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Gong X, Zhang Y, Yuan M, Wang Y, Xia C, Wang Y, Liu X, Ling T. Prognostic nomogram for external ear melanoma patients in the elderly: a SEER-based study. J Cancer Res Clin Oncol 2023; 149:12241-12248. [PMID: 37434093 DOI: 10.1007/s00432-023-05098-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
AIM The aim of this study was to construct and validate a nomogram to predict the 1-, 3- and 5-year overall survival (OS) in external ear melanoma (EEM) patients in the elderly based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS The information of patients diagnosed with EEM in the elderly between 2010 and 2014 was downloaded from the SEER database. Univariable and multivariable Cox analyses were carried out to identify the independent characteristics, and the independent factors were further included to construct a nomogram. The discriminative ability and calibration of the nomogram to predict OS were tested using C-index value, and calibration plots. Based on the risk score of the nomogram, the patients were divided into high- and low-risk subgroup. Finally, the survival differences of different subgroups were explored by Kaplan-Meier curves. All statistical analyses were performed by R 4.2.0. RESULTS A total of 710 elderly EMM patients were included and randomly divided into training cohort and validation cohort. Univariable Cox regression were used to identify age, race, sex, American Joint Committee on Cancer (AJCC), T, surgery, radiation, chemotherapy, and tumor size as independent risk factors. Then, multivariable Cox model to determine significant risk factors was used to establish the selected factors. A nomogram for predicting the 1-, 3- and 5-year OS was constructed using the independent variables including age, AJCC, T, surgery and chemotherapy. The C-index values were 0.78 (95% CI 0.75-0.81) in training set and 0.72 (95% CI 0.66-0.78) in validation set. The calibration curves were closer to ideal curves indicated the accurate predictive ability of this nomogram. The elderly patients with EEM in the low-risk group showed a longer OS than patients in the high-risk group in both training and validation cohorts. CONCLUSIONS Our study established and validated a novel model to predict 1-, 3- and 5-year OS for EEM. The individualized nomogram has a good prognostic ability and can be used as a new survival prediction tool for the elderly patients with EMM.
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Affiliation(s)
- Xue Gong
- Department of Plastic Surgery and Burn, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yang Zhang
- College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, China
| | - Meng Yuan
- The Second Clinical College, Chongqing Medical University, Chongqing, 400016, China
| | - Ying Wang
- The First Clinical College, Chongqing Medical University, Chongqing, 400016, China
| | - Chunna Xia
- The First Clinical College, Chongqing Medical University, Chongqing, 400016, China
| | - Yanqing Wang
- The First Clinical College, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaozhu Liu
- Department of Pharmacy, Suqian First Hospital, Suqian, 223800, China.
| | - Tao Ling
- Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
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Matrakool P, Chaisrisawadisuk S, Vongviriyangkoon T. Prognostic Factors and Outcomes of Cutaneous Malignant Melanoma: A 174-Patient Cohort Study in a Tertiary Hospital in Thailand. Ann Plast Surg 2023; 90:621-625. [PMID: 36880780 DOI: 10.1097/sap.0000000000003481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND Malignant melanoma is a common skin cancer among Asians. However, some features, such as tumor type and initial stages, are not comparable with those found in Western countries. We audited a large cohort of patients at a single tertiary referral hospital in Thailand to identify factors affecting the prognosis. METHODS A retrospective study was conducted of patients diagnosed with cutaneous malignant melanoma between 2005 and 2019. Details of demographic data, clinical characteristics, pathological reports, treatments, and outcomes were collected. Statistical analyses of overall survival and factors affecting survival were investigated. RESULTS The study enrolled 174 patients (79 men and 95 women) with pathologically confirmed cutaneous malignant melanoma. Their mean age was 63 years. The most common clinical presentation was a pigmented lesion (40.8%), with the plantar area being the most common site (25.9%). The mean duration of onset and hospitalization was 17.5 months. The 3 most common types of melanoma were acral lentiginous (50.7%), nodular (28.9%), and superficial spreading (9.9%). Eighty-eight cases (50.6%) had concomitant ulceration. Pathological stage III was the most common (42.1%). The 5-year overall survival was 43%, and the median survival time was 3.91 years. Multivariate analysis showed that clinically palpable lymph nodes, distant metastasis, a Breslow thickness ≥ 2 mm, and evidence of lymphovascular invasion were poor prognostic factors for overall survival. CONCLUSIONS In our study, most patients with cutaneous melanoma presented with a higher pathological stage. Independent factors affecting survival are palpable lymph nodes, distant metastases, Breslow thickness, and the presence of lymphovascular invasion. The overall 5-year survival rate was 43%.
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Affiliation(s)
- Piyawat Matrakool
- From the Division of Plastic surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Bajpai J, Abraham G, Saklani AP, Agarwal A, Das S, Chatterjee A, Kapoor A, Eaga P, Mondal PK, Chandrasekharan A, Bhargava PG, Srinivas S, Turkar S, Rekhi B, Khanna N, Janu AK, Bal M, Ostwal VS, Ramaswamy A, Rohila J, Desouza AL, Guha A, Kumar R, Menon NS, Rath S, Patil VM, Noronha VM, Joshi AP, Laskar S, Rangarajan V, Prabhash K, Gupta S, Banavali S. Demographics, Pattern of Care, and Outcome Analysis of Malignant Melanomas - Experience From a Tertiary Cancer Centre in India. Front Oncol 2021; 11:710585. [PMID: 34568037 PMCID: PMC8456006 DOI: 10.3389/fonc.2021.710585] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/30/2021] [Indexed: 12/19/2022] Open
Abstract
Background Treatment of malignant melanoma has undergone a paradigm shift with the advent of immune checkpoint inhibitors (ICI) and targeted therapies. However, access to ICI is limited in low-middle income countries (LMICs). Patients and Methods Histologically confirmed malignant melanoma cases registered from 2013 to 2019 were analysed for pattern of care, safety, and efficacy of systemic therapies (ST). Results There were 659 patients with a median age of 53 (range 44–63) years; 58.9% were males; 55.2% were mucosal melanomas. Most common primary sites were extremities (36.6%) and anorectum (31.4%). Nearly 10.8% of the metastatic cohort were BRAF mutated. Among 368 non-metastatic patients (172 prior treated, 185 de novo, and 11 unresectable), with a median follow-up of 26 months (0–83 months), median EFS and OS were 29.5 (95% CI: 22–40) and 33.3 (95% CI: 29.5–41.2) months, respectively. In the metastatic cohort, with a median follow up of 24 (0–85) months, the median EFS for BSC was 3.1 (95% CI 1.9–4.8) months versus 3.98 (95% CI 3.2–4.7) months with any ST (HR: 0.69, 95% CI: 0.52–0.92; P = 0.011). The median OS was 3.9 (95% CI 3.3–6.4) months for BSC alone versus 12.0 (95% CI 10.5–15.1) months in any ST (HR: 0.38, 95% CI: 0.28–0.50; P < 0.001). The disease control rate was 51.55%. Commonest grade 3–4 toxicity was anemia with chemotherapy (9.5%) and ICI (8.8%). In multivariate analysis, any ST received had a better prognostic impact in the metastatic cohort. Conclusions Large real-world data reflects the treatment patterns adopted in LMIC for melanomas and poor access to expensive, standard of care therapies. Other systemic therapies provide meaningful clinical benefit and are worth exploring especially when the standard therapies are challenging to administer.
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Affiliation(s)
- Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - George Abraham
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Avanish P Saklani
- Department of Surgical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Anshul Agarwal
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Sashanka Das
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Ambarish Chatterjee
- Department of Surgical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Akhil Kapoor
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Prathyusha Eaga
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Pradip Kumar Mondal
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Arun Chandrasekharan
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | | | - Sujay Srinivas
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Siddharth Turkar
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Bharat Rekhi
- Department of Surgical Pathology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Nehal Khanna
- Department of Radiation Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Amit Kumar Janu
- Department of Radiodiagnosis, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Munita Bal
- Department of Surgical Pathology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Vikas Sureshchand Ostwal
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Anant Ramaswamy
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Jitender Rohila
- Department of Surgical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Ashwin L Desouza
- Department of Surgical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Amrita Guha
- Department of Radiodiagnosis, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Rajiv Kumar
- Department of Surgical Pathology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Nandini Sharrel Menon
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Sushmita Rath
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Vijay Maruti Patil
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Vanita Maria Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Amit Prakashchandra Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Siddhartha Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
| | - Shripad Banavali
- Department of Medical Oncology, Tata Memorial Hospital, Homibhabha National Institute, Mumbai, India
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Tas F, Erturk K. Trends in the characteristics of skin melanoma in accordance with time intervals: A single Turkish tertiary referral center experience. J Cancer Res Ther 2021; 17:1119-1122. [PMID: 34528575 DOI: 10.4103/jcrt.jcrt_555_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM The incidence of skin melanoma has increased dramatically in recent years. The aim of this study was to analyze the trends in the features of Turkish cutaneous melanoma patients in a 25-year period. MATERIALS AND METHODS A total of 1258 adult melanoma patients who had been managed and followed up at a tertiary referral center between 1993 and 2017 were included in the study. RESULTS Males were predominant which did not vary between time intervals. There was an increase in the percentage of older patients over the years, whereas no change was observed in the percentage of younger patients. As the percentage of lower extremity melanoma dropped, the percentage of truncal melanomas rose. Both the incidences of thick (T3-T4) and thin melanomas (T1) were found to increase over time by 13.4% and 3.8%, respectively. There was no significant change in the percentage of the metastatic disease; however, Stage III disease was found to multiply by 10.1% and local disease was found to fall by 8.5% over the period. The percentages of patients with nodular histopathology and tumor-infiltrating lymphocytes were found to plummet, and there was a slight decline in the percentages of patients with high mitotic rate and lymphovascular invasion. CONCLUSIONS Most likely because of the delayed diagnosis, cutaneous melanoma was found to be associated with less favorable prognostic features as the time lapsed. We suggest that effective campaigns for public awareness of melanoma be implemented so the screening and early diagnosis of the disease can be promoted.
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Affiliation(s)
- Faruk Tas
- Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Kayhan Erturk
- Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
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SOLAK M, KILIÇKAP S, CELIK İ. Retrospective evaluation of malignant melanoma patients: A single-center experience. FAMILY PRACTICE AND PALLIATIVE CARE 2021. [DOI: 10.22391/fppc.717911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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İBİLOĞLU İ, ALABALIK U, KELEŞ AN. Diyarbakır Yöresindeki MM Olgularının Retrospektif Değerlendirilmesi. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.755755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sirvan SS, Demir IA, Irmak F, Kafi M, Budak K, Karsidag S. Does Wide Excisional Biopsy in Skin Cancer Prevent Finding The Real Sentinel Lymph Node? J INVEST SURG 2019; 33:741-747. [DOI: 10.1080/08941939.2018.1559898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Selami S Sirvan
- Plastic, Reconstructive and Aesthetic Surgery Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Isil Akgun Demir
- Plastic, Reconstructive and Aesthetic Surgery Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Fatih Irmak
- Plastic, Reconstructive and Aesthetic Surgery Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mesut Kafi
- Nuclear Medicine Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Kenan Budak
- Nuclear Medicine Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Semra Karsidag
- Plastic, Reconstructive and Aesthetic Surgery Department, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Is the frequency of primary cutaneous melanoma increasing in Turkey? An evaluation of the experiences of two dermatology centers. JOURNAL OF ONCOLOGICAL SCIENCES 2018. [DOI: 10.1016/j.jons.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kamyab K, Kazemi S, Azimi P, Azizpour A, Ghandi N, Pirooz E, Noormohammadpour P, Mirshams-Shahshahani M, Daneshpazhooh M. Characteristic features of cutaneous melanoma in a dermatology referral centre in Tehran, Iran. Australas J Dermatol 2017; 58:e228-e231. [PMID: 28295169 DOI: 10.1111/ajd.12616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 12/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES The characteristics of cutaneous melanoma in the Middle-Eastern countries is poorly described. Therefore we conducted this study to determine the characteristics of melanoma in Iran. METHODS A retrospective, cross sectional study of melanoma patients seen at a tertiary referral centre, Iran, from May 2004 to October 2014. Clinical data included age and gender of the patients at the time of diagnosis, tumour location and tumour size. Histological characteristics included Breslow thickness, Clark level and subtype of tumour. RESULTS A total of 450 cases of melanoma with a male/female ratio of 1.1:1 were reviewed. The mean age of patients was 57.5 years. The most frequent histological subtypes were acral lentiginous melanoma (30%) and lentigo maligna melanoma (29%). In 215 cases (49%) the tumour was located on the extremities. The second most common site was the face. Tumour invasion was mainly at Clark level III and IV. The mean Breslow thickness was 2.8 mm; 143 (38%) melanomas had a Breslow thickness less than 1 mm (T1) and 86 (23%) were more than 4 mm (T4). CONCLUSION This study indicates that clinical and histological features of melanoma in Iranians (who are mainly of skin phototypes 3-4) are different from those observed in Western countries. Further cohort studies are required to evaluate the role of ethnic and environmental risk factors for melanoma in different populations.
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Affiliation(s)
- Kambiz Kamyab
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheyda Kazemi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - Pourya Azimi
- Student Scientific Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Pirooz
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Daneshpazhooh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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Sula B, Uçmak F, Kaplan MA, Urakçi Z, Arica M, Isikdogan A. Epidemiological and clinical characteristics of malignant melanoma in Southeast Anatolia in Turkey. Pan Afr Med J 2016; 24:22. [PMID: 27583086 PMCID: PMC4992363 DOI: 10.11604/pamj.2016.24.22.9254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/27/2016] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The present study aimed to establish the epidemiological and clinical characteristics of patients who were histopathologically diagnosed with malignant melanoma (MM). METHODS The present study retrospectively analyzed the data of 78 patients who were histopathologically diagnosed with MM in Dicle University Medical Faculty, Dermatology and Medical Oncology departments between 2005 and 2014. RESULTS The study included 78 patients in total with 44 (56.4%) male and 34 (43.6%) female. Median age of the patients was 62.50 years (range: 27 - 84 years). Of the patients, 78.2% (n = 61) had cutaneous melanoma, 8.9% had solid organ melanoma, and 2.5% had ocular and mucosal melanoma. The most common tumor localization among the patients was the lower extremities with 29.4% (n = 23). The most common histopathological type was nodular malignant melanoma with 35.8% (n = 28). Based on TNM, Clark and Breslow classifications, 26.9% (n = 21) of the patients were stage 4, 26.9% (n = 21) were Clark stage 4, and 37.1% (n = 29) were Breslow stage 4. Median overall survival in all patients was 14.9 months (95% CI 10.9 - 18.8 months). In the multivariate Cox analysis, only stage statistically significantly affecting survival [odds ratio (OR): 0.54; (95% CI 0.16-1.82, p = 0.02)]. CONCLUSION Malignant melanoma data are also important for the optimal utilization of effective methods and healthcare resources to prevent the disease. In order to minimize MM mortality and morbidity, not only the society but also physicians from primary and secondary care hospitals should become familiar with melanoma.
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Affiliation(s)
- Bilal Sula
- Department of Dermatology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Feyzullah Uçmak
- Department of Gastroenterology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mehmet Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Zuhat Urakçi
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mustafa Arica
- Department of Dermatology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Abdurrahman Isikdogan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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Gamsizkan M, Yilmaz I, Buyukbabani N, Demirkesen C, Demiriz M, Cetin ED, Ince U, Akalin T, Demirkan NC, Lebe B, Erdem O, Gokoz O, Sakiz D, Demireli PT, Astarci HM, Adim SB, Zemheri IE, Acikalin A, Yaman B, Aydin O, Bassorgun CI. A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey. Asian Pac J Cancer Prev 2015; 15:10451-6. [DOI: 10.7314/apjcp.2014.15.23.10451] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mucosal melanoma in the head and neck region: different clinical features and same outcome to cutaneous melanoma. ISRN DERMATOLOGY 2013; 2013:586915. [PMID: 23762595 PMCID: PMC3670547 DOI: 10.1155/2013/586915] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 04/24/2013] [Indexed: 02/03/2023]
Abstract
Mucosal melanoma (MM) in the head and neck (H&N) is relatively rare and behaves in distinct pattern from cutaneous melanoma (CM). We performed this study to define clinical characteristics and outcomes of patients and emphasize MM differences from CM. Forty-one patients with MM located in H&N were assessed. 94 CM patients originated from H&N region were also used for comparison. Patients had oral cavity (51%) and sinonasal location (49%).The median age was 60 years and gender distribution was equal. Thirty-two (78%) patients had localized stage, four (10%) patients had regional lymph node metastasis, and five (12%) patients had distant metastasis. The 1- and 5-year overall survival rates were 81% and 58%, respectively. Outcomes were similar between sinonasal and oral cavity patients (P = 0.67). Advanced disease was the significant prognostic factor for outcome (P = 0.03). MM patients are older (P = 0.008) and more diagnosed as a localized disease patients at presentation than those with CM (P = 0.06). Overall survival rates were identical in patients with MM and CM (P = 0.53). In conclusion, despite different clinical features, outcome was identical in patients with MM and CM located in the H&N region.
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Tas F, Keskin S, Karadeniz A, Dağoğlu N, Sen F, Kilic L, Yildiz I. Noncutaneous melanoma have distinct features from each other and cutaneous melanoma. Oncology 2012; 81:353-8. [PMID: 22248874 DOI: 10.1159/000334863] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 11/01/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Compared to the cutaneous melanoma, noncutaneous melanomas are relatively rare and have a distinct pattern of behavior. We performed this study to define the clinical characteristics and outcomes of patients with noncutaneous melanomas and emphasize how they differ from cutaneous melanomas. METHODS 216 patients who were diagnosed with noncutaneous melanoma were assessed and their medical records between 2000 and 2010 were retrieved from the cancer registry. 475 patients with cutaneous melanoma were used for comparison. RESULTS Of the 216 noncutaneous melanoma patients, 83 had mucosal melanoma, 101 had ocular melanoma and 32 had unknown primaries. For mucosal melanoma, the head and neck was the most common anatomic site (53%), followed by the gastrointestinal tract (37%), female genital (6%) and urinary tract (4%). The majority of the ocular melanomas (94%) originated in the uvea. 32 patients demonstrated a primary unknown disease with regional metastasis as the dominant behavior (72%). Age was found to be statistically significantly different among melanoma patients (p < 0.001). Younger patients had more cutaneous and unknown primary melanomas, whereas older patients had more ocular and mucosal melanoma. In subset analyses, we found significant differences between cutaneous and ocular (p = 0.038) or mucosal (p < 0.001) melanomas. The ratios of metastasis on admission were higher in patients with mucosal (27.7%) and unknown primary (28.1%) melanomas, and lower for ocular (3%) melanomas (p < 0.001). Patients with cutaneous melanoma had an intermediate (12%) ratio. Patients with ocular melanoma had better outcome than patients with other melanoma sites (p < 0.05). While overall survival for cutaneous melanoma was significantly negatively correlated with male gender (p < 0.001), advanced stages (p < 0.001) and old age (p = 0.005), stage IV disease was the only independent prognostic factor in patients with ocular melanoma (p = 0.006). No prognostic factor for outcome was found for either mucosal or unknown primary melanomas. CONCLUSION The clinical presentations and prognoses of different primary sites of melanoma are distinctive. Therefore, approaches to these melanomas should be different.
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Affiliation(s)
- Faruk Tas
- Institute of Oncology, University of Istanbul, Istanbul, Turkey.
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Xu X, Liu Y, Wang L, He J, Zhang H, Chen X, Li Y, Yang J, Tao J. Gambogic acid induces apoptosis by regulating the expression of Bax and Bcl-2 and enhancing caspase-3 activity in human malignant melanoma A375 cells. Int J Dermatol 2009; 48:186-92. [PMID: 19200201 DOI: 10.1111/j.1365-4632.2009.03946.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To investigate the effect of a Chinese traditional medicine, gambogic acid (GA), on human malignant melanoma (MM) A375 cells and to study the mechanism of apoptosis induced by GA. METHODS A375 cells were treated with GA at different doses and for different times, and their proliferation and viability were detected by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis induced by GA in A375 cells was observed by annexin-V/propidium iodide doubling staining flow cytometry assay and Hoechst staining. To further determine the molecular mechanism of apoptosis induced by GA, the changes in expression of Bcl-2 and Bax were detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot, and caspase-3 activity was measured by fluorescence resonance energy transfer (FRET) probe. RESULTS After incubation with GA, A375 cell proliferation was dramatically inhibited in a dose-dependent manner. After these cells had been exposed to GA for 24, 36 and 48 h, the IC(50) values were 1.57 +/- 0.05, 1.31 +/- 0.20, and 1.12 +/- 0.19 microg/mL, respectively. Treatment of A375 cells with GA (2.5-7.5 microg/mL) for 36 h resulted in an increased number of early apoptotic cells, which ranged from 27.6% to 41.9%, in a dose-dependent manner, compared with only 3.5% apoptotic cells in the non-GA-treated group. An increase in Bax and decrease in Bcl-2 expression were found by real-time RT-PCR and Western blot. Caspase-3 activity was increased in a dose-dependent manner, observed by FRET probe. CONCLUSION GA can inhibit the proliferation of A375 cells and induce their apoptosis, which may be related to the up-regulation of the Bax/Bcl-2 ratio and caspase-3 activity.
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Affiliation(s)
- Xiaoyuan Xu
- Department of Histology and Embryology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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