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Fan F, Gou J, Li S, Ji Q. A Prognostic Model for Cancer-Specific Survival Among Patients with Nodular Melanoma in Head and Neck. Laryngoscope 2024. [PMID: 38400783 DOI: 10.1002/lary.31342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/06/2024] [Accepted: 01/26/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES This study aims to evaluate the correlation between risk factors and treatment methods affecting nodular melanoma (NM) in the head and neck, as well as cancer-specific survival (CSS), and provide personalized predictive tools for clinical physicians. METHODS The retrospective study data of 1848 patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. All variables were included in the correlation analysis using the Spearman method. Significant prognostic factors were extracted and integrated through Cox risk regression analysis to construct a nomogram. To assess the performance of the nomogram, Harrell's concordance index (C-index) and a receiver operating characteristic (ROC) curve analysis were employed. RESULTS Spearman's correlation analysis revealed a positive correlation between radiotherapy and lymph node metastasis, whereas chemotherapy showed a stronger association with distant metastasis. However, Cox risk regression analysis demonstrated that Mohs surgery and wide excision with margins exceeding 1 cm yielded substantial therapeutic advantages. Five independent risk prognostic factors (Breslow thickness, ulceration, N classification, M classification, and surgery type) were employed to construct a nomogram. The C-index for this nomogram was 0.713 for the training set and 0.720 for the validation set. In the training set, the 3-, 5-, and 8-year areas under the curve (AUCs) for CSS were 0.752, 0.723, and 0.720, whereas the validation set's AUCs were 0.754, 0.763, and 0.760, respectively. Calibration curves indicated the nomogram's strong discriminative ability for predicting CSS. CONCLUSION In this study, we identified independent prognostic factors for patients with NM in head and neck and developed a relatively accurate model to predict the survival probability of them, which could contribute to the tumor assessment and clinical decision-making. LEVEL OF EVIDENCE Level 3 Laryngoscope, 2024.
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Affiliation(s)
- Fangli Fan
- Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Juxiang Gou
- Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shulian Li
- Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Ji
- Department of Aesthetic Plastic Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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2
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Stark MS, Sturm RA, Pan Y, Smit DJ, Kommajosyula V, Lee KJ, Jagirdar K, McLean C, Duffy DL, Soyer HP, Mar VJ. Assessing the genetic risk of nodular melanoma using a candidate gene approach. Br J Dermatol 2024; 190:199-206. [PMID: 37766469 DOI: 10.1093/bjd/ljad365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/28/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Nodular melanoma (NM) is a challenge to diagnose early due to its rapid growth and more atypical clinical presentation, making it the largest contributor to melanoma mortality. OBJECTIVES Our study aim was to perform a rare-variant allele (RVA) analysis of whole-exome sequencing of patients with NM and non-NM (minor allele frequency ≤ 1% non-Finnish European) for a set of 500 candidate genes potentially implicated in melanoma. METHODS This study recruited 131 participants with NM and 194 with non-NM from South-east Queensland and patients with NM from Victoria to perform a comparative analysis of possible genetic differences or similarities between the two melanoma cohorts. RESULTS Phenotypic analysis revealed that a majority of patients diagnosed with NM were older males with a higher frequency of fair skin and red hair than is seen in the general population. The distribution of common melanoma polygenic risk scores was similar in patients with NM and non-NM, with over 28% in the highest quantile of scores. There was also a similar frequency of carriage of familial/high-penetrant melanoma gene and loss-of-function variants. We identified 39 genes by filtering 500 candidate genes based on the greatest frequency in NM compared with non-NM cases. The genes with RVAs of greatest frequency in NM included PTCH1, ARID2 and GHR. Rare variants in the SMO gene, which interacts with PTCH1 as ligand and receptor, were also identified, providing evidence that the Hedgehog pathway may contribute to NM risk. There was a cumulative effect in carrying multiple rare variants in the NM-associated genes. A 14.8-fold increased ratio for NM compared with non-NM was seen when two RVAs of the 39 genes were carried by a patient. CONCLUSIONS This study highlights the importance of considering frequency of RVA to identify those at risk of NM in addition to known high penetrance genes.
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Affiliation(s)
- Mitchell S Stark
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Richard A Sturm
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Yan Pan
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Vic, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences
| | - Darren J Smit
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Varsha Kommajosyula
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Katie J Lee
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Kasturee Jagirdar
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
| | - Catriona McLean
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Vic, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences
| | - David L Duffy
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - H Peter Soyer
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Qld, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, Qld, Australia
| | - Victoria J Mar
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Vic, Australia
- School of Public Health and Preventive Medicine; Monash University, Melbourne, Vic, Australia
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3
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Zheng S, Yu H, Zheng X, Wu UT, Ming WK, Huang H, Song J, Zhang X, Lyu J, Deng L. Analysis and prediction of 5-year survival in patients with cutaneous melanoma: a model-based period analysis. Front Endocrinol (Lausanne) 2023; 14:1238086. [PMID: 38125787 PMCID: PMC10731280 DOI: 10.3389/fendo.2023.1238086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
Background The survival and prognosis of patients are significantly threatened by cutaneous melanoma (CM), which is a highly aggressive disease. It is therefore crucial to determine the most recent survival rate of CM. This study used population-based cancer registry data to examine the 5-year relative survival rate of CM in the US. Methods Period analysis was used to assess the relative survival rate and trends of patients with CM in the Surveillance, Epidemiology, and End Results (SEER) database during 2004-2018. And based on the data stratified by age, gender, race and subtype in the SEER database, a generalized linear model was 12established to predict the 5-year relative survival rate of CM patients from 2019 to 2023. Results The 5-year relative survival increased to various degrees for both total CM and CM subtypes during the observation period. The improvement was greatest for amelanotic melanoma, increasing from 69.0% to 81.5%. The 5-year overall relative survival rates of CM were 92.9%, 93.5%, and 95.6% for 2004-2008, 2009-2013, and 2014-2018, respectively. Females had a marginally higher survival rate than males for almost all subtypes, older people had lower survival rates than younger people, white patients had higher survival rates than nonwhite ones, and urban locations had higher rates of survival from CM than rural locations did. The survival rate of CM was significantly lower for distant metastasis. Conclusion The survival rate of patients with CM gradually improved overall during 2004-2018. With the predicted survival rate of 96.7% for 2019-2023, this trend will still be present. Assessing the changes experienced by patients with CM over the previous 15 years can help in predicting the future course of CM. It also provides a scientific foundation that associated departments can use to develop efficient tumor prevention and control strategies.
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Affiliation(s)
- Suzheng Zheng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Hai Yu
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Xinkai Zheng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - U Tim Wu
- Meng Yi Centre Limited, Macao, Macao SAR, China
| | - Wai-kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hui Huang
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Jiaxin Song
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Xiaoxi Zhang
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China
| | - Liehua Deng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
- Department of Dermatology, The Fifth Affiliated Hospital of Jinan University, Heyuan, China
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Ganko AG, Copertino N. Late diagnosis of a giant, pedunculated, cutaneous melanoma: a rare case study in an Australian tertiary centre. J Surg Case Rep 2023; 2023:rjad594. [PMID: 37942344 PMCID: PMC10629865 DOI: 10.1093/jscr/rjad594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/08/2023] [Indexed: 11/10/2023] Open
Abstract
Giant melanomas are uncommon tumours that still occur in Australia despite extensive public health messaging on the importance of early detection of skin cancers. We present the case of a 49-year-old female with a giant melanoma of her left arm measuring 101 × 71 × 22 mm, which had been growing for over 1 year and was metastatic on presentation. In this interesting case, we identify reasons for delayed presentation and highlight the importance of multi-disciplinary care in the management of such large tumours, with reference to other cases in the literature.
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Affiliation(s)
- Annabelle G Ganko
- Department of General Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia
| | - Nicolas Copertino
- Department of General Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia
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5
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Navarro-Nuño DE, Villarreal-Salgado JL, Grano-González VH, García-Marín G, Nuño-Rodríguez VH, Torres-Salazar QL. Surgical technique for margin widening in the treatment of polypoid nodular malignant back melanoma. Int J Surg Case Rep 2023; 110:108659. [PMID: 37574630 PMCID: PMC10448261 DOI: 10.1016/j.ijscr.2023.108659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Nodular melanoma is the second most frequent cutaneous melanoma worldwide and due to its rapid growth rate and non-malignant appearance, is the most aggressive one. In its polypoid form, it is usually found in mucosal areas, but can also be seen on the trunk. This case is presented because it is an unusual manifestation and surgical treatment required wide excision, however, the patient's evolution is favorable. CASE PRESENTATION 70-year-old female patient shows a progressively growing lesion with irregular border, abnormal color and a heterogeneous appearance. The biopsy yields the histological diagnosis of nodular polypoid melanoma. The surgical technique results in the resection of a 10 × 9 × 67 cm piece with favorable evolution of the patient. CLINICAL DISCUSSION AND CONCLUSIONS The surgical technique of margin widening is considered a recommended option for polypoid nodular back melanomas. Although the excision is considered vast, the patient's evolution may turn out to be favorable.
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Affiliation(s)
| | - José Luis Villarreal-Salgado
- Regional Hospital "Dr. Valentín Gómez Farías", Institute of Security and Social Services for State Workers, Mexico
| | - Víctor Hugo Grano-González
- Regional Hospital "Dr. Valentín Gómez Farías", Institute of Security and Social Services for State Workers, Mexico
| | - Gustavo García-Marín
- Regional Hospital "Dr. Valentín Gómez Farías", Institute of Security and Social Services for State Workers, Mexico
| | - Víctor Hugo Nuño-Rodríguez
- Regional Hospital "Dr. Valentín Gómez Farías", Institute of Security and Social Services for State Workers, Mexico
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Francis MA, Shaikh R, Inban P, Akuma O, Intsiful TA, Akuma CM, Lat Aung LL, Chukwuedozie VC, Francis S, Sukhoroslov M. Extensive Scalp Melanoma in an Elderly Female: A Case Report and Literature Review. Cureus 2023; 15:e45425. [PMID: 37859876 PMCID: PMC10581861 DOI: 10.7759/cureus.45425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/21/2023] Open
Abstract
Scalp melanoma is a rare and aggressive form of skin cancer. Its occurrence in the elderly population poses unique challenges due to factors such as delayed diagnosis and comorbidities. We present a case of extensive scalp melanoma in an elderly female to highlight the clinical presentation, diagnostic process, treatment modalities, and outcomes. Biopsy and histopathological analysis showed the presence of dysplastic nevi arising in pigmented melanocytic nevi, with uncertain pagetoid spread of atypical melanocytes. The management involved complete excision with safety margins and immunotherapy based on melanoma guidelines. This case underscores the importance of early detection and tailored treatment strategies in managing melanoma in elderly patients.
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Affiliation(s)
- Maya A Francis
- Internal Medicine, Windsor University School of Medicine, Cayon, KNA
| | - Rahila Shaikh
- Dermatology/Internal Medicine, Saba University School of Medicine, The Bottom, BES
| | - Pugazhendi Inban
- General Medicine, Government Medical College, Omandurar, Chennai, IND
| | | | | | | | - Lynn Lat Lat Aung
- College of Medicine, MAHSA (Malaysian Allied Health Sciences Academy) University, Petaling Jaya, MYS
| | | | - Sandra Francis
- Internal Medicine, Windsor University School of Medicine, Cayon, KNA
| | - Mikhail Sukhoroslov
- Internal Medicine, S.M. Kirov Military Medical Academy, Saint Petersburg, RUS
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7
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Słowińska M, Czarnecka I, Czarnecki R, Tatara P, Nasierowska-Guttmejer A, Lorent M, Cierniak S, Owczarek W. Clinical, Dermoscopic, and Histological Characteristics of Melanoma Patients According to the Age Groups: A Retrospective Observational Study. Life (Basel) 2023; 13:1369. [PMID: 37374151 DOI: 10.3390/life13061369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Although the role of melanoma risk factors is well documented, their correlation with patients' age is less frequently analyzed. METHOD The analysis was performed among 189 melanoma patients in different age groups, including <30 years, 31-60 years, and >60 years, to investigate the risk factors, topography, and coexistence of morphological features of 209 melanomas (dermoscopic and histopathological). RESULTS Among the youngest age group, no correlation with the presence of estimated risk factors was found. The most common dermoscopic pattern was spitzoid and multicomponent asymmetric. The group of middle-aged patients was the most diverse in terms of the occurrence of risk factors, solar lentiginosis, dermoscopic patterns, topography, histological subtypes, and invasiveness of melanomas. The oldest group characterized a strong correlation between solar lentiginosis, NMSC comorbidity, the prevalence of facial melanomas, the dermoscopic pattern of melanoma arising on chronic sun-damaged skin, and regression. CONCLUSION The findings regarding the presence of age-specific features in melanoma patients, especially in the youngest and middle-aged groups, might be helpful for clinicians and to target secondary prevention efforts.
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Affiliation(s)
- Monika Słowińska
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
- Evimed Medical Centre Ltd., Private Dermatologic Practice, JP Woronicza 16, 02-625 Warsaw, Poland
| | - Iwona Czarnecka
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Robert Czarnecki
- Department of Cardiology, LUX MED Oncology, Limited Liability Company, St. Elizabeth Hospital, Goszczynskiego 1, 02-616 Warsaw, Poland
| | - Paulina Tatara
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Anna Nasierowska-Guttmejer
- Department of Pathomorphology, Central Clinical Hospital of Ministry of Interior and Administration-National Medical Institute, Woloska 137, 02-507 Warsaw, Poland
- Faculty of Medicine, Lazarski University, Swieradowska 43, 02-662 Warsaw, Poland
| | - Małgorzata Lorent
- Department of Pathomorphology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Szczepan Cierniak
- Department of Pathomorphology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
| | - Witold Owczarek
- Department of Dermatology, Central Clinical Hospital Ministry of Defense, Military Institute of Medicine-National Research Institute, Szaserow 128, 04-141 Warsaw, Poland
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8
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Gonzalez S, King AD, Moossavi M. Nodular melanoma in an African American Japanese male. Clin Case Rep 2023; 11:e7083. [PMID: 36937623 PMCID: PMC10017401 DOI: 10.1002/ccr3.7083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/28/2023] [Accepted: 02/26/2023] [Indexed: 03/18/2023] Open
Abstract
Nodular melanoma (NM) is the third most common subtype of melanoma among African Americans trailing behind acral lentiginous melanoma and superficial spreading melanoma. This case of NM in an African American Japanese male was selected due to the rare occurrence of NM in people of color.
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Affiliation(s)
- Sarah Gonzalez
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Andrew D. King
- Wayne State University School of MedicineDetroitMichiganUSA
| | - Meena Moossavi
- Wayne State University School of MedicineDetroitMichiganUSA
- Department of Dermatology, John D. Dingell VA Medical CenterWayne State University School of MedicineDetroitMichiganUSA
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9
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Dessinioti C, Geller AC, Stratigos AJ. A review of nevus-associated melanoma: What is the evidence? J Eur Acad Dermatol Venereol 2022; 36:1927-1936. [PMID: 35857388 DOI: 10.1111/jdv.18453] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Abstract
Cutaneous melanoma may have an adjacent nevus remnant on histological examination in 30% of cases (nevus-associated melanoma, NAM), while it may appear de novo, without a precursor lesion, in the remaining 70% of cases. Nevus-associated melanoma and the concept of acquired melanocytic nevi serving as precursors of melanoma, has long been considered as a controversial topic. This controversy is, in part, due to their overall low rate of transformation to melanoma and scarce data on the natural history of progression. Another matter of debate regarded the possibility that the reported differences of NAM versus de novo melanoma, were due to an underestimation of NAM in thicker lesions due to obliteration of the nevus component by the tumour. During the last few years, several evidence has accumulated in order to address these controversies. In this review, we present a comprehensive synthesis of the epidemiological, clinical, dermoscopic and genetic findings in NAM, including thin NAM, compared to de novo melanoma. Answering the questions on nevus-associated melanoma may provide further insight on the classification of these tumours and disentangle their biology and route of development from that of de novo melanoma.
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Affiliation(s)
- Clio Dessinioti
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard TH School of Public Health, Boston, MA, United States
| | - Alexander J Stratigos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
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10
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Rodríguez-Betancourt JD, Arias-Ortiz N. Cutaneous melanoma incidence, mortality, and survival in Manizales, Colombia: a population-based study. J Int Med Res 2022; 50:3000605221106706. [PMID: 35722901 PMCID: PMC9344176 DOI: 10.1177/03000605221106706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We estimated the cutaneous melanoma (CM) incidence, mortality, and survival in Manizales, Colombia to establish predictors for survival. METHODS This analytical cohort study used CM incident cases during 2006 to 2015 in the Manizales Cancer Registry (n = 132). Incidence and mortality rates were standardized using the direct method. Patients were followed up until 30 November 2020. Cause-specific survival was calculated using the Kaplan-Meier method for variables of interest, with the log-rank test for differences. Cox multivariate regression models were fitted. RESULTS Incidence (per 100,000) increased from 1.6 to 3.0 in men and 2.6 to 2.8 in women during 2006-2010 to 2011-2015, respectively. Mortality was low and stable. Five-year survival was 68.7%, with significant differences according to age (hazard ratio [HR] >70 vs. ≤70 years: 3.37); histological subtype (HR for melanoma not otherwise specified and HR for nodular melanoma vs lentigo malignant melanoma and superficial spreading melanoma: 17.39 and 10.16, respectively); and clinical stage (HR stages III-IV vs. stages I-II: 5.94). CONCLUSION CM is characterized by increasing incidence and unfavorable prognosis, particularly in patients aged >70 years, with melanoma not otherwise specified and nodular melanoma, and advanced stages. Promoting photoprotection and early detection and management of suspicious skin lesions is crucial.
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Affiliation(s)
- Juan David Rodríguez-Betancourt
- Young Researchers Program, Ministerio de Ciencia, Tecnología e
Innovación, Bogotá, Colombia
- Population-based Manizales Cancer Registry, Instituto de
Investigaciones en Salud, Universidad de Caldas, Manizales, Colombia
- Departamento de Salud Pública, Universidad de Caldas, Manizales,
Colombia
| | - Nelson Arias-Ortiz
- Population-based Manizales Cancer Registry, Instituto de
Investigaciones en Salud, Universidad de Caldas, Manizales, Colombia
- Departamento de Salud Pública, Universidad de Caldas, Manizales,
Colombia
- Grupo de Investigación Promoción de la Salud y Prevención de la
Enfermedad, Universidad de Caldas, Manizales, Colombia
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11
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Casalou C, Moreiras H, Mayatra JM, Fabre A, Tobin DJ. Loss of 'Epidermal Melanin Unit' Integrity in Human Skin During Melanoma-Genesis. Front Oncol 2022; 12:878336. [PMID: 35574390 PMCID: PMC9097079 DOI: 10.3389/fonc.2022.878336] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/09/2022] [Indexed: 12/13/2022] Open
Abstract
Cutaneous melanoma can be a most challenging neoplasm of high lethality, in part due to its extreme heterogeneity and characteristic aggressive and invasive nature. Indeed, its moniker 'the great masquerader' reflects that not all melanomas are created equal in terms of their originating cellular contexts, but also that melanoma cells in the malignant tumor can adopt a wide range of different cell states and variable organotropism. In this review, we focus on the early phases of melanomagenesis by discussing how the originating pigment cell of the melanocyte lineage can be influenced to embark on a wide range of tumor fates with distinctive microanatomical pathways. In particular, we assess how cells of the melanocyte lineage can differ by maturation status (stem cell; melanoblast; transiently amplifying cell; differentiated; post-mitotic; terminally-differentiated) as well as by micro-environmental niche (in the stratum basale of the epidermis; within skin appendages like hair follicle, eccrine gland, etc). We discuss how the above variable contexts may influence the susceptibility of the epidermal-melanin unit (EMU) to become unstable, which may presage cutaneous melanoma development. We also assess how unique features of follicular-melanin unit(s) (FMUs) can, by contrast, protect melanocytes from melanomagenesis. Lastly, we postulate how variable melanocyte fates in vitiligo, albinism, psoriasis, and alopecia areata may provide new insights into immune-/non immune-mediated outcomes for melanocytes in cutaneous melanin units.
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Affiliation(s)
- Cristina Casalou
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Hugo Moreiras
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jay M Mayatra
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland.,The Conway Institute of Biomedical and Biomolecular Science, University College Dublin, Dublin, Ireland
| | - Desmond J Tobin
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland.,The Conway Institute of Biomedical and Biomolecular Science, University College Dublin, Dublin, Ireland
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