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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 5 of 5 Research Studies Displayed
Herb JN, Ollila DW, Stitzenberg KB
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
This study looked at the utility of sentinel lymph node biopsy (SLNB) for non-ulcerated T1b melanoma. The aim of the study was to estimate SLNB use, positivity, prevalence, and procedural costs in patients with non-ulcerated T1b melanoma using a population-based registry. Patients with clinically node-negative, non-ulcerated T1b melanoma were identified in the SEER database from 2010 to 2016. Among 7245 included patients, 53% underwent SLNB of which 156 (4.1%) had a positive SLNB. Higher odds of positivity were associated with younger age, >1 mitosis per mm2, female sex, and truncal tumor location. Estimated SLNB costs to identify one patient with Stage II disease was $71,700. Out-of-pocket expenses for a Medicare patient was estimated to be $652 for a wide local excision (WLE) and SLNB and $79 for WLE alone.
Citation: Herb JN, Ollila DW, Stitzenberg KB . Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry. Ann Surg Oncol 2021 Jul;28(7):3470-78. doi: 10.1245/s10434-021-09998-6..
Keywords: Cancer: Skin Cancer, Cancer, Surgery, Healthcare Costs, Skin Conditions
Herb JN, Dunham LN, Ollila DW
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
This study examined the use and time trends of completion lymph node dissection (CLND) for sentinel lymph node-positive melanoma (SNPM). There has been found to be no benefit for CLND in SNPM patients. The National Cancer Database was used to find patients 18 years and older from 2012 to 2016 with SNPM. During that time period, 7,146 patients were identified with SNPM. From 2012 to 2014 the proportion of patients undergoing CLND was steady (61-63%) but decreased to 57% in 2015 and 50% in 2016. Use was less likely for women and increasing age. Higher use was more likely at high-volume centers, and associated with increased Breslow depth and ulceration.
Citation: Herb JN, Dunham LN, Ollila DW . Use of completion lymph node dissection for sentinel lymph node-positive melanoma. J Am Coll Surg 2020 Apr;230(4):515-24. doi: 10.1016/j.jamcollsurg.2019.12.010..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Treatments
Drucker AM, Adam GP, Rofeberg V
Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review.
This article discusses the results of a systematic review and network meta-analysis summary of treatments for primary squamous cell carcinoma (SCC) and squamous cell carcinoma in situ (SCCi) AHRQ comparative effective review. The authors included English-language randomized controlled trials (RCTs) with information on recurrence, histologic clearance, clinical clearance, cosmesis, and quality of life. They excluded studies enrolling less than 10 body lesions total or arms that had 5 or less lesions. They included 7 RCTs with a total of 418 participants. While they found some evidence of the best treatment options, there was little evidence to guide treatment of SC. There were no RCTs found on surgical modalities which is the first line of treatment for SCC.
Citation: Drucker AM, Adam GP, Rofeberg V . Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review. J Am Acad Dermatol 2020 Feb;82(2):479-82. doi: 10.1016/j.jaad.2019.06.030..
Keywords: Cancer: Skin Cancer, Cancer, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research
Huo J, Lairson DR, Du XL
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
This study investigated the influence of hospital case volume on malignant melanoma survival and treatment utilization. The researchers discovered that for patients diagnosed with metastatic melanoma, being treated in a high-volume hospital was associated with an improvement in survival and lower utilization of chemotherapy, immunotherapy, surgery, and radiation therapy.
Citation: Huo J, Lairson DR, Du XL . Hospital case volume is associated with improved survival for patients with metastatic melanoma. Am J Clin Oncol 2016 Oct;39(5):491-6. doi: 10.1097/coc.0000000000000074.
Keywords: Elderly, Hospitals, Mortality, Patient-Centered Outcomes Research, Cancer: Skin Cancer
Banerjee M, Lao CD, Wancata LM
Implications of age and conditional survival estimates for patients with melanoma.
This study identified newly diagnosed cutaneous melanoma patients and estimated conditional 5-year survival. Over time, conditional survival estimates improved for older patients with localized and regional disease. Understanding the conditional 5-year disease-specific survival of melanoma based on age and stage can help patients and physicians, informing decision-making about treatment and surveillance.
Citation: Banerjee M, Lao CD, Wancata LM . Implications of age and conditional survival estimates for patients with melanoma. Melanoma Res 2016 Feb;26(1):77-82. doi: 10.1097/cmr.0000000000000213.
Keywords: Elderly, Cancer: Skin Cancer, Cancer, Mortality, Skin Conditions