Mobile Dermatoscope Type in Patient-Performed Teledermoscopy: A Study Within A Trial
Abstract Importance: Patient-performed teledermoscopy may improve access to dermatologic care, but evidence to guide dermatoscope selection for patient use is limited. Objective: To compare a lower-cost, ambient-light, nonpolarized dermatoscope with a higher-cost, illuminated, polarized dermatoscope for patient-performed teledermoscopy following treatment for early-stage melanoma. Design, setting, and participants: This randomized study within a trial was embedded within the MEL-SELF trial and recruited adults previously treated for early-stage melanoma (American Joint Committee on Cancer stages 0-II) in the patient-led surveillance arm of MEL-SELF from specialist and general practitioner-led skin cancer clinics in Australia from December 2021 to June 2024 with 12-month follow-up. Data were [...]
Pathological response calculation assessment remains accurate with reduced tumor bed examination after neoadjuvant immunotherapy in clinically detectable stage III melanoma.
Abstract Background: Neoadjuvant immunotherapy produces event-free survival advantage over adjuvant therapy for patients with surgically resectable macroscopic stage IIIB/C/D melanoma. Pathological response, determined as percentage residual viable tumor (% RVT), provides critical prognostic information and informs management decisions. Here, we assessed accuracy of %RVT calculation when reduced tumor bed (TB) was examined and leverage these results proposing streamlined protocols for pathological examination. Patients and methods: Comprehensive histopathological examination was carried out on 134 patient specimens after neoadjuvant immunotherapy with ipilimumab and nivolumab. Impact on %RVT when evaluating less TB than recommended by the initial International Neoadjuvant Melanoma Consortium (INMC) protocol was [...]
Pathological response calculation assessment remains accurate with reduced tumor bed examination following neoadjuvant immunotherapy in clinically detectable stage III melanoma
Abstract Background: Neoadjuvant immunotherapy produces event-free survival advantage over adjuvant therapy for patients with surgically resectable macroscopic stage IIIB/C/D melanoma. Pathological response, determined as percentage residual viable tumor (% RVT), provides critical prognostic information and informs management decisions. Here, we assessed accuracy of %RVT calculation when reduced tumor bed (TB) was examined and leverage these results proposing streamlined protocols for pathological examination. Patients and methods: Comprehensive histopathological examination was carried out on 134 patient specimens after neoadjuvant immunotherapy with ipilimumab and nivolumab. Impact on %RVT when evaluating less TB than recommended by the initial International Neoadjuvant Melanoma Consortium (INMC) protocol was [...]
Oncoplastic surgery for cutaneous head and neck cancers: A novel technique combining wide excision, local flap reconstruction and sentinel node biopsy
Abstract Background and purposes: Sentinel node biopsy (SNB) procedures in the head and neck (H&N) region can be technically demanding due to anatomic and size constraints. Often, node procurement is attempted through small incisions, making identification of crucial anatomy difficult. Given the primary site may be close to the sentinel nodes (SN), a local flap can be designed for the dual purpose of gaining access to the sentinel node field through raising the flap while facilitating repair of the primary site resulting in superior aesthetic outcomes. We detail our technique hereof. Subjects studied and methods: A review of consecutive patients undergoing [...]
A dynamic recurrence risk prediction tool for adjuvant therapy in stage III melanoma
Abstract Background: Prognosis for AJCC stage III melanoma varies significantly. Adjuvant therapies, including pembrolizumab, nivolumab, and dabrafenib/trametinib, have markedly reduced recurrence risk, as shown in pivotal trials (Keynote-054, CheckMate-238, and Combi-AD). Despite these advancements, clinicians lack tools to dynamically assess recurrence risk across the patient journey. Patients and methods: Using pooled individual patient data (IPD) from Kaplan-Meier curves of these trials, we developed a tool to dynamically estimate relapse-free survival (RFS) and distant metastasis-free survival (DMFS) over time. Conditional survival analyses incorporated AJCC-8 substages, treatment regimens, and recurrence data. Results: The analysis included 2206 patients (IIIA: 174, IIIB: 768, IIIC: 1169, IIID: [...]
Nodal radioactivity after lymphoscintigraphy as a guide to sentinel node-positivity in melanoma patients
Abstract Objective: To determine how often the sentinel node (SN) with the highest gamma count after lymphoscintigraphy was metastasis-free in SN-positive melanoma patients. Background: SN biopsy (SNB) is a standard staging procedure for patients with primary cutaneous melanoma. After pre-operative radiotracer injection, intra-operative gamma counts are used, with blue dye localization, to guide SN retrieval. Sometimes only the "hottest" nodes are removed, but the reliability of predicting SN-positivity on the basis of a node's gamma count is uncertain. Methods: Patients who had a SNB and in whom ≥2 SNs were removed, at least one of which contained metastatic melanoma, were identified from [...]
ASO Visual Abstract: Cartilage Resection in the Surgical Management of Ear Melanoma.
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The Value of Sentinel Node Biopsy in Patients With Higher-Risk (T3, T4) Primary Cutaneous Melanomas: Insights Provided by a Stage II Risk Calculator.
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Incarcerated lateral inguinal hernia following ilioinguinal lymph node dissection: an unusual case.
Abstract Penile squamous cell carcinoma (SCC) spreads predictably from primary tumour to inguinal lymph nodes then pelvic nodes and finally, to distant sites. Inguinal dissection involves resection of all femoral and inguinal nodes and is part of the recommended management. Femoral hernias are a commonly reported consequence of these extensive dissections. This case describes an unusual hernia which developed lateral to the femoral vessels. A 68 year old man presented with penile SCC of the distal glans penis and underwent bilateral ilioinguinal node dissections for nodal recurrence. On post operative day 1, the patient developed abdominal distention and obstipation. [...]