Recurrence patterns in patients with Stage II melanoma: The evolving role of routine imaging for surveillance.
J Surg Oncol. 2020 Oct 24;:
Authors: Bleicher J, Swords DS, Mali ME, McGuire L, Pahlkotter MK, Asare EA, Bowles TL, Hyngstrom JR
BACKGROUND AND OBJECTIVES: The relatively recent availability of effective systemic therapies for metastatic melanoma necessitates reconsideration of current surveillance patterns. Evidence supporting surveillance guidelines for resected Stage II melanoma is lacking. Prior reports note routine imaging detects only 21% of recurrent disease. This study aims to define recurrence patterns for Stage II melanoma to inform future surveillance guidelines.
METHODS: This is a retrospective study of patients with Stage II melanoma. We analyzed risk factors for recurrence and methods of recurrence detection. We also assessed survival. Yearly hazards of recurrence were visualized.
RESULTS: With a median follow-up of 4.9 years, 158 per 580 patients (27.2%) recurred. Overall, most recurrences were patient-detected (60.7%) or imaging-detected (27.3%). Routine imaging was important in detecting recurrence in patients with distant recurrences (adjusted rate 43.1% vs. 9.4% for local/in-transit; p = .04) and with Stage IIC melanoma (42.5% vs. 18.5% for IIA; p = .01). Male patients also self-detected recurrent disease less than females (52.1% vs. 76.8%; p < .01).
CONCLUSIONS: Routine imaging surveillance played a larger role in detecting recurrent disease for select groups in this cohort than noted in prior studies. In an era of effective systemic therapy, routine imaging should be considered for detection of asymptomatic relapse for select, high-risk patient groups.
PMID: 33098702 [PubMed - as supplied by publisher]
CD147 inhibitors as a treatment for melanoma: promising agents against SARS-CoV-2 infection.
Dermatol Ther. 2020 Oct 24;:e14449
Authors: Pourani MR, Nekooghadam SM, Youssefian L, Vahidnezhad H, Abdollahimajd F
PMID: 33098610 [PubMed - as supplied by publisher]
Second primary cutaneous melanoma in patients with advanced melanoma treated with anti-PD-1 monoclonal antibodies.
Br J Dermatol. 2020 Oct 24;:
Authors: Charvet E, Kramkimel N, Chaplain L, Gantzer A, Kassem O, Longvert C, Blom A, Dupin N, Aractingi S, Hamon M, Zimmermann U, Emile JF, Sohier P, Sidibé T, Saiag P, Funck-Brentano E
Cases of second primary cutaneous melanoma (SPCM), which were mostly BRAF-wild type, have been reported in BRAF-inhibitor-treated advanced cutaneous melanoma patients.1 Anti-programmed-death-receptor-1 (anti-PD-1) monoclonal antibodies (mAb) nivolumab and pembrolizumab have also revolutionized the prognosis of these patients, but 10-15% of them experience grade 3-4 adverse events according to Common Terminology Criteria for Adverse Events The risk of developing a SPCM in this population has not been reported and could be reduced by anti-PD-1 treatment.
PMID: 33098566 [PubMed - as supplied by publisher]
Model-dependent outcomes: Sex as a biological variable in preclinical mouse models of melanoma.
Pigment Cell Melanoma Res. 2020 Oct 23;:
Authors: Parkman GL, Kircher DA, Stehn CM, McMahon M, Holmen SL
Cutaneous melanoma is the most lethal form of skin cancer and is a complex, heterogeneous disease in terms of its etiology, histopathology, and genetics. Genetically engineered mouse (GEM) models provide an important platform for investigations of specific hypotheses, and as such, there are multiple different mouse models that have been employed to answer crucial questions underlying the biology of melanoma. Each of these models has advantages and limitations. The National Institutes of Health (NIH) has proposed a multi-dimensional initiative that includes sex as an additional biological variable in basic and preclinical research in order to eliminate bias in data analysis.
PMID: 33098202 [PubMed - as supplied by publisher]
Association of surgical interval and survival among hospital and non-hospital based patients with melanoma in North Carolina.
Arch Dermatol Res. 2020 Oct 23;:
Authors: Adamson AS, Jackson BE, Baggett CD, Thomas NE, Pignone MP
Surgical excision is important for melanoma treatment. Delays in surgical excision after diagnosis of melanoma have been linked to decreased survival in hospital-based cohorts. This study was aimed at quantifying the association between the timeliness of surgical excision and overall survival in patients diagnosed with melanoma in hospital- and non-hospital-based settings, using a retrospective cohort study of patients with stage 0-III melanoma and using data linked between the North Carolina Central Cancer Registry to Medicare, Medicaid, and private health insurance plan claims across the state. We identified 6,496 patients diagnosed between 2004 and 2012 with follow-up through 2017. We categorized the time from diagnostic biopsy to surgical excision as < 6 weeks after diagnosis, 6 weeks to 90 days after diagnosis, and > 90 days after melanoma diagnosis. Multivariable Cox regression was used to estimate differences in survival probabilities. Five-year overall survival was lower for those with time to surgery over 90 days (78.6%) compared with those with less than 6 weeks (86%). This difference appeared greater for patients with Stage 1 melanoma. This study was retrospective, included one state, and could not assess melanoma specific mortality. Surgical timeliness may have an effect on overall survival in patients with melanoma. Timely surgery should be encouraged.
PMID: 33098016 [PubMed - as supplied by publisher]