Outcomes With Radiation Therapy as Primary Treatment for Unresectable Cutaneous Head and Neck Squamous Cell Carcinoma.
Abstract Aims: Unresectable cutaneous squamous cell cancer of the head and neck (HNcSCC) poses treatment challenges in elderly and comorbid patients. Radiation therapy (RT) is often employed for locoregional control. This study aimed to determine progression-free survival (PFS) and overall survival (OS) outcomes achieved with upfront RT in unresectable HNcSCC. It also aimed to determine the impact of varying RT dose regimes on disease outcomes. Methods: A retrospective cohort study was conducted of patients with unresectable HNcSCC treated with first-line RT at a tertiary teaching hospital in Sydney, Australia between 2015-2024. Patient, disease, treatment and follow-up data were extracted from the [...]
Mohs micrographic surgery for the treatment of invasive melanoma: A systematic review with meta-analyses.
Abstract Background: The use of Mohs micrographic surgery (MMS) in melanoma treatment has divided opinion and evidence-based guidelines are lacking. Objectives: This systematic review aimed to analyse clinical outcomes for patients with invasive melanomas treated with Mohs rather than wide local excision (WLE). Methods: Embase, MEDLINE and Cochrane databases (to 30 August 2023) were searched for studies using Mohs to treat invasive melanoma. Outcomes of interest were local recurrence and death from melanoma. Results: Thirty-five articles involving 41,499 patients with invasive melanoma treated with Mohs were identified. Sixteen studies compared Mohs with WLE and 19 were Mohs-only, non-comparative studies. Patients treated with Mohs [...]
Quality and usability of photographs of skin conditions taken in emergency departments for dermatology consultation.
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Experience, knowledge, practices and attitudes of emergency department medical staff regarding teledermatology.
Abstract Objectives: The present study aimed to assess self-reported experience, knowledge, practices and attitudes of ED medical staff regarding teledermatology. Methods: Online questionnaire of ED medical staff at Prince of Wales Hospital (Sydney, Australia). Results: Seventy-nine staff completed the questionnaire. Photographic technique and compliance with medicolegal policies were variable: 1% obtained written consent and 45.6% documented verbal consent for photography. 54.4% of respondents had concerns about the quality of their photographs. Conclusions: Skin photography image quality, knowledge and adherence to medicolegal policy were poor among ED medical staff. Education could reduce risk and improve outcomes. Read Full Paper
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 [...]
The tumor immune microenvironment in primary cutaneous melanoma.
Abstract Melanoma is an immunogenic tumor. The melanoma tumor immune microenvironment (TIME) is made up of a heterogenous mix of both immune and non-immune cells as well as a multitude of signaling molecules. The interactions between tumor cells, immune cells and signaling molecules affect tumor progression and therapeutic responses. Understanding the composition and function of the TIME in primary cutaneous melanoma is useful for prognostication and therapeutic decisions. This review provides an overview of the components of the TIME in primary cutaneous melanoma, and their influence on clinical outcomes. Read Full Paper
European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2024
Abstract This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality. The diagnosis of melanoma can be made clinically and must always be confirmed by dermoscopy. If melanoma is suspected, a histopathological examination is always required. [...]
European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2024.
Abstract This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality. The diagnosis of melanoma can be made clinically and must always be confirmed by dermoscopy. If melanoma is suspected, a histopathological examination is always required. [...]
Cancer cells impair monocyte-mediated T cell stimulation to evade immunity.
Abstract The tumour microenvironment is programmed by cancer cells and substantially influences anti-tumour immune responses1,2. Within the tumour microenvironment, CD8+ T cells undergo full effector differentiation and acquire cytotoxic anti-tumour functions in specialized niches3-7. Although interactions with type 1 conventional dendritic cells have been implicated in this process3-5,8-10, the underlying cellular players and molecular mechanisms remain incompletely understood. Here we show that inflammatory monocytes can adopt a pivotal role in intratumoral T cell stimulation. These cells express Cxcl9, Cxcl10 and Il15, but in contrast to type 1 conventional dendritic cells, which cross-present antigens, inflammatory monocytes obtain and present peptide-major histocompatibility [...]
Real-World Melanoma Miss-Rate In An NHS Hospital Dermatology Service. A Retrospective Study.
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