ABSTRACT
Background: The tumor, nodes and metastasis (TNM) classification and stage grouping have been updated in the 8th edition of the American Joint Committee on Cancer (AJCC) melanoma staging manual. However, restaging all the previous cases are not recommended. Aims: The aims of the study were to investigate the necessity of restaging Korean melanoma patients staged by the previous edition of the AJCC manual. Methods: Differences in the staging criteria of the 7th and 8th editions of the AJCC manual were identified. The staging of 276 primary melanomas from January 2011 to December 2018 was classified by both 7th and 8th editions of the manual and their differences were compared. Results: Staging by 7th and 8th edition of the AJCC manual differed in 64 cases (23.2%). The pathological prognostic staging changed in 35 (12.7%), and 29 (10.5%) had changes in only TNM classification but not the pathological staging. None of the patients needed additional sentinel lymph node biopsy or systemic treatment as a result of restaging. Additional counseling was needed for the patients, because melanoma-specific survival was increased in the 8th edition. Limitations: This is a retrospective study with relatively small number of patients at a single tertiary center in Korea. Conclusion: Assessment of the need for additional sentinel lymph node biopsy or systemic treatment is recommended because of the latest changes in the AJCC melanoma staging manual. Although the restaging of previously staged melanomas is not significantly needed in our patients, still the differences in TNM classification and/or pathological prognostic staging suggest the need to separately recognize the patients previously staged by 7th edition and recently staged by 8th edition. Careful counseling about melanoma-specific survival is needed for Asian patients
ABSTRACT
A avaliação pré-operatória de pacientes que irão se submeter a tratamento odontológico, do ponto de vista sistêmico, deve ser completa, detalhada e exige conhecimento acurado do cirurgião-dentista em reconhecer as manifestações de diferentes patologias e suas exteriorizações. A anamnese bem conduzida propiciará o reconhecimento de fatores de risco que levarão o profissional a adaptar a sua conduta terapêutica. Neste estudo, são apresentados os resultados da avaliação do estado clínico do paciente que foi submetido à anestesia local em Odontologia. Informações essenciais para a racionalização das decisões terapêuticas e na prevenção de situações de emergências médicas em tratamentos odontológicos. Demonstram que uma parcela importante da população chega à consulta odontológica em condições médicas que exigem adequação do profissional na conduta do tratamento dentário. Pacientes hipertensos ou com problemas cardiovasculares foram os que mais predominaram em relação a outros sistemas e foram, também, a parcela da população que mais se utilizava de fármacos.
Pre-treatment and carefully medical story in dental treatment must be complete and detailed. It is essencial to the dental surgeon to recognize the manifestations of different pathologies and their signals and symptoms. A well-conducted case history will provide the recognition of the risk factors that will lead the professionals to adapt their therapeutic approach and take the correct treatment decisions. This study presents the results of the clinical status of patient submetted to a local dentistry's anesthesia. It is an essential information to prevent situations of medical emergencies in dental practice and the dental surgeon should have the basic knowledge of medical emergencies. Our results show that a significant part of the population goes to dental appointment with no ideal medical conditions and requiring adjustment of the professional's conduct in dental treatment. Hypertensive patients or cardiovascular were the most common systemic disorders.