Evidence map›Paper›PMID 39576454›Full record

ArticleAnnals of surgical oncology2025

Impact of Social Determinants of Health on Melanoma Nodal Surveillance in a Multi-institutional Cohort.

Kelsey B Montgomery, M Chandler McLeod, Danielle K DePalo, Michelle M Dugan, Jonathan S Zager, Kelly M Elleson, Michael S Sabel, Tina J Hieken, Lisa A Kottschade, David W Ollila and 11 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Kelsey B MontgomeryDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. kmontgomery@uabmc.edu.ORCID http://orcid.org/0000-0002-1284-1830
M Chandler McLeodDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Danielle K DePaloDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Michelle M DuganDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Jonathan S ZagerDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Kelly M EllesonDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Michael S SabelDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Tina J HiekenDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Lisa A KottschadeDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
David W OllilaDepartment of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Veronica PhamDepartment of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Dion ArcherDepartment of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Russell S BermanDepartment of Surgery, NYU Langone Health, New York, NY, USA.
Ann Y LeeDepartment of Surgery, NYU Langone Health, New York, NY, USA.
Jessica A Cintolo-GonzalezDepartment of Surgery, University of Vermont, Burlington, VT, USA.
Hannah G McDonaldDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Sydney WinchesterDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Erin E BurkeDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Kristen E RhodinDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Georgia M BeasleyDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Kristy K BromanDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

UAB Health Services Research (HSR) Training ProgramT32HS013852 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEVITAN, EMILY B, MUGAVERO, MICHAEL J · 2003 to 2024
$8.0M
DEEP SOUTH TRANSLATIONAL RESEARCH MENTORED CAREER DEVELOPMENT PROGRAMKL2TR003097 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2019 to 2023
$5.2M
Oncology Research Training for Surgeon-ScientistsT32CA160003 · NCI · UNIVERSITY OF KENTUCKY · PI Bernard Mark Evers, Pamela Carmen Hull · 2011 to 2026
$3.2M
Leveraging Health Systems to Increase Implementation of Evidence-Based Surgical Cancer CareK08CA283001 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BROMAN, KRISTY KUMMEROW · 2023 to 2025
$592k
AHRQ HHS T32 HS013852NCATS NIH HHS KL2 TR003097NCI NIH HHS 1K08 CA283001NCI NIH HHS K08 CA283001NCI NIH HHS T32 CA160003NCI NIH HHS T32 CA60003
6 · The paper itself

Abstract

backgroundNodal surveillance (NS) has overtaken completion lymphadenectomy as the preferred management for sentinel node-positive (SLN+) melanoma, but requires frequent exams and nodal ultrasound (US). Social determinants of health (SDoH) may affect US adherence in real-world populations, and evaluation of these potential impacts is needed.

methodsAdults with SLN+ melanoma diagnosed from July 2017 to December 2019 who received NS at nine cancer centers were identified retrospectively. Exposures included insurance status, travel distance, and Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), a validated measure of area-level SDoH, indicated as 0 (low) to 1 (high) vulnerability. The primary outcome was US adherence (≥ 1 study per 6-month follow-up interval). The secondary outcomes were combined-modality adherence [US, computed tomography (CT), or positron emission tomography (PET)] and loss to follow-up (LTFU). Bivariate analyses and mixed-effects multivariable logistic regression were performed.

resultsMost of the 519 patients were male (57%), non-Hispanic white (94.4%), and insured privately (45.3%) or by Medicare (43.5%). The median travel distance was 63.3 miles (interquartile range [IQR], 31.2-111.0 miles), and the median SVI was 0.426 (IQR, 0.253-0.610). The surveillance adherence rates were 41.6% for US and 75.1% for combined modalities. No significant differences in US adherence were observed based on sociodemographic covariates in regression analysis. Medicaid (odds ratio [OR], 3.12; p = 0.02) and uninsured (OR 4.48; p = 0.01) patients had increased likelihood of LTFU.

conclusionsLess than half of the patients in this multicenter cohort achieved US adherence, although the rates improved with combined modalities. Medicaid or non-insurance were social risk factors for LTFU. Optimizing surveillance practices for socially vulnerable groups will be crucial for the ongoing real-world implementation of NS.

Indexed as

MelanomaSentinel Lymph NodeSkin NeoplasmsSocial Determinants of HealthAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSentinel Lymph Node BiopsyUnited StatesMelanomaNodal surveillanceSentinel node positiveSocial determinants of health

Identifiers

PMID39576454
PMCPMC11811232

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.