scholarly journals Total Body Skin Examination Practices: A Survey Study Amongst Dermatologists at High-Risk Skin Cancer Clinics

2019 ◽  
pp. 132-138 ◽  
Author(s):  
Shirin Bajaj ◽  
Zachary J. Wolner ◽  
Stephen W. Dusza ◽  
Ralph P. Braun ◽  
Ashfaq A. Marghoob ◽  
...  
Keyword(s):  
High Risk ◽  
Skin Cancer ◽  
Survey Study ◽  
Skin Examination ◽  
Patient Discomfort ◽  
Routine Surveillance ◽  
Cancer Specialists ◽  
Total Body ◽  
Low Prevalence

Background/Objectives: Although total body skin examination (TBSE) is the primary screening mechanism for melanoma, there is no consensus on which anatomic sites a screening TBSE should include. We sought to establish which anatomic sites are examined during routine (>90%) TBSEs of patients at high risk for skin cancer. Methods: A Google survey was emailed to 173 international dermatologist skin cancer specialists. Results: More than 75% of participants reported routinely examining the scalp, ears, face and neck, trunk, breasts, inframammary areas, axillae, extremities, palms and soles, nails, interdigital spaces, and buttocks. The least frequently inspected anatomic sites included genitalia, with male genitalia more frequently examined than female (penis n = 39; 52%; labia majora n = 21; 28%; P = 0.003), the perianal region (n = 26; 34.7%), and the ocular conjunctiva and oral mucosa (n = 35; 46.7%). Participants cited not screening these areas because of perceived patient discomfort, low prevalence of malignancy, and the expectation that other specialists examine the area. Conclusions: The role of routine surveillance of neglected anatomic sites is unclear and warrants further discussion weighing potential mortality benefit against the incidence of melanoma in obscure sites, morbidity of intervention in sensitive sites, cost-effectiveness, and potential for patient discomfort.

scholarly journals The oncogene BRAFV600E is associated with a high risk of recurrence and less differentiated papillary thyroid carcinoma due to the impairment of Na+/I− targeting to the membrane

2006 ◽  
Vol 13 (1) ◽  
pp. 257-269 ◽  
Author(s):  
G Riesco-Eizaguirre ◽  
P Gutiérrez-Martínez ◽  
M A García-Cabezas ◽  
M Nistal ◽  
P Santisteban
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Prognostic Impact ◽  
Erk Pathway ◽  
Papillary Thyroid ◽  
Thyroid Cells ◽  
Genetic Event ◽  
Total Body

The oncogene BRAFV600E is the most frequent genetic event in papillary thyroid carcinoma (PTC) but its prognostic impact still remains to be elucidated. We evaluated a representative series of 67 individuals with PTC who underwent total thyroidectomy. BRAF-positive tumours correlated with early recurrences (32% vs 7.6%; P=0.02) during a median postoperative follow-up period of 3 years. Interestingly, within the recurrences, a significant majority had negative radioiodine (131I) total body scans, predicting a poorer outcome as treatment with 131I is not effective. This last observation led us to investigate the role of BRAFV600E and the MEK-ERK pathway in thyroid dedifferentiation, particularly in Na+/I− symporter (NIS) impairment, as this thyroid-specific plasma membrane glycoprotein mediates active transport of I− into the thyroid follicular cells. A subset of 60 PTC samples was evaluated for NIS immunoreactivity and, accordingly, we confirmed a significant low NIS expression and impaired targeting to membranes in BRAF-positive samples (3.5% vs 30%; P=0.005). Furthermore, experiments with differentiated PCCl3 thyroid cells demonstrated that transient expression of BRAFV600E sharply impaired both NIS expression and targeting to membrane and, surprisingly, this impairment was not totally dependent on the MEK-ERK pathway. We have concluded that BRAFV600E is a new prognostic factor in PTC that correlates with a high risk of recurrences and less differentiated tumours due to the loss of NIS-mediated 131I uptake.

scholarly journals Total body skin examination adherence among young adults with an increased risk for skin cancer

2017 ◽  
Vol 23 (6) ◽  
Author(s):  
Julie Williams Merten ◽  
Jessica L King ◽  
Erin Largo-Wight
Keyword(s):  
Young Adults ◽  
Skin Cancer ◽  
Skin Examination ◽  
Increased Risk ◽  
Total Body

HER2 in high-risk rectal cancer patients treated in EXPERT-C, a randomized phase II trial of neoadjuvant capecitabine and oxaliplatin (CAPOX) and chemoradiotherapy (CRT) with or without cetuximab.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14616-e14616
Author(s):  
Francesco Sclafani ◽  
Amitesh Chandra Roy ◽  
Ian Chau ◽  
Andrew Wotherspoon ◽  
Clare Peckitt ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Therapeutic Target ◽  
Predictive Biomarker ◽  
Secondary Endpoints ◽  
Her 2 ◽  
Low Prevalence ◽  
The Impact

e14616 Background: HER-2 is a well established therapeutic target in breast and gastric cancer. The role of HER-2 in rectal cancer is unclear, as conflicting data on prevalence of HER-2 expression have been reported. Preclinical data indicate a potential role of HER-2 in mediating resistance of rectal cancer to chemoradiotherapy and cetuximab. This analysis evaluates the prevalence of HER-2 and its impact on the outcome of high risk rectal cancer patients treated with neoadjuvant CAPOX and CRT ± cetuximab in EXPERT-C. Methods: Eligible patients with available tumour tissue for HER-2 analysis were included. HER-2 expression was determined by immunohistochemistry (IHC) in biopsy and/or surgical specimens (score 0 to 3+). Tumours with equivocal IHC result (2+) were tested for HER-2 amplification by B-DISH. Tumours with IHC 3+ or B-DISH ratio ≥2.0 were classified as HER-2 positive. The impact of HER-2 on primary (CR) and secondary endpoints (RR, PFS, OS) of the study was analyzed. Results: Of 164 eligible study patients, 104 (63%) biopsy and 114 (69%) surgical specimens were available for analysis. Only 3/104 (2.9%) and 3/114 (2.6%) were HER-2 positive, respectively. In 77 patients with paired specimens, concordance for HER-2 status was found in 74 (96%). Overall 141 patients were assessable for HER-2; 6/141 (4.3%) had a HER-2 positive tumour in at least 1 specimen. The median follow-up was 58.7 months. HER-2 expression or amplification was not associated with a difference in outcome for any of the study endpoints, including in the subset of 90 KRAS/BRAF wild type patients treated ± cetuximab. In an exploratory analysis, 44 IHC 0/1+ random specimens were tested by B-DISH and HER-2 amplification was found in 3/38 (7.9%, insufficient material in 6 cases). Conclusions: Based on the low prevalence of expression (according to the classical criteria for defining HER-2 positivity) as recorded in EXPERT-C, HER-2 does not appear to represent a useful therapeutic target for high risk rectal cancer. We did not confirm the role of HER-2 as prognostic factor or potential predictive biomarker for cetuximab-based treatment.

Hematopoietic cell transplantation (HCT) after low-dose, total body irradiation-based regimen increased leukemia-free survival (LFS) in elderly patients with cytogenetic high-risk AML compared to chemotherapy (OSHO 97 study)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7003-7003
Author(s):  
D. Niederwieser ◽  
C. Becker ◽  
R. Krahl ◽  
H. Al-Ali ◽  
T. Lange ◽  
...  
Keyword(s):  
High Risk ◽  
Hematopoietic Cell Transplantation ◽  
Consolidation Chemotherapy ◽  
Free Survival ◽  
Allogeneic Hct ◽  
Transplant Patients ◽  
Total Body ◽  
Worse Prognosis ◽  
Related Mortality

7003 Background: Even after reaching initial CR, most AML patients > 60 years relapse within 2 years of diagnosis. Cytogenetic high risk AML (abn 3q26, abn 11q23, -5/5q-, -7/7q- and complex) has an even worse prognosis. Attempts to improve survival by intensifying consolidation chemotherapy have so far failed. We investigated the role of allogeneic HCT in comparison to chemotherapy among patients with high risk cytogenetics entered into the OSHO AML 97 protocol. Methods: Initial treatment consisted of a course of induction therapy (AraC 2 g/m2 iv on day 1,3,5,7 + mitoxantrone 10 mg/m2 iv day 1 –3, repeated once in case of PR) followed by one consolidation course (AraC 240 mg/m2 iv day 1 –5 + mitoxantrone 10 mg/m2 iv day 1 –2). Patients in CR1 after the consolidation I were either treated with an additional consolidation therapy or with an allogeneic HCT from related (n=2) or unrelated (n=10) donors. Transplant patients were conditioned with fludarabine and TBI 200 cGy and immunosuppressed with cyclosporine and mycofenolate mofetil. Results: A total of 347 patients are evaluable. Of 105 (33%) patients with high-risk cytogenetics, 53 (50%) went into remission after one or two cycles of induction chemotherapy. Of these 53 patients, 42 received consolidation I and 35 patients were available for either consolidation II (n=23) or HCT (n=12). Median age of the patients receiving chemotherapy was 64 (range 61–77) years and that of the transplant patients was 64 (range 61–68) years. LFS at 4 years was 42 ± 14% after HCT and 15 ± 8% after chemotherapy. Major differences in relapse incidences were seen between the two groups, with the lowest RI at 4 years after HCT (36 ± 15%) followed by chemotherapy (85±8%, p<0.04). Treatment related mortality at 4 years was 35±17% and 0±0% for patients receiving HCT and chemotherapy, respectively (p<0.05). Conclusions: From these results, we conclude that consolidation with allogeneic HCT after minimal conditioning is superior to chemotherapy even in older patients with high risk cytogenetics. While differences in TRM were seen between the treatment arms, a lower relapse incidence after related and unrelated HCT contributed to the improved LFS. No significant financial relationships to disclose.

scholarly journals Diagnostic accuracy of basal cell carcinoma in dermatology setting in Serbia - single center study

2021 ◽  
pp. 12-12
Author(s):  
Milana Ivkov-Simic ◽  
Branislava Gajic ◽  
Dejan Ogorelica ◽  
Zorica Gajinov
Keyword(s):  
Skin Cancer ◽  
Basal Cell Carcinoma ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Cell Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Skin Examination ◽  
Total Body

Background/Aim. Growing incidence of skin tumors require their accurate diagnosis. Dermoscopy, especially in-vivo, enhances diagnosis of basal cell carcinoma (BCC). Total body skin examination (TBSE), a visual inspection of the patient?s total body surface, is considered basic step in dermatological exam, especially in skin cancer screening. However, TBSE is still a matter of debate of its expediency in real clinical setting. Aim of this study is to analyze diagnostic accuracy of BCC detected and treated by referred dermatologists in Skin Cancer Unit of a Dermatology and Venereology Clinic. Methods. Retrospective analysis of the BCC detection during total body skin examination with visual inspection and dermoscopy. We calculated sensitivity and specificity and positive predictive value for BCC using histopathological results as correct diagnosis. Results. Out of 3346 biopsied skin tumors 49.58% were malignant and 50.42% benign. The most common malignant tumor was BCC, accounting for 84.09%. Localization of BCCs was mainly on the trunk 38.92% and on H-zone of the face 37.63%. Other localizations were face (non-H-zone) 6.67%, neck 3.01%, scalp 3.37%, arms 6.88% and limbs 3.51%. Of all BCCs, 0.83% were recurrent BCC. The sensitivity for diagnosis BCC was 97.71%, and positive predictive value 95.08%. Conclusion. In dermatology setting, total body skin examination (TBSE) and visual inspection with in-vivo dermoscopy results with very good diagnostic performance of BCC.

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