| Abstract: |
Background: Melanoma tumor thickness remains the most important determinant of patient survival. Several large population-based studies have shown that full-body skin examinations (FBSE) improve melanoma mortality and others that FBSEs may detect melanomas at a thinner, more curable stage. Purpose: To relate the detection method to lesion thickness at the time of diagnosis. Methods: A retrospective chart review of all cases of biopsy-proven primary cutaneous melanomas diagnosed from 2000 to 2012 at the Veterans Affairs Hospital in Brooklyn NY was conducted. Data were collected in 2012-2013 and analyzed in 2013. Main outcome measures include lesion thickness stratified by method of detection and probabilities of detecting thin lesions per method (using cutoffs of in situ and 0.75 mm). Secondary outcomes include interaction between method and body site or lesion diameter. Results: Sixty-three percent of melanomas were detected by FBSE and 59% of all melanomas were in situ. There was no statistically significant difference in thickness among the detection groups when a cut-off of in situ (Fisher's exact test, p=0.6148) or 0.75 mm was used (p=0.8910). A majority of lesions on the back were found by FBSE (68%). Conclusions: FBSE was not shown to detect melanomas at a thinner stage. Prospective studies are needed to analyze the utility and efficacy of FBSEs in clinical practice. |
