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The following is a summary of “Association between surgical delay and outcomes among patients with invasive cutaneous melanoma,” published in the NOVEMBER 2023 issue of Surgery by Hewitt, et al.
The impact of surgical delay on outcomes in patients with cutaneous melanoma has yet to be extensively explored. For a study, researchers sought to investigate the association between surgical delay and regional nodal involvement as well as mortality in individuals diagnosed with clinically node-negative invasive cutaneous melanoma between 2004 and 2018.
A retrospective analysis was conducted on a cohort of 423,001 patients. Surgical delay, defined as a delay of 45 days or more, was observed in 21.8% of cases. The primary outcomes assessed were the presence of regional lymph node disease and overall survival. Multivariable logistic regression and Cox proportional-hazards models were employed to account for relevant clinical factors.
Patients experiencing surgical delay were found to have an increased likelihood of nodal involvement (OR 1.09; P = 0.01). Surgical delay (HR 1.14; P < 0.001), Black race (HR 1.34; P = 0.002), and Medicaid coverage (HR 1.92; P < 0.001) were associated with reduced survival rates. Notably, patients treated at academic/research institutions (HR 0.87; P < 0.001) or integrated network cancer programs (HR 0.89; P = 0.001) exhibited improved survival.
Frequent occurrences of surgical delay were observed and were linked to higher rates of lymph node involvement and decreased overall survival in patients with cutaneous melanoma.
Source: americanjournalofsurgery.com/article/S0002-9610(23)00183-6/fulltext