630 results match your criteria: "The Role of Sentinal Node Biopsy in Skin Cancer"

Indocyanine green (ICG) is a fluorescent dye used for sentinel lymph node assessment and the assessment of perfusion in skin flaps and bowel anastomoses. ICG binds serum proteins and behaves as a macromolecule in the circulation. Tumour tissue has increased vascular permeability and reduced drainage, causing macromolecules to accumulate within it.

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CD36 expression in both immune and non-immune cells is known to be directly involved in cancer metastasis. Extracellular vesicles (EVs) secreted by malignant melanocytes play a vital role in developing tumor-promoting microenvironments, but it is unclear whether this is mediated through CD36. To understand the role of CD36 in melanoma, we first analyzed the SKCM dataset for clinical prognosis, evaluated the percentage of CD36 in lymphatic fluid-derived EVs (LEVs), and tested whether melanoma-derived EVs increase CD36 expression and induce M2-macrophage-like characteristics.

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Article Synopsis
  • - Melanoma of the external auditory canal (EAC) is rare and poorly understood, with this systematic review analyzing 30 patient cases to provide insights on management and survival, adhering to PRISMA 2020 guidelines.
  • - The review finds that Breslow thickness's influence on surgical decisions is unclear due to insufficient data, and both sentinel lymph node biopsy and adjuvant therapies are rarely used, highlighting the need for standardized treatment protocols.
  • - Overall, patients show a 50% survival rate at 5 years, indicating that EAC melanoma is an aggressive cancer, with surgical options like wide local excision and lateral temporal bone resection as primary treatments for those without metastatic disease.
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  • Porocarcinoma (PC) is a rare skin tumor primarily affecting older adults, originating from sweat glands and associated with a high risk of metastasis.
  • Differentiating PC from squamous cell carcinoma can be challenging, but markers like NUT expression and YAP1 fusions aid in diagnosis.
  • Treatment typically involves wide local excision, with Mohs surgery as a potential alternative; systemic therapies like pembrolizumab show promise, but guidelines for lymph node biopsy and radiotherapy are lacking.
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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.
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Management of Localized Melanoma in the Anti-PD-1 Era.

Curr Oncol Rep

August 2024

Melanoma Institute Australia, 40 Rocklands Road, Wollstonecraft, North Sydney, Sydney, NSW, 2060, Australia.

Article Synopsis
  • The management of localized cutaneous melanoma has advanced significantly due to new systemic therapies, necessitating an updated review of treatment strategies.
  • Recent clinical trials, like the SWOG1801, show that combining neoadjuvant and adjuvant anti-PD-1 therapy improves survival rates compared to traditional methods.
  • Future trials, such as the upcoming phase 3 Nadina trial, are expected to further refine the role of surgery and systemic treatments in melanoma, potentially decreasing the necessity for extensive surgical procedures.
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  • - MSLT-2 and DECOG-SLT trials showed that immediate complete axillary lymph node dissection (CLND) does not improve melanoma-specific survival compared to active observation, leading to a change in practice toward performing CLND only for clinically confirmed node-positive patients.
  • - A study reviewed 95 patients who underwent CLND for melanoma from 2014 to 2022, finding only 7.3% had level III lymph node positivity, with a small number influenced by neoadjuvant therapy, and no predictive factors for level III involvement identified.
  • - Patients without level III involvement had better overall and recurrence-free survival rates compared to those with level III positivity, prompting further research into prognostic factors that
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Inflammatory breast cancer: As surgical oncologists, what can we do?

Int Rev Cell Mol Biol

April 2024

Department of Surgical Oncology, Salah Azaiez Institute, Bab Saadoun, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Article Synopsis
  • - Breast cancer surgery is the main treatment for early-stage cases, but inflammatory breast cancer (IBC) requires a different approach due to its aggressive nature and skin involvement.
  • - IBC management involves a coordinated effort from oncologists, surgeons, and radiation therapists, with radical surgery still being the standard, although some advocate for conservative options after chemotherapy.
  • - The reliability of the sentinel lymph node biopsy (SLNB) in IBC patients remains uncertain, and more prospective studies are needed to enhance treatment strategies considering individual tumor characteristics and responses.
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  • Sentinel Lymph Node Biopsy (SLNB) is crucial for staging cutaneous melanoma, and this review evaluates advanced molecular testing methods like gene expression profiling (GEP) and immunohistochemistry (IHC) for predicting sentinel lymph node prognosis compared to traditional approaches.
  • The importance of identifying high-risk melanoma patients is increasing as advancements in therapy reduce the need for SLNB, and molecular testing platforms such as DecisionDx and Merlin Assay are under validation for clinical use.
  • Despite their promise, many tissue-based molecular tests face methodological challenges like small sample sizes and poor correlation with established clinical variables, leading to limited implementation in practice.
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Lymphatic drainage of sinonasal malignancies and the role of sentinel node biopsies.

Orphanet J Rare Dis

March 2024

Department of Otorhinolarnygology, Head and Neck Surgery, Ludwig-Maximilians University, Marchioninistrasse 15, 81377, Munich, Germany.

Background: Locoregional recurrence is a critical factor in the prognosis of sinonasal malignancies. Due to the rarity of these tumours, as well as the heterogeneity of histologies and anatomical subsites, there is little evidence regarding the rate and location of regional metastases in sinonasal malignancies. Elective regional lymph node dissection in the therapy of sinonasal malignancies has become controversial.

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Investigation of prognostic factors for non-sentinel lymph node metastasis in patients undergoing sentinel lymph node biopsy for cutaneous malignant melanoma: Experience from a reference centre in Turkey.

J Plast Reconstr Aesthet Surg

April 2024

Department of Plastic, Reconstructive and Aesthetic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul 34700, Turkey. Electronic address:

Article Synopsis
  • - The study analyzed the effectiveness of sentinel lymph node biopsy (SLNB) and completion lymph node dissection (CLND) in melanoma patients to understand factors linked to positive non-sentinel nodes, based on 110 cases over 7 years.
  • - Results showed that 34.5% of SLNBs were positive, and higher Breslow thickness and characteristics like perinodal invasion were associated with a greater risk of non-sentinel node metastasis.
  • - The authors emphasize the need for more studies in diverse populations to adapt findings from this cohort and address related issues in melanoma treatment.
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  • - This study examines how the distance between breast tumors and the skin affects the likelihood of lymph node involvement in breast cancer patients, which is crucial for treatment planning and survival rates.
  • - Data from 100 patients who received neoadjuvant chemotherapy were analyzed, finding that larger tumor sizes, estrogen receptor positivity, and shorter tumor-to-skin distances were linked to a higher risk of nodal metastasis.
  • - The results indicate that tumors closer to the skin have a greater chance of spreading to lymph nodes, suggesting that pre-operative assessments could help tailor treatment strategies to better address cancer spread.
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Article Synopsis
  • The tendency for solid cancers to spread (metastasize) is crucial for determining patient prognosis, and recent findings show that micrometastases can develop much earlier than previously recognized.
  • There is a complex interaction between blood vessel (vascular) and lymphatic spread of cancer cells that can begin before a primary tumor is even detectable, indicating cancer may be more systemic than localized.
  • The current cancer staging methods may need updates to accurately reflect cancer presence in different areas of the body, and early therapies for small-scale cancer spread could help prevent more severe disease later on, especially in high-risk cases like skin cancer.
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Article Synopsis
  • Melanoma is a serious skin cancer with a high death rate, but recent advancements in treatment, like immune checkpoint inhibitors, are changing the landscape of care.
  • New therapies are being used after surgery for certain stages of melanoma and have shown promise in trials, especially for patients with affected lymph nodes.
  • While innovative therapies may reduce the need for surgery in some cases, surgical procedures remain crucial for early-stage treatment and determining disease severity.
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Article Synopsis
  • Histopathologic regression of cutaneous melanoma is viewed as a positive indicator for patient prognosis, though its clinical relevance is still debated.
  • A study analyzed data from 1179 melanoma patients (2010-2015) undergoing sentinel lymph node biopsy, finding that those with regression had significantly better outcomes, including lower relapse and metastasis rates.
  • Regression was linked to favorable survival rates in patients receiving immune checkpoint inhibitors but did not demonstrate the same benefits for those undergoing targeted therapy or chemotherapy.
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Article Synopsis
  • The study emphasizes the importance of selecting the right candidates for sentinel lymph node biopsy (SLNB) to minimize surgical risks and determine eligibility for additional treatments in melanoma patients.
  • Researchers analyzed 101 primary melanoma patients, focusing on various clinical and histologic factors that might predict positive SLNB results.
  • Key findings indicated that factors like increased Breslow thickness, higher mitotic index, and ulceration significantly correlated with positive SLN results, leading to the development of a scoring system to improve patient selection for SLNB.
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  • The study focuses on sentinel node-positive melanoma patients who are monitored using active surveillance with ultrasound rather than undergoing additional surgery (CLND).
  • Out of 225 patients studied, 36% experienced recurrences, but only a small fraction (11%) recurred in the node-positive field and the detection methods varied among imaging techniques.
  • Results indicate that since all ultrasound-detected recurrences were also seen on CT/PET/CT, routine ultrasound may not be necessary for patients already receiving regular imaging.
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Tumor microenvironment plays a crucial role in primary cutaneous melanoma (CM) progression. Although the role of tumor-infiltrating lymphocyte (TIL) density has been known for a long time, its spatial distribution and impact with or without tumor-associated macrophages (TAMs) remain controversial. Herein, we investigated spatial proximity between tumor cells and immune cells in 113 primary CM and its correlation with disease-free (DFS) and overall survival (OS).

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Harold Gillies, pioneer of modern plastic surgery, and Donald Morton, pioneer of modern surgical oncology: Master problem-solvers and surgical role models.

J Plast Reconstr Aesthet Surg

December 2023

Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Division of Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Faculty of Health and Medical Sciences, The University of Western Australia. Electronic address:

Article Synopsis
  • Harold Gillies and Donald Morton were groundbreaking figures in plastic surgery and surgical oncology, respectively, known for innovative solutions to pressing medical issues.
  • Gillies focused on reconstructing injuries in World War I veterans, establishing foundational techniques in plastic surgery, while Morton developed the sentinel lymph node biopsy to manage melanoma more effectively.
  • Their individual contributions highlight the importance of problem-solving in surgery, inspiring current and future surgeons to emulate their approaches in clinical practice.
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  • Geographic location significantly impacts health literacy and access to care, with a specific focus on how these factors affect melanoma diagnosis and severity in South Dakotans.
  • The study involved a review of medical records from a Midwest dermatology practice, assessing the relationship between rural versus urban living and melanoma severity, using statistical analyses.
  • Results showed that while most patients had access to primary care, distance from care was initially linked to melanoma severity, but this relationship was not robust after further examination of outliers.
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Article Synopsis
  • The study analyzed data from 248 melanoma patients in advanced stages (III and IV) who received adjuvant therapies at eight medical centers between February 2019 and January 2021.
  • Patients were treated with either anti-PD1 therapies (nivolumab or pembrolizumab) or a combination of dabrafenib and trametinib, showing two-year survival rates of 86.7% for overall survival, 61.4% for relapse-free survival, and 70.2% for distant-metastases-free survival.
  • The findings suggest that adjuvant therapies are effective outside of clinical trials and support the idea of reducing the extent of surgery in melanoma treatment.
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Omission of Completion Lymph Node Dissection in Sentinel Node Biopsy Positive Head and Neck Cutaneous Melanoma Patients.

Ann Surg Oncol

November 2023

Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.

Article Synopsis
  • Recent studies suggest there's no significant difference in long-term survival between head and neck melanoma patients receiving only sentinel lymph node biopsy (SLNB) versus those also undergoing completion lymph node dissection (CLND).
  • An analysis of 634 patients with SLNB+ showed similar overall survival rates in both treatment groups, regardless of various risk factors like lymphovascular invasion, comorbidities, or whether patients received immunotherapy.
  • The findings indicate that for HN melanoma patients, CLND does not necessarily improve outcomes over SLNB alone, highlighting the need for more research to clarify the role of CLND in treatment.
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Article Synopsis
  • Key factors for staging primary cutaneous melanoma include Breslow thickness, ulceration, and sentinel lymph node (SLN) status, with SLN status being crucial for patients with intermediate-thickness melanoma (1-4 mm).
  • A study analyzed data from 10,491 patients with melanoma in Sweden, focusing on those with Breslow thickness greater than 4 mm (pT4), finding that 34% had positive SLN results and highlighting significant differences in melanoma-specific survival (MSS) based on SLN status.
  • The results suggest that SLN status remains a valuable prognostic indicator for thick melanoma cases, prompting a recommendation for updated clinical guidelines to include this information.
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Melanoma-derived mediators can foster the premetastatic niche: crossroad to lymphatic metastasis.

Trends Immunol

September 2023

Department of Oncology, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN, USA. Electronic address:

The natural history of advanced malignant melanoma demonstrates that, in most cases, widespread tumor dissemination is preceded by regional metastases involving tumor-draining lymph nodes [sentinel lymph nodes (SLNs)]. Under physiological conditions, LNs play a central role in immunosurveillance to non-self-antigens to which they are exposed via afferent lymph. The dysfunctional immunity in SLNs is mediated by tumor secretory factors that allow the survival of metastatic melanoma cells within the LN by creating a premetastatic niche (PMN).

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