Search Our Scientific Publications & Authors

Eur J Cancer 2022 Jun 19;171:203-231. Epub 2022 Jun 19.

Universite' de Paris, INSERM U976, AP-HP, Dermatology Department, Saint Louis Hospital, Paris, France. Electronic address:

Merkel cell carcinoma (MCC) is a rare skin cancer, accounting for less than 1% of all cutaneous malignancies. It is found predominantly in white populations and risk factors include advanced age, ultraviolet exposure, male sex, immunosuppression, such as AIDS/HIV infection, haematological malignancies or solid organ transplantation, and Merkel cell polyomavirus infection. MCC is an aggressive tumour with 26% of cases presenting lymph node involvement at diagnosis and 8% with distant metastases. Read More

Magy Onkol 2022 Jun 28;66(2):134-139. Epub 2022 May 28.

Onkodermatológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.

The development of the therapy of advanced melanoma resulted in significant improvement of disease outcome; over 6 years of median survival was reached in the CheckMate 067 study. The new therapeutic modalities are already implemented in the clinical practice according to the current guidelines, however some diagnostic and therapeutic questions are still unresolved. We aimed to highlight the topic of therapeutic options for BRAF mutated melanomas, the role of PD-L1 ligand examination, the adequate therapy of oligoprogression, and the current indication of sentinel lymph node biopsy. Read More

Head Neck 2022 Jun 17. Epub 2022 Jun 17.

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.

The aim of our study was to better define the role of sentinel lymph node biopsy (SLNB) in high-risk cutaneous squamous cell carcinoma of the head and neck (cSCCHN). A systematic review and meta-analysis was performed according to the PRISMA statement. Seven-hundred and five patients were included from 20 studies. Read More

Can J Surg 2022 May-Jun;65(3):E394-E403. Epub 2022 Jun 14.

From the University of British Columbia, Vancouver, BC (Ollek, Minkova, Taqi, Chen, Martinka); and the British Columbia Cancer Agency, Vancouver, BC (Davis, Hamilton, Stuart).

Background: Sentinel lymph node biopsy (SLNB) for melanoma plays a central role in determining prognosis and guiding treatment and surveillance strategies. Despite widely published guidelines for SLNB, variation exists in its use. We aimed to determine the frequency of and predictive factors for SLNB in patients with clinically node-negative melanoma in British Columbia. Read More

BMC Cancer 2022 Jun 3;22(1):610. Epub 2022 Jun 3.

Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, 35128, Padua, Italy.

Background: The management of melanoma patients with metastatic melanoma in the sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients.

Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Read More

Int J Mol Sci 2022 Apr 26;23(9). Epub 2022 Apr 26.

Clinica Dermatologica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, 60126 Ancona, Italy.

The tetraspanin CD9 is considered a metastasis suppressor in many cancers, however its role is highly debated. Currently, little is known about CD9 prognostic value in cutaneous melanoma. Our aim was to analyse CD9 expression in melanocytic nevi and primary cutaneous melanomas through immunohistochemistry and immunofluorescence approaches to determine its correlation with invasiveness and metastatic potential. Read More

J Drugs Dermatol 2022 05;21(5):510-516

Malignant melanoma is one of the most aggressive solid tumors but has low morbidity if treated at an early stage. Over the past decade, the advent of targeted therapy and immunotherapy have productively enriched the treatment options for advanced melanomas and further improved the prognosis. The treatment of melanoma is a rapidly evolving field. Read More

JAMA Dermatol 2022 Jun;158(6):680-683

Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.

Importance: A neural network-based model (i31-GEP-SLNB) that uses clinicopathologic factors (thickness, mitoses, ulceration, patient age) plus molecular analysis (31-gene expression profiling) has become commercially available to guide selection for sentinel lymph node (SLN) biopsy in cutaneous melanoma, but its clinical utility is not well characterized.

Objective: To determine if use of the i31-GEP-SLNB model is associated with clinical benefit when used to select patients for SLN biopsy.

Design, Setting, And Participants: This decision-analytic study used data derived from a published external validation study of the i31-GEP-SLNB prediction model. Read More

Int J Mol Sci 2022 Mar 22;23(7). Epub 2022 Mar 22.

Plastic and Reconstructive Surgery Unit, Regional Melanoma Referral Center and Melanoma & Skin Cancer Unit, Santa Maria Annunziata Hospital, 50012 Florence, Italy.

Langerhans cells (LCs) are crucial regulators of anti-cancer immune responses. Cancer, however, can alter DCs functions leading to tolerance. The enzyme indoleamine 2,3-dioxygenase (IDO1) plays a crucial role in this process. Read More

Lancet 2022 04 1;399(10336):1718-1729. Epub 2022 Apr 1.

University Medical Center Utrecht, Utrecht, Netherlands; Princess Máxima Center, Utrecht, Netherlands; Comprehensive Cancer Center Munich, Munich, Germany.

Background: Pembrolizumab prolongs progression-free and overall survival among patients with advanced melanoma and recurrence-free survival in resected stage III disease. KEYNOTE-716 assessed pembrolizumab as adjuvant therapy in patients with completely resected, high-risk, stage II melanoma. We report results from the planned first and second interim analyses for recurrence-free survival. Read More

Laryngoscope 2022 Feb 24. Epub 2022 Feb 24.

Department of Biophysics and Nuclear Medicine, Hadassah Medical Center and Hebrew University, Jerusalem, Israel.

Objective: Sentinel node (SN) biopsy following lymphoscintography is recommended for high-risk cutaneous malignancies. Herein, we investigate different lymphoscintography phases, focusing on the importance of the late static phase and the resultant discovery of distal echelon solitary positive sentinel nodes that would otherwise have been overlooked.

Methods: In this retrospective cohort study, conducted in a tertiary referral medical center, we assessed SN localization and time from tracer injection to SN identification on lymphoscintigraphy. Read More

Br J Surg 2022 04;109(5):397-398

Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Hautarzt 2022 Apr 7;73(4):283-290. Epub 2022 Jan 7.

Dermatopathologie Bodensee, Friedrichshafen, Deutschland.

Metabolic reprogramming mediated by hypoxia-inducible factors and its downstream targets plays a crucial role in many human malignancies. Excessive proliferation of tumor cells under hypoxic conditions leads to metabolic reprogramming and altered gene expression enabling tumors to adapt to their hypoxic environment. Here we analyzed the metabolic signatures of primary cutaneous melanomas with positive and negative sentinel node status in order to evaluate potential differences in their metabolic signature. Read More

Curr Oncol 2021 10 21;28(6):4264-4272. Epub 2021 Oct 21.

Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.

Primary mucosal melanomas of the female genital tract account for one percent or less of all cases of melanoma with even fewer originating in the clitoris. Given the rarity of diagnosis of clitoral melanoma, there is a paucity of data guiding management. There is no supporting evidence that radical vulvectomy (with or without inguinal lymphadenopathy) is associated with improved disease-free or overall survival compared to partial vulvectomy or wide local excision. Read More

Radiother Oncol 2022 01 25;166:110-117. Epub 2021 Nov 25.

Division of Medical Oncology, Department of Oncology, University of Alberta, & Cross Cancer Institute, Edmonton, Canada.

Background And Purpose: Prospective data evaluating the role of adjuvant radiotherapy (RT) for Merkel Cell Carcinoma(MCC) is lacking. To better understand the efficacy of adjuvant RT, a population-based patterns of failure study was conducted.

Methods: We identified MCC patients treated from 1988 to 2018. Read More

Clin Plast Surg 2021 Oct 2;48(4):607-616. Epub 2021 Jul 2.

Division of Plastic Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Suite 232, Indianapolis, IN 46202, USA.

Melanoma tumor thickness and ulceration are the strongest predictors of nodal spread. The recommendations for sentinel lymph node biopsy (SLNB) have been updated in recent American Joint Committee on Cancer and National Comprehensive Cancer Network guidelines to include tumor thickness ≥0.8 mm or any ulcerated melanoma. Read More

Acta Dermatovenerol Croat 2021 Jul;29(2):80-87

Marija Delaš Aždajić, MD, Department of Dermatology and Venereology , Sestre milosrdnice University Hospital Center , Vinogradska cesta 29 , 10 000 Zagreb , Croatia ;

Background: Melanoma can early metastasize to regional lymph nodes. The sentinel lymph node (SLN) is the first lymph node draining directly from the site of primary melanoma, and the pathohistological status of the SLN is the most significant prognostic factor for overall survival prevalence and prognosis in patients with melanoma. Ultrasound is a very useful for the imaging of regional lymph node metastases, combined with Doppler and cytopuncture. Read More

ANZ J Surg 2021 08;91 Suppl 2:3-13

Melanoma Institute Australia, The University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Australia and New Zealand have the highest incidence and mortality rates for melanoma in the world. Local surgery is still the standard treatment of primary cutaneous melanoma, and it is therefore important that surgeons understand the optimal care pathways for patients with melanoma. Accurate staging is critical to ensure a reliable assessment of prognosis and to guide treatment selection. Read More

J BUON 2021 May-Jun;26(3):1148-1158

1Department of Plastic and Reconstructive Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece.

Purpose: We sought to identify independent risk factors for positive sentinel lymph node biopsy (SLNB), local recurrence (LR), metastasis (M) and death caused by cutaneous squamous cell carcinoma (cSCC) (DCS) in high-risk cSCC patients. Moreover, we compared the Brigham and Women's Hospital (BWH) system with the previous used in Greece (based on tumor size) and proposed a new classification system.

Methods: 1,524 cSCC patients were enrolled between January 2004 and December 2014, from two medical institutions. Read More

Mod Pathol 2021 11 10;34(11):1999-2008. Epub 2021 Jul 10.

Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.

Regression in melanoma is an immunological phenomenon that results in partial or complete replacement of the tumor with variably vascular fibrous tissue, often accompanied by pigment-laden macrophages and chronic inflammation. In some cases, tumor-infiltrating lymphocytes (TILs) may represent the earliest phase of this process. The prognostic significance of regression has long been a matter of debate, with inconsistent findings reported in the literature to date. Read More

Ann Surg Oncol 2021 Dec 30;28(13):9009-9030. Epub 2021 Jun 30.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Background: Given the rapidly evolving nature of the field, the current state of "high-risk" head and neck cutaneous squamous cell carcinoma (HNcSCC) is poorly characterized.

Methods: Narrative review of the epidemiology, diagnosis, workup, risk stratification, staging and treatment of high-risk HNcSCC.

Results: Clinical and pathologic risk factors for adverse HNcSCC outcomes are nuanced (e. Read More

Ann Surg Oncol 2021 Aug 28;28(8):4082-4083. Epub 2021 May 28.

Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville, Louisville, KY, USA.

Int J Gynecol Cancer 2021 06 14;31(6):817-823. Epub 2021 May 14.

Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK.

Background: Vulvar cancer is a rare disease and despite broad adoption of sentinel lymph node mapping to assess groin metastases, inguino-femoral lymph node dissection still plays a role in the management of this disease. Inguino-femoral lymph node dissection is associated with high morbidity, and limited research exists to guide the best surgical approach.

Objective: To determine international practice patterns in key aspects of the inguino-femoral lymph node dissection technique and provide data to guide future research. Read More

Arch Dermatol Res 2022 May 10;314(4):369-378. Epub 2021 May 10.

Dermatology Department of Complejo Hospitalario de Navarra, C/Irunlarrea., 31008, Pamplona, Navarra, Spain.

Several authors have studied the potential of sentinel lymph node (SLN) tumor burden as prognostic factor but the microscopic classifications used in different study groups were variable. We examined the prognostic role of tumor burden in SLN on melanoma specific-survival and competing causes of death. We also analysed clinical and histological factors as predictors of disease relapses and additional non sentinel lymph node (NSLN) metastases. Read More

Clin Exp Metastasis 2022 02 7;39(1):21-28. Epub 2021 May 7.

Moffitt Cancer Center, Department of Pathology, 12902 Magnolia Drive, Tampa, FL, 33612, USA.

The clinical importance of metastatic spread of cancer has been recognized for centuries, and melanoma has loomed large in historical descriptions of metastases, as well as the numerous mechanistic theories espoused. The "fatal black tumor" described by Hippocrates in 5000 BC that was later termed "melanose" by Rene Laennec in 1804 was recognized to have the propensity to metastasize by William Norris in 1820. And while the prognosis of melanoma was uniformly acknowledged to be dire, Samuel Cooper described surgical removal as having the potential to improve prognosis. Read More

ESMO Open 2021 06 27;6(3):100136. Epub 2021 Apr 27.

Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale dei Tumori IRCCS Fondazione Pascale, Napoli, Italy. Electronic address:

Cutaneous melanoma is the most lethal form of skin cancer and its incidence has been increasing in the past 30 years. Although this is completely resectable in most cases, thicker melanoma and those with regional lymph-node involvement are at a high risk of relapse. In recent years, the management of locoregional disease has drastically changed. Read More

Eur J Cancer 2021 05 10;149:105-113. Epub 2021 Apr 10.

Department of Pathology, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands.

Introduction: Identification of sentinel node (SN) metastases can set the adjuvant systemic therapy indication for patients with stage III melanoma. Studies re-evaluating the diagnosis of initially positive SN biopsies are scarce.

Materials And Methods: Dutch patients with melanoma who underwent SN biopsy between 2003 and 2014 were selected from PALGA, the Dutch Pathology Registry. Read More

J Immunother Cancer 2021 03;9(3)

Department of Medical Oncology, Amsterdam University Medical Centers, Vrije Universiteit, Cancer Center Amsterdam, Amsterdam, The Netherlands

Background: We previously reported CpG-B injection at the primary tumor excision site prior to re-excision and sentinel node biopsy to result in immune activation of the sentinel lymph node (SLN), increased melanoma-specific CD8 T cell rates in peripheral blood, and prolonged recurrence-free survival. Here, we assessed recruitment and activation of antigen-presenting cell (APC) subsets in the SLN and at the injection site in relation to T cell infiltration.

Methods: Re-excision skin specimens from patients with clinical stage I-II melanoma, collected 7 days after intradermal injection of either saline (n=10) or 8 mg CpG-B (CPG7909, n=12), were examined by immunohistochemistry, quantifying immune subsets in the epidermis, papillary, and reticular dermis. Read More

J Am Coll Surg 2021 06 13;232(6):889-898. Epub 2021 Mar 13.

Division of Surgical Oncology, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA. Electronic address:

Background: Malignant cutaneous adnexal tumors (MCATs) are rare and their natural history is poorly understood. Available literature indicates aggressive behavior with a significant risk of metastasis.

Study Design: Retrospective review of our institutional surgical oncology databases was performed for patients diagnosed with MCATs (2001-2020). Read More

Medicine (Baltimore) 2021 Feb;100(5):e24284

Department of Aesthetic Plastic and Burn Surgery.

Background: Head and neck melanomas (HNMs) behave differently from cutaneous melanomas in other sites, and the efficacy of sentinel lymph node biopsy (SLNB) for patients with HNMs remains controversial.

Methods: Studies on prognosis following SLNB were included. The prognostic role of SLNB and other potential predictors were analyzed using pooled relative risk (RR) or hazard ratio (HR). Read More