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Excision of malignant melanomas in North Wales: effect of location and surgeon on time to diagnosis and quality of excision

Neal, Richard D., Cannings-John, Rebecca Louise, Hood, Kerenza, Sowden, Jonathan, Lawrence, Helen, Jones, Claire and Jones, Julie 2008. Excision of malignant melanomas in North Wales: effect of location and surgeon on time to diagnosis and quality of excision. Family Practice 25 (4) , pp. 221-227. 10.1093/fampra/cmn036

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Abstract

Background. The epidemiology of melanoma is changing and its current management is variable, with some lesions being removed in general practice. We aimed to determine the quality of excision and time to diagnosis relating to the excising surgeon and the place of excision. Method. Analysis of data from the North Wales Melanoma Database. Results. In total, 578 cases were diagnosed 1993–2001. There was a gender difference with anatomical location, with 107 (65%) males with lesions on their trunk compared to 57 (35%) females. Median Breslow thickness was 1.10 mm (range 0.05–16.0 mm). Ninety-five (16%) lesions were removed in general practice, of which 49 (52%) were referred on to hospital. In total, 266 (61%) lesions were excised with ‘adequate’ margins and 170 (39%) excised with margins narrower than the guidelines. General practice excisions were from a younger group than hospital excisions. There were no differences in quality of excision between general practice and hospital excisions. Time to diagnosis was shorter overall for general practice excisions than hospital excisions (median 12 versus 41 days, P < 0.001). Conclusion. These findings are of policy importance in that there is no evidence from this study that general practice excisions are managed poorly or have a worse prognosis.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RD Surgery
Uncontrolled Keywords: Breslow thickness; diagnostic delays; general practice; melanoma; quality of excision
Publisher: Oxford University Press
ISSN: 0263-2136
Last Modified: 05 Jun 2017 03:13
URI: http://orca.cf.ac.uk/id/eprint/27270

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