scholarly journals Excisional biopsy of a dysplastic nevus in a district polyclinic is a path to early detection of skin melanoma

2021 ◽  
pp. 66-72
Author(s):  
N. G. Artemeva ◽  
O. A. Romanova
Keyword(s):  
Mortality Rate ◽  
Early Diagnosis ◽  
Cutaneous Melanoma ◽  
Early Stage ◽  
Excisional Biopsy ◽  
Early Stage Disease ◽  
Dysplastic Nevus ◽  
Pigmented Lesions ◽  
Grade 3 ◽  
Surgery Department

Introduction. Russia has a high mortality rate of cutaneous melanoma – 2.5 per 100,000 population whereas the incidence rate is 7.7 per 100,000 population, i.e. one in every three patients dies. In the foreign countries (the USA, Australia), melanoma mortality rate is 10-15%. Such high rates are explained by the fact that patients with early-stage disease do not seek medical advice, as in early stages a tumour does not cause inconvenience to a patient and looks like an ordinary mole.The purpose of the study was to confirm the advisability of removing a progressive dysplastic nevus (grade 3 lentiginous melanocytic dysplasia) with a view to prevent and make early diagnosis of cutaneous melanoma.Materials and methods. The authors removed 180 pigmented lesions that were clinically diagnosed as a progressive dysplastic nevus in the Surgery Department of Central Polyclinic of Literary Fund from 2009 to March 2020. The patients were referred to the Surgery Department by physicians, dermatologists and other specialists of the polyclinic. Following an oncologist consultation, excisional biopsy of a nevus was performed under local anesthesia.Results. Histological examination revealed 29 (16%) dysplastic nevi with grade 3 LMD and 18 (10%) early-stage melanomas.Conclusions. If excisional biopsy of a dysplastic nevus becomes routine in Ambulatory Surgery practice, it will increase the early diagnosis of melanoma and significantly reduce mortality rates of this disease. For excisional biopsy, the authors recommend to excise at a distance of 0.5 to 1.0 cm from the lesion boundaries, since it is not possible to clinically distinguish a progressive dysplastic nevus from early melanoma.

scholarly journals Effectiveness of multi-agent technology in three-day campaign for early diagnosis of cutaneous melanoma

2021 ◽  
Vol 9 (3) ◽  
pp. 433-446
Author(s):  
E.Yu. Neretin ◽  
◽  
S.Kh. Sadreyeva ◽  
◽  
Keyword(s):  
Early Diagnosis ◽  
Cutaneous Melanoma ◽  
Large Scale ◽  
Early Stage ◽  
Good Prognosis ◽  
Agent Technology ◽  
Correct Treatment ◽  
Scale Population ◽  
Multi Agent ◽  
Epidemiological Situation

BACKGROUND: Melanoma — is a tumor that in most cases affects the skin and is characterized by an extremely aggressive course and a steadily increasing morbidity in the world. However, diagnosed at an early stage, cutaneous melanoma (CM) has a good prognosis with correct treatment. The results of the diagnosis of CM can be improved by joint the efforts of dermatologists and artificial intelligence (AI). AIM: Cutaneous melanoma is a tumor with an unpredictable course. The article discusses ways to solve the problem of early diagnosis using multi-agent technology and an expert system based on AI. MATERIALS AND METHODS: In a large industrial city with more than three million population, a three-day campaign for the early diagnostics of cutaneous melanoma was carried out, which revealed 4 cases of CM (4.35%) at pT1a stage in 96 patients registered in 2019. A total of 800 people were examined. RESULTS: As a result of diagnostics, the following data were obtained: specificity of self-diagnostics of the region was 6.78% by the inhabitants, 78.89% by dermatologists, and 95.24% by expert oncologists. In prospective quality control of diagnostics within 6 months, such parameters as the sensitivity of diagnosing cutaneous melanoma by oncologists and dermatologists were both 100%. As a result of the study, it was found that the multi-agent technology is necessary to improve the results of CM diagnostics, and also for a more complete assessment of the onco-epidemiological situation, and for forecasting of the necessary resources in the region. CONCLUSIONS: The multi-agent technology can improve diagnostic results, but for a more complete assessment of the onco-epidemiological situation, a large-scale population screening in the region is required.

Early Ofatumumab Treatment For High-Risk, Treatment-Naive Patients With Chronic Lymphocytic Leukemia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5307-5307
Author(s):  
Nitin Jain ◽  
Michael J. Keating ◽  
Alessandra Ferrajoli ◽  
Marina Konopleva ◽  
Deborah A. Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Chronic Lymphocytic Leukemia ◽  
Delay Time ◽  
Early Stage ◽  
Lymphocytic Leukemia ◽  
Early Stage Disease ◽  
Tumor Lysis ◽  
Ighv Gene ◽  
Grade 3

Background Ofatumumab is a human IgG1-kappa monoclonal antibody that binds to CD20 on normal B cells and on B chronic lymphocytic leukemia cells, resulting in B cell lysis. Ofatumumab has single-agent activity in patients (pts) with refractory CLL (Wierda, JCO 2010). Pts with CLL who have early stage disease (Rai 0-II) but have high-risk prognostic markers such as deletion 17p or deletion 11q have an increased risk of disease progression. Currently, these pts are offered watch-and-wait approach. The objective of this Phase II study is to evaluate the efficacy of ofatumumab in treating these pts with the goal to delay time to first chemoimmunotherapy treatment. Methods Pts with CLL/SLL were eligible provided they had high-risk for progression based on the presence of at least one of the following features: Rai stage II, serum beta-2 microglobulin (β2M) ≥3 mg/L, absolute lymphocyte count ≥25,000/µL, unmutated (≤2%) IGHV gene or mutated IGHV3-21, ZAP70 positive, CD38 positive (≥ 30%), or 11q or 17p deletion by FISH. Pts having a 2008 IWCLL/NCI-WG indication for CLL treatment were not eligible. Pts with Rai stage III-IV CLL were not eligible. Ofatumumab 300 mg dose 1, then 1000 mg weekly for 7 additional weeks (8 doses) was administered. Response assessment, including bone marrow evaluation, was done at least 2 months after last dose of ofatumumab and pts were followed for progression-free survival and time to first chemoimmunotherapy. Results Twenty-five pts (9 women, 16 men) were enrolled so far. The median age was 59 yrs (range, 40-81). The baseline characteristics are listed in the Table. Fifty percent of pts had unmutated IGHV gene. Thirty-four percent of pts had high-risk cytogenetic by FISH analysis. The median follow-up on the study is 4.7 months (range, 0.5-26). Grade 3-4 adverse events included infusion reaction in 6 pts. Autoimmune hepatitis with grade 4 ALT, grade 4 AST, and grade 4 alkaline phosphatase elevations was seen in 1 pt. Other grade 3-4 toxicities included rash (1 pt), shingles (1 pt), and tumor lysis (1 pt). Tumor lysis was seen in the pt with the WBC count of 207 K/µL. Eighteen pts (7 too early) are evaluable for response. Responses are as follows: 6 CR, 3 nPR, 3 PR, and 6 with stable disease. Three pts have progressed at 18.8, 14.1 and 3.2 months after starting the study treatment; 2 pts had unmutated IGHV gene (FISH negative) and one pt had trisomy 12 (IGHV mutation status unknown). None of the pts with deletion 17p or deletion 11q have progressed. All pts are alive at this time. The median overall follow up time is 7.6 months (range, 1-28). Conclusions Ofatumumab is well tolerated in pts with early stage CLL and may delay time to first chemoimmunotherapy. Disclosures: Ferrajoli: GlaxoSmithKline: Research Funding.

Is the Oncological Outcome of Early Stage Uterine Carcinosarcoma Different from That of Grade 3 Endometrioid Adenocarcinoma?

2020 ◽  
pp. 1-9
Author(s):  
Kemal Güngördük ◽  
Helmut Plett ◽  
Varol Gülseren ◽  
Mutlu Meydanlı ◽  
Gökhan Boyraz ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Recurrence Rate ◽  
Early Stage ◽  
Gynecologic Oncology ◽  
Independent Prognostic Factor ◽  
Disease Stage ◽  
Endometrioid Adenocarcinoma ◽  
Uterine Carcinosarcoma ◽  
Early Stage Disease ◽  
Grade 3

<b><i>Aim:</i></b> The clinicopathologic characteristics, recurrence patterns, and survival of patients with grade 3 endometrial cancer (G3-EAC) and uterine carcinosarcoma (UCS) were compared. <b><i>Materials and Methods:</i></b> The medical records of patients treated for G3-EAC and UCS between January 1996 and December 2016 at 11 gynecologic oncology centers in Turkey and Germany were analyzed. <b><i>Results:</i></b> Of all patients included in the study, 161 (45.1%) were diagnosed with UCS and 196 (54.9%) with G3-EAC at FIGO stage I–II (early stage) disease. The recurrence rate was higher in patients with UCS than in those with G3-EAC (17.4 vs. 9.2%, <i>p</i> = 0.02). The 5-year disease-free survival (DFS; 75.2 and 80.8%, respectively; <i>p</i> = 0.03) and overall survival (OS; 79.4 and 83.4%, respectively; <i>p</i> = 0.04) rates were significantly lower in the UCS group compared to the G3-EAC group. UCS histology was an independent prognostic factor for decreased 5-year DFS (HR 1.8, 95% CI 1.2–3.2; <i>p</i> = 0.034) and OS (HR 2.7, 95% CI 1.3–6.9; <i>p</i> = 0.041) rates. <b><i>Conclusions:</i></b> The recurrence rate was higher in UCS patients than in G3-EAC patients, regardless of disease stage. DFS and OS were of shorter duration in UCS than in G3-EAC patients. Adequate systematic lymphadenectomy and omentectomy were an independent prognostic factor for increased 5-year DFS and OS rates.

scholarly journals Medical and organizational approaches to early diagnosis of skin melanoma

2021 ◽  
Vol 65 (6) ◽  
pp. 557-564
Author(s):  
Evgeniy Yu. Neretin ◽  
Sergey V. Kozlov ◽  
Tatyana G. Zolotareva
Keyword(s):  
Mortality Rate ◽  
Early Diagnosis ◽  
Early Stage ◽  
Close Contact ◽  
Medical Documentation ◽  
Agent Technology ◽  
Skin Melanoma ◽  
Number Of Patients ◽  
Multi Agent ◽  
One Year

Introduction. The most significant problem is the early diagnosis of skin melanoma (SM). In many countries of the world, there is a constant increase in the incidence rate, and the organization of population screening can help solve this problem. Purpose of the study. Evaluation of the use of multi-agent technology in the diagnosis of SM. Material and methods. Study design: at the 1st stage, primary medical documentation was studied - Charts No. 090/y; 027-2/y, statistical reports of the Samara Regional Clinical Oncological Dispensary - Charts No. 7, No. 35, according to the results revealed at stage 2. There was developed and implemented multi-agent technology for SM diagnostics, including various agents of both qualified and specialized levels, these were both individuals and teams of departments who worked in close contact: a public relations agent; artificial intelligence secondary prevention planning agent; agent for training doctors and nurses, patients in the basics of early diagnosis and assessing their level of training; an agent for evaluating performance indicators. Results. After introducing the multi-agent system, the indicator of the share of 1-2 stages of MC in 2010-2019. increased by 48.3% compared to the period 2000-2009 and outpaced the growth in the total number of patients with SM by 6.96%; from 2010 to 2019 the proportion of patients with SM who were actively identified began to increase; one-year mortality rate from 2010 to 2019 decreased in waves (y = 0.0003x5 - 0.0104x4 - 0.2647x3 + 1.4818x2 - 1.8942x + 10.585; R2 = 0.554). Conclusion. The use of multi-agent technology makes it possible to reduce the one-year mortality rate, to achieve a faster growth rate of the newly detected number of patients with an early stage of SM (stage 1-2) compared to the increase in the number of cases, to improve the indicators of early diagnosis, active detection of skin melanoma, which is a positive result.

Four ABVD and Involved-Field Radiotherapy in Unfavorable Supradiaphragmatic Clinical Stages (CS) I-II Hodgkin’s Lymphoma (HL): Preliminary Results of the EORTC-GELA H9-U Trial.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 813-813 ◽  
Author(s):  
Christophe Ferme ◽  
Marine Diviné ◽  
Andrej Vranovsky ◽  
Frank Morschhauser ◽  
Réda Bouabdallah ◽  
...  
Keyword(s):  
Early Stage ◽  
Hematological Toxicity ◽  
P Value ◽  
Related Complication ◽  
Early Stage Disease ◽  
Preliminary Results ◽  
Stage Disease ◽  
Grade 3 ◽  
Involved Field ◽  
Involved Field Radiotherapy

Abstract The aim of the trial was to compare three modalities of chemotherapy and involved-field radiotherapy (IF-RT) in adult patients with supradiaphragmatic CS I-II HL with risk factors. Patients were randomized if they presented with age ≥ 50, or CS II4–5, or A + ESR ≥ 50, or B + ESR ≥ 30, or MT ratio ≥ 0.35. The trial compared ABVD x 6 cycles and IF-RT (36–40 Gy) vs ABVD x 4 cycles and IF-RT vs BEACOPP baseline x 4 cycles and IF-RT. From October 1998 to September 2002, 808 patients were enrolled in 111 institutions from 10 European countries. The proportions of grade 3–4 chemotherapy-related hematological toxicity (mainly WBC) were 74%, 70% and 63%, respectively; That of grade 1–3 RT-related hematological toxicity were 10%, 12% and 17%, respectively. Ten (2+3+5, 1%) patients stopped chemotherapy because of toxicity and 8 (2+2+4, 1%) refused the treatment; Six (2+2+2, 1%) patients stopped radiotherapy because of toxicity and 9 (3+1+5, 1%) refused the treatment. The proportions of patients in CR/CRu were 74%, 71% and 59% after 6, 4 ABVD and 4 BEACOPP, respectively. After a median follow-up of 57 months (range 33–81), 78 events (26 progressions, 37 relapses, 15 deaths) were observed. At July 2005, the 4-year event-free survival (EFS) and overall survival (OS) rates are as follows: Treatment No. Pts CR-CRu /PR /NC-PD 4-yr EFS 4-yr OS 6 ABVD + IF-RT 276 87% /8% /5% 91% 95% 4 ABVD + IF-RT 277 86% /11% /3% 87% 94% 4 BEACOPP + IF-RT 255 84% /12% /4% 90% 93% P value 0.607 0.380 0.978 Overall, 42 patients have died of progressive disease (5, 7 and 7 patients), treatment-related complication (7, 5 and 2), intercurrent disease (1, 0 and 2), second malignancy (1 NHL, 0 and 1 AML) or cause unspecified (0, 3 and 1). These preliminary results indicate that a combination of 4 cycles of ABVD and IF-RT is sufficient to cure a large majority of HL patients with unfavorable early stage disease and that BEACOPP baseline has no advantage over ABVD in these patients.

Phase II Study of Capecitabine, Oxaliplatin, and Erlotinib in Previously Treated Patients With Metastastic Colorectal Cancer

2006 ◽  
Vol 24 (12) ◽  
pp. 1892-1897 ◽  
Author(s):  
Jeffrey A. Meyerhardt ◽  
Andrew X. Zhu ◽  
Peter C. Enzinger ◽  
David P. Ryan ◽  
Jeffrey W. Clark ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Early Stage ◽  
Progression Free Survival ◽  
Early Stage Disease ◽  
Free Survival ◽  
Previously Treated ◽  
Grade 3

Purpose To investigate the combination of erlotinib, capecitabine, and oxaliplatin in patients who were previously treated for metastatic colorectal cancer. Patients and Methods Patients were eligible if they had metastatic colorectal cancer that progressed, were intolerant to first-line chemotherapy, or had disease recurrence within 1 year of adjuvant therapy for early-stage disease. Each 21-day cycle consisted of daily oral erlotinib at 150 mg, oral capecitabine at 1,000 mg/m2 (reduced to 750 mg/m2 after the first 13 patients) twice a day on days 1 to 14, and intravenous oxaliplatin at 130 mg/m2 on day 1. Results Thirty-two patients were enrolled onto this phase II study. By intention-to-treat analyses, eight patients (25%) experienced a partial response and 14 patients (44%) had stable disease for at least 12 weeks. The median progression-free survival was 5.4 months and the median overall survival was 14.7 months. These results were essentially unchanged when limited to the cohort of patients (78%) who received prior irinotecan for metastatic colorectal cancer. Most common grade 3 to 4 toxicities included diarrhea (38%), nausea/emesis (19%), fatigue (16%), dehydration (16%), and dermatitis (13%); grade 3 or 4 toxicities were reduced with a lower starting dose of capecitabine. Conclusion The combination of capecitabine, oxaliplatin, and erlotinib seems to have promising activity against metastatic colorectal cancer in patients who received prior chemotherapy, with a relatively higher response rate and progression-free survival compared with previous reports of either infusional FU, leucovorin, and oxaliplatin or capecitabine and oxaliplatin in similar patient populations.

Breast carcinoma in young females below the age of 35 years - histopathological and prognostic significance

1970 ◽  
Vol 2 (3) ◽  
pp. 198-202
Author(s):  
D Ghartimagar ◽  
A Ghosh ◽  
OP Talwar ◽  
R Narasimhan
Keyword(s):  
Breast Carcinoma ◽  
Young Women ◽  
Early Stage ◽  
Prognostic Significance ◽  
Age Group ◽  
Breast Cancers ◽  
Young Females ◽  
Younger Age ◽  
Grade 3 ◽  
Group Grade

Background: Breast cancers rarely occur in young women but are known to have more aggressive behaviors and poorer outcome. We here compare the significance of breast carcinoma in female below the age of 35 to the age over 35 whose specimens were submitted to Manipal teaching hospital, Pokhara. Materials and Methods: All cases of mastectomy with carcinoma from January 2000 to September 2011 were included in the study. Clinical and histopathological datas of all cases were reviewed and collated. Results: A total of 148 mastectomy specimens were received, among which, 23 cases (16%) were below 35 years; whereas 125 cases (84%) were above 35 years of age. In both groups, Stage II was the commonest stage but stage III was much more common in older group (33% versus 9%) and stage I was more common in younger age group (39% versus 27%). Bloom Richardson grading showed that in the older age group, grade 1 is the commonest grade (50%) while in the younger group; grade 3 is the commonest (39%). Patients were followed for a varying period of 6 months to 5 years. Two cases (2% of followed up cases) in older group and 3 cases (15% of followed up cases) in the younger group showed recurrence. Conclusion: Breast carcinoma in the patients younger than 35 years though presented at an early stage has higher grade tumor and poorer outcome. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6021 JPN 2012; 2(3): 198-202

scholarly journals Photonic Crystal Nanobeam Cavities for Nanoscale Optical Sensing: A Review

Micromachines ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 72 ◽  
Author(s):  
Da-Quan Yang ◽  
Bing Duan ◽  
Xiao Liu ◽  
Ai-Qiang Wang ◽  
Xiao-Gang Li ◽  
...  
Keyword(s):  
Photonic Crystal ◽  
Optical Waveguides ◽  
Optical Sensing ◽  
Early Stage ◽  
Disease Diagnosis ◽  
Label Free ◽  
Quality Factors ◽  
Integrated Sensor ◽  
Early Stage Disease ◽  
Wide Range

The ability to detect nanoscale objects is particular crucial for a wide range of applications, such as environmental protection, early-stage disease diagnosis and drug discovery. Photonic crystal nanobeam cavity (PCNC) sensors have attracted great attention due to high-quality factors and small-mode volumes (Q/V) and good on-chip integrability with optical waveguides/circuits. In this review, we focus on nanoscale optical sensing based on PCNC sensors, including ultrahigh figure of merit (FOM) sensing, single nanoparticle trapping, label-free molecule detection and an integrated sensor array for multiplexed sensing. We believe that the PCNC sensors featuring ultracompact footprint, high monolithic integration capability, fast response and ultrahigh sensitivity sensing ability, etc., will provide a promising platform for further developing lab-on-a-chip devices for biosensing and other functionalities.

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