Pennington, Tom

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. [...]

March 1st, 2025|Tags: , , |Comments Off on Incarcerated lateral inguinal hernia following ilioinguinal lymph node dissection: an unusual case.

Approaches to Surgical Management of Anorectal Melanoma in the Pre- and Post-Immunotherapy Eras.

Abstract Background: Whilst revolutionary in cutaneous melanoma, immune checkpoint inhibitors have shown reduced efficacy in anorectal melanoma. Nevertheless, their emergence, and the possibility of improved outcomes, may have changed the surgical management paradigm. Objective: To review the surgical management of anorectal melanoma in pre- and post-immunotherapy eras. Design: A retrospective cohort study from the Melanoma Institute Australia Research Database. Settings: A quaternary melanoma referral center. Patients: Patients with anorectal melanoma from 1958 to 2021. Interventions: The use of abdominoperineal resection and wide local excision were compared in pre- and post-immunotherapy eras from first use in 2014. Main outcome measures: Type of surgery performed over time and [...]

February 1st, 2025|Comments Off on Approaches to Surgical Management of Anorectal Melanoma in the Pre- and Post-Immunotherapy Eras.

Sentinel Node Biopsy in Melanoma Remains a Valuable Clinical Tool. Comment on Dixon et al. Primary Cutaneous Melanoma-Management in 2024. J. Clin. Med. 2024, 13, 1607.

Abstract Management of melanoma in 2024 requires at times complex decision making and a multidisciplinary approach. An article by Dixon and collaborators published in this Journal contained broad-reaching recommendations, some of which are in contradiction of accepted National and International Guidelines. This article seeks to highlight these points of contention and outline widely accepted standards of care that are considered best practice. Read Full Paper

January 2nd, 2025|Tags: , , |Comments Off on Sentinel Node Biopsy in Melanoma Remains a Valuable Clinical Tool. Comment on Dixon et al. Primary Cutaneous Melanoma-Management in 2024. J. Clin. Med. 2024, 13, 1607.

Approaches to Surgical Management of Anorectal Melanoma in the Pre- and Post-Immunotherapy Eras.

Abstract Background: Whilst revolutionary in cutaneous melanoma, immune checkpoint inhibitors have shown reduced efficacy in anorectal melanoma. Nevertheless, their emergence, and the possibility of improved outcomes, may have changed the surgical management paradigm. Objective: To review the surgical management of anorectal melanoma in pre- and post-immunotherapy eras. Design: A retrospective cohort study from the Melanoma Institute Australia Research Database. Settings: A quaternary melanoma referral center. Patients: Patients with anorectal melanoma from 1958 to 2021. Interventions: The use of abdominoperineal resection and wide local excision were compared in pre- and post-immunotherapy eras from first use in 2014. Main outcome measures: Type of surgery performed over time and [...]

January 1st, 2025|Comments Off on Approaches to Surgical Management of Anorectal Melanoma in the Pre- and Post-Immunotherapy Eras.

Clinical significance of intra-thoracic and intra-abdominal sentinel lymph nodes detected on lymphoscintigraphy in truncal melanoma patients.

Abstract Background: Although most melanomas drain to the more common major lymph node basins (axilla, groin, neck), rarely they drain to deep SLN locations such as intra-abdominal and intra-thoracic (including intercostal and internal mammary) sites, which pose a higher surgical risk and complexity for procurement. Our study is aimed at determining the rate of positivity and likelihood of recurrence in these nodal sites to guide management decisions for patients with truncal melanomas which drain to these 'deep' SLN locations. Methods: Retrospective data collected between May 2008 and May 2022 including all patients with truncal melanomas who underwent lymphoscintigraphy resulting in the [...]

December 9th, 2024|Comments Off on Clinical significance of intra-thoracic and intra-abdominal sentinel lymph nodes detected on lymphoscintigraphy in truncal melanoma patients.

Patient and Staff Experiences of Embedding Electronic Patient Reported Outcome Measures for Distress Screening and Quality of Life Assessment, Into Routine Melanoma Care: A Mixed-Methods Study.

Abstract Objective: Patient reported outcome measures (PROMs) are commonly collected in melanoma research. However, they are not used to guide immediate clinical care in Australia. This study explored the views and experiences of patients with Stage III melanoma and clinic staff during implementation of an electronic Patient-Reported Outcome Measures in melanoma (ePROMs-MEL) pilot to assess distress and quality of life. Methods: A prospective mixed-methods study in specialist melanoma clinics in Sydney, Australia between May 2021 and February 2023. Forty-two post-ePROMs implementation surveys and 17 semi-structured interviews were undertaken among patients and staff (including oncologists, melanoma nurses and clinic managers). Survey responses [...]

December 1st, 2024|Tags: , , , , , , , , |Comments Off on Patient and Staff Experiences of Embedding Electronic Patient Reported Outcome Measures for Distress Screening and Quality of Life Assessment, Into Routine Melanoma Care: A Mixed-Methods Study.
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