UNASSIGNED: 110 Background: Assessment of compliance with national quality guidelines for the management of @entity320 may be complicated by controversy about selection of @entity1 for nodal surgery and limited by a lack of data on quality metrics. Previous reports suggest suboptimal overall compliance, with sentinel @entity1600 biopsy (SLNB) not performed for many suitable @entity1 and @entity1600 ( @entity1600 ) omitted in many biopsy-proven node-positive ( @entity1600 +) cases. The purpose of this study was to assess compliance with national ASCO/SSO guidelines for @entity1600 ( @entity1600 ) surgery for T2 and T3 (intermediate thickness, 1.01-4.00 mm) primary @entity320 @entity1 and elucidate factors associated with non-compliance. METHODS: All cases of T2 and T3, M0 @entity320 were identified from 2004-2010 SEER data. Multivariable logistic regression was utilized to identify independent predictors of compliance. Five-year cancer specific survival (CSS) was estimated using the Kaplan-Meier method. RESULTS: Overall, 75.3% (6,609/8,782) of T2-T3 primary @entity320 @entity1 underwent @entity1600 staging including SLNB in 6,330 (74.5%) of 8,492 clinically @entity1600 negative @entity1 . Among these 6,609 @entity1 , 1,279 (19.4%) had one or more @entity1600 +. 940 @entity1600 + @entity1 (73.4%) underwent @entity1600 with removal of a mean (median, IQR) of 20.7 (18, 11-27) LNs. Compliance with @entity1600 staging and management guidelines was associated with truncal primary site (for SLNB), p<0.001 and with @entity1 age <65 yrs and increasing number of metastatic LNs (for @entity1600 ), both p<0.0001. Compliance with @entity1600 for @entity1600 + @entity1 was associated with improved 5 year CSS: 70.0% vs 64.6%, p<0.001. CONCLUSIONS: Compliance with guidelines for @entity1600 surgery in T2 and T3 @entity320 is poor despite the well-defined benefit for this group of @entity1 . These data suggest that non-compliance is multifactorial and not simply due to practice differences arising from the controversial aspects of @entity320 management. Room for improvement exists. Assessment of modifiable factors associated with poor compliance, design of strategies to improve compliance and the development of performance measures around appropriate @entity1600 staging and management of T2 and T3 @entity320 deserve further investigation.

Adherence to national quality guidelines for nodal staging and treatment of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['LN', 'CLND', 'completion lymph node dissection', 'lymph node'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'cutaneous melanoma']
@entity320 :: (MESH:D008545,Disease) :: ['cutaneous melanoma']
