Publications by authors named "Chitra DeSilva"

Cellular senescence permanently restricts the replicative capacity of cells in response to various stress signals, including aberrant activation of oncogenes. The presence of predictive senescence markers in human premalignant lesions suggests that senescence may function as a genuine tumor suppressor. These markers are not exclusive to the senescence program, however, and it is possible that their expression in vivo does not discriminate irreversible from reversible forms of proliferative arrest.

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Background: Some authors have suggested that patients with very small (<0.1 mm) deposits of metastatic melanoma in sentinel lymph nodes (SLNs) should be considered SLN-negative, whereas others have reported that such patients can have adverse long-term outcomes. The aims of the present study were to determine whether extensive sectioning of SLNs resulted in more accurate categorization of histologic features of tumor deposits and to assess prognostic associations of histologic parameters obtained using more intensive sectioning protocols.

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Background: Studies which have found that histologic features of metastatic melanoma in sentinel lymph nodes (SNs) were predictive of survival have differed considerably in their design and results. We investigated in detail the influence of SN tumor characteristics and clinical and primary tumor parameters on clinical outcomes in a large cohort of patients treated in a single center.

Methods: In SN-positive melanoma patients, the association of clinical, primary tumor, and SN tumor features [maximum size (MaxSize), % cross-sectional area of SN occupied by tumor (%CS), tumor-penetrative depth (TPD), intranodal location of tumor, extranodal spread (ENS), and perinodal lymphatic invasion (PLI)] with disease-free (DFS), distant metastasis-free (DMFS), and melanoma-specific (MSS) survival was analyzed.

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Purpose: Sentinel node (SN) biopsy allows identification of patients with melanoma at risk of further metastatic disease in regional non-sentinel nodes (NSN). We investigated clinicopathologic factors that predict NSN positivity in an attempt to identify patients who may be safely spared completion lymph node dissection (CLND).

Patients And Methods: Clinicopathologic factors previously shown to be predictive of NSN positivity were analyzed in 409 patients with SN-positive disease (309 of whom underwent CLND) managed at a single melanoma center.

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Previous studies have suggested that immunotherapy with dendritic cell (DC) vaccines may be effective in treatment of patients with AJCC stage IV melanoma. We examined this treatment in phase I/II studies in 33 patients with good performance status and low volume disease. Nineteen patients received DCs plus autologous lysates and 14 patients DCs plus peptides from the melanoma antigens MAGE-3.

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