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Sentinel Lymph Node Biopsy in Cutaneous Melanoma, a Clinical Point of View. Medicina (B Aires) 2022; 58:medicina58111589. [DOI: 10.3390/medicina58111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Sentinel lymph node biopsy (SLNB) is a surgical procedure that has been used in patients with cutaneous melanoma for nearly 30 years. It is used for both staging and regional disease control with minimum morbidity, as proven by numerous worldwide prospective studies. It has been incorporated in the recommendations of national and professional guidelines. In this article, we provide a summary of the general information on SLNB in the clinical guidelines for the management of cutaneous malignant melanoma (American Association of Dermatology, European Society of Medical Oncology, National Comprehensive Cancer Network, and Cancer Council Australia) and review the most relevant literature to provide an update on the existing recommendations for SLNB.
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2
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Clinical features associated with the invasive component in lentigo maligna of the head and neck: A retrospective study of 175 cases. Ann Dermatol Venereol 2022; 149:258-263. [DOI: 10.1016/j.annder.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/29/2021] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
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3
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Chandra SR, Singu S, Foster J. Principles of Surgery in Head and Neck Cutaneous Melanoma. Oral Maxillofac Surg Clin North Am 2022; 34:251-262. [PMID: 35428503 DOI: 10.1016/j.coms.2021.11.006] [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] [Indexed: 11/18/2022]
Abstract
Surgical management of head and neck melanoma starts from the primary biopsy of the cutaneous site by a narrow excision with a 1 to 3 mm margins. The margin should include the whole breadth and sufficient depth of the lesion. The key is not to transect the lesion. With the advent of molecular testing, gene expression profiling, and immunotherapies, the surgical management of advanced melanoma has changed. Sentinel lymph node biopsy is an essential armamentarium for T2a and higher staging/greater than 1 mm thick and advance stage disease. Molecular pathogenesis and cancer immunology are recognized in the recent treatment protocols along with surgery in advanced stages of melanoma.
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Affiliation(s)
- Srinivasa Rama Chandra
- Oral and Maxillofacial Surgery, Oregon Health & Sciences University, 3181 SW Sam Jackson Park, Portland, OR 97239, USA.
| | - Sravani Singu
- University of Nebaraska Medical Center, College of Medicine, Omaha, NE 68198, USA
| | - Jason Foster
- Division of Surgical Oncology, University of Nebraska Medical Center, 986345 Nebraska Medical Center, Omaha, NE 68198-6345, USA
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4
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Zhao C, Shuai R, Ma L, Liu W, Wu M. Segmentation of dermoscopy images based on deformable 3D convolution and ResU-NeXt +. Med Biol Eng Comput 2021; 59:1815-1832. [PMID: 34304370 DOI: 10.1007/s11517-021-02397-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
Melanoma is one of the most dangerous skin cancers. The current melanoma segmentation is mainly based on FCNs (fully connected networks) and U-Net. Nevertheless, these two kinds of neural networks are prone to parameter redundancy, and the gradient of neural networks disappears that occurs when the neural network backpropagates as the neural network gets deeper, which will reduce the Jaccard index of the skin lesion image segmentation model. To solve the above problems and improve the survival rate of melanoma patients, an improved skin lesion segmentation model based on deformable 3D convolution and ResU-NeXt++ (D3DC- ResU-NeXt++) is proposed in this paper. The new modules in D3DC-ResU-NeXt++ can replace ordinary modules in the existing 2D convolutional neural networks (CNNs) that can be trained efficiently through standard backpropagation with high segmentation accuracy. In particular, we introduce a new data preprocessing method with dilation, crop operation, resizing, and hair removal (DCRH), which improves the Jaccard index of skin lesion image segmentation. Because rectified Adam (RAdam) does not easily fall into a local optimal solution and can converge quickly in segmentation model training, we also introduce RAdam as the training optimizer. The experiments show that our model has excellent performance on the segmentation of the ISIC2018 Task I dataset, and the Jaccard index achieves 86.84%. The proposed method improves the Jaccard index of segmentation of skin lesion images and can also assist dermatological doctors in determining and diagnosing the types of skin lesions and the boundary between lesions and normal skin, so as to improve the survival rate of skin cancer patients. Overview of the proposed model. An improved skin lesion segmentation model based on deformable 3D convolution and ResU-NeXt++ (D3DC- ResU-NeXt++) is proposed in this paper. D3DC-ResU-NeXt++ has strong spatial geometry processing capabilities, it is used to segment the skin lesion sample image; DCRH and transfer learning are used to preprocess the data set and D3DC-ResU-NeXt++ respectively, which can highlight the difference between the lesion area and the normal skin, and enhance the segmentation efficiency and robustness of the neural network; RAdam is used to speed up the convergence speed of neural network and improve the efficiency of segmentation.
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Affiliation(s)
- Chen Zhao
- College of Computer Science and Technology, Nanjing Tech University, Nanjing, 211816, China
| | - Renjun Shuai
- College of Computer Science and Technology, Nanjing Tech University, Nanjing, 211816, China.
| | - Li Ma
- Nanjing Health Information Center, Nanjing, 210003, China
| | - Wenjia Liu
- Changzhou No. 2 People's Hospital affiliated with Nanjing Medical University, Changzhou, 213003, China
| | - Menglin Wu
- College of Computer Science and Technology, Nanjing Tech University, Nanjing, 211816, China
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5
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“Personalized Excision” of Malignant Melanoma—Need for a Paradigm Shift in the Beginning Era of Personalized Medicine. Am J Dermatopathol 2019; 41:884-896. [DOI: 10.1097/dad.0000000000001450] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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6
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Paganelli A, Garbarino F, Toto P, Martino GD, D’Urbano M, Auriemma M, Giovanni PD, Panarese F, Staniscia T, Amerio P, Paganelli R. Serological landscape of cytokines in cutaneous melanoma. Cancer Biomark 2019; 26:333-342. [DOI: 10.3233/cbm-190370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Alessia Paganelli
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Garbarino
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Toto
- Private practice, Chieti, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Aging Sciences, Section of Hygiene, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Marika D’Urbano
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Matteo Auriemma
- Department of Medicine and Aging Sciences, Section of Dermatology, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Pamela Di Giovanni
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Fabrizio Panarese
- Department of Medicine and Aging Sciences, Section of Dermatology, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Tommaso Staniscia
- Department of Medicine and Aging Sciences, Section of Hygiene, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Paolo Amerio
- Department of Medicine and Aging Sciences, Section of Dermatology, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Roberto Paganelli
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
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7
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Podlipnik S, Carrera C, Boada A, Richarz NA, López-Estebaranz JL, Pinedo-Moraleda F, Elosua-González M, Martín-González MM, Carrillo-Gijón R, Redondo P, Moreno E, Malvehy J, Puig S. Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study. J Eur Acad Dermatol Venereol 2019; 33:857-862. [PMID: 30702163 PMCID: PMC6483866 DOI: 10.1111/jdv.15454] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 01/04/2019] [Indexed: 12/23/2022]
Abstract
Background The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31‐gene expression profile (DecisionDx‐Melanoma) test has shown promising results. Objectives To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease‐free survival was determined using Kaplan–Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results Median follow‐up time was 26 months (IQR 22–30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31‐gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow‐up strategies.
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Affiliation(s)
- S Podlipnik
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - C Carrera
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Boada
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - N A Richarz
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - F Pinedo-Moraleda
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Elosua-González
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M M Martín-González
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Carrillo-Gijón
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Redondo
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - E Moreno
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - J Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - S Puig
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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8
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Bertolli E, de Macedo MP, Calsavara VF, Pinto CAL, Duprat Neto JP. A nomogram to identify high-risk melanoma patients with a negative sentinel lymph node biopsy. J Am Acad Dermatol 2018; 80:722-726. [PMID: 30395920 DOI: 10.1016/j.jaad.2018.10.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 10/16/2018] [Accepted: 10/28/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Melanoma patients with negative nodes after sentinel lymph node biopsy are a heterogeneous group. Current guidelines fail to adequately stratify surveillance and treatment for this group. Also, there is scarce data on adjuvant treatments for these patients. OBJECTIVE To create a nomogram including clinical and pathologic characteristics capable of evaluating the risk for recurrence of primary melanoma patients with negative sentinel lymph node biopsies (SLNBs). METHODS We used a retrospective cohort of patients who underwent SLNB during 2000-2015 at a single institution. RESULTS Our cohort comprised 1213 patients. Among these patients, 967 (79.7%) had a negative SLNB, and mean follow-up was 59.67 months. There were 133 recurrences (13.8%); 45 (33.8%) presented with nodal recurrence, and 35 (26.3%) recurred where a SLNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk for recurrence at 1, 2, 5, and 10 years. LIMITATION Single center analysis. CONCLUSION We created a predictive nomogram for melanoma patients with negative SLNBs. This nomogram is easy to use and identifies high-risk patients who should have more strict surveillance and be considered for adjuvant treatment.
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Affiliation(s)
- Eduardo Bertolli
- Skin Cancer Department, AC Camargo Cancer Center, São Paulo, Brazil.
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9
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Swetter SM, Tsao H, Bichakjian CK, Curiel-Lewandrowski C, Elder DE, Gershenwald JE, Guild V, Grant-Kels JM, Halpern AC, Johnson TM, Sober AJ, Thompson JA, Wisco OJ, Wyatt S, Hu S, Lamina T. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol 2018; 80:208-250. [PMID: 30392755 DOI: 10.1016/j.jaad.2018.08.055] [Citation(s) in RCA: 328] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.
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Affiliation(s)
- Susan M Swetter
- Department of Dermatology, Stanford University Medical Center and Cancer Institute, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Boston, Massachusetts
| | - Christopher K Bichakjian
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Clara Curiel-Lewandrowski
- Division of Dermatology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona
| | - David E Elder
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pathology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut
| | - Allan C Halpern
- Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Timothy M Johnson
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Arthur J Sober
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - John A Thompson
- Division of Oncology, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington
| | - Oliver J Wisco
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | | | - Shasa Hu
- Department of Dermatology, University of Miami Health System, Miami, Florida
| | - Toyin Lamina
- American Academy of Dermatology, Rosemont, Illinois
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Bregeon B, Nguyen JM, Varey E, Quereux G, Saint-Jean M, Peuvrel L, Khammari A, Dreno B. Positive margins after surgical excision of locoregional cutaneous melanoma metastasis and their impact on patient outcome. Eur J Dermatol 2018; 28:661-667. [PMID: 30378546 DOI: 10.1684/ejd.2018.3402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For melanoma patients, surgery is a standard treatment for locoregional skin metastasis (LSM). To assess the frequency and risk factors for positive margins after excision of LSM and their impact on patient overall survival (OS) and progression-free survival (PFS). A monocentric, retrospective observational study was performed including 87 patients with LSM who had undergone surgical excision. Positive margins were found in 45% of patients after excision. After additional excision, 28% of patients still had positive margins. Interestingly, there was no difference in PFS or OS for clear margins after the first or additional excision or for margins that remained positive without additional excision. LSM size was the only identified predictive factor for positive margins. This is the first reported study investigating the frequency of, and risk factors for positive margins of cutaneous LSM, which raises the question of whether additional excision should be performed following positive margin excision.
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Affiliation(s)
- Barbara Bregeon
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France
| | - Jean-Michel Nguyen
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, PIMESP-SEB, Saint-Jacques Hospital, Nantes, France
| | - Emilie Varey
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
| | - Gaelle Quereux
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
| | - Mélanie Saint-Jean
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
| | - Lucie Peuvrel
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
| | - Amir Khammari
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
| | - Brigitte Dreno
- Service de dermatologie, Hôtel-Dieu, CHU de Nantes, Nantes, France, Service de dermatologie, CIC 1413, CRCINA INSERM 1232, CHU de Nantes, Nantes, France
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11
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Piłat P, Borzęcki A, Jazienicki M, Krasowska D. Skin melanoma imaging using ultrasonography: a literature review. Postepy Dermatol Alergol 2018; 35:238-242. [PMID: 30008639 PMCID: PMC6041713 DOI: 10.5114/ada.2018.76211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 07/23/2017] [Indexed: 01/27/2023] Open
Abstract
Melanoma is one of the most unpredictable tumours, as regards both morphology and the course of disease. It may have different clinical forms making it very difficult to diagnose. Therefore, it often surprises even the most experienced dermatologists. Despite numerous attempts, no efficient treatment of advanced stages have been elaborated, and early detection and removal of a skin lesion currently constitutes the most efficient treatment method. Diagnostics uses different types of dermoscopic techniques characterised by considerable sensitivity and specificity in detecting melanoma at an early developmental stage. A continuous development of medical technologies leads to improving many methods of skin lesion imaging. Ultrasonography is one of these methods, enabling evaluation of the thickness of melanoma in vivo with high precision. Change thickness is the decisive factor influencing 5-year survival. The paper evaluates the usefulness of high-frequency ultrasonography (HFUS) in pre-operative melanoma imaging on the basis of literature review. Additionally, the use, role and placement of HFUS in skin melanoma diagnostics is determined.
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Affiliation(s)
- Paweł Piłat
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
- Non-Public Health Care Centre Med-Laser, Lublin, Poland
| | - Adam Borzęcki
- Non-Public Health Care Centre Med-Laser, Lublin, Poland
| | - Mieczysław Jazienicki
- Department of Surgical Oncology, Independent Public Clinical Hospital, Lublin, Poland
| | - Dorota Krasowska
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
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12
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Ortega FT, Kondo RN, Belinetti FM, Okamura MO, Tuma B. Primary cutaneous amelanotic melanoma and gastrointestinal stromal tumor in synchronous evolution. An Bras Dermatol 2018; 92:707-710. [PMID: 29166513 PMCID: PMC5674708 DOI: 10.1590/abd1806-4841.20174520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/27/2015] [Indexed: 11/22/2022] Open
Abstract
Gastrointestinal stromal tumor is rare digestive tract mesenchymal tumor, most often in the wall of the stomach. It is a benign neoplasm, but it can become malignant if not treated. We report a case of gastrointestinal stromal tumor that was discovered after abdominal ultrasonography during staging of a patient with primary cutaneous amelanotic melanoma. Mutation in the tyrosine kinase receptor could explain the development of two types of tumors in the same patient.
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Affiliation(s)
| | - Rogério Nabor Kondo
- Dermatology Service of Hospital Universitário Regional do Norte do Paraná (HURNP) - Universidade Estadual de Londrina (UEL) - Londrina (PR), Brazil
| | | | | | - Bruna Tuma
- Dermatology Service of Hospital Universitário Regional do Norte do Paraná (HURNP) - Universidade Estadual de Londrina (UEL) - Londrina (PR), Brazil
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13
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Humanistic burden of disease for patients with advanced melanoma in Canada. Support Care Cancer 2018; 26:1985-1991. [PMID: 29322243 PMCID: PMC5919988 DOI: 10.1007/s00520-017-4025-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/18/2017] [Indexed: 11/04/2022]
Abstract
Background Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). Methods Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach. Results Many patients’ journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients’ overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers. Conclusion Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.
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14
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Ribero S, Podlipnik S, Osella-Abate S, Sportoletti-Baduel E, Manubens E, Barreiro A, Caliendo V, Chavez-Bourgeois M, Carrera C, Cassoni P, Malvehy J, Fierro M, Puig S. Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study. Eur J Cancer 2017; 85:59-66. [DOI: 10.1016/j.ejca.2017.07.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/19/2017] [Accepted: 07/30/2017] [Indexed: 10/18/2022]
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15
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Moncayo VM, Alazraki AL, Alazraki NP, Aarsvold JN. Sentinel Lymph Node Biopsy Procedures. Semin Nucl Med 2017; 47:595-617. [DOI: 10.1053/j.semnuclmed.2017.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Alfonso J, Bauer A, Bensefa-Colas L, Boman A, Bubas M, Constandt L, Crepy M, Goncalo M, Macan J, Mahler V, Mijakoski D, Ramada Rodilla J, Rustemeyer T, Spring P, John S, Uter W, Wilkinson M, Giménez-Arnau A. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe - position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol 2017; 31 Suppl 4:31-43. [DOI: 10.1111/jdv.14319] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 12/23/2022]
Affiliation(s)
- J.H. Alfonso
- Department of Occupational Medicine and Epidemiology; National Institute of Occupational Health; Oslo Norway
| | - A. Bauer
- Department of Dermatology; University Allergy Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - L. Bensefa-Colas
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
- Laboratoire Santé Publique et Environnement; Paris France
| | - A. Boman
- Institute of Environmental Medicine; Occupational and Environmental Dermatology; Stockholm Sweden
| | - M. Bubas
- Department for Education and Information; Croatian Institute for Health Protection and Safety at Work; Zagreb Croatia
| | - L. Constandt
- Fedris, Agence Fédérale des risques professionnels; Brussels Belgium
| | - M.N. Crepy
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
| | - M. Goncalo
- Clinic of Dermatology; University Hospital and Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - J. Macan
- Unit for Occupational and Environmental Health; Institute for Medical Research and Occupational Health; Zagreb Croatia
| | - V. Mahler
- Department of Dermatology; University Hospital of Erlangen; Erlangen Germany
| | - D. Mijakoski
- Institute for Occupational Health of Republic of Macedonia; Skopje Macedonia
| | - J.M. Ramada Rodilla
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM); CIBER de Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
| | - T. Rustemeyer
- Department of Dermatology and Allergology; VU University Medical Centre; Amsterdam The Netherlands
| | - P. Spring
- Department of Dermatology; University of Lausanne; Lausanne Switzerland
| | - S.M. John
- Department of Dermatology, Environmental Medicine; University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Lower-Saxony Institute of Occupational Dermatology (NIB); Osnabrück Germany
| | - W. Uter
- Department of Medical Informatics, Biometry and Epidemiology; Friedrich-Alexander Universität Erlangen/Nürnberg; Erlangen Germany
| | | | - A.M. Giménez-Arnau
- Department of Dermatology; Hospital del Mar; Institut Mar d´Investigacions Mèdiques (IMIM); Universitat Autònoma de Barcelona; Barcelona Spain
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17
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Karimkhani C, Green AC, Nijsten T, Weinstock MA, Dellavalle RP, Naghavi M, Fitzmaurice C. The global burden of melanoma: results from the Global Burden of Disease Study 2015. Br J Dermatol 2017; 177:134-140. [PMID: 28369739 PMCID: PMC5575560 DOI: 10.1111/bjd.15510] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite recent improvements in prevention, diagnosis and treatment, vast differences in melanoma burden still exist between populations. Comparative data can highlight these differences and lead to focused efforts to reduce the burden of melanoma. OBJECTIVES To assess global, regional and national melanoma incidence, mortality and disability-adjusted life year (DALY) estimates from the Global Burden of Disease Study 2015. METHODS Vital registration system and cancer registry data were used for melanoma mortality modelling. Incidence and prevalence were estimated using separately modelled mortality-to-incidence ratios. Total prevalence was divided into four disease phases and multiplied by disability weights to generate years lived with disability (YLDs). Deaths in each age group were multiplied by the reference life expectancy to generate years of life lost (YLLs). YLDs and YLLs were added to estimate DALYs. RESULTS The five world regions with the greatest melanoma incidence, DALY and mortality rates were Australasia, North America, Eastern Europe, Western Europe and Central Europe. With the exception of regions in sub-Saharan Africa, DALY and mortality rates were greater in men than in women. DALY rate by age was highest in those aged 75-79 years, 70-74 years and ≥ 80 years. CONCLUSIONS The greatest burden from melanoma falls on Australasian, North American, European, elderly and male populations, which is consistent with previous investigations. These substantial disparities in melanoma burden worldwide highlight the need for aggressive prevention efforts. The Global Burden of Disease Study results can help shape melanoma research and public policy.
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Affiliation(s)
- C Karimkhani
- Department of Dermatology, University of Colorado, Aurora, CO, U.S.A
| | - A C Green
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,CRUK Manchester Institute, University of Manchester, Manchester, U.K
| | - T Nijsten
- Erasmus MC Cancer Institute, Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M A Weinstock
- Center for Dermatoepidemiology, Department of Veterans Affairs Medical Center, Providence, RI, U.S.A.,Department of Dermatology and Epidemiology, Brown University, Providence, RI, U.S.A
| | - R P Dellavalle
- Department of Dermatology, University of Colorado, Aurora, CO, U.S.A.,Dermatology of Epidemiology, Colorado School of Public Health, Aurora, CO, U.S.A.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health System, Denver, CO, U.S.A
| | - M Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, U.S.A
| | - C Fitzmaurice
- Institute for Health Metrics and Evaluation, Seattle, WA, U.S.A.,Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, U.S.A
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Maisel K, Sasso MS, Potin L, Swartz MA. Exploiting lymphatic vessels for immunomodulation: Rationale, opportunities, and challenges. Adv Drug Deliv Rev 2017; 114:43-59. [PMID: 28694027 PMCID: PMC6026542 DOI: 10.1016/j.addr.2017.07.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 12/12/2022]
Abstract
Lymphatic vessels are the primary route of communication from peripheral tissues to the immune system; as such, they represent an important component of local immunity. In addition to their transport functions, new immunomodulatory roles for lymphatic vessels and lymphatic endothelial cells have come to light in recent years, demonstrating that lymphatic vessels help shape immune responses in a variety of ways: promoting tolerance to self-antigens, archiving antigen for later presentation, dampening effector immune responses, and resolving inflammation, among others. In addition to these new biological insights, the growing field of immunoengineering has begun to explore therapeutic approaches to utilize or exploit the lymphatic system for immunotherapy.
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Affiliation(s)
- Katharina Maisel
- Institute for Molecular Engineering, University of Chicago, Chicago, IL, USA
| | - Maria Stella Sasso
- Institute for Molecular Engineering, University of Chicago, Chicago, IL, USA
| | - Lambert Potin
- Institute for Molecular Engineering, University of Chicago, Chicago, IL, USA; École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Melody A Swartz
- Institute for Molecular Engineering, University of Chicago, Chicago, IL, USA; Ben May Institute for Cancer Research, University of Chicago, Chicago, IL, USA.
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19
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Pardo LM, van der Leest RJT, de Vries E, Soerjomataram I, Nijsten T, Hollestein LM. Comparing survival of patients with single or multiple primary melanoma in the Netherlands: 1994-2009. Br J Dermatol 2017; 176:531-533. [PMID: 27377396 DOI: 10.1111/bjd.14846] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L M Pardo
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - R J T van der Leest
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - E de Vries
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - I Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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20
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Aubuchon MMF, Bolt LJJ, Janssen-Heijnen MLG, Verleisdonk-Bolhaar STHP, van Marion A, van Berlo CLH. Epidemiology, management and survival outcomes of primary cutaneous melanoma: a ten-year overview. Acta Chir Belg 2017; 117:29-35. [PMID: 27774842 DOI: 10.1080/00015458.2016.1242214] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. METHODS Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed. Relevant patient features, tumour characteristics, and (surgical) outcomes were evaluated. RESULTS The majority of all the patients presented thin tumours (59.1% stage 1A/in situ melanoma). Men showed more ulceration (17.7% vs. 8.4%, p < .01) and a significantly higher Breslow thickness than women (1.2 mm vs. 0.9 mm, p < .01). 14.6% (40/273) underwent sentinel lymph node biopsy (SLNB); 10/40 (25%) showed nodal metastasis, 50 patients (7.3%) developed distant metastases (M: 10.6%, F: 5%, p < .01). One-, 5- and 10- year disease specific survival rates were 96%, 86% and 84%, respectively. Median survival for stage 4 MM was 3 months. Extensive surgery was uncommon (n = 3). CONCLUSIONS Patients generally presented with thin melanomas. Lymph node disease and distant metastases remained infrequently observed during following years, and general 1- and 5-year overall disease-specific survival rates exceeded 85%. Small numbers of rescue surgery and palliative medical treatment warrant further centralisation and investigation.
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Affiliation(s)
- M M F Aubuchon
- a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands
| | - L J J Bolt
- a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands
| | - M L G Janssen-Heijnen
- b Department of Clinical Epidemiology , VieCuri Medical Centre Venlo , Venlo , The Netherlands
| | | | - A van Marion
- d Department of Pathology , VieCuri Medical Centre Venlo , Venlo , The Netherlands
| | - C L H van Berlo
- a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands
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21
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Castro LGM, Bakos RM, Duprat Neto JP, Bittencourt FV, Di Giacomo THB, Serpa SS, Messina MCDL, Loureiro WR, Macarenco RSES, Stolf HO, Gontijo G. Brazilian guidelines for diagnosis, treatment and follow-up of primary cutaneous melanoma - Part II. An Bras Dermatol 2016; 91:49-58. [PMID: 26982779 PMCID: PMC4782647 DOI: 10.1590/abd1806-4841.20164715] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/27/2015] [Indexed: 01/04/2023] Open
Abstract
The last Brazilian guidelines on melanoma were published in 2002. Development in
diagnosis and treatment made updating necessary. The coordinators elaborated ten
clinical questions, based on PICO system. A Medline search, according to
specific MeSH terms for each of the 10 questions was performed and articles
selected were classified from A to D according to level of scientific evidence.
Based on the results, recommendations were defined and classified according to
scientific strength. The present Guidelines were divided in two parts for
editorial and publication reasons. In this second part, the following clinical
questions were answered: 1) which patients with primary cutaneous melanoma
benefit from sentinel lymph node biopsy? 2) Follow-up with body mapping is
indicated for which patients? 3) Is preventive excision of acral nevi
beneficious to patients? 4) Is preventive excision of giant congenital nevi
beneficious to patients? 5) How should stages 0 and I primary cutaneous melanoma
patients be followed?
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Affiliation(s)
| | - Renato Marchiori Bakos
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | | | | | | | - Gabriel Gontijo
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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22
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Serra-Arbeloa P, Rabines-Juárez ÁO, Álvarez-Ruiz MS, Guillén-Grima F. Sentinel node biopsy in patients with primary cutaneous melanoma of any thickness: A cost-effectiveness analysis. Surg Oncol 2016; 25:205-11. [PMID: 27566024 DOI: 10.1016/j.suronc.2016.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of the sentinel node biopsy with lymphadenectomy for nodal metastases (SNB) in patients with primary cutaneous melanoma (CM) of different Breslow thickness (intermediate, thick, thin). METHODS Decision tree models were constructed to compare two different strategies of management of patients with CM, wide excision of the primary lesion and SNB and wide excision only (WE). Tree models were created for every Breslow thickness over 1-, 5- and 10-year time horizons. Mean and total direct healthcare costs, life years saved (LYSs), quality-adjusted life years (QALYs), cost effectiveness ratio (CER), and incremental cost effectiveness ratio (ICER) were estimated. Every model was considered as a base case, and its results tested with sensitivity analyses. RESULTS Base case analyses showed that the best results were obtained for intermediate CM over 10-year time horizon. In this case, ICER for SNB was 130,508€/QALY, well over the threshold of acceptance (30,000€/QALY). In patients with intermediate CM over 1 and 5 years, and for those with thick and thin CM at any time horizon, negative ICER values were estimated since SNB was proved to be more expensive and less effective than WE. Sensitivity analyses confirmed the robustness of our results. CONCLUSIONS SNB caused no improvement in health outcomes in terms of LYSs and QALYs in patients with thick and thin CM, and only a slight benefit in those with intermediate CM. WE was more cost-effective compared with SNB for any CM thickness over any time horizon up to 10 years.
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Affiliation(s)
- Patricia Serra-Arbeloa
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain; Department of Nuclear Medicine, Navarra Hospital, Pamplona, Spain.
| | | | | | - Francisco Guillén-Grima
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain; Department of Preventive Medicine, University of Navarra Clinic, Pamplona, Spain; IDISNA Navarra Health Research Institute, Spain.
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Gordon LG, Elliott TM, Wright CY, Deghaye N, Visser W. Modelling the healthcare costs of skin cancer in South Africa. BMC Health Serv Res 2016; 16:113. [PMID: 27039098 PMCID: PMC4818961 DOI: 10.1186/s12913-016-1364-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 03/24/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Skin cancer is a growing public health problem in South Africa due to its high ambient ultraviolet radiation environment. The purpose of this study was to estimate the annual health system costs of cutaneous melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in South Africa, incorporating both the public and private sectors. METHODS A cost-of-illness study was used to measure the economic burden of skin cancer and a 'bottom-up' micro-costing approach. Clinicians provided data on the patterns of care and treatments while national costing reports and clinician fees provided cost estimates. The mean costs per melanoma and per SCC/BCC were extrapolated to estimate national costs using published incidence data and official population statistics. One-way and probabilistic sensitivity analyses were undertaken to address the uncertainty of the parameters used in the model. RESULTS The estimated total annual cost of treating skin cancers in South Africa were ZAR 92.4 million (2015) (or US$15.7 million). Sensitivity analyses showed that the total costs could vary between ZAR 89.7 to 94.6 million (US$15.2 to $16.1 million) when melanoma-related variables were changed and between ZAR 78.4 to 113.5 million ($13.3 to $19.3 million) when non-melanoma-related variables were changed. The primary drivers of overall costs were the cost of excisions, follow-up care, radical lymph node dissection, cryotherapy and radiation therapy. CONCLUSION The cost of managing skin cancer in South Africa is sizable. Since skin cancer is largely preventable through improvements to sun-protection awareness and skin cancer prevention programs, this study highlights these healthcare resources could be used for other pressing public health problems in South Africa.
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Affiliation(s)
- Louisa G Gordon
- Griffith University, Menzies Health Institute Queensland, Centre for Applied Health Economics, Logan Campus, University Dr, Meadowbrook, QLD, Q4131, Australia.
- Centre for Research Excellence in Sun and Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Q4059, Brisbane, Australia.
| | - Thomas M Elliott
- Griffith University, Menzies Health Institute Queensland, Centre for Applied Health Economics, Logan Campus, University Dr, Meadowbrook, QLD, Q4131, Australia
- Centre for Research Excellence in Sun and Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Q4059, Brisbane, Australia
| | - Caradee Y Wright
- Environment & Health Research Unit, South African Medical Research Council and Department of Geography, Meteorology and Geoinformatics, University of Pretoria, Pretoria, South Africa
| | - Nicola Deghaye
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Willie Visser
- Division of Dermatology, Department of Medicine, Stellenbosch University, Tygerberg Academic Hospital, Cape Town, South Africa
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Heiduschka G, Virk SA, Palme CE, Ch’ng S, Elliot M, Gupta R, Clark J. Margin to tumor thickness ratio – A predictor of local recurrence and survival in oral squamous cell carcinoma. Oral Oncol 2016; 55:49-54. [DOI: 10.1016/j.oraloncology.2016.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/09/2016] [Accepted: 01/13/2016] [Indexed: 10/22/2022]
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Robbins HA, Clarke CA, Arron ST, Tatalovich Z, Kahn AR, Hernandez BY, Paddock L, Yanik EL, Lynch CF, Kasiske BL, Snyder J, Engels EA. Melanoma Risk and Survival among Organ Transplant Recipients. J Invest Dermatol 2015; 135:2657-2665. [PMID: 26270022 PMCID: PMC4640996 DOI: 10.1038/jid.2015.312] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/05/2015] [Accepted: 06/10/2015] [Indexed: 01/07/2023]
Abstract
Solid organ transplant recipients, who are medically immunosuppressed to prevent graft rejection, have increased melanoma risk, but risk factors and outcomes are incompletely documented. We evaluated melanoma incidence among 139,991 non-Hispanic white transplants using linked US transplant-cancer registry data (1987-2010). We used standardized incidence ratios (SIRs) to compare incidence with the general population and incidence rate ratios (IRRs) from multivariable Poisson models to assess risk factors. Separately, we compared post-melanoma survival among transplant recipients (n=182) and non-recipients (n=131,358) using multivariable Cox models. Among transplant recipients, risk of invasive melanoma (n=519) was elevated (SIR=2.20, 95% CI 2.01-2.39), especially for regional stage tumors (SIR=4.11, 95% CI 3.27-5.09). Risk of localized tumors was stable over time after transplantation but higher with azathioprine maintenance therapy (IRR=1.35, 95% CI 1.03-1.77). Risk of regional/distant stage tumors peaked within 4 years following transplantation and increased with polyclonal antibody induction therapy (IRR=1.65, 95% CI 1.02-2.67). Melanoma-specific mortality was higher among transplant recipients than non-recipients (hazard ratio 2.98, 95% CI 2.26-3.93). Melanoma exhibits increased incidence and aggressive behavior under transplant-related immunosuppression. Some localized melanomas may result from azathioprine, which acts synergistically with UV radiation, whereas T-cell-depleting induction therapies may promote late-stage tumors. Our findings support sun safety practices and skin screening for transplant recipients.
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Affiliation(s)
- Hilary A Robbins
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA.
| | - Christina A Clarke
- Cancer Prevention Institute of California, Fremont, California, USA; Department of Health Research and Policy, Stanford University School of Medicine and Stanford Cancer Institute, Palo Alto, California, USA
| | - Sarah T Arron
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - Zaria Tatalovich
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Amy R Kahn
- New York State Cancer Registry, Albany, New York, USA
| | - Brenda Y Hernandez
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, USA
| | - Lisa Paddock
- New Jersey State Cancer Registry, Trenton, New Jersey, USA; Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Elizabeth L Yanik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Bertram L Kasiske
- Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jon Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, USA
| | - Eric A Engels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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Odashiro M, Hans Filho G, Pereira PR, Castro ARCM, Stief AC, Pontes ERJC, Odashiro AN. Melanoma inhibitory activity in Brazilian patients with cutaneous melanoma. An Bras Dermatol 2015; 90:327-32. [PMID: 26131861 PMCID: PMC4516101 DOI: 10.1590/abd1806-4841.20153248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 07/31/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Melanoma inhibitory activity is a protein secreted by melanoma cells and has been used as a tumor marker. Increased Melanoma inhibitory activity serum levels are related to metastatic disease or tumor recurrence. Currently there are no studies on Melanoma inhibitory activity and cutaneous melanoma involving Brazilian patients. OBJECTIVE To evaluate the performance and feasibility of measuring Melanoma inhibitory activity levels in Brazilian patients with cutaneous melanoma. METHODS Blood was obtained from ten patients with proved metastatic cutaneous melanoma (Group 1), 15 patients resected for cutaneous melanoma without metastasis (Group 2) and 5 healthy donors (Group 3). Melanoma inhibitory activity was measured using a commercially available ELISA kit. RESULTS There was a statistically significant difference of Melanoma inhibitory activity levels between patients with and without metastasis (p=0.002), and between patients with metastasis and healthy donors (p=0.002). There was no difference between patients without metastasis and healthy donors (p=0.443). CONCLUSION Melanoma inhibitory activity is a tumor marker for cutaneous melanoma and the Melanoma inhibitory activity-ELISA test can be easily performed. Patients with metastasis have increased Melanoma inhibitory activity serum levels when compared to patients without metastasis and healthy donors.
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Affiliation(s)
- Macanori Odashiro
- Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Gunter Hans Filho
- Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
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Decreased expression of NKG2D, NKp46, DNAM-1 receptors, and intracellular perforin and STAT-1 effector molecules in NK cells and their dim and bright subsets in metastatic melanoma patients. Melanoma Res 2015; 24:295-304. [PMID: 24769842 DOI: 10.1097/cmr.0000000000000072] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although natural killer (NK) cells play an important antitumor role, melanoma cells may affect their effector functions. In this study, we analyzed the expression of various receptors and effector molecules in NK cells and their subsets in metastatic melanoma (MM) patients compared with healthy controls (HCs). In HC and MM patients, we analyzed NK cell activity using a chromium release assay and the expression of CD107a degranulation marker, activating NKG2D, NKp46, DNAM-1, and inhibitory CD158a and CD158b receptors, IL-12R beta 1, IL-12R beta 2, intracellular interferon (IFN)-γ, perforin, and STAT-1 in CD3-CD56+ NK cells, and cytotoxic CD3-CD56 and immunoregulatory CD3-CD56 subsets by flow cytometry. MM patients compared with HC not only had significantly decreased NK cell activity, lower expression of CD107a, and impaired IFN-γ production but also had decreased expression of activating NKG2D, NKp46, and DNAM-1 receptors, which was followed by lower expression of perforin, STAT-1, and both IL-12R subunits in NK cells. In MM patients only, there was a positive correlation between NKG2D expression and degranulation capacity, as well as IFN-γ production in NK cells. Analysis of the expression of various parameters of NK cell effector functions between MM patients with different localization of distant metastases showed that patients in the unfavorable M1c subclass had decreased expression of NKG2D and NKp46 on NK cells compared with patients in the M1a+b group. Downregulated NKG2D, NKp46, and DNAM-1 receptors associated with impaired NK cell effector function are important biomarkers of advanced disease with a poor prognosis in melanoma patients.
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Skin cancer and new treatment perspectives: A review. Cancer Lett 2015; 357:8-42. [DOI: 10.1016/j.canlet.2014.11.001] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/31/2014] [Accepted: 11/04/2014] [Indexed: 12/25/2022]
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Livingstone E, Krajewski C, Eigentler TK, Windemuth-Kieselbach C, Benson S, Elsenbruch S, Hauschild A, Rompel R, Meiss F, Mauerer A, Kähler KC, Dippel E, Möllenhoff K, Kilian K, Mohr P, Utikal J, Schadendorf D. Prospective evaluation of follow-up in melanoma patients in Germany - results of a multicentre and longitudinal study. Eur J Cancer 2015; 51:653-67. [PMID: 25638778 DOI: 10.1016/j.ejca.2015.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/05/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patient numbers requiring long-term melanoma surveillance are constantly rising. Surveillance is costly and guideline recommendations vary substantially. METHODS In this German nationwide study, information on surveillance and treatment of patients diagnosed with melanoma and melanoma in situ (MMis) between April and June 2008 was prospectively collected over four years. Additionally, patient self-report questionnaires were evaluated to assess anxiety, depression, health-related quality of life, socio-demographic information and use of disease specific health information sources at year 4 after primary diagnosis. RESULTS Complete data was available for 668 patients from 67 centres, of whom 96.0% were in regular melanoma surveillance. In year 3-4 of surveillance, only 55.6% of locoregionary metastases were detected during surveillance visits. Only 33.3% were self-detected by the patient even though 69.4% were documented as being clinically visible or palpable. Costs of 4year surveillance of 550 patients without tumour recurrence (stage I-IIC and MMis) accumulated to 228,155.75 €. Guideline-adherence for follow-up frequency, lymph node ultrasound, S100 serum level tests and diagnostic imaging recommendations was approximately 60% in year 3-4 of surveillance. Multivariate regression analysis showed that certain patient/tumour characteristics and regional differences were significantly associated with guideline deviations. The percentage of patients who exceeded published cut-off scores indicating clinically relevant symptoms of anxiety and depression were significantly increased. Patients frequently reported lack of psychosocial support and education but ascribed great importance to these. CONCLUSIONS We recommend further reduction of melanoma follow-up in low-risk melanoma patients and improvement of psycho-social support and patient education for all melanoma patients.
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Affiliation(s)
- E Livingstone
- Dept. of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - C Krajewski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - T K Eigentler
- Dept. of Dermatology, University Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany
| | | | - S Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - S Elsenbruch
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - A Hauschild
- Dept. of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105 Kiel, Germany
| | - R Rompel
- Dept. of Dermatology Kassel, Clinical Centre Kassel, Mönchebergstr. 41, 34125 Kassel, Germany
| | - F Meiss
- Dept. of Dermatology, University Medical Centre Freiburg, Hauptstr. 7, 79104 Freiburg, Germany
| | - A Mauerer
- Dept. of Dermatology, University Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - K C Kähler
- Dept. of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105 Kiel, Germany
| | - E Dippel
- Dept. of Dermatology, Clinical Centre Ludwigshafen, Bremserstr. 79, 67073 Ludwigshafen, Germany
| | - K Möllenhoff
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - K Kilian
- Dept. of Dermatology, Ludwig-Maximilians University Munich, Frauenlobstrasse 9-11, 80337 München, Germany
| | - P Mohr
- Dept. of Dermatology, Elbekliniken Stade-Buxtehude GmbH, Am Krankenhaus 1, 21614 Buxtehude, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht-Karl University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - D Schadendorf
- Dept. of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Hufelandstr. 55, 45122 Essen, Germany
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Lymphangiogenesis: Implications for Diagnosis, Treatment, and Prognosis in Patients With Melanoma. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Marlier J, Cocquyt V, Brochez L, Van Belle S, Kruse V. Ipilimumab, not just another anti-cancer therapy: hypophysitis as side effect illustrated by four case-reports. Endocrine 2014; 47:878-83. [PMID: 24554495 DOI: 10.1007/s12020-014-0199-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/31/2014] [Indexed: 12/14/2022]
Abstract
Ipilimumab is a monoclonal antibody that blocks cytotoxic T-lymphocyte antigen4 (CTLA-4), an inhibitory molecule typically expressed on T cells. Blockade of CTLA-4 induces an overall activation of T cells, including an immune-mediated anti-tumour response. Unfortunately, this broad T cell stimulation also causes immune-related adverse events (irAEs), such as dermatitis, colitis, hepatitis and hypophysitis. Ipilimumab is currently available in Belgium as a second line of treatment for patients with advanced melanoma, and is used at a dose of 3 mg/kg of body weight, although higher doses were previously used (up to 10 mg/kg). We performed a retrospective analysis to identify melanoma patients treated with ipilimumab at the Ghent University Hospital between 2010 and 2013. Data on symptoms, stage and timing of ipilimumab, response and adverse events were collected with a special attention to endocrine disturbances, going from a limited involvement of one endocrine axis to development of a hypophysitis. We identified a total of 39 patients with stage III (No. = 7) or stage IV (No. = 32) melanoma, who received a dose of 3 (No. = 31) or 10 (No. = 8) mg/kg. Six patients developed a severe form of irAEs, including one case of colitis (2 %), one case of sarcoidosis (2 %) and 4 cases (10 %) of hypophysitis. Hypophysitis developed between the second and fourth cycle of ipilimumab administration and was independent of the dose used. We describe four cases of involvement of the pituitary gland during treatment with ipilimumab. When managed with vigilant monitoring and high-dose corticosteroids, the acute symptoms resolve, but lifelong hormone substitution therapy can be necessary. Involvement of the pituitary axes is a severe side effect of treatment with ipilimumab with an urgent need for the correct medical intervention.
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Affiliation(s)
- Joke Marlier
- Department of Medical Oncology, University Hospital Ghent, De Pintelaan 185, 9000, Ghent, Belgium,
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Tromme I, Devleesschauwer B, Beutels P, Richez P, Leroy A, Baurain JF, Cornelis F, Bertrand C, Legrand N, Degueldre J, Thomas L, Legrand C, Lambert J, Haagsma J, Speybroeck N. Health-related quality of life in patients with melanoma expressed as utilities and disability weights. Br J Dermatol 2014; 171:1443-50. [DOI: 10.1111/bjd.13262] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2014] [Indexed: 12/01/2022]
Affiliation(s)
- I. Tromme
- Department of Dermatology; Centre du Cancer; Cliniques Universitaires St Luc; Université catholique de Louvain; Brussels Belgium
| | - B. Devleesschauwer
- Institute of Health and Society; Faculty of Public Health; Université catholique de Louvain; Brussels Belgium
| | - P. Beutels
- Centre for Health Economics Research & Modelling Infectious Diseases; Vaccine & Infectious Disease Institute; University of Antwerp; Antwerp Belgium
| | - P. Richez
- Department of Dermatology; Centre du Cancer; Cliniques Universitaires St Luc; Université catholique de Louvain; Brussels Belgium
| | - A. Leroy
- Department of Dermatology; Centre du Cancer; Cliniques Universitaires St Luc; Université catholique de Louvain; Brussels Belgium
| | - J.-F. Baurain
- Department of Medical Oncology; Centre du Cancer, Cliniques Universitaires St Luc, Université catholique de Louvain; Brussels Belgium
| | - F. Cornelis
- Department of Medical Oncology; Centre du Cancer, Cliniques Universitaires St Luc, Université catholique de Louvain; Brussels Belgium
| | - C. Bertrand
- Department of Medical Oncology; Centre du Cancer, Cliniques Universitaires St Luc, Université catholique de Louvain; Brussels Belgium
| | - N. Legrand
- Department of Medical Oncology; Centre du Cancer, Cliniques Universitaires St Luc, Université catholique de Louvain; Brussels Belgium
| | - J. Degueldre
- Brussels Branch; Ludwig Institute for Cancer Research Ltd; Brussels Belgium
| | - L. Thomas
- Department of Dermatology; Lyon 1 University; Centre Hospitalier Lyon Sud; Lyon France
| | - C. Legrand
- Institute of Statistics; Biostatistics and Actuarial Sciences; Université catholique de Louvain; Louvain-la-neuve Belgium
| | - J. Lambert
- Department of Dermatology; Universitair Ziekenhuis Antwerpen; Antwerp Belgium
| | - J. Haagsma
- Department of Public Health; Erasmus University Rotterdam; Rotterdam the Netherlands
| | - N. Speybroeck
- Institute of Health and Society; Faculty of Public Health; Université catholique de Louvain; Brussels Belgium
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A review of sentinel lymph node biopsy for thin melanoma. Ir J Med Sci 2014; 184:119-23. [PMID: 25366817 DOI: 10.1007/s11845-014-1221-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/27/2014] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Although there is a lack of established survival benefit of sentinel lymph node biopsy (SLNB), this technique has been increasingly applied in the staging of patients with thin (≤1.00 mm) melanoma (T1Nx), without clear supportive evidence. METHODS We review the guidelines and available literature on the indications and rationale for performing SLNB in thin melanoma. RESULTS As a consequence of the paucity of evidence of SLNB in thin melanoma, there is considerable variability in the guidelines. It is difficult to define clinicopathologic factors that reliably predict the presence of nodal metastasis. SLNB does not yet inform management in thin melanoma to improve survival outcome. CONCLUSION Based on available evidence, high risk patients with melanomas between 0.75 and 1.00 mm may be appropriate candidates to be considered for SLN biopsy after discussing the likelihood of finding evidence of nodal progression, the risks of sentinel node biopsy, and the lack of proven survival benefit from any form of surgical nodal staging.
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Abstract
BACKGROUND Melanoma is a potentially curable cancer, but around 20% of patients will develop disease which is beyond surgical clearance. Rising incidence alongside breakthroughs in understanding the molecular biology of this disease identifying systemic therapies offering survival gains now demand a more proactive, integrated approach to melanoma management. SOURCES OF DATA PubMed references relating to aspects of melanoma research and treatment. AREAS OF AGREEMENT Rapidly rising incidence throughout the world. Effective surgery as well as new molecular targeted systemic biological agents and immunotherapies necessitating early diagnosis and multidisciplinary therapeutic interventions. AREAS OF CONTROVERSY Role of screening and prevention. Benefit of interventions for locoregional melanoma, including role of sentinel lymph node biopsy. Integration and sequencing of treatments for unresectable melanoma. GROWING POINTS Molecular determinants of melanoma influencing disease outcome and treatment decisions. AREAS TIMELY FOR DEVELOPING RESEARCH Education and training of patient and healthcare professionals. Role of screening, surveillance and follow-up strategies. Biology of melanoma guiding treatment decisions.
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Affiliation(s)
- Pippa Corrie
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge CB2 0QQ, UK
| | - Mirela Hategan
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge CB2 0QQ, UK
| | - Kate Fife
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge CB2 0QQ, UK
| | - Christine Parkinson
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge CB2 0QQ, UK
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Mrazek AA, Chao C. Surviving cutaneous melanoma: a clinical review of follow-up practices, surveillance, and management of recurrence. Surg Clin North Am 2014; 94:989-1002, vii-viii. [PMID: 25245963 DOI: 10.1016/j.suc.2014.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The number of melanoma survivors in the United States continues to steadily increase 2.6% per year, while death rates have remained stable over time. Although controversy exists regarding optimal surveillance strategies, recommendations for clinical monitoring are based on tumor stage, tumor phenotype, likelihood of recurrence, prognosis, risk factors, psychosocial impact of disease, and patient well-being. Management guidelines for recurrent disease depend on the type of recurrence: local, satellite/in-transit, regional, or distant metastasis. This article is a current review of the literature concerning melanoma survivorship.
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Affiliation(s)
- Amy A Mrazek
- Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Route 0534, Galveston, TX 77555, USA
| | - Celia Chao
- Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Route 0737, Galveston, TX 77555, USA.
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Wang W, Chen K, Liu Q, Johnston N, Ma Z, Zhang F, Zheng X. Suppression of tumor growth by Pleurotus ferulae ethanol extract through induction of cell apoptosis, and inhibition of cell proliferation and migration. PLoS One 2014; 9:e102673. [PMID: 25029345 PMCID: PMC4100894 DOI: 10.1371/journal.pone.0102673] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 06/22/2014] [Indexed: 01/29/2023] Open
Abstract
Cancer is the second leading cause of death worldwide. Edible medicinal mushrooms have been used in traditional medicine as regimes for cancer patients. Recently anti-cancer bioactive components from some mushrooms have been isolated and their anti-cancer effects have been tested. Pleurotus ferulae, a typical edible medicinal mushroom in Xinjiang China, has also been used to treat cancer patients in folk medicine. However, little studies have been reported on the anti-cancer components of Pleurotus ferulae. This study aims to extract bioactive components from Pleurotus ferulae and to investigate the anti-cancer effects of the extracts. We used ethanol to extract anti-cancer bioactive components enriched with terpenoids from Pleurotus ferulae. We tested the anti-tumour effects of ethanol extracts on the melanoma cell line B16F10, the human gastric cancer cell line BGC 823 and the immortalized human gastric epithelial mucosa cell line GES-1 in vitro and a murine melanoma model in vivo. Cell toxicity and cell proliferation were measured by MTT assays. Cell cycle progression, apoptosis, caspase 3 activity, mitochondrial membrane potential (MMP), migration and gene expression were studied in vitro. PFEC suppressed tumor cell growth, inhibited cell proliferation, arrested cells at G0/G1 phases and was not toxic to non-cancer cells. PFEC also induced cell apoptosis and necrosis, increased caspase 3 activity, reduced the MMP, prevented cell invasion and changed the expression of genes associated with apoptosis and the cell cycle. PFEC delayed tumor formation and reduced tumor growth in vivo. In conclusion, ethanol extracted components from Pleurotus ferulae exert anti-cancer effects through direct suppression of tumor cell growth and invasion, demonstrating its therapeutic potential in cancer treatment.
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Affiliation(s)
- Weilan Wang
- Life Science and Technology, Xinjiang University, Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, Urumqi, China
| | - Kaixu Chen
- Life Science and Technology, Xinjiang University, Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, Urumqi, China
| | - Qing Liu
- Norman Bethune College of Medicine, Jilin University, Changchun, China
| | | | - Zhenghai Ma
- Life Science and Technology, Xinjiang University, Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, Urumqi, China
| | - Fuchun Zhang
- Life Science and Technology, Xinjiang University, Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, Urumqi, China
- * E-mail: (XZ); (FZ)
| | - Xiufen Zheng
- Life Science and Technology, Xinjiang University, Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, Urumqi, China
- Department of Pathology, Western University, London, Canada
- Lawson Health Research Institute, London, Canada
- * E-mail: (XZ); (FZ)
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Breit MN, Kisseberth WC, Bear MD, Landesman Y, Kashyap T, McCauley D, Kauffman MG, Shacham S, London CA. Biologic activity of the novel orally bioavailable selective inhibitor of nuclear export (SINE) KPT-335 against canine melanoma cell lines. BMC Vet Res 2014; 10:160. [PMID: 25022346 PMCID: PMC4105800 DOI: 10.1186/1746-6148-10-160] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 07/01/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Exportin 1 (XPO1, also known as CRM1), is a chaperone protein responsible for the export of over 200 target proteins out of the nucleus. The expression and activity of XPO1 is upregulated in several human cancers and its expression is also linked to the development of chemotherapy resistance. Recent studies using both human and murine cancer cell lines have demonstrated that XPO1 is a relevant target for therapeutic intervention. The present study sought to characterize the biologic activity of an orally bioavailable selective inhibitor of nuclear export (SINE), KPT-335, against canine melanoma cell lines as a prelude to future clinical trials in dogs with melanoma. RESULTS We evaluated the effects of KPT-335 on 4 canine malignant melanoma cell lines and found that KPT-335 inhibited proliferation, blocked colony formation, and induced apoptosis of treated cells at biologically relevant concentrations of drug. Additionally, KPT-335 downregulated XPO1 protein while inducing a concomitant increase in XPO1 messenger RNA. Lastly, KPT-335 treatment of cell lines upregulated the expression of both protein and mRNA for the tumor suppressor proteins p53 and p21, and promoted their nuclear localization. CONCLUSIONS KPT-335 demonstrates biologic activity against canine melanoma cell lines at physiologically relevant doses, suggesting that KPT-335 may represent a viable treatment option for dogs with malignant melanoma.
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Affiliation(s)
- Megan N Breit
- Departments of Veterinary Biosciences and Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Rd., Columbus, OH 43210, USA
| | - William C Kisseberth
- Departments of Veterinary Biosciences and Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Rd., Columbus, OH 43210, USA
| | - Misty D Bear
- Departments of Veterinary Biosciences and Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Rd., Columbus, OH 43210, USA
| | | | | | | | | | | | - Cheryl A London
- Departments of Veterinary Biosciences and Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1925 Coffey Rd., Columbus, OH 43210, USA
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Fong ZV, Tanabe KK. The clinical management of hepatocellular carcinoma in the United States, Europe, and Asia: A comprehensive and evidence-based comparison and review. Cancer 2014; 120:2824-38. [DOI: 10.1002/cncr.28730] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 02/18/2014] [Accepted: 03/21/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Zhi Ven Fong
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
| | - Kenneth K. Tanabe
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
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Pastushenko I, Conejero C, Carapeto FJ. Lymphangiogenesis: implications for diagnosis, treatment, and prognosis in patients with melanoma. ACTAS DERMO-SIFILIOGRAFICAS 2014; 106:7-16. [PMID: 24890812 DOI: 10.1016/j.ad.2014.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 01/06/2014] [Accepted: 02/14/2014] [Indexed: 01/01/2023] Open
Abstract
Disease course in melanoma often cannot be accurately predicted by means of the prognostic factors usually considered in patients with melanoma; therefore, new factors are clearly needed. Increasingly robust scientific evidence shows that tumor lymph vessels play a key role in melanoma that metastasizes by lymphatic and hematogenous pathways. We review current knowledge and examine the implications of lymphangiogenesis in the diagnosis, treatment, and prognosis of patients with melanoma.
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Affiliation(s)
- I Pastushenko
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - C Conejero
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - F J Carapeto
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
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Tsao H. Opening the melanoma black box. Br J Dermatol 2014; 170:9-10. [DOI: 10.1111/bjd.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H. Tsao
- Department of Dermatology; Massachusetts General Hospital; Boston MA U.S.A
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