EJC Skin Cancer最新文献

英文中文

Corrigendum to: Hidden beneath the surface: Atypical presentation of Desmoplastic Melanoma in the Teledermatology era [EJC Skin Cancer, 2 (December 2024) 100023] 隐藏在表面之下的勘误表：在远程皮肤病学时代的非典型表现的韧带塑性黑色素瘤[EJC皮肤癌，2（2024年12月）100023]

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100745

Dalila Malek, Paul Gatt

引用次数: 0

Challenges in developing a digital pathology consultation network: insights from the MELCAYA experience 发展数字病理咨询网络的挑战：来自MELCAYA经验的见解

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100742

Dario Di Gangi , Roberta Gugliotta , Filippo Ugolini , Anna Szumera-Ciećkiewicz , Llucia Alos , Natalia Castrejón , Stephan Forchhammer , Barbara Valeri , Nicolas Macagno , Sule Ozturk Sari , Ozge Hurdogan , Sokol Sina , Sylvie Fraitag , Valerio Gaetano Vellone , Chiara Trambaiolo , Rita Alaggio , Sabrina Rossi , Giovanni Arcuri , Daniela Massi , Claudio Conti

Objectives

The increasing adoption of Whole Slide Image (WSI) technology has created new opportunities for collaboration in diagnostic pathology. This study aims to describe the development, implementation, and challenges of establishing a second-opinion platform for pathology revision, focusing on improving the diagnostic assessment of melanoma in children, adolescents, and young adults (CAYA).

Methods

Two-hundred-eight melanomas and atypical melanocytic lesions from CAYA patients were retrospectively collected, resulting in 311 associated WSIs. Recognizing the rarity of these cases, patient enrollment was distributed across 11 centers spanning 6 European countries. All slides were digitalized at each participating institution and uploaded into a centralized digital platform to be reviewed.

Results

A total of 144 WSIs (46.3 %) exhibited technical defects, classified as critical, major, or minor based on their impact on WSI quality and visualization. Of these, 101 (70.1 %) showed analytical defects, while the remaining 43 (29.9 %) presented pre-analytical issues. Significant inter-center variability in file sizes was observed, reflecting differences in scanning protocols and tissue processing. Twenty-four cases (11.5 %) exhibited major discordances on melanoma vs atypical melanocytic lesions classification, underscoring the importance of centralized pathological review.

Discussion

This study highlights the challenges of obtaining standardized, high-quality WSIs in real-world settings, particularly due to the rarity of the disease and the limited availability of tissue. Thesefindings reinforce the importance of establishing standardized protocols across institutions to provide pathologists with a high-quality repository and improve patient outcome through effective second-opinion reviews.

目的越来越多地采用全幻灯片图像（WSI）技术为诊断病理学的合作创造了新的机会。本研究旨在描述建立病理修订第二意见平台的发展、实施和挑战，重点是改善儿童、青少年和年轻人（CAYA）黑色素瘤的诊断评估。方法回顾性收集CAYA患者黑色素瘤及非典型黑素细胞病变308例，合并wsi 311例。认识到这些病例的罕见性，患者登记分布在6个欧洲国家的11个中心。所有的幻灯片在每个参与机构都被数字化，并上传到一个集中的数字平台上进行审查。结果144个WSI（46.3% %）表现出技术缺陷，根据其对WSI质量和可视化的影响分为严重、主要和次要。其中，101个（70.1 %）显示出分析缺陷，而其余43个（29.9 %）呈现出分析前问题。观察到显著的中心间文件大小差异，反映了扫描协议和组织处理的差异。24例（11.5 %）在黑色素瘤与非典型黑色素细胞病变分类上表现出重大不一致，强调集中病理检查的重要性。本研究强调了在现实环境中获得标准化、高质量wsi的挑战，特别是由于疾病的罕见性和组织的有限可用性。这些发现强化了跨机构建立标准化协议的重要性，为病理学家提供高质量的知识库，并通过有效的第二意见审查改善患者预后。

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引用次数: 0

The TRIAGE and ASSIST scan: A new concept in 3D total body imaging for early melanoma detection TRIAGE和ASSIST扫描：用于早期黑色素瘤检测的3D全身成像的新概念

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100748

Katrien Vossaert , Sven Lanssens , Anna Beirens, Nele Van Vaerenbergh, Emma Coussens

Background

Concerning early melanoma detection, dermatologists experience two major challenges: an overwhelming number of patients seeking total body skin examinations, and limited access to a standardized imaging system for monitoring their patients with increased risk for melanoma. This study introduces, for the first time, the concept of an independent imaging center utilizing a three-dimensional (3D) imaging system operated without a dermatologist present on site. The 3D scan performed in low-and mid-risk patients serves as a ‘TRIAGE scan’ to filter the patients who require a dermatology consultation. In high-risk patients, it functions as an ‘ASSIST scan’, assisting dermatologists during follow-up consultations.

Data collection

In 2024, 3228 scans were performed. Of these, 1169 patients were referred by a dermatologist, while 2059 patients presented on their own initiative. This publication focuses on the self-referred cohort, which was stratified into low-, mid-, and high-risk groups.

Results

The overall skin cancer detection rate across these groups was 4.8 %. Melanoma detection rates were 0.58 % in the low-risk group, 1.10 % in the mid-risk group, and 0.33 % in the high-risk group. The observed number needed to excise (NNE) to detect one skin cancer was 2.0.

Conclusions

The TRIAGE and ASSIST scan approach provides an accessible and cost-effective method for skin cancer screening, particularly for individuals who are uncomfortable relying on self-examination. It offers mid-risk patients the opportunity for efficient screening without placing additional strain on the healthcare system. Furthermore, it supports dermatologists in the follow-up of high-risk patients by providing high-quality, standardized imaging, without requiring substantial infrastructure investment.

关于黑色素瘤的早期检测，皮肤科医生面临着两大挑战：绝大多数患者寻求全身皮肤检查，以及用于监测黑色素瘤风险增加的标准化成像系统的限制。这项研究首次引入了独立成像中心的概念，利用三维（3D）成像系统，在没有皮肤科医生在场的情况下进行操作。在低风险和中等风险患者中进行的3D扫描作为“TRIAGE扫描”来过滤需要皮肤科会诊的患者。在高危患者中，它作为一种“ASSIST扫描”，协助皮肤科医生进行后续会诊。数据收集在2024年，进行了3228次扫描。其中，1169名患者是由皮肤科医生转诊的，而2059名患者是主动就诊的。本出版物着重于自我参考的队列，分为低、中、高风险组。结果两组的皮肤癌检出率为4.8 %。低危组黑色素瘤检出率为0.58 %，中危组为1.10 %，高危组为0.33 %。检测1例皮肤癌所需切除数（NNE）为2.0。结论：TRIAGE和ASSIST扫描方法为皮肤癌筛查提供了一种方便、经济的方法，特别是对于那些不愿意依赖自我检查的个体。它为中等风险患者提供了有效筛查的机会，而不会给医疗保健系统带来额外的压力。此外，它通过提供高质量、标准化的成像来支持皮肤科医生对高危患者的随访，而不需要大量的基础设施投资。

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引用次数: 0

Letter Re: “Comparative analysis of international melanoma guidelines” 信件回复：“国际黑色素瘤指南的比较分析”

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100751

Susan M. Swetter, Douglas Johnson

引用次数: 0

Outcomes from early discontinuation of immune checkpoint inhibitor therapy following response in patients with advanced cutaneous squamous cell carcinoma 晚期皮肤鳞状细胞癌患者应答后早期停止免疫检查点抑制剂治疗的结果

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100759

Rahul Ladwa , Margaret McGrath

Introduction

High, durable responses to anti-PD-1 immune checkpoint inhibitors (ICI) have been demonstrated in cutaneous squamous cell carcinoma (cSCC). We evaluated the prognosis of patients with advanced cSCC following early cessation of ICI due to response to treatment.

Methods

This was a retrospective study of patients with advanced, unresectable cSCC who had discontinued ICI following response, prior to completion of 24 months of planned therapy. The endpoints included disease-specific survival (DSS), progression-free survival (PFS) and overall survival (OS).

Results

Of the 306 patients treated with ICI during 2020–2024, 55 (18 %) patients had discontinued treatment following a response. The median time on treatment was 8 months (95 % CI 7–11 months).

At a median follow-up of 24 months (95 %CI 21–27 months), 5 patients (9 %) had developed progressive disease (PD) and 7 patients (13 %) had died, 1 due to PD and 6 due to non-malignant etiology. At 24 months, the estimated rate of DSS was 97 %, PFS 78 % and OS 83 %. Prognosis was not significantly affected by baseline characteristics. The PFS was significantly longer for patients ceasing therapy secondary to response without treatment limiting toxicities compared with those experiencing treatment limiting toxicities (NR vs 27 months [95 %CI 23–31]; P = 0.027).

Rechallenge with ICI for PD was associated with a response in 4 out of 5 evaluable patients.

Discussion

A low incidence of PD following cessation of ICI was observed, with high 24-month DSS, PFS and OS rates, suggesting patients may be able to safely cease therapy following response to reduce potential toxicity and burden of treatment.

在皮肤鳞状细胞癌（cSCC）中，抗pd -1免疫检查点抑制剂（ICI）已被证明具有高、持久的应答。我们评估了晚期cSCC患者由于对治疗的反应而在早期停止ICI后的预后。方法：这是一项回顾性研究，研究对象为晚期、不可切除的cSCC患者，这些患者在完成24个月的计划治疗前，因缓解而停止了ICI治疗。终点包括疾病特异性生存期（DSS）、无进展生存期（PFS）和总生存期（OS）。结果在2020-2024年期间接受ICI治疗的306例患者中，55例（18% %）患者在缓解后停止治疗。治疗中位时间为8个月（95 % CI 7-11个月）。在中位随访24个月（95% %CI 21-27个月），5名患者（9 %）发展为进展性疾病（PD）， 7名患者（13 %）死亡，1名患者死于PD， 6名死于非恶性病因。在24个月时，DSS的估计率为97 %，PFS为78 %，OS为83 %。基线特征对预后无显著影响。与出现治疗限制性毒性的患者相比，无治疗限制性毒性的继发性停药患者的PFS明显更长（NR vs 27个月[95 %CI 23-31]； P = 0.027）。在5名可评估的患者中，有4名患者再次使用ICI治疗PD。我们观察到停止ICI后PD的发生率较低，24个月的DSS、PFS和OS率较高，这表明患者可以在缓解后安全地停止治疗，以减少潜在的毒性和治疗负担。

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引用次数: 0

Response to Letter: Re: “Comparative analysis of international melanoma guidelines” 回复：回复：“国际黑色素瘤指南的比较分析”

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100752

Ahmad Idrissi-Yaghir, Henning Schäfer, Hendrik Damm, Georg C. Lodde, Elisabeth Livingstone, Dirk Schadendorf, Christoph M. Friedrich

引用次数: 0

Intrapatient comparative study on indoor daylight photodynamic therapy (idl-PDT) with exposure time 1 hour vs 2 hours for the treatment of multiple actinic keratoses of the scalp 室内日光光动力疗法（idl-PDT）照射时间1小时与2小时治疗多发性光化性头皮角化病的患者内比较研究

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100302

P. Antonetti , G.L. Artelli , C. Pellegrini , M. Arisi , M. Bruni , A. Zola , P. Calzavara-Pinton , M.C. Fargnoli

引用次数: 0

Melanoma-specific survival and relapse-free survival are significantly improved for tumors with high tumor mutational burden and BRAF V600 mutation – results of 83 stage IIIC-IV patients with adjuvant anti-PD-1 therapy 83例接受辅助抗pd -1治疗的IIIC-IV期患者的结果显示，高肿瘤突变负担和BRAF V600突变的肿瘤的黑色素瘤特异性生存率和无复发生存率显著提高

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100360

J. Forschner , J. Huynh , C. Schroeder , S. Armeanu-Ebinger , O. Kelemen , A. Gschwind , I. Bonzheim , T. Eigentler , T. Amaral , S. Ossowski , O. Rieß , L. Flatz , C. Garbe , A. Forschner , M. Reitmajer

引用次数: 0

The importance of health and economic analyses in skin cancer for the optimalization of skin cancer care 皮肤癌的健康和经济分析对优化皮肤癌护理的重要性

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100355

A. Meertens , L. Brochez , E. Verhaeghe , I. Hoorens , N. Verhaeghe

引用次数: 0

Saggy skin, but what else? 皮肤松弛，还有什么？

EJC Skin Cancer

Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100348

M.A. Pradeau, A. Dilling, P.G.M. Milde, R. Moritz, G. Dobos, S. Leson, T. Eigentler

引用次数: 0

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