Background: Sentinel lymph node biopsy (SLNB) is not routinely recommended for thin melanoma. However, it is considered when high-risk features, clinicopathological, or sociodemographic, are present. It was our objective to evaluate the impact of travel distance on decision-making for SLNB in thin melanoma.
Methods: We used the National Cancer DataBase (1998-2011) to identified patients with thin melanoma (≤1 mm thickness). The primary exposure was distance traveled for care, categorized as short (<12.5 miles), intermediate (12.5-49.9 miles), or long (≥50 miles). The primary outcome was receipt of SLNB.
Results: We identified 21 124 cases of thin melanoma; 48.8%, 38.2%, and 13.0% traveled short, intermediate, and long distances, respectively. Overall, SLNB was performed in 32.8% of patients. Traveling farther was associated with a step-wise increase in the likelihood of undergoing a SLNB (P-trend < 0.001). Even after adjusting for patient, disease, and facility factors, we found that patients who traveled an intermediate distance were 18% more likely to undergo a SLNB (OR:1.18; 95%CI: 1.10,1.27), and those who traveled a long distance were 24% more likely (OR:1.24; 95%CI: 1.11,1.39) compared with those who traveled a short distance.
Conclusions: The distance patients travel for surgical care appears to be an independent factor influencing the receipt of SLNB.
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