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Depth of Melanoma Excision Varies by Physician Type

Excision depth consistent for melanoma in situ but varies for invasive melanoma

WEDNESDAY, Sept. 22 (HealthDay News) -- The depth of excision of invasive melanomas differs substantially among different types of physicians, according to a study in the September issue of the Archives of Dermatology.

Jennifer L. DeFazio, M.D., of the Memorial Sloan-Kettering Cancer Center in Hauppauge, N.Y., and colleagues surveyed 1,184 U.S. physicians, including 1,000 dermatologists and 184 melanoma specialists. The latter group included dermatologists, oncologists, and surgeons in pigmented lesion clinics. The authors included 498 surveys in the final analysis.

The investigators found that specialists reported fewer patient visits per month compared to non-specialist dermatologists; however, 51 percent of specialists reported diagnosing more than 20 invasive melanomas in the previous year compared to 11 percent of non-specialist dermatologists. Although no significant difference in excision depth was reported among the specialties for melanoma in situ, significant differences were reported among treating groups for invasive melanoma, with the greatest incongruence found for thin invasive melanoma. Compared to specialist dermatologists and non-specialist dermatologists, specialist non-dermatologists consistently reported excising more deeply.

"There is considerable variation among physician groups with regard to depth of excision practices for the treatment of melanoma," the authors write. "Given the current lack of clinical data available, studies assessing depth of excision and patient outcomes are needed to better define our surgical management of melanoma."

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