Real-world data on melanoma brain metastases and survival outcome

xlomafota13 shared this article with you from Inoreader Real-world data on melanoma brain metastases and survival outcome Via Melanoma Research - Published Ahead-of-Print Introduction Novel medical therapies have revolutionized outcome for patients with melanoma. However, patients with melanoma brain metastases (MBM) still have poor survival. Data are limited as these patients are generally excluded from clinical trials, wherefore real-world data on clinical outcome may support evidence-based treatment choices for patients with MBM. Methods Patients diagnosed with MBM between 2008 and 2020 were included retrospectively. Patient characteristics, treatment, and outcome data were recorded from The Danish Metastatic Melanoma Database, pathology registries, electronic patient files, and radiation plans. Anti-programmed cell death protein 1 antibodies and the combination of BRAF/MEK-inhibitors were introduced in Denmark in 2015, and the cohort was split accordingly for comparison. Results A total of 527 patients were identified; 148 underwent surgical excision of MBM, 167 had stereotactic radiosurgery (SRS), 270 received whole-brain radiation therapy (WBRT), and 343 received systemic therapies. Median overall survival (mOS) for patients diagnosed with MBM before and after 2015 was 4.4 and 7.6 months, respectively. Patients receiving surgical excision as first choice of treatment had the best mOS of 10.9 months, whereas patients receiving WBRT had the worst outcome (mOS, 3.4 months). Postoperative SRS did not improve survival or local control after surgical excision of brain metastases. Of the 40 patients alive >3 years after diagnosis of MBM, 80% received immunotherapy at some point after diagnosis. Patients with meningeal carcinosis did not benefit from treatment with CPI. Conclusion Outcome for patients with MBM has significantly improved after 2015, but long-term survivors are rare. Most patients alive >3 years after diagnosis of MBM received immunotherapy. Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Received 2 November 2021 Accepted 13 February 2022 Correspondence to Eva Ellebaek, MD, PhD, Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark, Tel: +45 38689517; e-mail: eva.ellebaek.steensgaard@regionh.dk Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term control of melanoma adrenal metastasis treated with radiotherapy

xlomafota13 shared this article with you from Inoreader Long-term control of melanoma adrenal metastasis treated with radiotherapy Via Melanoma Research - Published Ahead-of-Print Introduction Melanoma remains a large global burden with a significant proportion of patients succumbing to metastatic disease. The adrenal gland is a common area for metastasis with surgical treatment as the main modality. Radiotherapy is less utilised in this setting with uncertainty over deliverability and efficacy. Here, we present the details and outcomes of 20 patients treated with radiotherapy, with or without systemic therapy, for melanoma adrenal metastasis in a single institute. Methods Twenty patients were identified from radiation treatment and medical records from between 2015 and 2019 at our institution. Three patients had bilateral radiotherapy treatments and therefore 23 adrenal lesions were analysed. Demographics, indications for treatment, radiotherapy methodology and outcomes were recorded. Outcomes were based on serial 18F FDG PET/computerized tomography scans reporting using the PERCIST criteria. Results The most common indication for radiotherapy was oligo-progressive disease (70%) followed by symptom palliation. Eight (35%) of the treatments were delivered by stereotactic ablative body radiotherapy. Twelve (60%) patients had concurrent immunotherapy. Twenty of twenty-three (87%) adrenal lesions had an initial response to treatment with 12 (60%) maintaining local control until death or end of follow-up. Median adrenal-specific progression-free survival was 13 months. Four patients (17%) required salvage adrenalectomy. Symptom palliation was achieved in the majority of patients for which it was indicated and there were no grade three toxicities. The median time from radiotherapy to change of immunotherapy treatment was 4 months. Conclusions Radiotherapy for melanoma adrenal metastasis is effective and deliverable. With the majority of patients achieving a palliative and clinically relevant durable response, adrenalectomy can be reserved as a salvage option. Received 2 August 2021 Accepted 13 February 2022 Correspondence to Brendan McCann, MbChB, Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia, Tel: +44 7505398515; e-mail: brendanmccann85@gmail.comBrendan.mccann@ggc.scot.nhs.uk Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of lateral neck nodes in common and aggressive variants of thyroid cancer

xlomafota13 shared this article with you from Inoreader Management of lateral neck nodes in common and aggressive variants of thyroid cancer Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Although nodal metastasis in thyroid cancer does not have a major impact on outcome, it does have some prognostic implication in adverse metastasis and aggressive histology. The purpose of this review is to discuss evaluation and management of lateral neck nodes in thyroid cancer. Recent findings There is a high incidence of central and lateral neck node metastasis in thyroid cancer. Appropriate preoperative evaluation is key prior to first surgical procedure. The distribution of nodal metastasis is well recognized and so generally a modified neck dissection is recommended from levels II through V. The risk of nodal metastasis at level IIb is rare. The complications of lateral neck dissection, though rare, are of significant importance to the quality of life. Summary Appropriate preoperative evaluation, including good ultrasound and CT scan with contrast, is recommended. Preoperative FNA of the lateral neck node will be helpful, along with thyroglobulin management if indicated. The neck dissection should include significant levels of neck, avoiding neural injury. Nonsurgical therapies may be recommended in selected patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcopenia and its impact in head and neck cancer treatment

xlomafota13 shared this article with you from Inoreader Sarcopenia and its impact in head and neck cancer treatment Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review The aim of this review is to discuss recent studies on the assessment of sarcopenia and its predictive and prognostic value in head and neck cancer (HNC) patients. Recent findings There is increasing evidence that low skeletal muscle mass (SMM), often named sarcopenia, can easily be assessed on cross-sectional imaging of the head and neck and is associated with chemotherapy (dose limiting) and radiotherapy toxicity and survival. Summary SMM measurement at the level of the third cervical vertebra (C3) on routine computed tomography and magnetic resonance imaging is easy and robust to perform. Several studies have shown a significantly higher incidence of cisplatin dose limiting toxicity in HNC patients with a low SMM. In HNC patients pretreatment low SMM is associated with acute and late toxicity and adverse events of radiotherapy, complications of major head and neck surgery and decreased disease-specific and overall survival. This information can be used for individualized treatment planning in HNC patients with low SMM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Indications of external beams radiation for thyroid cancer

xlomafota13 shared this article with you from Inoreader Indications of external beams radiation for thyroid cancer Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review The use of external beam radiation therapy (EBRT) for the treatment of the different histologic subtypes of thyroid cancer is a matter of debate. This article provides an up-to-date review on the current evidence concerning the benefits of EBRT in thyroid cancer in specific indications. Recent findings Based on retrospective studies, adjuvant EBRT lessens the risk of locoregional recurrence in locally advanced differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC) with high-risk features. The effect of EBRT on overall survival remains uncertain. EBRT should also be part of the multimodality treatment in anaplastic thyroid cancer (ATC), as it improves survival rates in incompletely resected ATC. Summary The role of EBRT in thyroid cancer remains unclear. To date, no randomized control studies are available. Retrospective data showed improved outcomes in patients with high-risk features for locoregional recurrence. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound Guided Biopsy in Patients With HPV‐Associated Oropharyngeal Squamous Cell Carcinoma

xlomafota13 shared this article with you from Inoreader Ultrasound Guided Biopsy in Patients With HPV‐Associated Oropharyngeal Squamous Cell Carcinoma Via The Laryngoscope Objectives To identify the differences in sensitivity and accuracy between ultrasound-guided and palpation-guided fine needle aspirations (FNA) of suspicious lymph nodes in patients with human papillomavirus (HPV) (+) oropharyngeal squamous cell carcinoma (OPSCC). Additional objectives included identifying patient specific factors affecting biopsy accuracy and evaluating potential differences in accuracy between fine and core needle biopsies. Study Design Retrospective chart review. Materials and Methods A retrospective study of diagnostic sensitivity was completed at a single tertiary care center between 1/1/2006–12/31/2016. Participants included patients who underwent pretreatment FNA biopsy with HPV(+)OPSCC confirmed pathologically following neck dissection or excisional lymph node biopsy. A true positive (TP) on FNA biopsy was defined as an FNA biopsy concerning for squamous cell carcinoma (SCC) that was confirmed on excisional biopsy or neck dissection. A false negative (FN) was defined as a negative FNA but metastatic disease identified on excisional biopsy or neck dissection. Sensitivity was calculated as TPs/(TPs + FNs). Sensitivity was compared among techniques using chi-square and Fisher exact tests. Results A total of 209 FNA biopsies among 198 patients were included in the study, including 31 (15%) palpation-guided FNAs, 160 (77%) ultrasound-guided FNAs, and 18 (9%) ultrasound-guided FNA + core biopsies. Sensitivity was significantly different among palpation-guided FNA, ultrasound-guided FNA, and ultrasound-guided FNA + core biopsies (48% vs. 83% vs. 94%, respectively; P < .001) but there was no significant difference in sensitivity between ultrasound-guided FNA versus ultrasound-guided FNA + core biopsies (P = .31). Conclusion The use of ultrasound guidance in FNA biopsies of nodal metastases in HPV(+)OPSCC improves sensitivity compared to palpation guidance alone. Ultrasound guided biopsies are preferred in patients with suspected nodal metastasis from HPV(+)OPSCC. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autologous lipoaspirate as a new treatment of vulvar lichen sclerosus: a review on literature

xlomafota13 shared this article with you from Inoreader Autologous lipoaspirate as a new treatment of vulvar lichen sclerosus: a review on literature Via Experimental Dermatology Abstract Lichen sclerosus (LS) is a chronic inflammatory dermatosis that mostly affects the genital and anal skin areas. Symptoms may vary from pruritis and pain to sexual dysfunction, however, LS can also be asymptomatic. LS occurs at all ages and in both sexes. Approximately 5% of all women affected by vulvar LS will develop vulvar squamous cell carcinoma. Topical treatment is safe but less effective resulting in chronic course in most patients, who suffer from persistent itching and pain. In severe cases of therapy-resistant LS, there is no adequate treatment. Fat grafting is a novel regenerative therapy to reduce dermal fibrosis. The therapeutic effect of adipose tissue grafts for LS is already investigated in various pioneering studies. This review provides an overview of these studies and the putative mechanisms-of-action of fat grafting to treat LS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The perfusion index as a noninvasive method for continuous monitoring of peripheral perfusion: A baseline study to assess the perfusion index in healthy adult volunteers

xlomafota13 shared this article with you from Inoreader The perfusion index as a noninvasive method for continuous monitoring of peripheral perfusion: A baseline study to assess the perfusion index in healthy adult volunteers Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 26:S1748-6815(22)00117-6. doi: 10.1016/j.bjps.2022.02.031. Online ahead of print. NO ABSTRACT PMID:35277365 | DOI:10.1016/j.bjps.2022.02.031 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves' disease diagnosed in remnant thyroid after lobectomy for thyroid cancer

xlomafota13 shared this article with you from Inoreader Graves' disease diagnosed in remnant thyroid after lobectomy for thyroid cancer Via radioactive iodine PLoS One. 2022 Mar 11;17(3):e0265332. doi: 10.1371/journal.pone.0265332. eCollection 2022. ABSTRACT BACKGROUND: The coexistence of Graves' disease with thyroid cancer is well-known and total thyroidectomy is recommended in such cases. However, Graves' disease might be dormant at the time of surgery and diagnosed after lobectomy for thyroid cancer. METHODS: We assessed the incidence and clinicopathological characteristic of newly developed Graves' disease after lobectomy for t hyroid cancer between 2010 and 2019. RESULTS: In all, 11043 patients underwent lobectomy for thyroid cancer during the study period, and 26 (0.2%) were diagnosed with Graves' disease during follow-up. The median age was 43.8 years, 88.5% were female, and all were euthyroid before surgery. The median time from lobectomy to the diagnosis of Graves' disease was 3.3 years. Half of the patients were diagnosed based on thyroid function tests during routine follow-up, and others were diagnosed due to symptoms of thyrotoxicosis. Among patients who had checked preoperative thyroid autoantibodies, 61.1% showed positivity. Twenty-one (80.8%), and 2 (7.7%) patients received antithyroid drugs and radioactive iodine therapy, respectively, and 3 (11.5%) underwent completion thyroidectomy. CONCLUSION: Although rare, Graves' disease can occur in the remnant thyroid after lobectomy. Such patients are more likely to have autoantibodies. An appropriate workup is required when hyperthyroidis m is found during the follow-up of patients after lobectomy. PMID:35275968 | PMC:PMC8916678 | DOI:10.1371/journal.pone.0265332 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the Perception of Own Voice Affect Our Behavior?

xlomafota13 shared this article with you from Inoreader Does the Perception of Own Voice Affect Our Behavior? Via Journal of Voice This study aimed to investigate what are the factors that influence the perception of one's own voice, and if there are any differences using voice between speaking and singing. Further the study purported to examine how these attitudes affect individuals' vocal behavior in personal and social contexts. A total of 100 participants completed the survey which comprised 23 questions about demographics, music experience, speaking voice, and singing voice. The quantitative data were analyzed by correlations and paired t test. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.