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Garcia-Casado Z, Millán-Esteban D, Manrique-Silva E, Requena C, Traves V, Nagore E. Germline cancer-related mutations detected by routine targeted NGS for tumour analysis: A series of 357 melanoma patients. J Eur Acad Dermatol Venereol 2023; 37:e1384-e1387. [PMID: 37422710 DOI: 10.1111/jdv.19323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Z Garcia-Casado
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - D Millán-Esteban
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - E Manrique-Silva
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - V Traves
- Department of Pathological Anatomy, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Requena C, Traves V, Ferrandis E, Almero MA, Casado ZG, Silva EM, Briz ÁS, Escalonilla P, Nagore E. [[Translated article]]Melanoma arising in plaque-type blue nevus and dermal melanocytosis: Diagnostic and prognostic value of BAP1. Actas Dermosifiliogr 2023:S0001-7310(23)00477-5. [PMID: 37302484 DOI: 10.1016/j.ad.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/02/2023] [Indexed: 06/13/2023] Open
Abstract
Melanoma arising in blue nevus, also known as melanoma ex blue nevus, is a specific form of melanoma whose genetic profile is different to that of other cutaneous melanomas and surprisingly similar to that of uveal melanoma. Although melanoma ex blue nevus can appear de novo, it usually arises in a preexisting blue nevus or dermal melanocytosis. Not all nodular lesions arising in association with blue nevus or dermal melanocytosis are melanomas, however, and because clinical and histologic findings may be insufficient for a definitive diagnosis, additional studies such as comparative genomic hybridization are important. Detection of chromosomal aberrations supports a diagnosis of malignancy. Studies of the BAP1 gene are particularly useful in this setting because loss of expression is indicative of melanoma. We present 3 cases on the spectrum of blue nevus to melanoma ex blue nevus that were studied using molecular biology techniques.
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Affiliation(s)
- C Requena
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain.
| | - Víctor Traves
- Servicios de Dermatología, Anatomía Patológica, Spain
| | - E Ferrandis
- Otorrinolaringología y Biología molecular, Spain
| | | | - Z García Casado
- del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain
| | - E Manrique Silva
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - Á Santos Briz
- del Hospital Universitario Salamanca y Dermatología, Spain
| | - P Escalonilla
- del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - E Nagore
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
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Requena C, Traves V, Ferrandis E, Antón Almero M, García-Casado Z, Manrique-Silva E, Santos Briz Á, Escalonilla P, Nagore E. Melanoma Arising in Plaque-Type Blue Nevus and Dermal Melanocytosis: Diagnostic and Prognostic Value of BAP1. Actas Dermosifiliogr 2023:S0001-7310(23)00299-5. [PMID: 37088284 DOI: 10.1016/j.ad.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
Melanoma arising in blue nevus, also known as melanoma ex blue nevus, is a specific form of melanoma whose genetic profile is different to that of other cutaneous melanomas and surprisingly similar to that of uveal melanoma. Although melanoma ex blue nevus can appear de novo, it usually arises in a preexisting blue nevus or dermal melanocytosis. Not all nodular lesions arising in association with blue nevus or dermal melanocytosis are melanomas, however, and because clinical and histologic findings may be insufficient for a definitive diagnosis, additional studies such as comparative genomic hybridization are important. Detection of chromosomal aberrations supports a diagnosis of malignancy. Studies of the BAP1 gene are particularly useful in this setting because loss of expression is indicative of melanoma. We present 3 cases on the spectrum of blue nevus to melanoma ex blue nevus that were studied using molecular biology techniques.
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Affiliation(s)
| | | | | | | | | | | | - Á Santos Briz
- del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain
| | - P Escalonilla
- del Hospital Universitario Salamanca y Dermatología del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - E Nagore
- Servicios de Dermatología, Spain
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Martinez-de-Juan F, Traves V, Requena C. A Rare Hidden Mole, an Incidental Finding in Colonoscopy. Gastroenterology 2022; 163:e6-e7. [PMID: 35143818 DOI: 10.1053/j.gastro.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/02/2022]
Affiliation(s)
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain.
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. [Translated article] Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. Actas Dermosifiliogr 2022; 113:347-353. [PMID: 35623724 DOI: 10.1016/j.ad.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Vitamin D plays a fundamental role in many metabolic pathways, including those involved in cell proliferation and the immune response. Serum levels of this vitamin have been linked to melanoma risk and prognosis. This study aimed to assess the prognostic value of vitamin D serum level in melanoma. MATERIAL AND METHODS Retrospective, observational, longitudinal, and analytical study of 286 patients with a histologic diagnosis of melanoma in whom serum levels of vitamin D were measured at the time of diagnosis. We analyzed associations between serum level and epidemiologic and clinical variables and pathology findings; we also analyzed the influence of vitamin D on overall survival. An iterative loop was used to identify a vitamin D serum level to test for its an association with survival. RESULTS A vitamin D level less than 9.25ng/mL was associated with a histologic finding of ulceration. After a median follow-up period of 39.4 months, 24 patients (8.4%) had died. The cutoff of 9.25ng/mL was associated with lower overall survival according to both the Kaplan-Meier curves and multivariate Cox regression analysis. CONCLUSION Vitamin D levels less than 9.25ng/mL are associated with ulceration in melanoma and serve as an independent prognostic factor for overall survival in this disease.
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Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Clinica San Carlo, Paderno Dugnano, Italia
| | - A Sánchez-Silva
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - M Aguerralde-Martin
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España
| | - R González-Cuevas
- Servicio de Dermatología, Hospital del Salvador, Santiago, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Peruilh-Bagolini
- Facultad de Medicina, Universidad de Chile, Santiago, Chile; Fundación Arturo López Pérez (FALP), Oncologic Institute, Santiago, Chile
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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Gavillero A, García-Casado Z, Requena C, Manrique-Silva E, Traves V, Kumar R, Nagore E. Differences by Anatomical Site of Non-Acral Lentiginous Melanomas of the Lower Limb. Dermatology 2022; 238:977-985. [PMID: 35350018 DOI: 10.1159/000522492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/06/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Acral location of melanomas is associated with poor survival. It can be due, at least in part, to the fact that acral lentiginous melanoma, a distinct melanoma subtype, has a particular biological profile and a bad clinical behavior. However, since almost 50% of acral melanomas are not of acral lentiginous melanoma subtype, the worse clinical behavior could also be attributable to the intrinsic characteristics of the location. OBJECTIVE This study aimed to investigate if melanomas of the lower limb excluding acral lentiginous melanoma differ by location. METHODS This retrospective, observational study recruited patients from an oncology referral center in Spain. We included 285 patients with superficial spreading and nodular melanomas of the lower limb. We compare melanomas by site, clinical and pathological characteristics, and the differences by location of disease-free and melanoma-specific survival by the Kaplan-Meier method and Cox proportional hazard method. RESULTS Patients with melanomas on the foot, compared to those on the rest of the limb, were older and reported having suffered less sunburns; the melanoma more frequently appeared in areas that had been rarely sun exposed, were more frequently of nodular type, presented thicker tumors, with more ulceration, less regression, and more advanced stage of the disease. Foot location increased the risk of relapse and decreased melanoma-specific survival. CONCLUSION Melanoma development in foot is less related to sun exposure and is associated with pathological features that can account for the worse prognosis and poorer survival.
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Affiliation(s)
- Alicia Gavillero
- School of Physiotherapy and Podiatry, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Víctor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, Division of Genomic Functional Analysis. DKFZ, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Tejera-Vaquerizo A, Boada A, Ribero S, Puig S, Paradela S, Moreno-Ramírez D, Cañueto J, de Unamuno-Bustos B, Brinca A, Descalzo-Gallego MA, Osella-Abate S, Cassoni P, Podlipnik S, Carrera C, Vidal-Sicart S, Pigem R, Toll A, Rull R, Alos L, Requena C, Bolumar I, Traves V, Pla Á, Fernández-Orland A, Jaka A, Fernández-Figueras MT, Richarz NA, Vieira R, Botella-Estrada R, Román-Curto C, Ferrándiz-Pulido L, Iglesias-Pena N, Ferrándiz C, Malvehy J, Quaglino P, Nagore E. Sentinel Lymph Node Biopsy vs. Observation in Thin Melanoma: A Multicenter Propensity Score Matching Study. J Clin Med 2021; 10:jcm10245878. [PMID: 34945175 PMCID: PMC8708109 DOI: 10.3390/jcm10245878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/22/2022] Open
Abstract
The therapeutic value of sentinel lymph node biopsy (SLNB) in thin melanoma remains controversial. The aim of this study is to determine the role of SLNB in the survival of thin melanomas (≤1 mm). A multicenter retrospective observational study was designed. A propensity score matching was performed to compare patients who underwent SLNB vs. observation. A multivariate Cox regression was used. A total of 1438 patients were matched by propensity score. There were no significant differences in melanoma-specific survival (MSS) between the SLNB and observation groups. Predictors of MSS in the multivariate model were age, tumor thickness, ulceration, and interferon treatment. Results were similar for disease-free survival and overall survival. The 5- and 10-year MSS rates for SLN-negative and -positive patients were 98.5% vs. 77.3% (p < 0.001) and 97.3% vs. 68.7% (p < 0.001), respectively. SLNB does not improve MSS in patients with thin melanoma. It also had no impact on DSF or OS. However, a considerable difference in MSS, DFS, and OS between SLN-positive and -negative patients exists, confirming its value as a prognostic procedure and therefore we recommend discussing the option of SLNB with patients.
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Affiliation(s)
- Antonio Tejera-Vaquerizo
- Dermatology Department, Instituto Dermatológico GlobalDerm, 14700 Palma del Río, Spain
- Cutaneous Oncology Unit, Hospital San Juan de Dios, 14012 Córdoba, Spain
- Correspondence: ; Tel.: +34-957644564
| | - Aram Boada
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain; (A.B.); (A.J.); (N.A.R.); (C.F.)
| | - Simone Ribero
- Medical Sciences Department, Section of Dermatology, University of Turin, 10124 Turin, Italy; (S.R.); (P.Q.)
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Sabela Paradela
- Departamento de Dermatología, Hospital Universitario de la Coruña, 15006 La Coruña, Spain; (S.P.); (N.I.-P.)
| | - David Moreno-Ramírez
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain; (D.M.-R.); (A.F.-O.); (L.F.-P.)
| | - Javier Cañueto
- Dermatology Department, Complejo Asistencial Universitario de Salamanca, 37007 Salamanca, Spain; (J.C.); (C.R.-C.)
| | - Blanca de Unamuno-Bustos
- Dermatology Department, Hospital Universitario La Fe, 46126 Valencia, Spain; (B.d.U.-B.); (R.B.-E.)
| | - Ana Brinca
- Departament of Dermatology, University Hospital of Coimbra, 3000-075 Coimbra, Portugal; (A.B.); (R.V.)
| | | | - Simona Osella-Abate
- Medical Sciences Department, Section of Surgical Pathology, University of Turin, 10124 Turin, Italy; (S.O.-A.); (P.C.)
| | - Paola Cassoni
- Medical Sciences Department, Section of Surgical Pathology, University of Turin, 10124 Turin, Italy; (S.O.-A.); (P.C.)
| | - Sebastian Podlipnik
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Cristina Carrera
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clinic Barcelona, Universitat de Barcelona, Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
| | - Ramón Pigem
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Agustí Toll
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Ramón Rull
- Surgery Department, Hospital Clinic, Universidad de Barcelona, 08036 Barcelona, Spain;
| | - Llucìa Alos
- Pathology Department, Hospital Clinic, Universidad de Barcelona, 08036 Barcelona, Spain;
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; (C.R.); (E.N.)
| | - Isidro Bolumar
- Surgery Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain;
| | - Víctor Traves
- Pathology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain;
| | - Ángel Pla
- Otorhinolaringology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain;
| | - Almudena Fernández-Orland
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain; (D.M.-R.); (A.F.-O.); (L.F.-P.)
| | - Ane Jaka
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain; (A.B.); (A.J.); (N.A.R.); (C.F.)
| | | | - Nina Anika Richarz
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain; (A.B.); (A.J.); (N.A.R.); (C.F.)
| | - Ricardo Vieira
- Departament of Dermatology, University Hospital of Coimbra, 3000-075 Coimbra, Portugal; (A.B.); (R.V.)
| | - Rafael Botella-Estrada
- Dermatology Department, Hospital Universitario La Fe, 46126 Valencia, Spain; (B.d.U.-B.); (R.B.-E.)
| | - Concepción Román-Curto
- Dermatology Department, Complejo Asistencial Universitario de Salamanca, 37007 Salamanca, Spain; (J.C.); (C.R.-C.)
- Instituto de Investigación Biomédica de Salamanca, Complejo Asistencial Universitario de Salamanca, 37007 Salamanca, Spain
| | - Lara Ferrándiz-Pulido
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain; (D.M.-R.); (A.F.-O.); (L.F.-P.)
| | - Nicolás Iglesias-Pena
- Departamento de Dermatología, Hospital Universitario de la Coruña, 15006 La Coruña, Spain; (S.P.); (N.I.-P.)
| | - Carlos Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trials i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain; (A.B.); (A.J.); (N.A.R.); (C.F.)
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (S.P.); (C.C.); (R.P.); (A.T.); (J.M.)
- Biomedical Research Networking Center on Rare Diseases (CIBERER), ISCIII, 28029 Barcelona, Spain
| | - Pietro Quaglino
- Medical Sciences Department, Section of Dermatology, University of Turin, 10124 Turin, Italy; (S.R.); (P.Q.)
| | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; (C.R.); (E.N.)
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Millán-Esteban D, García-Casado Z, Manrique-Silva E, Virós A, Kumar R, Furney S, López-Guerrero JA, Requena C, Bañuls J, Traves V, Nagore E. Distribution and clinical role of KIT gene mutations in melanoma according to subtype: a study of 492 Spanish patients. Eur J Dermatol 2021; 31:830-838. [PMID: 33648909 PMCID: PMC7615026 DOI: 10.1684/ejd.2021.3971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND KIT mutations are primarily associated with acral and mucosal melanoma, and have been reported to show higher prevalence in chronic sun-damaged (CSD) than non-CSD melanomas. OBJECTIVES To investigate the prevalence of KIT mutations in melanoma according to subtype, and determine the clinical role of such mutations. MATERIALS & METHODS We present results from a study of a Spanish population of 492 melanomas, classified according to the latest World Health Organization (WHO) guidelines. We analysed the mutational status of KIT and correlated with different clinical variables related to sun exposure and family history. RESULTS KIT mutations were significantly more frequent in acral (3/36; 8.3%) and mucosal (4/8; 50%) melanomas than non-acral cutaneous melanomas. No significant difference was observed in KIT mutational status between CSD and non-CSD melanomas. CONCLUSION Our results suggest that KIT mutations in melanoma tumours are unrelated to the development of nevi or chronic sun damage, but their presence is associated with aggressive melanomas which show ulceration, vascular invasiveness, and increased Breslow thickness. These findings are consistent with those reported by The Cancer Genome Atlas network.
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Affiliation(s)
- David Millán-Esteban
- Laboratory of Molecular Biology. Fundación Instituto Valenciano de Oncología. València, Spain
| | - Zaida García-Casado
- Laboratory of Molecular Biology. Fundación Instituto Valenciano de Oncología. València, Spain
| | | | - Amaya Virós
- Laboratory of Skin Cancer and Aging. CRUK-Manchester Institute. University of Manchester. Manchester. UK
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, Division of Genomic Functional Analysis. DKFZ. Heidelberg, Germany
| | - Simon Furney
- Genomic Oncology Research Group, Centre for Systems Medicine, Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Celia Requena
- Department of Dermatology. Fundación Instituto Valenciano de Oncología. València, Spain
| | - Jose Bañuls
- Department of Dermatology. Hospital General Universitario de Alicante. Alicante, Spain
| | - Víctor Traves
- Department of Pathology. Fundación Instituto Valenciano de Oncología. València, Spain
| | - Eduardo Nagore
- Department of Dermatology. Fundación Instituto Valenciano de Oncología. València, Spain
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10
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Millán-Esteban D, Peña-Chilet M, García-Casado Z, Manrique-Silva E, Requena C, Bañuls J, López-Guerrero JA, Rodríguez-Hernández A, Traves V, Dopazo J, Virós A, Kumar R, Nagore E. Mutational Characterization of Cutaneous Melanoma Supports Divergent Pathways Model for Melanoma Development. Cancers (Basel) 2021; 13:5219. [PMID: 34680367 PMCID: PMC8533762 DOI: 10.3390/cancers13205219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/22/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
According to the divergent pathway model, cutaneous melanoma comprises a nevogenic group with a propensity to melanocyte proliferation and another one associated with cumulative solar damage (CSD). While characterized clinically and epidemiologically, the differences in the molecular profiles between the groups have remained primarily uninvestigated. This study has used a custom gene panel and bioinformatics tools to investigate the potential molecular differences in a thoroughly characterized cohort of 119 melanoma patients belonging to nevogenic and CSD groups. We found that the nevogenic melanomas had a restricted set of mutations, with the prominently mutated gene being BRAF. The CSD melanomas, in contrast, showed mutations in a diverse group of genes that included NF1, ROS1, GNA11, and RAC1. We thus provide evidence that nevogenic and CSD melanomas constitute different biological entities and highlight the need to explore new targeted therapies.
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Affiliation(s)
- David Millán-Esteban
- School of Medicine, Universidad Católica de València San Vicente Mártir, 46001 Valencia, Spain;
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (Z.G.-C.); (J.A.L.-G.)
| | - María Peña-Chilet
- Clinical Bioinformatics Area, Fundación Progreso y Salud, Hospital Virgen del Rocío, 41013 Sevilla, Spain; (M.P.-C.); (J.D.)
- Bioinformatics in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 41013 Sevilla, Spain
- Computational Systems Medicine, Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (Z.G.-C.); (J.A.L.-G.)
| | - Esperanza Manrique-Silva
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (E.M.-S.); (A.R.-H.)
| | - Celia Requena
- Computational Systems Medicine, Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - José Bañuls
- Department of Dermatology, El Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - Jose Antonio López-Guerrero
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (Z.G.-C.); (J.A.L.-G.)
| | - Aranzazu Rodríguez-Hernández
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (E.M.-S.); (A.R.-H.)
| | - Víctor Traves
- Department of Pathological Anatomy, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain;
| | - Joaquín Dopazo
- Clinical Bioinformatics Area, Fundación Progreso y Salud, Hospital Virgen del Rocío, 41013 Sevilla, Spain; (M.P.-C.); (J.D.)
- Bioinformatics in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 41013 Sevilla, Spain
- Computational Systems Medicine, Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocío, 41013 Sevilla, Spain;
- Fundación Progreso y Salud-ELIXIR-es, Hospital Virgen del Rocío, 41013 Sevilla, Spain
| | - Amaya Virós
- Skin Cancer and Aging Lab, Cancer Research UK Manchester Institute, University of Manchester, Manchester SK10 4TG, UK;
| | - Rajiv Kumar
- Division of Functional Genome Analysis, Deutsches Krebsforschüngzentrum, 69120 Heidelberg, Germany;
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska, 142 20 Prague, Czech Republic
- Institute of Medical Biometry and Informatics, University of Heidelberg, 69117 Heidelberg, Germany
| | - Eduardo Nagore
- School of Medicine, Universidad Católica de València San Vicente Mártir, 46001 Valencia, Spain;
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain; (E.M.-S.); (A.R.-H.)
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11
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Budden T, Gaudy-Marqueste C, Porter A, Kay E, Gurung S, Earnshaw CH, Roeck K, Craig S, Traves V, Krutmann J, Muller P, Motta L, Zanivan S, Malliri A, Furney SJ, Nagore E, Virós A. Ultraviolet light-induced collagen degradation inhibits melanoma invasion. Nat Commun 2021; 12:2742. [PMID: 33980846 PMCID: PMC8115293 DOI: 10.1038/s41467-021-22953-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/08/2021] [Indexed: 01/26/2023] Open
Abstract
Ultraviolet radiation (UVR) damages the dermis and fibroblasts; and increases melanoma incidence. Fibroblasts and their matrix contribute to cancer, so we studied how UVR modifies dermal fibroblast function, the extracellular matrix (ECM) and melanoma invasion. We confirmed UVR-damaged fibroblasts persistently upregulate collagen-cleaving matrix metalloprotein-1 (MMP1) expression, reducing local collagen (COL1A1), and COL1A1 degradation by MMP1 decreased melanoma invasion. Conversely, inhibiting ECM degradation and MMP1 expression restored melanoma invasion. Primary cutaneous melanomas of aged humans show more cancer cells invade as single cells at the invasive front of melanomas expressing and depositing more collagen, and collagen and single melanoma cell invasion are robust predictors of poor melanoma-specific survival. Thus, primary melanomas arising over collagen-degraded skin are less invasive, and reduced invasion improves survival. However, melanoma-associated fibroblasts can restore invasion by increasing collagen synthesis. Finally, high COL1A1 gene expression is a biomarker of poor outcome across a range of primary cancers.
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Affiliation(s)
- Timothy Budden
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | | | - Andrew Porter
- Cell Signalling Group, Cancer Research UK Manchester Institute, The University of Manchester, Alderley Park, Manchester, UK
| | - Emily Kay
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- CRUK Beatson Institute, Glasgow, UK
| | - Shilpa Gurung
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - Charles H Earnshaw
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - Katharina Roeck
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - Sarah Craig
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - Víctor Traves
- Department of Dermatology, Institut Valencià Oncologia, Valencia, Spain
| | - Jean Krutmann
- IUF - Leibniz Research Institute of Environmental Medicine, Düsseldorf, Germany
- Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Patricia Muller
- Tumour Suppressors Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - Luisa Motta
- Department of Histopathology, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Sara Zanivan
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- CRUK Beatson Institute, Glasgow, UK
| | - Angeliki Malliri
- Cell Signalling Group, Cancer Research UK Manchester Institute, The University of Manchester, Alderley Park, Manchester, UK
| | - Simon J Furney
- Genomic Oncology Research Group, Department of Physiology and Medical Physics, Royal College of Surgeons in, Ireland, Dublin, Ireland
- Centre for Systems Medicine, Royal College of Surgeons in Ireland Dublin, Dublin, Ireland
| | - Eduardo Nagore
- Department of Dermatology, Institut Valencià Oncologia, Valencia, Spain
| | - Amaya Virós
- Skin Cancer and Ageing Lab, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK.
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12
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Moro R, Requena C, Ríos-Viñuela E, Manrique-Silva E, Traves V, Calzavara-Pinton PG, Gualdi G, Nagore E. May melanophages hinder the subclinical spread of lentigo maligna and lentigo maligna melanoma? Results from a pilot study. J Eur Acad Dermatol Venereol 2021; 35:e365-e367. [PMID: 33462879 DOI: 10.1111/jdv.17127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/10/2020] [Accepted: 01/14/2021] [Indexed: 12/31/2022]
Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Dermatologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - E Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - V Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - P G Calzavara-Pinton
- Department of Dermatology, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - G Gualdi
- Dermatologic Clinic, Department of Medicine and Aging Science, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
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13
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Ríos-Viñuela E, Bernia E, Diago A, Traves V, Requena C, Llombart B, Sanmartín O. Cutaneous intralymphatic histiocytosis associated with breast and orthopedic surgery. J Cutan Pathol 2021; 48:725-729. [PMID: 32396263 DOI: 10.1111/cup.13740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Eduardo Bernia
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Adrián Diago
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor Traves
- Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Onofre Sanmartín
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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14
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Tejera-Vaquerizo A, Fernández-Figueras M, Santos-Briz Á, Ríos-Martín J, Monteagudo C, Fernández-Flores Á, Requena C, Traves V, Descalzo-Gallego M, Rodríguez-Peralto J. Protocol for the Histologic Diagnosis of Cutaneous Melanoma: Consensus Statement of the Spanish Society of Pathology and the Spanish Academy of Dermatology and Venereology (AEDV) for the National Cutaneous Melanoma Registry. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2020.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Tejera-Vaquerizo A, Fernández-Figueras MT, Santos-Briz A, Ríos-Martín JJ, Monteagudo C, Fernández-Flores A, Requena C, Traves V, Descalzo-Gallego MA, Rodríguez-Peralto JL. Protocol for the Histologic Diagnosis of Cutaneous Melanoma: Consensus Statement of the Spanish Society of Pathology and the Spanish Academy of Dermatology and Venereology (AEDV) for the National Cutaneous Melanoma Registry. Actas Dermosifiliogr (Engl Ed) 2021; 112:32-43. [PMID: 33038295 PMCID: PMC7540207 DOI: 10.1016/j.ad.2020.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/15/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022] Open
Abstract
This article describes a proposed protocol for the histologic diagnosis of cutaneous melanoma developed for the National Cutaneous Melanoma Registry managed by the Spanish Academy of Dermatology and Venereology (AEDV). Following a review of the literature, 36 variables relating to primary tumors, sentinel lymph nodes, and lymph node dissection were evaluated using the modified Delphi method by a panel of 8 specialists (including 7 pathologists). Consensus was reached on the 30 variables that should be included in all pathology reports for cutaneous melanoma and submitted to the Melanoma Registry. This list can also serve as a model to guide routine reporting in pathology departments.
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Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, España; Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, España.
| | - M T Fernández-Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallès, Barcelona, España
| | - A Santos-Briz
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - J J Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - C Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
| | - A Fernández-Flores
- Servicio de Anatomía Patológica, Hospital del Bierzo, Ponferrada, León, España; Servicio de Anatomía Patológica, Hospital de la Reina, Ponferrada, León, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - M A Descalzo-Gallego
- Unidad de Investigación, Fundación Academia Española de Dermatología y Venereología, Madrid, España
| | - J L Rodríguez-Peralto
- Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
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16
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Machado I, Giner F, Lavernia J, Cruz J, Traves V, Requena C, Llombart B, López-Guerrero JA, Llombart-Bosch A. Angiosarcomas: histology, immunohistochemistry and molecular insights with implications for differential diagnosis. Histol Histopathol 2020; 36:3-18. [PMID: 32885407 DOI: 10.14670/hh-18-246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Angiosarcomas (AS) represent a heterogenous group of tumors with variable clinical presentation. AS share an important morphologic and immunohistochemical overlap with other sarcomas, hence the differential diagnosis is challenging, especially in poorly-differentiated tumors. Although molecular studies provide significant clues, especially in the differential diagnosis with other vascular neoplasms, a thorough hematoxylin and eosin analysis remains an essential tool in AS diagnosis. In this review, we discuss pathological and molecular insights with emphasis on implications for differential diagnosis in cutaneous, breast, soft tissue and visceral AS.
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Affiliation(s)
- Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain.,Pathology Department, Hospital Quirón, Valencia, Spain.
| | - Francisco Giner
- Pathology Department, University Hospital La Fe, Valencia, Spain
| | - Javier Lavernia
- Department of Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Julia Cruz
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - José Antonio López-Guerrero
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain.,IVO-CIPF Joint Research Unit of Cancer, Príncipe Felipe Research Center (CIPF), Valencia, Spain.,Department of Pathology, School of Medicine, Catholic University of Valencia 'San Vicente Mártir', Valencia, Spain
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17
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Moro R, Traves V, Requena C, Nagore E. Staged Excision With Micrographic Monitoring of Margins in Lentigo Maligna. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Moro R, Traves V, Requena C, Nagore E. Cirugía por etapas con control micrográfico de los márgenes del lentigo maligno. Actas Dermo-Sifiliográficas 2020; 111:522-523. [DOI: 10.1016/j.ad.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/06/2019] [Accepted: 09/29/2019] [Indexed: 10/24/2022] Open
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19
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Pastor-Tomás N, Martínez-Franco A, Bañuls J, Peñalver JC, Traves V, García-Casado Z, Requena C, Kumar R, Nagore E. Risk factors for the development of a second melanoma in patients with cutaneous melanoma. J Eur Acad Dermatol Venereol 2020; 34:2295-2302. [PMID: 32163215 DOI: 10.1111/jdv.16341] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/25/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cutaneous melanoma patients have an increased risk of developing other neoplasms, especially cutaneous neoplasms and other melanomas. Identifying factors associated with an increased risk might be useful in the development of melanoma guidelines. OBJECTIVES To identify risk factors related to the development of a second primary melanoma in a series of patients diagnosed with sporadic melanoma and to establish the estimated incidence rate. METHODS A longitudinal study based on prospective follow-up information of patients diagnosed with sporadic cutaneous melanoma at our centre from 2000 to 2015 was performed. Cumulative incidence was estimated based on competing risk models, and the association of characteristics with the risk of a second melanoma was performed by Cox proportional hazard models. RESULTS Out of 1447 patients included in the study, after a median follow-up of 61 months, 55 patients (3.8%) developed a second melanoma. Fair hair colour, more than 100 common melanocytic nevi and the presence of more than 50 cherry angiomas were independently associated with the development of a second melanoma. The site and the histological subtype of the first and second melanomas were not consistent. The second melanomas were thinner than the first ones. CONCLUSIONS Fair-haired and multiple-nevi patients might benefit from more intensive prevention measures. The finding of cherry angiomas as a risk factor suggests that these lesions could be markers of skin sun damage in the setting of certain degree of genetic susceptibility.
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Affiliation(s)
- N Pastor-Tomás
- Department of Dermatology, Hospital General Universitario de Elda, Alicante, Spain.,Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - A Martínez-Franco
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - J Bañuls
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain.,Departament of Medicina Clínica, Universidad Miguel Hernández. Sant Joan D'Alacant, Alicante, Spain
| | - J C Peñalver
- Department of Thoracic Surgery, Instituto Valenciano de Oncología, València, Spain
| | - V Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - Z García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, València, Spain
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
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20
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Calomarde-Rees L, García-Calatayud R, Requena Caballero C, Manrique-Silva E, Traves V, García-Casado Z, Soriano V, Kumar R, Nagore E. Risk Factors for Lymphatic and Hematogenous Dissemination in Patients With Stages I to II Cutaneous Melanoma. JAMA Dermatol 2020; 155:679-687. [PMID: 31042264 DOI: 10.1001/jamadermatol.2019.0069] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance The lymphatic and the hematogenous pathways have been proposed for disease progression in cutaneous melanoma, but association with recurrence has not been studied separately to date. Objective To identify the risk factors associated with lymphatic and hematogenous metastasis. Design, Setting, and Participants This retrospective cohort study included 1177 patients with malignant melanoma treated at Instituto Valenciano de Oncología, València, Spain. Data were retrieved from the melanoma database from January 1, 2000, through December 31, 2015, and analyzed from June 1 to 30, 2018. Exposure Malignant melanoma at stages I to II. Main Outcomes and Measures Analyses of survival free of lymphatic and hematogenous metastasis were performed using Kaplan-Meier curves and Cox proportional hazards regression. Results For the 1177 patients included in the study analysis (51.1% women; median age at diagnosis, 55 years [interquartile range, 42-68 years), median follow-up was 75 months (interquartile range, 33-121 months); 108 (9.2%) developed lymphatic metastasis, and 108 (9.2%) developed hematogenous metastasis. In the multivariate analysis, being older than 55 years (hazard ratio [HR], 1.9; 95% CI, 1.2-3.1), tumor in the head/neck (HR, 1.7; 95% CI, 1.0-2.9) and acral locations (HR, 2.4; 95% CI, 1.3-4.5), greater Breslow thickness (HR for >4.00 mm, 5.4; 95% CI, 2.4-12.4), and presence of vascular invasion (HR, 3.2; 95% CI, 0.9-10.6) were associated with lymphatic spreading. Hematogenous metastasis was associated with greater Breslow thickness (HR for >4.00 mm, 10.4; 95% CI, 3.6-29.7), the absence of regression (HR, 0.1; 95% CI, 0.0-1.0), TERT promoter mutations (HR, 2.9; 95% CI, 1.5-5.7), and BRAF mutations (HR, 1.9; 95% CI, 1.1-3.6). Conclusions and Relevance Risk factors associated with lymphatic and hematogenous metastasis differ. Follow-up and adjuvant treatment strategies may therefore need to be adapted to individual clinical, histopathologic, and molecular characteristics.
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Affiliation(s)
| | | | | | | | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, València, Spain
| | - Virtudes Soriano
- Department of Medical Oncology, Instituto Valenciano de Oncología, València, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
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21
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Manrique-Silva E, Reyes-García D, Folgado B, Martín-Gorgojo A, Traves V, Requena C, Nagore E. The proportion of nevus-associated invasive melanoma differs with Breslow thickness: A cross-sectional study of 1087 cutaneous melanomas. J Am Acad Dermatol 2019; 81:852-854. [DOI: 10.1016/j.jaad.2019.04.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 04/01/2019] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
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Tejera‐Vaquerizo A, Ribero S, Puig S, Boada A, Paradela S, Moreno‐Ramírez D, Cañueto J, de Unamuno B, Brinca A, Descalzo‐Gallego MA, Osella‐Abate S, Cassoni P, Carrera C, Vidal‐Sicart S, Bennássar A, Rull R, Alos L, Requena C, Bolumar I, Traves V, Pla Á, Fernández‐Orland A, Jaka A, Fernández‐Figueres MT, Hilari JM, Giménez‐Xavier P, Vieira R, Botella‐Estrada R, Román‐Curto C, Ferrándiz L, Iglesias‐Pena N, Ferrándiz C, Malvehy J, Quaglino P, Nagore E. Survival analysis and sentinel lymph node status in thin cutaneous melanoma: A multicenter observational study. Cancer Med 2019; 8:4235-4244. [PMID: 31215168 PMCID: PMC6675713 DOI: 10.1002/cam4.2358] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 12/27/2022] Open
Abstract
Mitotic rate is no longer considered a staging criterion for thin melanoma in the 8th edition of the American Joint Committee on Cancer Staging Manual. The aim of this observational study was to identify prognostic factors for thin melanoma and predictors and prognostic significance of sentinel lymph node (SLN) involvement in a large multicenter cohort of patients with melanoma from nine tertiary care hospitals. A total of 4249 consecutive patients with thin melanoma diagnosed from January 1, 1998 to December 31, 2016 were included. The main outcomes were disease-free interval and melanoma-specific survival for the overall population and predictors of SLN metastasis (n = 1083). Associations between survival and SLN status and different clinical and pathologic variables (sex, age, tumor location, mitosis, ulceration, regression, lymphovascular invasion, histologic subtype, Clark level, and Breslow thickness) were analyzed by Cox proportional hazards regression and logistic regression. SLN status was the most important prognostic factor for melanoma-specific survival (hazard ratio, 13.8; 95% CI, 6.1-31.2; P < 0.001), followed by sex, ulceration, and Clark level for patients who underwent SLNB. A mitotic rate of >2 mitoses/mm2 was the only factor associated with a positive SLN biopsy (odds ratio, 2.9; 95% CI, 1.22-7; P = 0.01. SLN status is the most important prognostic factor in thin melanoma. A high mitotic rate is associated with metastatic SLN involvement. SLN biopsy should be discussed and recommended in patients with thin melanoma and a high mitotic rate.
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Affiliation(s)
| | - Simone Ribero
- Medical Sciences Department, Section of DermatologyUniversity of TurinTurinItaly
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital ClinicUniversitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades RarasBarcelonaSpain
| | - Aram Boada
- Departamento de DermatologíaHospital Universitari Germans Trial i PujolBadalonaSpain
| | - Sabela Paradela
- Departamento de DermatologíaHospital Universitario de la CoruñaLa CoruñaSpain
| | - David Moreno‐Ramírez
- Melanoma Unit, Medical‐&‐Surgical Dermatology DepartmentHospital Universitario Virgen MacarenaSevillaSpain
| | - Javier Cañueto
- Servicio de DermatologíaComplejo Asistencial Universitario de SalamancaSalamancaSpain
- Instituto de Investigación Biomédica de SalamancaComplejo Asistencial Universitario de SalamancaSalamancaSpain
| | - Blanca de Unamuno
- Departamento de DermatologíaHospital Universitario La FeValenciaSpain
| | - Ana Brinca
- Department of DermatologyUniversity Hospital of CoimbraCoimbraPortugal
| | | | - Simona Osella‐Abate
- Medical Sciences Department, Section of Surgical PathologyUniversity of TurinTurinItaly
| | - Paola Cassoni
- Medical Sciences Department, Section of Surgical PathologyUniversity of TurinTurinItaly
| | - Cristina Carrera
- Melanoma Unit, Dermatology Department, Hospital ClinicUniversitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Sergi Vidal‐Sicart
- Nuclear Medicine DepartmentHospital Clinic Barcelona, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Antoni Bennássar
- Melanoma Unit, Dermatology Department, Hospital ClinicUniversitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Ramón Rull
- Surgery DepartmentHospital ClinicBarcelonaSpain
| | - Llucìa Alos
- Pathology Department, Hospital ClinicUniversidad de BarcelonaBarcelonaSpain
| | - Celia Requena
- Dermatology DepartmentInstituto Valenciano de OncologíaValenciaSpain
| | - Isidro Bolumar
- Surgery DepartmentInstituto Valenciano de OncologíaValenciaSpain
| | - Víctor Traves
- Pathology DepartmentInstituto Valenciano de OncologíaValenciaSpain
| | - Ángel Pla
- Otorhinolaringology DepartmentInstituto Valenciano de OncologíaValenciaSpain
| | - A. Fernández‐Orland
- Melanoma Unit, Medical‐&‐Surgical Dermatology DepartmentHospital Universitario Virgen MacarenaSevillaSpain
| | - Ane Jaka
- Departamento de DermatologíaHospital Universitari Germans Trial i PujolBadalonaSpain
| | | | - Josep M. Hilari
- Departamento de DermatologíaHospital Universitari Germans Trial i PujolBadalonaSpain
| | - Pol Giménez‐Xavier
- Melanoma Unit, Dermatology Department, Hospital ClinicUniversitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades RarasBarcelonaSpain
| | - Ricardo Vieira
- Department of DermatologyUniversity Hospital of CoimbraCoimbraPortugal
| | | | - Concepción Román‐Curto
- Servicio de DermatologíaComplejo Asistencial Universitario de SalamancaSalamancaSpain
- Instituto de Investigación Biomédica de SalamancaComplejo Asistencial Universitario de SalamancaSalamancaSpain
| | - Lara Ferrándiz
- Melanoma Unit, Medical‐&‐Surgical Dermatology DepartmentHospital Universitario Virgen MacarenaSevillaSpain
| | | | - Carlos Ferrándiz
- Departamento de DermatologíaHospital Universitari Germans Trial i PujolBadalonaSpain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital ClinicUniversitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades RarasBarcelonaSpain
| | - Pietro Quaglino
- Medical Sciences Department, Section of DermatologyUniversity of TurinTurinItaly
| | - Eduardo Nagore
- Dermatology DepartmentInstituto Valenciano de OncologíaValenciaSpain
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23
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Tejera-Vaquerizo A, Descalzo-Gallego MA, Traves V, Requena C, Bolumar I, Pla A, Nagore E. No association between smoking and sentinel lymph node metastasis and survival in cutaneous melanoma. J Eur Acad Dermatol Venereol 2019; 33:2283-2290. [PMID: 31283036 DOI: 10.1111/jdv.15789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/21/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is little evidence that smoking is associated with metastasis in patients with cutaneous melanoma. OBJECTIVE Using a propensity score matching analysis, we assessed whether smoking was associated with a higher rate of sentinel lymph node (SLN) metastasis and worse survival in these patients. METHODS Retrospective cohort study at a referral hospital for melanoma. We studied 762 patients with known smoking status from the melanoma database of the Instituto Valenciano de Oncología who underwent SLN biopsy between 1 January 2000 and 31 December 2016. The patients were matched by smoking status. The matching procedure was implemented using three logistic regression models featuring never vs. former smokers, never vs. current smokers and former vs. current smokers. The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), overall survival (OS) and SLN status. RESULTS The following groups were formed based on the propensity matching scores: 114 pairs of smokers vs. never smokers, 113 pairs of smokers vs. former smokers and 174 pairs of never smokers vs. former smokers. Smoking status was not associated with SLN metastasis or with DFS, MSS or OS in any of the three groups. CONCLUSION Smoking does not influence SLN metastasis or survival in patients with cutaneous melanoma.
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Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain
| | | | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| | - I Bolumar
- Servicio de Cirugía, Instituto Valencia de Oncología, Valencia, Spain
| | - A Pla
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Moreno A, Manrique-Silva E, Virós A, Requena C, Sanmartín O, Traves V, Nagore E. Histologic Features Associated With an Invasive Component in Lentigo Maligna Lesions. JAMA Dermatol 2019; 155:782-788. [PMID: 31066867 PMCID: PMC6506897 DOI: 10.1001/jamadermatol.2019.0467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/21/2019] [Indexed: 11/14/2022]
Abstract
Importance Lentigo maligna (LM) presents an invasive component in up to 20% of biopsied cases, but to date the histologic features useful in detecting this invasive component have not been described. Some histologic characteristics are hypothesized to contribute to the progression of LM invasion. Objective To identify the histologic characteristics associated with lentigo maligna melanoma (LMM) in patients with LM diagnosed by a partial diagnostic biopsy. Design, Setting, and Participants A retrospective cross-sectional study of patients treated between January 1, 2000, and December 31, 2017, was conducted in a referral oncology center in València, Spain. Data and specimens of patients (n = 96) with a diagnosis of primary cutaneous melanoma in the form of either LM or LMM who had undergone surgical treatment, a complete histologic examination of the whole tumor, and an initial diagnostic partial biopsy of LM were included in the study. Histologic assessment was blinded to the presence of an invasive component. Interventions All biopsy specimens were evaluated for the presence of certain histologic characteristics. Main Outcomes and Measures Comparisons between invasive samples and samples without an invasive component were performed. The differences in the distribution of variables between the groups were assessed using the χ2 and Fisher exact tests, and the degree of association of the relevant variables was quantified by logistic regression models. A classification and regression tree analysis was performed to rank the variables by importance. Results In total, 96 patients had sufficient histologic material that could be evaluated. The patients were predominantly male (56 [58.3%]) and had a mean (SD) age at diagnosis of 72 (12) years. Of these patients, 63 (65.6%) had an LM diagnosis and 33 (34.4%) had an LMM diagnosis (an invasive component). The histologic variables associated with the presence of an invasive component were melanocytes forming rows (odds ratio [OR], 11.5; 95% CI, 1.4-94.1; P = .02), subepidermal clefts (OR, 2.8; 95% CI, 1.0-7.9; P = .049), nests (OR, 3.0; 95% CI, 1.1-8.6; P = .04), and a lesser degree of solar elastosis (OR, 0.4; 95% CI, 0.1-1.1; P = .07). A classification and regression tree analysis of the relevant histologic features was able to accurately identify lentigo maligna with an invasive component (LMM) in more than 60% of patients. Conclusions and Relevance These findings may be useful in classifying early LM specimens at higher risk of invasion, which may eventually be relevant in identifying the most appropriate management for LM.
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Affiliation(s)
- Angela Moreno
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - Esperanza Manrique-Silva
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - Amaya Virós
- Skin Cancer and Ageing Laboratory, CRUK Manchester Institute, The University of Manchester, Manchester, United Kingdom
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Onofre Sanmartín
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - Eduardo Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
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25
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Martin-Gorgojo A, Llinares M, Virós A, Requena C, Garcia-Casado Z, Traves V, Kumar R, Nagore E. Correction: Cutaneous melanoma primary site is linked to nevus density. Oncotarget 2018; 9:36816. [PMID: 30613369 PMCID: PMC6298408 DOI: 10.18632/oncotarget.26445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
[This corrects the article DOI: 10.18632/oncotarget.22016.].
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Affiliation(s)
| | - Marta Llinares
- 2 Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Amaya Virós
- 3 Skin Cancer and Ageing Laboratory, CRUK Manchester Institute, Manchester, UK
- 4 Salford Royal NHS Foundation Trust, Manchester, UK
| | - Celia Requena
- 2 Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Zaida Garcia-Casado
- 5 Department of Molecular Biology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Víctor Traves
- 6 Department of Pathology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Rajiv Kumar
- 7 Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- 2 Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
- 8 Dermatology Department, School of Medicine, Universidad Católica de València “San Vicente Mártir”, Valencia, Spain
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26
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Bernia E, Llombart B, Serra-Guillén C, Bancalari B, Nagore E, Requena C, Calomarde L, Diago A, Lavernia J, Traves V, Guillén C, Sanmartín O. Experience With Vismodegib in the Treatment of Advanced Basal Cell Carcinoma at a Cancer Center. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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27
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Olmedo D, Brotons-Seguí M, del Toro C, González M, Requena C, Traves V, Pla A, Bolumar I, Moreno-Ramírez D, Nagore E. Use of Lymph Node Ultrasound Prior to Sentinel Lymph Node Biopsy in 384 Patients with Melanoma: A Cost-Effectiveness Analysis. Actas Dermo-Sifiliográficas (English Edition) 2017. [DOI: 10.1016/j.adengl.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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28
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Martin-Gorgojo A, Llinares M, Virós A, Requena C, Garcia-Casado Z, Traves V, Kumar R, Nagore E. Cutaneous melanoma primary site is linked to nevus density. Oncotarget 2017; 8:98876-98886. [PMID: 29228734 PMCID: PMC5716774 DOI: 10.18632/oncotarget.22016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/23/2017] [Indexed: 11/25/2022] Open
Abstract
There are at least two pathways driving cutaneous melanoma; one is linked to an inherent melanoma susceptibility to nevi development and the second to environmental cumulative ultraviolet light exposure. In this study, we examined the relation between nevus density, accrued sun damage and the site of primary melanoma excision. In a series of 888 consecutive cutaneous melanoma patients, melanomas appearing in skin areas with a high relative nevus density were most prominent in men, with an elevated nevus count, at sites without solar elastosis, but with an epidemiological history of previous sunburn. The present study associates melanoma development to sites with high nevus density. Our study supports more careful surveillance of body areas with increased nevus density in patients with high total body number of nevi, especially when they report a history of sunburns at these sites.
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Affiliation(s)
| | - Marta Llinares
- Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Amaya Virós
- Skin Cancer and Ageing Laboratory, CRUK Manchester Institute, Manchester, UK.,Salford Royal NHS Foundation Trust, Manchester, UK
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Zaida Garcia-Casado
- Department of Molecular Biology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain.,Dermatology Department, School of Medicine, Universidad Católica de València "San Vicente Mártir", Valencia, Spain
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29
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Boada A, Tejera-Vaquerizo A, Ribero S, Puig S, Moreno-Ramírez D, Descalzo-Gallego MA, Fierro MT, Quaglino P, Carrera C, Malvehy J, Vidal-Sicart S, Bennássar A, Rull R, Alos L, Requena C, Bolumar I, Traves V, Pla Á, Fernández-Figueras MT, Ferrándiz C, Pascual I, Manzano JL, Sánchez-Lucas M, Giménez-Xavier P, Ferrandiz L, Nagore E. Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study. Int J Cancer 2017; 142:641-648. [DOI: 10.1002/ijc.31078] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Aram Boada
- Dermatology Department; Hospital Universitari Germans Trial i Pujol, Badalona, Universitat Autònoma de Barcelona; Spain
| | | | - Simone Ribero
- Medical Sciences Department, Section of Dermatology; University of Turin; Italy
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras; Barcelona Spain
| | - David Moreno-Ramírez
- Melanoma Unit, Medical-&-Surgical Dermatology Department; Hospital Universitario Virgen Macarena; Sevilla Spain
| | | | - María T. Fierro
- Medical Sciences Department, Section of Dermatology; University of Turin; Italy
| | - Pietro Quaglino
- Medical Sciences Department, Section of Dermatology; University of Turin; Italy
| | - Cristina Carrera
- Melanoma Unit, Dermatology Department, Hospital Clinic; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras; Barcelona Spain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras; Barcelona Spain
| | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clinic Barcelona; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Antoni Bennássar
- Melanoma Unit, Dermatology Department, Hospital Clinic; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Ramón Rull
- Surgery Department; Hospital Clinic; Barcelona Spain
| | - Llucìa Alos
- Pathology Department, Hospital Clinic; Universidad de Barcelona; Barcelona Spain
| | - Celia Requena
- Dermatology Department; Instituto Valenciano de Oncología; Valencia Spain
| | - Isidro Bolumar
- Surgery Department; Instituto Valenciano de Oncología; Valencia Spain
| | - Víctor Traves
- Pathology Department; Instituto Valenciano de Oncología; Valencia Spain
| | - Ángel Pla
- Otorhinolaringology Department; Instituto Valenciano de Oncología; Valencia Spain
| | | | - Carlos Ferrándiz
- Dermatology Department; Hospital Universitari Germans Trial i Pujol, Badalona, Universitat Autònoma de Barcelona; Spain
| | - Iciar Pascual
- Surgery Department; Hospital Universitari Germans Trial i Pujol; Badalona Spain
| | - José L. Manzano
- Medical Oncology Department; Institut Català d'Oncologia, Hospital Universitari Germans Trial i Pujol; Badalona Spain
| | - Marina Sánchez-Lucas
- Grupo de Investigación, Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica, Hospital Universitario Virgen Macarena; Sevilla Spain
| | - Pol Giménez-Xavier
- Melanoma Unit, Dermatology Department, Hospital Clinic; Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras; Barcelona Spain
| | - Lara Ferrandiz
- Melanoma Unit, Medical-&-Surgical Dermatology Department; Hospital Universitario Virgen Macarena; Sevilla Spain
| | - Eduardo Nagore
- Dermatology Department; Instituto Valenciano de Oncología; Valencia Spain
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30
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Tejera-Vaquerizo A, Pérez-Cabello G, Marínez-Leborans L, Gallego E, Oliver-Martínez V, Martín-Cuevas P, Arias-Santiago S, Aneiros-Fernández J, Herrera-Acosta E, Traves V, Herrera-Ceballos E, Nagore E. Is mitotic rate still useful in the management of patients with thin melanoma? J Eur Acad Dermatol Venereol 2017; 31:2025-2029. [DOI: 10.1111/jdv.14485] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/12/2017] [Indexed: 12/30/2022]
Affiliation(s)
- A. Tejera-Vaquerizo
- Servicio de Dermatología; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
- Servicio de Dermatología; Instituto dermatológico Globalderm; Palma del Río Córdoba Spain
| | - G. Pérez-Cabello
- Servicio de Dermatología; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
| | - L. Marínez-Leborans
- Servicio de Dermatología; Hospital General Universitario de Valencia; Valencia Spain
| | - E. Gallego
- Servicio de Anatomía Patológica; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
| | - V. Oliver-Martínez
- Servicio de Dermatología; Hospital General Universitario de Valencia; Valencia Spain
| | - P. Martín-Cuevas
- Servicio de Dermatología; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
| | - S. Arias-Santiago
- Unidad de Dermatología; Instituto de Investigaciones Biosanitarias IBS, Granada; Hospitales Universitarios de Granada/Universidad de Granada; Granada Spain
| | - J. Aneiros-Fernández
- Unidad de Anatomía Patológica; Instituto de Investigaciones Biosanitarias IBS, Granada; Hospitales Universitarios de Granada/Universidad de Granada; Granada Spain
| | - E. Herrera-Acosta
- Servicio de Dermatología; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
| | - V. Traves
- Servicio de Anatomía Patológica; Instituto Valenciano de Oncología; Valencia Spain
| | - E. Herrera-Ceballos
- Servicio de Dermatología; Instituto de Biomedicina de Málaga (IBIMA); Hospital Universitario Virgen de la Victoria/Universidad de Málaga; Málaga Spain
| | - E. Nagore
- Servicio de Dermatología; Instituto Valenciano de Oncología; Valencia Spain
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31
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Olmedo D, Brotons-Seguí M, Del Toro C, González M, Requena C, Traves V, Pla A, Bolumar I, Moreno-Ramírez D, Nagore E. Use of Lymph Node Ultrasound Prior to Sentinel Lymph Node Biopsy in 384 Patients with Melanoma: A Cost-Effectiveness Analysis. Actas Dermosifiliogr 2017; 108:931-938. [PMID: 28801012 DOI: 10.1016/j.ad.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/26/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Locoregional lymph node ultrasound is not typically included in guidelines as part of the staging process prior to sentinel lymph node biopsy (SLNB). The objective of the present study was to make a clinical and economic analysis of lymph node ultrasound prior to SLNB. MATERIALS AND METHODS We performed a retrospective study of 384 patients with clinical stage I-II primary melanoma who underwent locorregional lymph node ultrasound (with or without ultrasound-guided biopsy) prior to SLNB between 2004 and 2015. We evaluated the reliability and cost-effectiveness of the strategy. RESULTS Use of locorregional lymph node ultrasound avoided SLNB in 23 patients (6%). Ultrasound had a sensitivity of 46% and specificity of 76% for the detection of metastatic lymph nodes that were not clinically palpable. False negatives were significantly more common in patients aged over 60 years and in tumors with a thickness of less than 2mm. The staging process using SLNB and ultrasound with ultrasound-guided biopsy produced an increase of €16.30 in the unit price. Our cost-effectiveness analysis identified the staging protocol with ultrasound and SLNB as the dominant strategy, with a lower cost-effectiveness ratio than the alternative, consisting of SLNB alone (8,095.24 vs. €28,605.00). CONCLUSIONS Ultrasound with ultrasound-guided biopsy for the diagnostic staging of melanoma prior to SLNB is a useful and cost-effective tool. This procedure does not substitute SLNB, though it does allow to avoid SLNB in a not insignificant proportion of patients.
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Affiliation(s)
- D Olmedo
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - M Brotons-Seguí
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, España
| | - C Del Toro
- Servicio de Radiodiagnóstico, Instituto Valenciano de Oncología, Valencia, España
| | - M González
- Servicio de Radiodiagnóstico, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - A Pla
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valencia, España
| | - I Bolumar
- Servicio de Cirugía, Instituto Valenciano de Oncología, Valencia, España
| | - D Moreno-Ramírez
- Unidad de Gestión Clínica de Dermatología MQ, Hospital Universitario Virgen Macarena, Sevilla, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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Requena C, Sendra E, Llombart B, Sanmartín O, Guillén C, Lavernia J, Traves V, Cruz J. Cutaneous Angiosarcoma: Clinical and Pathology Study of 16 Cases. Actas Dermo-Sifiliográficas (English Edition) 2017. [DOI: 10.1016/j.adengl.2017.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Machado I, Llombart B, Cruz J, Traves V, Requena C, Nagore E, Parafioriti A, Monteagudo C, Llombart-Bosch A. Desmoplastic melanoma may mimic a cutaneous peripheral nerve sheath tumor: Report of 3 challenging cases. J Cutan Pathol 2017; 44:632-638. [DOI: 10.1111/cup.12949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/06/2017] [Accepted: 04/08/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Isidro Machado
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Beatriz Llombart
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Julia Cruz
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Víctor Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Celia Requena
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Eduardo Nagore
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Antonina Parafioriti
- Department of Pathology; ASST - Centro Specialistico Ortopedico Traumatologico Gaetano PINI - CTO; Milano Italy
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Requena C, Sendra E, Llombart B, Sanmartín O, Guillén C, Lavernia J, Traves V, Cruz J. Cutaneous Angiosarcoma: Clinical and Pathology Study of 16 Cases. Actas Dermosifiliogr 2017; 108:457-465. [PMID: 28318524 DOI: 10.1016/j.ad.2017.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Primary cutaneous angiosarcoma is one of the most aggressive skin tumors and carries a very poor prognosis. Its initially indolent clinical presentation explains the frequently late diagnosis that, together with its typically multifocal pattern and poor delimitation, often makes surgery difficult. The low incidence of primary cutaneous angiosarcoma means that few large single-center series have been published. We review the clinical and pathologic characteristics of cutaneous angiosarcomas treated in our hospital, looking for prognostic factors and for possible diagnostic traits that could facilitate early diagnosis. MATERIAL AND METHODS This was a retrospective observational study including all patients diagnosed with cutaneous angiosarcoma in Instituto Valenciano de Oncología in Valencia, Spain between January 2000 and December 2015. We recorded 16 clinical parameters, including age, sex, type of angiosarcoma, site, size, and time since diagnosis, and 8 histopathologic parameters. RESULTS We identified 16 patients (11 women and 5 men) with cutaneous angiosarcoma. Their mean age was 67 years (median, 71 years). The most common site was the trunk (10 cases), followed by the head and neck (5 cases). The mean size of the tumor was 10cm (median, 6.5cm). Fourteen patients underwent surgical excision. Six of the 16 patients were alive at the end of the study, after a mean follow-up period of 42.5 months. CONCLUSIONS The major determinants of survival among patients with cutaneous angiosarcoma are tumor size and patient age. Other characteristics associated with a poor prognosis were infiltration of deep planes (muscle), a predominantly solid histologic pattern, and a larger number of mitoses.
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Affiliation(s)
- C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - E Sendra
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Guillén
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - J Lavernia
- Servicio de Oncología, Instituto Valenciano de Oncología, Valencia, España
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - J Cruz
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
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Denisova E, Heidenreich B, Nagore E, Rachakonda PS, Hosen I, Akrap I, Traves V, García-Casado Z, López-Guerrero JA, Requena C, Sanmartin O, Serra-Guillén C, Llombart B, Guillén C, Ferrando J, Gimeno E, Nordheim A, Hemminki K, Kumar R. Frequent DPH3 promoter mutations in skin cancers. Oncotarget 2016; 6:35922-30. [PMID: 26416425 PMCID: PMC4742151 DOI: 10.18632/oncotarget.5771] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/12/2015] [Indexed: 12/24/2022] Open
Abstract
Recent reports suggested frequent occurrence of cancer associated somatic mutations within regulatory elements of the genome. Based on initial exome sequencing of 21 melanomas, we report frequent somatic mutations in skin cancers in a bidirectional promoter of diphthamide biosynthesis 3 (DPH3) and oxidoreductase NAD-binding domain containing 1 (OXNAD1) genes. The UV-signature mutations occurred at sites adjacent and within a binding motif for E-twenty six/ternary complex factors (Ets/TCF), at -8 and -9 bp from DPH3 transcription start site. Follow up screening of 586 different skin lesions showed that the DPH3 promoter mutations were present in melanocytic nevi (2/114; 2%), melanoma (30/304; 10%), basal cell carcinoma of skin (BCC; 57/137; 42%) and squamous cell carcinoma of skin (SCC; 12/31; 39%). Reporter assays carried out in one melanoma cell line for DPH3 and OXNAD1 orientations showed statistically significant increased promoter activity due to -8/-9CC > TT tandem mutations; although, no effect of the mutations on DPH3 and OXNAD1 transcription in tumors was observed. The results from this study show occurrence of frequent somatic non-coding mutations adjacent to a pre-existing binding site for Ets transcription factors within the directional promoter of DPH3 and OXNAD1 genes in three major skin cancers. The detected mutations displayed typical UV signature; however, the functionality of the mutations remains to be determined.
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Affiliation(s)
- Evgeniya Denisova
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Barbara Heidenreich
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Ismail Hosen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Ivana Akrap
- Interfaculty Institute of Cell Biology, Tuebingen University, and IMPRS ("From Molecules to Organisms"), Tuebingen, Germany
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Onofre Sanmartin
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Beatriz Llombart
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Carlos Guillén
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Jose Ferrando
- Departments of Pathology & Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | - Enrique Gimeno
- Departments of Pathology & Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | - Alfred Nordheim
- Interfaculty Institute of Cell Biology, Tuebingen University, and IMPRS ("From Molecules to Organisms"), Tuebingen, Germany.,German Cancer Consortium (DKTK/DKFZ), Heidelberg, Germany
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
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Rivas-Tolosa N, Sanmartín O, Traves V, Guillén C, Nagore E. Erythematous-violaceous macule on the chest in a patient with dysplastic nevus syndrome. J Am Acad Dermatol 2016; 75:e55-6. [PMID: 27444088 DOI: 10.1016/j.jaad.2016.01.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/19/2016] [Accepted: 01/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Nancy Rivas-Tolosa
- Department of Dermatology at Instituto Valenciano de Oncología, Valencia, Spain.
| | - Onofre Sanmartín
- Department of Dermatology at Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor Traves
- Department of Dermatology at Instituto Valenciano de Oncología, Valencia, Spain
| | - Carlos Guillén
- Department of Dermatology at Instituto Valenciano de Oncología, Valencia, Spain
| | - Eduardo Nagore
- Department of Dermatology at Instituto Valenciano de Oncología, Valencia, Spain
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Alcalá R, Llombart B, Lavernia J, Traves V, Guillén C, Sanmartín O. Skin involvement as the first manifestation of breast implant-associated anaplastic large cell lymphoma. J Cutan Pathol 2016; 43:602-608. [DOI: 10.1111/cup.12697] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/15/2015] [Accepted: 07/25/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Rebeca Alcalá
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Beatriz Llombart
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Javier Lavernia
- Department of Oncology; Instituto Valenciano de Oncología; Valencia Spain
| | - Víctor Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Carlos Guillén
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Onofre Sanmartín
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
- Department of Dermatology; Catholic University of Valencia ‘San Vicente Mártir’; Valencia Spain
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Rivas-Tolosa N, Ortiz-Brugués A, Toledo-Pastrana T, Baradad M, Traves V, Soriano V, Sanmartín V, Requena C, Martí R, Nagore E. Local cryosurgery and imiquimod: A successful combination for the treatment of locoregional cutaneous metastasis of melanoma: A case series. J Dermatol 2015; 43:553-6. [PMID: 26660713 DOI: 10.1111/1346-8138.13197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/25/2015] [Indexed: 11/30/2022]
Abstract
Locoregional cutaneous metastases of melanoma (LCMM) represent a therapeutic challenge. Many treatment options are available with varying results. The combination of cryotherapy and imiquimod, two treatments with a possible synergistic effect, has not yet been described for treating this disease. In this paper, we aimed to show the response of LCMM to cryotherapy combined with topical imiquimod 5%. A retrospective review of 20 patients diagnosed with LCMM and treated with cryotherapy combined with topical imiquimod 5% between November 2000 and May 2014 at three institutions was performed. The locoregional cutaneous response was evaluated. After a mean of five sessions, 13 patients (65%) responded to treatment, eight (40%) of these completely and five (25%) partially. Systemic disease progressed in 16 (80%) patients. Cryotherapy followed by topical imiquimod 5% is simple to apply, has minimal adverse effects and provides response rates similar to other, more complex treatment options.
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Affiliation(s)
- Nancy Rivas-Tolosa
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | - Manel Baradad
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Virtudes Soriano
- Department of Medical Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Verónica Sanmartín
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Rosa Martí
- Department of Dermatology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
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Tejera-Vaquerizo A, Nagore E, Puig S, Robert C, Saiag P, Martín-Cuevas P, Gallego E, Herrera-Acosta E, Aguilera J, Malvehy J, Carrera C, Cavalcanti A, Rull R, Vilalta-Solsona A, Lannoy E, Boutros C, Benannoune N, Tomasic G, Aegerte P, Vidal-Sicart S, Palou J, Alos LL, Requena C, Traves V, Pla Á, Bolumar I, Soriano V, Guillén C, Herrera-Ceballos E. Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma. Eur J Cancer 2015; 51:1780-93. [PMID: 26072362 DOI: 10.1016/j.ejca.2015.05.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/26/2015] [Accepted: 05/21/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumour and sentinel-node biopsy. The objective of this study is to analyse the prognostic implications of this delay. PATIENTS AND METHOD This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival. RESULTS A delay time of 40 days or less (hazard ratio (HR), 1.7; confidence interval (CI), 1.2-2.5) increased Breslow thickness (Breslow ⩾ 2 mm, HR, > 3.7; CI, 1.4-10.7), ulceration (HR, 1.6; CI, 1.1-2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9-4.2), and primary melanoma localised in the head or neck were independently associated with worse melanoma-specific survival (all P < 0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression. CONCLUSION Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma.
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Affiliation(s)
- Antonio Tejera-Vaquerizo
- Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Susana Puig
- Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - Caroline Robert
- Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Philippe Saiag
- Service de dermatologie générale et oncologique, Hôpital Ambroise-Paré, Université de Versailles, Boulogne cedex, France.
| | - Paula Martín-Cuevas
- Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
| | - Elena Gallego
- Servicio de Anatomía Patológica, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
| | - Enrique Herrera-Acosta
- Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
| | - José Aguilera
- Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
| | - Josep Malvehy
- Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - Cristina Carrera
- Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - Andrea Cavalcanti
- Department of Surgery, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Ramón Rull
- Departamento de Cirugía, Hospital Clínic, Universidad de Barcelona, Villarroel 170, 08036 Barcelona, Spain.
| | - Antonio Vilalta-Solsona
- Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - Emilie Lannoy
- Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Celine Boutros
- Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Naima Benannoune
- Department of Dermatology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Gorana Tomasic
- Department of Pathology, Gustave Roussy Cancer Campus, 114 rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Philippe Aegerte
- Service de Biostatistique et Informatique Médicale, Hôpital Ambroise-Paré, Boulogne, France.
| | - Sergi Vidal-Sicart
- Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - Josep Palou
- Melanoma Unit, Servicio de Dermatología y Anatomía Patológica, Hospital Clínic, Universidad de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.
| | - L Lúcia Alos
- Departamento de Anatomía Patológica, Universidad de Barcelona, Villarroel 170, 08036 Barcelona, Spain.
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Víctor Traves
- Departamento de Anatomía Patológica, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Ángel Pla
- Departamento de Otorrinolaringología, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Isidro Bolumar
- Departamento de Cirugía, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Virtudes Soriano
- Departamento de Oncología Médica, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Carlos Guillén
- Department of Dermatology, Instituto Valenciano de Oncología, c/ Profesor Beltrán Báguena, 8, 46009 Valencia, Spain.
| | - Enrique Herrera-Ceballos
- Servicio de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Boulevard Louis Pasteur, 32, 29071 Málaga, Spain.
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Tejera-Vaquerizo A, Martín-Cuevas P, Gallego E, Herrera-Acosta E, Traves V, Herrera-Ceballos E, Nagore E. Predictors of Sentinel Lymph Node Status in Cutaneous Melanoma: A Classification and Regression Tree Analysis. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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41
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Serra-Guillén C, Llombart B, Nagore E, Guillén C, Requena C, Traves V, Kindem S, Alcalá R, Rivas N, Sanmartín O. Mohs micrographic surgery in dermatofibrosarcoma protuberans allows tumour clearance with smaller margins and greater preservation of healthy tissue compared with conventional surgery: a study of 74 primary cases. Br J Dermatol 2015; 172:1303-7. [DOI: 10.1111/bjd.13417] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2014] [Indexed: 12/12/2022]
Affiliation(s)
- C. Serra-Guillén
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - B. Llombart
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - E. Nagore
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
- Facultad de Medicina; Universidad Católica de Valencia; Valencia Spain
| | - C. Guillén
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - C. Requena
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - V. Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - S. Kindem
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - R. Alcalá
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - N. Rivas
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - O. Sanmartín
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
- Facultad de Medicina; Universidad Católica de Valencia; Valencia Spain
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García-Casado Z, Traves V, Bañuls J, Niveiro M, Gimeno-Carpio E, Jimenez-Sanchez A, Moragón M, Onrubia J, Oliver V, Kumar R, Nagore E. BRAF,NRASandMC1Rstatus in a prospective series of primary cutaneous melanoma. Br J Dermatol 2015; 172:1128-31. [DOI: 10.1111/bjd.13521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Z. García-Casado
- Laboratory of Molecular Biology; Instituto Valenciano de Oncología; Valencia Spain
| | - V. Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - J. Bañuls
- Department of Dermatology; Hospital General Universitario de Alicante; Alicante Spain
| | - M. Niveiro
- Department of Pathology; Hospital General Universitario de Alicante; Alicante Spain
| | - E. Gimeno-Carpio
- Department of Dermatology; Hospital Arnau de Vilanova; Valencia Spain
| | | | - M. Moragón
- Department of Dermatology; Hospital Universitario San Joan; Alicante Spain
| | - J.A. Onrubia
- Department of Pathology; Hospital Universitario San Joan; Alicante Spain
| | - V. Oliver
- Department of Dermatology; Consorcio Hospital General Universitario; Valencia Spain
| | - R. Kumar
- Division of Molecular Genetic Epidemiology; German Cancer Research Center; Heidelberg Germany
| | - E. Nagore
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
- Universidad Católica ‘San Vicente Ferrer’ de Valencia; Valencia Spain
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Rivas-Tolosa N, Llombart B, Traves V, Guillén C. Small-Cell Neuroendocrine Carcinoma, Not Merkel Cell Carcinoma, in the Sinonasal Region: A Case Report. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2014.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kindem S, Traves V, Requena C, Alcalá R, Llombart B, Serra-Guillén C, Nagore E, Guillén C, Sanmartin O. Bilateral cauliflower ear as the presenting sign of B-cell chronic lymphocytic leukemia. J Cutan Pathol 2014; 41:73-7. [PMID: 24460879 DOI: 10.1111/cup.12290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- S Kindem
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain.
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Heidenreich B, Nagore E, Rachakonda P, Garcia-Casado Z, Requena C, Traves V, Hemminki K, Kumar R. 415: Telomerase reverse transcriptase promoter mutations in primary cutaneous melanoma. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sanz-Motilva V, Martorell-Calatayud A, Llombart B, Requena C, Serra-Guillén C, Nagore E, Guillén C, Traves V, Sanmartín O. Sunitinib-induced pseudoporphyria. J Eur Acad Dermatol Venereol 2014; 29:1848-50. [PMID: 24813651 DOI: 10.1111/jdv.12539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- V Sanz-Motilva
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - B Llombart
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Serra-Guillén
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Guillén
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - V Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - O Sanmartín
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
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Peña-Vilabelda M, García-Casado Z, Requena C, Traves V, López-Guerrero J, Guillén C, Kumar R, Nagore E. Clinical Characteristics of Patients With Cutaneous Melanoma According to Variants in the Melanocortin 1 Receptor Gene. Actas Dermo-Sifiliográficas (English Edition) 2014. [DOI: 10.1016/j.adengl.2013.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Requena C, Alfaro A, Traves V, Nagore E, Llombart B, Serra C, Martorell A, Guillén C, Sanmartín O. Paraneoplastic dermatomyositis: a study of 12 cases. Actas Dermosifiliogr 2014; 105:675-82. [PMID: 24484630 DOI: 10.1016/j.ad.2013.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 11/19/2013] [Accepted: 11/24/2013] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Adult dermatomyositis presents as a paraneoplastic syndrome in up to 25% of cases, but no clinical, histologic, or laboratory markers completely specific for paraneoplastic disease in dermatomyositis have been identified to date. Furthermore, studies on adult dermatomyositis do not usually report the frequency of cutaneous features of dermatomyositis in patients with associated cancer. Our aim was to review the characteristics of paraneoplastic dermatomyositis in patients seen at our hospital. MATERIAL AND METHODS We studied 12 cases of paraneoplastic dermatomyositis and recorded patient age and sex, associated cancer, time between onset of dermatomyositis and cancer, emergent cutaneous manifestations, muscle involvement, dysphagia, lung disease, and levels of creatine phosphokinase and circulating autoantibodies. RESULTS The mean age of the patients was 61 years and the 2 most common malignancies were ovarian cancer and bladder cancer. The mean time between the diagnosis of cancer and dermatomyositis was 7 months and in most cases, the cancer was diagnosed first. Seven patients had amyopathic dermatomyositis. The most common cutaneous signs were a violaceous photodistributed rash sparing the interscapular area and a heliotrope rash, followed by Gottron papules and cuticle involvement. Superficial cutaneous necrosis was observed in 3 cases. Myositis-specific autoantibodies were not detected in any of the 6 patients who underwent this test. CONCLUSIONS Paraneoplastic dermatomyositis is often amyopathic. There are no specific cutaneous markers for malignancy in dermatomyositis. Myositis-specific antibodies are not associated with paraneoplastic dermatomyositis.
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Affiliation(s)
- C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - A Alfaro
- Servicio de Dermatología, Hospital de Manises, Valencia, España
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Serra
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - A Martorell
- Servicio de Dermatología, Hospital de Manises, Valencia, España
| | - C Guillén
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España; Departamento de Patología Médico-Quirúrgica, Universidad Católica de Valencia, San Vicente Mártir, Valencia, España
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Nagore E, Requena C, Traves V, Guillen C, Hayward NK, Whiteman DC, Hacker E. Prognostic value of BRAF mutations in localized cutaneous melanoma. J Am Acad Dermatol 2014; 70:858-62.e1-2. [PMID: 24388723 DOI: 10.1016/j.jaad.2013.10.064] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/15/2013] [Accepted: 10/28/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND BRAF mutations are frequent in melanoma but their prognostic significance remains unclear. OBJECTIVE We sought to further evaluate the prognostic value of BRAF mutations in localized cutaneous melanoma. METHODS We undertook an observational retrospective study of 147 patients with localized invasive (stages I and II) cutaneous melanomas to determine the prognostic value of BRAF mutation status. RESULTS After a median follow-up of 48 months, patients with localized melanomas with BRAF-mutant melanomas exhibited poorer disease-free survival than those with BRAF-wt genotype (hazard ratio 2.2, 95% confidence interval 1.1-4.3) even after adjustment for Breslow thickness, tumor ulceration, location, age, sex, and tumor mitotic rate. LIMITATIONS The retrospective design and the small number of events are limitations. CONCLUSIONS Our findings suggest that reappraisal of clinical treatment approaches for patients with localized melanoma harboring tumors with BRAF mutation might be warranted.
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Affiliation(s)
- Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain; Universidad Católica de Valencia, Valencia, Spain.
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Carlos Guillen
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Nicholas K Hayward
- Genetics and Computational Biology Department, Queensland Institute of Medical Research, Brisbane, Australia
| | - David C Whiteman
- Population Health Department, Queensland Institute of Medical Research, Brisbane, Australia
| | - Elke Hacker
- Genetics and Computational Biology Department, Queensland Institute of Medical Research, Brisbane, Australia; Center for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Serra-Guillén C, Llombart B, Nagore E, Requena C, Traves V, Llorca D, Kindem S, Alcalá R, Guillén C, Sanmartín O. Positive margins in excised dermatofibrosarcoma protuberans: a study of 58 cases treated with slow-Mohs surgery. J Eur Acad Dermatol Venereol 2013; 28:1012-5. [PMID: 23931335 DOI: 10.1111/jdv.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 07/11/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) is characterized by unpredictable subclinical extension, meaning that positive margins are frequently detected following conventional surgical excision. OBJECTIVE To study the presence or absence of residual tumour in DFSP with positive margins after conventional surgery and identify possible predictors of residual tumour or clear margins following a single Mohs micrographic surgery (MMS) stage. METHODS A retrospective study of patients with DFSP and positive margins following conventional excision referred for MMS was performed. We studied gender, age, tumour site, time from presentation to diagnosis, and affected margins. RESULTS We studied 58 cases, 35 (60.3%) of which had histological evidence of residual tumour. Tumours of the head and neck were significantly associated with the persistence of tumour. A single MMS stage was sufficient to achieve clearance in the majority of cases (n = 46). All tumours with lateral involvement only were resolved with a single Mohs stage. CONCLUSIONS DFSPs with positive margins after conventional surgical excision should undergo re-excision because the majority have histologic evidence of residual tumour. Re-excision with 1-cm margins beyond the scar could be an option in certain tumour sites, particularly when it is known which margins are involved.
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Affiliation(s)
- C Serra-Guillén
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia
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