Factors Influencing the Use of Sentinel Lymph Node Biopsy in the Netherlands

Huismans, Anna M.; Niebling, Maarten G.; Wevers, Kevin; Schuurman, M.S.; Hoekstra, Harald J.

doi:10.1245/s10434-014-3764-9

Cited by 12 publications

(30 citation statements)

References 27 publications

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“…Another finding supported by previous literature is that head and neck melanomas had the lowest percentage of SLNB enactment 23–25,29. This may be explained by the technical challenge associated with localization, and also as lymphatic drainage can occur to multiple or bilateral sites, with the sentinel lymph node itself being relatively small 37.…”

Section: Discussionsupporting

confidence: 63%

“…This may be explained by the technical challenge associated with localization, and also as lymphatic drainage can occur to multiple or bilateral sites, with the sentinel lymph node itself being relatively small 37. Furthermore, our finding that older patients more often refrain from SLNB is also sustained by others 23–26,28. An explanation for this could be relevant comorbidities influencing prognosis in older patients, or a more conservative approach in view of a generally lower life expectancy.…”

Section: Discussionmentioning

confidence: 76%

“…We found female sex, older age, and melanoma in the head and neck region to be associated with non-enactment of SLNB. Huismans et al assessed factors such as sex, age, socioeconomic status, BT, and hospital type influencing the use of SLNB in the north-eastern part of The Netherlands and found 42% of SLNB enactment in a total of 2413 patients with melanomas with a BT > 1 mm;23 however, compared with other nations, this percentage is low. Bilimoria et al24 used US National Cancer Database (NCDB) data ( n = 16,598) of stage I and II melanoma patients, between 2004 and 2005, and found a 48.7% enactment rate; Murtha et al25 used Surveillance, Epidemiology, and End Results (SEER) data of 13,307 melanoma patients, between 2010 and 2012, with a 59.9% enactment rate; Moreno-Ramirez et al26 analyzed 478 melanoma stage T1a–T4b patients in their center, with a 63.2% enactment rate; and Blakely et al27 analyzed 865 melanoma patients, between 2005 and 2015, with a 93.2% enactment rate.…”

Section: Discussionmentioning

confidence: 99%

“…Although we assessed multiple factors associated with SLNB use, we did not take into consideration socioeconomic status, race, and regional practice variation, which have been shown to influence SLNB use 23–25,28. Another limitation is that mitosis status was missing in 41.6% of T1 melanomas.…”

Section: Discussionmentioning

confidence: 99%

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Trends in Sentinel Lymph Node Biopsy Enactment for Cutaneous Melanoma

et al. 2019

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Background Over recent years, sentinel lymph node biopsy (SLNB) recommendations in guidelines for cutaneous melanoma have changed considerably. We aimed to assess trends in enactment of SLNB to evaluate to what extent guidelines were adhered to, and to identify clinical and pathological determinants of (non-)adherence. Methods Clinicopathological data from the Dutch nationwide network and registry of histopathology and cytopathology were retrieved from patients diagnosed with primary cutaneous melanoma in The Netherlands between 2003 and 2014. SLNB enactment was analyzed per year. Multivariable regression models were developed to assess the determinants of SLNB enactment. Results A total of 51,510 primary cutaneous melanomas in 49,514 patients were diagnosed, of which 24,603 melanomas were eligible for SLNB as they were staged T1b or higher. In practice, only 9761 (39.7%) patients underwent SLNB, with an increasing trend from 39.1% in 2003 to 47.8% in 2014 ( p < 0.001). A total of 759 (2.9%) of 26,426 patients without SLNB indication underwent SLNB anyway. Variables significantly associated with enactment of SLNB were male sex, younger age, and melanoma on sites other than the head and neck. Conclusions Although there was an increasing trend in time in SLNB enactment, enactment of SLNB did not comply well with recommendations in (inter)national guidelines. Female sex, higher age, and melanoma located on the head and neck were associated with non-enactment of SLNB.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Trends in Sentinel Lymph Node Biopsy Enactment for Cutaneous Melanoma

et al. 2019

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“…An association has been identified between patients ‘Socioeconomic Status’ (SES) and different cancer outcomes. Studies from various countries highlighted a significant impact of the SES on cancer diagnosis [ 4 – 6 ], treatment [ 7 , 8 ], mortality [ 9 – 13 ] and cancer survivors' rehabilitation [ 14 ] : the lower the SES is, the worse the outcome is. Socioeconomic Status has also been demonstrated to be linearly related to cancer screening attendance [ 15 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Social inequalities and cancer: can the European deprivation index predict patients' difficulties in health care access? a pilot study

et al. 2015

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ContextThe European Deprivation Index (EDI), is a new ecological estimate for Socio-Economic Status (SES). This study postulates that Time-To-Treatment could be used as a cancer quality-of -care surrogate in order to identify the association between cancer patient's SES and quality of care in a French comprehensive cancer center.Methodsretrospective mono-centered cohort study. All consecutive incoming adult patients diagnosed for breast cancer(BC), prostate cancer(PC), colorectal cancer (CRC), lung cancer(LC) or sarcoma(S) were included between January 2013 and December 2013. The association of EDI and Time-To-Diagnosis(TTD), as well as Time-To-Treatment(TTT) was analyzed using a cox regression, and a strata analysis per tumor site was performed.Results969 patients were included. Primitive tumor site was 505 BC(52%), 169 PC(17%), 145 LC(15%), 116 CRC(12%), and 34 S(4%). Median TTD was 1.41 months (Q1-Q3 0.5 to 3.5 months). Median TTT was 0.9 months (0.4 - 1.4). In a multivariate analysis, we identified the tumor site as a predictive factor to influence TTD, shorter for BC (0.75months, [0.30- 1.9]) than PC (4.69 months [1.6-29.7]), HR 0.27 95%CI= [0.22-0.34], p < 0.001. TTT was also shorter for BC (0.75months [0.4-1.1]) than PC (2.02 [0.9-3.2]), HR 0.32 95%CI= [0.27-0.39], p < 0.001. EDI quintiles were not found associated with either TTT or TTD.ConclusionsDeprivation estimated by the EDI does not appear to be related to an extension of the Time-to-Diagnosis or Time-to-Treatment in our real-life population. Further research should be done to identify other frailty-sensitive factors that could be responsible for delays in care.

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A retrospective study of sentinel lymph node biopsy for skin cancer in Japan: Comparison with breast cancer and evaluation of factors related to its use

Wada,

Watanabe,

Ishii

et al. 2023

Cancer Medicine

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BackgroundSentinel lymph node biopsy (SLNB) underuse has been reported for skin cancers; however, actual performance rates have not been compared. The objective of this study was to investigate the SLNB performance rate in skin cancers covered by health insurance in Japan and compare it with that in breast cancer.MethodsThis was a retrospective study of the SLNB performance rate in SLNB‐eligible patients with breast or skin cancer from 2018 to 2019, utilizing a database linked to the Hospital‐Based Cancer Registry and Diagnosis Procedure Combination survey. Demographic and tumor characteristics were analyzed using logistic regression.ResultsA total of 71,652 patients were included in this study. SLNB was performed in 86.4% (57,904/67,036) of the patients with breast cancer, 44.7% (694/1552) with melanomas, 3.1% (89/2849) with squamous cell carcinomas (SCCs), and 13.5% (29/215) with Merkel cell carcinomas (MCCs). The performance rate of SLNB was significantly lower for skin cancers than for breast cancers (odds ratio [OR], 0.03; p < 0.001). In addition, the performance rates of SLNB were significantly lower for SCCs and MCCs than for melanomas (SCC: OR, 0.04; p < 0.001; MCC: OR, 0.19; p < 0.001). Factors associated with SLNB performance included age, sex, year of incidence, primary tumor site, T stage, and number of hospital beds.ConclusionsSLNB is underutilized for skin cancer. Further investigation is required to explore the reasons for its underutilization so that it may be implemented more universally.

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Factors Influencing the Use of Sentinel Lymph Node Biopsy in the Netherlands

Cited by 12 publications

References 27 publications

Trends in Sentinel Lymph Node Biopsy Enactment for Cutaneous Melanoma

Trends in Sentinel Lymph Node Biopsy Enactment for Cutaneous Melanoma

Social inequalities and cancer: can the European deprivation index predict patients' difficulties in health care access? a pilot study

A retrospective study of sentinel lymph node biopsy for skin cancer in Japan: Comparison with breast cancer and evaluation of factors related to its use

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