少数民族医院（MSHs）与各种癌症的指南依从性较低和不良结局有关。然而，关于MSH地位、遵循哨兵淋巴结活检（SLNB）指南和对具有皮肤黑素瘤患者的总体生存的关系研究不足。查询了全国癌症数据库，对2012年至2017年间诊断为T1a*、T2和T3黑色素瘤的患者进行了数据分析。MSHs被定义为以少数民族治疗的比例排名前10%的机构。根据全国综合癌症网络指南，如果厚度小于0.76毫米，没有溃疡、有核分裂≥1/mm²或淋巴血管侵犯（T1a*），则定义指南符合性护理（GCC）不需要进行SLNB，对于介于1.0和4.0毫米之间的中等厚度黑色素瘤（T2/T3）患者则需进行SLNB。多变量逻辑回归分析了与GCC的关联。Kaplan-Meier方法和log-rank检验用于评估在MSH和非MSH设施之间的总体生存率。总体而言，全队中有5.9%（N = 2182/36,934）的患者，在少数民族中有37.8%（n = 199/527）在MSH治疗。总体而言，GCC率为89.5%（n = 33,065/36,934），在少数民族亚组中为85.4%（n = 450/527）。与非MSHs相比，总体人群（OR0.85；P = 0.02）和少数民族亚组（OR0.55；P = 0.02）在MSHs接受护理时较不易获得GCC。少数民族在MSH接受治疗的患者与在非MSH接受治疗的患者相比，生存率降低（P = 0.002）。MSH对黑色素瘤的SLNB指南的遵循不足。需要持续关注美国少数民族黑色素瘤护理的平等化。©2023外科肿瘤学会。

Minority-serving hospitals (MSHs) have been associated with lower guideline adherence and worse outcomes for various cancers. However, the relationship among MSH status, concordance with sentinel lymph node biopsy (SLNB) guidelines, and overall survival (OS) for patients with cutaneous melanoma is not well studied.The National Cancer Database was queried for patients diagnosed with T1a*, T2, and T3 melanoma between 2012 and 2017. MSHs were defined as the top decile of institutions ranked by the proportion of minorities treated for melanoma. Based on National Comprehensive Cancer Network guidelines, guideline-concordant care (GCC) was defined as not undergoing SLNB if thickness was < 0.76 mm without ulceration, mitosis ≥ 1/mm2, or lymphovascular invasion (T1a*), and performing SLNB for patients with intermediate thickness melanomas between 1.0 and 4.0 mm (T2/T3). Multivariable logistic regressions examined associations with GCC. The Kaplan-Meier method and log-rank tests were used to evaluate OS between MSH and non-MSH facilities.Overall, 5.9% (N = 2182/36,934) of the overall cohort and 37.8% of minorities (n = 199/527) were managed at MSHs. GCC rates were 89.5% (n = 33,065/36,934) in the overall cohort and 85.4% (n = 450/527) in the minority subgroup. Patients in the overall cohort (odds ratio [OR] 0.85; p = 0.02) and the minority subgroup (OR 0.55; p = 0.02) were less likely to obtain GCC if they received their care at MSHs compared with non-MSHs. Minority patients receiving care at MSHs had a decreased survival compared with those treated at non-MSHs (p = 0.002).Adherence to SLNB guidelines for melanoma was lower at MSHs. Continued focus is needed on equity in melanoma care for minority patients in the United States.© 2023. Society of Surgical Oncology.