Geographic Distance and Time to Definitive Surgery for Primary Cutaneous Melanoma in the Toowoomba Regional Catchment: A Retrospective Audit

Abstract

Background Timely melanoma treatment is essential to minimise disease progression. Current guidelines recommend completion of diagnostic assessment, specialist referral, staging and definitive surgery within six weeks of biopsy. Toowoomba Hospital serves a large, geographically dispersed regional catchment, and travel distance may affect access to specialist melanoma care. This study examined the association between residential distance from Toowoomba and time from melanoma biopsy to definitive surgery. Methods A retrospective audit included patients who underwent wide local excision with sentinel lymph node biopsy for primary cutaneous melanoma at Toowoomba Hospital between 2021 and 2025. Time to surgery and the proportion treated within 42 days were compared across residential distance groups. Simple linear regression assessed the association between continuous distance and surgical interval. Results Among 69 patients, the median time from biopsy to definitive surgery was 50 days (IQR 38-60), and 22 patients (31.9%) underwent surgery within 42 days. Residential distance showed a weak, non-significant association with time to surgery (β = 0.029 days/km, 95% CI −0.008 to 0.066, p = 0.118, R² = 0.036). Time to surgery did not differ significantly between distance groups (Kruskal-Wallis p = 0.25), nor did the proportion undergoing surgery within 42 days (χ²(2) = 1.24, p = 0.54). Conclusions No significant association was found between residential distance and time to definitive melanoma surgery within the Toowoomba regional catchment. However, most patients underwent surgery beyond 42 days, supporting further evaluation of referral pathways, service coordination and other determinants of treatment timing.