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Characteristics, Treatment and Outcomes of 589 Melanoma Patients Documented by 27 General Practitioners on the Skin Cancer Audit Research Database Publisher Pubmed



Hay J1 ; Keir J2 ; Jimenez Balcells C3 ; Rosendahl N4 ; Coetzerbotha M2 ; Wilson T5 ; Clark S4, 6 ; Baade A7 ; Becker C8, 9 ; Bookallil L10 ; Clifopoulos C2 ; Dicker T2 ; Denby MP11 ; Duthie D12 Show All Authors
Authors
  1. Hay J1
  2. Keir J2
  3. Jimenez Balcells C3
  4. Rosendahl N4
  5. Coetzerbotha M2
  6. Wilson T5
  7. Clark S4, 6
  8. Baade A7
  9. Becker C8, 9
  10. Bookallil L10
  11. Clifopoulos C2
  12. Dicker T2
  13. Denby MP11
  14. Duthie D12
  15. Elliott C13
  16. Fishburn P2
  17. Foley M14
  18. Franck M15
  19. Giam I16
  20. Gordillo P17
  21. Lilleyman A18
  22. Macauley R19
  23. Maher J20
  24. Mcphee E21
  25. Reid M22
  26. Shirlaw B23
  27. Siggs G24
  28. Spark R25
  29. Stretch J26
  30. Van Den Heever K27
  31. Van Rensburg T28
  32. Watson C29
  33. Kittler H30
  34. Rosendahl C2, 6
Show Affiliations
Authors Affiliations
  1. 1. Upper Hutt Skin Clinic, Upper Hutt, Wellington, New Zealand
  2. 2. General Practice Clinical Unit, Medical School, The University of Queensland, Australia
  3. 3. 4D Skin Cancer Clinic, Belmont North, NSW, Australia
  4. 4. Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
  5. 5. SCARD, Brisbane, QLD, Australia
  6. 6. Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Gladstone GP Superclinic, Gladstone, QLD, Australia
  8. 8. Wairarapa Skin Clinic, Masterton, New Zealand
  9. 9. Wairarapa Hospital, Lansdowne, Masterton, New Zealand
  10. 10. The University of New England, Armidale, NSW, Australia
  11. 11. Silverdale Medical, Silverdale, Auckland, New Zealand
  12. 12. Darwin Skin Cancer Clinic, Parap, NT, Australia
  13. 13. Solarderm Skin Cancer Practice, Caboolture, QLD, Australia
  14. 14. The Skin Clinic, Marlborough – Blenheim, New Zealand
  15. 15. MoleSafe Skin Cancer Clinic, Windsor, VIC, Australia
  16. 16. Skin2 Clinic, Deakin, ACT, Australia
  17. 17. Cairns Skin Cancer Clinic, Cairns, QLD, Australia
  18. 18. Newcastle Skin Check, Charlestown, NSW, Australia
  19. 19. Bateau Bay Medical Centre, Bateau Bay, NSW, Australia
  20. 20. Skin Cancer Ballarat, Alfredton, VIC, Australia
  21. 21. Emerald Medical Group, Emerald, QLD, Australia
  22. 22. Nelson Bay Skin Cancer Clinic, Nelson Bay, NSW, Australia
  23. 23. Lakeside Medical, Springfield Lakes, QLD, Australia
  24. 24. Regency Medical Clinic, Sefton Park, SA, Australia
  25. 25. Toukley Family Practice, Toukley, NSW, Australia
  26. 26. Bond University, Robina, QLD, Australia
  27. 27. CQ Skin Cancer Clinic, Bucasia, QLD, Australia
  28. 28. Kippax Ochre Medical Centre, Holt, ACT, Australia
  29. 29. Brisbane City Doctors, Brisbane, QLD, Australia
  30. 30. Vienna Dermatologic Imaging Research Group, Department of Dermatology, Medical University of Vienna, Vienna, Austria

Source: Australasian Journal of Dermatology Published:2022


Abstract

Background and objective: General practitioners manage more melanomas than dermatologists or surgeons in Australia. Previously undescribed, the management and outcomes of melanoma patients treated by multiple Australasian general practitioners are examined. Methods: The characteristics, management and outcomes of 589 melanoma patients, managed by 27 Australasian general practitioners and documented on the Skin Cancer Audit Research Database (SCARD), were analysed. Results: Most patients (58.9%) were males with mean age at diagnosis of 62.7 years (range 18–96), and most melanomas were in situ or thin-invasive. Patients aged under 40 years had fewer melanomas, but a higher proportion (the majority) were invasive, compared with older patients (P < 0.0001). Most (55.9%) melanomas were diagnosed following elliptical excision biopsy, the rate of unintended involved margins being eightfold higher for shave biopsies. Wide re-excision was performed by the treating general practitioner for most (74.9%) melanomas, with thick melanomas preferentially referred to surgeons. The average Breslow thickness of invasive melanomas re-excised by general practitioners was 0.67 mm compared with 1.99 mm for those referred to other specialists (P < 0.0001). Of 205 patients with invasive melanoma, 14 progressed to metastatic disease, 50% of these being associated with nodular melanoma. Nine patients progressed to melanoma-specific death. The 5-year survival rate for patients with invasive melanoma was 95.2% (95% CI: 91.2–98.5%). Conclusions: Diagnostic and therapeutic management of a series of melanoma patients by Australasian general practitioners were closely aligned with current guidelines and 5-year survival with respect to invasive melanoma was at least as favourable as national population-based metrics. © 2022 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.