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Melanoma: HELP
Articles by Pietro Quaglino
Based on 68 articles published since 2008
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Between 2008 and 2019, P. Quaglino wrote the following 68 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Effect of Age on Melanoma Risk, Prognosis and Treatment Response. 2018

Ribero, Simone / Stucci, Luigia Stefania / Marra, Elena / Marconcini, Riccardo / Spagnolo, Francesco / Orgiano, Laura / Picasso, Virginia / Queirolo, Paola / Palmieri, Guiseppe / Quaglino, Pietro / Bataille, Veronique. ·Department of Medical Sciences, Section of Dermatology, University of Turin, IT-10126 Turin, Italy. simone.ribero@unito.it. ·Acta Derm Venereol · Pubmed #29648671.

ABSTRACT: As for all types of cancer, the incidence of melanoma increases with age. However, naevus counts (the principal risk factor for melanoma) decrease with age; hence the relationship between ageing and melanoma is complex. Subjects who maintain a high naevus count after the age of 50 years are more likely to be affected by melanoma, as their lesions do not senesce. Longer telomere length, which is strongly related to age, is linked to high naevus counts/melanoma risk; thus melanoma biology is influenced by factors that slow down ageing. Age is also an important prognostic factor in melanoma. Increasing age leads to worse survival in stages I, II and III. Sentinel lymph node (SLN) status, which is a strong predictor of melanoma survival, is also affected by age, as SLN positivity decreases with age. However, the prognostic value of SLN on survival increases with age, so, again, these relationships are complex. In patients with stage IV melanoma, age impacts on survival because it affects responses to treatment. This review examines the effects of age on melanoma risk, prognostic factors and responses to treatment.

2 Review Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases. 2018

Gehl, Julie / Sersa, Gregor / Matthiessen, Louise Wichmann / Muir, Tobian / Soden, Declan / Occhini, Antonio / Quaglino, Pietro / Curatolo, Pietro / Campana, Luca G / Kunte, Christian / Clover, A James P / Bertino, Giulia / Farricha, Victor / Odili, Joy / Dahlstrom, Karin / Benazzo, Marco / Mir, Lluis M. ·a Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care , Zealand University Hospital , Roskilde , Denmark. · b Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark. · c Department of Oncology Herlev and Gentofte Hospital , University of Copenhagen , Herlev , Denmark. · d Department of Experimental Oncology , Institute of Oncology Ljubljana , Ljubljana , Slovenia. · e South Tees NHS Foundation Trust , James Cook University Hospital , Middlesbrough , UK. · f Cork Cancer Research Centre , Western Gateway Building University College Cork , Cork , Ireland. · g Department of Otolaryngology Head and Neck Surgery , University of Pavia - IRCCS Policlinico San Matteo Foundation , Pavia , Italy. · h Department of Medical Sciences , Dermatologic Clinic, University of Turin , Turin , Italy. · i Department of Dermatology and Plastic Surgery , La Sapienza University , Roma , Italy. · j Department of Surgery Oncology and Gastroenterology (DISCOG) , University of Padova , Padova , Italy. · k Surgical Oncology Unit , Veneto Institute of Oncology IRCCS , Padova , Italy. · l Department of Dermatologic Surgery and Dermatology , Artemed Fachklinik München , Munich , Germany. · m Department of Dermatology and Allergology , Ludwig-Maximillian University , Munich , Germany. · n Department of Plastic Surgery , Cork University Hospital , Cork , Ireland. · o Melanoma and Sarcoma Unit Department of Surgery , Portuguese Institute of Oncology, Rua Professor Lima Basto, Faculty of Medicine of Lisbon , Lisbon , Portugal. · p Department of Plastic Surgery , St. George's University Hospitals NHS Foundation Trust , London , UK. · q Department of Plastic Surgery , Herlev and Gentofte Hospital, University of Copenhagen , Copenhagen , Denmark. · r Vectorology and Anticancer Therapies , UMR 8203, CNRS, Univ. Paris-Sud, Gustave Roussy, Université Paris-Saclay , Villejuif , France. ·Acta Oncol · Pubmed #29577784.

ABSTRACT: Electrochemotherapy is now in routine clinical use to treat cutaneous metastases of any histology, and is listed in national and international guidelines for cutaneous metastases and primary skin cancer. Electrochemotherapy is used by dermatologists, surgeons, and oncologists, and for different degrees and manifestations of metastases to skin and primary skin tumours not amenable to surgery. This treatment utilises electric pulses to permeabilize cell membranes in tumours, thus allowing a dramatic increase of the cytotoxicity of anti-cancer agents. Response rates, often after only one treatment, are very high across all tumour types. The most frequent indications are cutaneous metastases from malignant melanoma and breast cancer. In 2006, standard operating procedures (SOPs) were written for this novel technology, greatly facilitating introduction and dissemination of the therapy. Since then considerable experience has been obtained treating a wider range of tumour histologies and increasing size of tumours which was not originally thought possible. A pan-European expert panel drawn from a range of disciplines from dermatology, general surgery, head and neck surgery, plastic surgery, and oncology met to form a consensus opinion to update the SOPs based on the experience obtained. This paper contains these updated recommendations for indications for electrochemotherapy, pre-treatment information and evaluation, treatment choices, as well as follow-up.

3 Review Treatment of metastatic melanoma: a multidisciplinary approach. 2017

Fava, Paolo / Astrua, Chiara / Sanlorenzo, Martina / Ribero, Simone / Brizio, Matteo / Filippi, Andrea R / Marra, Elena / Picciotto, Franco / Sangiolo, Dario / Carnevale-Schianca, Fabrizio / Aglietta, Massimo / Sandrucci, Sergio / Ricardi, Umberto / Caliendo, Virginia / Quaglino, Pietro / Fierro, Maria T. ·Clinic of Dermatology, Department of Medical Sciences, School of Medicine, University of Turin, Turin, Italy. · Department of Dermatology, Mt. Zion Cancer Research Center, University of California, San Francisco, CA, USA. · Department of Oncology, University of Turin, Turin, Italy. · Radiation Oncology Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy. · Section of Surgical Dermatology, AOU Città della Salute e della Scienza, Turin, Italy. · Medical Oncology Unit, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy. · Sarcoma Unit, Department of Surgery, University of Turin, Turin, Italy. · Clinic of Dermatology, Department of Medical Sciences, School of Medicine, University of Turin, Turin, Italy - pietro.quaglino@unito.it. ·G Ital Dermatol Venereol · Pubmed #28290625.

ABSTRACT: The prognosis of stage IV metastatic melanoma is poor. An overall 1-year survival of 25.5% and a median survival of 6.2 months were reported without any significant improvement during the last 30 years before the introduction of new drugs (immune checkpoint inhibitors and targeted therapies) which completely modified the therapeutic approach and induced an overwhelming improvement on the survival rates of these patients. This review will analyze the therapeutic tools available for the treatment of patients with metastatic melanoma, including adjuvant interferon and locoregional therapies (surgery, radiotherapy and electrochemotherapy) and will mainly focus on the presentation of results obtained by the new treatments (checkpoint inhibitors and targeted therapies).

4 Review Role of interferon in melanoma: old hopes and new perspectives. 2017

Sanlorenzo, Martina / Vujic, Igor / Carnevale-Schianca, Fabrizio / Quaglino, Pietro / Gammaitoni, Loretta / Fierro, Maria Teresa / Aglietta, Massimo / Sangiolo, Dario. ·a Department of Oncology , University of Torino , Candiolo , Torino , Italy. · b Department of Medical Sciences, Section of Dermatology , University of Turin , Torino , Italy. · c Division of Medical Oncology, Experimental Cell Therapy , Candiolo Cancer Institute , Candiolo , Torino , Italy. · d School of Medicine , Sigmund Freud University , Vienna , Austria. · e Department of Dermatology , The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna , Vienna , Austria. ·Expert Opin Biol Ther · Pubmed #28274138.

ABSTRACT: INTRODUCTION: Interferons (IFNs) play a key role in modulating anti-microbial and antitumor immune responses. In oncology, past attempts to exploit IFNs therapeutically did not fulfill expectations, and had only modest clinical results, mostly limited to adjuvant melanoma treatment. The recent successes of immunotherapy in oncology have brought new attention to the potential of immune-modulatory agents like the IFNs. Areas covered: The authors review the biological effects of IFN on melanoma and immune cells. Then, the authors summarize the clinical results of adjuvant and therapeutic IFN in melanoma, giving focus to possible prognostic factors and new on-going clinical trials. Expert opinion: IFNs offer intriguing opportunities for synergism between conventional treatments and recently introduced molecular-targeted and immunotherapy approaches. However, the full comprehension of all IFN effects and their multiple biologic links is challenging. A strong commitment toward parallel translational research is needed to facilitate the interpretation of IFN's expected and unexpected effects, guiding the rational design of informative clinical studies.

5 Review Prognostic role of histological regression in cutaneous melanoma. 2017

Ribero, Simone / Osella-Abate, Simona / Dika, Emi / Sportoletti Baduel, Eugenio / Marra, Elena / Picciotto, Franco / Caliendo, Virginia / Fierro, Maria T / Quaglino, Pietro. ·Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy - simone.ribero@unito.it. · Section of Dermatologic Surgery, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy - simone.ribero@unito.it. · Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy. · Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. · Section of Dermatologic Surgery, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. ·G Ital Dermatol Venereol · Pubmed #27845512.

ABSTRACT: Histological regression in primary cutaneous melanoma occurs in 10-35% of cases. Although there is a large body of literature on histological regression and prognosis in melanoma patients, not clear data concerning this feature has been reported. In the current review, a comprehensive overview of the main aspects of regression will be provided. The clinical utility of regression as a prognostic factor has been challenged recently. Nowadays evidences reported that this feature is protective on SLN metastases. Despite its association with poor prognostic factors, it maintained a favourable prognostic role in many different survival studies.

6 Review Sentinel lymph node biopsy in cutaneous melanoma. 2017

Ribero, Simone / Sportoletti Baduel, Eugenio / Osella-Abate, Simona / Dika, Emi / Quaglino, Pietro / Picciotto, Franco / Macripò, Giuseppe / Bataille, Veronique. ·Section of Dermatologic Surgery, Department of Oncology, Città della Salute e della Scienza di Torino Hospital, Turin, Italy - Simone.ribero@unito.it. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin Italy - Simone.ribero@unito.it. · Department of Twins Research and Genetic Epidemiology, King's College London, London, UK - Simone.ribero@unito.it. · Section of Dermatologic Surgery, Department of Oncology, Città della Salute e della Scienza di Torino Hospital, Turin, Italy. · Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy. · Dermatology Department, University of Bologna, Bologna, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin Italy. · Department of Twins Research and Genetic Epidemiology, King's College London, London, UK. ·G Ital Dermatol Venereol · Pubmed #27248147.

ABSTRACT: The management of melanoma is constantly evolving. New therapies and surgical advances have changed the landscape over the last years. Since being introduced by Dr Donald Morton, the role of sentinel lymph node has been debated. In many melanoma centers, sentinel node biopsy is not a standard of care for melanoma above 1 mm in thickness. The results of the MSLT-II Trial are not available for a while and in the meantime, this procedure is offered as a prognostic indicator as it has been shown to be very useful for assessing risk of relapse. The biology of lymph node spread in melanoma is a complex field and there are many factors which influence it such as age, melanoma body site, thickness but other factors such as regression, ulceration and gender need further evaluation. In this review, we address the clinical value of sentinel lymph node biopsy and how its indication has changed over the years especially recently with the setup of many adjuvant trials which are offered to stage 3 melanomas.

7 Review Radiotherapy and immune checkpoints inhibitors for advanced melanoma. 2016

Filippi, Andrea Riccardo / Fava, Paolo / Badellino, Serena / Astrua, Chiara / Ricardi, Umberto / Quaglino, Pietro. ·Department of Oncology, Radiation Oncology, University of Torino, Italy. Electronic address: andreariccardo.filippi@unito.it. · Department of Medical Sciences, Dermatology/Oncology, University of Torino, Italy. · Department of Oncology, Radiation Oncology, University of Torino, Italy. ·Radiother Oncol · Pubmed #27345592.

ABSTRACT: INTRODUCTION: The therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical studies (many of them still ongoing). We here summarize the rationale and the preliminary clinical results of this approach. MATERIALS AND METHODS: In the first part of this review article, redacted with narrative non-systematic methodology, we describe the clinical results of immune checkpoints blockade in melanoma as well as the biological basis for the combination of ICI with RT; in the second part, we systematically review scientific publications reporting on the clinical results of the combination of ICI and RT for advanced melanoma. RESULTS: The biological and mechanistic rationale behind the combination of ICI and radiation is well supported by several preclinical findings. Retrospective observational series and few prospective trials support the potential synergistic effect between radiation and ICI for metastatic melanoma. CONCLUSION: RT may potentiate anti-melanoma activity of ICI by enhancing response on both target and non-target lesions. Several prospective trials are ongoing with the aim of further exploring this combination in the clinical setting, hopefully confirming initial observations and opening a new therapeutic window for advanced melanoma patients.

8 Review Synergy of molecular targeted approaches and immunotherapy in melanoma: preclinical basis and clinical perspectives. 2015

Sanlorenzo, Martina / Vujic, Igor / Moy, Adrian / Quaglino, Pietro / Fierro, Maria Teresa / Gammaitoni, Loretta / Carnevale-Schianca, Fabrizio / Aglietta, Massimo / Sangiolo, Dario. ·a 1 University of Turin, Department of Medical Sciences, Section of Dermatology , Via Cherasco 23, Torino, Italy. · b 2 University of California San Francisco, Mt. Zion Cancer Research Center , 2340 Sutter Street N461, San Francisco, CA, USA. · c 3 Candiolo Cancer Institute FPO- IRCCS, Division and Laboratory of Medical Oncology , Candiolo, Torino, Italy. · d 4 University of Torino, Department of Oncology , Torino, Italy +390119933503 ; +390119933522 ; dario.sangiolo@ircc.it. ·Expert Opin Biol Ther · Pubmed #26206099.

ABSTRACT: INTRODUCTION: Targeted therapy and immunotherapies are the novel pharmacologic treatment strategies for metastatic melanoma. BRAF and MEK inhibitors effectively block the hyperactivation of the MAPK pathway in BRAF mutant melanomas and also have several other effects on melanoma cells and on the immune response. The aim of this work is to discuss the rationale, evidence and perspectives of approaches combining target and immunotherapy against melanoma. AREAS COVERED: We first review the effects of BRAF and MEK inhibitors on melanoma cells and on the different components of the immune system. Afterwards, we summarize the results of the preclinical and clinical studies that have combined targeted therapy and immunotherapy for the treatment of melanoma. EXPERT OPINION: Clinical applications of immunotherapy strategies have recently changed the therapeutic mainstay for metastatic melanoma. Biologic and initial preclinical data support their integration with innovative molecular targeted therapies, opening enormous perspectives for researchers in the effort of finding a definitive cure. Main open challenges are the definition of reliable research models, assessment of effective schedules, safety issues and designing of personalized approaches.

9 Review The risk of melanoma in airline pilots and cabin crew: a meta-analysis. 2015

Sanlorenzo, Martina / Wehner, Mackenzie R / Linos, Eleni / Kornak, John / Kainz, Wolfgang / Posch, Christian / Vujic, Igor / Johnston, Katia / Gho, Deborah / Monico, Gabriela / McGrath, James T / Osella-Abate, Simona / Quaglino, Pietro / Cleaver, James E / Ortiz-Urda, Susana. ·Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco2Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco3School of Medicine, Stanford University, Stanford, California. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco. · Department of Epidemiology and Biostatistics, University of California, San Francisco. · Center for Devices and Radiological Health, Division of Physics, US Food and Drug Administration, Silver Spring, Maryland. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco6Department of Dermatology,The Rudolfstiftung Hospital, Vienna, Austria. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. ·JAMA Dermatol · Pubmed #25188246.

ABSTRACT: IMPORTANCE: Airline pilots and cabin crew are occupationally exposed to higher levels of cosmic and UV radiation than the general population, but their risk of developing melanoma is not yet established. OBJECTIVE: To assess the risk of melanoma in pilots and airline crew. DATA SOURCES: PubMed (1966 to October 30, 2013), Web of Science (1898 to January 27, 2014), and Scopus (1823 to January 27, 2014). STUDY SELECTION: All studies were included that reported a standardized incidence ratio (SIR), standardized mortality ratio (SMR), or data on expected and observed cases of melanoma or death caused by melanoma that could be used to calculate an SIR or SMR in any flight-based occupation. DATA EXTRACTION AND SYNTHESIS: Primary random-effect meta-analyses were used to summarize SIR and SMR for melanoma in any flight-based occupation. Heterogeneity was assessed using the χ2 test and I2 statistic. To assess the potential bias of small studies, we used funnel plots, the Begg rank correlation test, and the Egger weighted linear regression test. MAIN OUTCOMES AND MEASURES: Summary SIR and SMR of melanoma in pilots and cabin crew. RESULTS: Of the 3527 citations retrieved, 19 studies were included, with more than 266 431 participants. The overall summary SIR of participants in any flight-based occupation was 2.21 (95% CI, 1.76-2.77; P < .001; 14 records). The summary SIR for pilots was 2.22 (95% CI, 1.67-2.93; P = .001; 12 records). The summary SIR for cabin crew was 2.09 (95% CI, 1.67-2.62; P = .45; 2 records). The overall summary SMR of participants in any flight-based occupation was 1.42 (95% CI, 0.89-2.26; P = .002; 6 records). The summary SMR for pilots was 1.83 (95% CI, 1.27-2.63, P = .33; 4 records). The summary SMR for cabin crew was 0.90 (95% CI, 0.80-1.01; P = .97; 2 records). CONCLUSIONS AND RELEVANCE: Pilots and cabin crew have approximately twice the incidence of melanoma compared with the general population. Further research on mechanisms and optimal occupational protection is needed.

10 Review Melanoma immunotherapy. 2014

Sanlorenzo, Martina / Vujic, Igor / Posch, Christian / Dajee, Akshay / Yen, Adam / Kim, Sarasa / Ashworth, Michelle / Rosenblum, Michael D / Algazi, Alain / Osella-Abate, Simona / Quaglino, Pietro / Daud, Adil / Ortiz-Urda, Susanna. ·University of California San Francisco; San Francisco, CA USA; Department of Medical Sciences; Section of Dermatology; University of Turin; Turin, Italy. · University of California San Francisco; San Francisco, CA USA; The Rudolfstiftung Hospital; Vienna, Austria. · University of California San Francisco; San Francisco, CA USA. · Department of Medical Sciences; Section of Dermatology; University of Turin; Turin, Italy. ·Cancer Biol Ther · Pubmed #24651672.

ABSTRACT: Immunotherapy is a cornerstone in the treatment of melanoma, and is intended to modulate the host immunity against the tumor. Immunotherapy can be used in an adjuvant setting, after complete surgical excision in patients with a high risk of disease relapse and as a treatment in advanced (unresectable or metastatic) stages. Development of novel therapeutic approaches and the optimization of existing therapies hold a great promise in the field of melanoma therapy research. Different clinical trials are ongoing, and immunotherapy is showing the ability to confirm durable clinical benefits in selected groups of melanoma patients. The aim of this review is to summarize different types of immunotherapy agents, as well as to discuss different strategies, complementary regimens, and possible biomarkers of response to the treatment.

11 Review Clinico-pathologic features of primary melanoma and sentinel lymph node predictive for non-sentinel lymph node involvement and overall survival in melanoma patients: a single centre observational cohort study. 2011

Quaglino, P / Ribero, S / Osella-Abate, S / Macrì, L / Grassi, M / Caliendo, V / Asioli, S / Sapino, A / Macripò, G / Savoia, P / Bernengo, M G. ·Department of Biomedical Sciences and Human Oncology, Section of Dermatology, 1st Dermatologic Division, University of Turin, Italy. pietro.quaglino@unito.it ·Surg Oncol · Pubmed #21145730.

ABSTRACT: OBJECTIVE: Completion Lymph Node Dissection (CLND) is the current standard of practice for patients with a positive Sentinel Lymph Node Biopsy (SLNB). Significant morbidity is associated to CLND, so we tried to evaluate which prognostic variables could predict NSLN invasion in SLN-positive patients and their impact on the overall survival (OS). METHODS: A retrospective chart review of 603 patients that had undergone SLNB for melanoma between 2000 and 2009 at our department was done. 100 SLN were positive at the histopathological analysis of SLN. Demographic variables, primary melanoma, SLN pathologic features and results of CLND were analysed. Multivariate logistic regression and OS analyses were carried out to test the prognostic relevance of clinico-pathologic variables on CLND results and disease course. RESULTS: Breslow thickness, ulceration and micro/macrometastatic pattern of SLN invasion carried a significantly independent higher likelihood of NSLN involvement; Starz classification did not maintain a statistical significance in multivariate analysis. Only one patient (4.3%) without adverse prognostic factors showed NSLN involvement, which was found in 33.3% of patients with one and 55.9% with two or more adverse parameters (p = 0.0001). OS analyses confirmed the prognostic significance of these factors. CONCLUSION: Waiting for the results of Multicenter Selective Lymphadenectomy Trial II, our study suggests a clinically useful and easily applicable means of identifying patients with an unfavourable disease course. The presence of one or more adverse factors identifies patients in whom CLND is mandatory to include thereafter in a more strict follow-up program. Moreover, the finding of no adverse prognostic indicators associated to the presence of significant co-morbidities and/or elderly age, could be useful in identifying patients not to treat by CLND.

12 Clinical Trial Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. 2017

Kunte, C / Letulé, V / Gehl, J / Dahlstroem, K / Curatolo, P / Rotunno, R / Muir, T / Occhini, A / Bertino, G / Powell, B / Saxinger, W / Lechner, G / Liew, S-H / Pritchard-Jones, R / Rutkowski, P / Zdzienicki, M / Mowatt, D / Sykes, A J / Orlando, A / Mitsala, G / Rossi, C R / Campana, L / Brizio, M / de Terlizzi, F / Quaglino, P / Odili, J / Anonymous4800894. ·Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany. · Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark. · Department of Plastic Surgery, Copenhagen University Hospital Herlev, Denmark. · Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Rome 'La Sapienza', Rome, Italy. · Department of Reconstructive Plastic Surgery, James Cook University Hospital, Middlesbrough, U.K. · Department of Otolaryngology Head & Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. · Department of Plastic Surgery, St George's Hospital, London, U.K. · Department of Dermatology, Klinikum Wels-Grieskirchen, Wels, Austria. · Department of Plastic Surgery, Whiston Hospital, Prescot, Merseyside, U.K. · Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. · Department of Plastic Surgery. · Department of Clinical Oncology, Christie Hospital, NHS Foundation Trust, Manchester, U.K. · Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, U.K. · Veneto Institute of Oncology IOV-IRCCS, Padova, Italy. · Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. · Department of Medical Sciences, Dermatologic Clinic, University of Torino, Torino, Italy. · Scientific and Medical Department, IGEA S.p.A., Carpi, Italy. ·Br J Dermatol · Pubmed #28118487.

ABSTRACT: BACKGROUND: (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. OBJECTIVES: To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. METHODS: Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. RESULTS: In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67% (95% confidence interval 57-77%), while melanoma-specific survival was 74% (95% confidence interval 64-84%). No serious adverse events were reported, and the treatment was in general very well tolerated. CONCLUSIONS: ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

13 Clinical Trial Ipilimumab retreatment in patients with pretreated advanced melanoma: the expanded access programme in Italy. 2014

Chiarion-Sileni, V / Pigozzo, J / Ascierto, P A / Simeone, E / Maio, M / Calabrò, L / Marchetti, P / De Galitiis, F / Testori, A / Ferrucci, P F / Queirolo, P / Spagnolo, F / Quaglino, P / Carnevale Schianca, F / Mandalà, M / Di Guardo, L / Del Vecchio, M. ·Melanoma Cancer Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy. · Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione 'G Pascale', Via Cappella dei Cangiani, 1, 80131 Naples, Italy. · Medical Oncology and Immunotherapy Unit, University Hospital of Siena, Istituto Toscano Tumori, Strada delle Scotte, 14, 53100 Siena, Italy. · 1] Medical Oncology, Dermopathic Institute of the Immaculate IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy [2] Medical Oncology, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-39, 00189 Rome, Italy. · Medical Oncology, Dermopathic Institute of the Immaculate IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy. · Divisione Melanoma, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milan, Italy. · Oncology of Melanoma Unit, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milan, Italy. · Department of Medical Oncology A, San Martino Hospital, National Institute for Cancer Research, L.go R. Benzi, 10, 16132 Genoa, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Torino, San Giovanni Battista di Torino, Via Cherasco, 23, 10126 Turin, Italy. · Division of Medical Oncology, Institute for Cancer Research and Treatment, IRCC, Piedmont Oncology Foundation, Strada Provinciale, 142, 10060 Candiolo, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Piazza OMS-Organizzazione Mondiale della Sanità, 1, 24127 Bergamo, Italy. · Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133 Milan, Italy. ·Br J Cancer · Pubmed #24619072.

ABSTRACT: BACKGROUND: Retreatment with ipilimumab has been shown to re-establish disease control in some patients with disease progression. Here, we report the efficacy and safety of retreatment with ipilimumab 3 mg kg(-1) among patients participating in an expanded access programme in Italy. METHODS: Patients who achieved disease control during induction therapy were retreated with ipilimumab upon progression (3 mg kg(-1) every 3 weeks for up to four doses), providing they had not experienced toxicity that precluded further dosing. Tumour assessments were conducted after retreatment, and patients were monitored throughout for adverse events. RESULTS: Of 855 patients treated with ipilimumab, 51 were retreated upon disease progression. Of these, 28 (55%) regained disease control upon retreatment and 42% were alive 2 years after the first induction dose of ipilimumab; median overall survival was 21 months. Eleven patients (22%) had a treatment-related adverse event of any grade during retreatment. These were generally mild-to-moderate and resolved within a median of 4 days. No new types of toxicity were reported. CONCLUSIONS: For patients who meet predefined criteria, retreatment with ipilimumab is generally well tolerated and can translate into clinical benefit. This strategy should be compared with other therapeutic options in randomised controlled trials.

14 Clinical Trial Electrochemotherapy with intravenous bleomycin in the local treatment of skin melanoma metastases. 2008

Quaglino, P / Mortera, C / Osella-Abate, S / Barberis, M / Illengo, M / Rissone, M / Savoia, P / Bernengo, M G. ·Department of Biomedical Sciences and Human Oncology, Section of Clinics and Oncological Dermatology, University of Turin, v Cherasco 23, 10126 Torino, Italy. ·Ann Surg Oncol · Pubmed #18498012.

ABSTRACT: BACKGROUND: Electrochemotherapy (ECT) combines chemotherapy and electroporation to increase drug uptake. Its role in cutaneous melanoma metastasis treatment is not well defined; indeed, few studies have been reported, without complete follow-up data. AIM: To prospectively evaluate clinical activity and tolerability of ECT with i.v. bleomycin, and to analyze the response increase associated to repeated sessions, in the largest series of cutaneous melanoma metastases reported to date (n = 233). PATIENTS AND METHODS: 14 stage III relapsed/refractory patients were enrolled according to European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines and treated under general sedation using the Cliniporator(TM) pulse generator. RESULTS: A response was obtained in 13/14 patients (93%) after the first ECT, with a complete regression (CR) in 7 (50%). Seven patients underwent a second and three a third ECT on newly appearing and residual lesions, all achieving a response. Overall, a response was obtained in 93% metastases, with lower response rates in >1 cm(2) lesions. The CR rate was 58%; none of the CR nodules relapsed. The repeated ECT sessions gave rise to a new response in 21/29 (72%) re-treated lesions. The local tumor control rate was 74.5% at 2 years. CONCLUSION: ECT is a safe procedure, easily performed in terms of toxicities and cost-effectiveness ratios, and constitutes a therapeutic tool for relapsed/refractory cutaneous melanoma patients. The repeated ECT sessions are associated with a response increase in re-treated lesions which could allow to overcome the reduced activity in >1 cm(2) sized metastases.

15 Article Can sentinel node biopsy be safely omitted in thin melanoma? Risk factor analysis of 1272 multicenter prospective cases. 2019

Piazzalunga, Dario / Ceresoli, Marco / Allievi, Niccolò / Ribero, Simone / Quaglino, Pietro / Di Lorenzo, Sara / Corradino, Bartolo / Campana, Luca Giovanni / Mocellin, Simone / Rossi, Carlo Riccardo / Anonymous4781168. ·General Surgery Unit, Papa Giovanni XXIII Hospital, piazza OMS 1, 24127, Bergamo, Italy. · General Surgery Unit, Papa Giovanni XXIII Hospital, piazza OMS 1, 24127, Bergamo, Italy. Electronic address: marco.ceresoli@libero.it. · Medical Sciences Department, Dermatologic Clinic, University of Torino, Via Cherasco 23, 10126, Torino, Italy. · Surgical, Oncological and Stomatologic Disciplines, Plastic Surgery Unit, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy. · Veneto Institute of Oncology IOV-IRCCS, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Via Gattamelata, 64, 35128, Padova, Italy. ·Eur J Surg Oncol · Pubmed #30527782.

ABSTRACT: BACKGROUND: The indication to sentinel node biopsy (SNB) for thin melanomas (Breslow <1 mm) is still subject to controversies. The aim of this paper is to review all SNB performed for thin melanoma and to analyze factors related to lymphatic metastasis. Moreover, the diagnostic performance of the 5th, 6th, 7th and 8th AJCC classifications for cutaneous melanoma were investigated. METHODS: All sentinel node biopsies performed for thin melanomas were selected from a multicentre prospectively-collected database. For each patient the following was collected: age, sex, date of treatment, site of primary melanoma, histopathologic features (Breslow, Clark, number of mitoses/mm RESULTS: From 1998 to 2017 were performed a total of 1272 SNB for thin melanoma. Mean age was 51years with 48.7% of male patients. Overall, 5.6% positive SNB were found. At univariate and multivariate analyses, Breslow thickness and ulceration were related to the presence of lymphatic metastasis. We compared the four versions of the AJCC classification: among pT1a patients there were respectively 5.32%, 5.63%, 3.72% and 3.49% of positive SNB. CONCLUSIONS: in thin melanoma Breslow thickness and ulceration were the only factors related to a positive SNB. Although convincing improvements resulted from the implementation of AJCC classifications with a reduction of positive biopsies among pT1a, a 10.71% rate among all positive nodes remains in the low-risk group. No recommendations can be drawn from this research and adjunctive evidences are needed to better identify patients at risk of nodal metastasis.

16 Article Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness. 2019

Ribero, Simone / Galli, Francesca / Osella-Abate, Simona / Bertero, Luca / Cattaneo, Laura / Merelli, Barbara / Tondini, Carlo / Ghilardi, Laura / De Giorgi, Vincenzo / Occelli, Marcella / Quaglino, Pietro / Cassoni, Paola / Palmieri, Giuseppe / Massi, Daniela / Mandala, Mario / Anonymous3041096. ·Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy. · Methodology for Clinical Research Laboratory, Instituto di Ricovero e Cura a Carattere Scientifico, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · Section of Surgical Pathology, Medical Sciences Department, University of Turin, Turin, Italy. · Unit of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Azienda Ospedaliera Santa Croce e Carle di Cuneo SC Oncologia, Cuneo, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: mariomandala@tin.it. ·J Am Acad Dermatol · Pubmed #30447951.

ABSTRACT: BACKGROUND: The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain. OBJECTIVE: To investigate whether and to what extent regression <75% is able to predict SLNB status and clinical outcome of patients with melanoma >1-mm thick. METHODS: The study included patients with diagnoses given at 4 centers of the Italian Melanoma Intergroup. Univariate and multivariate Cox proportional hazard models stratified by center were used to analyze the effect of regression on disease-free interval and melanoma-specific survival. RESULTS: Out of 1182 patients given primary cutaneous melanoma diagnoses during 1998-2015 with a Breslow thickness >1 mm, 954 (304 with and 650 without regression) were included in the analysis. The proportion of patients with a positive SLNB was lower in patients with regression than without (24.4% vs 31.6%, chi-squared test P = .0368). At multivariate analysis, no association was detected between regression and disease-free interval (hazard ratio 1.11, 95% confidence interval 0.85-1.46; P = .4509) or melanoma-specific survival (hazard ratio 1.05, 95% confidence interval 0.77-1.44; P = .7600). LIMITATION: Retrospective analysis. CONCLUSION: In our series, regression was not an independent prognostic factor in primary cutaneous melanoma patients with Breslow thickness >1 mm whereas it was associated with a lower incidence of SLNB positivity.

17 Article Soluble CTLA-4 as a favorable predictive biomarker in metastatic melanoma patients treated with ipilimumab: an Italian melanoma intergroup study. 2019

Pistillo, Maria Pia / Fontana, Vincenzo / Morabito, Anna / Dozin, Beatrice / Laurent, Stefania / Carosio, Roberta / Banelli, Barbara / Ferrero, Francesca / Spano, Laura / Tanda, Enrica / Ferrucci, Pier Francesco / Martinoli, Chiara / Cocorocchio, Emilia / Guida, Michele / Tommasi, Stefania / De Galitiis, Federica / Pagani, Elena / Antonini Cappellini, Gian Carlo / Marchetti, Paolo / Quaglino, Pietro / Fava, Paolo / Osella-Abate, Simona / Ascierto, Paolo Antonio / Capone, Mariaelena / Simeone, Ester / Romani, Massimo / Spagnolo, Francesco / Queirolo, Paola / Anonymous3681033. ·Unit of Tumor Epigenetics, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. mariapia.pistillo@hsanmartino.it. · Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Unit of Tumor Epigenetics, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. · Department of Internal Medicine, University of Genoa, Genoa, Italy. · Department of Health Sciences, University of Genoa, Genoa, Italy. · Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Oncology of Melanoma Unit, European Institute of Oncology, Milan, Italy. · iTeos Therapeutics, Gosselies, Belgium. · Department of Medical Oncology and Molecular Genetics Laboratory, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy. · Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy. · Sapienza University of Rome, Rome, Italy. · Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy. · Department of Medical Sciences, Section of Surgical Pathology, University of Turin, Turin, Italy. · Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione'G. Pascale', Naples, Italy. ·Cancer Immunol Immunother · Pubmed #30311027.

ABSTRACT: CTLA-4 blockade by means of ipilimumab (IPI) potentiates the immune response and improves overall survival (OS) in a minority of metastatic melanoma (MM) patients. We investigated the role of soluble CTLA-4 (sCTLA-4) as a possible biomarker for identifying this subset of patients. sCTLA-4 levels were analyzed at baseline in sera from 113 IPI-treated MM patients by ELISA, and the median value (200 pg/ml) was used to create two equally sized subgroups. Associations of sCTLA-4 with best overall response (BOR) to IPI and immune-related adverse events (irAEs) were evaluated through logistic regression. Kaplan-Meier and Cox regression methods were used to analyze OS. A remarkable association between sCTLA-4 levels and BOR was found. Specifically, the proportion of patients with sCTLA-4 > 200 pg/ml in irSD or irPD (immune-related stable or progressive disease) was, respectively, 80% (OR = 0.23; 95%CL = 0.03-1.88) and 89% (OR = 0.11; 95%CL = 0.02-0.71) and was lower than that observed among patients in irCR/irPR (immune-related complete/partial response). sCTLA-4 levels increased during IPI treatment, since the proportion of patients showing sCTLA > 200 pg/ml after 3 cycles was 4 times higher (OR = 4.41, 95%CL = 1.02-19.1) than that after 1 cycle. Moreover, a significantly lower death rate was estimated for patients with sCTLA-4 > 200 pg/ml (HR = 0.61, 95%CL = 0.39-0.98). Higher baseline sCTLA-4 levels were also associated with the onset of any irAE (p value = 0.029), in particular irAEs of the digestive tract (p value = 0.041). In conclusion, our results suggest that high sCTLA-4 serum levels might predict favorable clinical outcome and higher risk of irAEs in IPI-treated MM patients.

18 Article BRAFi/MEKi in patients with metastatic melanoma: predictive factors of complete response. 2019

Ribero, Simone / Malavenda, Ottavia / Fava, Paolo / Astrua, Chiara / Marra, Elena / Osella-Abate, Simona / Sanlorenzo, Martina / Caliendo, Virginia / Fierro, Maria Teresa / Quaglino, Pietro. ·Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy. · Faculty of Medicine, University of Turin, Turin, Italy. · Department of Medicine I, Institute of Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. · Department of Oncology, Section of Dermatologic Surgery, University Hospital Citta della Scienza e della Salute di Torino, Turin, Italy. ·Future Oncol · Pubmed #30196713.

ABSTRACT: AIM: A survival benefit was demonstrated by dabrafenib + trametinib for metastatic BRAF-mutated melanoma patients. Best response is a strong prognostic marker for survival. PATIENTS & METHODS: The specific features associated with complete response (CR) were evaluated. RESULTS: A total of 15/66 patients achieved CR. Median size of lesions was 3 cm (range: 0.5-10). Using that value as cut-off, the CR rate was 39.3% in patients with smaller lesions and 10.5% in patients with bigger size (p = 0.006). The clinical features associated with CR were the number of metastatic sites and the largest diameter of the biggest metastatic site. CONCLUSION: The number of the metastases and the diameter of the largest metastatic site are associated with a higher CR rate.

19 Article Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry. 2018

Rotunno, R / Campana, L G / Quaglino, P / de Terlizzi, F / Kunte, C / Odili, J / Gehl, J / Ribero, S / Liew, S H / Marconato, R / Brizio, M / Curatolo, P. ·Dermatologic Clinic, 'Sapienza' University of Rome, Rome, Italy. · Department of Surgery Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy. · Veneto Institute of Oncology IOV-IRCCS, Padova, Italy. · Dermatologic Clinic, Department Medical Sciences, University of Turin, Turin, Italy. · Scientific & Medical Department, IGEA S.p.A., Carpi, Modena, Italy. · Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany. · Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany. · Plastic and Reconstructive Surgeon, St Georges' University Hospitals NHS Foundation Trust, London, UK. · Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark. · Department of Plastic Surgery, Whiston Hospital, Liverpool, UK. ·J Eur Acad Dermatol Venereol · Pubmed #29178483.

ABSTRACT: BACKGROUND: Electrochemotherapy (ECT) is currently used to treat unresectable superficial tumours of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing Practices of Electrochemotherapy (InspECT) aims to refine the ESOPE and improve clinical practice. Limiting patient exposure to systemic chemotherapy would be advisable to ameliorate ECT safety profile. OBJECTIVE: The aim of this study was to evaluate the efficacy and toxicity of ECT with reduced chemotherapy dosages. METHODS: In a retrospective analysis of a prospectively maintained database (InspECT registry), we evaluated the outcome of patients who received ECT with reduced dosages of bleomycin (7500, 10 000 or 13 500 IU/m RESULTS: We identified 57 patients with 147 tumours (melanoma, 38.6%; squamous cell carcinoma, 22.8%; basal cell carcinoma, 17.5%; breast cancer 7%; Kaposi sarcoma 7%; other histotypes, 7.1%). Per-tumour complete response (CR) rate at 60 days was 70.1% (partial, 16.3%); per-patient CR was 57.9% (partial, 21.1%). Local pain was the most frequently reported side-effect (n = 22 patients [39%]), mostly mild; two patients experienced flu-like symptoms, one patient nausea. We observed the same CR rate (55%) in patients with melanoma treated by reduced or conventional bleomycin dosages (P = 1.00). CONCLUSIONS: Electrochemotherapy performed with reduced bleomycin dosages could be as effective as with currently recommended dose. Patients with impaired renal function or candidate to multiple ECT cycles could benefit from a reduced dose protocol. Our findings need prospective confirmation before being adopted in clinical practice.

20 Article Favourable prognostic role of histological regression in stage III positive sentinel lymph node melanoma patients. 2018

Zugna, D / Senetta, R / Osella-Abate, S / Fierro, M T / Pisacane, A / Zaccagna, A / Sapino, A / Bataille, V / Maurichi, A / Picciotto, F / Cassoni, P / Quaglino, P / Ribero, S. ·Department of Medical Sciences, Unit of Cancer Epidemiology, CERMS, University of Turin, C.So Dogliotti, 14, Torino 10126, Italy. · Department of Medical Sciences, Section of Surgical Pathology, University of Turin, C.So Dogliotti, 14, Torino 10126, Italy. · Department of Medical Sciences, Section of Dermatology, University of Turin, C.So Dogliotti, 14, Torino 10126, Italy. · Pathology Unit, Fondazione del Piemonte per l'Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Km 3,95, SP142, 10060 Candiolo, Torino Italy. · Dermatologic Surgery Section, Fondazione del Piemonte per l'Oncologia (FPO), Candiolo Cancer Institute (IRCCS), Km 3,95, SP142, 10060 Candiolo, Torino, Italy. · Mount Vernon Cancer Centre, Rickmansworth Road, Northwood HA6 2RN, UK. · Department of Twin Research and Genetic Epidemiology, King's College London, South Wing Block D, Westminster Bridge Road, London SE1 7EH, UK. · Melanoma and Sarcoma Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumouri, Via Giacomo Venezian, 1, 20133 Milan, Italy. · Dermatologic Surgery Section, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Via Cherasco 23, 10123 Torino, Italy. ·Br J Cancer · Pubmed #29123256.

ABSTRACT: BACKGROUND: Sentinel lymph node (SLN)-positive melanoma patients are a heterogeneous group of patients with survival rates ranging from ∼20 to over 80%. No data are reported concerning the role of histological regression on survival in stage III melanoma. METHODS: The study included 365 patients with positive SLN from two distinct hospitals. The model was developed on patients from 'AOU Città della Salute e della Scienza di Torino', and externally validated on patients from IRCCS of Candiolo. Survival analyses were carried out according to the presence of regression and adjusted for all other prognostic factors. RESULTS: Among patients followed at 'AOU Città della Salute e della Scienza di Torino' (n=264), the median follow-up time to death or censoring (whatever two events occurred earlier) was 2.7 years since diagnosis (interquartile range: 1.3-5.8). In all, 79 patients died from melanoma and 11 from other causes. Histological regression (n=43) was associated with a better prognosis (sub-HR=0.34, CI 0.12-0.92), whereas the other factors above showed an inverse association. In the external validation, the concordance index was 0.97 at 1 year and decreased to 0.66 at 3 years and to 0.59 at 5 years. Adding histological regression in the prognostic model increased the discriminative ability to 0.75 at 3 years and to 0.62 at 5 years. Finally, using a cutoff of 20% for the risk of death led to a net re-classification improvement of 15 and 11% at 3 and 5 years after diagnosis, respectively. CONCLUSIONS: Histological regression could lead to an improvement in prognostic prediction in patients with stage III-positive SLN melanoma.

21 Article Prediction of Non-sentinel Node Status in Patients with Melanoma and Positive Sentinel Node Biopsy: An Italian Melanoma Intergroup (IMI) Study. 2018

Rossi, Carlo Riccardo / Mocellin, Simone / Campana, Luca Giovanni / Borgognoni, Lorenzo / Sestini, Serena / Giudice, Giuseppe / Caracò, Corrado / Cordova, Adriana / Solari, Nicola / Piazzalunga, Dario / Carcoforo, Paolo / Quaglino, Pietro / Caliendo, Virginia / Ribero, Simone / Anonymous261079. ·Surgical Oncology Unit, IOV-IRCCS of Padova, Padua, Italy. · Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padua, Italy. · Surgical Oncology Unit, IOV-IRCCS of Padova, Padua, Italy. simone.mocellin@unipd.it. · Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padua, Italy. simone.mocellin@unipd.it. · Centro di Riferimento Regionale per il Melanoma, Ospedale S.M. Annunziata, Azienda USL Toscana Centro, Florence, Italy. · U.O.C. di Chirurgia Plastica Ricostruttiva e Centro Ustioni Policlinico, University of Bari, Bari, Italy. · Struttura Complessa Chirurgia Oncologica Melanoma - Istituto Nazionale Tumori Pascale, Napoles, Italy. · A.O.U.P. Paolo Giaccone, Dip. Discipline Chirurgiche, University of Palermo, Oncologiche e Stomatologiche - Sezione di Chirurgia Plastica, Palermo, Italy. · Chirurgia I - Ospedale San Martino, Genoa, Italy. · Chirurgia Generale 1, Ospedale Papa Giovanni XXIII, Bergamo, Italy. · UOC Chirurgia II Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. · Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy. · Dermatologic Surgery Division, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy. ·Ann Surg Oncol · Pubmed #29067603.

ABSTRACT: BACKGROUND AND PURPOSE: Approximately 20% of melanoma patients harbor metastases in non-sentinel nodes (NSNs) after a positive sentinel node biopsy (SNB), and recent evidence questions the therapeutic benefit of completion lymph node dissection (CLND). We built a nomogram for prediction of NSN status in melanoma patients with positive SNB. METHODS: Data on anthropometric and clinicopathological features of patients with cutaneous melanoma who underwent CLND after a positive SNB were collected from nine Italian centers. Multivariate logistic regression was utilized to identify predictors of NSN status in a training set, while model efficiency was validated in a validation set. RESULTS: Data were available for 1220 patients treated from 2000 through 2016. In the training set (n = 810), the risk of NSN involvement was higher when (1) the primary melanoma is thicker or (2) sited in the trunk/head and neck; (3) fewer nodes are excised and (4) more nodes are involved; and (5) the lymph node metastasis is larger or (6) is deeply located. The model showed high discrimination (area under the receiver operating characteristic curve 0.74, 95% confidence interval [CI] 0.70-0.79) and calibration (Brier score 0.16, 95% CI 0.15-0.17) performance in the validation set (n = 410). The nomogram including these six clinicopathological variables performed significantly better than five other previously published models in terms of both discrimination and calibration. CONCLUSIONS: Our nomogram could be useful for follow-up personalization in clinical practice, and for patient risk stratification while conducting clinical trials or analyzing their results.

22 Article Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study. 2018

Boada, Aram / Tejera-Vaquerizo, Antonio / Ribero, Simone / Puig, Susana / Moreno-Ramírez, David / Descalzo-Gallego, Miguel A / Fierro, María T / Quaglino, Pietro / Carrera, Cristina / Malvehy, Josep / Vidal-Sicart, Sergi / Bennássar, Antoni / Rull, Ramón / Alos, Llucìa / Requena, Celia / Bolumar, Isidro / Traves, Víctor / Pla, Ángel / Fernández-Figueras, María T / Ferrándiz, Carlos / Pascual, Iciar / Manzano, José L / Sánchez-Lucas, Marina / Giménez-Xavier, Pol / Ferrandiz, Lara / Nagore, Eduardo. ·Dermatology Department, Hospital Universitari Germans Trial i Pujol, Badalona, Universitat Autònoma de Barcelona, Spain. · Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain. · Medical Sciences Department, Section of Dermatology, University of Turin, Italy. · Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain. · Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Unidad de Investigación, Fundación Piel Sana, Academia Española de Dermatología, Madrid, Spain. · Nuclear Medicine Department, Hospital Clinic Barcelona, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Surgery Department, Hospital Clinic, Barcelona, Spain. · Pathology Department, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain. · Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Surgery Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Otorhinolaringology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Hospital Universitari Germans Trial i Pujol, Badalona, Spain. · Surgery Department, Hospital Universitari Germans Trial i Pujol, Badalona, Spain. · Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trial i Pujol, Badalona, Spain. · Grupo de Investigación, Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica, Hospital Universitario Virgen Macarena, Sevilla, Spain. ·Int J Cancer · Pubmed #28960289.

ABSTRACT: The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow-up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs. observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61-0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60-0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65-1.08; p = 0.165). SLN-negative patients had better 5- and 10-year MSS compared with SLN-positive patients (65.4 vs. 51.9% and 48.3 vs. 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups.

23 Article Prognostic role of histological regression in primary cutaneous melanoma: a systematic review and meta-analysis. 2018

Gualano, M R / Osella-Abate, S / Scaioli, G / Marra, E / Bert, F / Faure, E / Baduel, E S / Balagna, E / Quaglino, P / Fierro, M T / Siliquini, R / Ribero, S. ·Department of Public Health, University of Turin, Turin, Italy. · Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. · Department of Pathophysiology and Transplantation, Section of Dermatology, Fondazione IRCCS Ca Granda, University of Milan. ·Br J Dermatol · Pubmed #28386936.

ABSTRACT: The prognostic significance of histological regression in primary melanoma has been debated for many years. We aim to review the evidence to see how histological regression may affect prognosis. A systematic review was performed by searching in MEDLINE, Scopus and the Cochrane Library from 1 January 1966 to 1 August 2015. All studies reporting hazard ratios or data on survival and histological regression were included. Primary random-effects meta-analyses were used to summarize outcome measures. Heterogeneity was assessed using the χ

24 Article Clinicopathological predictors of recurrence in nodular and superficial spreading cutaneous melanoma: a multivariate analysis of 214 cases. 2017

Pizzichetta, Maria A / Massi, Daniela / Mandalà, Mario / Queirolo, Paola / Stanganelli, Ignazio / De Giorgi, Vincenzo / Ghigliotti, Giovanni / Cavicchini, Stefano / Quaglino, Pietro / Corradin, Maria T / Rubegni, Pietro / Alaibac, Mauro / Astorino, Stefano / Ayala, Fabrizio / Magi, Serena / Mazzoni, Laura / Manganoni, Maria Ausilia / Talamini, Renato / Serraino, Diego / Palmieri, Giuseppe / Anonymous1471021. ·Division of Oncology B, CRO Aviano National Cancer Institute, Via Franco Gallini 2, 33081, Aviano, Italy. pizzichetta@cro.it. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Department of Medical Oncology, National Institute for Cancer Research, IRCCS San Martino, Genoa, Italy. · Skin Cancer Unit, Istituto Tumori Romagna (IRST), Meldola, Italy. · Department of Dermatology, University of Parma, Parma, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Clinic of Dermatology, IRCCS San Martino-IST, Genoa, Italy. · Department of Dermatology, Fondazione Ospedale Maggiore Policlinico IRCCS, Milan, Italy. · Dermatologic Clinic, Dept Medical Sciences, University of Torino, Turin, Italy. · Division of Dermatology, Pordenone Hospital, Pordenone, Italy. · Department of Dermatology, University of Siena, Siena, Italy. · Department of Dermatology, University of Padova, Padua, Italy. · Division of Dermatology, Celio Hospital, Rome, Italy. · National Cancer Institute, "Fondazione G. Pascale"-IRCCS, Naples, Italy. · Department of Dermatology, ASST degli Spedali Civili di Brescia, Brescia, Italy. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Sassari, Italy. ·J Transl Med · Pubmed #29115977.

ABSTRACT: BACKGROUND: Nodular melanoma (NM) accounts for most thick melanomas and because of their frequent association with ulceration, fast growth rate and high mitotic rate, contribute substantially to melanoma-related mortality. In a multicentric series of 214 primary melanomas including 96 NM and 118 superficial spreading melanoma (SSM), histopathological features were examined with the aim to identify clinicopathological predictors of recurrence. METHODS: All consecutive cases of histopathologically diagnosed primary invasive SSM and NM during the period 2005-2010, were retrieved from the 12 participating Italian Melanoma Intergroup (IMI) centers. Each center provided clinico-pathological data such as gender, age at diagnosis, anatomical site, histopathological conventional parameters, date of excision and first melanoma recurrence. RESULTS: Results showed that NM subtype was significantly associated with Breslow thickness (BT) at multivariate analysis: [BT 1.01-2 mm (OR 7.22; 95% CI 2.73-19.05), BT 2.01-4 mm (OR 7.04; 95% CI 2.54-19.56), and BT > 4 mm (OR 51.78; 95% CI 5.65-474.86) (p < 0.0001)]. Furthermore, mitotic rate (MR) was significantly correlated with NM histotype: [(MR 3-5 mitoses/mm CONCLUSIONS: We found that NM subtype was significantly associated with higher BT and MR but it was not a prognostic factor since it did not significantly correlate with melanoma recurrence rate. Conversely, increased BT and MR as well as SNLB positivity were significantly associated with a higher risk of melanoma recurrence.

25 Article Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients. 2017

Ribero, Simone / Osella Abate, Simona / Pasquali, Sadro / Rossi, Carlo Riccardo / Borgognoni, Lorenzo / Piazzalunga, Dario / Solari, Nicola / Schiavon, Mauro / Brandani, Paola / Ansaloni, Luca / Ponte, Erica / Silan, Francesco / Sommariva, Antonio / Bellucci, Francesco / Macripò, Giuseppe / Quaglino, Pietro / Anonymous6940913. ·Dermatologic Clinic, Medical Sciences Department, University of Turin, Turin, Italy. ·Dermatology · Pubmed #28738392.

ABSTRACT: OBJECTIVES: This study was aimed at investigating the prognostic role of multiple lymph node basin drainage (MLBD) in patients with positive sentinel lymph node (SLN) biopsy. BACKGROUND: MLBD is frequently observed in patients with trunk melanoma undergoing SLN. The prognostic value of MLBD in SLN-positive patients is still debated. METHODS: Retrospective data from 312 trunk melanoma patients with positive SLN biopsy (1991-2012) at 6 Italian referral centres were gathered in a multicentre database. MLBD was defined at preoperative lymphoscintigraphy. Clinical and pathological data were analysed for their association with disease-free interval (DFI) and disease-specific (DSS) survival. RESULTS: MLBD was identified in 34.6% of patients (108/312) and was significantly associated with >1 positive SLN (37 vs. 15.2%; p < 0.001) and with >1 positive lymph node (LN) after complete lymph node dissection (CLND) (50.9 vs. 34.8%; p = 0.033). No differences were observed according to drainage pattern in patients who had negative and positive non-SLN at CLND. MLBD was not associated with either DFI or DSS. Multivariate analyses showed that tumour thickness, ulceration, and number of metastatic LNs were associated with worse DFI and DSS, while regression confirmed its protective role in survival. CONCLUSION: In positive SLN patients, MLBD has no association with survival, which is mainly related to American Joint Committee on Cancer (AJCC) prognostic factors. Since the overall number of positive LNs drives the prognosis, the importance of a CLND in all the positive basins is confirmed.

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