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

Autor:	Smith AL; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia., Watts CG; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.; Surveillance, Epidemiology and Prevention Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia., Robinson S; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia., Schmid H; Centre for Cancer Research, Westmead Institute for Medical Research, Sydney, NSW, Australia., Goumas C; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia., Mar VJ; Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia., Thompson JF; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.; The Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.; Royal Prince Alfred Hospital, Sydney, NSW, Australia.; Mater Hospital, Sydney, NSW, Australia., Rapport F; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia., Cust AE; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Jazyk:	angličtina
Zdroj:	The Australasian journal of dermatology [Australas J Dermatol] 2021 May; Vol. 62 (2), pp. 168-176. Date of Electronic Publication: 2020 Dec 05.
DOI:	10.1111/ajd.13518
Abstrakt:	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.)
Databáze:	MEDLINE
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