Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Queensland, 4006, Australia; CRUK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, United Kingdom.
Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Queensland, 4006, Australia.
Cancer Epidemiol. 2021 Feb;70:101872. doi: 10.1016/j.canep.2020.101872. Epub 2020 Dec 24.
Primary care skin cancer clinics facilitate early treatment of melanoma in Australia. We investigated the clinical and histopathological features of melanomas diagnosed and treated in an established clinic in Brisbane.
Retrospective audit of medical records of patients diagnosed with in situ or invasive primary cutaneous melanoma in a primary care clinic specializing in skin cancer, 2000-2017. Demographic and clinical data were standardly extracted by a medically-trained investigator. We used descriptive analyses to assess characteristics of patients and melanomas, and examine surgical management according to tumour thickness.
Of 380 patients (median age 57 years; 57 % male) newly diagnosed with 497 histologically-confirmed primary cutaneous melanomas, 369 were in situ and 128 invasive. Of the 369 in situ melanomas, 143 (39 %) were on the trunk and 87 (24 %) on the head and neck; 247 (67 %) were diagnosed by shave biopsy; and 141 (38 %) referred for wide local excision (WLE). Of the 128 invasive melanomas, only 21 (16 %) had thickness ≥ 0.8 mm and these occurred more often on head and neck than thin invasive melanomas (p = 0.02). The majority of invasive melanomas were diagnosed by excision biopsy, and WLE was carried out in a median of 3 days (melanomas ≥ 0.8 mm) and 2 days (<0.8 mm). The doctor detected the majority of in situ (83 %) and thin invasive (73 %) melanomas during surveillance, compared with 48 % of thicker invasive melanomas ≥ 0.8 mm (p < 0.001).
In Australia, specialised primary care practice plays a major role in detection and treatment of early primary melanoma.
初级保健皮肤癌诊所有助于澳大利亚早期治疗黑色素瘤。我们调查了在布里斯班一家专门从事皮肤癌的初级保健诊所诊断和治疗的原位或侵袭性原发性皮肤黑色素瘤的临床和组织病理学特征。
对 2000 年至 2017 年期间在专门从事皮肤癌的初级保健诊所诊断为原位或侵袭性原发性皮肤黑色素瘤的患者的病历进行回顾性审核。由一名医学专业培训的调查员标准提取人口统计学和临床数据。我们使用描述性分析来评估患者和黑色素瘤的特征，并根据肿瘤厚度检查手术管理。
在新诊断的 380 例（中位年龄 57 岁；57%为男性）组织学证实的 497 例原发性皮肤黑色素瘤患者中，369 例为原位，128 例为侵袭性。在 369 例原位黑色素瘤中，143 例（39%）位于躯干，87 例（24%）位于头颈部；247 例（67%）通过切除活检诊断；141 例（38%）转诊行广泛局部切除术（WLE）。在 128 例侵袭性黑色素瘤中，只有 21 例（16%）厚度≥0.8mm，这些黑色素瘤比薄侵袭性黑色素瘤更常见于头颈部（p=0.02）。大多数侵袭性黑色素瘤通过切除活检诊断，WLE 在中位数 3 天（厚度≥0.8mm）和 2 天（<0.8mm）进行。医生在监测期间发现了大多数原位（83%）和薄侵袭性（73%）黑色素瘤，而厚度≥0.8mm的较厚侵袭性黑色素瘤中只有 48%（p<0.001）。
在澳大利亚，专门的初级保健实践在检测和治疗早期原发性黑色素瘤方面发挥了重要作用。
