Accuracy in melanoma detection: A 10-year multicenter survey

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• 作者：Giuseppe Argenziano ; MD ; ^{g.argenziano@gmail.com} ; Lorenzo Cerroni ; MD ; Iris Zalaudek ; MD ; Stefania Staibano ; MD ; Rainer Hofmann-Wellenhof ; MD ; Nicola Arpaia ; MD ; Renato Marchiori Bakos ; MD ; PhD ; Brigitte Balme ; MD ; Jadran Bandic ; MD ; Roberto Bandelloni ; MD ; Alexandra M.G. Brunasso ; MD ; Horacio Cabo ; MD ; David A. Calcara ; BS ; Blanca Carlos-Ortega ; MD ; Ana Carolina Carvalho ; MD ; Gabriel Casas ; MD ; Huiting Dong ; MD ; DMSc ; Gerardo Ferrara ; MD ; Raffaele Filotico ; MD ; Guillermo Gó ; mez ; MD ; Allan Halpern ; MD ; Gennaro Ilardi ; MTD ; PhD ; Akira Ishiko ; MD ; PhD ; Gulsen Kandiloglu ; MD ; Hiroshi Kawasaki ; MD ; Ken Kobayashi ; MD ; Hiroshi Koga ; MD ; Ivanka Kovalyshyn ; MD ; David Langford ; MB ; ChB ; Xin Liu ; MD ; Ashfaq A. Marghoob ; MD ; Massimo Mascolo ; MD ; Cesare Massone ; MD ; Laura Mazzoni ; MD ; Scott Menzies ; MBBS ; PhD ; Akane Minagawa ; MD ; Loredana Nugnes ; MD ; Fezal Ozdemir ; MD ; Giovanni Pellacani ; MD ; Stefania Seidenari ; MD ; Katherine Siamas ; MD ; Ignazio Stanganelli ; MD ; William V. Stoecker ; MD ; Masaru Tanaka ; MD ; Luc Thomas ; MD ; Philipp Tschandl ; MD ; Harald Kittler ; MD
• 关键词：clinical diagnosis ; dermatoscopy ; melanoma ; number needed to excise ; skin cancer
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2012
• 期刊代码：200_01909622
• 类别：med
• 出版时间：July, 2012
• 卷：67
• 期：1
• 页码：54-59.e1
• 文件大小：461 K

摘要

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Background

Early excision is the only strategy to reduce melanoma mortality, but unnecessary excision of benign lesions increases morbidity and healthcare costs.

Objective

To assess accuracy in melanoma detection based on number-needed-to-excise (NNE) values over a 10-year period.

Methods

Information was retrieved on all histopathologically confirmed cutaneous melanomas or melanocytic nevi that were excised between 1998 and 2007 at participating clinics. NNE values were calculated by dividing the total number of excised lesions by the number of melanomas. Analyses included changes in NNE over time, differences in NNE between specialized clinical settings (SCS) versus non-specialized clinical settings (NSCS), and patient factors influencing NNE.

Results

The participating clinics contributed a total of 300,215 cases, including 17,172 melanomas and 283,043 melanocytic nevi. The overall NNE values achieved in SCS and NSCS in the 10-year period were 8.7 and 29.4, respectively. The NNE improved over time in SCS (from 12.8 to 6.8), but appeared unchanged in NSCS. Most of the effect on NNE in SCS was due to a greater number of excised melanomas. Higher NNE values were observed in patients younger than 40 years and for lesions located on the trunk.

Limitations

No data concerning the use of dermatoscopy and digital monitoring procedures were collected from the participating centers.

Conclusion

Over the 10-year study period, accuracy in melanoma detection improved only in specialized clinics maybe because of a larger use of new diagnostic techniques such as dermatoscopy.