Clinicopathological characteristics of cutaneous malignant melanoma in patients at a tertiary hospital in Macaronesia. Survival as a function of locoregional prognostic factors per the American Joint Committee on Cancer.

BACKGROUND: Despite suffering high ultraviolet radiation levels, few data on malignant melanoma (MM) in Macaronesia are available. METHODS: Observational study of cutaneous MM cases diagnosed during a period of 12 years at a tertiary hospital in Canary Islands. RESULTS: A total of 532 patients (female/male = 1.4) with an average age of 56 years were included; 5% developed more than one MM, and 7% reported family history of MM. Phototype II (43%), dark eyes (41%), and dark hair (41%) predominated. There was a lower frequency of light-colored hair and eyes in those born in the Canary Islands. The most frequent locations of MM were on the back for men (37%) and on the lower extremities for women (35%). Among the infiltrating tumors (83%), the (median) thickness was 1.07 mm (women, 0.90 mm; men, 1.21 mm). Anatomopathological ulceration (AU) and a mitotic rate ≥1 mitosis/mm2 (HMR) were recorded in 27% of patients. Patients with regional disease constituted 12% of the population. The most common stage was IA (34%). Melanoma-specific survival (MSSV) decreased significantly with thickness, presence of AU, HMR, and sentinel lymph node disease. These four variables were independent prognostic factors. The five-year MSSV varied between 100% (stage IA) and 39% (stage IIIC). CONCLUSIONS: The characteristics of the patients were similar to those published in datasets from continental Europe, although the pigmentary features were darker in those originating from Macaronesia. The prognostic parameters described in the 7th edition of the American Joint Committee on Cancer (AJCC) independently predict MSSV in our patients.

Evaluation of freezing in arterial microsurgical anastomosis.

In this work, the authors discuss the effect of freezing on vascular anastomosis performed in the femoral arteries of the rat. For this purpose, they utilize dimethyl propane ether (-60 degrees C). Two experiments were performed independently from each other. On the right side, they froze the artery before cutting and anastomosing it. On the left side, the artery was first transected and then frozen before anastomosis was performed. Patency was studied at 7 days. Changes in diameter of the vascular lumen were measured both in the experimental as well in the control group. Permeability of the arteries frozen before being cut was greater than in those in which freezing was performed subsequently. On the other hand, the authors found some cases of thrombosed vessels, which have not been previously described in the literature. They also noticed proximal and distal vasospasm when cool was applied locally. They conclude that freezing of microarteries before cutting them produces vasodilatation with a low incidence of thrombotic phenomena. However, the presence of a significant proximal and distal vasospasm leads them to believe that further studies are necessary before this technique is applied in the clinical setting.