The fourth publication utilizing SCARD (and part of 3 papers by the same research team) was in May 2022 with the Australasian Journal of Dermatology in a paper called “Characteristics, treatment and outcomes of 589 melanoma patients documented by 27 general practitioners on the Skin Cancer Audit Research Database.”
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.
Authors
Jeremy Hay, Jeff Keir, Clara Jimenez Balcells, Nikita Rosendahl, Martelle Coetzer-Botha, Tobias Wilson, Simon Clark, Astrid Baade, Cath Becker, Luke Bookallil, Chris Clifopoulos, Tony Dicker, Martin Paul Denby, Douglas Duthie, Charles Elliott, Paul Fishburn, Mark Foley, Mark Franck, Irene Giam, Patricio Gordillo, Alister Lilleyman, Roger Macauley, James Maher, Ewen McPhee, Michael Reid, Bob Shirlaw, Graeme Siggs, Robert Spark, John Stretch, Keith van Den Heever, Thinus van Rensburg, Chris Watson, Harald Kittler, Cliff Rosendahl
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.
https://pubmed.ncbi.nlm.nih.gov/35437755/
Hay J, Keir J, Jimenez Balcells C, Rosendahl N, Coetzer-Botha M, Wilson T, Clark S, Baade A, Becker C, Bookallil L, Clifopoulos C, Dicker T, Denby MP, Duthie D, Elliott C, Fishburn P, Foley M, Franck M, Giam I, Gordillo P, Lilleyman A, Macauley R, Maher J, McPhee E, Reid M, Shirlaw B, Siggs G, Spark R, Stretch J, van Den Heever K, van Rensburg T, Watson C, Kittler H, Rosendahl C. Characteristics, treatment and outcomes of 589 melanoma patients documented by 27 general practitioners on the Skin Cancer Audit Research Database. Australas J Dermatol. 2022 May;63(2):204-212. doi: 10.1111/ajd.13843. Epub 2022 Apr 19. PMID: 35437755; PMCID: PMC9320831.
