Publications by authors named "Francisco Aparecido Belfort"
Patients with cutaneous malignancies and locoregional involvement represent a high-risk population for disease recurrence, even if they receive optimal surgery and adjuvant treatment. Here, we discuss how neoadjuvant therapy has the potential to offer significant advantages over adjuvant treatment, further improving outcomes in some patients with skin cancers, including melanoma, Merkel cell carcinoma, and cutaneous squamous-cell carcinoma. Both preclinical studies and in vivo trials have demonstrated that exposure to immunotherapy prior to surgical resection can trigger a broader and more robust immune response, resulting in increased tumor cell antigen presentation and improved targeting by immune cells, potentially resulting in superior outcomes.
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- - Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with low survival rates, primarily treated through surgery and radiation, as highlighted by the Brazilian Society of Surgical Oncology's guidelines on its management.
- - The consensus emphasizes the importance of comprehensive staging, including imaging techniques like PET or CT scans, and recommends that all potential MCC cases be evaluated by a multidisciplinary team, including discussions in tumor boards to prevent treatment delays.
- - For early-stage patients (clinical stage I or II), local excision and sentinel lymph node biopsy are advised, while those with positive lymph nodes should receive radiation therapy, and advanced cases should consider participation in clinical trials for treatment options.
Purpose Of Review: The purpose of this study is to discuss the current knowledge and future perspectives regarding the treatment options for in-transit metastases (ITM), along with the optimal algorithms for patients presenting with this adverse manifestation of melanoma.
Recent Findings: In addition to procedures historically accepted for the management of ITM, encompassing surgery and regional techniques, novel medications in the form of immune checkpoint inhibitors (ICI) and targeted therapies now represent standard options, allowing for the possibility of combined approaches, with an expanding role of systemic therapies. Melanoma in-transit metastases consist of intralymphatic neoplastic implants distributed between the primary site and the regional nodal basin, within the subepidermal and dermal lymphatics.
Demographic, Clinical, and Pathologic Features of Patients With Cutaneous Melanoma: Final Analysis of the Brazilian Melanoma Group Database.
JCO Glob Oncol
April 2020
Purpose: National epidemiologic data on melanoma are scarce in Brazil. The current work presents final demographic, clinical, and pathologic results from the Brazilian Melanoma Group database to detail how patients with melanoma present at diagnosis.
Methods: The online database includes patients diagnosed between 1982 and 2015 and evaluated at their centers of origin between 2001 and 2016.