1
|
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
| |
Collapse
|
2
|
Machado I, Requena C, López-Reig R, Fernández-Serra A, Giner F, Cruz J, Traves V, Lavernia J, Claramunt R, Llombart B, López-Guerrero JA, Llombart-Bosch A. Tumor Microenvironment and Its Clinicopathologic and Prognostic Association in Cutaneous and Noncutaneous Angiosarcomas. Am J Clin Pathol 2023; 160:18-34. [PMID: 36893014 DOI: 10.1093/ajcp/aqad003] [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] [Received: 10/30/2022] [Accepted: 01/09/2023] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVES We explored features of the angiosarcoma (AS) tumor microenvironment to discover subtypes that may respond to immunotherapy. METHODS Thirty-two ASs were included. Tumors were studied by histology, immunohistochemistry (IHC), and gene expression profile using the HTG EdgeSeq Precision Immuno-Oncology Assay. RESULTS Comparing cutaneous and noncutaneous ASs, the second group showed 155 deregulated genes, and unsupervised hierarchical clustering (UHC) delineated two groups: the first mostly cutaneous AS and the second mainly noncutaneous AS. Cutaneous ASs showed a significantly higher proportion of T cells, natural killer cells, and naive B cells. ASs without MYC amplification revealed a higher immunoscore in comparison with ASs with MYC amplification. PD-L1 was significantly overexpressed in ASs without MYC amplification. UHC showed 135 deregulated genes differentially expressed when comparing ASs from the non-head and neck area with patients who had AS in the head and neck area. ASs from the head and neck area showed high immunoscore. PD1/PD-L1 content was significantly more highly expressed in ASs from the head and neck area. IHC and HTG gene expression profiling revealed a significant correlation between PD1, CD8, and CD20 protein expression but not PD-L1. CONCLUSIONS Our HTG analyses confirmed a high degree of tumor and microenvironment heterogeneity. Cutaneous ASs, ASs without MYC amplification, and ASs located in the head and neck area seem to be the most immunogenic subtypes in our series.
Collapse
Affiliation(s)
- Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
- Patologika Laboratory, Hospital QuirónSalud, Valencia, Spain
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Raquel López-Reig
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Francisco Giner
- Pathology Department, Universitary Hospital, La Fe, Valencia, Spain
| | - Julia Cruz
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Javier Lavernia
- Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain
| | - Reyes Claramunt
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | |
Collapse
|
3
|
Ríos-Viñuela E, Traves V, Cruz J, Machado I, López-Guerrero JA, Requena C, Llombart B. Combined Merkel cell carcinoma and cutaneous squamous cell carcinoma with lymph node metastases: Report of two cases. J Cutan Pathol 2023; 50:230-237. [PMID: 36377830 DOI: 10.1111/cup.14360] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/03/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
Merkel cell carcinoma (MCC) is an infrequent, aggressive cutaneous neoplasm, that typically affects the photodamaged skin of elderly individuals, and immunosuppressed patients. Because a subset of MCC is closely related to UV radiation, MCC can develop concurrently with other tumors, most commonly, as a combined tumor with squamous cell carcinoma (SCC). These combined tumors appear to represent a distinct disease process from pure MCC, as they are mostly Merkel cell polyomavirus (MCPyV) negative, and show a more aggressive behavior. We present two additional cases of combined MCC and SCC with nodal metastases, one of which was MCPyV positive. Two different subtypes of MCC have been proposed based on their origin: a true neuroendocrine carcinoma, that is MCPyV positive and has a dermal origin, and a UV-related SCC with neuroendocrine differentiation. This theory could explain why MCC can develop concurrently with SCC, and why these combined cases are generally MCPyV negative. However, it fails to explain the minority of combined MCC and SCC tumors that are MCPyV positive. Because both our patients had a history of chronic UV exposure, we hypothesize that UV radiation probably played a major role in the pathogenesis of these tumors, while MCPyV integration probably acted as an additional trigger.
Collapse
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Julia Cruz
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Isidro Machado
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
4
|
Mayo-Martínez F, Moro R, Traves V, Llombart B, Requena C. Trichoepithelioma on the Finger: A Rare Location and Dermoscopic-Histopathologic Correlation. Am J Dermatopathol 2023; 45:142-144. [PMID: 36669081 DOI: 10.1097/dad.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT Trichoepithelioma is a benign adnexal neoplasm of follicular germinative cells, with bulbs, papillae, and sheaths of perifollicular connective tissue as signs of follicular differentiation. Accordingly, trichoepithelioma may arise in any hair-bearing location, mostly on the face. That is why trichoepithelioma cannot appear in glabrous skin, and, although the dorsum of the hands and feet are a hair-bearing area, acral location is exceptional. We report the first case of trichoepithelioma localized in the finger of a 79-year-old man. It was a brown-pink, firm, 7-mm diameter, solid papule on the dorsal aspect of his left index finger. The lesion was completely asymptomatic, and he remembered to have it for many years. We describe this case highlighting its rare anatomical location and correlate its dermoscopic features with the histopathological appearance.
Collapse
Affiliation(s)
| | - Ruggero Moro
- Instituto Dermatológico Dr Alonso, Hospital Vithas Valencia 9 de Octubre, Valencia, Spain; and
| | - Victor Traves
- Departments of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Departments of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Departments of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
5
|
Vargas-Mora P, Llombart B, Castro JR, Cruz J, Serra C, Requena C, Traves V, Sanmartín O. Primary cutaneous leiomyosarcoma: a single institution study treated with modified Mohs surgery. Int J Dermatol 2023; 62:e10-e13. [PMID: 36039993 DOI: 10.1111/ijd.16412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/24/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Pablo Vargas-Mora
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain.,Dermatology Department, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Beatriz Llombart
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Juan Raúl Castro
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain.,Dermatology Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Julia Cruz
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Carlos Serra
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Onofre Sanmartín
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
6
|
Machado I, Hosler GA, Traves V, Claramunt R, Sanmartín O, Santonja C, Carvajal N, Zazo S, Requena L, Alfonso VS, Domenech EV, Llombart‐Bosch A, Bridge JA, Linos K. Superficial
GLI1
‐amplified mesenchymal neoplasms: Expanding the spectrum of an emerging entity which reaches the realm of dermatopathology. J Cutan Pathol 2022; 50:487-499. [PMID: 36316249 DOI: 10.1111/cup.14345] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
Mesenchymal neoplasms with GLI1 alterations (rearrangements and/or amplification) have been reported recently in several anatomic locations, which include head and neck, soft tissue, and gastrointestinal tract. Herein, to the best of our knowledge, we describe the first three cases of superficial/subcutaneous mesenchymal neoplasm with GLI1 amplification. The neoplasms exhibited low-grade cytologic features with predominant round cell morphology, glomangioma-like areas and a rich background capillary network. There were two to three mitotic figures per 10 HPF and focal necrosis in one case. The tumors exhibited variable expression of CDK4, MDM2, STAT6, D2-40, CD56 and cyclin D1. p16 had strong and diffuse nuclear and cytoplasmic expression in two cases. Numerous other stains were negative. Fluorescence in situ hybridization detected GLI1, DDIT3, and CDK4 coamplification in all cases, while next generation sequencing did not detect a GLI1 gene fusion. The overall features were compatible with a GLI1-amplified mesenchymal neoplasm. In Case 1 a new distant skin lesion appeared 1 month after the surgery exhibiting similar morphology albeit with a higher mitotic index. In Cases 2 and 3, there is no evidence of local recurrence or systemic disease after 8 years and 1 month of follow-up, respectively. These new cases of superficial GLI1-amplified neoplasm expand its clinical spectrum and enter the realm of dermatopathology. The combination of CDK4, cyclin D1, D2-40, and p16 expression with variable MDM2, STAT6, CD56, and S100 immunoreactivity in a low-grade neoplasm with round/ovoid cytomorphology resembling a vascular or adnexal neoplasm may suggest the possibility of GLI1-amplified neoplasm.
Collapse
Affiliation(s)
- Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología Valencia Spain
- Pathology Department, Patologika Laboratory, Hospital QuironSalud Valencia Spain
| | - Gregory A. Hosler
- Dermatopathology, ProPath, Dallas, TX. University of Texas Southwestern, Department of Dermatology
| | - Victor Traves
- Pathology Department, Instituto Valenciano de Oncología Valencia Spain
| | - Reyes Claramunt
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología Valencia Spain
| | - Onofre Sanmartín
- Department of Dermatology Instituto Valenciano de Oncología Valencia Spain
| | | | - Nerea Carvajal
- Pathology Department Fundación Jiménez Díaz Madrid Spain
| | - Sandra Zazo
- Pathology Department Fundación Jiménez Díaz Madrid Spain
| | - Luis Requena
- Dermatology Department Fundación Jiménez Díaz Madrid Spain
| | | | | | | | - Julia A. Bridge
- Department of Pathology and Microbiology University of Nebraska Medical Center Omaha NE USA
- Division of Molecular Pathology, ProPath Dallas TX USA
| | - Konstantinos Linos
- Memorial Sloan Kettering Cancer Center, Department of Pathology & Laboratory Medicine New York NY USA
| |
Collapse
|
7
|
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
|
8
|
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.
Collapse
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.
| |
Collapse
|
9
|
Boada A, Tejera-Vaquerizo A, Requena C, Manrique-Silva E, Traves V, Nagore E. Association between melanoma thickness and clinical and demographic characteristics. Eur J Dermatol 2021; 31:ejd.2021.4096. [PMID: 34463273 DOI: 10.1684/ejd.2021.4096] [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] [Indexed: 11/17/2022]
Abstract
The large-scale implementation of primary and secondary skin cancer prevention strategies in recent decades has led to an increase in the diagnosis of thin melanomas and a decrease in the mean thickness of tumours diagnosed. The number of newly diagnosed thick melanomas, however, has remained stable. To investigate associations between melanoma thickness, clinical presentation and demographic and phenotypic characteristics. The study is based on a cross-sectional study of 1,459 patients with melanoma from a dermatology department at a tertiary hospital in Spain between 2000 and 2017. We analysed associations between median Breslow thickness and demographic, phenotypic, and clinical characteristics, including the method of melanoma detection. Age ≥ 70 years (regression coefficient [RC] = 1.2, 95% CI: 1.1-1.3; p < 0.001), male sex (RC = 0.9, 95% CI: 0.8-0.9; p < 0.001), symptom-based detection (RC = 1.3, 95% CI: 1.1-1.4; p < 0.001), and a history of sunburn at the melanoma site (RC = 0.9, 95% CI: 0.8-0.9; p = 0.04) were all associated with thicker tumours. Melanomas on the lower extremities, by contrast, were significantly thinner (RC = 0.9, 95% CI: 0.8-0.9; p = 0.04). Thick melanomas occur preferentially in older men and show changes such as bleeding or an increase in volume or colour. This information should be incorporated into health training and education programs to design better prevention strategies and minimize diagnostic delays.
Collapse
Affiliation(s)
- Aram Boada
- Dermatology Department. Hospital Universitari Germans Trial i Pujol. Institut d'Investigació Germans Trias i Pujol, Badalona. Universitat Autònoma de Barcelona, Spain
| | | | - Celia Requena
- Dermatology Department. Instituto Valenciano de Oncología. València, Spain
| | | | - Victor Traves
- Pathology Department. Instituto Valenciano de Oncología. València, Spain
| | - Eduardo Nagore
- Dermatology Department. Instituto Valenciano de Oncología. València, Spain, School of Medicine. Universidad Católica de Valencia San Vicente Mártir, València, Spain
| |
Collapse
|
10
|
Ríos-Viñuela E, Bernia E, Toledo-Pastrana T, Requena C, Diago A, Serra-Guillén C, Llombart B, Traves V, Nagore E, Guillén C, Sanmartin O. Localized Injection-site Toxic Erythema of Chemotherapy: An Under-recognized Acquaintance Revisited. Acta Derm Venereol 2021; 101:adv00429. [PMID: 33734421 DOI: 10.2340/00015555-3791] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, ES-46009 Valencia, Spain. E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
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
| |
Collapse
|
12
|
Torrecilla-Martínez I, Manrique-Silva E, Traves V, Requena C, Nagore E. Adherence to Primary Prevention and Skin Self-Examination Practices by Spanish Melanoma Patients. Dermatology 2021; 237:1016-1022. [PMID: 33465771 DOI: 10.1159/000512887] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The incidence of cutaneous melanoma, an important global public health problem, has been increasing over the last several decades. OBJECTIVES In order to decrease melanoma-related mortality, ways to communicate and implement the correct methods for conducting primary and secondary prevention measures (such as early detection via self-examination) should be investigated. MATERIALS AND METHODS An observational, cross-sectional, retrospective study consisting of 409 patients diagnosed with cutaneous melanoma was conducted. An online questionnaire was created to evaluate knowledge levels, attitudes, and adherence to primary preventive measures and to skin self-examination practices. RESULTS The results revealed that even when 43% of the patients perform cutaneous self-examinations, only half of them fully followed the recommendations. Patients aged <45 years, female, with a I-II phototype, with an intermediate/high level of education, and with a history of NMSC were more likely to have an adequate degree of knowledge. Moreover, patients aged <45 years and with an adequate degree of knowledge more frequently showed an adequate adherence to the primary prevention measures. Finally, patients aged 45-60 years and with an adequate degree of knowledge presented a good adherence to the self-skin examination measures. LIMITATIONS Possible limitations of this study were memory bias through the influence of age within the study population, and bias due to a greater proportion of subjects with a high education level. CONCLUSION Within the population of patients with melanoma, a high percentage of patients do not rigorously follow the recommended prevention measures. Our study highlights the need to implement awareness in this population to improve the prevention of cutaneous cancer.
Collapse
Affiliation(s)
| | - Esperanza Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain.,Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor 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,
| |
Collapse
|
13
|
Diago A, Llombart B, Serra-Guillen C, Arana E, Guillén C, Requena C, Traves V, Bancalari B, Bernia E, Ríos-Viñuela E, Sanmartín O. Usefulness of ultrasound in dermatofibrosarcoma protuberans and correlation with histopathological findings: A series of 30 cases. Skin Res Technol 2021; 27:701-708. [PMID: 33455037 DOI: 10.1111/srt.13003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 10/25/2020] [Revised: 12/07/2020] [Accepted: 12/24/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Small series of ultrasound findings in dermatofibrosarcoma protuberans (DFSP) have been published, but the usefulness of this technique as a preoperative planning tool for tumor resection has not been studied. MATERIALS AND METHODS We retrospectively reviewed patients with DFSP at our hospital that underwent ultrasound examination. Depth of invasion was evaluated by ultrasound and histopathology. Accuracy of ultrasound for assessing depth of tumor invasion was estimated. RESULTS Thirty histopathologically confirmed DFSPs were studied. Classic finger-like projections were observed in 73.3% of cases. A posterior hyperechoic area extending deep into the subcutaneous tissue correlated with the honeycomb DFSP pattern and was observed in 53.3% of patients. Concordance between ultrasound and histopathologic depth measurements was excellent. Lateral tumor extension and Doppler activity were not evaluated in our series. CONCLUSION Ultrasound showed excellent prediction of depth of invasion. Further studies are required to define the usefulness of ultrasound for determining lateral tumor extension.
Collapse
Affiliation(s)
- Adrian Diago
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Estanislao Arana
- Department of Radiology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Carlos Guillén
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Bernardo Bancalari
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Eduardo Bernia
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Onofre Sanmartín
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
14
|
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
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Tejera-Vaquerizo A, Fernández-Figueras MT, Santos-Briz Á, Ríos-Martín JJ, Monteagudo C, Fernández-Flores Á, Requena C, Traves V, Descalzo-Gallego MÁ, 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]. Rev Esp Patol 2020; 54:29-40. [PMID: 33455691 DOI: 10.1016/j.patol.2020.10.004] [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] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/15/2020] [Accepted: 10/04/2020] [Indexed: 10/22/2022]
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.
Collapse
Affiliation(s)
- Antonio Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, España; Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, España.
| | - María Teresa Fernández-Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallès, Barcelona, España
| | - Ángel Santos-Briz
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - Juan José Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Carlos Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
| | - Ángel Fernández-Flores
- Servicio de Anatomía Patológica, Hospital del Bierzo, Ponferrada, León, España; Servicio de Anatomía Patológica, Hospital de la Reina, Ponferrada, León, España
| | - Celia Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - Victor Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | | | | |
Collapse
|
17
|
Moro R, González-Ramos J, Martínez-García S, Requena C, Traves V, Manrique-Silva E, Nagore E. Locoregional Lymph Node Recurrence of Trunk Melanoma in Non-sentinel Lymph Node Basins: An Observational Retrospective Study. Acta Derm Venereol 2020; 100:adv00284. [PMID: 32945339 PMCID: PMC9274927 DOI: 10.2340/00015555-3635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/16/2022] Open
Abstract
Locoregional lymph node recurrences of primary trunk melanoma can occur in basins not identified during sentinel lymph node biopsy. However, the factors associated with recurrences in non-sentinel lymph node basins are unknown. To evaluate these factors, this observational retrospective study examined the patterns of first lymph node recurrence and the factors associated with recurrence in non-sentinel lymph node basins. A total of 305 patients with primary trunk melanoma who had undergone sentinel lymph node biopsy from 2000 to 2015 were evaluated. Twenty-three patients presented locoregional lymph node recurrence; 8 of which (34.8%) were in non-sentinel lymph node basins. Non-sentinel lymph node recurrences were more frequent in patients with positive sentinel lymph nodes and in those patients whose number of tumour-involved nodes was > 3. These results suggest that clinical examination and ultrasound surveillance should be performed on all potential lymph node drainage basins of trunk melanomas.
Collapse
Affiliation(s)
- Ruggero Moro
- Doctorate School, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | | | | | | | | | | | | |
Collapse
|
18
|
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
|
19
|
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
|
20
|
Dessinioti C, Dimou N, Geller AC, Stergiopoulou A, Lo S, Keim U, Gershenwald JE, Haydu LE, Ribero S, Quaglino P, Puig S, Malvehy J, Kandolf-Sekulovic L, Radevic T, Kaufmann R, Meister L, Nagore E, Traves V, Champsas GG, Plaka M, Dreno B, Varey E, Ramirez DM, Dummer R, Mangana J, Hauschild A, Egberts F, Peris K, Del Regno L, Forsea AM, Zurac SA, Vieira R, Brinca A, Zalaudek I, Deinlein T, Linos E, Evangelou E, Thompson JF, Scolyer RA, Garbe C, Stratigos AJ. Distinct Clinicopathological and Prognostic Features of Thin Nodular Primary Melanomas: An International Study from 17 Centers. J Natl Cancer Inst 2020; 111:1314-1322. [PMID: 30863861 DOI: 10.1093/jnci/djz034] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/26/2019] [Accepted: 03/08/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Nodular melanoma (NM) is more likely to be fatal compared with other melanoma subtypes, an effect attributed to its greater Breslow thickness. METHODS Clinicopathological features of NM and superficial spreading melanoma (SSM) diagnosed in 17 centers in Europe (n = 15), the United States, and Australia between 2006 and 2015, were analyzed by multivariable logistic regression analysis, with emphasis on thin (T1 ≤ 1.0 mm) melanomas. Cox analysis assessed melanoma-specific survival. All statistical tests were two sided. RESULTS In all, 20 132 melanomas (NM: 5062, SSM: 15 070) were included. Compared with T1 SSM, T1 NM was less likely to have regression (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.29 to 0.72) or nevus remnants histologically (OR = 0.60, 95% CI = 0.42 to 0.85), and more likely to have mitoses (OR = 1.97, 95% CI = 1.33 to 2.93) and regional metastasis (OR = 1.77, 95% CI = 1.02 to 3.05). T1 NM had a higher mitotic rate than T1 SSM (adjusted geometric mean = 2.2, 95% CI = 1.9 to 2.5 vs 1.6, 95% CI = 1.5 to 1.7 per mm2, P < .001). Cox multivariable analysis showed a higher risk for melanoma-specific death for NM compared with SSM for T1 (HR = 2.10, 95% CI = 1.24 to 3.56) and T2 melanomas (HR = 1.30, 95% CI = 1.01 to 1.68), and after accounting for center heterogeneity, the difference was statistically significant only for T1 (HR = 2.20, 95% CI = 1.28 to 3.78). The NM subtype did not confer increased risk within each stratum (among localized tumors or cases with regional metastasis). CONCLUSIONS T1 NM (compared with T1 SSM) was associated with a constellation of aggressive characteristics that may confer a worse prognosis. Our results indicate NM is a high-risk melanoma subtype that should be considered for inclusion in future prognostic classifications of melanoma.
Collapse
|
21
|
Ríos-Viñuela E, Bernia E, Diago A, Requena L, Traves V, Requena C. A unilateral zosteriform cutaneous eruption on the lower extremity. Int J Dermatol 2020; 60:e137-e139. [PMID: 32496581 DOI: 10.1111/ijd.14980] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Eduardo Bernia
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Adrián Diago
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Madrid, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Boada A, Tejera-Vaquerizo A, Ribero S, Puig S, Moreno-Ramírez D, Quaglino P, Osella-Abate S, Cassoni P, Malvehy J, Carrera C, Pigem R, Barreiro-Capurro A, Requena C, Traves V, Manrique-Silva E, Fernández-Orland A, Ferrandiz L, García-Senosiain O, Fernández-Figueras MT, Ferrándiz C, Nagore E. Corrigendum to "Factors associated with sentinel lymph node status and prognostic role of completion lymph node dissection for thick melanoma" [Eur J Surg Oncol 46 2 (2019) 263-271]. Eur J Surg Oncol 2020; 46:928. [PMID: 32165000 DOI: 10.1016/j.ejso.2020.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Aram Boada
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol, Badalona, Departament de Medicina, Universitat Autònoma de Barcelona, Spain.
| | | | - Simone Ribero
- Medical Sciences Department, Section of Dermatology, University of Turin, 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
| | - Pietro Quaglino
- Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy
| | - Simona Osella-Abate
- Section of Surgical Pathology, Medical Science Department, University of Turin, Italy
| | - Paola Cassoni
- Section of Surgical Pathology, Medical Science Department, University of Turin, Italy
| | - 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
| | - 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
| | - Ramon Pigem
- 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
| | - Alicia Barreiro-Capurro
- 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
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Almudena Fernández-Orland
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Lara Ferrandiz
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | - Carlos Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol, Badalona, Departament de Medicina, Universitat Autònoma de Barcelona, Spain
| | - Edurado Nagore
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | |
Collapse
|
24
|
Boada A, Tejera-Vaquerizo A, Ribero S, Puig S, Moreno-Ramírez D, Quaglino P, Osella-Abate S, Cassoni P, Malvehy J, Carrera C, Pigem R, Barreiro-Capurro A, Requena C, Traves V, Manrique-Silva E, Fernández-Orland A, Ferrandiz L, García-Senosiain O, Fernández-Figueras MT, Ferrándiz C, Nagore E. Factors associated with sentinel lymph node status and prognostic role of completion lymph node dissection for thick melanoma. Eur J Surg Oncol 2019; 46:263-271. [PMID: 31594672 DOI: 10.1016/j.ejso.2019.09.189] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/31/2019] [Revised: 07/14/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Sentinel lymph node (SLN) biopsy is useful for the prognostic stratification of patients with thick melanoma. Identifying which variables are associated with SLN involvement and establishing risk in different subgroups of patients could be useful for guiding the indication of SLN biopsy. The value of complete lymph node dissection (CLND) in patients with a positive SLN biopsy is currently under debate. MATERIALS AND METHODS To identify factors associated with SLN involvement in thick melanoma we performed a multicentric retrospective cohort study involving 660 patients with thick melanoma who had undergone SLN biopsy. To analyze the role of CLND in thick melanoma patients with a positive SLN biopsy, we built a multivariate Cox proportional hazards model for melanoma-specific survival (MSS) and disease-free survival (DFS) and compared 217 patients who had undergone CLND with 44 who had not. RESULTS The logistic regression analysis showed that age, histologic subtype, ulceration, microscopic satellitosis, and lymphovascular invasion were associated with nodal disease. The CHAID (Chi-squared Automatic Interaction Detection) decision tree showed ulceration to be the most important predictor of lymphatic involvement. For nonulcerated melanomas, the histologic subtype lentigo maligna melanoma was associated with a low rate of SLN involvement (4.3%). No significant differences were observed for DFS and MSS between the CLND performed and not-performed groups. Nodal status on CLND was associated with differences in DFS and MSS rates. CONCLUSION We identified subgroups of thick melanoma patients with a low likelihood of SLN involvement. CLND does not offer survival benefit, but provides prognostic information.
Collapse
Affiliation(s)
- Aram Boada
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain.
| | | | - Simone Ribero
- Medical Sciences Department, Section of Dermatology, University of Turin, 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
| | - Pietro Quaglino
- Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy
| | - Simona Osella-Abate
- Section of Surgical Pathology, Medical Science Department, University of Turin, Italy
| | - Paola Cassoni
- Section of Surgical Pathology, Medical Science Department, University of Turin, Italy
| | - 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
| | - 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
| | - Ramon Pigem
- 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
| | - Alicia Barreiro-Capurro
- 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
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Almudena Fernández-Orland
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Lara Ferrandiz
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | - Carlos Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain
| | - Edurado Nagore
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Requena C, Requena L, Kazakov DV, Traves V, Nagore E, Llombart B, Serra C, Guillén C, Sanmartín O. Multiple facial plaque variant of trichoblastoma. J Cutan Pathol 2019; 46:285-289. [DOI: 10.1111/cup.13416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/07/2018] [Accepted: 12/23/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Celia Requena
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Luis Requena
- Department of DermatologyFundación Jiménez Díaz Madrid Spain
| | - Dmitry V. Kazakov
- Sikl’s Department of Pathology, Medical Faculty in PilsenCharles University in Prague Pilsen Czech Republic
| | - Victor Traves
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Eduardo Nagore
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Beatriz Llombart
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Carlos Serra
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Carlos Guillén
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| | - Onofre Sanmartín
- Departments of Dermatology and PathologyInstituto Valenciano de Oncología Valencia Spain
| |
Collapse
|
27
|
Rachakonda S, Srinivas N, Mahmoudpour SH, Garcia-Casado Z, Requena C, Traves V, Soriano V, Cardelli M, Pjanova D, Molven A, Gruis N, Nagore E, Kumar R. Author Correction: Telomere length and survival in primary cutaneous melanoma patients. Sci Rep 2018; 8:17963. [PMID: 30552372 PMCID: PMC6294772 DOI: 10.1038/s41598-018-36657-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.
Collapse
Affiliation(s)
| | - Nalini Srinivas
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Seyed Hamidreza Mahmoudpour
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.,Institute of Medical Biostatistics, University Medical Center of Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Zaida Garcia-Casado
- Labortory of Molecular Biology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Virtudes Soriano
- Department of Medical Oncology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Maurizio Cardelli
- Advanced Technology Center for Aging Research, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Dace Pjanova
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Anders Molven
- Department of Clinical Medicine, Gade Laboratory of Pathology, Haukeland University Hospital, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Nelleke Gruis
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany. .,German Consortium for Translational Research, German Cancer Research Center, Heidelberg, Germany.
| |
Collapse
|
28
|
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
|
29
|
Rachakonda S, Kong H, Srinivas N, Garcia-Casado Z, Requena C, Fallah M, Heidenreich B, Planelles D, Traves V, Schadendorf D, Nagore E, Kumar R. Telomere length, telomerase reverse transcriptase promoter mutations, and melanoma risk. Genes Chromosomes Cancer 2018; 57:564-572. [PMID: 30203894 DOI: 10.1002/gcc.22669] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 05/04/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 12/21/2022] Open
Abstract
Telomere repeats at chromosomal ends, critical for genomic integrity, undergo age-dependent attrition and telomere length has been associated with different disorders including cancers. In this study, based on 1469 patients and 1158 healthy controls, we show a statistically significant (P = 6 × 10-10 ) association between increased telomere length and melanoma risk. Mendelian randomization, using 5 telomere length-associated polymorphisms, ruled out confounding factors or reverse causality and showed association between increased telomere length and melanoma risk with odds ratio of 2.66 (95% confidence interval: 2.07-3.25). Age-dependent telomere attrition was faster in melanoma cases than controls (P = .01). The carriers of a highly penetrant germline -57A>C TERT promoter mutation, in a previously reported melanoma family, had longer telomeres than the noncarriers. The mutation causes increased TERT and telomerase levels through creation of a binding motif for E-twenty six (ETS) transcription factors and the carriers develop melanoma with an early age of onset and rapid progression to metastasis. In analogy, we hypothesize that increased telomere length in melanoma patients reflects stochastic increased telomerase levels due to common genetic variation. Paradoxically, we observed shorter telomeres (P = 1 × 10-5 ) in primary tumors from unrelated melanoma patients with (121) than without (170) somatic TERT promoter mutations that similar to the germline mutation, also create binding motifs for ETS transcription factors. However, the age-dependent telomere attrition was faster in tumors with the TERT promoter mutations than in those without such mutations. Besides a robust association between increased telomere length and risk, our data show a perturbed telomere homeostasis in melanoma.
Collapse
Affiliation(s)
| | - Haiying Kong
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Nalini Srinivas
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Zaida Garcia-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Mahdi Fallah
- Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Barbara Heidenreich
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany.,German Consortium for Translational Research (DKTK), German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.,German Consortium for Translational Research (DKTK), German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|
30
|
Rachakonda S, Srinivas N, Mahmoudpour SH, Garcia-Casado Z, Requena C, Traves V, Soriano V, Cardelli M, Pjanova D, Molven A, Gruis N, Nagore E, Kumar R. Telomere length and survival in primary cutaneous melanoma patients. Sci Rep 2018; 8:10947. [PMID: 30026606 PMCID: PMC6053393 DOI: 10.1038/s41598-018-29322-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 07/10/2018] [Indexed: 01/16/2023] Open
Abstract
Telomere repeats at chromosomal ends, critical to genomic integrity, undergo age-dependent attrition. Telomere length, a polygenic trait, has been associated with risk of several disorders including cancers. In contrast to association of long telomeres with increased risk of several cancers, including melanoma, emerging reports suggest that short telomeres predict poor survival in patients with different cancers. In this study based on 1019 stage I and II cutaneous melanoma patients, we show an association between the patients with short telomeres and poor melanoma-specific survival (HR 2.05, 95% CI 1.33-3.16) compared to patients with long telomeres. Due to inverse correlation between age and telomere length (r -0.19, P < 0.0001), we stratified the patients into quantiles based on age at diagnosis and also carried out age-matched analysis. The effect of short telomeres on survival was determined by using multivariate Cox regression that included composite genetic risk score computed from genotyping of the patients for telomere-length associated polymorphisms. The effect of decreased telomere length on poor melanoma-specific survival was particularly strong in patients within the age quantile below 30 years (HR 3.82, 95% CI 1.10-13.30) and between 30-40 years (HR 2.69, 95% CI 1.03-7.03). Our study shows that in contrast to increased melanoma risk associated with increased telomere length, decreased telomere length predicts poor survival in melanoma subgroups.
Collapse
Affiliation(s)
| | - Nalini Srinivas
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Seyed Hamidreza Mahmoudpour
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
- Institute of Medical Biostatistics, University Medical Center of Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - Zaida Garcia-Casado
- Labortory of Molecular Biology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Virtudes Soriano
- Department of Medical Oncology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Maurizio Cardelli
- Advanced Technology Center for Aging Research, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Dace Pjanova
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Anders Molven
- Department of Clinical Medicine, Gade Laboratory of Pathology, Haukeland University Hospital, Bergen, Norway
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Nelleke Gruis
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.
- German Consortium for Translational Research, German Cancer Research Center, Heidelberg, Germany.
| |
Collapse
|
31
|
Martin-Gorgojo A, Requena C, Garcia-Casado Z, Traves V, Kumar R, Nagore E. Dysplastic vs. Common Naevus-associated vs. De novo Melanomas: An Observational Retrospective Study of 1,021 Patients. Acta Derm Venereol 2018; 98:556-562. [PMID: 29583157 DOI: 10.2340/00015555-2908] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this case-case study was to determine the differences between dysplastic and common naevus-associated melanomas (NAM) and de novo melanomas. A total of 1,021 prospectively collected patients with invasive cutaneous melanoma from an oncology referral centre were included in the study. Of these, 75.51% had de novo melanomas, 12.93% dysplastic NAM, and 11.56% common NAM. Dysplastic NAM, compared with de novo melanomas, were associated with intermittently photo-exposed sites, atypical melanocytic naevi, decreased tumour thickness, and presence of MC1R non-synonymous variants. Common NAM were more frequent on the trunk and of superficial spreading type. Comparison of dysplastic with common NAM showed significant difference only with regard to mitoses. Both subtypes of NAM shared less aggressive traits than de novo melanomas, albeit with no significant differences in survival after multivariate adjustment. In conclusion, NAM present with less aggressive traits, mostly due to a greater awareness among patients of changing moles than due to their intrinsic biological characteristics.
Collapse
Affiliation(s)
- Alejandro Martin-Gorgojo
- Dermatology Department, Gregorio Marañon General University Hospital and Clinica Dermatologica Internacional, Madrid, Spain
| | | | | | | | | | | |
Collapse
|
32
|
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
|
33
|
Tejera-Vaquerizo A, Descalzo-Gallego MA, Traves V, Requena C, Bolumar I, Pla A, Nagore E. The intriguing effect of delay time to sentinel lymph node biopsy on survival: a propensity score matching study on a cohort of melanoma patients. Eur J Dermatol 2017; 27:487-495. [PMID: 28944755 DOI: 10.1684/ejd.2017.3065] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
BACKGROUND Time between primary melanoma excision and sentinel lymph node biopsy (SLNB) has not been sufficiently studied as an independent predictor of survival in cutaneous melanoma. OBJECTIVES We used propensity score matching to evaluate whether early SLNB (performed ≤40 days from excisional biopsy) is associated with higher mortality in patients with cutaneous melanoma. MATERIALS & METHODS A retrospective cohort study at a tertiary melanoma referral centre. We included 787 consecutive patients from the melanoma database of the Instituto Valenciano de Oncología who underwent a SLNB between 1st January 2000 and 31st December 2015, of whom 350 were matched into pairs using propensity score matching. The variable of interest was the time between primary melanoma excision and SLNB (≤40 days vs >40 days). The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), and overall survival (OS). RESULTS A delay time of 40 days or less was associated with worse DSF (adjusted hazard ratio [AHR]: 1.68; 95% confidence interval [CI]: 1.07-2.65; p = 0.024), MSS (AHR: 2.06; 95% CI: 1.1-3.53; p = 0.08), and OS (AHR: 1.77; 95% CI: 1.11-2.83; p = 0.017). Other variables associated with shorter MSS were age, tumour location and thickness, mitotic rate, and SLN status. CONCLUSION Early SLNB was associated with worse survival in patients with cutaneous melanoma after adjusting for classic prognostic factors. A delay time of over 40 days was not associated with higher mortality.
Collapse
Affiliation(s)
| | | | - Victor Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| | - Isidro Bolumar
- Servicio de Cirugía, Instituto Valencia de Oncología, Valencia, Spain
| | - Angel Pla
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valenciano, Spain
| | - Eduardo Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
34
|
Llombart B, Serra-Guillén C, Rubio L, Nagore E, Requena C, Traves V, Calomarde L, Bancalari B, López-Guerrero JA, Guillen-Barona C, Sanmartín O. Subcutaneous dermatofibrosarcoma protuberans, a rare subtype with predilection for the head: A retrospective series of 18 cases. J Am Acad Dermatol 2017; 77:503-511.e1. [DOI: 10.1016/j.jaad.2017.02.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/19/2017] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
|
35
|
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
| |
Collapse
|
36
|
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.
Collapse
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.
| |
Collapse
|
37
|
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
|
38
|
Requena C, Requena L, Traves V, Sanmartín O. Hereditary progressive mucinous histiocytosis: 3 different phenotypes in 3 family members. J Cutan Pathol 2017; 44:781-785. [PMID: 28556021 DOI: 10.1111/cup.12970] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/19/2017] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
Abstract
We describe 3 cases of multiple histiocytic cutaneous tumors that began in childhood and affected 3 members from 2 generations of the same family: a mother, a daughter and a nephew. The lesions were mostly skin-colored papules distributed symmetrically on the dorsum of the forearms and hands and on the face and thighs. There were no signs of spontaneous regression. The clinical and histopathological features were consistent with a diagnosis of hereditary progressive mucinous histiocytosis (HPMH), but phenotypic expression varied somewhat between the 3 patients. HPMH has only been described in 8 families to date, and just one of the reports included 3 well-documented cases. Our cases confirm that HPMH can affect males and expands the clinical spectrum of skin lesions in this disease.
Collapse
Affiliation(s)
- Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Madrid, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Onofre Sanmartín
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
39
|
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.
Collapse
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
| |
Collapse
|
40
|
Nagore E, Heidenreich B, Rachakonda S, Garcia-Casado Z, Requena C, Soriano V, Frank C, Traves V, Quecedo E, Sanjuan-Gimenez J, Hemminki K, Landi MT, Kumar R. TERT promoter mutations in melanoma survival. Int J Cancer 2016; 139:75-84. [PMID: 26875008 DOI: 10.1002/ijc.30042] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [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: 12/16/2015] [Revised: 02/03/2016] [Accepted: 02/08/2016] [Indexed: 12/20/2022]
Abstract
Despite advances in targeted therapies, the treatment of advanced melanoma remains an exercise in disease management, hence a need for biomarkers for identification of at-risk primary melanoma patients. In this study, we aimed to assess the prognostic value of TERT promoter mutations in primary melanomas. Tumors from 300 patients with stage I/II melanoma were sequenced for TERT promoter and BRAF/NRAS mutations. Cumulative curves were drawn for patients with and without mutations with progression-free and melanoma-specific survival as outcomes. Cox proportional hazard regression models were used to determine the effect of the mutations on survivals. Individually, presence of TERT promoter and BRAF/NRAS mutations associated with poor disease-free and melanoma-specific survival with modification of the effect by the rs2853669 polymorphism within the TERT promoter. Hazard ratio (HR) for simultaneous occurrence of TERT promoter and BRAF/NRAS mutations for disease-free survival was 2.3 (95% CI 1.2-4.4) and for melanoma-specific survival 5.8 (95% CI 1.9-18.3). The effect of the mutations on melanoma-specific survival in noncarriers of variant allele of the polymorphism was significant (HR 4.5, 95% CI 1.4-15.2) but could not be calculated for the carriers due to low number of events. The variant allele per se showed association with increased survival (HR 0.3, 95% CI 0.1-0.9). The data in this study provide preliminary evidence that TERT promoter mutations in combination with BRAF/NRAS mutations can be used to identify patients at risk of aggressive disease and the possibility of refinement of the classification with inclusion of the rs2853669 polymorphism within TERT promoter.
Collapse
Affiliation(s)
- Eduardo Nagore
- Department of Dermatology, Instituto Valenciano De Oncologia, Valencia, Spain
| | - Barbara Heidenreich
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Zaida Garcia-Casado
- Laboratory of Molecular Biology, Instituto Valenciano De Oncologia, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano De Oncologia, Valencia, Spain
| | - Virtudes Soriano
- Medical Oncology Department, Instituto Valenciano De Oncologia, Valencia, Spain
| | - Christoph Frank
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Victor Traves
- Department of Pathology, Instituto Valenciano De Oncologia, Valencia, Spain
| | - Esther Quecedo
- Department of Dermatology, Hospital Arnau De Vilanova De Valencia, Valencia, Spain
| | | | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Maria Teresa Landi
- Division of Epidemiology and Genetics, National Cancer Institute, US National Institutes of Health, Bethesda, MD
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|
41
|
Machado I, Sanmartin O, Diez-Ares JA, Traves V, Avaria A, Salazar C, Rubio L, Lavernia J. [Intestinal infiltration of high-grade large T-cell non-Hodgkin lymphoma with cyclin-D1 overexpression and aberrant CD79a expression in a patient with a diagnosis of tumour stage mycosis fungoides]. Gastroenterol Hepatol 2016; 39:362-4. [PMID: 26826778 DOI: 10.1016/j.gastrohep.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/28/2015] [Accepted: 12/04/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Isidro Machado
- Servicio de Patología, Instituto Valenciano de Oncología, Valencia, España.
| | - Onofre Sanmartin
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | | | - Victor Traves
- Servicio de Patología, Instituto Valenciano de Oncología, Valencia, España
| | - Amparo Avaria
- Unidad de Hematología, Instituto Valenciano de Oncología, Valencia, España
| | - Claudia Salazar
- Unidad de Hematología, Instituto Valenciano de Oncología, Valencia, España
| | - Luis Rubio
- Laboratorio de Biología Molecular, Instituto Valenciano de Oncología, Valencia, España
| | - Javier Lavernia
- Servicio de Oncología Médica, Instituto Valenciano de Oncología, Valencia, España
| |
Collapse
|
42
|
Ribero S, Davies JR, Requena C, Carrera C, Glass D, Rull R, Vidal‐Sicart S, Vilalta A, Alos L, Soriano V, Quaglino P, Traves V, Newton‐Bishop JA, Nagore E, Malvehy J, Puig S, Bataille V. High nevus counts confer a favorable prognosis in melanoma patients. Int J Cancer 2015; 137:1691-8. [PMID: 25809795 PMCID: PMC4503475 DOI: 10.1002/ijc.29525] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 01/14/2015] [Accepted: 03/06/2015] [Indexed: 01/31/2023]
Abstract
A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi.
Collapse
Affiliation(s)
- Simone Ribero
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of Medical Sciences, Section of DermatologyUniversity of TurinTurinItaly
- Department of DermatologyLondon North West Healthcare NHS Trust Northwick Park HospitalLondonUnited Kingdom
- Imperial College LondonLondonUnited Kingdom
| | - John R. Davies
- Section of Epidemiology and BiostatisticsLICAP, University of LeedsLeedsUnited Kingdom
| | - Celia Requena
- Department of DermatologyInstituto Valenciano De OncologıaValenciaSpain
| | - Cristina Carrera
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Daniel Glass
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of DermatologyLondon North West Healthcare NHS Trust Northwick Park HospitalLondonUnited Kingdom
- Imperial College LondonLondonUnited Kingdom
| | - Ramon Rull
- Department of SurgeryMelanoma UnitHospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Sergi Vidal‐Sicart
- Department of Nuclear Medicine ServiceMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Antonio Vilalta
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Lucia Alos
- Department of Pathology ServiceMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Virtudes Soriano
- Department of OncologyInstituto Valenciano De OncologıaValenciaSpain
| | - Pietro Quaglino
- Department of Medical Sciences, Section of DermatologyUniversity of TurinTurinItaly
| | - Victor Traves
- Department of PathologyInstituto Valenciano De OncologıaValenciaSpain
| | | | - Eduardo Nagore
- Department of DermatologyInstituto Valenciano De OncologıaValenciaSpain
| | - Josep Malvehy
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
- Instituto de Salud Carlos IIICIBER on Rare DiseasesBarcelonaSpain
| | - Susana Puig
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
- Instituto de Salud Carlos IIICIBER on Rare DiseasesBarcelonaSpain
| | - Veronique Bataille
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of DermatologyWest Herts NHS TrustHertfordshireUnited Kingdom
| |
Collapse
|
43
|
Tejera-Vaquerizo A, Arias-Santiago S, Nagore E, Martín-Cuevas P, Orgaz-Molina J, Traves V, Herrera-Acosta E, Naranjo-Sintes R, Guillén C, Herrera-Ceballos E. Defining the dermoscopic characteristics of fast-growing cutaneous melanomas. Melanoma Res 2015; 25:269-72. [PMID: 25919929 DOI: 10.1097/cmr.0000000000000157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A high growth rate in melanomas has been associated with a more aggressive phenotype and worse survival. The aim of this study was to define the dermoscopic characteristics associated with this type of cutaneous melanoma. We carried out a retrospective study of 132 cutaneous melanomas, analyzing certain clinical characteristics and the most important dermoscopic variables related to the melanomas. Fast-growing melanomas were considered to be those with a growth rate of more than 0.5 mm per month. Fast-growing melanomas more often lacked an atypical network, were symmetrical, presented ulceration, and were hypopigmented. The dermoscopic vascular pattern often showed atypical irregular vessels and milky-red areas. The association of these two is a specific characteristic. Fast-growing melanomas have a characteristic phenotype and dermoscopy can be useful for their identification.
Collapse
Affiliation(s)
- Antonio Tejera-Vaquerizo
- aUnidad de Gestión Clínica de Dermatología, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Málaga bServicio de Dermatología, Hospital Universitario San Cecilio cServicio de Dermatología dServicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
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
|
45
|
Montero I, Requena C, Traves V, García-Casado Z, Kumar R, Nagore E. Age-related characteristics of cutaneous melanoma in a Spanish Mediterranean population. Int J Dermatol 2015; 54:778-84. [PMID: 25771683 DOI: 10.1111/ijd.12496] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 09/06/2013] [Accepted: 09/11/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Melanoma is considered a heterogeneous tumor with genetic and environmental factors involved in its pathogenesis. The impact of these factors varies depending on age. OBJECTIVE The aim of this study was to characterize the epidemiological, phenotypic, and histological features of patients with melanoma according to three age groups: ≤40, 41-65, and >65 years. METHODS A total of 1122 consecutive patients with invasive melanoma definitively treated in our institution since January 2000 were selected from our melanoma database. Epidemiological, phenotypic, and histological data were retrieved and analyzed as a function of age. RESULTS Female patients predominated in the younger age group. The location of cutaneous malignant melanoma differed with age. In the younger and middle age groups, tumors presented mainly on the trunk, while in the older group they were mainly found on the head/neck. Signs of actinic damage such as actinic keratoses, solar lentigines, or other skin tumors increased with age, while genetic factors such as family history of melanoma or a high number of common melanocytic nevi were more frequent in the younger group. CONCLUSION Our results suggest that melanoma development in younger patients is the result of genetic factors, particularly related to multiple nevi, whereas in older patients environmental factors such as severe chronic sun exposure play a major role.
Collapse
Affiliation(s)
- Iria Montero
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Zaida García-Casado
- Department of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.,Universidad Católica de Valencia, Valencia, Spain
| |
Collapse
|
46
|
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
| |
Collapse
|
47
|
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
| |
Collapse
|
48
|
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
|
49
|
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.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Botella-Estrada R, Traves V, Requena C, Guillen-Barona C, Nagore E. Correlation of Histologic Regression in Primary Melanoma With Sentinel Node Status. JAMA Dermatol 2014; 150:828-35. [DOI: 10.1001/jamadermatol.2013.9856] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rafael Botella-Estrada
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain2now with Department of Dermatology, Hospital Universitario La Fe and University of Valencia, Valencia, Spain
| | - Victor 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
| |
Collapse
|