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Melanoma: HELP
Articles by Mohammed Kashani-Sabet
Based on 58 articles published since 2010
(Why 58 articles?)
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Between 2010 and 2020, M. Kashani-Sabet wrote the following 58 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial PHIPing along: Evolution of PHIP as a cancer biomarker and a target for therapy. 2018

Kashani-Sabet, Mohammed / Bezrookove, Vladimir / de Semir, David. ·Center for Melanoma Research and Treatment, California Pacific Medical Center (CPMC) Research Institute, San Francisco, CA, USA. ·Oncotarget · Pubmed #30546826.

ABSTRACT: -- No abstract --

2 Editorial Tumor progression by immune evasion in melanoma: role of the programmed cell death-1/programmed cell death-1 ligand 1 interaction. 2010

Kashani-Sabet, Mohammed. · ·Cancer · Pubmed #20143442.

ABSTRACT: -- No abstract --

3 Review Chemoprevention agents for melanoma: A path forward into phase 3 clinical trials. 2019

Jeter, Joanne M / Bowles, Tawnya L / Curiel-Lewandrowski, Clara / Swetter, Susan M / Filipp, Fabian V / Abdel-Malek, Zalfa A / Geskin, Larisa J / Brewer, Jerry D / Arbiser, Jack L / Gershenwald, Jeffrey E / Chu, Emily Y / Kirkwood, John M / Box, Neil F / Funchain, Pauline / Fisher, David E / Kendra, Kari L / Marghoob, Ashfaq A / Chen, Suephy C / Ming, Michael E / Albertini, Mark R / Vetto, John T / Margolin, Kim A / Pagoto, Sherry L / Hay, Jennifer L / Grossman, Douglas / Ellis, Darrel L / Kashani-Sabet, Mohammed / Mangold, Aaron R / Markovic, Svetomir N / Meyskens, Frank L / Nelson, Kelly C / Powers, Jennifer G / Robinson, June K / Sahni, Debjani / Sekulic, Aleksandar / Sondak, Vernon K / Wei, Maria L / Zager, Jonathan S / Dellavalle, Robert P / Thompson, John A / Weinstock, Martin A / Leachman, Sancy A / Cassidy, Pamela B. ·Department of Medicine, Divisions of Genetics and Oncology, The Ohio State University, Columbus, Ohio. · Department of Surgery, Intermountain Health Care, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah. · Department of Medicine, The University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center Cancer Institute, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Systems Biology and Cancer Metabolism, Program for Quantitative Systems Biology, University of California Merced, Merced, California. · Department of Dermatology, University of Cincinnati, Cincinnati, Ohio. · Department of Dermatology, Cutaneous Oncology Center, Columbia University Medical Center, New York, New York. · Department of Dermatologic Surgery, Mayo Clinic Minnesota, Rochester, Minnesota. · Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. · Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia. · Departments of Surgical Oncology and Cancer Biology, Melanoma and Skin Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. · Melanoma and Skin Cancer Program, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. · Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado. · Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio. · Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. · Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, Ohio. · Memorial Sloan Kettering Skin Cancer Center and Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Medicine, University of Wisconsin, School of Medicine and Public Health, University of Wisconsin Carbone Cancer Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. · Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon. · Department of Medical Oncology, City of Hope National Medical Center, Duarte, California. · Department of Allied Health Sciences, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, Connecticut. · Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York. · Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah. · Department of Dermatology, Vanderbilt University Medical Center and Division of Dermatology, Vanderbilt Ingram Cancer Center, Nashville, Tennessee. · Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center, Nashville, Tennessee. · Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California. · Department of Dermatology, Mayo Clinic, Scottsdale, Arizona. · Department of Hematology and Oncology, Mayo Clinic, Rochester, Minnesota. · Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, University of Iowa, Iowa City, Iowa. · Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Department of Dermatology, Boston Medical Center, Boston, Massachusetts. · Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida. · Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida. · Department of Dermatology, University of California, San Francisco, San Francisco, California. · Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California. · Department of Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida. · Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington. · Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island. · Department of Dermatology, Brown University, Providence, Rhode Island. · Department of Epidemiology, Brown University, Providence, Rhode Island. · Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island. · Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. ·Cancer · Pubmed #30281145.

ABSTRACT: Recent progress in the treatment of advanced melanoma has led to unprecedented improvements in overall survival and, as these new melanoma treatments have been developed and deployed in the clinic, much has been learned about the natural history of the disease. Now is the time to apply that knowledge toward the design and clinical evaluation of new chemoprevention agents. Melanoma chemoprevention has the potential to reduce dramatically both the morbidity and the high costs associated with treating patients who have metastatic disease. In this work, scientific and clinical melanoma experts from the national Melanoma Prevention Working Group, composed of National Cancer Trials Network investigators, discuss research aimed at discovering and developing (or repurposing) drugs and natural products for the prevention of melanoma and propose an updated pipeline for translating the most promising agents into the clinic. The mechanism of action, preclinical data, epidemiological evidence, and results from available clinical trials are discussed for each class of compounds. Selected keratinocyte carcinoma chemoprevention studies also are considered, and a rationale for their inclusion is presented. These data are summarized in a table that lists the type and level of evidence available for each class of agents. Also included in the discussion is an assessment of additional research necessary and the likelihood that a given compound may be a suitable candidate for a phase 3 clinical trial within the next 5 years.

4 Review MicroRNA-mediated regulation of melanoma. 2014

Sun, V / Zhou, W B / Majid, S / Kashani-Sabet, M / Dar, A A. ·Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, 475 Brannan St Suite 220, San Francisco, CA, 94107, U.S.A. ·Br J Dermatol · Pubmed #24665835.

ABSTRACT: Melanoma is one of the most aggressive and deadly skin cancers, and, in its advanced stages, accounts for > 80% mortality. The incidence of melanoma is increasing worldwide; however, beyond surgical removal of the tumour, there is currently no curative therapy available, especially for its advanced stages. This may, in part, be owing to incomplete understanding of the molecular mechanisms that regulate the initiation and/or progression of melanoma to metastasis. The molecular mechanisms leading to the development and progression of melanoma are the focus of intense investigation, and many genetic/epigenetic alterations affecting melanoma progression and development have been identified. microRNAs (miRNAs) are emerging as important causal modulators in the development and progression of melanoma. The understanding of miRNA-mediated regulation of tumours has grown immensely over the last few years, as it has been understood to regulate most biological processes. Here, we review the currently available data on miRNAs associated with melanoma, highlighting those deregulated miRNAs that target important genes and pathways involved in the progression of melanocytes to primary and metastatic melanoma. We also review their potential clinical utility as biomarkers and potential use in targeted therapy.

5 Review Molecular markers in melanoma. 2014

Kashani-Sabet, M. ·Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, 475 Brannan St., Suite 220, San Francisco, CA, 94107, U.S.A. ·Br J Dermatol · Pubmed #23815339.

ABSTRACT: The last few years have witnessed the dawn of the molecular era in melanoma treatment. With the advent of successful therapy targeting mutant BRAF, melanoma is leading the field of cancer research in the molecular approach to therapy of advanced disease. Attempting to keep pace with advances in therapy are advances in the molecular assessment of melanoma progression, facilitated by the availability of genome-wide approaches to interrogate the malignant phenotype. At the DNA level, this has included approaches such as comparative genomic hybridization. At the RNA level, this has consisted of gene expression profiling using various assay methodologies. In certain instances, markers identified using these platforms have been further examined and developed using fluorescence in situ hybridization and immunohistochemical analysis. In this article, we will review recent progress in the development of novel molecular markers for melanoma that are nearing clinical application. We will review developments in the molecular classification of melanoma, in the molecular diagnosis of melanoma, and in the molecular assessment of melanoma prognosis.

6 Review Progression of cutaneous melanoma: implications for treatment. 2012

Leong, Stanley P L / Mihm, Martin C / Murphy, George F / Hoon, Dave S B / Kashani-Sabet, Mohammed / Agarwala, Sanjiv S / Zager, Jonathan S / Hauschild, Axel / Sondak, Vernon K / Guild, Valerie / Kirkwood, John M. ·Center for Melanoma Research and Treatment and Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA. leongsx@cpmcri.org ·Clin Exp Metastasis · Pubmed #22892755.

ABSTRACT: The survival rates of melanoma, like any type of cancer, become worse with advancing stage. Spectrum theory is most consistent with the progression of melanoma from the primary site to the in-transit locations, regional or sentinel lymph nodes and beyond to the distant sites. Therefore, early diagnosis and surgical treatment before its spread is the most effective treatment. Recently, new approaches have revolutionized the diagnosis and treatment of melanoma. Genomic profiling and sequencing will form the basis for molecular taxonomy for more accurate subgrouping of melanoma patients in the future. New insights of molecular mechanisms of metastasis are summarized in this review article. Sentinel lymph node biopsy has become a standard of care for staging primary melanoma without the need for a more morbid complete regional lymph node dissection. With recent developments in molecular biology and genomics, novel molecular targeted therapy is being developed through clinical trials.

7 Review Cutaneous melanoma: a model to study cancer metastasis. 2011

Leong, Stanley P L / Gershenwald, Jeffrey E / Soong, Seng-Jaw / Schadendorf, Dirk / Tarhini, Ahmad A / Agarwala, Sanjiv / Hauschild, Axel / Soon, Christopher W M / Daud, Adil / Kashani-Sabet, Mohammed. ·Center for Melanoma Research and Treatment and Department of Surgery, California Pacific Medical Center and Research Institute, San Francisco, California 94115, USA. leongsx@cpmcri.org ·J Surg Oncol · Pubmed #21480247.

ABSTRACT: Nodal status in melanoma is a critically important prognostic factor for patient outcome. The survival rate drops to <10% when melanoma has spread beyond the regional lymph nodes and includes visceral involvement. In general, the process of melanoma metastasis is progressive in that dissemination of melanoma from the primary site to the regional lymph nodes occurs prior to systemic disease. The goal of this review article is to describe melanoma as a clinical model to study cancer metastasis. A future challenge is to develop a molecular taxonomy to subgroup melanoma patients at various stages of tumor progression for more accurate targeted treatment.

8 Review Patellar metastatic melanoma in a 13-year-old boy. 2010

Burk, Thomas F / Horvai, Andrew E / Gottschalk, Alexander R / Leong, Stanley P L / Kashani-Sabet, Mohammed / Goldsby, Robert E / Law, Jason / O'Donnell, Richard J. ·Department of Orthopaedic Surgery, University of California, San Francisco, USA. odonnelr@orthosurg.ucsf.edu ·Am J Orthop (Belle Mead NJ) · Pubmed #21720575.

ABSTRACT: The incidence of melanoma in US adults is approximately 1.5 per million, with 2% to 5% of patients developing metastatic disease. In children, melanoma is distinctly uncommon, and metastatic disease occurs even more seldom. This case report, the first of a patellar lesion as the initial presentation of metastatic melanoma in a pediatric patient, highlights use of patellectomy and intraoperative radiation therapy in obtaining palliative local control while avoiding periarticular functional morbidity.

9 Clinical Trial Long-Term Survival after Complete Surgical Resection and Adjuvant Immunotherapy for Distant Melanoma Metastases. 2017

Faries, Mark B / Mozzillo, Nicola / Kashani-Sabet, Mohammed / Thompson, John F / Kelley, Mark C / DeConti, Ronald C / Lee, Jeffrey E / Huth, James F / Wagner, Jeffrey / Dalgleish, Angus / Pertschuk, Daniel / Nardo, Christopher / Stern, Stacey / Elashoff, Robert / Gammon, Guy / Morton, Donald L / Anonymous90923. ·John Wayne Cancer Institute, Santa Monica, CA, USA. mfaries@theangelesclinic.org. · Istituto Nazionale dei Tumori de Napoli, Naples, Italy. · Mt. Zion Medical Center, University of California, San Francisco, San Francisco, CA, USA. · Royal Prince Alfred Hospital, Sydney, Australia. · Vanderbilt University, Nashville, TN, USA. · H. Lee Moffitt Cancer Center, Tampa, FL, USA. · MD Anderson Cancer Center, Houston, TX, USA. · Southwestern Medical Center at Dallas, University of Texas, Dallas, TX, USA. · Wagner & Associates, Indianapolis, IN, USA. · St. George's Hospital Medical School, London, Great Britain. · CancerVax Corp, Carlsbad, CA, USA. · John Wayne Cancer Institute, Santa Monica, CA, USA. · UCLA Life Sciences, Biomathematics, Los Angeles, CA, USA. ·Ann Surg Oncol · Pubmed #29019177.

ABSTRACT: BACKGROUND: This phase III study was undertaken to evaluate the efficacy of an allogeneic whole-cell vaccine (Canvaxin™) plus bacillus Calmette-Guerin (BCG) after complete resection of stage IV melanoma. METHODS: After complete resection of ≤5 distant metastases, patients were randomly assigned to BCG+Canvaxin (BCG/Cv) or BCG+placebo (BCG/Pl). The primary endpoint was overall survival (OS); secondary endpoints were disease-free survival (DFS), and immune response measured by skin test (ClinicalTrials.gov identifier: NCT00052156). RESULTS: Beginning in May 1998, 496 patients were randomized. In April 2005, the Data Safety Monitoring Board recommended stopping enrollment due to a low probability of efficacy. At that time, median OS and 5-year OS rate were 38.6 months and 44.9%, respectively, for BCG/Pl versus 31.4 months and 39.6% in the BCG/Cv group (hazard ratio (HR), 1.18; p = 0.250). Follow-up was extended at several trial sites through March 2010. Median OS and 5-year and 10-year survival was 39.1 months, 43.3 and 33.3%, respectively, for BCG/Pl versus 34.9 months, 42.5 and 36.4%, in the BCG/Cv group (HR 1.053; p = 0.696). Median DFS, 5- and 10-year DFS were 7.6 months, 23.8 and 21.7%, respectively, for BCG/Pl versus 8.5 months, 30.0%, and 30.0%, respectively, for the BCG/Cv group (HR 0.882; p = 0.260). Positive DTH skin testing correlated with increased survival. DISCUSSION: In this, the largest study of postsurgical adjuvant therapy for stage IV melanoma reported to date, BCG/Cv did not improve outcomes over BCG/placebo. Favorable long-term survival among study patients suggests that metastasectomy should be considered for selected patients with stage IV melanoma.

10 Clinical Trial The safety of and indications for immediate reconstruction of head and neck melanoma defects: our early experience. 2014

Parrett, Brian M / Kashani-Sabet, Mohammed / Leong, Stanley P L / Buncke, Neal / Singer, Mark I. ·From the *Buncke Clinic, and †Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, CA. ·Ann Plast Surg · Pubmed #24691340.

ABSTRACT: Melanoma excision requires wide margins, leaving large defects. Surgical dogma has taught that definitive reconstruction of melanoma defects be performed after permanent pathology results, with skin grafts favored. However, this results in an open wound and the need for a second operation. The advantages of immediate reconstruction with flaps are single-stage surgery, high patient satisfaction, no period of disfigurement, and cost savings. Our purpose was to evaluate rate of positive margins and local recurrence after immediate reconstruction of head and neck melanoma (HNM) defects with flaps to determine safety of this approach. We prospectively followed all patients with HNM treated at a single center from January 2010 to June 2012 and collected patient and tumor data and reconstruction type. Outcomes assessed were permanent pathology margins and local recurrence rate. Risk factors for positive margins were assessed. Seventy-six patients with HNM were treated with wide excision and immediate flap reconstruction with a mean age of 59 years. Five patients had melanoma in situ and 71 had invasive melanoma. There was a 15.4% ulceration rate. Median thickness for invasive melanoma was 2.2 mm. Mean excision margin was 1.4 cm. Median follow-up was 2 years; 5.3% of patients had positive margins on permanent pathology after reconstruction and 3 were reexcised with negative margins. Local recurrence rate was 2.6% with no recurrence in patients with previous reexcised positive margins. Significant risk factors for positive margins were melanoma in situ excised with 5-mm margins (P=0.012) and desmoplastic melanoma (P<0.02). Immediate flap reconstruction after excision of HNM can be safely performed with low positive margin and local recurrence rates. This should be offered to patients, especially those with primary melanomas with distinct borders and excision margins greater than or equal to 1 cm.

11 Clinical Trial Final trial report of sentinel-node biopsy versus nodal observation in melanoma. 2014

Morton, Donald L / Thompson, John F / Cochran, Alistair J / Mozzillo, Nicola / Nieweg, Omgo E / Roses, Daniel F / Hoekstra, Harold J / Karakousis, Constantine P / Puleo, Christopher A / Coventry, Brendon J / Kashani-Sabet, Mohammed / Smithers, B Mark / Paul, Eberhard / Kraybill, William G / McKinnon, J Gregory / Wang, He-Jing / Elashoff, Robert / Faries, Mark B / Anonymous4490784. ·The authors' affiliations are listed in the Appendix. ·N Engl J Med · Pubmed #24521106.

ABSTRACT: BACKGROUND: Sentinel-node biopsy, a minimally invasive procedure for regional melanoma staging, was evaluated in a phase 3 trial. METHODS: We evaluated outcomes in 2001 patients with primary cutaneous melanomas randomly assigned to undergo wide excision and nodal observation, with lymphadenectomy for nodal relapse (observation group), or wide excision and sentinel-node biopsy, with immediate lymphadenectomy for nodal metastases detected on biopsy (biopsy group). Results No significant treatment-related difference in the 10-year melanoma-specific survival rate was seen in the overall study population (20.8% with and 79.2% without nodal metastases). Mean (± SE) 10-year disease-free survival rates were significantly improved in the biopsy group, as compared with the observation group, among patients with intermediate-thickness melanomas, defined as 1.20 to 3.50 mm (71.3 ± 1.8% vs. 64.7 ± 2.3%; hazard ratio for recurrence or metastasis, 0.76; P=0.01), and those with thick melanomas, defined as >3.50 mm (50.7 ± 4.0% vs. 40.5 ± 4.7%; hazard ratio, 0.70; P=0.03). Among patients with intermediate-thickness melanomas, the 10-year melanoma-specific survival rate was 62.1 ± 4.8% among those with metastasis versus 85.1 ± 1.5% for those without metastasis (hazard ratio for death from melanoma, 3.09; P<0.001); among patients with thick melanomas, the respective rates were 48.0 ± 7.0% and 64.6 ± 4.9% (hazard ratio, 1.75; P=0.03). Biopsy-based management improved the 10-year rate of distant disease-free survival (hazard ratio for distant metastasis, 0.62; P=0.02) and the 10-year rate of melanoma-specific survival (hazard ratio for death from melanoma, 0.56; P=0.006) for patients with intermediate-thickness melanomas and nodal metastases. Accelerated-failure-time latent-subgroup analysis was performed to account for the fact that nodal status was initially known only in the biopsy group, and a significant treatment benefit persisted. CONCLUSIONS: Biopsy-based staging of intermediate-thickness or thick primary melanomas provides important prognostic information and identifies patients with nodal metastases who may benefit from immediate complete lymphadenectomy. Biopsy-based management prolongs disease-free survival for all patients and prolongs distant disease-free survival and melanoma-specific survival for patients with nodal metastases from intermediate-thickness melanomas. (Funded by the National Cancer Institute, National Institutes of Health, and the Australia and New Zealand Melanoma Trials Group; ClinicalTrials.gov number, NCT00275496.).

12 Article Recurrence of Melanoma After a Negative Sentinel Node Biopsy: Predictors and Impact of Recurrence Site on Survival. 2019

Thomas, Daniel C / Han, Gang / Leong, Stanley P / Kashani-Sabet, Mohammed / Vetto, John / Pockaj, Barbara / White, Richard L / Faries, Mark B / Schneebaum, Schlomo / Mozzillo, Nicola / Charney, Kim J / Sondak, Vernon K / Messina, Jane L / Zager, Jonathan S / Han, Dale. ·Yale School of Medicine, New Haven, CT, USA. · Texas A and M University, College Station, TX, USA. · California Pacific Medical Center, San Francisco, CA, USA. · Oregon Health and Science University, Portland, OR, USA. · Mayo Clinic, Phoenix, AZ, USA. · Carolinas Medical Center, Charlotte, NC, USA. · The Angeles Clinic-Cedars Sinai, Los Angeles, CA, USA. · Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. · National Cancer Institute of Naples, Naples, Italy. · St. Joseph Hospital, Orange, CA, USA. · Moffitt Cancer Center, Tampa, FL, USA. · Oregon Health and Science University, Portland, OR, USA. handal@ohsu.edu. ·Ann Surg Oncol · Pubmed #31011906.

ABSTRACT: BACKGROUND: Factors that predict melanoma recurrence after a negative sentinel lymph node biopsy (SLNB) are not well-defined. We evaluated melanoma recurrence patterns, factors prognostic for recurrence, and the impact of recurrence on outcomes after a negative SLNB. METHODS: The Sentinel Lymph Node Working Group database was evaluated from 1996 to 2016 for negative SLNB melanoma patients. Clinicopathologic characteristics were correlated with recurrence, overall survival (OS), and melanoma-specific survival (MSS). RESULTS: Median follow-up was 32.1 months. Recurrences developed in 558 of 5351 negative SLN patients (10.4%). First-site of recurrence included a local or in-transit recurrence (LITR) in 221 cases (4.1%), nodal recurrence (NR) in 109 cases (2%), and distant recurrence (DR) in 220 cases (4.1%). On multivariable analysis, age, thickness, head/neck or lower extremity primary, and microsatellitosis significantly predicted for an LITR as first-site. Having an LITR as first-site significantly predicted for a subsequent NR and DR, and significantly predicted for worse OS and MSS. Furthermore, thickness and head/neck or lower extremity primary significantly predicted for an NR as first-site, while a prior LITR significantly predicted for a subsequent NR. Factors significantly predictive for a DR included thickness, head/neck or trunk primary, ulceration, and lymphovascular invasion. Patients with any type of locoregional recurrence were at higher risk for a DR. CONCLUSIONS: Recurrences occur in 10.4% of negative SLN patients, with LITR and DR being the most common types. Importantly, having an LITR significantly predicts for a subsequent NR and DR, and is prognostic for worse survival after a negative SLNB.

13 Article Completion lymphadenectomy for a positive sentinel node biopsy in melanoma patients is not associated with a survival benefit. 2019

Klemen, Nicholas D / Han, Gang / Leong, Stanley P / Kashani-Sabet, Mohammed / Vetto, John / White, Richard / Schneebaum, Schlomo / Pockaj, Barbara / Mozzillo, Nicola / Charney, Kim / Hoekstra, Harald / Sondak, Vernon K / Messina, Jane L / Zager, Jonathan S / Han, Dale. ·Section of Surgical Oncology, Yale School of Medicine, New Haven, Connecticut. · Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas. · California Pacific Medical Center and Research Institute, San Francisco, California. · Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon. · Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina. · Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. · Mayo Clinic, Phoenix, Arizona. · Instituto Tumori Napoli Fondazione G. Pascale, Napoli, Italy. · St. Joseph Hospital of Orange, Orange, California. · University of Groningen, Groningen, Netherlands. · Moffitt Cancer Center, Tampa, Florida. ·J Surg Oncol · Pubmed #30883771.

ABSTRACT: BACKGROUND: Completion lymph node dissection (CLND) for sentinel lymph node (SLN) disease in melanoma patients is debated. We evaluated the impact of CLND on survival and assessed for predictors of nonsentinel node metastasis (positive CLND). METHODS: Positive SLN melanoma patients were retrospectively identified in the Sentinel Lymph Node Working Group database. Clinicopathological factors were correlated with CLND status, overall survival (OS), and melanoma-specific survival (MSS). RESULTS: There were 953 positive SLN patients of whom 831 (87%) had CLND. Positive CLND was seen in 141 (17%) cases and was associated with worse OS and MSS (both P < 0.001). CLND was not performed (No-CLND) in 122 of 953 positive SLN cases (13%), of whom 100 had follow-up and 18 (18%) developed a nodal recurrence (NR). No significant differences in OS and MSS were seen comparing CLND with No-CLND (P = 0.084, P = 0.161, respectively) and comparing positive CLND with No-CLND NR patients (P = 0.565, P = 0.998, respectively). Gender, primary site, ulceration, and number of positive SLNs were correlated with nonsentinel node metastasis. CONCLUSIONS: Performance of CLND provides prognostic information but is not associated with a survival benefit. Clinical variables can predict a positive CLND in patients who may be at high risk of recurrence.

14 Article Microsatellitosis in Patients with Melanoma. 2019

Karakousis, Giorgos C / Gimotty, Phyllis A / Leong, Stanley P / Pockaj, Barbara A / White, Richard L / O'Donoghue, Cristina / Sinnamon, Andrew J / Bartlett, Edmund K / Dueck, Amylou C / Gould Rothberg, Bonnie E / Messina, Jane L / Vetto, John T / Sondak, Vernon K / Schneebaum, Schlomo / Kashani-Sabet, Mohammed / Han, Dale / Faries, Mark B / Zager, Jonathan S / Anonymous3950968. ·Hospital of the University of Pennsylvania, Philadelphia, PA, USA. giorgos.karakousis@uphs.upenn.edu. · Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA. · California Pacific Medical Center and Research Institute, San Francisco, CA, USA. · Mayo Clinic, Phoenix, AZ, USA. · Carolinas Medical Center, Charlotte, NC, USA. · Department of Surgery, Rush Medical College, Chicago, IL, USA. · Hospital of the University of Pennsylvania, Philadelphia, PA, USA. · Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Yale University School of Medicine, New Haven, CT, USA. · Moffitt Cancer Center, Tampa, FL, USA. · Oregon Health and Science University, Portland, OR, USA. · Ichilov Hospital, Tel Aviv, Israel. · Angeles Clinic and Research Institute, Los Angeles, CA, USA. ·Ann Surg Oncol · Pubmed #30421045.

ABSTRACT: BACKGROUND: Microsatellitosis (mS) in melanoma has been considered a marker of unfavorable tumor biology, leading to the current American Joint Committee on Cancer staging of IIIB/C/D disease, despite few investigative studies of this entity limited by the small sample sizes and incomplete nodal microstaging. We sought to better characterize outcomes and prognostic factors in a multi-institutional cohort of patients with mS and nodal microstaging. METHODS: The Sentinel Lymph Node Working Group cohort included 414 mS patients who underwent sentinel lymph node (SLN) biopsy. Cox regression analysis was used to evaluate the prognostic significance of established clinicopathologic characteristics. Melanoma-specific survival (MSS) of patients with mS was compared with 3002 similarly staged patients from the Surveillance, Epidemiology, and End Results (SEER) Program registry. RESULTS: The median age of the mS cohort was 64.9 years; 39.6% were female. Median thickness was 3 mm, 40.6% of cases were ulcerated, and the SLN positivity rate was 46.7%. Increasing thickness, male sex, and SLN positivity were significantly associated with poorer MSS. Stage IIIB/C/D 5-year MSS rates were 86.3% (95% confidence interval [CI] 79.4-93.3%), 54.1% (95% CI 45.4-59.7%), and 44.2% (95% CI 25.4-63.0%), respectively. MSS survival for the stage IIIB mS cohort was significantly better than a similarly staged SEER cohort (5-year MSS of 70.1%, 95% CI 66.0-74.2%), while no significant difference was observed for the stage IIIC or D cohorts. CONCLUSIONS: SLN metastases are common and are a significant prognostic factor in patients with mS. Survival in stage IIIB patients with mS was considerably more favorable than their stage would otherwise suggest, which has important implications for decisions regarding adjuvant therapy for patients with mS.

15 Article Natural history of pain associated with melanoma surgery. 2018

Slagelse, Charlotte / Munch, Troels / Glazer, Clara / Greene, Kaitlin / Finnerup, Nanna Brix / Kashani-Sabet, Mohammed / Leong, Stanley P / Petersen, Karin Lottrup / Rowbotham, Michael C. ·California Pacific Medical Center Research Institute, San Francisco, CA, USA. · Department of Epidemiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Medicine, The Danish Pain Research Center, Aarhus University, Aarhus, Denmark. ·Pain Rep · Pubmed #30706034.

ABSTRACT: Introduction: After excision of a primary malignant melanoma (MM), treatment of stage IB or higher MM consists of sentinel lymph node biopsy (SLNB). If malignant cells are identified, a complete lymph node dissection (CLND) can be performed. Objective: To determine the natural history of pain and sensory changes after MM surgery. Methods: We prospectively followed 39 patients (29 SLNB-only, 2 CLND-only, and 8 CLND preceded by SLNB) from before inguinal or axillary surgery through 6 months after surgery on measures of pain intensity, sensory symptoms, allodynia, and questionnaires of anxiety, depression, and catastrophizing. Results: No patient had pain preoperatively. Ten days after surgery, 35% had surgical site pain after SLNB-only compared with 90% after CLND ( Conclusion: Acute pain is more common after CLND surgery. Undergoing SLNB followed by more invasive CLND surgery may increase the likelihood of pain at 6 months. Persistent sensory symptoms typical of those associated with nerve injury are more common after CLND. Surgery for MM is a good model for studying the natural history of postsurgical pain and sensory changes.

16 Article Intraoperative Imaging with a Portable Gamma Camera May Reduce the False-Negative Rate for Melanoma Sentinel Lymph Node Surgery. 2018

Leong, Stanley P / Wu, Max / Lu, Ying / Torre, Donald M / von Bakonyi, Anna / Ospina, Arianna M / Newsom, James D / Luckett, William S / Soon, Christopher W / Kim, Kevin B / Kashani-Sabet, Mohammed. ·California Pacific Medical Center, San Francisco, CA, USA. leongsx@cpmcri.org. · California Pacific Medical Center, San Francisco, CA, USA. · Stanford University, Stanford, CA, USA. ·Ann Surg Oncol · Pubmed #30105436.

ABSTRACT: BACKGROUND: Preoperative imaging and intraoperative gamma probe (GP) localization is standard for identifying sentinel lymph nodes (SLNs) in melanoma patients. The aim of this prospective Institutional Review Board-approved study was to investigate whether an intraoperative portable gamma camera (PGC) improves SLN detection over the GP. METHODS: Lymphoscintigraphy and single photon emission computed tomography/computed tomography were performed after injection of 99mTc-Tilmanocept in melanoma patients (≥ 18 years, Breslow thickness ≥ 1.0 mm). A GP was used to localize the SLNs in each basin, which was explored by the GP to ensure that the operative field was < 10% counts of the hottest SLN. The PGC was then used after a negative GP screening. Any residual hotspots identified by the PGC were considered as additional SLNs and were removed following the 10% rule. RESULTS: Preoperative imaging of 100 patients identified 138 SLN basins, with 306 SLNs being identified by conventional surgery. The PGC localized 89 additional SLNs in 54 patients. Thus, the PGC identified an additional 23% of SLNs [95% confidence interval (CI) 18-27%]. Four of these 89 SLNs showed micrometastasis in four patients, in two of whom the only tumor-positive SLN was identified by the PGC, preventing two false-negative cases. Thus, the null hypothesis that the PGC did not detect additional positive SLNs was rejected (p = 0.000). The overall SLN positive rate was 9.9% (39/395, 95% CI 6-12), and the overall patient positive rate was increased using the PGC, from 25 to 27% (27/100). CONCLUSIONS: Intraoperative PGC imaging yielded additional SLNs in a significant number of patients over GP alone. Identification of these additional SLNs resulted in upstaging of four patients with two patients being converted from a negative to a positive status, thus, preventing two false-negative cases.

17 Article PHIP as a therapeutic target for driver-negative subtypes of melanoma, breast, and lung cancer. 2018

de Semir, David / Bezrookove, Vladimir / Nosrati, Mehdi / Dar, Altaf A / Wu, Clayton / Shen, Julia / Rieken, Christopher / Venkatasubramanian, Meenakshi / Miller, James R / Desprez, Pierre-Yves / McAllister, Sean / Soroceanu, Liliana / Debs, Robert J / Salomonis, Nathan / Schadendorf, Dirk / Cleaver, James E / Kashani-Sabet, Mohammed. ·California Pacific Medical Center Research Institute, San Francisco, CA 94107. · Carl Zeiss Microscopy, LLC, New York, NY 10594. · Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229. · Department of Dermatology, University of Duisburg-Essen, D-45147 Essen, Germany. · German Cancer Consortium, 69120 Heidelberg, Germany. · Department of Dermatology and Pharmaceutical Chemistry, University of California San Francisco, CA 94121 james.cleaver@ucsf.edu kashani@cpmcri.org. · California Pacific Medical Center Research Institute, San Francisco, CA 94107; james.cleaver@ucsf.edu kashani@cpmcri.org. ·Proc Natl Acad Sci U S A · Pubmed #29866840.

ABSTRACT: The identification and targeting of key molecular drivers of melanoma and breast and lung cancer have substantially improved their therapy. However, subtypes of each of these three common, lethal solid tumors lack identified molecular drivers, and are thus not amenable to targeted therapies. Here we show that pleckstrin homology domain-interacting protein (PHIP) promotes the progression of these "driver-negative" tumors. Suppression of PHIP expression significantly inhibited both tumor cell proliferation and invasion, coordinately suppressing phosphorylated AKT, cyclin D1, and talin1 expression in all three tumor types. Furthermore, PHIP's targetable bromodomain is functional, as it specifically binds the histone modification H4K91ac. Analysis of TCGA profiling efforts revealed PHIP overexpression in triple-negative and basal-like breast cancer, as well as in the bronchioid subtype of nonsmall cell lung cancer. These results identify a role for PHIP in the progression of melanoma and breast and lung cancer subtypes lacking identified targeted therapies. The use of selective, anti-PHIP bromodomain inhibitors may thus yield a broad-based, molecularly targeted therapy against currently nontargetable tumors.

18 Article Role of Elevated 2018

Bezrookove, Vladimir / Nosrati, Mehdi / Miller, James R / De Semir, David / Dar, Altaf A / Vosoughi, Elham / Vaquero, Edith / Sucker, Antje / Lazar, Alexander J / Gershenwald, Jeffrey E / Davies, Michael A / Schadendorf, Dirk / Kashani-Sabet, Mohammed. ·Center for Melanoma Research and Treatment, California Pacific Medical Center (CPMC) Research Institute, San Francisco, California. · Department of Dermatology, University of Duisburg-Essen, Essen, Germany, and German Cancer Consortium, Heidelberg, Germany. · Departments of Pathology, Genomic Medicine, Dermatology & Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Center for Melanoma Research and Treatment, California Pacific Medical Center (CPMC) Research Institute, San Francisco, California. kashani@cpmcri.org. ·Clin Cancer Res · Pubmed #29776954.

ABSTRACT:

19 Article Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies. 2018

Vosoughi, Elham / Lee, Jee Min / Miller, James R / Nosrati, Mehdi / Minor, David R / Abendroth, Roy / Lee, John W / Andrews, Brian T / Leng, Lewis Z / Wu, Max / Leong, Stanley P / Kashani-Sabet, Mohammed / Kim, Kevin B. ·Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, 2100 Webster Street, Suite 326, San Francisco, CA, 94115, USA. · Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, 2100 Webster Street, Suite 326, San Francisco, CA, 94115, USA. KimKB@sutterhealth.org. ·BMC Cancer · Pubmed #29703161.

ABSTRACT: BACKGROUND: Melanoma brain metastasis is associated with an extremely poor prognosis, with a median overall survival of 4-5 months. Since 2011, the overall survival of patients with stage IV melanoma has been significantly improved with the advent of new targeted therapies and checkpoint inhibitors. We analyze the survival outcomes of patients diagnosed with brain metastasis after the introduction of these novel drugs. METHODS: We performed a retrospective analysis of our melanoma center database and identified 79 patients with brain metastasis between 2011 and 2015. RESULTS: The median time from primary melanoma diagnosis to brain metastasis was 3.2 years. The median overall survival duration from the time of initial brain metastasis was 12.8 months. Following a diagnosis of brain metastasis, 39 (49.4%), 28 (35.4%), and 24 (30.4%) patients were treated with anti-CTLA-4 antibody, anti-PD-1 antibody, or BRAF inhibitors (with or without a MEK inhibitor), with a median overall survival of 19.2 months, 37.9 months and 12.7 months, respectively. Factors associated with significantly reduced overall survival included male sex, cerebellar metastasis, higher number of brain lesions, and treatment with whole-brain radiation therapy. Factors associated with significantly longer overall survival included treatment with craniotomy, stereotactic radiosurgery, or with anti-PD-1 antibody after initial diagnosis of brain metastasis. CONCLUSIONS: These results show a significant improvement in the overall survival of patients with melanoma brain metastasis in the era of novel therapies. In addition, they suggest the activity of anti-PD-1 therapy specifically in the setting of brain metastasis.

20 Article Stratifying SLN incidence in intermediate thickness melanoma patients. 2018

Chang, James M / Kosiorek, Heidi E / Dueck, Amylou C / Leong, Stanley P L / Vetto, John T / White, Richard L / Avisar, Eli / Sondak, Vernon K / Messina, Jane L / Zager, Jonathan S / Garberoglio, Carlos / Kashani-Sabet, Mohammed / Pockaj, Barbara A. ·Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA. · Section of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA. · Center for Melanoma Research and Treatment, Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA. · Department of Surgery, Oregon Health & Science University, Portland, OR, USA. · Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA. · Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA. · Departments of Cutaneous Oncology and Sarcoma, Moffitt Cancer Center, Tampa, FL, USA. · Department of Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA. · Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA. Electronic address: pockaj.barbara@mayo.edu. ·Am J Surg · Pubmed #29502857.

ABSTRACT: BACKGROUND: Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors <1.5 mm a low-risk group for positive SLNB. METHODS: A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01-4.00 mm) who had SLNB, and assessed predictors for positive SLNB. RESULTS: 3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm CONCLUSIONS: Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.

21 Article Prospective Validation of Molecular Prognostic Markers in Cutaneous Melanoma: A Correlative Analysis of E1690. 2017

Kashani-Sabet, Mohammed / Nosrati, Mehdi / Miller, James R / Sagebiel, Richard W / Leong, Stanley P L / Lesniak, Andrew / Tong, Schuyler / Lee, Sandra J / Kirkwood, John M. ·Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, San Francisco, California. kashani@cpmcri.org. · Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, San Francisco, California. · Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania. · Dana-Farber Cancer Institute, Boston, Massachusetts. · ECOG-ACRIN Melanoma Committee, Philadelphia, Pennsylvania. · University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. ·Clin Cancer Res · Pubmed #28790109.

ABSTRACT:

22 Article Is the non-sentinel lymph node compartment the next site for melanoma progression from the sentinel lymph node compartment in the regional nodal basin? 2017

Rios-Cantu, Andrei / Lu, Ying / Melendez-Elizondo, Victor / Chen, Michael / Gutierrez-Range, Alejandra / Fadaki, Niloofar / Thummala, Suresh / West-Coffee, Carla / Cleaver, James / Kashani-Sabet, Mohammed / Leong, Stanley P L. ·Center for Melanoma Research & Treatment, California Pacific Medical Center, 2340 Clay Street, 2nd Floor, San Francisco, CA, 94115, USA. · Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico. · Consorcio de Universidades Mexicanas (CuMEX), Pachuca, Mexico. · Departments of Biomedical Data Science, Health Research and Policy, and Radiology, The Stanford Cancer Institute, Stanford University, Stanford, CA, USA. · University of Nevada, Las Vegas, Las Vegas, NV, USA. · Department of Dermatology, University of California, San Francisco, CA, USA. · Center for Melanoma Research & Treatment, California Pacific Medical Center, 2340 Clay Street, 2nd Floor, San Francisco, CA, 94115, USA. leongsx@cpmcri.org. ·Clin Exp Metastasis · Pubmed #28699042.

ABSTRACT: Melanoma patients with additional positive lymph nodes in the completion lymph node dissection (CLND) following a positive sentinel lymph node (SLN) biopsy would have a poorer prognosis than patients with no additional positive lymph nodes. We hypothesize that the progression of disease from the SLN to the non-SLN compartment is orderly and is associated with the worsening of the disease status. Thus, the SLN and non-SLN compartments are biologically different in that cancer cells, in general, arrive in the SLN compartment before spreading to the non-SLN compartment. To validate this concept, we used a large cohort of melanoma patients from our prospective SLN database in an academic tertiary medical center. Adult cutaneous melanoma patients (n = 291) undergoing CLND after a positive SLN biopsy from 1994 to 2009 were analyzed. Comparison of 5-year disease-free survival and 5-year overall survival between positive (n = 66) and negative (n = 225) CLND groups was made. The 5-year disease-free survival rates were 55% (95% CI 49-62%) for patients with no additional LN on CLND versus 14% (95% CI 8-26%) in patients with positive LN on CLND (p < 0.0001, log-rank test). The median disease-free survival time was 7.4 years with negative CLND (95% CI 4.4-15+ years) and 1.2 years with positive CLND (95% CI 1.0-1.8 years). The 5-year overall survival rates were 67% (95% CI 61-74%) for negative CLND versus 38% (95% CI 28-52%) for positive CLND (p < 0.0001, log-rank test). The median overall survival time was 12.1 years for negative CLND (95% CI 9.3-15+ years) and 2.5 years for positive CLND (95% CI 2.2-5.7 years). This study shows that CLND status is a significant prognostic factor for patients with positive SLNs undergoing CLND. Also, it suggests an orderly progression of metastasis from the SLN to the non-SLN compartment. Thus, the SLN in the regional nodal basin draining the primary melanoma may serve as an important gateway for metastasis to the non-SLN compartment and beyond to the systemic sites.

23 Article Is pelvic sentinel node biopsy necessary for lower extremity and trunk melanomas? 2017

Schuitevoerder, Darryl / Leong, Stanley P L / Zager, Jonathan S / White, Richard L / Avisar, Eli / Kosiorek, Heidi / Dueck, Amylou / Fortino, Jeanine / Kashani-Sabet, Mohammed / Hart, Kyle / Vetto, John T. ·Department of Surgery, Oregon Health & Science University, Portland, OR, USA. Electronic address: schuitev@ohsu.edu. · Center for Melanoma Research and Treatment, Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA. · Departments of Cutaneous Oncology and Sarcoma, Moffitt Cancer Center, Tampa, FL, USA. · Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA. · Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA. · Section of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA. · Department of Surgery, Division of Surgical Oncology, Oregon Health & Science University, Portland, OR, USA. · Department of Surgery, Oregon Health & Science University, Portland, OR, USA. ·Am J Surg · Pubmed #28411863.

ABSTRACT: OBJECTIVE: There is currently no consensus regarding how to address pelvic sentinel lymph nodes (PSLNs) in melanoma. Thus, our objectives were to identify the incidence and clinical impact of PSLNs. METHODS: Retrospective review of a prospectively collected multi-institutional melanoma database. RESULTS: Of 2476 cases of lower extremity and trunk melanomas, 227 (9%) drained to PSLNs (181 to both PSLNs and superficial (inguinal or femoral) sentinel lymph nodes (SSLN) and 46 to PSLNs alone). Seventeen (7.5%) of 227 PSLN cases were positive for nodal metastasis, 8 of which drained to PSLNs only while 9 drained to both PSLNs and SSLNs. Complication rates between PSLN and SSLN biopsy were similar (15% vs. 14% respectively). In 181 cases with drainage to both SSLNs and PSLNs, PSLN biopsy upstaged one patient (0.6%), and completion dissection based on a positive PSLN did not upstage any. CONCLUSIONS: PSLN biopsy is safe, however in the setting of negative SSLNs there is minimal clinical impact. We therefore recommend PSLN biopsy when the SSLNs are positive or when the tumor drains to PSLNs alone.

24 Article The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma. 2017

Jones, Maris S / Jones, Peter C / Stern, Stacey L / Elashoff, David / Hoon, Dave S B / Thompson, John / Mozzillo, Nicola / Nieweg, Omgo E / Noyes, Dirk / Hoekstra, Harald J / Zager, Jonathan S / Roses, Daniel F / Testori, Alessandro / Coventry, Brendon J / Smithers, Mark B / Andtbacka, Robert / Agnese, Doreen / Schultz, Erwin / Hsueh, Eddy C / Kelley, Mark / Schneebaum, Schlomo / Jacobs, Lisa / Bowles, Tawnya / Kashani-Sabet, Mohammed / Johnson, Douglas / Faries, Mark B. ·Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. · Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. · Department of Biostatistics, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. · UCLA Department of Biostatistics, Los Angeles, CA, USA. · Melanoma Institute Australia, Sydney, NSW, Australia. · Istituto Nazionale dei Tumori Napoli, Napoli, Italy. · IHC Cancer Services, Intermountain Medical Center, Salt Lake City, UT, USA. · Universitair Medisch Centrum Groningen, Groningen, The Netherlands. · H. Lee Moffitt Cancer Center, Tampa, USA. · NYU Langone Medical Center, New York, USA. · Istituto Europeo di Oncologia, Milano, Italy. · Royal Adelaide Hospital Discipline of Surgery, Royal Adelaide HospitalUniversity of Adelaide, Adelaide, SA, Australia. · Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. · Huntsman Cancer Institute, Salt Lake City, USA. · Ohio State University, Columbus, USA. · Nuremberg General Hospital - Paracelsus Medical University, Nuremberg, Germany. · Saint Louis University, St. Louis, USA. · Vanderbilt University, Nashville, USA. · Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. · Johns Hopkins Medical Institute, Baltimore, USA. · California Pacific Medical Center, San Francisco, USA. · Department of Melanoma Research, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA. mark.faries@jwci.org. ·Ann Surg Oncol · Pubmed #28224364.

ABSTRACT: BACKGROUND: Although a well-established causative relationship exists between smoking and several epithelial cancers, the association of smoking with metastatic progression in melanoma is not well studied. We hypothesized that smokers would be at increased risk for melanoma metastasis as assessed by sentinel lymph node (SLN) biopsy. METHODS: Data from the first international Multicenter Selective Lymphadenectomy Trial (MSLT-I) and the screening-phase of the second trial (MSLT-II) were analyzed to determine the association of smoking with clinicopathologic variables and SLN metastasis. RESULTS: Current smoking was strongly associated with SLN metastasis (p = 0.004), even after adjusting for other predictors of metastasis. Among 4231 patients (1025 in MSLT-I and 3206 in MSLT-II), current or former smoking was also independently associated with ulceration (p < 0.001 and p < 0.001, respectively). Compared with current smoking, never smoking was independently associated with decreased Breslow thickness in multivariate analysis (p = 0.002) and with a 0.25 mm predicted decrease in thickness. CONCLUSION: The direct correlation between current smoking and SLN metastasis of primary cutaneous melanoma was independent of its correlation with tumor thickness and ulceration. Smoking cessation should be strongly encouraged among patients with or at risk for melanoma.

25 Article Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma. 2016

Danielsen, Maria / Kjaer, Andreas / Wu, Max / Martineau, Lea / Nosrati, Mehdi / Leong, Stanley Pl / Sagebiel, Richard W / Miller, James R / Kashani-Sabet, Mohammed. ·Center for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteSan Francisco, California 95107, USA; University of CopenhagenCopenhagen, Denmark. · Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen Copenhagen, Denmark. · Department of Nuclear Medicine and Radiology, California Pacific Medical Center San Francisco, California 95107, USA. · Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute San Francisco, California 95107, USA. ·Am J Nucl Med Mol Imaging · Pubmed #27766186.

ABSTRACT: Positron emission tomography/computed tomography (PET/CT) is an important tool to identify occult melanoma metastasis. To date, it is controversial which patients with primary cutaneous melanoma should have staging PET/CT. In this retrospective analysis of more than 800 consecutive patients with cutaneous melanoma, we sought to identify factors predictive of PET/CT positivity in the setting of newly-diagnosed high-risk primary melanoma to determine those patients most appropriate to undergo a PET/CT scan as part of their diagnostic work up. 167 patients with newly-diagnosed high-risk primary cutaneous melanoma underwent a PET/CT scan performed as part of their initial staging. Clinical and histologic factors were evaluated as possible predictors of melanoma metastasis identified on PET/CT scanning using both univariate and multivariate logistic regression. In all, 32 patients (19.2%) had a positive PET/CT finding of metastatic melanoma. In more than half of these patients (56.3%), PET/CT scanning identified disease that was not detectable on clinical examination. Mitotic rate, tumor thickness, lymphadenopathy, and bleeding were significantly predictive of PET/CT positivity. A combinatorial index constructed from these factors revealed a significant association between number of high-risk factors observed and prevalence of PET/CT positivity, which increased from 5.8% (with the presence of 0-2 factors) to 100.0%, when all four factors were present. These results indicate that combining clinical and histologic prognostic factors enables the identification of patients with a higher likelihood of a positive PET/CT scan.

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