Oral Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

Does a same day ‘See and Treat’ clinic improve skin cancer excision rates? (1413)

Annelise Neal 1 , Hyok Jun Kwon 1 , Aaron Withers 1
  1. Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Lower Hutt

Purpose: In 2017 our unit introduced ‘See and Treat’ skin cancer clinics providing consultation and surgery on the same day. Prior studies of similar service models have demonstrated decreased waiting times, lower treatment costs and high patient satisfaction. We hypothesise that the shorter waiting time to treatment and greater consultant supervision improves excision rates for cutaneous malignancies.

 

Methods: A retrospective analysis compared patients treated via the traditional consultation and waitlist model in the 11 months prior to June 2017 with ‘See and Treat’ patients from September 2017 for the same duration.  Patient demographics, surgeon experience level, pathology type and anatomic location of lesions were recorded. Excision rates were classified as complete for microscopic margins ≥0.5mm for basal cell carcinomas, ≥5mm for squamous cell carcinoma and any clearance for squamous cell carcinoma in situ or excision biopsies of melanoma.

 

Results: 762 patients with 1189 lesions were treated through traditional waitlist clinics and 870 patients with 1117 lesions through ‘See and Treat’. Patient demographics, pathology and lesion locations were comparable between the groups. Complete excision rates were higher in the ‘See and Treat’ group (79.7% vs 74%, p=0.0175). Risk factors for incomplete or narrow excision were lesions located on the ear, scalp, nose and eyelids.

 

Conclusion: ‘See and Treat’ clinics improve excision rates for skin cancers, in addition to reducing waiting times and increasing patient satisfaction.