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Characterization of long-term survivors with metastatic uveal melanoma and liver metastases diagnosed between 2005 and 2021 2005年至2021年间诊断为转移性葡萄膜黑色素瘤和肝转移的长期幸存者的特征
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100385
J. Laukuf , L. Wiens , G. Grözinger , H. Dittmann , K. Thiel , U. Leiter , T. Amaral , L. Nanz , L. Flatz , M. Reitmajer , A. Forschner
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引用次数: 0
Cross-method comparison for BRAF p.V600 mutation cfDNA testing in Melanoma: BRAFI study BRAF p.V600突变cfDNA检测在黑色素瘤中的交叉方法比较:BRAFI研究
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100738
Clara Mayo de las Casas , Eloisa Jantus-Lewintre , Sebastian Ortiz Reina , Ana Drozdowskyj , Pablo Cerezuela-Fuentes , Jose Luis Manzano , Pablo Ayala de Miguel , Ana Arance Fernandez , Miguel Angel Berciano-Guerrero , Almudena Garcia-Castaño , Teresa Puertolas , Guillermo Crespo , Maria Quindos-Varela , Juan Francisco Rodriguez-Moreno , Alfonso Berrocal , Eva Muñoz-Couselo , Enrique Espinosa , Joselyn Valarezo , Susana Muñoz , Silvia Calabuig-Fariñas , Maria Gonzalez-Cao

Background

BRAF p.V600 mutation is the most frequent molecular driver alteration in melanoma. Detection of BRAF mutations in circulating-free DNA (cfDNA) reflects the shedding of tumor DNA and offers a potential non-invasive biomarker for disease monitoring and prognosis. However, the lack of standardized methodologies and inter-assay variability hinders its clinical implementation.

Methods

The sensitivity, agreement and concordance of seven BRAF mutation detection assays were assessed across four laboratories. BRAF p.V600 mutation in pretreatment plasma samples was analyzed in 51 patients diagnosed with advanced stage melanoma using two digital PCR-based assays (droplet digital PCR -ddPCR- Bio-Rad and microfluidic digital PCR -Absolute Q, ThermoFisher Scientific-), three RT-PCR based assays (Idylla®, Cobas®, PNA-Q-PCR) and two NGS based assays (Oncomine™ Pan-Cancer Cell-Free Assay and Illumina Platforms).

Results

digital PCR-based assays and Cobas® exhibited the highest sensitivity (51.0 %), followed by NGS Illumina® (45.1 %), Oncomine NGS / PNA-Q-PCR (43.1 %) and Idylla® (37.2 %). Results of different techniques showed a moderate to strong agreement, except for the comparison of Cobas with Idylla that was poor (Kappa=0.57). There was near-perfect agreement on detection of BRAF mutation between both NGS platforms and the NGS Illumina® with PNA-Q-PCR (Kappa = 0.92). Concordance of the quantitative results in terms of mutant allele frequency was near-perfect between NGS Illumina and ddPCR Bio-Rad assays (ICC = 0.99).

Conclusions

Our study demonstrates substantial agreement among multiple cfDNA BRAF mutation detection assays, particularly between NGS and digital PCR assays. These findings support the potential utility of different techniques for BRAF testing in cfDNA.
braf p.V600突变是黑色素瘤中最常见的分子驱动改变。循环游离DNA (cfDNA)中BRAF突变的检测反映了肿瘤DNA的脱落,为疾病监测和预后提供了一种潜在的非侵入性生物标志物。然而,缺乏标准化的方法和测定间的可变性阻碍了其临床实施。方法在4个实验室对7种BRAF突变检测方法的敏感性、一致性和一致性进行评估。使用两种基于数字PCR的方法(液滴数字PCR- ddpcr - Bio-Rad和微流控数字PCR- absolute Q, ThermoFisher Scientific-),三种基于RT-PCR的方法(Idylla®,Cobas®,PNA-Q-PCR)和两种基于NGS的方法(Oncomine™Pan-Cancer Cell-Free Assay和Illumina平台),分析了51例晚期黑色素瘤患者预处理血浆样本中的BRAF p.V600突变。结果基于数字pcr的检测方法和Cobas®的灵敏度最高(51.0 %),其次是NGS Illumina®(45.1% %)、Oncomine NGS / PNA-Q-PCR(43.1% %)和Idylla®(37.2% %)。除了Cobas与Idylla的比较较差(Kappa=0.57)外,不同技术的结果显示中度至高度一致。NGS平台和NGS Illumina®的PNA-Q-PCR检测BRAF突变的结果几乎完全一致(Kappa = 0.92)。在突变等位基因频率方面,NGS Illumina和ddPCR Bio-Rad的定量结果几乎完全一致(ICC = 0.99)。结论sour的研究证明了多种cfDNA BRAF突变检测方法之间的一致性,特别是NGS和数字PCR检测方法之间的一致性。这些发现支持了在cfDNA中检测BRAF的不同技术的潜在效用。
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引用次数: 0
Evaluating perineural invasion severity in head and neck cutaneous squamous cell carcinomas to refine prognostic accuracy: A retrospective case-control study 评估头颈部皮肤鳞状细胞癌的神经周围浸润严重程度以提高预后准确性:一项回顾性病例对照研究
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100743
Filippo Nozzoli , Silvia Mancini , Andrea Ambrosini-Spaltro , Emilia Crisanti , Luca Riccioni , Giovanni De Luca , Annarita Lombardi , Fabio Falcini , Rosa Vattiato , Federica Zamagni , Lorenzo Borgognoni , Serena Sestini , Vincenzo De Giorgi , Laura Doni , Ismaela Vascotto , Angelo Cassisa , Chiara Anichini , Romina Nassini , Pierangelo Geppetti , Emanuele Crocetti , Daniela Massi

Aims

Perineural invasion (PNI) is a well-recognized risk factor for head and neck cutaneous squamous cell carcinoma (HNCSCC). This study investigates whether a detailed scoring system for PNI can improve prognostic accuracy in HNCSCC, beyond the traditional PNI binary assessment.

Methods

Among the Emilia-Romagna Cancer Registry, we analysed 61 patients with tumour progression and 61 without, using six histological PNI features: number of nerves involved, nerve diameter and depth, intra- vs. extratumoral location, nerve sheath involvement, and presence of mitotic figures within PNI. These parameters were compiled into a cumulative PNI score, categorizing patients as high- or low-risk based on the median score. An additional 20 patients treated with immunotherapy and 25 external PNI-positive cases were included for validation. Prognostic correlations were then analyzed by Cox proportional hazards regression model.

Results

Twenty-one patients (17.2 %) had PNI and 81 % of them were cases with recurrence. A significantly higher proportion of cases (81.0 %) exhibited perineural invasion compared to controls (19.0 %) (p = 0.005). High-risk PNI scores were significantly associated with worse outcomes: five-year overall survival was lower in high-risk patients (10.1 % vs. 23.3 %), and disease-specific survival was also reduced (75.0 % vs. 88.9 %). High-risk PNI scores conferred a four-fold increased risk of recurrence and nearly eight-fold higher risk of death. Among immunotherapy-treated patients, the risk of death was nineteen times higher for those in the high-risk PNI group.

Conclusions

Our findings suggest that a multi-parameter PNI scoring system can refine prognostic stratification, potentially guiding more personalized treatment decisions and informing updates to the current staging guidelines.
AimsPerineural invasion (PNI)是头颈部皮肤鳞状细胞癌(HNCSCC)公认的危险因素。本研究探讨了PNI的详细评分系统是否可以提高HNCSCC的预后准确性,超越传统的PNI二元评估。方法在Emilia-Romagna癌症登记处,我们分析了61例肿瘤进展患者和61例未进展患者,使用PNI的6个组织学特征:受累神经数量、神经直径和深度、瘤内与瘤外位置、神经鞘受累以及PNI内有丝分裂象的存在。这些参数被汇编成累积的PNI评分,根据中位评分将患者分为高风险或低风险。另外20例接受免疫治疗的患者和25例外部pni阳性病例被纳入验证。采用Cox比例风险回归模型分析预后相关性。结果21例(17.2% %)有PNI, 81 %有复发。与对照组(19.0 %)相比,出现神经周围侵犯的病例比例(81.0 %)明显更高(p = 0.005)。高风险PNI评分与较差的预后显著相关:高风险患者的五年总生存率较低(10.0 %对23.3 %),疾病特异性生存率也降低(75.0 %对88.9 %)。高风险PNI评分使复发风险增加4倍,死亡风险增加近8倍。在接受免疫治疗的患者中,高危PNI组的死亡风险高出19倍。研究结果表明,多参数PNI评分系统可以细化预后分层,可能指导更个性化的治疗决策,并为当前分期指南的更新提供信息。
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引用次数: 0
Corrigendum to: Line-field confocal optical coherence tomography (LC-OCT) features of a melanotic macule of the lip [EJC Skin Cancer, vol. 2, December (2024), 100016] 唇部黑色素斑的线场共聚焦光学相干断层扫描(LC-OCT)特征的勘误表[EJC皮肤癌,vol. 2, December (2024), 100016]
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100765
Barouyr Baroudjian , Clothilde Raoux , Perla El Zeinaty , Camille Gandon , Celeste Lebbé
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引用次数: 0
Neoadjuvant and adjuvant therapy for locally advanced cutaneous squamous cell carcinoma 局部晚期皮肤鳞状细胞癌的新辅助和辅助治疗
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100769
William Liakos , Kevin Varghese , Kennedy Sun , Vishal A. Patel
Neoadjuvant and adjuvant treatment strategies are promising approaches to enhance outcomes in locally advanced, resectable cutaneous squamous cell carcinoma (LACSCC). This review summarizes key studies of neoadjuvant, adjuvant, and combination therapies to guide clinical practice in treatment of LACSCC. The clinical trials and real-world studies reviewed in this study collectively demonstrate that neoadjuvant strategies for LACSCC, especially with immune checkpoint inhibitors, yielded high pathological response rates, improved survival, reduced treatment side effects, and decreased surgical morbidity. Adjuvant immunotherapy also has recently been shown to also provide a substantial benefit in specific LACSCC tumors, often in combination with radiation therapy. Moreover, adaptive neoadjuvant therapies could enable treatment de-escalation and even avoidance of surgery altogether, while achieving high durable response rates.
新辅助和辅助治疗策略是提高局部晚期可切除的皮肤鳞状细胞癌(LACSCC)预后的有希望的方法。本文综述了新辅助、辅助和联合治疗的关键研究,以指导LACSCC的临床实践。本研究回顾的临床试验和现实世界的研究共同表明,LACSCC的新辅助治疗策略,特别是免疫检查点抑制剂,产生了高的病理反应率,提高了生存率,减少了治疗副作用,降低了手术发病率。辅助免疫治疗最近也被证明对特定的LACSCC肿瘤也有实质性的益处,通常与放射治疗联合使用。此外,适应性新辅助治疗可以使治疗降级,甚至完全避免手术,同时获得高持久的反应率。
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引用次数: 0
Molecular analyses in melanocytoma diagnosis and risk progression assessment 黑素细胞瘤诊断和风险进展评估的分子分析
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100763
Lauren Souverijns , Rob Somers , Hanne Boon , Annemiek Leeman , Isabelle Vanden Bempt , Francesca Maria Bosisio
Melanocytomas have been defined as a category of intermediate melanocytic tumors that are situated biologically and genetically between benign nevi and malignant melanomas. Although melanocytomas typically display low-grade clinical behavior, their exact risk of malignant progression remains uncertain. Since the WHO introduced this concept in 2018, there have been substantial advances in understanding their genetic complexity and diagnostic challenges. Reduced inter-observer variability and advanced molecular diagnostics, including next-generation sequencing and copy number variation analysis, can support clinical decisions for management of melanocytomas. This literature review summarizes advances in understanding melanocytoma biology, focusing specifically on WHO pathways 1, 4, 7 and 8, which encompass clinically relevant entities such as Wnt-activated melanocytomas, BAP1-inactivated lesions, pigmented epithelioid melanocytomas, Spitz tumors, congenital nevi and “blue pathway” melanocytic tumors. In particular, we highlight key molecular features that have been linked with the presence of risk of progression to metastatic disease, including gene mutations (e.g., TERT promoter mutations, homozygous CDKN2A deletions, SF3B1 mutation and secondary mutations in BAP1 outside of pathway I) and copy number variations involving parts of the genomes pivotal for melanoma biology. Despite recent progress, further studies are still required to fully characterize the molecular landscape of melanocytomas, aiming to optimize clinical guidelines, reduce diagnostic uncertainty and facilitate appropriate treatment strategies.
黑色素细胞瘤被定义为一类介于良性痣和恶性黑色素瘤之间的中间黑色素细胞肿瘤。尽管黑素细胞瘤通常表现为低级别临床行为,但其恶性进展的确切风险仍不确定。自2018年世卫组织引入这一概念以来,在了解其遗传复杂性和诊断挑战方面取得了重大进展。减少观察者之间的差异和先进的分子诊断,包括下一代测序和拷贝数变异分析,可以支持黑素细胞瘤管理的临床决策。本文综述了黑素细胞瘤生物学方面的研究进展,特别关注WHO通路1、4、7和8,包括临床相关实体,如wnt激活的黑素细胞瘤、bap1失活病变、色素上皮样黑素细胞瘤、Spitz肿瘤、先天性痣和“蓝色通路”黑素细胞瘤。特别是,我们强调了与转移性疾病进展风险相关的关键分子特征,包括基因突变(例如,TERT启动子突变、纯合子CDKN2A缺失、SF3B1突变和BAP1通路I外的继发性突变)和涉及黑色素瘤生物学关键基因组部分的拷贝数变异。尽管最近取得了进展,但仍需要进一步的研究来充分表征黑素细胞瘤的分子景观,旨在优化临床指南,减少诊断不确定性并促进适当的治疗策略。
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引用次数: 0
Adjuvant and neoadjuvant immunotherapy for acral and mucosal melanoma 肢端和粘膜黑色素瘤的辅助和新辅助免疫治疗
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2024.100277
Takaya Komori , Shigeru Koizumi , Sadao Inoue , Maiko Yamaura , Yuri Murayama , Atsushi Otsuka , Yasuhiro Nakamura
Significant advancements have been made in the treatment of cutaneous melanoma over the past decade, particularly with the effectiveness of immune checkpoint inhibitors (ICIs) in advanced and adjuvant stages. However, the efficacy of ICIs for non-Caucasian populations and the rare clinical subtypes acral melanoma (AM) and mucosal melanoma (MM), has gradually been recognized to be lower in the advanced setting than cutaneous melanoma, suggesting that the use of ICIs in treating AM and MM need careful consideration in terms of ethnic and disease-specific factors to optimize outcomes in the adjuvant and neoadjuvant setting. However, the efficacy of adjuvant and neoadjuvant ICIs for AM and MM remains unclear. Therefore, in this review, we discussed the latest study updates on adjuvant and neoadjuvant therapies for AM and MM, focusing on anti-PD-1 antibody-based therapies. Our findings revealed that the efficacy of adjuvant and neoadjuvant therapy with anti-programmed death-1 receptor (anti-PD-1) antibody-based therapies for cutaneous melanoma is promising; however, their effectiveness varies according to ethnicity and melanoma subtype. There are several ongoing clinical trials on adjuvant and neoadjuvant therapies targeting AM or MM, which will provide the future perspectives of the strategy in the adjuvant and neoadjuvant settings for these rare melanoma subtypes.
在过去的十年中,皮肤黑色素瘤的治疗取得了重大进展,特别是免疫检查点抑制剂(ICIs)在晚期和辅助期的有效性。然而,ICIs对非高加索人群和罕见临床亚型肢端黑色素瘤(AM)和粘膜黑色素瘤(MM)的疗效逐渐被认为在晚期环境中低于皮肤黑色素瘤,这表明使用ICIs治疗AM和MM需要仔细考虑种族和疾病特异性因素,以优化辅助治疗和新辅助治疗的结果。然而,辅助和新辅助ICIs对AM和MM的疗效尚不清楚。因此,在这篇综述中,我们讨论了AM和MM的辅助和新辅助治疗的最新研究进展,重点是基于抗pd -1抗体的治疗。我们的研究结果表明,基于抗程序性死亡-1受体(anti-PD-1)抗体的辅助治疗和新辅助治疗对皮肤黑色素瘤的疗效是有希望的;然而,它们的效果因种族和黑色素瘤亚型而异。目前正在进行一些针对AM或MM的辅助和新辅助治疗的临床试验,这将为这些罕见黑色素瘤亚型的辅助和新辅助治疗策略提供未来的视角。
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引用次数: 0
Patient and physician-reported outcomes with tirbanibulin 1% ointment for actinic keratosis under conditions close to routine clinical practice in Spain and Italy (TIRBASKIN study) 在西班牙和意大利,在接近常规临床实践的条件下,使用1%替巴布林软膏治疗光化性角化病的患者和医生报告的结果(TIRBASKIN研究)
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100300
Y. Gilaberte , O. Yélamos , J. Cañueto , C. Serra-Guillén , A. Conti , F. Pajuelo , A. Lecchi , V. Cappello , B. Kostov , M. Romanelli
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引用次数: 0
Prognostic and predictive importance of body mass index and type 2 diabetes in the European Organisation for Research and Treatment of Cancer 1325/KEYNOTE-054 phase III trial of pembrolizumab versus placebo in resected high-risk stage III melanoma 在欧洲癌症研究和治疗组织1325/KEYNOTE-054 III期试验中,pembrolizumab与安慰剂在切除的高风险III期黑色素瘤中的预后和预测重要性
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100284
Oliver John Kennedy , Nina Glassee , Michal Kicinski , Emanuel Bührer , Sara Valpione , Sara Gandini , Stefan Suciu , Christian U. Blank , Georgina V. Long , Victoria G. Atkinson , Stéphane Dalle , Andrew M. Haydon , Andrey Meshcheryakov , Adnan Khattak , Matteo S. Carlino , Shahneen Sandhu , James Larkin , Susana Puig , Paolo A. Ascierto , Piotr Rutkowski , Mario Mandala

Background

Metabolic conditions, such as obesity and type 2 diabetes mellitus (T2DM), cause changes in immune function that may influence immunotherapy effectiveness and immune-related adverse events (irAEs).

Objectives

To investigate the prognostic and predictive effects of BMI and T2DM and investigate the effect of BMI on toxicity using data from the EORTC 1325/KEYNOTE-054 randomised controlled trial.

Methods

Pembrolizumab (n = 514) was administered every three weeks for 1 year and prolonged recurrence-free survival (RFS) compared to placebo (n = 505) among patients with resected high-risk stage III melanoma. Here, we used multivariate Cox regression to investigate associations of BMI and T2DM with RFS, and Fine and Gray regression to investigate the association of BMI with the cumulative incidence of irAEs.

Results

BMI had an approximately U-shaped association with RFS (p = 0.004) in both treatment arms combined. The RFS hazard ratios (HR)s for BMIs of 20, 30 and 35 kg/m2 (compared to 25 kg/m2) were 1.28 (95 % CI 1.05–1.56), 0.96 (95 % CI 0.88–1.06) and 1.14 (95 % CI 0.98–1.34), respectively. There was no evidence that BMI was associated with pembrolizumab effectiveness (p = 0.20) or the cumulative incidence of irAEs (p = 0.74). T2DM was not associated with RFS (HR 1.01, 95 % CI 0.73–1.40) in both arms combined and there was no evidence of an association between T2DM and pembrolizumab effectiveness (p = 0.83). In summary, in patients with resected high-risk stage III melanoma, BMI was associated with RFS in patients overall and within each treatment group.

Conclusions

BMI appeared to confer a prognostic effect but was not predictive of pembrolizumab effectiveness regarding RFS. BMI was not related to irAEs among patients receiving pembrolizumab, while T2DM was not associated with RFS irrespective of treatment.
代谢条件,如肥胖和2型糖尿病(T2DM),引起免疫功能的改变,可能影响免疫治疗的有效性和免疫相关不良事件(irAEs)。目的利用EORTC 1325/KEYNOTE-054随机对照试验的数据,研究BMI和T2DM的预后和预测作用,并研究BMI对毒性的影响。方法spembrolizumab (n = 514)在切除的高风险III期黑色素瘤患者中每3周给予一次,与安慰剂(n = 505)相比,延长了1年无复发生存期(RFS)。在这里,我们使用多变量Cox回归来研究BMI和T2DM与RFS的关系,并使用Fine和Gray回归来研究BMI与irAEs累积发病率的关系。结果两个治疗组的bmi与RFS呈近似u型相关(p = 0.004)。bmi为20、30和35 kg/m2(与25 kg/m2相比)的RFS风险比分别为1.28(95 % CI 1.05-1.56)、0.96(95 % CI 0.88-1.06)和1.14(95 % CI 0.98-1.34)。没有证据表明BMI与派姆单抗的有效性(p = 0.20)或irAEs的累积发生率(p = 0.74)相关。两组合并T2DM与RFS无关(HR 1.01, 95 % CI 0.73-1.40),并且没有证据表明T2DM与派姆单抗有效性之间存在关联(p = 0.83)。总之,在切除的高风险III期黑色素瘤患者中,BMI与患者总体和每个治疗组的RFS相关。结论:bmi似乎具有预后作用,但不能预测派姆单抗对RFS的有效性。在接受派姆单抗治疗的患者中,BMI与irae无关,而T2DM与RFS无关,无论治疗方式如何。
{"title":"Prognostic and predictive importance of body mass index and type 2 diabetes in the European Organisation for Research and Treatment of Cancer 1325/KEYNOTE-054 phase III trial of pembrolizumab versus placebo in resected high-risk stage III melanoma","authors":"Oliver John Kennedy ,&nbsp;Nina Glassee ,&nbsp;Michal Kicinski ,&nbsp;Emanuel Bührer ,&nbsp;Sara Valpione ,&nbsp;Sara Gandini ,&nbsp;Stefan Suciu ,&nbsp;Christian U. Blank ,&nbsp;Georgina V. Long ,&nbsp;Victoria G. Atkinson ,&nbsp;Stéphane Dalle ,&nbsp;Andrew M. Haydon ,&nbsp;Andrey Meshcheryakov ,&nbsp;Adnan Khattak ,&nbsp;Matteo S. Carlino ,&nbsp;Shahneen Sandhu ,&nbsp;James Larkin ,&nbsp;Susana Puig ,&nbsp;Paolo A. Ascierto ,&nbsp;Piotr Rutkowski ,&nbsp;Mario Mandala","doi":"10.1016/j.ejcskn.2025.100284","DOIUrl":"10.1016/j.ejcskn.2025.100284","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic conditions, such as obesity and type 2 diabetes mellitus (T2DM), cause changes in immune function that may influence immunotherapy effectiveness and immune-related adverse events (irAEs).</div></div><div><h3>Objectives</h3><div>To investigate the prognostic and predictive effects of BMI and T2DM and investigate the effect of BMI on toxicity using data from the EORTC 1325/KEYNOTE-054 randomised controlled trial.</div></div><div><h3>Methods</h3><div>Pembrolizumab (n = 514) was administered every three weeks for 1 year and prolonged recurrence-free survival (RFS) compared to placebo (n = 505) among patients with resected high-risk stage III melanoma. Here, we used multivariate Cox regression to investigate associations of BMI and T2DM with RFS, and Fine and Gray regression to investigate the association of BMI with the cumulative incidence of irAEs.</div></div><div><h3>Results</h3><div>BMI had an approximately U-shaped association with RFS (p = 0.004) in both treatment arms combined. The RFS hazard ratios (HR)s for BMIs of 20, 30 and 35 kg/m<sup>2</sup> (compared to 25 kg/m<sup>2</sup>) were 1.28 (95 % CI 1.05–1.56), 0.96 (95 % CI 0.88–1.06) and 1.14 (95 % CI 0.98–1.34), respectively. There was no evidence that BMI was associated with pembrolizumab effectiveness (p = 0.20) or the cumulative incidence of irAEs (p = 0.74). T2DM was not associated with RFS (HR 1.01, 95 % CI 0.73–1.40) in both arms combined and there was no evidence of an association between T2DM and pembrolizumab effectiveness (p = 0.83). In summary, in patients with resected high-risk stage III melanoma, BMI was associated with RFS in patients overall and within each treatment group.</div></div><div><h3>Conclusions</h3><div>BMI appeared to confer a prognostic effect but was not predictive of pembrolizumab effectiveness regarding RFS. BMI was not related to irAEs among patients receiving pembrolizumab, while T2DM was not associated with RFS irrespective of treatment.</div></div>","PeriodicalId":100396,"journal":{"name":"EJC Skin Cancer","volume":"3 ","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment of dermatofibrosarcoma protuberans with fixed Mohs' micrographic surgery: A French cohort prospective study 固定Mohs显微摄影手术治疗隆突性皮肤纤维肉瘤:一项法国队列前瞻性研究
Pub Date : 2025-01-01 DOI: 10.1016/j.ejcskn.2025.100286
Jean F. Séi , Véronique Chaussade , Leire Gonzalez-Lara , Iman Aouidad , Arnold Tchakérian , Marc Serra , Ute Zimmermann , Thierry Clerici , Astrid Blom , Elisa Funck-Brentano , Philippe Saiag

Background

Dermatofibrosarcoma protuberans (DFSP) presents a high recurrence rate after conventional excision. Mohs' micrographic surgery (MMS) ensures complete excision and minimal normal tissue loss. However, discriminating between residual tumor and normal skin can be difficult on frozen sections compared with fixed paraffin sections.

Objectives

To develop a MMS procedure in conjunction with fixed paraffin sections to treat DFSP with reduced lateral margins and to evaluate the long-term recurrence rate in a consecutive series of DFSP patients.

Methods

We prospectively collected 223 consecutive cases of DFSP (206 primary and 17 recurrent) treated with fixed-MMS between October 1998 and December 2014 in our skin cancer referral center. Follow-up was provided until October 2020. The fixed-MMS was favored to treat DFSP due to the frequent large size of MMS layer, which made analysis of frozen sections difficult. Determined on the basis of publications on MMS in DFSP, we decided to proceed with a first stage of fixed MMS including a 13 mm lateral margin and a deep margin extending to the underlying muscle fascia.

Results

Most patients (N = 196; 87.9 %) had a complete resection after the first stage. In cases with incomplete resection (N = 27; 12.1 %), only the deep margin was involved in most cases (N = 21/27; 77.8 %). Complete resection was always achieved with a second (N = 23) or third or more stages (N = 3). Only one local recurrence was observed (after 85.3 months) with a median follow-up of 63.9 months [4.4–243.9].

Conclusions

We report the largest cohort of DFSP treated with fixed-MMS. Only one tumor recurred (0.4 % recurrence rate).
背景:隆突性皮肤纤维肉瘤(DFSP)在常规切除后具有很高的复发率。Mohs显微手术(MMS)确保完全切除和最小的正常组织损失。然而,与固定石蜡切片相比,在冷冻切片上区分残余肿瘤和正常皮肤是困难的。目的建立MMS联合固定石蜡切片治疗侧缘缩小的DFSP,并评估连续系列DFSP患者的长期复发率。方法回顾性收集1998年10月至2014年12月在我院皮肤癌转诊中心接受固定mms治疗的DFSP患者223例(原发206例,复发17例)。后续工作一直持续到2020年10月。固定MMS处理DFSP更受青睐,因为MMS层经常较大,这给冰冻切片的分析带来了困难。根据DFSP中关于MMS的出版物,我们决定进行固定MMS的第一阶段,包括13 mm的外侧缘和延伸到下肌筋膜的深缘。结果大多数患者(N = 196;87.9% %)一期手术后全部切除。不完全切除病例(N = 27;12.1 %),大多数病例仅深缘受累(N = 21/27;77.8 %)。完全切除总是在第二期(N = 23)或第三期或更多期(N = 3)完成。仅1例局部复发(85.3个月),中位随访63.9个月[4.4-243.9]。结论:我们报道了固定mms治疗DFSP的最大队列。仅有1例肿瘤复发(0.4 %复发率)。
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期刊
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