surgical Oncology, University Medical Centre Groningen, Groningen, The Netherlands

    Anna M. Huismans MD, Maarten G. Niebling MD, PhD, Kevin P. Wevers MD, PhD & Harald J. Hoekstra MD, PhD

  2. Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands

    Anna M. Huismans MD

  3. Department of Research, Comprehensive Cancer Centre the Netherlands (IKNL), Amsterdam, The Netherlands

    Melinda S. Schuurman MSc

Authors
  1. Anna M. Huismans MD
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  2. Maarten G. Niebling MD, PhD
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  3. Kevin P. Wevers MD, PhD
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  4. Melinda S. Schuurman MSc
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  5. Harald J. Hoekstra MD, PhD
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Corresponding author

Correspondence to Harald J. Hoekstra MD, PhD.

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Huismans, A.M., Niebling, M.G., Wevers, K.P. et al. Factors Influencing the Use of Sentinel Lymph Node Biopsy in the Netherlands. Ann Surg Oncol 21, 3395–3400 (2014). https://doi.org/10.1245/s10434-014-3764-9

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  • DOI: https://doi.org/10.1245/s10434-014-3764-9

Keywords

  • Melanoma
  • Sentinel Lymph Node Biopsy
  • Academic Hospital
  • Neck Area
  • Breslow Thickness