In the past three years, Guthrie Cancer Center in Sayre, Pa. has seen a significant upward trend for melanoma cases, going from 48 cases in 2009 to 78 cases in 2011. With the treatment of melanoma shared among several services, including Surgical Oncology, Dermatology, and Plastic Surgery, there was a need to analyze appropriate utilization of sentinel lymph node biopsy in Stage IB to IIC melanoma patients.
David J. Bertsch, MD stated, “With the increase of melanoma cases and the number of departments involved in patient diagnosis of melanoma we identified a need to review our data on Stage IB to IIC melanoma patients to ensure patients are receiving treatment in accordance with NCCN Guidelines.”
NCCN Guidelines indicate Stage IB to IIC melanoma patients should be educated about the sentinel lymph node biopsy procedure. The decision to perform sentinel lymph node biopsy may be based on significant patient comorbidities, patient preference, or other factors that may be involved.
The analysis included reviewing 2011 cancer registry data for patients with stage IB to IIC. Fifteen cases in 2011 fit this staging criterion. Of the fifteen cases, seven patients underwent sentinel lymph node biopsy. Review of the medical records revealed of the eight patients not receiving sentinel node biopsy, seven had discussed the option of sentinel node biopsy with their physician.
Bertsch concluded, “After a thorough review, we determined that our first course of therapy was in concordance with NCCN treatment guidelines and no change in practice was warranted.” .