Division of Surgical Oncology, Department of Surgery, University of California at Davis, Sacramento, California.
J Surg Res. 2013 Oct;184(2):1157-60. doi: 10.1016/j.jss.2013.04.091. Epub 2013 Jun 6.
We hypothesized that patients in urban areas with intermediate thickness cutaneous melanoma would have higher rates of sentinel lymph node biopsy (SLNB) relative to their rural-dwelling counterparts.
The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgery for intermediate thickness cutaneous melanoma from 2004-2008. Patients were categorized as coming from urban or rural counties based on a nine-point scale. We used multivariate logistic regression models to predict use of SLNB. Covariates examined included sex, race/ethnicity, age, T stage, tumor histology, tumor location, and ulceration. The likelihood of undergoing SLNB was reported as OR with 95% CI.
Of 8441 patients, 8382 (99.3%) had complete information regarding use of SLNB. On multivariate analysis, patients from rural counties had a decreased likelihood of receiving a SLNB (OR 0.87, CI 0.78-0.97; P = 0.014). Additional factors associated with a decreased likelihood of receiving a SLNB included increasing age, Asian/Hispanic/Unknown race, and head and neck or overlapping primary tumor site.
Patients in rural areas are less likely to receive a SLNB for intermediate thickness cutaneous melanoma than their urban-dwelling counterparts.
我们假设，与居住在农村地区的患者相比，城市地区患有中度厚度皮肤黑色素瘤的患者接受前哨淋巴结活检（SLNB）的比率更高。
从 2004 年至 2008 年，对接受手术治疗的中度厚度皮肤黑色素瘤患者的监测、流行病学和最终结果数据库进行了查询。根据九点量表，患者被归类为来自城市或农村县。我们使用多变量逻辑回归模型来预测 SLNB 的使用。检查的协变量包括性别、种族/民族、年龄、T 分期、肿瘤组织学、肿瘤位置和溃疡。SLNB 的可能性以 OR 及其 95%CI 报告。
在 8441 名患者中，有 8382 名（99.3%）患者的 SLNB 使用情况信息完整。多变量分析显示，来自农村县的患者接受 SLNB 的可能性较低（OR 0.87，CI 0.78-0.97；P = 0.014）。与接受 SLNB 的可能性降低相关的其他因素包括年龄增加、亚洲/西班牙裔/未知种族以及头颈部或重叠原发性肿瘤部位。
与居住在城市地区的患者相比，农村地区的患者接受中度厚度皮肤黑色素瘤 SLNB 的可能性较低。
