Melanoma Excision Depth Varies by Physician Specialty

Non-dermatologist melanoma specialists cut deeper than dermatologists for thin melanomas

WEDNESDAY, July 21 (HealthDay News) -- Melanoma specialists who are not dermatologists tend to excise thin invasive melanomas to a deeper level than do dermatologist specialists and non-specialists, according to research published online July 19 in the Archives of Dermatology.

Jennifer L. DeFazio, M.D., of the Memorial Sloan-Kettering Cancer Center in Hauppauge, N.Y., and colleagues studied survey responses from 498 U.S. physicians to assess current treatment practices relating to the depth of melanoma excision. The survey was sent to dermatologists and melanoma specialists, including dermatologists, oncologists, and surgeons.

The researchers observed no significant differences in excision depth for melanoma in situ between specialists and non-specialists. There were, however, significant differences found between these two groups for thin invasive melanomas. Specialists who were not dermatologists were more likely to report deeper excision to the fascia for thin invasive melanomas than were specialist dermatologists and non-specialist dermatologists. For those melanomas thicker than 1.00 mm, differences between the physician groups decreased, with the majority in each group excising down to the fascia.

"Given the current variation in depth of excision practices and lack of clinical data, studies assessing depth of excision and patient outcomes are needed to better define the surgical management of melanoma," the authors write.

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