Wait Times for Melanoma Surgery: Is There an Association with Overall Survival?

Annals of Surgical Oncology
Alyson B CrawfordCarl van Walraven

Abstract

Wait times for access to care have been of increasing interest to public health care officials, health care providers, and the public. There is a paucity of data determining whether extended wait times for melanoma surgery influence patient outcomes. This study measured the association of wait times to surgical treatment with overall survival in patients with melanoma. Population-based health administrative databases were used to identify all Ontario adults diagnosed with melanoma between 2004 and 2011, time to various treatment modalities, and death dates. Proportional hazards modeling using time-dependent covariates was used to determine the adjusted association of time from melanoma diagnosis to various post-diagnostic surgical interventions with overall survival. A total of 2573 patients were included. The 5-year overall survival was 81.1% [95% confidence interval (CI) 79.1-83.0]. Of all patients, 82.9% underwent a wide local excision (WLE) with a median wait time of 43 days [interquartile range (IQR) 24-64], 29.1% underwent a sentinel lymph node biopsy (SNB) with a median wait time of 59 days (IQR 41-81), and 35.0% underwent a lymph node dissection (LND) with a median wait time of 63 days (IQR 43-91). After adjusting for a...Continue Reading

References

May 30, 2002·Annals of Surgery·Rebekah R WhiteHilliard F Seigler
Apr 25, 2006·Annals of Surgery·Charles R ScogginsUNKNOWN Sunbelt Melanoma Trial
Nov 18, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Charles M BalchVernon K Sondak
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Sep 11, 2012·The British Journal of Surgery·A P T van der PloegUNKNOWN European Organization for Research and Treatment of Cancer Melanoma Group
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Jun 8, 2017·The New England Journal of Medicine·Mark B FariesRobert M Elashoff
Jul 3, 2017·Journal of the American College of Surgeons·Daniel W NelsonMark B Faries

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Citations

Jul 26, 2018·Plastic and Reconstructive Surgery·Thomas KnackstedtBrian Gastman
Dec 6, 2018·Annals of Surgical Oncology·Carolyn Nessim, Alyson B Crawford
Aug 3, 2020·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Mario MandalàUNKNOWN Italian Melanoma Intergroup (IMI)
Jun 2, 2021·American Society of Clinical Oncology Educational Book·Nikhil I KhushalaniJohn F Thompson

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