Introduction
The Victorian Melanoma Service (VMS) is a dermatologist driven, fully multi-disciplinary consultative clinic for the management of melanoma. Established in 1994, the service provides comprehensive assessment and management of patients diagnosed with primary cutaneous or metastatic melanoma by various health care professionals involved in the treatment of melanoma.
Methods
Retrospective review of the clinic database of all patients who attended the VMS from 1st October 1994 to 30th September 2013 was performed.
Results
A total of 6,721 new patients attended the VMS during the review period. The number of new patients seen each year has steadily increased from less than 200 to over 500 patients per year. Approximately 73% of patients seen live in metropolitan Victoria and 27% of patients were from regional Victoria. Overall, 20% of all melanomas seen were in situ melanomas and 70% were invasive melanomas. The median invasive melanoma Breslow thickness has increased from 0.85mm to 1.2mm. Pathology reviews performed by VMS histopathologists resulted in a change to diagnosis in approximately 20% of cases. Full skin examination revealed a second primary melanoma in 12% of patients and non-melanoma skin cancers in 30%. The dermatological drive places more emphasis on the care of primary melanoma and uses the guidance of dermatologists to ensure that other disciplines have the best opportunity to contribute.
Conclusion
The review conducted demonstrated the current trends in melanoma within a state-wide multi-disciplinary referral service. The results reflect a stronger role for dermatologists leading to emphasis on histological review and the detection of synchronous skin cancer.