Search Results for: Valutazione e gestione del Melanoma

This cost-effectiveness analysis compares costs and health effects of 3-dimensional total-body photography and sequential digital dermoscopy imaging vs usual care for early detection of melanoma.

Total-body photography (TBP) has been used by dermatologists for approximately 40 years to enhance melanoma screening efforts. Advances in noninvasive skin imaging technology hold promise for improving melanoma outcomes by enhancing early detection, decreasing the number of benign lesions biopsied, and even reducing the cost of care. However, that promise remains theoretical unless the technology is subject to rigorous evaluation, ideally in the form of a clinical trial.

Modificata la piattaforma di monitoraggio dei nuovi farmaci

I delegati si riuniranno martedì a Ginevra per perfezionare il testo e dare la loro approvazione definitiva

Il 15 aprile, parte dell’incasso alla Fondazione Melanoma

Background
Sweden has one of the highest incidence rates of cutaneous melanoma globally, and the incidence is rapidly increasing. Melanoma mortality is linked to the thickness of the primary tumour, with thicker melanomas having a poorer prognosis. Thin invasive melanomas (≤1.0 mm Breslow thickness) have excellent prognosis. Traditionally, the surgical approach for melanoma involves a two-step procedure of a diagnostic excision followed by a wide local excision (WLE) with 10 mm clinical margins. The WLE aims to remove potential microsatellites and residual melanoma, which in theory would prevent loco-regional recurrence and could improve survival. However, recent research questions the necessity of WLE for thin invasive melanomas, given their favourable prognosis, minimal risk of microsatellitosis and low rates of residual melanoma found in WLE tissue specimens.

Methods and analysis
This multicentre, non-inferiority, randomised controlled trial seeks to enrol 2486 patients with thin invasive melanomas that are completely excised with ≥1.5 mm histopathological margins following the diagnostic excision. Patients will be randomly assigned to either a control group that will undergo a WLE with 10 mm clinical margins according to current clinical routine or an experimental group without a WLE. The primary and secondary endpoints are recurrence-free survival at 5 and 10 years, respectively, with tertiary aims including postoperative complications, scar quality, patient satisfaction and quality of life, healthcare resource utilisation as well as differences in biomarkers of recurrent and non-recurrent melanomas. Patients will be assessed at clinical follow-up visits at 3 months as well as at 1, 2, 3, 5 and 10 years.

Ethics and dissemination
Approval of this study was obtained from the Swedish Ethical Review Authority (2024-03274-01). The findings of the study will be presented at international scientific meetings and published in peer-reviewed academic journals.

Trial registration number
NCT06363591.

This case report describes a light pink plaque underneath an atrophied and broken nail plate that was surrounded by depigmentation.

Immunotherapy stands as one of the most transformative breakthroughs in modern cancer treatment. These innovative therapies target signaling pathways used by cancer cells to induce T-cell exhaustion at immune checkpoints, allowing the cancer to evade immune detection. In the last 10 years, immune checkpoint inhibitors have achieved long-lasting responses and, in some cases, even cures for cancers that once had poor prognoses. However, the journey to proving the efficacy of immunotherapy in breast cancer has been anything but straightforward. It took 8 years after the initial approval of an immune checkpoint inhibitor for melanoma before breast cancer saw its first approval in 2019, when atezolizumab received an indication for metastatic triple-negative breast cancer (TNBC) based on the IMpassion130 trial. Shortly thereafter, the US Food and Drug Administration granted approval to pembrolizumab for metastatic TNBC, fueling optimism that patients with this aggressive form of cancer were on the cusp of reaping vast benefits from immune-based therapies. Yet excitement gave way to uncertainty following the negative results of IMpassion131, leading to the voluntary withdrawal of atezolizumab’s indication for TNBC. Although pembrolizumab remained in play, confidence in immune therapy for breast cancer had been shaken.

Ok alla rimborsabilità negli stadi iniziali della malattia, può aumentare le guarigioni

Objectives
A previous cohort study of male Norwegian Navy submariners showed higher overall cancer incidence and lower all-cause mortality than the general Norwegian population. We have extended the follow-up and show more precise estimates through seven decades.

Design
Historical cohort study using outcome data from Norwegian cancer incidence and cause-of-death registries.

Setting
Linkage with the outcome registries was performed by means of unique national identification numbers given to all Norwegian citizens.

Participants
2663 military men who ever served aboard a Navy submarine between 1942 and 2005.

Outcome measures
Standardised incidence ratios for cancer and mortality ratios were calculated from national period-specific, gender-specific and age-specific rates. Poisson regression was used to compare cancer incidence in groups with different length of submarine service ( >2 years vs ≤2 years).

Results
The overall cancer incidence was 15% higher than expected from the national rates, with colon, lung, skin (melanoma and non-melanoma) and urinary tract contributing 90% of the excess number of cases. Most of the excess was confined to those with shorter-time service, who also showed elevated risk of alcohol-related cancers. Excess non-melanoma skin cancer was most clearly seen among submariners with >2 years of service. Mortality from all causes combined was lower among submariners than in the general population, due to a markedly low mortality from non-neoplastic diseases and external causes.

Conclusions
Increased risk of non-melanoma skin cancer was found among submariners with long-term service, and skin exposure to carcinogens in petroleum products was hypothesised as an explanation. Less support for occupational risks was found for other cancers, although the lack of specific exposure data and limited statistical power reduced the possibility of identifying such associations. A ‘healthy soldier effect’ appeared in the mortality data, mainly restricted to low mortality from non-neoplastic diseases and external causes.

New England Journal of Medicine, Volume 392, Issue 12, Page 1245-1246, March 27, 2025.