scholarly journals Melanoma in Singapore: A 20-year review of disease and treatment outcomes

2021 ◽  
Vol 50 (6) ◽  
pp. 456-466 ◽  
Author(s):  
Pei Ming Yeo ◽  
Ziying Vanessa Lim ◽  
Wei Ding Virlynn Tan ◽  
Xiahong Zhao ◽  
Hui Yi Chia ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Cutaneous Melanoma ◽  
Mortality Rates ◽  
Clinicopathological Characteristics ◽  
Time Interval ◽  
Cancer Awareness ◽  
Tertiary Referral ◽  
Superficial Spreading ◽  
Acral Lentiginous Melanoma ◽  
Median Time Interval

Introduction: Melanomas in Asians have different clinicopathological characteristics and prognosis from melanomas in Caucasians. This study reviewed the epidemiology and treatment outcomes of cutaneous melanoma diagnosed at a tertiary referral dermatology centre in Singapore, which has a multiracial population. The study also determined whether Asians had comparable relapse-free and overall survival periods to Caucasians in Singapore. Method: This is a retrospective review of cutaneous melanoma cases in our centre between 1996 and 2015. Results: Sixty-two cases of melanoma were diagnosed in 61 patients: 72.6% occurred in Chinese, 19.4% in Caucasians and 3.2% in Indians, with an over-representation of Caucasians. Superficial spreading melanoma, acral lentiginous melanoma and nodular melanoma comprised 37.1%, 35.5% and 22.6% of the cases, respectively. The median time interval to diagnosis was longer in Asians than Caucasians; median Breslow’s thickness in Asians were significantly thicker than in Caucasians (2.6mm versus 0.9mm, P=0.018) and Asians tend to present at a later stage. The mortality rates for Asians and Caucasians were 52% and 0%, respectively. Conclusion: More physician and patient education on skin cancer awareness is needed in our Asian-predominant population for better outcomes. Keywords: Asian, melanoma, nails, skin neoplasm, survival

Head and neck sarcomas: treatment outcomes in a tertiary referral center in Argentina

2021 ◽  
Author(s):  
Alejandro Yanzon ◽  
Natalia Lucia Gomez ◽  
Pedro Picco ◽  
Luis Boccalatte ◽  
Federico Cayol ◽  
...  
Keyword(s):  
Head And Neck ◽  
Treatment Outcomes ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

Abstract 13248: The Impact of Instructions for Covering the Mouth and the Nose on Dispatch-Assisted Cardiopulmonary Resuscitation

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Hidetada Fukushima ◽  
Hideki Asai ◽  
Koji Yamamoto ◽  
Yasuyuki Kawai
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Median Time ◽  
Chest Compression ◽  
Fire Department ◽  
Emergency Call ◽  
Time Interval ◽  
Time Intervals ◽  
Median Time Interval ◽  
Study Results ◽  
The Impact

Introduction: Under the SARS-CoV-2 pandemic, rescuers are recommended to cover their mouth and nose with a facemask or a cloth as well as victim’s mouth and nose when performing cardiopulmonary resuscitation (CPR). However, its impact on dispatch-assisted CPR (DACPR) has not been investigated well. Hypothesis: DACPR including the instruction for covering the rescuer’s and the victim’s mouth and nose can significantly delay the start of the first chest compression. Methods: We retrospectively analyzed DACPR records of the Nara Wide Area Fire Department, covering population of 853,000/3361km 2 , in Japan. We investigated the key time intervals of 505 DACPR records between May 2020 and March 2021. We also compared the results to that of the same period in 2019 (535 records). Results: Dispatchers failed to provide mask instruction in 322 cases (63.8%). The median time interval from the emergency call and the start of CPR instruction was longer in 2020 (197 seconds vs 190 seconds, p=0.641). The time to the first chest compression was also delayed in 2020 (264 seconds vs 246 seconds, p=0.015). Among the cases that dispatchers successfully provided mask instruction (183 cases, 36.2%), median time intervals to the start of instruction and the first chest compression were relatively faster than cases without mask instruction (177 seconds vs 211 seconds and 254 seconds vs 269.5 seconds, respectively). Conclusions: Dispatchers failed to provide mask instruction in the majority of CA cases. However, our study results indicate that the impact of mask instruction on DACPR can be minor in terms of immediate CPR provision.

scholarly journals Treat bronchopleural fistula after right lower lobectomy by extra right middle lobectomy—a neglected approach

2020 ◽  
Vol 31 (1) ◽  
pp. 63-70
Author(s):  
Yan-Qing Wang ◽  
Wei Zhuang
Keyword(s):  
Treatment Outcomes ◽  
Median Duration ◽  
Inflammatory Cell ◽  
Perioperative Complications ◽  
Bronchopleural Fistula ◽  
Mortality Rates ◽  
Pathological Examination ◽  
Lower Lobectomy ◽  
Duration Of Hospitalization ◽  
Right Lower Lobectomy

Abstract OBJECTIVES Bronchopleural fistula (BPF) after right lower lobectomy (RLL), although uncommon, is associated with high mortality rates. This study was aimed at evaluating the therapeutic effect of extra right middle lobectomy (ERML) in the management of BPF after RLL. METHODS We investigated 12 consecutive patients who were treated at our hospital for BPF occurring after RLL. The diagnosis of BPF was established by bronchoscopy in all cases and BPFs were treated by ERML. All patients were followed up for at least 1 year after ERML to assess treatment outcomes. RESULTS The severity of infection and malnutrition after BPF was different for different patients. All patients agreed to undergo ERML. The procedure was uneventful in all cases, and there were no cases of perioperative complications or death. The median duration of hospitalization after ERML was 10.5 (range 6–21) days. Postoperative pathological examination showed the presence of hyperaemia and oedema in the BPF stump, and inflammatory cell infiltration in the stroma. The fresh stump of the bronchus intermedius was well structured. Patients were followed up for a median duration of 27 (range 12–41) months. The BPFs were successfully treated in all patients, and a new BPF did not develop in the new fresh stump in any of the cases. CONCLUSIONS ERML aimed at creating a fresh stump for quick healing could be alternative for treating BPF after RLL.

scholarly journals Melanoma: clinical-pathological and molecular analysis in patients of Ibague city, Colombia

Duazary ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 5-18 ◽  
Author(s):  
Carlos Puentes ◽  
Ana Estrada ◽  
Mabel Bohórquez ◽  
Anggi Vélez ◽  
Carlos Giraldo ◽  
...  
Keyword(s):  
Gene Mutations ◽  
Mitotic Rate ◽  
Clinicopathological Characteristics ◽  
Lower Limbs ◽  
Braf Gene ◽  
Acral Lentiginous Melanoma ◽  
Kaplan Meier ◽  
Age Of Diagnosis ◽  
Pathology Reports ◽  
Clinicopathological Variables

This study aimed to establish the clinicopathological characteristics of patients with melanoma and its association with BRAF gene mutations. The pathology reports and paraffin-embedded tumor samples from 47 women and 30 men with melanoma, with an average age of diagnosis of 60 years, were reviewed at the Hospital Federico Lleras Acosta of Ibague, between 2010 and 2016. The presence of V600E mutation at the exon 15 of BRAF gene, was analyzed in these tumoral samples by Sanger sequencing and visual inspection of the electropherograms. We also studied the clinicopathological variables with X2, t-Student and the Kaplan Meier index. Most of the lesions were located in the lower limbs (46.6%). The most frequent subtype was Acral Lentiginous Melanoma (41.8%). Most lesions were of poor prognosis: Breslow depth greater than 4.1 mm (52.7%), ulceration (61.4%) and medium or high mitotic rate (> 30 %). The V600E mutation was identified in five patients with large, deep and ulcerated tumors, four of them had less than four years of survival. In conclusion, there was a higher frequency of melanoma in women, V600E BRAF mutation was present in patients with advanced disease (high Breslow index) and, the probability of five-year survival was less than 40%.

scholarly journals A comprehensive evaluation of pathogenic mutations in primary cutaneous melanomas, including the identification of novel loss-of-function variants

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ivana Ticha ◽  
Jan Hojny ◽  
Romana Michalkova ◽  
Ondrej Kodet ◽  
Eva Krkavcova ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Comprehensive Evaluation ◽  
Mapk Pathway ◽  
Driver Mutations ◽  
Molecular Testing ◽  
Loss Of Function ◽  
Superficial Spreading ◽  
Pathogenic Variants ◽  
Frequent Mutations ◽  
Cycle Regulation

AbstractThe most common histological subtypes of cutaneous melanoma include superficial spreading and nodular melanoma. However, the spectrum of somatic mutations developed in those lesions and all potential druggable targets have not yet been fully elucidated. We present the results of a sequence capture NGS analysis of 114 primary nodular and superficial spreading melanomas identifying driver mutations using biostatistical, immunohistochemical and/or functional approach. The spectrum and frequency of pathogenic or likely pathogenic variants were identified across 54 evaluated genes, including 59 novel mutations, and the newly identified TP53 loss-of-function mutations p.(L194P) and p.(R280K). Frequently mutated genes most commonly affected the MAPK pathway, followed by chromatin remodeling, and cell cycle regulation. Frequent aberrations were also detected in the genes coding for proteins involved in DNA repair and the regulation and modification of cellular tight junctions. Furthermore, relatively frequent mutations were described in KDR and MET, which represent potential clinically important targets. Those results suggest that with the development of new therapeutic possibilities, not only BRAF testing, but complex molecular testing of cutaneous melanoma may become an integral part of the decision process concerning the treatment of patients with melanoma.

Acral Lentiginous Melanoma Harboring a ROS1 Gene Fusion With Clinical Response to Entrectinib

2017 ◽  
pp. 1-7 ◽  
Author(s):  
Kasey L. Couts ◽  
Caroline E. McCoach ◽  
Danielle Murphy ◽  
Jason Christiansen ◽  
Jacqueline Turner ◽  
...  
Keyword(s):  
Clinical Response ◽  
Cutaneous Melanoma ◽  
Gene Fusions ◽  
Small Cell Lung ◽  
Durable Response ◽  
Acral Lentiginous Melanoma ◽  
Multiple Tumor ◽  
Alk Inhibitor ◽  
Basket Trial ◽  
Tumor Types

Purpose ROS1 gene fusions demonstrate oncogenic activity, and patients with non–small-cell lung cancer (NSCLC) harboring a ROS1 fusion benefit from the use of a ROS1 inhibitor; however, clinical response to ROS1 inhibitors remains largely uncharacterized outside of NSCLC. ROS1 fusions have been identified in multiple tumor types but have not been reported in cutaneous melanoma. Patients and Methods Tumors from 22 patients with acral lentiginous melanoma (ALM) were analyzed with targeted RNA sequencing to detect fusions in ROS1, NTRK1, NTRK2, NTRK3, and ALK genes. A patient harboring a ROS1 fusion was enrolled in a phase I basket trial of a ROS1/TRK/ALK inhibitor (entrectinib). An additional 78 tumors with different subtypes of melanoma were screened by ROS1 immunohistochemistry. Results Targeted sequencing identified a GOPC- ROS1 fusion in a patient with ALM. The patient underwent a dramatic and durable response to entrectinib, with a RECIST (version 1.1) partial response of −38% at 3 months and −55% at 11 months. The response is ongoing, and the patient has not developed any new lesions. No additional ROS1 fusions were identified by immunohistochemistry, resulting in a frequency of 3.0% in ALM and 1.3% in all melanomas. Conclusion ROS1 fusions occur and can respond to targeted therapy in cutaneous melanoma; however, they may be specific to ALM subtype. This report expands knowledge of ROS1 inhibitor response outside of NSCLC and identifies new therapeutic options for a subset of patients with ALM.

Carotid Endarterectomy: Are We Meeting the Two Week Target?

2009 ◽  
Vol 54 (2) ◽  
pp. 27-29 ◽  
Author(s):  
RV Guest ◽  
JMJ Richards ◽  
SCA Fraser ◽  
RTA Chalmers
Keyword(s):  
Health Services ◽  
Vascular Surgery ◽  
Carotid Endarterectomy ◽  
Median Time ◽  
Retrospective Review ◽  
Stroke Prevention ◽  
Time Interval ◽  
Median Time Interval ◽  
Timing Of Onset ◽  
Prevention Benefit

Objective It has been recommended that carotid endarterectomy should be carried out within fourteen days of the index event if maximum stroke prevention benefit is to be achieved. The aim of this study was to see whether this target was being met in our region and where in the pathway delays occurred. Methods This was a retrospective review of all patients (n=75) undergoing carotid endarterectomy in 2006 in a regional vascular unit. Eleven patients were excluded as the timing of onset of symptoms was unclear, leaving 64 patients for further analysis. Results The median time-interval from onset of symptoms to surgery was 47 days (interquartile range 32-65 days). Five of 64 patients (4.5%) had a carotid endarterectomy within 14 days. Median time from onset of symptoms to presentation to health services was one day (IQR 0-7 days), from presentation to health services to neurovascular clinic was 16 days (IQR 10-23 days), from neurovascular clinic to vascular surgery clinic was 13 days (IQR 9-24 days), and from vascular surgery clinic to operation was 13 days (IQR 8-22 days). Fifteen of the 51 patients (29%) attending a neurovascular clinic and five of the 57 patients (9%) attending a vascular surgery clinic were seen within 14 days. Conclusion The fourteen-day target is difficult to achieve due to the number of steps in the referral pathway. This delay may be jeopardising outcome. Reduction in the delay to surgery would require a multi-disciplinary approach and should involve education of the general public.

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