Staging Studies for Cutaneous Melanoma in the United States: A Population-Based Analysis

Nabil Wasif, David Etzioni, Dana Haddad, Richard J. Gray, Sanjay P. Bagaria, Barbara A Pockaj

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Routine cross-sectional imaging for staging of early-stage cutaneous melanoma is not recommended. This study sought to investigate the use of imaging for staging of cutaneous melanoma in the United States.

Methods: Patients with nonmetastatic cutaneous melanoma newly diagnosed between 2000 and 2007 were identified from the Surveillance Epidemiology End Results-Medicare registry. Any imaging study performed within 90 days after diagnosis was considered a staging study.

Results: The study identified 25,643 patients, 3,116 (12.2 %) of whom underwent cross-sectional imaging: positron emission tomography (PET) (7.2 %), computed tomography (CT) (5.9 %), and magnetic resonance imaging (MRI) (0.6 %). From 2000 to 2007, the use of cross-sectional imaging increased from 8.7 to 16.1 % (p < 0.001), driven predominantly by increased usage of PET (4.2–12.1 %). Stratification by T and N classification showed that cross-sectional imaging was used for 8.6 % of T1, 14.3 % of T2, 18.6 % of T3, and 26.7 % of T4 tumors (p < 0.001) and for 33.3 % of node-positive patients versus 11.1 % of node-negative patients (p < 0.001). Factors predictive of cross-sectional imaging included T classification [odds ratio (OR) for T4 vs T1, 2.66; 95 % confidence interval (CI) 2.33–3.03], node positivity (OR 2.70; 95 % CI 2.36–3.10), more recent year of diagnosis (OR 2.05 for 2007 vs 2000; 95 % CI 1.74–2.42), atypical histology, and non-Caucasian race (OR 1.32; 95 % CI 1.02–1.73).

Conclusions: The use of cross-sectional imaging for staging of early-stage cutaneous melanoma is increasing in the Medicare population. Better dissemination of guidelines and judicious use of imaging should be encouraged.

Original languageEnglish (US)
Pages (from-to)1366-1370
Number of pages5
JournalAnnals of Surgical Oncology
Volume22
Issue number4
DOIs
StatePublished - 2015

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Melanoma
Odds Ratio
Confidence Intervals
Skin
Medicare
Population
Positron-Emission Tomography
Registries
Histology
Epidemiology
Magnetic Resonance Imaging
Guidelines
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Staging Studies for Cutaneous Melanoma in the United States : A Population-Based Analysis. / Wasif, Nabil; Etzioni, David; Haddad, Dana; Gray, Richard J.; Bagaria, Sanjay P.; Pockaj, Barbara A.

In: Annals of Surgical Oncology, Vol. 22, No. 4, 2015, p. 1366-1370.

Research output: Contribution to journalArticle

Wasif, Nabil ; Etzioni, David ; Haddad, Dana ; Gray, Richard J. ; Bagaria, Sanjay P. ; Pockaj, Barbara A. / Staging Studies for Cutaneous Melanoma in the United States : A Population-Based Analysis. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 4. pp. 1366-1370.
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title = "Staging Studies for Cutaneous Melanoma in the United States: A Population-Based Analysis",
abstract = "Background: Routine cross-sectional imaging for staging of early-stage cutaneous melanoma is not recommended. This study sought to investigate the use of imaging for staging of cutaneous melanoma in the United States.Methods: Patients with nonmetastatic cutaneous melanoma newly diagnosed between 2000 and 2007 were identified from the Surveillance Epidemiology End Results-Medicare registry. Any imaging study performed within 90 days after diagnosis was considered a staging study.Results: The study identified 25,643 patients, 3,116 (12.2 {\%}) of whom underwent cross-sectional imaging: positron emission tomography (PET) (7.2 {\%}), computed tomography (CT) (5.9 {\%}), and magnetic resonance imaging (MRI) (0.6 {\%}). From 2000 to 2007, the use of cross-sectional imaging increased from 8.7 to 16.1 {\%} (p < 0.001), driven predominantly by increased usage of PET (4.2–12.1 {\%}). Stratification by T and N classification showed that cross-sectional imaging was used for 8.6 {\%} of T1, 14.3 {\%} of T2, 18.6 {\%} of T3, and 26.7 {\%} of T4 tumors (p < 0.001) and for 33.3 {\%} of node-positive patients versus 11.1 {\%} of node-negative patients (p < 0.001). Factors predictive of cross-sectional imaging included T classification [odds ratio (OR) for T4 vs T1, 2.66; 95 {\%} confidence interval (CI) 2.33–3.03], node positivity (OR 2.70; 95 {\%} CI 2.36–3.10), more recent year of diagnosis (OR 2.05 for 2007 vs 2000; 95 {\%} CI 1.74–2.42), atypical histology, and non-Caucasian race (OR 1.32; 95 {\%} CI 1.02–1.73).Conclusions: The use of cross-sectional imaging for staging of early-stage cutaneous melanoma is increasing in the Medicare population. Better dissemination of guidelines and judicious use of imaging should be encouraged.",
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T1 - Staging Studies for Cutaneous Melanoma in the United States

T2 - A Population-Based Analysis

AU - Wasif, Nabil

AU - Etzioni, David

AU - Haddad, Dana

AU - Gray, Richard J.

AU - Bagaria, Sanjay P.

AU - Pockaj, Barbara A

PY - 2015

Y1 - 2015

N2 - Background: Routine cross-sectional imaging for staging of early-stage cutaneous melanoma is not recommended. This study sought to investigate the use of imaging for staging of cutaneous melanoma in the United States.Methods: Patients with nonmetastatic cutaneous melanoma newly diagnosed between 2000 and 2007 were identified from the Surveillance Epidemiology End Results-Medicare registry. Any imaging study performed within 90 days after diagnosis was considered a staging study.Results: The study identified 25,643 patients, 3,116 (12.2 %) of whom underwent cross-sectional imaging: positron emission tomography (PET) (7.2 %), computed tomography (CT) (5.9 %), and magnetic resonance imaging (MRI) (0.6 %). From 2000 to 2007, the use of cross-sectional imaging increased from 8.7 to 16.1 % (p < 0.001), driven predominantly by increased usage of PET (4.2–12.1 %). Stratification by T and N classification showed that cross-sectional imaging was used for 8.6 % of T1, 14.3 % of T2, 18.6 % of T3, and 26.7 % of T4 tumors (p < 0.001) and for 33.3 % of node-positive patients versus 11.1 % of node-negative patients (p < 0.001). Factors predictive of cross-sectional imaging included T classification [odds ratio (OR) for T4 vs T1, 2.66; 95 % confidence interval (CI) 2.33–3.03], node positivity (OR 2.70; 95 % CI 2.36–3.10), more recent year of diagnosis (OR 2.05 for 2007 vs 2000; 95 % CI 1.74–2.42), atypical histology, and non-Caucasian race (OR 1.32; 95 % CI 1.02–1.73).Conclusions: The use of cross-sectional imaging for staging of early-stage cutaneous melanoma is increasing in the Medicare population. Better dissemination of guidelines and judicious use of imaging should be encouraged.

AB - Background: Routine cross-sectional imaging for staging of early-stage cutaneous melanoma is not recommended. This study sought to investigate the use of imaging for staging of cutaneous melanoma in the United States.Methods: Patients with nonmetastatic cutaneous melanoma newly diagnosed between 2000 and 2007 were identified from the Surveillance Epidemiology End Results-Medicare registry. Any imaging study performed within 90 days after diagnosis was considered a staging study.Results: The study identified 25,643 patients, 3,116 (12.2 %) of whom underwent cross-sectional imaging: positron emission tomography (PET) (7.2 %), computed tomography (CT) (5.9 %), and magnetic resonance imaging (MRI) (0.6 %). From 2000 to 2007, the use of cross-sectional imaging increased from 8.7 to 16.1 % (p < 0.001), driven predominantly by increased usage of PET (4.2–12.1 %). Stratification by T and N classification showed that cross-sectional imaging was used for 8.6 % of T1, 14.3 % of T2, 18.6 % of T3, and 26.7 % of T4 tumors (p < 0.001) and for 33.3 % of node-positive patients versus 11.1 % of node-negative patients (p < 0.001). Factors predictive of cross-sectional imaging included T classification [odds ratio (OR) for T4 vs T1, 2.66; 95 % confidence interval (CI) 2.33–3.03], node positivity (OR 2.70; 95 % CI 2.36–3.10), more recent year of diagnosis (OR 2.05 for 2007 vs 2000; 95 % CI 1.74–2.42), atypical histology, and non-Caucasian race (OR 1.32; 95 % CI 1.02–1.73).Conclusions: The use of cross-sectional imaging for staging of early-stage cutaneous melanoma is increasing in the Medicare population. Better dissemination of guidelines and judicious use of imaging should be encouraged.

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