Sant'Ambrogio di Torino, Italy
Sant'Ambrogio di Torino, Italy

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Ribero S.,University of Turin | Osella-Abate S.,University of Turin | Sanlorenzo M.,University of Turin | Savoia P.,University of Turin | And 7 more authors.
British Journal of Dermatology | Year: 2013

Background The prognostic significance of regression in primary melanoma has been debated over the past few years. Once it was considered to be a negative prognostic factor, as it may have prevented proper melanoma thickness measurement, therefore affecting the staging of the tumours. For this reason, it was considered to be an indication for sentinel lymph node biopsy (SLNB) in melanoma < 1 mm. Objectives To ascertain the utility of SLNB in thin melanoma and to clarify the role of regression in disease-free survival (DFS) and overall survival (OS) in our series. Methods We analysed data collected from 1693 consecutive patients with AJCC (American Joint Committee on Cancer) stage I-II melanoma. Results Globally, SLNB was performed in 656 out of 1693 patients. Regression was present in 349 patients and 223 of them were characterized by thin lesions. SLNB was performed in 104 cases of thin melanoma with regression. The majority of regional lymph node metastases were observed in patients who did not undergo SLNB (89 out of 132). Among the remaining 43 'false negative' patients only three showed regression in the primary. Using the Cox multivariate model, histological regression maintained a significant protective role [hazard ratio (HR) 0·62, P = 0·012 for DFS; HR 0·43, P = 0·008 for OS] when corrected for the principal histopathological and clinical features, despite SLNB. Conclusions We confirmed that regression alone should not be a reason to perform SLNB in thin melanoma and, on the contrary, it can be considered a favourable prognostic factor in patients with AJCC stage I-II melanoma. What's already known about this topic? Regression has been considered a negative prognostic factor, as it may prevent proper melanoma thickness measurement. There is no consensus regarding the need for sentinel lymph node biopsy (SLNB) when regression is present within the primary tumour. What does this study add? Regression alone should not be a reason to perform SLNB in thin melanoma. Regression can be considered a favourable prognostic factor for overall survival and disease-free survival in patients with AJCC stage I-II melanoma. © 2013 British Association of Dermatologists.

Peris K.,Catholic University of Rome | Licitra L.,Fondazione IRCCS Instituto Tumori | Ascierto P.A.,Instituto Nazionale Tumori Fondazione G Pascale | Corvo R.,University of Genoa | And 4 more authors.
Future Oncology | Year: 2015

Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Most occur on the head and neck, where cosmetic and functional outcomes are critical. BCC can be locally destructive if not diagnosed early and treated appropriately. Surgery is the treatment of choice for the majority of high-risk lesions. Aggressive, recurrent or unresectable tumors can be difficult to manage. Until recently, no approved systemic therapy was available for locally advanced or metastatic BCC inappropriate for surgery or radiotherapy. Vismodegib provides a systemic treatment option. However, a consensus definition of advanced BCC is lacking. A multidisciplinary panel with expertise in oncology, dermatology, dermatologic surgery and radiation oncology proposes a consensus definition based on published evidence and clinical experience. © 2015 Future Medicine Ltd.

Sanlorenzo M.,University of Turin | Ribero S.,University of Turin | Osella-Abate S.,University of Turin | Balagna E.M.,Section of Dermatologic Surgery | And 4 more authors.
Giornale Italiano di Dermatologia e Venereologia | Year: 2013

Aim. Melanoma is rare in children and uncommon in adolescents. Clinical and prognostic factors can differ from adult population. There is often a delay in diagnosis and the therapeutic management is not unequivocally established. The aim of this study was to review our monocentric case series to establish the characteristics of the population and the possible different behaviour of the malignancy compared to adults. Methods. From 1975 to 2011 we selected 36 out of 43 patients with a diagnosis of melanoma before the age of 20. We reported a female predominance, the most common site of primary lesions for both sexes were the lower extremities and according to adulthood population the most common histotype was Superficial Spreading Melanoma. Results. None of our patients presented distant metastasis at diagnosis, but 29.4% showed a progression, and the 17.6% died during the follow-up. A significant difference based on gender was found at the multivariate analysis on Disease free survival as well as Breslow thickness, but only Breslow thickness was the only parameter that maintained a role on survival at multivariate analysis when corrected for gender and age. We performed the sentinel lymph node biopsy in 3 patients and they all resulted negative. Conclusion. Despite our small case series we observed some important differences of melanoma in children compared to adults. It remains difficult to establish the prognostic factors in younger melanoma patients. Similar to adults, the detection of melanoma in an early phase of development, with a low Breslow thickness, is the most important prognostic factor.

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