Surgical quality metrics for lymph node staging of intermediate thickness melanoma: A population based study

Abstract

Background. Variability in compliance with guidelines for lymph node (LN) surgery for melanoma patients has been attributed to controversy about patient selection and quality metrics. Prior data indicate suboptimal practice of sentinel LN biopsy (SLNB) and a trend for omission of LN dissection (LND) for LN+ disease that began well before publication of the MSLT-II trial data. To minimize bias, we studied compliance with ASCO/SSO guidelines in patients for whom there is general agreement, namely T2-T3 (intermediate thickness) melanoma, and analyzed contributing factors and outcomes.