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Melanoma: HELP
Articles by Ignazio Stanganelli
Based on 44 articles published since 2008
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Between 2008 and 2019, I. Stanganelli wrote the following 44 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Spitz/Reed nevi: proposal of management recommendations by the Dermoscopy Study Group of the Italian Society of Dermatology (SIDeMaST). 2014

Broganelli, P / Titli, S / Lallas, A / Alaibac M Annetta, A / Battarra, V / Brunetti, B / Castagno, I / Cavicchini, S / Ferrari, A / Ghigliotti, G / Landi, C / Manganoni, A / Moscarella, E / Pellacani, G / Pizzichetta, M A / Rosina, P / Rubegni, P / Satta, R / Scalvenzi, M / Stanganelli, I / Stinco, G / Zalaudek, I / Zampieri, P / Argenziano, G / Anonymous1410806. ·Department of Oncology and Hematology, Section of Dermatology, City of Health and Science Hospital of Turin, Turin, Italy - paolobroganelli@inwind.it. ·G Ital Dermatol Venereol · Pubmed #25213387.

ABSTRACT: -- No abstract --

2 Review Anti-hypertensive drugs and skin cancer risk: a review of the literature and meta-analysis. 2018

Gandini, Sara / Palli, Domenico / Spadola, Giuseppe / Bendinelli, Benedetta / Cocorocchio, Emilia / Stanganelli, Ignazio / Miligi, Lucia / Masala, Giovanna / Caini, Saverio. ·Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. · Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy. · Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. · Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. · Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: s.caini@ispo.toscana.it. ·Crit Rev Oncol Hematol · Pubmed #29458778.

ABSTRACT: INTRODUCTION: Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). METHODS: We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. RESULTS: Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07-1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05-1.40), with acceptable between-studies heterogeneity (I CONCLUSION: Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations.

3 Review Vitamin D status and risk for malignant cutaneous melanoma: recent advances. 2017

Ombra, Maria N / Paliogiannis, Panagiotis / Doneddu, Valentina / Sini, Maria C / Colombino, Maria / Rozzo, Carla / Stanganelli, Ignazio / Tanda, Francesco / Cossu, Antonio / Palmieri, Giuseppe. ·aInstitute of Food Sciences, National Research Council (CNR), Avellino bDepartment of Surgical, Microsurgical and Medical Sciences, University of Sassari cInstitute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari dRomagna Scientific Institute for the Study and Cure of Tumors, Skin Cancer Unit, Meldola, Italy. ·Eur J Cancer Prev · Pubmed #28125434.

ABSTRACT: Cutaneous malignant melanoma, whose incidence is increasing steadily worldwide, is the result of complex interactions between individual genetic factors and environmental risk factors. Ultraviolet radiation represents the most important environmental risk factor for the development of skin cancers, including melanoma. Sun exposure and early sunburn during childhood are the principal causes of cutaneous melanoma insurgence in adults, with double the risk relative to a nonexposed population. Consequently, ultraviolet protection has long been recognized as an important measure to prevent such a malignancy. Biological and epidemiological data suggest that vitamin D status could affect the risk of cancer and play a role in cancer prevention by exerting antiproliferative effects. Solar radiations are critical for vitamin D synthesis in humans; however, uncontrolled and intensive sun exposure is dangerous to skin health and may contribute toward the development of cutaneous malignant melanoma. An optimum balance between sun protection and exposure is thus advocated. Additional research is required to confirm the preventive role of vitamin D in melanoma incidence or a positive influence on patient outcome.

4 Review Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: a comprehensive review and meta-analysis. 2014

Caini, Saverio / Boniol, Mathieu / Tosti, Giulio / Magi, Serena / Medri, Matelda / Stanganelli, Ignazio / Palli, Domenico / Assedi, Melania / Marmol, Veronique Del / Gandini, Sara. ·Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy. Electronic address: s.caini@ispo.toscana.it. · International Prevention Research Institute, Lyon, France. · Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy. · Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. · Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy. · Department of Dermatology. Hopital Erasme. Université Libre de Bruxelles, Brussels, Belgium. · Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. ·Eur J Cancer · Pubmed #25087185.

ABSTRACT: Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60-3.53) and 1.64 (95% CI 1.02-2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63-1.13) for CM and 1.03 (95% CI 0.95-1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.

5 Review Dermoscopy, confocal laser microscopy, and hi-tech evaluation of vascular skin lesions: diagnostic and therapeutic perspectives. 2012

Grazzini, Marta / Stanganelli, Ignazio / Rossari, Susanna / Gori, Alessia / Oranges, Teresa / Longo, Anna Sara / Lotti, Torello / Bencini, Pier Luca / De Giorgi, Vincenzo. ·Department of Dermatology, University of Florence, Firenze, Italy. ·Dermatol Ther · Pubmed #22950556.

ABSTRACT: Vascular skin lesions comprise a wide and heterogeneous group of malformations and tumors that can be correctly diagnosed based on natural history and physical examination. However, considering the high incidence of such lesions, a great number of them can be misdiagnosed. In addition, it is not so rare that an aggressive amelanotic melanoma can be misdiagnosed as a vascular lesion. In this regard, dermoscopy and confocal laser microscopy examination can play a central role in increasing the specificity of the diagnosis of such lesions. In fact, the superiority of these tools over clinical examination has encouraged dermatologists to adopt these devices for routine clinical practice, with a progressive spread of their use. In this review, we will go through the dermoscopic and the confocal laser microscopy of diagnosis of most frequent vascular lesions (i.e., hemangiomas angiokeratoma, pyogenic granuloma, angiosarcoma) taking into particular consideration the differential diagnosis with amelanotic melanoma.

6 Article Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy. 2019

Peccerillo, Francesca / Mandel, Victor Desmond / Di Tullio, Francesca / Ciardo, Silvana / Chester, Johanna / Kaleci, Shaniko / de Carvalho, Nathalie / Del Duca, Ester / Giannetti, Luca / Mazzoni, Laura / Nisticò, Steven Paul / Stanganelli, Ignazio / Pellacani, Giovanni / Farnetani, Francesca. ·Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Division of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. · Skin Cancer Unit, Scientific Institute of Romagna for the Study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy. · Dermatology Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy. · Department of Dermatology, University of Parma, Parma, Italy. · Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy, farnetani.francesca@gmail.com. ·Dermatology · Pubmed #30404078.

ABSTRACT: BACKGROUND: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. OBJECTIVES: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). METHODS: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. RESULTS: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). CONCLUSIONS: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.

7 Article Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy. 2018

Persechino, Flavia / De Carvalho, Nathalie / Ciardo, Silvana / De Pace, Barbara / Casari, Alice / Chester, Johanna / Kaleci, Shaniko / Stanganelli, Ignazio / Longo, Caterina / Farnetani, Francesca / Pellacani, Giovanni. ·Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy. · Skin Cancer Unit Scientific Institute of Romagna for The study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy. · Skin Cancer Unit, IRCCS Santa Maria Nuova, Reggio Emilia, Italy. ·Exp Dermatol · Pubmed #29274094.

ABSTRACT: Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging. Reflectance confocal microscopy (RCM) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already-described RCM features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of LM/LMM compared to non-melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus-like keratosis resulted better distinguishable from LM/LMM because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (PAK) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for PAK 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between PAK and LM/LMM at RCM analysis.

8 Article Dermoscopy and confocal microscopy for metachronous multiple melanomas: morphological, clinical, and molecular correlations. 2018

Colombino, Maria / Paliogiannis, Panagiotis / Pagliarello, Calogero / Cossu, Antonio / Lissia, Amelia / Satta, Rosanna / Mazzoni, Laura / Magi, Serena / Sini, Maria Cristina / Manca, Antonella / Casula, Milena / Doneddu, Valentina / Palmieri, Giuseppe / Stanganelli, Ignazio. ·Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, 07100, Sassari, Italy. · Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy. · Dermatologic Unit, University of Parma, 43121 Parma, Italy. · Anatomic Pathology Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Via Matteotti 64, 07100, Sassari, Italy. · Dermatology Unit, Department of Clinical and Experimental Medicine, University of Sassari, V.le San Pietro 43, 07100, Sassari, Italy. · Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy. · Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy, Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy. ·Eur J Dermatol · Pubmed #29180316.

ABSTRACT: Cutaneous melanoma is one of the most frequent malignancies of the skin in Caucasian populations. Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. The estimated incidence of multiple primary melanoma (MPM) ranges from 1.2% to 8.2% of cases, with a high preponderance of melanomas occurring metachronously. The aim of this study was to describe dermoscopic, microscopic, clinical, and molecular correlations between first and subsequent melanomas in patients with metachronous MPMs. Twenty-four paired melanomas from 12 MPM patients were evaluated for architectural characteristics based on dermoscopy and confocal microscopy, as well as for mutations in BRAF and NRAS genes by Sanger-based sequencing analysis. Specific scores used for classifying features of dermoscopy (global pattern; 7-point check list; ABCD Stolz score) and confocal microscopy (Segura and Pellacani) were compared with genetic and histological data. Consistency in dermoscopic patterns between the primary and subsequent cutaneous melanomas were observed in about two thirds of cases, whereas concordant features based on confocal microscopy were found in only about two fifths of cases. The majority of patients (7/12; 58%) presented consistent BRAF/NRAS mutation patterns between first and subsequent primary melanomas. A significant association between BRAF mutations and Pellacani score was evident. Similarities between the index melanoma and subsequent cutaneous melanomas were observed with regards to dermoscopic features and, to a much less extent, confocal microscopy findings. Our data further indicate that the Pellacani score may be used to predict BRAF mutations.

9 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.

10 Article Atopic dermatitis, naevi count and skin cancer risk: A meta-analysis. 2016

Gandini, Sara / Stanganelli, Ignazio / Palli, Domenico / De Giorgi, Vincenzo / Masala, Giovanna / Caini, Saverio. ·Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. Electronic address: sara.gandini@ieo.it. · Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. Electronic address: igstanga@tin.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: d.palli@ispo.toscana.it. · Department of Dermatology, University of Florence, Florence, Italy. Electronic address: vincenzo.degiorgi@unifi.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: g.masala@ispo.toscana.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: s.caini@ispo.toscana.it. ·J Dermatol Sci · Pubmed #27461758.

ABSTRACT: BACKGROUND: The risk of skin malignancy among atopic dermatitis (AD) patients is not well established. OBJECTIVE: We reviewed the epidemiological evidence on the association between AD, naevi count, and the risk of cutaneous melanoma and keratinocyte skin cancer (KSC). METHODS: We included all studies that compared the naevi count and the risk of skin cancer (melanoma and/or KSC) between AD patients and unaffected individuals. We calculated summary relative risks (SRRs) and 95% confidence intervals (CI) through random effects models; explored correlates of between-studies heterogeneity using sub-group and sensitivity analysis; and assessed publication bias using a funnel-plot-based approach. RESULTS: The number of common naevi larger ≥2mm on the whole body was consistently lower among AD patients vs. unaffected individuals when measured by trained health professionals. The risk of melanoma was not increased among AD patients (SRR=0.77, 95%CI 0.44-1.35, I CONCLUSIONS: AD patients may be at increased BCC risk; however, methodological limitations prevented from drawing definitive conclusions. Despite the lack of strong scientific evidence, AD patients should avoid excessive sun exposure, regularly perform skin self examination, and consult a doctor in case of a suspicious skin lesion.

11 Article Presurgical assessment of a melanoma during pregnancy based on dermoscopy and confocal laser microscopy. 2016

Stanganelli, Ignazio / Medri, Matelda / Tavaniello, Beatrice / Marengo, Mario / Mazzoni, Laura / Salfi, Nunzio C / Zannetti, Guido. ·Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Forlì-Cesena, Italy - matelda.medri@irst.emr.it. ·G Ital Dermatol Venereol · Pubmed #27348323.

ABSTRACT: -- No abstract --

12 Article Skin Cancer Diagnosis With Reflectance Confocal Microscopy: Reproducibility of Feature Recognition and Accuracy of Diagnosis. 2015

Farnetani, Francesca / Scope, Alon / Braun, Ralph P / Gonzalez, Salvador / Guitera, Pascale / Malvehy, Josep / Manfredini, Marco / Marghoob, Ashfaq A / Moscarella, Elvira / Oliviero, Margaret / Puig, Susana / Rabinovitz, Harold S / Stanganelli, Ignazio / Longo, Caterina / Malagoli, Carlotta / Vinceti, Marco / Pellacani, Giovanni. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Sheba Medical Center, Department of Dermatology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel3Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. · Internal Medicine Department, Alcala University, Madrid, Spain. · Melanoma Institute Australia, The University of Sydney, Sydney7Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia. · Melanoma Unit, Dermatology Department, Hospital Clinic and University of Barcelona, Institut de Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain9Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III. · Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. · Department of Dermatology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida. · Skin Cancer Unit-Istituto di Ricovero e Cura a Carattere Scientifico Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena, Italy. · Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. ·JAMA Dermatol · Pubmed #25993262.

ABSTRACT: IMPORTANCE: Reflectance confocal microscopy (RCM) studies have been performed to identify criteria for diagnosis of skin neoplasms. However, RCM-based diagnosis is operator dependent. Hence, reproducibility of RCM criteria needs to be tested. OBJECTIVE: To test interobserver reproducibility of recognition of previously published RCM descriptors and accuracy of RCM-based skin cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTS: Observational retrospective web-based study of a set of RCM images collected at a tertiary academic medical center. Nine dermatologists (6 of whom had ≥3 years of RCM experience) from 6 countries evaluated an RCM study set from 100 biopsy-proven lesions, including 55 melanocytic nevi, 20 melanomas, 15 basal cell carcinomas, 7 solar lentigines or seborrheic keratoses, and 3 actinic keratoses. Between June 15, 2010, and October 21, 2010, participanting dermatologists, blinded to histopathological diagnosis, evaluated 3 RCM mosaic images per lesion for the presence of predefined RCM descriptors. MAIN OUTCOMES AND MEASURES: The main outcome was identification of RCM descriptors with fair to good interrater agreement (κ statistic, ≥0.3) and independent correlation with malignant vs benign diagnosis on discriminant analysis. Additional measures included sensitivity and specificity for diagnosis of malignant vs benign for each evaluator, for majority diagnosis (rendered by ≥5 of 9 evaluators), and for experienced vs recent RCM users. RESULTS: Eight RCM descriptors showed fair to good reproducibility and were independently associated with a specific diagnosis. Of these, the presence of pagetoid cells, atypical cells at the dermal-epidermal junction, and irregular epidermal architecture were associated with melanoma. Aspecific junctional pattern, basaloid cords, and ulceration were associated with basal cell carcinomas. Ringed junctional pattern and dermal nests were associated with nevi. The mean sensitivity for the group of evaluators was 88.9% (range, 82.9%-100%), and the mean specificity was 79.3% (range, 69.2%-90.8%). Majority diagnosis showed sensitivity of 100% and specificity of 80.0%. Sensitivity was higher for experienced vs recent RCM users (91.0% vs. 84.8%), but specificity was similar (80.0% vs. 77.9%). CONCLUSIONS AND RELEVANCE: The study highlights key RCM diagnostic criteria for melanoma and basal cell carcinoma that are reproducibly recognized among RCM users. Diagnostic accuracy increases with experience. The higher accuracy of majority diagnosis suggests that there is intrinsically more diagnostic information in RCM images than is currently used by individual evaluators.

13 Article Pigmented nodular melanoma: the predictive value of dermoscopic features using multivariate analysis. 2015

Pizzichetta, M A / Kittler, H / Stanganelli, I / Bono, R / Cavicchini, S / De Giorgi, V / Ghigliotti, G / Quaglino, P / Rubegni, P / Argenziano, G / Talamini, R / Anonymous1690828. ·Division of Medical Oncology - Preventive Oncology, Centro di Riferimento Oncologico, National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy. · Department of Dermatology, University of Vienna, Vienna, Austria. · Skin Cancer Unit, Istituto Tumori Romagna (IRST), Meldola, Italy. · Istituto Dermopatico Immacolata, IRCCS, Rome, Italy. · Department of Dermatology, Fondazione Ospedale Maggiore Policlinico IRCCS, Milan, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Clinic of Dermatology, IRCCS San Martino - Ist, Genoa, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy. · Department of Dermatology, University of Siena, Siena, Italy. · Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. · Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy. ·Br J Dermatol · Pubmed #25916655.

ABSTRACT: BACKGROUND: Nodular melanoma (NM), representing 10-30% of all melanomas, plays a major role in global mortality related to melanoma. Nonetheless, the literature on dermoscopy of NM is scanty. OBJECTIVES: To assess odds ratios (ORs) to quantify dermoscopic features of pigmented NM vs. pigmented superficial spreading melanoma (SSM), and pigmented nodular nonmelanocytic and benign melanocytic lesions. METHODS: To assess the presence or absence of global patterns and dermoscopic criteria, digitized images of 457 pigmented skin lesions from patients with a histopathological diagnosis of NM (n = 75), SSM (n = 93), and nodular nonmelanocytic and benign melanocytic lesions (n = 289; namely, 39 basal cell carcinomas, 85 seborrhoeic keratoses, 81 blue naevi, and 84 compound/dermal naevi) were retrospectively collected and blindly evaluated by three observers. RESULTS: Multivariate analysis showed that ulceration (OR 4.07), homogeneous disorganized pattern (OR 10.76), and homogeneous blue pigmented structureless areas (OR 2.37) were significantly independent prognostic factors for NM vs. SSM. Multivariate analysis of dermoscopic features of NM vs. nonmelanocytic and benign melanocytic lesions showed that the positive correlating features leading to a significantly increased risk of NM were asymmetric pigmentation (OR 6.70), blue-black pigmented areas (OR 7.15), homogeneous disorganized pattern (OR 9.62), a combination of polymorphous vessels and milky-red globules/areas (OR 23.65), and polymorphous vessels combined with homogeneous red areas (OR 33.88). CONCLUSIONS: Dermoscopy may be helpful in improving the recognition of pigmented NM by revealing asymmetric pigmentation, blue-black pigmented areas, homogeneous disorganized pattern and abnormal vascular structures, including polymorphous vessels, milky-red globules/areas and homogeneous red areas.

14 Article Activating PIK3CA mutations coexist with BRAF or NRAS mutations in a limited fraction of melanomas. 2015

Manca, Antonella / Lissia, Amelia / Capone, Mariaelena / Ascierto, Paolo A / Botti, Gerardo / Caracò, Corrado / Stanganelli, Ignazio / Colombino, Maria / Sini, MariaCristina / Cossu, Antonio / Palmieri, Giuseppe. ·Institute of Biomolecular Chemistry, National Research Council (CNR), Traversa La Crucca 3 - Baldinca Li Punti, Sassari, 07100, Italy. gpalmieri@yahoo.com. ·J Transl Med · Pubmed #25627962.

ABSTRACT: BACKGROUND: Activated PI3K-AKT pathway may contribute to decrease sensitivity to inhibitors of key pathogenetic effectors (mutated BRAF, active NRAS or MEK) in melanoma. Functional alterations are deeply involved in PI3K-AKT activation, with a minimal role reported for mutations in PIK3CA, the catalytic subunit of the PI3K gene. We here assessed the prevalence of the coexistence of BRAF/NRAS and PIK3CA mutations in a series of melanoma samples. METHODS: A total of 245 tumor specimens (212 primary melanomas and 33 melanoma cell lines) was screened for mutations in BRAF, NRAS, and PIK3CA genes by automated direct sequencing. RESULTS: Overall, 110 (44.9%) samples carried mutations in BRAF, 26 (10.6%) in NRAS, and 24 (9.8%) in PIK3CA. All identified PIK3CA mutations have been reported to induce PI3K activation; those detected in cultured melanomas were investigated for their interference with the antiproliferative activity of the BRAF-mutant inhibitor vemurafenib. A reduced suppression in cell growth was observed in treated cells carrying both BRAF and PIK3CA mutations as compared with those presenting a mutated BRAF only. Among the analysed melanomas, 12/245 (4.9%) samples presented the coexistence of PIK3CA and BRAF/NRAS mutations. CONCLUSIONS: Our study further suggests that PIK3CA mutations account for a small fraction of PI3K pathway activation and have a limited impact in interfering with the BRAF/NRAS-driven growth in melanoma.

15 Article CDKN2A mutations could influence the dermoscopic pattern of presentation of multiple primary melanoma: a clinical dermoscopic genetic study. 2015

De Giorgi, V / Savarese, I / D'Errico, A / Gori, A / Papi, F / Colombino, M / Sini, M Cristina / Stanganelli, I / Palmieri, G / Massi, D. ·Division Dermatology, Dept. of Surgery and Translational Medicine, University of Florence, Florence, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #25200134.

ABSTRACT: BACKGROUND: Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. There are many aetiological reasons by which the risk of a second melanoma increases. Among others, genetic factors may contribute to modulating this risk. The risk of identifying a CDKN2A germline mutation increases with the number of primary melanomas and with the presence of familial history of melanoma. Patients with melanoma are especially encouraged to have regular follow-up visits with their dermatologist to perform clinical and dermatoscopic examination. In particular, dermoscopy could be very useful in multiple primary melanoma (MPM) patients. OBJECTIVES: To analyse the clinical and dermatoscopic features of multiple melanomas, focusing on those features that are more frequently found in the same patient to recognize them earlier and understand whether they appear with the similar peculiar dermatoscopic features, especially in CDKN2A carriers. METHODS: Medical records of MPM patients were selected from a database including 1065 patients with histopathologically proven melanoma diagnosis, all treated at the dermatology clinic of the University of Florence from 2000 to 2013. Pictures of melanoma were independently and blindly administered to three dermatologist experts in dermoscopy to evaluate the presence or absence of ABCD criteria for each clinical image, and the main pattern for the dermoscopic images. The results were then analyzed and crossed to rate the clinical and dermoscopic features of MPM. RESULTS: Seventy five (7.0%) of 1065 patients included in our database were found to carry an MPM disease. Among them, we selected 12 (16%) patients with three or more MPMs. The presence of the CDKN2A melanoma susceptibility gene was observed in 4/12 (33.33%) patients; two patients presented the C500G and c.5 + 1delG polymorphisms in the CDKN2A gene. In CDKN2A carriers, each patient showed a similar and specific dermatoscopic pattern in their lesions. CONCLUSIONS: Even being aware of the limitations of this study, according to hereditary characters and their modes of transmissions, we could speculate that for each patient with a CDKN2A germline mutation, it is possible to find the same kind of dermoscopical pattern among their melanocytic tumours.

16 Article Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy. 2015

Stanganelli, I / Longo, C / Mazzoni, L / Magi, S / Medri, M / Lanzanova, G / Farnetani, F / Pellacani, G. ·Skin Cancer Unit, IRCCS IRST, Istituto Scientifico Romagnolo per lo Studio e la Cura Tumori, Meldola, FC, Italy. ·Br J Dermatol · Pubmed #25154446.

ABSTRACT: BACKGROUND: Successful treatment of melanoma depends on early diagnosis, but its varied clinical presentation means that no single noninvasive method or criterion can provide reliable detection in all cases. OBJECTIVES: To determine whether combining sequential dermoscopy imaging with reflectance confocal microscopy (RCM) can improve melanoma detection and reduce the burden of unnecessary excisions. METHODS: We conducted a retrospective study with median follow-up of 25 months. We included equivocal pigmented lesions that lacked clear dermoscopy criteria for melanoma at baseline but were excised subsequently because of changes during digital monitoring. RCM imaging was performed before excision. Main melanoma dermoscopy features, seven-point checklist score at baseline, and changes in structure and/or colour, and development of new melanoma-specific criteria at follow-up (scored as major, moderate or minor) were considered. Main melanoma RCM criteria were evaluated and diagnosis was made. Histopathological diagnosis was the reference standard for defining parameter frequency and diagnostic accuracy. RESULTS: Seventy lesions were included. Major changes were more frequently correlated with melanoma diagnosis, although one-third (four of 12) of melanomas showed moderate or minor changes. Cytological atypia and architectural disarrangement on RCM were correlated with melanoma diagnosis. A correct melanoma diagnosis was achieved with RCM in almost all cases (11 of 12, 92%). Referring for excision only those lesions with RCM-positive features and/or presenting major changes at digital dermoscopy follow-up, theoretically 27 of 58 naevi could be saved from surgery. CONCLUSIONS: Integration of RCM in the clinical and instrumental strategy for managing difficult pigmented lesions provided additional diagnostic information useful in the decision-making process.

17 Article Follow-up of cutaneous melanoma patients: a proposal for standardization. 2014

Moscarella, E / Ricci, C / Borgognoni, L / Bottoni, U / Catricalà, C / Dika, E / Fanti, P A / Landi, C / Manganoni, A M / Pellacani, G / Peris, K / Pimpinelli, N / Quaglino, P / Richetta, A / Simonetti, V / Stanganelli, I / Testori, A / Zalaudek, I / Argenziano, G. ·Dermatology and Skin Cancer Unit Arcispedale S. Maria Nuova, IRCCS Reggio Emilia, Italy - g.argenziano@gmail.com. ·G Ital Dermatol Venereol · Pubmed #24938723.

ABSTRACT: -- No abstract --

18 Article Discrepant alterations in main candidate genes among multiple primary melanomas. 2014

Colombino, Maria / Sini, MariaCristina / Lissia, Amelia / De Giorgi, Vincenzo / Stanganelli, Ignazio / Ayala, Fabrizio / Massi, Daniela / Rubino, Corrado / Manca, Antonella / Paliogiannis, Panagiotis / Rossari, Susanna / Magi, Serena / Mazzoni, Laura / Botti, Gerardo / Capone, Mariaelena / Palla, Marco / Ascierto, Paolo A / Cossu, Antonio / Palmieri, Giuseppe / Anonymous180796. ·Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR) - Traversa La Crucca 3, Baldinca Li Punti, 07100 Sassari, Italy. gpalmieri@yahoo.com. ·J Transl Med · Pubmed #24885594.

ABSTRACT: BACKGROUND: Alterations in key-regulator genes of disease pathogenesis (BRAF, cKIT, CyclinD1) have been evaluated in patients with multiple primary melanoma (MPM). METHODS: One hundred twelve MPM patients (96 cases with two primary melanomas, 15 with three, and 1 with four) were included into the study. Paired synchronous/asynchronous MPM tissues (N=229) were analyzed for BRAF mutations and cKIT/CyclynD1 gene amplifications. RESULTS: BRAF mutations were identified in 109/229 (48%) primary melanomas, whereas cKIT and CyclinD1 amplifications were observed in 10/216 (5%) and 29/214 (14%) tumor tissues, respectively. While frequency rates of BRAF mutations were quite identical across the different MPM lesions, a significant increase of cKIT (p<0.001) and CyclinD1 (p=0.002) amplification rates was observed between first and subsequent primary melanomas. Among the 107 patients with paired melanoma samples, 53 (49.5%) presented consistent alteration patterns between first and subsequent primary tumors. About one third (40/122; 32.8%) of subsequent melanomas presented a discrepant pattern of BRAF mutations as compared to incident primary tumors. CONCLUSIONS: The low consistency in somatic mutation patterns among MPM lesions from same patients provides further evidence that melanomagenesis is heterogeneous and different cell types may be involved. This may have implications in clinical practice due to the difficulties in molecularly classifying patients with discrepant primary melanomas.

19 Article Melanoma detection in Italian pigmented lesion clinics. 2014

Argenziano, G / Moscarella, E / Annetta, A / Battarra, V C / Brunetti, B / Buligan, C / Cantisani, C / Capizzi, R / Carbone, A / Carlino, A / Corsetti, V / Damiano, A / De Salvo, V / De Simone, P / Di Caterino, P / Fargnoli, M C / Ferrari, A / Fossati, B / Frascione, P / Ghigliotti, G / González Inchaurraga, M A / Guerriero, C / Landi, C / Mazzoni, L / Mirizzi, S / Palazzo, G / Pedretti, A / Peris, K / Piemonte, P / Rossi, A / Satta, R / Savoia, F / Scalvenzi, M / Stanganelli, I / Stinco, G / Zampieri, P / Zalaudek, I. ·Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia, Italy - g.argenziano@gmail.com. ·G Ital Dermatol Venereol · Pubmed #24819635.

ABSTRACT: AIM: Accuracy in melanoma detection is important to recognize early curable melanomas and to minimize the unnecessary excision of benign lesions. The aim of this paper was to evaluate melanoma screening accuracy of Italian pigmented lesion clinics in terms of number needed to excise (NNE), melanoma thickness, and number of melanomas diagnosed during patient follow-up. METHODS: Information on all skin tumors excised in 2011 were extracted from the databases of the participating centers. Information whether the lesion was excised at the baseline examination or during patient follow-up was recorded, as well as the overall number of patients examined in each center in 2011. RESULTS: After e-mail solicitation, 22 of 40 centers agreed to participate. A total of 8229 excised lesions were collected. The overall number of examined patients was 86.564, thus 9.5% of screened patients had a lesion removed. Of the excised lesions, 866 were diagnosed as melanoma (1% of examined patients) and 5311 (88.9%) were melanocytic nevi. Three NNE were calculated giving values of 7.9 excised lesions to find 1 melanoma, 7.1 melanocytic lesions to find 1 melanoma, and 3.7 lesions to find 1 skin malignancy. The median melanoma thickness was 0.6 mm, with only 15.1% of melanomas ≥ 1 mm of thickness. Melanomas detected over time were 96 (11.1%; mean thickness, 0.3 mm), with 15.6% of lesions excised after short-term follow-up and 84.4% after long-term follow-up. CONCLUSION: The NNE values comparable to those achieved in specialized clinical settings and the high number of early melanomas diagnosed at the baseline examination or during patient follow-up indicate a high level of accuracy in melanoma screening achieved by Italian pigmented lesion clinics.

20 Article Melanoma attributable to sunbed use and tan seeking behaviours: an Italian survey. 2014

Gandini, Sara / Stanganelli, Ignazio / Magi, Serena / Mazzoni, Laura / Medri, Matelda / Agnoletti, Veronica / Lombi, Linda / Falcini, Fabio. ·Division of Epidemiology, Biostatistics, European Institute of Oncology, Milan, Italy. · Skin Cancer Unit IRCCS IRST, Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori, Meldola (FC), Italy. · Centro di Studi Avanzati sull'Umanizzazione, delle Cure e sulla Salute Sociale University of Bologna, Italy. · Tumour Registry Romagna IRCCS IRST, Meldola FC, Italy. ·Eur J Dermatol · Pubmed #24334101.

ABSTRACT: Melanoma is the most deadly form of skin cancer and its incidence is increasing worldwide. In 2009, the International Agency for Research on Cancer classified the entire UV spectrum as carcinogenic. In many countries, including Italy, the use of tanning equipment by minors and individuals with high risk phenotypes has been banned. This study assessed tan-seeking behaviour in a Mediterranean population with a relatively high melanoma incidence, where a considerable time is spent tanning outdoors. Subjects spending the most time in the sun were typically young single men, who use significantly less sunscreen and sunglasses. The overall prevalence of sunbed use was 22% in youth (≤35 years old) and 18% of them used sunbeds throughout the year. Sunbed use in youth was greater for phenotypes at risk. In Italy, 3.8% of melanoma cases are attributable to sunbed use, more in women (4.2% vs 3.1%, for women and men respectively) and much more in the young (17%). Of 8013 new melanoma cases in 2008 in Italy, 293 were attributable to sunbed use, with a high proportion of these in women (168) and 1045 were attributable to sun exposure. Among youth, 172 cases were attributable to sunbed use and 140 exclusively to sunbed use. This analysis reveals that a large number of cancers each year in Italy could be avoided by changing cultural attitudes to tanning. Sun avoidance and protection is generally inadequate in adults, especially young men. These results have important implications for the primary prevention of melanoma.

21 Article Dermoscopy of acral melanoma: a multicenter study on behalf of the international dermoscopy society. 2013

Braun, Ralph P / Thomas, L / Dusza, S W / Gaide, O / Menzies, S / Dalle, S / Blum, A / Argenziano, G / Zalaudek, I / Kopf, A / Rabinovitz, H / Oliviero, M / Perrinaud, A / Cabo, H / Pizzichetta, M / Pozo, L / Langford, D / Tanaka, M / Saida, T / Perusquia Ortiz, A M / Kreusch, J / De Giorgi, V / Piccolo, D / Grichnik, J M / Kittler, H / Puig, S / Malvehy, J / Seidenari, S / Stanganelli, I / French, L / Marghoob, A A. ·Department of Dermatology, University Hospital Zürich, Zürich, Switzerland. ·Dermatology · Pubmed #24296632.

ABSTRACT: BACKGROUND: Most studies on dermoscopy of acral lesions were conducted in Asian populations. In this study, we analyzed these features in a predominantly Caucasian population. OBJECTIVE: Estimate the prevalence of dermoscopic features in acral lesions, and assess their level of agreement between observers. METHODS: In this retrospective multicenter study, 167 acral lesions (66 melanomas) were evaluated for 13 dermoscopic patterns by 26 physicians, via a secured Internet platform. RESULTS: Parallel furrow pattern, bizarre pattern, and diffuse pigmentation with variable shades of brown had the highest prevalence. The agreement for lesion patterns between physicians was variable. Agreement was dependent on the level of diagnostic difficulty. CONCLUSION: Lesions with a diameter >1 cm were more likely to be melanoma. We found as well that a benign pattern can be seen in parts of melanomas. For this reason one should evaluate an acral lesion for the presence of malignant patterns first.

22 Article Heterogeneous distribution of BRAF/NRAS mutations among Italian patients with advanced melanoma. 2013

Colombino, Maria / Lissia, Amelia / Capone, Mariaelena / De Giorgi, Vincenzo / Massi, Daniela / Stanganelli, Ignazio / Fonsatti, Ester / Maio, Michele / Botti, Gerardo / Caracò, Corrado / Mozzillo, Nicola / Ascierto, Paolo A / Cossu, Antonio / Palmieri, Giuseppe. ·Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, Baldinca Li Punti 07100, Sassari, Italy. gpalmieri@yahoo.com. ·J Transl Med · Pubmed #23987572.

ABSTRACT: BACKGROUND: Prevalence and distribution of pathogenetic mutations in BRAF and NRAS genes were evaluated in multiple melanoma lesions from patients with different geographical origin within the same Italian population. METHODS: Genomic DNA from a total of 749 tumor samples (451 primary tumors and 298 metastases) in 513 consecutively-collected patients with advanced melanoma (AJCC stages III and IV) was screened for mutations in exon 15 of BRAF gene and, at lower extension (354/513; 69%), in the entire coding DNA of NRAS gene by automated direct sequencing. Among tissues, 236 paired samples of primary melanomas and synchronous or asynchronous metastases were included into the screening. RESULTS: Overall, mutations were detected in 49% primary melanomas and 51% metastases, for BRAF gene, and 15% primary tumors and 16% secondaries, for NRAS gene. A heterogeneous distribution of mutations in both genes was observed among the 451 primary melanomas according to patients' geographical origin: 61% vs. 42% (p = 0.0372) BRAF-mutated patients and 2% vs. 21% (p < 0.0001) NRAS-mutated cases were observed in Sardinian and non-Sardinian populations, respectively. Consistency in BRAF/NRAS mutations among paired samples was high for lymph node (91%) and visceral metastases (92.5%), but significantly lower for brain (79%; p = 0.0227) and skin (71%; p = 0.0009) metastases. CONCLUSIONS: Our findings about the two main alterations occurring in the different tumor tissues from patients with advanced melanoma may be helpful in improving the management of such a disease.

23 Article Follow-up of melanoma: a survey of Italian hospitals. 2013

Testori, Alessandro / Chiarion-Sileni, Vanna / Stanganelli, Ignazio / Rossi, Carlo Riccardo / Di Filippo, Franco / Ridolfi, Ruggero / Parmiani, Giorgio / Gandini, Sara / Soteldo, Javier. ·Divisione Melanoma e Sarcomi Muscolo-Cutanei, Istituto Europeo di Oncologia, Milan, Italy. alessandro.testori @ ieo.it ·Dermatology · Pubmed #23736269.

ABSTRACT: Follow-up is managed internally in 94% of centers and is programmed according to international guidelines in 52% of high-volume hospitals (>25 melanoma diagnoses per year); the remainder use internal guidelines; fewer low-volume centers (≤ 25 diagnoses per year) have internal guidelines (25%, p = 0.001). Instrumental examinations for stage III and IV disease are similar, while the examination interval changes from 3/4 months for stage III to 2/3 months for stage IV, and use of PET/CT increases from 44 to 54%. Overall, thoracic and abdominal CT is used most for follow-up in stage III (83%), while bone scintigraphy is used more commonly in low-volume centers (41 vs. 19%, p = 0.003), despite similar use of PET/CT (48 vs. 41%). Brain CT or MRI is more common in high-volume centers (63 vs. 39%, p > 0.0001), as is echography of draining lymph nodes (71 vs. 52%, p = 0.01). Hepatic/abdominal echography and thoracic radiography are used in about 50% of centers, regardless of type. In stage IV, use of bone scintigraphy is similar among groups (ca. 40%); brain CT/NMR use increases from 51 to 64% and is more common in high-volume centers (p = 0.03). Lymph node echography is more common in high-volume centers (56 vs. 39%, p = 0.03).

24 Article Surgical treatment of melanoma: a survey of Italian hospitals. 2013

Testori, Alessandro / Chiarion-Sileni, Vanna / Stanganelli, Ignazio / Rossi, Carlo Riccardo / Di Filippo, Franco / Ridolfi, Ruggero / Parmiani, Giorgio / Gandini, Sara / Soteldo, Javier. ·Divisione Melanoma e Sarcomi Muscolo-Cutanei, Istituto Europeo di Oncologia, Milan, Italy. alessandro.testori @ ieo.it ·Dermatology · Pubmed #23736268.

ABSTRACT: Surgery is the first option for treating melanoma regardless of stage at presentation. We surveyed a representative sample of hospitals to evaluate management and quality of surgical indications for melanoma in Italy. At analysis, hospitals were grouped into high- or low-volume centers, with the population median of 25 diagnoses serving as the cut-off. Surgery for primary melanoma was similar between hospital groups. More high-volume centers were organized to perform sentinel node biopsy (91 vs. 56%). There were no major differences between high- and low-volume centers concerning the surgical approach to stage III and IV disease.

25 Article Diagnostic and therapeutic approaches in Italian hospitals: adjuvant and metastatic therapy in melanoma. 2013

Chiarion-Sileni, Vanna / Guida, Michele / Romanini, Antonella / Bernengo, Maria Grazia / Ascierto, Paolo / Queirolo, Paola / Mandalà, Mario / Maio, Michele / Ferraresi, Virginia / Stanganelli, Ignazio / Testori, Alessandro / Ridolfi, Ruggero. ·Melanoma and Skin Cancer Unit, Veneto Oncology Institute, IRCCS, Padua, Italy. mgaliz @ tiscali.it ·Dermatology · Pubmed #23736267.

ABSTRACT: Melanoma incidence and mortality rates are rising in Italy, indicating that more effective treatments are required both in the adjuvant and metastatic settings. We analyzed clinical practices in the adjuvant and metastatic settings by conducting a nationwide survey of clinicians responsible for managing melanoma treatment and follow-up in a representative sample of Italian hospitals. 95% of participating hospitals completed the panel of questions on adjuvant and metastatic treatment, making it likely that these results give a realistic picture of treatment and follow-up of melanoma patients in Italy. In low-volume hospitals (<25 new melanoma diagnoses yearly) adjuvant therapy was significantly more used than in large-volume hospitals for patients in stage III and IV (82 versus 66% and 56 versus 30%, respectively), and only 11% of patients were enrolled in clinical trials. In the metastatic setting dacarbazine was the preferred first-line treatment (32%) followed by polychemotherapy (23%); 12% of patients were enrolled in clinical trials and less than 10% received interleukin-2, usually subcutaneously. The information provided by this study was used by the Italian Melanoma Intergroup to improve the quality of care and to redirect financial resources.

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