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Titolo:
The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: Results from a multi-institutional retrospective study
Autore:
Fleischer, AB; Feldman, SR; Barlow, JO; Zheng, BY; Hahn, HB; Chuang, TY; Draft, KS; Golitz, LE; Wu, E; Katz, AS; Maize, JC; Knapp, T; Leshin, B;
Indirizzi:
Wake Forest Univ, Sch Med, Westwood Squibb Ctr Dermatol Res, Winston Salem, NC 27109 USA Wake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Wake Forest Univ, Sch Med, Dept Dermatol, Winston Salem, NC 27109 USA WakeForest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Wake Forest Univ, Sch Med, Dept Pathol, Winston Salem, NC 27109 USA Wake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USAWake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Indiana Univ, Med Ctr, Dept Dermatol, Indianapolis, IN USA Indiana Univ Indianapolis IN USA tr, Dept Dermatol, Indianapolis, IN USA Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA Univ Colorado Denver CO USA 80262 Ctr, Dept Pathol, Denver, CO 80262 USA Med Univ S Carolina, Dept Dermatol, Charleston, SC 29425 USA Med Univ S Carolina Charleston SC USA 29425 tol, Charleston, SC 29425 USA
Titolo Testata:
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
fascicolo: 2, volume: 44, anno: 2001,
pagine: 224 - 230
SICI:
0190-9622(200102)44:2<224:TSOTTP>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
SURGEON EXPERIENCE; RECURRENCE RATES; OPERATOR VOLUME; LEARNING-CURVE; UNITED-STATES; MOHS SURGERY; SKIN-CANCER; MANAGEMENT; EXCISION; OUTCOMES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Fleischer, AB Wake Forest Univ, Sch Med, Westwood Squibb Ctr Dermatol Res,Winston Salem, NC 27109 USA Wake Forest Univ Winston Salem NC USA 27109 m, NC 27109 USA
Citazione:
A.B. Fleischer et al., "The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: Results from a multi-institutional retrospective study", J AM ACAD D, 44(2), 2001, pp. 224-230

Abstract

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Surgical experience and physician specialty may affect the outcome quality of surgical excision of BCC. Methods: We performed a multicenter retrospective study of BCC excisions submitted to the respective Departments of Pathology at 4 major university medical centers. Our outcome measure was presence of histologic evidence of tumor present in surgical margins of excision specimens (incomplete excision). Clinician experience was defined as the number of excisions that a clinician performed during the study interval. The analytic sample pool included 1459 tumors that met all inclusion and exclusion criteria. Analyses included univariate and multivariate techniques involving the entire sample and separate subsample analyses that excluded 2 outlying dermatologists. Results: Tumor was present at the surgical margins in 243 (16.6%) of 1459 specimens. A patient's sex, age, and tumor size were not significantly related to the presence of tumor in the surgical margin. Physician experience did not demonstrate a significant difference either in the entire sample (P <.09) or in the subsample analysis (P >.30). Tumors of the head and neck were more likely to be incompletely excised than truncal tumors in all the analyses (P <.03). Compared with dermatologists, otolaryngologists (P <.02) and plastic surgeons (P <.008) were more likely to incompletely excise tumors; however, subsample analysis for plastic surgeons found only a trend toward significance (P <.10). Dermatologists and general surgeons did not differ in the likelihood of performing an incomplete excision (P >.4). Conclusion: The physician specialty may affect the quality of care in the surgical management of BCC.

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Documento generato il 02/04/20 alle ore 22:14:55