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1.
Arch Dermatol Res ; 314(4): 369-378, 2022 May.
Article in English | MEDLINE | ID: mdl-33973061

ABSTRACT

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. We included all patients with cutaneous melanoma that underwent SLN biopsy between 2002 and 2012 at Complejo Hospitalario de Navarra (Spain). The study end-points were death due to melanoma, melanoma relapse and involvement of NSLN. We used Fine-Gray test for competing risk analysis. A logistic regression model was performed to predict the risk of involvement of NSLN. Between 2002 and 2012, there were 348 patients who underwent SLN biopsy in our centre (308 were eligible for the study). 26.9% patients positive SLN. 88 patients died during the follow-up period and 66 (75%) died from melanoma. The 5-year cumulative incidence of melanoma death was 15.33% (95 % CI 15.25-15.42). The cumulative probability of death from melanoma was associated with gender, histological subtype, Breslow thickness, mitotic rate, ulceration and SLN tumor burden. In multivariable analysis, Breslow thickness and SLN tumor burden remained as independent prognostic factors. SLN tumor burden appears to be an important prognostic factor. It is very important reporting these characteristics in pathological reports. More prospective studies would be necessary to analyze these variables and to be able to make recommendations in management of melanoma patients.


Subject(s)
Melanoma , Sentinel Lymph Node , Skin Neoplasms , Follow-Up Studies , Humans , Lymphatic Metastasis , Melanoma/pathology , Neoplasm Recurrence, Local/epidemiology , Prognosis , Prospective Studies , Retrospective Studies , Risk Assessment , Sentinel Lymph Node/pathology , Skin Neoplasms/pathology , Tumor Burden , Melanoma, Cutaneous Malignant
3.
Eur J Cancer Care (Engl) ; 30(1): e13344, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33089896

ABSTRACT

OBJECTIVES: To investigate the patterns of melanoma recurrence in the local population, including factors that may influence in this event and timing of relapse, and to determine the mode of detection of them. METHODS: This is a retrospective cohort study of patients with melanoma who underwent sentinel lymph node biopsy at the Complejo Hospitalario de Navarra (Spain) from 2002 to 2012. The following data were collected of each patient: age, gender, date of diagnosis, location of melanoma, histological subtype, Breslow thickness, ulceration, mitosis, sentinel node status, AJCC 8th edition stage, site of first diagnosed metastasis, mode of relapse, date of first relapse and time of death. RESULTS: Of 308 patients, 30% people suffered metastasis. The mean follow-up time was 68.63 months. 51.1% of relapses were locoregional and 48.9% haemato-visceral. Sentinel node status was the only variable associated with higher risk of haemato-visceral metastasis (p < 0.001). The mean time between diagnosis of melanoma and recurrence was 2.7 years. Most recurrences were detected by the patient himself or had any type of symptoms and were consequently selected for a complementary test. CONCLUSION: It is important to follow-up all patients with diagnosis of cutaneous melanoma, essentially during the first 5 years after diagnosis.


Subject(s)
Melanoma , Skin Neoplasms , Follow-Up Studies , Humans , Lymphatic Metastasis , Melanoma/pathology , Neoplasm Recurrence, Local , Neoplasm Staging , Retrospective Studies , Sentinel Lymph Node Biopsy , Skin Neoplasms/pathology
5.
Med. clín (Ed. impr.) ; 147(4): 157-161, ago. 2016. tab, ilus
Article in Spanish | IBECS | ID: ibc-154593

ABSTRACT

Fundamento y objetivo: La calcifilaxia es una vasculopatía cutánea isquémica de vasos de pequeño tamaño con una alta morbimortalidad. Hasta el momento actual han sido publicadas muy pocas series de pacientes con esta enfermedad, ninguna procedente de un hospital español. Los principales objetivos de este trabajo son analizar el perfil demográfico, clínico e histológico de los pacientes diagnosticados de calcifilaxia en nuestro servicio, para identificar posibles factores de riesgo y potenciales estrategias terapéuticas. Material y método: Estudio retrospectivo de los casos vistos en el Servicio de Dermatología con diagnóstico de calcifilaxia con una biopsia confirmatoria, en el periodo de enero de 2010 a agosto de 2015. Resultados: Se estudiaron 9 pacientes, con edades de 76-86 años. Todos tenían comorbilidades cardiovasculares y el 67% tenía insuficiencia renal. Se observó un 33% de mortalidad. Conclusiones: Ante el posible diagnóstico de calcifilaxia debe realizarse una analítica sanguínea completa para descartar otras causas de úlceras cutáneas. El tratamiento de estos pacientes debe llevarse a cabo por un equipo multidisciplinar. Resaltamos el papel del tiosulfato sódico en el tratamiento de esta entidad (AU)


Background and objective: Calciphylaxis is a cutaneous ischaemic vascular disease of small vessels with high morbidity and mortality. To date very few series of patients with this disease have been published, none from a Spanish hospital. The main objectives of this work are to analyze the demographic, clinical and histological profile of patients diagnosed in our department to identify risk factors and potential therapeutic strategies. Material and method: We made a retrospective study of the cases seen in the dermatology department with a diagnosis of calciphylaxis and who had a confirmatory biopsy in the period between January 2010 to August 2015. Results: Nine patients were studied, with an age range of 76-86 years. All had cardiovascular comorbidities and 67% had renal failure. A 33% mortality was observed. Conclusions: Faced with a possible diagnosis of calciphylaxis, a complete blood analysis is mandatory to rule out other causes of skin ulcers. The management of these patients should be undertaken by a multidisciplinary team. We emphasize the role of sodium thiosulfate in the treatment of this condition (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Calciphylaxis/epidemiology , Hyperparathyroidism/epidemiology , Skin Ulcer/etiology , Retrospective Studies , Cardiovascular Diseases/epidemiology , Renal Insufficiency, Chronic/epidemiology , Gold Sodium Thiosulfate/therapeutic use
6.
Med Clin (Barc) ; 147(4): 157-61, 2016 Aug 19.
Article in Spanish | MEDLINE | ID: mdl-27422736

ABSTRACT

BACKGROUND AND OBJECTIVE: Calciphylaxis is a cutaneous ischaemic vascular disease of small vessels with high morbidity and mortality. To date very few series of patients with this disease have been published, none from a Spanish hospital. The main objectives of this work are to analyze the demographic, clinical and histological profile of patients diagnosed in our department to identify risk factors and potential therapeutic strategies. MATERIAL AND METHOD: We made a retrospective study of the cases seen in the dermatology department with a diagnosis of calciphylaxis and who had a confirmatory biopsy in the period between January 2010 to August 2015. RESULTS: Nine patients were studied, with an age range of 76-86 years. All had cardiovascular comorbidities and 67% had renal failure. A 33% mortality was observed. CONCLUSIONS: Faced with a possible diagnosis of calciphylaxis, a complete blood analysis is mandatory to rule out other causes of skin ulcers. The management of these patients should be undertaken by a multidisciplinary team. We emphasize the role of sodium thiosulfate in the treatment of this condition.


Subject(s)
Calciphylaxis/diagnosis , Aged , Aged, 80 and over , Calciphylaxis/etiology , Calciphylaxis/pathology , Calciphylaxis/therapy , Female , Follow-Up Studies , Humans , Male , Retrospective Studies , Risk Factors
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