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Defining an acceptable period of time from melanoma biopsy to excision

Laura S. Huff, Caroline A. Chang, Jacob F. Thomas, Margaret K. Cook-Shimanek, Paul Blomquist, Nellie Konnikov, Robert P. Dellavalle
  • Laura S. Huff
    University of Colorado School of Medicine, Aurora, CO, United States
  • Caroline A. Chang
    Department of Dermatology, Tufts Medical Center, Boston, MA, United States
  • Jacob F. Thomas
    Colorado School of Public Health, Aurora, CO, United States
  • Margaret K. Cook-Shimanek
    Department of Preventive Medicine, University of Colorado, Aurora, CO, United States
  • Paul Blomquist
    Health Sciences Library, University of Colorado, Aurora, CO, United States
  • Nellie Konnikov
    Dermatology Service, Department of Veterans Affairs Medical Center, Boston, MA, United States
  • Robert P. Dellavalle
    Department of Dermatology, University of Colorado, Aurora, CO Dermatology Service, Department of Veterans Affairs, Denver, CO Colorado School of Public Health Department of Epidemiology, Aurora, CO, United States | robert.dellavalle@ucdenver.edu

Abstract

Melanoma is the most lethal form of skin cancer and it is the second most common cancer among adolescents and young adults. The aim of this work is to determine if surgical intervals differ between four different clinics and between departments within the hospitals, and to compare these to industry standards. Surgical intervals were measured through retrospective chart review at four dermatology clinics. Of 205 melanoma cases, clinic and departmental median surgical intervals ranged 15-36.5 days and 26-48 days, respectively. There was significant association between clinic and time between biopsy and pathology report, time between pathology report and excision, and total surgical interval (P<0.0001, P=0.03, and P<0.0001 respectively). There was significant association between department and time between pathology report and excision, and surgical interval (P<0.0001, and P=0.003 respectively). Pair-wise comparisons detected significantly longer intervals between some clinics and departments (maximum difference 67.3%, P<0.0001). Hypothesis-based, informal guidelines recommend treatment within 4-6 weeks. In this study, median surgical intervals varied significantly between clinics and departments, but nearly all were within a 6-week frame.

Keywords

melanoma; surgical interval; treatment time; melanoma survival; time factors

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Submitted: 2011-08-26 20:08:33
Published: 2012-01-17 14:38:48
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Copyright (c) 2012 Laura S. Huff, Caroline A. Chang, Jacob F. Thomas, Margaret K. Cook-Shimanek, Paul Blomquist, Nellie Konnikov, Robert P. Dellavalle

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