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 [...]
Accuracy of PET/CT in the diagnosis of pelvic lymph node metastases in melanoma: A subgroup analysis of the prospective, randomised, phase III Evaluation of groin lymphadenectomy extent for metastatic melanoma (EAGLE-FM) trial
Abstract Background: PET/CT is widely used in the staging of patients with melanoma groin lymph node (LN) metastases. This study aims to utilise prospectively collected data to determine the accuracy of this modality in the diagnosis of pelvic metastases in those patients with known inguinal LN involvement. Methods: Data collected as part of the Evaluation of Groin Lymphadenectomy Extent for Metastatic Melanoma (EAGLE-FM) trial was analysed. Patients with known inguinal LN metastases were evaluated with 18 F-FDG PET/CT. Those without evidence of pelvic LN abnormalities were randomised to inguinal dissection or ilio-inguinal dissection. Those with evidence of abnormality in the pelvic [...]
Effectiveness of a stepped-care model to address fear of cancer recurrence in patients with early-stage melanoma: results at 6- and 12-month follow-up
Abstract Purpose: To investigate the effectiveness of the Melanoma Care Program, an evidence-based, psychological intervention delivered through a stepped-care model, to address fear of cancer recurrence (FCR) in patients with early-stage melanoma at 6- and 12-month follow-up, when implemented into routine practice. Methods: Individuals with stage 0-II melanoma participated in FCR severity screening using the Fear of Cancer Recurrence Inventory. Participants with an FCR severity score of ≤ 12 were offered usual care. Participants with an FCR severity score of ≥ 13 were offered a psychoeducational booklet and a stepped-care model offering participants up to 5 psychotherapeutic telehealth sessions with a [...]
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 [...]
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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