Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Knowledge and attitudes of Australian dermatologists towards sentinel lymph node biopsy for melanoma: a mixed methods study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • معلومة اضافية
    • Corporate Authors:
    • المصدر:
      Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 0135232 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1440-0960 (Electronic) Linking ISSN: 00048380 NLM ISO Abbreviation: Australas J Dermatol Subsets: MEDLINE
    • بيانات النشر:
      Publication: New South Wales : Wiley-Blackwell
      Original Publication: [Sydney] Australasian College of Dermatologists.
    • الموضوع:
    • نبذة مختصرة :
      Background/objectives: In melanoma management, sentinel lymph node biopsy (SLNB) is used to stage patients and to indicate prognosis. More recently, it has been used to select patients for adjuvant therapy. This study aimed to report knowledge of and attitudes towards SLNB for patients with melanoma among Australian dermatologists.
      Methods: Mixed methods study using cross-sectional questionnaires (n = 88) and semi-structured interviews (n = 13), May-September 2019.
      Results: Of the dermatologists surveyed, 56% thought SLNB had an important role in melanoma management, 26% were unsure and 18% thought SLNB unimportant. Of the 92% who would discuss SLNB with their patients, the main stated value of SLNB was for assessing eligibility for adjuvant therapies (79%); only 60% indicated SLNB was of value for providing prognostic information, and just over half (53%) thought it could improve staging. Interview data indicated that attitudes towards SLNB are shifting among dermatologists, driven by data from landmark clinical trials and the influence of professional networks. Accordingly, interviewees adopted one of three positions in relation to SLNB: (a) believed in utility of SLNB and adhered to the guidelines; (b) were unconvinced about utility of SLNB but adhered to the guidelines; and (c) were unconvinced about utility of SLNB and did not adhere to the guidelines.
      Conclusion: Although most of the dermatologists surveyed were familiar with and follow the SLNB recommendations, some disagreement with and distrust of the recommendations was evident. Greater acceptance of the SLNB recommendations appeared to be driven by the improved outcomes demonstrated in stage III patients receiving adjuvant systemic therapy.
      (© 2020 Australasian College of Dermatologists.)
    • References:
      Australian Institute of Health and Welfare (AIHW). Cancer in Australia 2019. Cancer series no. 119. Cat. No. CAN 123. Canberra: AIHW.
      Amin MB, Edge SB, Greene FL (eds). AJCC Cancer Staging Manual, 8th edn. New York: Springer, 2017.
      Faries MB, Thompson JF, Cochran AJ et al. Completion dissection or observation for sentinel-node metastasis in melanoma. New Engl. J. Med. 2017; 376: 2211-22.
      Leiter U, Stadler R, Mauch C et al. Complete lymph node dissection versus no dissection in patients with sentinel lymph node biopsy positive melanoma (DeCOG-SLT): a multicentre, randomised, phase 3 trial. Lancet Oncol. 2016; 17: 757-67.
      Gershenwald JE, Scolyer RA, Hess KR et al. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J. Clin. 2017;67:472-92.
      Long GV, Hauschild A, Santinami M et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. New Engl. J. Med. 2017; 377: 1813-23.
      Weber J, Mandala M, Vecchio M et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. New Engl. J. Med. 2017; 377: 1824-35.
      Eggermont A, Blank CU, Mandala M et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma. New Engl. J. Med. 2018; 378: 1789-801.
      Schuchter LM. Adjuvant melanoma therapy - head-spinning progress. New Engl. J. Med. 2017; 377: 1888-1890.
      Cancer Council Australia Melanoma Guidelines Working Party. Clinical practice guidelines for the diagnosis and management of melanoma. Sydney: Cancer Council Australia. Available from: https://wiki.cancer.org.au/australia/Guidelines:Melanoma.
      Watts CG, Madronio CM, Morton RL et al. Diagnosis and clinical management of melanoma patients at higher risk of a new primary melanoma: A population-based study in New South Wales, Australia. Australas. J. Dermatol. 2017; 58: 278-85.
      McGregor JM, Sasieni P. Sentinel node biopsy in cutaneous melanoma: time for consensus to better inform patient choice. Br J Dermatol. 2015; 172: 552-4.
      Zagarella S. Sentinel lymph node biopsy still provides no benefits for patients with melanoma. Am. J. Dermatopathol. 2020; 1: 481-483.
      Sladden M, Zagarella S, Popescu C et al. The sentinel node biopsy has not come of age. Br. J. Dermatology. 2019; 182: 518.
      Bigby M, Zagarella S, Sladden M et al. Time to reconsider the role of sentinel lymph node biopsy in melanoma. J. Am. Acad. Dermatol. 2018; 80: 1168-1171.
      Smithers MB, Hughes MB, Beesley VL et al. Prospective study of patterns of surgical management in adults with primary cutaneous melanoma at high risk of spread, in Queensland, Australia. J. Surg. Oncol. 2015; 112: 359-65.
      Varey AH, Madronio CM, Cust AE et al. Poor adherence to national clinical management guidelines: a population-based, cross-sectional study of the surgical management of melanoma in New South Wales, Australia. Ann. Surg. Oncol. 2017; 24(8): 2080-8.
      Silva E. Adjunct primer for the use of national comprehensive cancer network guidelines for the surgical management of cutaneous malignant melanoma patients. World J. Surg. Oncol. 2012; 10: 54.
      Grange F, Vitry F, Granel-Brocard F et al. Variations in management of stage I to stage III cutaneous melanoma: a population-based study of clinical practices in France. Arch. Dermatol. 2008; 144: 629-36.
      Sharouni M-AE, Witkamp AJ, Sigurdsson V et al. Trends in sentinel lymph node biopsy enactment for cutaneous melanoma. Ann. Surg. Oncol. 2019; 26: 1494-502.
      Watts C, Smith AL, Robinson S et al. Australian general practitioners’ attitudes and knowledge of sentinel lymph node biopsy in melanoma management. Aust. J. Gen. Pract. 2020; 49: 355-62.
      Sandelowski M. Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Res. Nurs. Health. 2000; 23: 246-55.
      Australian Bureau of Statistics (ABS)Socio-Economic Indexes for Areas (SEIFA): The Index for Relative Socio-Economic Advantage and Disadvantage. Canberra: ABS. 2018.
      McNutt L-A, Wu C, Xue X et al. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am. J. Epidemiol. 2003; 157: 940-3.
      Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual. Res. Sport Exerc. Heal. 2019; 11: 1-9.
      Braun V, Clarke V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006; 3: 77-101.
      Flottorp SA, Oxman AD, Krause J et al. A checklist for identifying determinants of practice: A systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implement. Sci. 2013; 8: 35.
      Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 2007; 19: 349-57.
      von Elm E, Altman DG, Egger M et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int. J. Surg. 2014; 12: 1495-9.
      Morton DL, Thompson JF, Cochran AJ et al. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. New Engl. J. Med. 2014; 370: 599-609.
      Cabana MD, Rand CS, Powe NR et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282: 1458-65.
      Grol R, Wensing M. What drives change? Barriers to and incentives for achieving evidence-based practice. Medical J. Australia 2004; 180(6 Suppl): S57-60.
      Streiner DL, Norman GR. Correction for multiple testing is there a resolution? Chest 2011; 140: 16-8.
      Rothman KJ. No adjustments are needed for multiple comparisons. Epidemiology 1990; 1: 43-6.
      Moran-Ellis J, Alexander VD, Cronin A et al. Triangulation and integration: processes, claims and implications. Qual. Res. 2006; 6: 45-59.
      Willson ML, Vernooij RWM, Gagliardi AR et al. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review. J. Clin. Epidemiol. 2017;86:25-38.
      Mar V, Kelly J, Soyer HP et al. Sentinel node biopsy in 2020: a guide for Australian dermatologists [Internet]. Sydney, Australia: Australasian College of Dermatologists, 2020. Available from: https://www.dermcoll.edu.au/wp-content/uploads/2020/01/ACD-Guide-for-Sentinel-Node-Biopsy-in-2020-Jan-2020.pdf.
      Australian Bureau of Statistics (ABS). The Australian Statistical Geography Standard (ASGS) remoteness structure. ABS. 2018.
    • Grant Information:
      Cancer Institute NSW; 1093017 National Health and Medical Research Council; 1135285 National Health and Medical Research Council; 1147843 National Health and Medical Research Council; 1150989 National Health and Medical Research Council; University of Sydney; Melanoma Institute Australia
    • Contributed Indexing:
      Investigator: J Braithwaite; DE Gyorki; M Henderson; AM Hong; JW Kelly; GV Long; AM Menzies; RL Morton; R Saw; RA Scolyer; AJ Spillane; GJ Mann
      Keywords: clinical practice guidelines; dermatology; diagnosis; management; melanoma; metastasis; sentinel lymph node biopsy; staging
    • الموضوع:
      Date Created: 20201205 Date Completed: 20211203 Latest Revision: 20211214
    • الموضوع:
      20231215
    • الرقم المعرف:
      10.1111/ajd.13518
    • الرقم المعرف:
      33277693