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Pilśniak A, Szlauer-Stefańska A, Tukiendorf A, Rutkowski T, Składowski K, Kamińska-Winciorek G. Dermoscopy of acute radiation-induced dermatitis in patients with head and neck cancers treated with radiotherapy. Sci Rep 2023; 13:15711. [PMID: 37735505 PMCID: PMC10514312 DOI: 10.1038/s41598-023-42507-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
Head and neck cancer (HNC) was the seventh most common cancer in the world in 2018. Treatment of a patient may include surgery, radiotherapy (RT), chemotherapy, targeted therapy, immunotherapy, or a combination of these methods. Ionizing radiation used during RT covers relatively large volumes of healthy tissue surrounding the tumor. The acute form of radiation-induced dermatitis (ARD) are skin lesions that appear usually within 90 days of the start of RT. This is a prospective study which compares 2244 dermoscopy images and 374 clinical photographs of irradiated skin and healthy skin of 26 patients at on average 15 time points. Dermoscopy pictures were evaluated independently by 2 blinded physicians. Vessels in reticular distribution, white, yellow or brown scale in a patchy distribution, perifollicular pigmentation and follicular plugs arranged in rosettes were most often observed. For these dermoscopic features, agreement with macroscopic features was observed. Two independent predictors of severe acute toxicity were identified: gender and concurrent chemotherapy. Knowledge of dermoscopic features could help in the early assessment of acute toxicity and the immediate implementation of appropriate therapeutic strategies. This may increase the tolerance of RT in these groups of patients.
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Affiliation(s)
- Aleksandra Pilśniak
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anastazja Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | | | - Tomasz Rutkowski
- Inpatient Department of Radiation and Clinical Oncology, Maria Sklodowska Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Krzysztof Składowski
- Inpatient Department of Radiation and Clinical Oncology, Maria Sklodowska Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
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Placzke J, Rosińska M, Sobczuk P, Ziętek M, Kempa-Kamińska N, Cybulska-Stopa B, Kamińska-Winciorek G, Bal W, Mackiewicz J, Galus Ł, Las-Jankowska M, Jankowski M, Dziura R, Drucis K, Borkowska A, Świtaj T, Rogala P, Kozak K, Klimczak A, Jagodzińska-Mucha P, Szumera-Ciećkiewicz A, Koseła-Paterczyk H, Rutkowski P. Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or BRAF/MEK Targeted Therapy: Multicenter Real-World Report. Cancers (Basel) 2023; 15:4384. [PMID: 37686659 PMCID: PMC10486524 DOI: 10.3390/cancers15174384] [Citation(s) in RCA: 1] [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: 07/05/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The landscape of melanoma management changed as randomized trials have launched adjuvant treatment. MATERIALS AND METHODS An analysis of data on 248 consecutive melanoma stage III and IV patients given adjuvant therapy in eight centers (February 2019 to January 2021) was conducted. RESULTS The analyzed cohort comprised 147 melanoma patients given anti-PD1 (33% nivolumab, 26% pembrolizumab), and 101 (41%) were given dabrafenib plus trametinib (DT). The 2-year overall survival (OS), relapse-free survival (RFS), and distant-metastases-free survival (DMFS) rates were 86.7%, 61.4%, and 70.2%, respectively. The disease stage affected only the RFS rate; for stage IV, it was 52.2% (95% CI: 33.4-81.5%) vs. 62.5% (95% CI: 52.3-74.8%) for IIIA-D, p = 0.0033. The type of lymph node surgery before adjuvant therapy did not influence the outcomes. Completion of lymph node dissection cessation after positive SLNB did not affect the results in terms of RFS or OS. Treatment-related adverse events (TRAE) were associated with longer 24-month RFS, with a rate of 68.7% (55.5-84.9%) for TRAE vs. 56.6% (45.8-70%) without TRAE, p = 0.0031. For TRAE of grade ≥ 3, a significant decline in OS to 60.6% (26.9-100%; p = 0.004) was observed. CONCLUSIONS Melanoma adjuvant therapy with anti-PD1 or DT outside clinical trials appears to be effective and comparable with the results of registration studies. Our data support a de-escalating surgery approach in melanoma treatment.
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Affiliation(s)
- Joanna Placzke
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Magdalena Rosińska
- Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paweł Sobczuk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Marcin Ziętek
- Division of Surgical Oncology, Department of Oncology, Wroclaw Medical University, 53-413 Wroclaw, Poland
| | - Natasza Kempa-Kamińska
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 31-115 Kraków, Poland
| | - Grażyna Kamińska-Winciorek
- Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Wiesław Bal
- Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland
| | - Manuela Las-Jankowska
- Department of Clinical Oncology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University and Oncology Centre, 85-094 Bydgoszcz, Poland
| | - Michał Jankowski
- Department of Oncological Surgery, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University and Oncology Centre, 85-094 Bydgoszcz, Poland
| | - Robert Dziura
- Department of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, Poland
| | - Kamil Drucis
- Department of Surgical Oncology, Medical University of Gdansk, 80-308 Gdańsk, Poland
| | - Aneta Borkowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paweł Rogala
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Katarzyna Kozak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna Klimczak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paulina Jagodzińska-Mucha
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Hanna Koseła-Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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Krzysztofiak T, Suchorzepka M, Tukiendorf A, Wojcieszek P, Kamińska-Winciorek G. Basal Cell Carcinoma After High Dose Rate Brachytherapy: Medium-term Dermoscopic Evaluation of Cancer's Response. Dermatol Ther (Heidelb) 2023; 13:2063-2078. [PMID: 37558829 PMCID: PMC10442298 DOI: 10.1007/s13555-023-00981-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Basal cell carcinoma of the facial region remains a challenge for contemporary oncology due to the presence of aesthetic regions and critical organs. Surgery is not always the optimal solution, and high dose rate (HDR) brachytherapy has emerged as an organ-sparing treatment method whose effectiveness has been proven by a growing number of publications. Dermoscopy is a diagnostic tool that bridges clinical and pathological examination of skin lesions. It is routinely used for diagnosis, monitoring of treatment, and post-treatment evaluation; however, the literature lacks data concerning changes in dermoscopic patterns of skin cancers during and after irradiation. METHODS Our team conducted a prospective non-randomized trial of 39 patients with high-risk basal cell carcinomas (BCCs), mostly localized within the high-risk zone (H-zone) of the facial region, and who qualified for HDR brachytherapy. HDR contact brachytherapy with custom-made surface molds was introduced, delivering a dose of 45 Gy in 9 fractions prescribed to the tumor. Every patient was observed clinically and dermoscopically at three observational points: before treatment, at the end of treatment (3rd week), and 24 weeks after the end of therapy. The evolution of clinical and dermoscopic patterns was observed by two independent dermoscopists using current diagnostic criteria. A database of 12,088 photographic observations was evaluated. RESULTS Univariate logistic regression proved that brachytherapy decreases the number of clinical and dermoscopic patterns typical for basal cell carcinoma, as well as dermoscopic features not related to BCC, presumably due to the formation of scar tissue. In addition, univariate logistic regression with random effects proved a positive correlation between tumor size and presence of various dermoscopic patterns typical for BCC. CONCLUSION Dermoscopy is proven to be easy to perform and an adequate monitoring tool for patients with BCCs undergoing HDR brachytherapy.
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Affiliation(s)
- Tomasz Krzysztofiak
- Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej 15, 44-100 Gliwice, Poland
| | - Magdalena Suchorzepka
- Pathology Tumor Department, Maria Sklodowska, Curie National Research Institute of Oncology, Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej 15, 44-100 Gliwice, Poland
| | - Andrzej Tukiendorf
- Institute of Health Sciences, University of Opole, ul. Katowicka 68, 45-060 Opole, Poland
| | - Piotr Wojcieszek
- Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej 15, 44-100 Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Haematology-Oncology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej 15, 44-100 Gliwice, Poland
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Kamińska-Winciorek G, Gładyś A, Suchorzepka-Simek M. Multiple segmental piloleiomyoma: unrecognised entity. Postepy Dermatol Alergol 2023; 40:574-576. [PMID: 37692266 PMCID: PMC10485748 DOI: 10.5114/ada.2023.130493] [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] [Received: 02/11/2023] [Accepted: 03/10/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Aleksandra Gładyś
- Students' Research Group, Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Doctoral School, Medical University of Silesia, Katowice, Poland
| | - Magdalena Suchorzepka-Simek
- Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Arasiewicz H, Kamińska-Winciorek G, Dec M, Leśniak-Jakubiec L. Successful treatment of a child's lupus erythematosus tumidus with antimalarials. Postepy Dermatol Alergol 2023; 40:581-583. [PMID: 37692277 PMCID: PMC10485747 DOI: 10.5114/ada.2023.130475] [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] [Received: 02/13/2023] [Accepted: 04/24/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Hubert Arasiewicz
- Department of Dermatology and Vascular Anomalies, John Paul II Center of Pediatrics, Sosnowiec, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology; Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Michał Dec
- Department of Dermatology and Vascular Anomalies, John Paul II Center of Pediatrics, Sosnowiec, Poland
| | - Lilianna Leśniak-Jakubiec
- Department of Dermatology and Vascular Anomalies, John Paul II Center of Pediatrics, Sosnowiec, Poland
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Ziętek M, Teterycz P, Wierzbicki J, Jankowski M, Las-Jankowska M, Zegarski W, Piekarski J, Nejc D, Drucis K, Cybulska-Stopa B, Łobaziewicz W, Galwas K, Kamińska-Winciorek G, Zdzienicki M, Sryukina T, Ziobro A, Kluz A, Czarnecka AM, Rutkowski P. The Current Treatment Trends and Survival Patterns in Melanoma Patients with Positive Sentinel Lymph Node Biopsy (SLNB): A Multicenter Nationwide Study. Cancers (Basel) 2023; 15:2667. [PMID: 37345002 DOI: 10.3390/cancers15102667] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND In melanoma treatment, an approach following positive sentinel lymph node biopsy (SLNB) has been recently deescalated from completion lymph node dissection (CLND) to active surveillance based on phase III trials data. In this study, we aim to evaluate treatment strategies in SLNB-positive melanoma patients in real-world practice. METHODS Five-hundred-fifty-seven melanoma SLNB-positive patients from seven comprehensive cancer centers treated between 2017 and 2021 were included. Kaplan-Meier methods and the Cox Proportional-Hazards Model were used for analysis. RESULTS The median follow-up was 25 months. Between 2017 and 2021, the percentage of patients undergoing CLND decreased (88-41%), while the use of adjuvant treatment increased (11-51%). The 3-year OS and RFS rates were 77.9% and 59.6%, respectively. Adjuvant therapy prolonged RFS (HR:0.69, p = 0.036)), but CLND did not (HR:1.22, p = 0.272). There were no statistically significant differences in OS for either adjuvant systemic treatment or CLND. Lower progression risk was also found, and time-dependent hazard ratios estimation in patients treated with systemic adjuvant therapy was confirmed (HR:0.20, p = 0.002 for BRAF inhibitors and HR:0.50, p = 0.015 for anti-PD-1 inhibitors). CONCLUSIONS Treatment of SLNB-positive melanoma patients is constantly evolving, and the role of surgery is currently rather limited. Whether CLND has been performed or not, in a group of SLNB-positive patients, adjuvant systemic treatment should be offered to all eligible patients.
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Affiliation(s)
- Marcin Ziętek
- Department of Oncology, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Jędrzej Wierzbicki
- Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology & Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - Michał Jankowski
- Chair of Surgical Oncology, Collegium Medicum Nicolaus Copernicus University, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland
| | - Manuela Las-Jankowska
- Chair of Surgical Oncology, Collegium Medicum Nicolaus Copernicus University, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland
| | - Wojciech Zegarski
- Chair of Surgical Oncology, Collegium Medicum Nicolaus Copernicus University, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland
| | - Janusz Piekarski
- Department of Surgical Oncology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Dariusz Nejc
- Department of Surgical Oncology, Medical University of Lodz, 90-419 Lodz, Poland
- Nicolaus Copernicus Multidisciplinary Center for Oncology and Traumatology, 93-513 Lodz, Poland
| | - Kamil Drucis
- Department of Surgical Oncology, Gdansk Medical University, 80-210 Gdansk, Poland
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Cracow, Poland
| | - Wojciech Łobaziewicz
- Department of Surgical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Cracow, Poland
| | - Katarzyna Galwas
- 2nd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Marcin Zdzienicki
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Tatsiana Sryukina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Ziobro
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Agnieszka Kluz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Department of Experimental Pharmacology, Mossakowski Medical Research Centers, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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Cybulska-Stopa B, Piejko K, Ostaszewski K, Dziura R, Galus Ł, Ziółkowska B, Kempa-Kamińska N, Ziętek M, Bal W, Kamycka A, Dudzisz-Śledź M, Kubiatowski T, Kamińska-Winciorek G, Suwiński R, Mackiewicz J, Czarnecka AM, Rutkowski P. Long-term clinical evidence of comparable efficacy and toxicity of nivolumab and pembrolizumab in advanced melanoma treatment. Melanoma Res 2023; 33:208-217. [PMID: 37015054 DOI: 10.1097/cmr.0000000000000885] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Pembrolizumab and nivolumab (anty-PD-1 antibody) are commonly used for the treatment of melanoma patients. However, their efficacy and safety have never been directly compared, leaving little guidance for clinicians to select the best therapy. The study included patients with inoperable or metastatic melanoma treated in first line with anti-PD-1 immunotherapy (nivolumab or pembrolizumab). In total 1037 patients were enrolled in the study, 455 (44%) patients were treated with pembrolizumab and 582 (56%) with nivolumab. The estimated median overall survival (OS) in the pembrolizumab and nivolumab groups was 17.4 and 20.0 months [P = 0.2323; hazard ratio (HR), 1.1; 95% confidence interval (CI), 0.94-1.28], respectively, whereas the median progression-free survival (PFS) was 5.6 and 7.5 months (P = 0.0941; HR, 1.13; 95% CI, 0.98-1.29), respectively. The estimated 2- and 3-year OS in the pembrolizumab and nivolumab groups were 42/34% and 47/37%, respectively, and the PFS was 25/21% and 29/23%, respectively. There were 391 (49%) immune-related adverse events (irAEs) of any grade during treatment, including 133 (42%) related to pembrolizumab treatment and 258 (53%) to nivolumab treatment. A total of 72 (9.6%) irAEs were in G3 or G4, including during pembrolizumab 29 (9%) and nivolumab 48 (11%). There were no differences in OS, PFS and overall response rates between nivolumab and pembrolizumab therapy in previously untreated patients with advanced/metastatic melanoma. There were no differences in the frequency of G1/G2 or G3/G4 irAEs. The choice of treatment should be based on the preferences of the patient and the clinician.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow
| | - Krzysztof Ostaszewski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw
| | - Robert Dziura
- Department of Clinical Oncology, Holy Cross Cancer Center, Kielce
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznan
| | - Barbara Ziółkowska
- 2 Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice
| | - Natasza Kempa-Kamińska
- Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw
| | - Marcin Ziętek
- Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw
- Department of Oncology, Wroclaw Medical University, Wroclaw
| | - Wiesław Bal
- Department of Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice
| | | | - Monika Dudzisz-Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw
| | | | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice
| | - Rafał Suwiński
- 2 Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznan
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, Poznan
| | - Anna Małgorzata Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw
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Piejko K, Cybulska-Stopa B, Ziętek M, Dziura R, Galus Ł, Kempa-Kamińska N, Ziółkowska B, Rutkowska E, Kopciński T, Kubiatowski T, Bal W, Suwiński R, Mackiewicz J, Kamińska-Winciorek G, Czarnecka AM, Rutkowski P. Long-Term Real-World Outcomes and Safety of Vemurafenib and Vemurafenib + Cobimetinib Therapy in Patients with BRAF-Mutated Melanoma. Target Oncol 2023; 18:235-245. [PMID: 36906728 PMCID: PMC10042754 DOI: 10.1007/s11523-023-00954-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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Combined treatment with BRAFi and/or MEK inhibitors (MEKi) improves outcomes in advanced melanoma patients in comparison with monotherapy. OBJECTIVE We aim to report real-world treatment efficacy and safety of vemurafenib (V) and vemurafenib + cobimetinib (V + C) from 10 years of practice. PATIENTS AND METHODS A total of 275 consecutive patients with unresectable or metastatic BRAF mutated melanoma started first-line V or V + C treatment between 1 October 2013 and 31 December 2020. Survival analyses were performed using the Kaplan-Meier method, and Log-rank and Chi-square tests were used for comparison between groups. RESULTS The estimated median overall survival (mOS) was 10.3 months in the V group, and 12.3 months in the V + C group (p = 0.0005; HR = 1.58, 95% CI 1.2-2.1), although the latter group of patients had lactate dehydrogenase elevated numerically more often. Estimated median progression-free survival (mPFS) was 5.5 months in the V group, and 8.3 months in the V + C group (p = 0.0002; HR = 1.62, 95% CI 1.3-2.1). Complete response, partial response, stable disease, and progressive disease as best responses were recorded in the V/V + C groups in 7%/10%, 52%/46%, 26%/28%, and 15%/16% of patients, respectively. The numbers of patients with any grade of adverse effects were similar in both groups. CONCLUSIONS We confirmed significant improvement in the mOS and mPFS of unresectable and/or metastatic BRAF mutated-melanoma patients treated outside clinical trials with V + C as compared with V, with no major increase in toxicity for the combination.
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Affiliation(s)
- Karolina Piejko
- Department of Clinical Oncology, Clinical Oncology Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Garncarska 11, 31-115, Cracow, Poland
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Clinical Oncology Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Garncarska 11, 31-115, Cracow, Poland. .,Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.
| | - Marcin Ziętek
- Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.,Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Robert Dziura
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, Poznan, Poland
| | | | - Barbara Ziółkowska
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Ewa Rutkowska
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Tomasz Kopciński
- Department of Clinical Oncology, Clinical Oncology Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Garncarska 11, 31-115, Cracow, Poland
| | - Tomasz Kubiatowski
- Warmian-Masurian Cancer Center of The Ministry of The Interior and Administration's Hospital, Olsztyn, Poland
| | - Wiesław Bal
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences, Poznan, Poland.,Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, Poznan, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Anna M Czarnecka
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.,Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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9
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Zietek M, Teterycz P, Wierzbicki J, Sryukina T, Ziobro A, Kluz A, Jankowski M, Zegarski W, Piekarski J, Nejc D, Drucis K, Żadkowski S, Cybulska-Stopa B, Łobaziewicz W, Kamińska-Winciorek G, Galwas K, Zdzienicki M, Czarnecka AM, Rutkowski P. The current treatment trends and survival patterns in melanoma patients with positive sentinel lymph node biopsy (SLNB): a multicenter nationwide study. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.189] [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: 02/24/2023]
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10
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Kamińska-Winciorek G, Szlauer-Stefańska A, Mendrek W, Giebel S. Dermoscopic Evolution of Mycosis Fungoides After Allogeneic Hematopoietic Stem Cell Transplantation: a Case Series. Dermatol Pract Concept 2023; 13:dpc.1301a47. [PMID: 36892337 PMCID: PMC9946067 DOI: 10.5826/dpc.1301a47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Grażyna Kamińska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland
| | - Anastazja Szlauer-Stefańska
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland
| | - Włodzimierz Mendrek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland
| | - Sebastian Giebel
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland
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11
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Rutkowski P, Wysocki PJ, Kozak K, Nasierowska-Guttmejer A, Jeziorski A, Wysocki WM, Kalinka E, Świtaj T, Kamińska-Winciorek G, Czarnecka AM, Koseła-Paterczyk H, Cybulska-Stopa B, Wiśniewski P, Szumera-Ciećkiewicz A, Zdzienicki M, Ziobro M, Fijuth J, Kawecki A, Tysarowski A, Romanowska-Dixon B, Markiewicz A, Dedecjus M, Kubiatowski T, Dolecki K, Tchórzewska-Korba H, Rudnicka L, Owczarek W, Krzakowski M. Expert recommendations on diagnostic-therapeutic management of melanoma patients. Oncol Clin Pract 2022. [DOI: 10.5603/ocp.2021.0042] [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: 12/12/2022] Open
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12
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Krzysztofiak T, Kamińska-Winciorek G, Tukiendorf A, Suchorzepka M, Wojcieszek P. MSS08 Presentation Time: 4:20 PM. Brachytherapy 2022. [DOI: 10.1016/j.brachy.2022.09.060] [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: 12/05/2022]
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13
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Pham F, Boespflug A, Duru G, Phan A, Poulalhon N, Weiler L, Tanaka M, Lallas A, Ogata D, Davaine AC, Bahadoran P, Balguerie X, Kamińska-Winciorek G, Tromme I, Correia O, Kim MB, Marghoob AA, Linda Martin, Guitera P, Meziane M, Miquel J, Mun JH, Argenziano G, Bessis D, Bourke J, Mijuskovic Z, Chiaverini C, Corven-Benoit C, Droitcourt C, Skowron F, Marque M, Zalaudek I, Rosendahl C, Moreno-Ramirez D, Vabres P, Haenssle H, Malvehy J, Puig S, Robert C, Schopf TR, Scope A, Dalle S, Thomas L. Dermatoscopic and clinical features of congenital or congenital-type nail matrix nevi: A multicenter prospective cohort study by the International Dermoscopy Society. J Am Acad Dermatol 2022; 87:551-558. [PMID: 35104588 PMCID: PMC10035057 DOI: 10.1016/j.jaad.2022.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/18/2021] [Revised: 01/03/2022] [Accepted: 01/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Congenital nail matrix nevi (NMN) are difficult to diagnose because they feature clinical characteristics suggestive of adult subungual melanoma. Nail matrix biopsy is difficult to perform, especially in children. OBJECTIVE To describe the initial clinical and dermatoscopic features of NMN appearing at birth (congenital) or after birth but before the age of 5 years (congenital-type). METHODS We conducted a prospective, international, and consecutive data collection in 102 hospitals or private medical offices across 30 countries from 2009 to 2019. RESULTS There were 69 congenital and 161 congenital-type NMNs. Congenital and congenital-type NMN predominantly displayed an irregular pattern of longitudinal microlines (n = 146, 64%), reminiscent of subungual melanoma in adults. The distal fibrillar ("brush-like") pattern, present in 63 patients (27.8%), was more frequently encountered in congenital NMN than in congenital-type NMN (P = .012). Moreover, congenital NMN more frequently displayed a periungual pigmentation (P = .029) and Hutchinson's sign (P = .027) than did congenital-type NMN. LIMITATIONS Lack of systematic biopsy-proven diagnosis and heterogeneity of clinical and dermatoscopic photographs. CONCLUSION Congenital and congenital-type NMN showed worrisome clinical and dermatoscopic features similar to those observed in adulthood subungual melanoma. The distal fibrillar ("brush-like") pattern is a suggestive feature of congenital and congenital-type NMN.
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Affiliation(s)
- Félix Pham
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | - Amélie Boespflug
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | | | - Alice Phan
- Nephrology-Rheumatology-Dermatology Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Nicolas Poulalhon
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Laura Weiler
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Masaru Tanaka
- Department of Dermatology, Saitama Medical University, Japan
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Dai Ogata
- Department of Dermatologic oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | | | - Philippe Bahadoran
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France
| | - Xavier Balguerie
- Department of Dermatology, Rouen University Medical Center, Rouen, France
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Gliwice Branch, Poland
| | - Isabelle Tromme
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Osvaldo Correia
- Centro Dermatologia Epidermis, Instituto CUF and Faculty of Medicine of University of Porto, Porto, Portugal
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University Medical Research Institute, Pusan National University, Busan, Korea
| | - Ashfaq A Marghoob
- Memorial Sloan Kettering Skin Cancer Center, Hauppauge, New York, USA
| | - Linda Martin
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Mariame Meziane
- Department of Dermatology, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V university, Rabat, Morocco
| | - Juliette Miquel
- Unit of Pediatric Dermatology, Saint-Pierre University Hospital, Saint-Pierre, la Réunion, France
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Napoli, Italy
| | - Didier Bessis
- Service de Dermatologie, Hôpital Saint-Eloi et Hôpital Universitaire de Montpellier, Montpellier, France
| | - Johnny Bourke
- Dermatology Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Zeljko Mijuskovic
- Department of Dermatology and Venereology,School of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Christine Chiaverini
- Department of Dermatology, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Catherine Droitcourt
- Department of Dermatology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - François Skowron
- Service de dermatologie, Hôpitaux Drôme Nord, Romans sur Isère, Romans sur Isère, France
| | - Myriam Marque
- Department of Dermatology, Caremeau Hospital, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Trieste, Trieste, Italy
| | - Cliff Rosendahl
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Pierre Vabres
- Centre de Référence MAGEC, Service de Dermatologie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Holger Haenssle
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karl Universität, Heidelberg, Germany
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Caroline Robert
- Department of Medicine, Dermatology Service, Gustave Roussy and Paris-Saclay University, INSERM U981, Villejuif, France
| | - Thomas R Schopf
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Alon Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stéphane Dalle
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | - Luc Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France.
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14
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Cybulska-Stopa B, Czarnecka A, Ostaszewski K, Piejko K, Ziętek M, Dziura R, Galus L, Ziolkowska B, Seredynska J, Kamycka A, Bal W, Kubiatowski T, Switaj T, Kempa-Kaminska N, Rutkowska E, Rogala P, Kamińska-Winciorek G, Suwinski R, Mackiewicz J, Rutkowski P. 835P Efficacy of checkpoint inhibitors and targeted therapy depending on the line of treatment in patients with advanced / metastatic melanoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.961] [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: 11/01/2022] Open
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15
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Krzysztofiak T, Kamińska-Winciorek G, Pilśniak A, Wojcieszek P. High Dose Rate Brachytherapy in non - melanoma skin cancer - systematic review. Dermatol Ther 2022; 35:e15675. [PMID: 35770511 DOI: 10.1111/dth.15675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/13/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
Non-melanoma skin cancers (NMSC's) are the most common malignancies worldwide. Millions of new cases every year present challenge to healthcare systems. Recent years brought numerous new data concerning High Dose Rate (HDR) brachytherapy as treatment option for NMSC's. International guidelines do not recognize brachytherapy as a method of choice given lack of randomized trials, however many prospective and retrospective studies show promising results. Aim of the study was to present the efficacy of HDR brachytherapy, with analysis of its safety and adverse effects based on review of the English published medical full-text papers. Literature review of thirteen articles published between 1999 and 2021 was performed. Pubmed and Google Scholar databases were searched on October 2021 using keywords: ((Basal cell carcinoma) OR (squamous cell carcinoma) OR (non-melanoma skin cancer)) AND (HDR brachytherapy). Fourteen full text English articles with follow up over 1 year and study group over 50 patients were included into analysis. In analyzed material 2403 patients received High Dose Rate brachytherapy. Local control varied between 71 and 99%.Dominant reported cosmetic effect was good or very good. Results were cross-referenced with recent meta-analyses comparing brachytherapy to surgical excision, Mohs microsurgery and external beam radiotherapy. Radiodermitis is the main adverse effect of radiation treatment during and after radiotherapy. HDR brachytherapy emerges as potentially non-inferior treatment method providing very good reported cosmetic outcomes.
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Affiliation(s)
- Tomasz Krzysztofiak
- Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej, Gliwice
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Haematology-Oncology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland ul. WybrzeżeArmiiKrajowej, Gliwice
| | - Aleksandra Pilśniak
- Inpatient Department of Radiation and Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland.ul. WybrzeżeArmiiKrajowej, Gliwice.,Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Piotr Wojcieszek
- Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Poland ul. Wybrzeże Armii Krajowej, Gliwice
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16
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Ciążyńska M, Pabianek M, Sławińska M, Reich A, Lewandowski B, Szczepaniak K, Ułańska M, Nejc D, Brodowski R, Sobjanek M, Owczarek W, Kamińska-Winciorek G, Lange D, Słowińska M, Wróbel K, Bieniek A, Woźniacka A, Pękala A, Kuncman Ł, Salińska M, Noweta M, Skibińska M, Narbutt J, Ciążyński K, Lewandowska M, Dziankowska-Zaborszczyk E, Lesiak A. Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas. Cancers (Basel) 2022; 14:cancers14133069. [PMID: 35804841 PMCID: PMC9264931 DOI: 10.3390/cancers14133069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/04/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Patients with basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) often develop new keratinocyte carcinoma (KC), but information is limited on the frequency and timing of these subsequent tumors. This information is crucial to guide follow-up care. Given the significant clinical differences of the characteristic feature of individual skin cancer, estimation of the risk of a subsequent tumor should be estimating separately. The aim of our retrospective study was to assess risk factors for a subsequent skin cancer development. We demonstrated that patients with multiple tumors must be followed up carefully and for a long time. Moreover, we indicated the connection between the BCC subtype and increased risk for further KC development. BCC subtypes with an aggressive growth pattern predispose not only to increased risk for the recurrence but also are expected to be at an increased risk for a subsequent tumor. The non-invasive diagnosis, monitoring and follow up should be more comprehensive for those patients compared to low-risk BCC. Abstract Background: Patients with diagnosed keratinocyte carcinomas (KCs) have an increased risk of subsequent skin cancers development. Current studies indicate that patients with subsequent tumors should be followed up regularly. However, none of the studies indicate the connection between the specific subtypes and an increased risk for further KCs development. The study assesses the differences in the risk of developing a subsequent skin cancer after a previous diagnosis of KC, especially considering individual types of skin malignances, and identifies potential factors associated with an increased risk of new cutaneous tumor describing non-invasive diagnosis and monitoring. Methods: Pathology and medical records were examined to identify the characteristics of patients with multiple KCs diagnosed between 1999 and 2019. Results: The study group comprised 13,913 KCs occurring in 10,083 patients. Multiple KCs were observed in 2300 patients (22.8%). The analysis showed aggressive subtypes, multiple tumors, and male sex as significant prognostic factors. Conclusions: The most crucial risk factors for developing subsequent KC are being of a male gender, an aggressive tumor subtype, and previous history of multiple skin cancers. Basal cell carcinoma subtypes, such as infiltrative basosquamous, with aggressive growth patterns predispose not only to increased risk for the recurrence but are also expected to be at higher risk of subsequent KCs.
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Affiliation(s)
- Magdalena Ciążyńska
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, ul. Pabianicka 62, 93-513 Lodz, Poland; (M.P.); (K.S.); (M.U.); (A.P.)
- Department of Dermatology, Paediatric Dermatology and Oncology Clinic, Medical University of Lodz, 91-347 Lodz, Poland; (M.N.); (M.S.); (J.N.); (A.L.)
- Correspondence: ; Tel.: +48-660-726-304
| | - Marta Pabianek
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, ul. Pabianicka 62, 93-513 Lodz, Poland; (M.P.); (K.S.); (M.U.); (A.P.)
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.S.); (M.S.)
| | - Adam Reich
- Department of Dermatology, University of Rzeszow, 35-310 Rzeszow, Poland;
| | - Bogumił Lewandowski
- Clinical Department of Maxillo-Facial Surgery, Frederic Chopin Provincial Specialist Hospital, 35-310 Rzeszow, Poland; (B.L.); (R.B.)
| | - Katarzyna Szczepaniak
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, ul. Pabianicka 62, 93-513 Lodz, Poland; (M.P.); (K.S.); (M.U.); (A.P.)
| | - Małgorzata Ułańska
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, ul. Pabianicka 62, 93-513 Lodz, Poland; (M.P.); (K.S.); (M.U.); (A.P.)
| | - Dariusz Nejc
- Department of Surgical Oncology, Medical University in Lodz, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, 93-513 Lodz, Poland;
| | - Robert Brodowski
- Clinical Department of Maxillo-Facial Surgery, Frederic Chopin Provincial Specialist Hospital, 35-310 Rzeszow, Poland; (B.L.); (R.B.)
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.S.); (M.S.)
| | - Witold Owczarek
- Dermatology Clinic, Military Institute of Medicine in Warsaw, 04-141 Warsaw, Poland; (W.O.); (M.S.); (K.W.)
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Branch in Gliwice, 44-102 Gliwice, Poland;
| | - Dariusz Lange
- Department of Tumor Pathology, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Branch in Gliwice, 44-102 Gliwice, Poland;
| | - Monika Słowińska
- Dermatology Clinic, Military Institute of Medicine in Warsaw, 04-141 Warsaw, Poland; (W.O.); (M.S.); (K.W.)
| | - Katarzyna Wróbel
- Dermatology Clinic, Military Institute of Medicine in Warsaw, 04-141 Warsaw, Poland; (W.O.); (M.S.); (K.W.)
| | | | - Anna Woźniacka
- Department of Dermatology and Venereology, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (M.S.)
| | - Anika Pękala
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, ul. Pabianicka 62, 93-513 Lodz, Poland; (M.P.); (K.S.); (M.U.); (A.P.)
| | - Łukasz Kuncman
- Department of Radiotherapy, Medical University of Lodz, 93-513 Lodz, Poland;
| | - Magdalena Salińska
- Department of Dermatology and Venereology, Medical University of Lodz, 90-419 Lodz, Poland; (A.W.); (M.S.)
| | - Marcin Noweta
- Department of Dermatology, Paediatric Dermatology and Oncology Clinic, Medical University of Lodz, 91-347 Lodz, Poland; (M.N.); (M.S.); (J.N.); (A.L.)
| | - Małgorzata Skibińska
- Department of Dermatology, Paediatric Dermatology and Oncology Clinic, Medical University of Lodz, 91-347 Lodz, Poland; (M.N.); (M.S.); (J.N.); (A.L.)
| | - Joanna Narbutt
- Department of Dermatology, Paediatric Dermatology and Oncology Clinic, Medical University of Lodz, 91-347 Lodz, Poland; (M.N.); (M.S.); (J.N.); (A.L.)
| | - Karol Ciążyński
- Institute of Applied Computer Science, Lodz University of Technology, 90-537 Lodz, Poland;
| | - Marta Lewandowska
- Department of Infectious Diseases and Hepatology for Adults, Medical University of Lodz, 93-513 Lodz, Poland;
| | | | - Aleksandra Lesiak
- Department of Dermatology, Paediatric Dermatology and Oncology Clinic, Medical University of Lodz, 91-347 Lodz, Poland; (M.N.); (M.S.); (J.N.); (A.L.)
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17
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Rogala P, Czarnecka AM, Cybulska-Stopa B, Ostaszewski K, Piejko K, Ziętek M, Dziura R, Rutkowska E, Galus Ł, Kempa-Kamińska N, Calik J, Sałek-Zań A, Zemełka T, Bal W, Kamycka A, Świtaj T, Kamińska-Winciorek G, Suwiński R, Mackiewicz J, Rutkowski P. Long-Term Outcomes of Targeted Therapy after First-Line Immunotherapy in BRAF-Mutated Advanced Cutaneous Melanoma Patients—Real-World Evidence. J Clin Med 2022; 11:jcm11082239. [PMID: 35456332 PMCID: PMC9032972 DOI: 10.3390/jcm11082239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Currently, limited data on targeted therapy and immunotherapy sequencing in patients with BRAF-mutant melanoma is available. Targeted therapy and immunotherapy are expected to be comparable in terms of overall survival (OS) when used as second-line therapies; therefore, understanding the characteristics of patients who completed sequential treatment is needed. Methods: The primary objective of this study was to analyze the efficacy of BRAFi/MEKi activity as second-line therapy in patients with advanced melanoma. We also aimed to describe the clinical characteristics of patients with advanced melanoma who were treated sequentially with immunotherapy and targeted therapy. We enrolled 97 patients treated between 1st December 2015 and 31st December 2020 with first-line immunotherapy with programmed cell death 1 (PD-1) checkpoint inhibitors; and for the second-line treatment with at least one cycle of BRAFi/MEKi therapy with follow-up through 31 January 2022. Results: Median OS since first-line treatment initiation was 19.9 months and 12.8 months since initiation of BRAFi/MEKi treatment. All BRAFi/MRKi combinations were similarly effective. Median progression free survival (PFS) was 7.5 months since initiation of any BRAFi/MEKi treatment. Conclusions: BRAFi/MEKi therapy is effective in the second-line in advanced and metastatic melanoma patients. For the first time, the efficacy of all BRAFi/MEKi combinations as second-line therapy is shown.
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Affiliation(s)
- Paweł Rogala
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-546-24-55
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Krzysztof Ostaszewski
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Marcin Ziętek
- Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland;
- Department of Oncology, Wroclaw Medical University, 50-376 Wroclaw, Poland
| | - Robert Dziura
- Department of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, Poland; (R.D.); (E.R.)
| | - Ewa Rutkowska
- Department of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, Poland; (R.D.); (E.R.)
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland; (Ł.G.); (J.M.)
| | - Natasza Kempa-Kamińska
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland; (N.K.-K.); (J.C.)
| | - Jacek Calik
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland; (N.K.-K.); (J.C.)
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Tomasz Zemełka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Wiesław Bal
- Department of Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | | | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Grażyna Kamińska-Winciorek
- The Skin Cancer and Melanoma Team, Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland; (Ł.G.); (J.M.)
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
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18
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Jha AK, Sławińska M, Vinay K, Akay BN, Kamińska-Winciorek G, Sobjanek M, Zeeshan M, Singh A, Ankad BS, Bhat YJ, Lallas A, Apalla Z, Zalaudek I, Errichetti E. Dermoscopic Features of Actinic Cheilitis and Other Common Inflammatory Cheilitis: A Multicentric Retrospective Observational Study by the International Dermoscopy Society. Dermatology 2022; 238:870-875. [PMID: 35390798 DOI: 10.1159/000522602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/28/2021] [Accepted: 02/12/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. OBJECTIVES To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. METHODS This was a retrospective, multicenter study being a part of an ongoing project "Mucoscopy - an upcoming tool for oral mucosal disorders" under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. RESULTS Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. CONCLUSION Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis.
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Affiliation(s)
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bengu Nisa Akay
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Grażyna Kamińska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska- Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Gliwice, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Md Zeeshan
- Department of Skin & VD, Patna Medical College & Hospital, Patna, India
| | - Anupama Singh
- Department of Skin & VD, Patna Medical College & Hospital, Patna, India
| | - Balachandra S Ankad
- Department of Dermatology, S. Nijalingappa Medical College, Navanagar, Bagalkot, India
| | | | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Iris Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
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19
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Tukiendorf A, Kamińska-Winciorek G, Lancé MD, Olszak-Wąsik K, Szczepanowski Z, Kulik-Parobczy I, Wolny-Rokicka EI. Recent Malignant Melanoma Epidemiology in Upper Silesia, Poland. A Decade-Long Study Focusing on the Agricultural Sector. Int J Environ Res Public Health 2021; 18:ijerph182010863. [PMID: 34682617 PMCID: PMC8535977 DOI: 10.3390/ijerph182010863] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to create spatial and spatio-temporal patterns of cutaneous malignant melanoma (MM) incidence in Upper Silesia, Poland, using the largest MM database (<4K cases) in Central Europe, focusing on the agricultural sector. The data comprised all the registered cancer cases (C43, according to the International Classification of Diseases after the 10th Revision) between the years 2004-2013 by the Regional Cancer Registries (RCRs) in Opole and Gliwice. The standardized incidence ratios (SIRs), spatio-temporal growth rates (GRs), and disease cluster relative risks (RRs) were estimated. Based on the regression coefficients, we have indicated irregularities of spatial variance in cutaneous malignant melanoma, especially in older women (≥60), and a possible age-migrating effect of agricultural population density on the risk of malignant melanoma in Upper Silesia. All the estimates were illustrated in choropleth thematic maps.
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Affiliation(s)
- Andrzej Tukiendorf
- Department of Population Health, Wrocław Medical University, ul. Bartla 5, 51-618 Wrocław, Poland
- Correspondence: ; Tel.: +48-601-409-079
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, National Institute of Oncology, Gliwice, ul. Armii Krajowej 15, 44-101 Gliwice, Poland;
| | - Marcus Daniel Lancé
- Department of Anesthesiology, Hamad Medical Corporation, Al Rayyan Street, Doha P.O. Box 3050, Qatar;
| | - Katarzyna Olszak-Wąsik
- Department of Gynecology, Obstetrics and Oncological Gynecology, School of Medicine and Division of Dentistry in Zabrze, Medical University of Silesia, ul. Batorego 15, 41-902 Bytom, Poland;
| | | | - Iwona Kulik-Parobczy
- Department of Physical Education and Physiotherapy, Opole University of Technology, ul. Prószkowska 76, 45-758 Opole, Poland;
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20
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Szlauer-Stefańska A, Kamińska-Winciorek G. What Do the Lips Say in Chronic Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation? A Case Series. Dermatol Ther (Heidelb) 2021; 11:1423-1434. [PMID: 34014505 PMCID: PMC8322242 DOI: 10.1007/s13555-021-00546-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Chronic graft-versus-host disease (cGvHD) affects around half of allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, with frequent involvement of the oral mucosa and lip vermillion, that clinically may resemble other autoimmune and inflammatory conditions. Our objectives were to define the dermoscopic patterns of lip vermilion in patients suffering from cGvHD and to compare the presentation with previously published dermoscopic presentations of other disease entities presenting on the lip vermillion. Methods A group of 16 patients diagnosed with cGvHD was assessed clinically and dermoscopically. The dermoscopic descriptions were made according to recent consensus on terminology of non-neoplastic disorders. Results Dermoscopy of vermillion frequently revealed dotted vessels that were found in all patients, while linear vessels without bends or branches were seen in 10 of them (62.5%). Peripheral scale, mainly in white color (13/16, 81.2%) was often present. Most striking features were parallel and perpendicular white lines, found in all patients. Other structures included brown dots and blood spots that were present in 10 patients (62.5%). Four patients (25.0%) had blurred vermillion border and in 8 (50.0%) linear fissures or ulceration were found. Typical Wickham striae were found in 3 (18.8%) patients. Conclusions The dermoscopic features observed in cGvHD affecting lip vermillion warrant differentiation with inflammatory (lichen planus), autoimmune (lichen sclerosus, discoid lupus erythematosus), precancerous (actinic keratosis, leukoplakia), and neoplastic diseases (squamous cell carcinoma), among others. Dermoscopy of lip vermillion might be an additional tool to visualize diagnostic mucoscopic features of cGvHD (lichen planus-like, lichen sclerosus-like lesions).
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Affiliation(s)
- Anastazja Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
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21
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Cybulska-Stopa B, Ziętek M, Kamińska-Winciorek G, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Zemełka T, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Anti-programmed cell death-1 therapy in octogenarian and nonagenarian advanced/metastatic melanoma patients. Melanoma Res 2021; 31:49-57. [PMID: 33165240 DOI: 10.1097/cmr.0000000000000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/26/2022]
Abstract
Immunotherapy with anti-programmed cell death-1 (PD-1) agents is an effective treatment for metastatic melanoma. Octogenarians and nonagenarians represent a significant cohort of melanoma patients. This multicenter retrospective analysis enrolled 499 patients treated with nivolumab or pembrolizumab. Seventy-three patients were aged 80-100, 218 patients were aged 65-79, and 208 patients were <65 years old. Baseline parameters were comparable. The median overall survival (OS) was 14.7, 18.7, 25.9, and the median progression-free survival (PFS) was 8.7, 7.7, and 6.2 months in the age groups of 80-100, 65-79, and <65 years, respectively. The median melanoma-specific survival (MSS) was 22.5, 27.8, and 31.6 months in the age groups of 80-100, 65-79, and <65 years, respectively. There was no statistically significant difference in OS (P = 0.2897), PFS (P = 0.7155), and MSS (P = 0.9235) between the group of 80-100 years old vs. 65-79 and vs. <65 years old patients. Overall response rate and disease control rate was similar in all groups (P = 0.06974 and P = 0.89435, respectively). Overall, the immune-related adverse event (irAE) rate was comparable in the three age groups (41, 34, and 37.5% in the groups of patients aged 80-100, 65-79, and <65 years, respectively). Also, the rates of G3 and G4 irAEs were comparable (4, 6, and 7% in the groups of patients, respectively). The efficacy and toxicity of anti-PD-1 therapy in octogenarians and nonagenarians with metastatic melanoma are similar as in patients aged <65 years and 65-79 years. The patients' age should not be considered as an exclusion criterion for anti-PD-1 treatment.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Marcin Ziętek
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center
- Department of Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences
- Chemotherapy Department, Greater Poland Cancer Centre, Poznan
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Stanisław Kieszko
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin
| | | | - Jacek Calik
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center
| | - Tomasz Zemełka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Tomasz Kubiatowski
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences
- Department of Clinical Oncology, Lower Silesian Oncology Center, Wroclaw
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology
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22
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Cybulska-Stopa B, Pacholczak-Madej R, Kamińska-Winciorek G, Ziętek M, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Rolski J, Sałek-Zań A, Gajewska-Wicher K, Drosik-Kwaśniewska A, Rogala P, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. First-line treatment of advanced/metastatic melanoma with anti-PD-1 antibodies: multicenter experience in Poland. Immunotherapy 2020; 13:297-307. [PMID: 33353420 DOI: 10.2217/imt-2020-0217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/13/2022] Open
Abstract
Aim: To evaluate treatment results in advanced/metastatic melanoma patients treated with anti-PD-1 immunotherapy in routine practice in oncology centers in Poland. Methods: Multicenter retrospective analysis included 499 patients with unresectable/metastatic (stage IIIC-IV) melanoma treated with anti-PD-1 in first-line therapy. Results: Estimated median overall survival (OS) and progression-free survival (PFS) were 19.9 and 7.9 months, respectively. Multivariate analysis confirmed that ECOG 0, no brain metastases, normal lactate dehydrogenase level and occurrence of immune-related adverse events (irAEs) were statistically significantly associated with improved OS and PFS. Any irAE occurred in 24% of patients. Grade 3 or Grade 4 irAEs occurred in 6% of patients. Conclusion: Analysis revealed a slightly worse OS in real-world treatment in comparison to clinical trials (KEYNOTE-006 and CheckMate 066). Polish population treatment results are similar to other studies of real-world data. PFS and ORR are similar in our research and clinical trials.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Renata Pacholczak-Madej
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland.,Department of Anatomy, Jagiellonian University, Medical College, 31-543 Krakow, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation & Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Marcin Ziętek
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland.,Department of Oncological Surgery, Wroclaw Medical University, 53-413 Wroclaw, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Łukasz Galus
- Department of Medical & Experimental Oncology, Poznan University of Medical Sciences, 60-786 Poznan, Poland.,Chemotherapy Department, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy & Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Stanisław Kieszko
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, 20-090 Lublin, Poland
| | | | - Jacek Calik
- Department of Clinical Oncology, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland
| | - Janusz Rolski
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Katarzyna Gajewska-Wicher
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Anna Drosik-Kwaśniewska
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Paweł Rogala
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Tomasz Kubiatowski
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, 20-090 Lublin, Poland
| | - Rafał Suwiński
- II Clinic of Radiotherapy & Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Jacek Mackiewicz
- Department of Medical & Experimental Oncology, Poznan University of Medical Sciences, 60-786 Poznan, Poland.,Department of Diagnostics & Cancer Immunology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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23
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Cybulska-Stopa B, Ziętek M, Kamińska-Winciorek G, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Porównanie pośrednie wyników leczenia chorych na zaawansowane/przerzutowe czerniaki za pomocą niwolumabu lub pembrolizumabu – analiza wieloośrodkowa. Oncol Clin Pract 2020. [DOI: 10.5603/ocp.2020.0037] [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: 11/25/2022] Open
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Kamińska-Winciorek G, Szlauer-Stefańska A. Mucoscopy in acute graft-versus-host disease. Oral Dis 2020; 27:1193-1196. [PMID: 32931619 DOI: 10.1111/odi.13642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Anastazja Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
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Szlauer-Stefańska A, Kamińska-Winciorek G, Giebel S, Bagłaj M. Secondary skin neoplasms in patients after autologous and allogeneic hematopoietic stem cell transplantation procedures. ADV CLIN EXP MED 2020; 29:1221-1230. [PMID: 33064381 DOI: 10.17219/acem/126739] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The increasing number of hematopoietic stem cell transplantation (HSCT) procedures and lower transplant-related mortality has led to a growing population of survivors facing long-term increased risk of secondary malignancy, including cutaneous neoplasms. In this review, we aim to discuss the incidence, risk factors and preventive strategies for secondary skin neoplasms after autologous and allogeneic HSCT. Cutaneous neoplasms, such as basal cell carcinoma, squamous cell carcinoma and melanoma, are among the most common solid cancers arising in patients after HSCT. Besides risk factors established in the general population, primary disease, chronic graft-versus-host disease (CGvHD), prolonged immunosuppression, especially with the use of cyclosporine and azathioprine, radiation exposure, light skin color, male sex, and young age at transplantation play a role in the development of cutaneous neoplasms in HSCT recipients. Skin cancer development after HSCT may be explained by cumulative effects of chemotherapy and radiotherapy-induced DNA damage, prolonged immunosuppressive conditions and chronic mucosal inflammation, particularly after allogeneic HSCT. Delayed immune recovery and persistent immunodeficiency in patients with graft-versus-host disease (GvHD) may also contribute to carcinogenesis. Regular dermatological surveillance and prompt recognition of precancerous and cancerous lesions is crucial for patient's prognosis and management.
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Affiliation(s)
- Anastazja Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Poland
| | - Maciej Bagłaj
- Department of Pediatric Surgery and Urology, Wroclaw Medical University, Poland
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Rutkowski P, Wysocki PJ, Nasierowska-Guttmejer A, Jeziorski A, Wysocki WM, Kalinka E, Świtaj T, Kozak K, Kamińska-Winciorek G, Czarnecka AM, Koseła-Paterczyk H, Wiśniewski P, Szumera-Ciećkiewicz A, Zdzienicki M, Cybulska-Stopa B, Ziobro M, Fijuth J, Kawecki A, Rudnicka L, Owczarek W, Krzakowski M. Czerniak skóry. Oncol Clin Pract 2020. [DOI: 10.5603/ocp.2020.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Szlauer-Stefańska A, Krawczyk-Kuliś M, Kamińska-Winciorek G, Bobek-Billewicz B, Giebel S. Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Case Report. Transplant Proc 2020; 52:2551-2553. [PMID: 32444124 DOI: 10.1016/j.transproceed.2020.01.123] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/26/2020] [Indexed: 11/25/2022]
Abstract
We present a case of a young patient with life-threatening pulmonary complications after allogeneic hematopoietic stem cell transplantation (HSCT). The 25-year-old woman, after HSCT for multiple myeloma, developed severe chronic graft-vs-host disease (GvHD), including bronchiolitis obliterans syndrome. During the treatment of chronic GvHD, 18 months after HSCT, she experienced sudden massive pulmonary hemorrhage with cardiac arrest. The computed tomography imaging revealed lesions suggestive of fungal etiology, with cavity adjacent to the pulmonary vessels. Disqualified from invasive treatment due to poor pulmonary performance, she was treated conservatively with broad-spectrum antibiotics and antifungals. The microbiological workup consistently revealed only Pseudomonas aeruginosa colonization. Her condition steadily improved on treatment. Over 18 months after the incident, she did not experience recurrent bleeding nor serious infection, her primary disease remains in remission, and GvHD symptoms are controlled. Allogeneic HSCT offers possibility of sustained immune-mediated disease control and sometimes even cure, but despite reduced transplant related mortality, GvHD and infections may be detrimental for transplant recipients. Our report illustrates atypical manifestation of pulmonary lesions and highlights the importance of infection control during GvHD treatment.
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Affiliation(s)
- Anastazja Szlauer-Stefańska
- Bone Marrow Transplantation and Oncohematology Department, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland.
| | - Małgorzata Krawczyk-Kuliś
- Bone Marrow Transplantation and Oncohematology Department, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Bone Marrow Transplantation and Oncohematology Department, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Barbara Bobek-Billewicz
- Radiology and Diagnostic Imaging Department, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Sebastian Giebel
- Bone Marrow Transplantation and Oncohematology Department, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
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Szlauer-Stefańska A, Kamińska-Winciorek G, Giebel S. Onychoscopy of non-infectious nail abnormalities in patients after allogeneic haematopoietic stem cell transplantation. J Eur Acad Dermatol Venereol 2018; 33:637-642. [PMID: 30468536 DOI: 10.1111/jdv.15357] [Citation(s) in RCA: 5] [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: 08/07/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
Abstract
Nail abnormalities after allogeneic haematopoietic stem cell transplantation procedure (alloHSCT) are often reported. Usually, they are related to chronic graft-versus-host disease (cGvHD). So far, only clinical manifestations of selected nail abnormalities have been described, without the presentation of dermoscopic images. In this article, we present morphologic and dermoscopic manifestations of potential non-infectious nail abnormalities in patients after alloHSCT procedure based on reviewed literature and our own experience with dermoscopic iconography. In majority of studies published till now, nail changes are not connected to severity of other cGvHD symptoms; however, e.g. the presence of pterygium inversum unguis may be an indicator of lung dysfunction. As nail changes may be an early sign of cGvHD and always present in association with other manifestations, routine clinical assessment should include nails examination. Knowledge of possible presentation of nail involvement after alloHSCT may be valuable for treating physician.
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Affiliation(s)
- A Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - G Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
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Gajda M, Kamińska-Winciorek G, Wydmański J, Tukiendorf A, Kowalska M. Behaviors of active sunbeds users and their knowledge on the potential health risks; results of cross-sectional study in Poland. J Cosmet Dermatol 2018; 17:538-544. [DOI: 10.1111/jocd.12548] [Citation(s) in RCA: 5] [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] [Accepted: 03/06/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Maksymilian Gajda
- Department of Epidemiology; School of Medicine in Katowice Medical University of Silesia; Katowice Poland
| | - Grażyna Kamińska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology; Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology Gliwice Branch; Gliwice Poland
| | - Jerzy Wydmański
- Department of Conventional and Intraoperative Radiotherapy; Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology Gliwice Branch; Gliwice Poland
| | - Andrzej Tukiendorf
- Department of Biostatistics; Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology Gliwice Branch; Gliwice Poland
| | - Małgorzata Kowalska
- Department of Epidemiology; School of Medicine in Katowice Medical University of Silesia; Katowice Poland
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Gajda M, Kamińska-Winciorek G, Grzesiak I, Wydmański J. Melanoma as a surprising solution to the puzzle of intestinal obstruction. An Bras Dermatol 2017; 91:95-97. [PMID: 28300908 PMCID: PMC5325007 DOI: 10.1590/abd1806-4841.20164685] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 10/13/2015] [Indexed: 02/03/2023] Open
Abstract
We present a case of a 71-year-old man with an advanced melanoma of the right
colon. The final diagnosis was determined based on histopathological examination
of the material collected during urgent laparotomy performed due to ileus.
Although we considered the tumor to be a disseminated primary melanoma of the
colon, the possibility of unknown primary origin could not be excluded.
Palliative chemotherapy and radiotherapy reduced symptoms associated with the
disease and prolonged patient's survival.
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Affiliation(s)
- Maksymilian Gajda
- Clinical Oncology Ward, Starkiewicz Specialised Hospital - Dąbrowa Górnicza, Poland
| | - Grażyna Kamińska-Winciorek
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice - Branch Gliwice, Poland
| | - Iwona Grzesiak
- Clinical Oncology Ward, Starkiewicz Specialised Hospital - Dąbrowa Górnicza, Poland
| | - Jerzy Wydmański
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice - Branch Gliwice, Poland
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Kamińska-Winciorek G, Gajda M, Wydmański J, Tukiendorf A. What do Web users know about skin self-examination and melanoma symptoms? Asian Pac J Cancer Prev 2015; 16:3051-6. [PMID: 25854404 DOI: 10.7314/apjcp.2015.16.7.3051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Skin self-examination (SSE) may facilitate early diagnosis of melanoma at a potentially curable stage. Little data are available concerning the SSE frequency and knowledge about the symptoms of melanoma in non-patient populations. The aim of our study was to assess the performance of skin self-examination, recognition of potential melanoma symptoms as well as behavior related to sun exposure among web users in Poland. MATERIALS AND METHODS A cross-sectional study was conducted among readers of a scientific portal. Invited respondents were asked to complete an online questionnaire. Finally, statistical analysis was conducted on 4,919 surveys towards potential clinical signs of melanoma and SSE performance. RESULTS Approximately 60% of respondents had ever performed SSE in their life. Only 18.4% declared performance on a regular, monthly, basis. Factors promoting this activity were established to be bigger place of residence, higher education and sensitive skin phototype, higher level of knowledge concerning melanoma, safe tanning rules and, especially, past surgical excision of naevi. Declared longer use of tanning beds was linked to understanding better the importance of clinical features of melanoma. Awareness of hazardous behavior during sunbathing is associated with the attempts to change them. CONCLUSIONS Regular SSE is not a common practice, whilst the knowledge about the clinical features of melanoma is varied. Therefore, constant pressure should be put on promotion of regular skin self-examination and teaching its proper techniques, including familiarity with the ABCD (asymmetry; border; color; diameter) rule and its extension of "EFG" (elevated, firm, progressive growth) criteria.
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Kamińska-Winciorek G, Wydmański J. Dermoscopy of skin metastases from breast cancer and of the orange peel type ("peau d'orange"): a report of two cases. Int J Dermatol 2013; 54:343-6. [PMID: 24372008 DOI: 10.1111/ijd.12094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
UNLABELLED Subungual melanoma is a rare, but one of the diagnostically most difficult variants of melanoma. Unfortunately, due to its late detection, lack of an early reaction from the patient and diagnosis in advanced stages, subungual melanoma is deemed as a prognostically unfavorable variant of this malignancy. Diagnosis of subungual melanoma is very difficult to establish merely on the basis of clinical examination due to the resemblance of subungual hematoma to melanocytic nevus, fungal or bacterial infections. Dermoscopy seems to be the ideal diagnostic tool in the differential diagnosis of this life-threatening disease. AIMS To describe the basic aspects of dermoscopy of subungual melanoma and other conditions involving the nails. METHODS Review of medical database PubMed for the literature of the last 10 years on the dermoscopic patterns of subungual melanoma and other subungual diseases. RESULTS We collate the fundamental rules of performing dermoscopy in subungual melanoma, as well as basic dermoscopic features and diagnostic algorithms of selected subungual lesions requiring differentiation from melanoma. CONCLUSIONS Dermoscopy is a safe, easily repeatable diagnostic method, and the knowledge of basic dermoscopic patterns of developing melanoma in subungual localization, along with the differential diagnosis of other diseases within the nail plate, will help not only dermatologists, but also the professionals of other specialties, such as surgeons, oncologists, orthopedists, and also general practitioners.
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Kamińska-Winciorek G. Entomodermoscopy in scabies - is it a safe and friendly screening test for scabies in children? Acta Dermatovenerol Croat 2012; 20:117-119. [PMID: 22726288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Kamińska-Winciorek G, Spiewak R. [Basic dermoscopy of melanocytic lesions for beginners]. ACTA ACUST UNITED AC 2011; 65:501-8. [PMID: 21918252 DOI: 10.5604/17322693.955121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 07/06/2011] [Indexed: 11/13/2022]
Abstract
BACKGROUND Dermoscopy is a safe, easy-to-repeat diagnostic method used especially in the diagnosis of melanocytic lesions and others. Performing dermoscopy for skin lesions on the whole body takes only one minute more than standard clinical examination. Therefore the knowledge of basic dermoscopy among multi-specialization doctors - from general practitioners, surgeons, oncologists to dermatologists - increases the possibility of detection of potential melanoma. AIM To describe the basic aspects of dermoscopy of melanocytic lesions. METHODS Review of medical databases PubMed and Medline from the last 8 years and a retrospective analysis of own experience. RESULTS We report the fundamental principles of performing dermoscopy, basic dermoscopic features and diagnostic algorithms of selected melanocytic lesions. Conclusions. The knowledge base of dermoscopy is very important among doctors of many specializations. It increases melanoma detection in very early stages.
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Affiliation(s)
- Grażyna Kamińska-Winciorek
- Zakład Dermatologii Doświadczalnej i Kosmetologii, Wydział Farmaceutyczny, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
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Kamińska-Winciorek G, Brzezińska-Wcisło L, Lis-Swiety A, Krauze E. Paraneoplastic type of acanthosis nigricans in patient with hepatocellular carcinoma. Adv Med Sci 2007; 52:254-256. [PMID: 18217428] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
UNLABELLED Paraneoplastic acanthosis nigricans is connected with malignancies in adults in almost 100% of cases. The typical skin changes include: thickening and hyperpigmentation in typical localization with mucocutaneous involvement. PURPOSE The authors report a case of a malignant type of acanthosis nigricans in 42-year-old female patient with hepatocellular carcinoma. CASE REPORT First skin lesions appeared in 2000. The patient died within 22 months (of the first appearance of skin symptoms), because of hepatocellular carcinoma. Herein we report the clinical picture, skin involvement and diagnostic procedures in acanthosis nigricans. CONCLUSIONS Paraneoplastic type of acanthosis nigricans--in patient with hepatocellular carcinoma is not frequently reported in the literature. In the aspect of clinical occurrence of skin lesions suggesting acanthosis nigricans the diagnostics should be focused on internal malignancies.
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Wygledowska-Kania M, Kamińska-Winciorek G, Krauze E, Brzezińska-Wcisło L, Kajor M. Multifocal type of pilomatrixoma. Adv Med Sci 2007; 52:251-253. [PMID: 18217427] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Pilomatrixoma is a benign skin neoplasm that arises from hair follicle matrix cells. The skin lesion occurs usually as a solitary tumor and the multifocal types are very rare. Skin changes can be described as a firm to hard, non-painful, oval-shaped tumor that is covered by normal skin. It commonly occurs on a scalp, face, neck and rarely back and extremities. Complete surgical excision with the proper margin is the treatment of choice, what guaranteed the radical therapy of pilomatrixoma. In this paper case of 16-years-old male patient with many solid tumors in subcutaneous tissue on both arms will be reported. The first skin lesion appeared on the left arm 6 years ago. Clinically the disturbance was diagnosed as an atheroma, and it was excised. One year after surgical procedure the patient observed the appearance of new nodules on both arms. In the therapy surgical excision was performed with histopathological examination of the tissues. Histopathological test has proved the clinical diagnosis of pilomatrixoma. The case of multifocal pilomatrixoma, which is rarely diagnosed and described in professional literature, will be presented.
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Kamińska-Winciorek G, Brzezińska-Wcisło L, Wcisło-Dziadecka D, Syguła E. [Efficacy of acitretin in disseminated discoid lupus erythematosus]. Ann Dermatol Venereol 2005; 132:899-900. [PMID: 16327722 DOI: 10.1016/s0151-9638(05)79511-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Krauze E, Brzezińska-Wcisło L, Kamińska-Winciorek G, Wygledowska-Kania M, Sygula E. Pyoderma gangrenosum coexisting with acute myelogenous leukaemia. J Eur Acad Dermatol Venereol 2005; 19:589-92. [PMID: 16164714 DOI: 10.1111/j.1468-3083.2005.01202.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/28/2022]
Abstract
The frequency of occurrence of malignant neoplasms in the cases of pyoderma gangrenosum is not exactly determined, but it can be assessed to be at 7%. The aim of the study was to report a 26-year-old male patient with pyoderma gangrenosum coexisting with acute myelogenous leukaemia. The first skin lesions on both tibia occurred in June 2001. Prior to the proper diagnosis of pyoderma gangrenosum, the patient was treated surgically. Because of the dramatic dermatological and general condition in November 2001, the patient was admitted to the Dermatological Department of the Silesian Medical Academy in Katowice where the diagnosis of pyoderma gangrenosum was established. On the clinical and biochemical picture, the diagnosis of pyoderma gangrenosum within acute myelogenous leukaemia was made. Initially, cyclosporin A 200 mg orally per day in the therapy of pyoderma gangrenosum was administered to achieve a slight clinical improvement. Although chemotherapy leukaemia was performed, the patient died after 4 months of the confirmation of the acute myelogenous leukaemia diagnosis.
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Affiliation(s)
- E Krauze
- Dermatological Departament of Silesian Medical Academy, 40-027 Katowice, ul. Francuska 20/24, Poland.
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