Implementation of melanoma guidelines in the multidisciplinary setting: A qualitative analysis

Area of Science:

• Oncology
• Dermatology
• Surgical Oncology

Background:

• Variation exists in the use of completion lymph node dissection (CLND) and adjuvant systemic therapy (AT) for sentinel lymph node-positive melanoma.
• Multidisciplinary treatment approaches are crucial but present challenges in melanoma care.

Purpose of the Study:

• To explore how clinicians consider multidisciplinary treatment options for melanoma.
• To identify challenges and opportunities in current melanoma care practices.

Main Methods:

• Semi-structured interviews were conducted with 26 surgical oncologists, medical oncologists, and otolaryngologists.
• Thematic analysis was used to analyze interview data on melanoma treatment decision-making.

Main Results:

• Participants emphasized the importance of multidisciplinary care, facilitated by shared clinic time.
• Divergent perspectives on CLND and AT were revealed, alongside challenges in patient surveillance and role delineation.
• Concerns were raised regarding nodal ultrasound fidelity and a "surveillance burden" on patients.

Conclusions:

• Opportunities exist to enhance multidisciplinary melanoma care.
• Broader consensus is needed on translating emerging data into patient care and clarifying surveillance roles.