{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:07Z","timestamp":1786978267736,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T00:00:00Z","timestamp":1512950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Internal Academic Enrichment Grant from Sunnybrook Health Sciences Centre, Department of General Surgery, Toronto, Ontario"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Variability in melanoma management has prompted concerns about equitable and timely treatment. We investigated patterns of melanoma diagnosis and treatment using population\u2010level data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with invasive cutaneous melanoma were identified retrospectively from the Ontario Cancer Registry (2003\u20102012) and deterministically linked with administrative databases to identify incidence, disease characteristics, geographic origin, and multimodal treatment within a year of diagnosis. Melanoma treatment was categorized as inadequate or adequate based on multidisciplinary clinical algorithms. Multivariable logistic regression was used to model factors associated with treatment adequacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2003 to 2012, 22\u2009918 patients with invasive melanoma were identified with annual age\/sex standardized incidence rates of 11.7\u201014.3\/100\u2009000 for females and 13.4\u201015.9\/100\u2009000 for males. Melanoma occurred at median age of 62 and primarily on extremities (43.9%). Within 1 year after diagnosis, 86.7% of patients received surgery as primary therapy. A total of 2312 (10.6%) patients received inadequate or no treatment after diagnosis. Receiving adequate treatment was associated with consultation with dermatology (OR 1.92, CI 1.71\u20102.14), plastic surgery (OR 4.80, CI 4.32\u20105.34), or general surgery (OR 2.15, CI 1.94\u20102.38).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant variation exists in melanoma management and nearly one in nine patients is inadequately treated. Referral to sub\u2010specialized providers is critical for ensuring appropriate care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.24936","type":"journal-article","created":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T12:44:50Z","timestamp":1512996290000},"page":"597-617","source":"Crossref","is-referenced-by-count":10,"title":["Melanoma patterns of care in Ontario: A call for a strategic alignment of multidisciplinary care"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2106-341X","authenticated-orcid":false,"given":"Nicole J.","family":"Look Hong","sequence":"first","affiliation":[{"name":"Department of General Surgery Sunnybrook Health Sciences Centre Toronto Ontorio Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Y.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Ontorio Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy N.","family":"Baxter","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Ontorio Canada"},{"name":"St. Michael's Hospital Department of Surgery and Keenan Research Centre Toronto Ontorio Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances C.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of General Surgery Sunnybrook Health Sciences Centre Toronto Ontorio Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Canadian Cancer Society (2016). Canadian Cancer Statistics 2016. Provincial\/Territorial Cancer Registries. Public Health Agency of Canada. 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