• Title, Summary, Keyword: non-melanoma skin cancer

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Sirolimus and Non-melanoma Skin Cancer Prevention after Kidney Transplantation: A Meta-analysis

  • Gu, Yu-Hong;Du, Jia-Xin;Ma, Man-Ling
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4335-4339
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    • 2012
  • Background: Whether sirolimus is useful in the prevention of non-melanoma skin cancer (NMSC) remains unclear and we therefore performed this meta-analysis of randomized controlled trials to test the hypothesis that Sirolimus-based immunosuppression is associated with a decrease in NMSC. Methods: The main outcomes were NMSC, squamous-cell carcinoma and basal-cell carcinoma. The pooled risk ratio (RR) with its 95% confidence interval (95%CI) were used to assess the effects. Results: 5 randomized trials involving a total of 1499 patients receiving kidney transplantation were included. Patients undergoing Sirolimus-based immunosuppression had much lower risk of NMSC (RR = 0.49, 95%CI 0.32-0.76, P = 0.001). Subgroup analyses by tumor type showed that Sirolimus-based immunosuppression significantly decreased risk of both squamous-cell carcinoma (RR = 0.58, 95%CI 0.43-0.78, P < 0.001) and basal-cell carcinoma (RR = 0.56, 95%CI 0.37-0.85, P = 0.006). The quality of evidence was high for NMSC, and moderate for squamous-cell carcinoma and basal-cell carcinoma. No evidence of publication bias was observed. Conclusion: High quality evidence suggests that Sirolimus-based immunosuppression decreases risk of non-melanoma skin cancer, and Sirolimus has an antitumoral effect among kidney-transplant recipients.

Skin Cancer: Clinico-Pathological Study of 204 Patients in Southern Governorates of Yemen

  • Al-Zou, Amer Bin;Thabit, Mazen Abood Bin;Al-Sakkaf, Khalid Abdulla;Basaleem, Huda Omer
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3195-3199
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    • 2016
  • Background: Skin cancer is a group of heterogeneous malignancies, in general classified into non-melanoma skin cancer (NMSC) and melanoma skin cancer (MSC). Incidences are high in many parts in the world with considerable geographical and racial variation. In the Yemen, there has been scarce information about skin cancer. The aim of this study was to evaluate the demographic characteristics and histological trend of skin cancer in Southern Governorates of Yemen. Materials and Methods: This retrospective study covered 204 cases of skin cancer at the Modern Histopathology Laboratory and Aden Cancer Registry and Research Center, Faculty of Medicine and Health Sciences, University of Aden, for the period 2006-2013. Data were classified regarding different demographic and tumor related variables and analyzed using CanReg-4 for cancer registry and SPSS (version 21). Results: The commonest encountered skin cancer was NMSC (93.1%). Generally, skin cancer appears slightly more frequently in females than males with a 1:1.06 male: female ratio, with a mean age of 62.9 years. Slightly higher than one-third (36.3%) were from Aden governorate. The head and neck proved to be the most common site in both males and females (58%). Basal cell carcinoma (BCC) is the most common histological type of skin cancer (50.5%). Conclusions: Skin cancer is a common cancer in patients living in southern governorates of Yemen. The pattern appears nearly similar to the international figures with a low incidence of MSC.

What Do Web Users Know about Skin Self-Examination and Melanoma Symptoms?

  • Kaminska-Winciorek, Grazyna;Gajda, Maksymilian;Wydmanski, Jerzy;Tukiendorf, Andrzej
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.3051-3056
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    • 2015
  • Background: Skin self-examination (SSE) may facilitate early diagnosis of melanoma at a potentially curable stage. Little data are available concerning the SSE frequency and knowledge about the symptoms of melanoma in non-patient populations. The aim of our study was to assess the performance of skin self-examination, recognition of potential melanoma symptoms as well as behavior related to sun exposure among web users in Poland. Materials and Methods: A cross-sectional study was conducted among readers of a scientific portal. Invited respondents were asked to complete an online questionnaire. Finally, statistical analysis was conducted on 4,919 surveys towards potential clinical signs of melanoma and SSE performance. Results: Approximately 60% of respondents had ever performed SSE in their life. Only 18.4 % declared performance on a regular, monthly, basis. Factors promoting this activity were established to be bigger place of residence, higher education and sensitive skin phototype, higher level of knowledge concerning melanoma, safe tanning rules and, especially, past surgical excision of naevi. Declared longer use of tanning beds was linked to understanding better the importance of clinical features of melanoma. Awareness of hazardous behavior during sunbathing is associated with the attempts to change them. Conclusions: Regular SSE is not a common practice, whilst the knowledge about the clinical features of melanoma is varied. Therefore, constant pressure should be put on promotion of regular skin self-examination and teaching its proper techniques, including familiarity with the ABCD (asymmetry; border; color; diameter) rule and its extension of "EFG" (elevated, firm, progressive growth) criteria.

XPD Lys751Gln and Asp312Asn Polymorphisms and Susceptibility to Skin Cancer: A Meta-Analysis of 17 Case-control Studies

  • Zhu, Hai-Li;Bao, Ji-Ming;Lin, Pei-Xin;Li, Wen-Xia;Zou, Zhen-Ning;Huang, Ye-En;Chen, Qing;Shen, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6619-6625
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    • 2014
  • Background: Numerous studies have explored the influence of XPD Lys751Gln and/or Asp312Asn polymorphisms on skin cancer susceptibility. However, the results remain inconclusive. To derive a more precise estimation, we conducted a comprehensive search to identify all available published studies and performed a meta-analysis. Materials and Methods: Electronic literature searches of the PubMed, CBM and CNKI databases were performed up to March 2014. Odds ratios (ORs) with 95% confidence intervals (CIs) were applied to assess the strength of associations. Results: Seventeen case-control studies were included with a total sample size of 6, 113 cases and 11, 074 controls for the XPD Lys751Gln polymorphism, and 10 studies (3, 840cases and 7, 637 controls) for the XPD Asp312Asn polymorphism were pooled for analysis. Overall, no significant associations were found between the XPD Lys751Gln polymorphism and skin cancer risk in any genetic model. On stratified analysis by tumor type, XPD Lys751Gln polymorphism was not associated with increased risk of non-melanoma skin cancer, but was significantly related with increased risk of cutaneous melanoma (Gln/Gln vs Lys/Lys: OR=1.15, 95%CI=1.02-1.29, p=0.023; dominant model: OR=1.09, 95%CI=1.01-1.18, p=0.036). For the XPD Asp312Asn polymorphism, no significant association with skin cancer risk was observed in overall or subgroup analyses. Conclusions: The present meta-analysis suggests that the XPD Lys751Gln polymorphism may contribute to the risk of cutaneous melanoma from currently available evidence. Further investigations are needed to obtain more insight into possible roles of these two polymorphisms in skin carcinogenesis.

Lack of Increased P15INK4B Protein Expression in Basal Cell Carcinomas

  • Moad, Ahmed Ismail Hassan;Tan, Mei Lan;Kaur, Gurjeet;Mabruk, Mohamed
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6239-6244
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    • 2012
  • Background: The basal cell carcinoma (BCC) is the most common non-melanoma skin cancer (NMSK). BCC might develop because of the faulty cell cycle arrest. $p15^{INK4b}$ is a tumor suppressor gene, involved in cell cycle arrest and inactivated in most human cancers. The role of $p15^{INK4b}$ protein expression in the genesis of BCC is as yet unknown. In a previous study we showed the absence of $p15^{INK4b}$ expression in the majority of tissue microarray cores of cutaneous squamous cell carcinoma (SCCs), another type of non-melanoma skin cancer, indicating that $p15^{INK4b}$ could possibly be involved in the pathogenesis of cutaneous SCC. The aim of this study was to investigate $p15^{INK4b}$ protein expression in BCCs. Materials and Method: Protein expression of $p15^{INK4b}$ in 35 cases of BCC tissue arrays and 19 cases of normal human skin tissue was studied using an immunohistochemical approach. Results: The expression of $p15^{INK4b}$ was not significantly different in the BCC cases as compared with normal human skin (p=0.356; p>0.05). In addition, there were no significant relationship between clinicopathologic variables of patients (age and sex) and $p15^{INK4b}$ protein expression. Conclusions: Our finding may indicate that $p15^{INK4b}$ protein expression does not play a role in the genesis of BCC.

Prediction of the risk of skin cancer caused by UVB radiation exposure using a method of meta-analysis (Meta-analysis를 이용한 UVB 조사량에 따른 피부암 발생 위해도의 예측 연구)

  • Shin, D.C.;Lee, J.T.;Yang, J.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1
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    • pp.91-103
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    • 1998
  • Under experimental conditions, UVB radiation, a type of ultra violet radiation, has shown to .elate with the occurrence of skin erythema (sun-burn) in human and skin cancer in experimental animal. Cumulative exposure to UVB is also believed to be at least partly responsible for the 'aging' process of the skin in human. It has also been observed to have an effect of altering DNA (deoxyribonucleic acid). UVB radiation is both an initiator and a promoter of non-melanoma skin cancer. Meta-analysis is a new discipline that critically reviews and statistically combines the results of previous researches. A recent review of meta-analysis in the field of public health emphasized its growing importance. Using a meta-analysis in this study, we explored more reliable dose-response relationships between UVB radiation and skin cancer incidence. We estimated skin cancer incidence using measured UVB radiation dose at a local area of Seoul (Shin chou-dong). The studies showing the dose-response relationships between UVB radiation and non-melanoma skin cancer incidence were searched and selected for a meta-analysis. The data for 7 reported epidemiological studies of three counties (USA, England, Australia) were pooled to estimated the risk. We estimated rate of incidence change of skin cancer using pooled data by meta-analysis method, and exponential and power models. Using either model, the regression coefficients for UVB did not differ significantly by gender and age. In each analysis of variance, non-melanoma skin cancer incidence after removing the gender and age and UVB effects was significant (p>0.01). The coefficients for UVB dose were estimated $2.07\times10^{-6}$ by the exponential model and 2.49 by the power model. At a local area of Seoul (Shinchon-Dong), BAF value were estimated 1.90 and 2.51 by the exponential and power model, respectively. The estimated BAP value were increased statistical power than that of primary studies that using a meta-analysis method.

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A Clinical Study of Multiple Non-melanoma Skin Cancers over 4 Years in a Single Institution Center (단일기관에서 4년간 시행한 다발성 비흑색종 피부암 16예에 관한 분석)

  • Kim, Min Sung;Kim, Yoon Soo;Na, Chan Ho;Shin, Bong Seok
    • Korean journal of dermatology
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    • v.55 no.3
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    • pp.165-170
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    • 2017
  • Background: Non-melanoma skin cancers (NMSCs, basal cell carcinoma [BCC], and squamous cell carcinoma, [SCC]) are skin conditions, and the propensity of NMSCs to develop multiple tumors may be associated with some genodermatoses, arsenic poisoning, and chronic exposure to radiation or coal tar. Objective: To report our experience of treating multiple NMSCs and to investigate the clinical characteristics of NMSCs. Methods: We retrospectively evaluated 16 patients who had been diagnosed with NMSCs from May 2010 to December 2014. Results: The male-female sex ratio was 0.6 : 1 in the patients with multiple BCCs and SCCs. The most frequent age group was the seventh decade (75%). The mean patient age was 76.36 years. The most common involved site was the face, particularly the cheek (54.3%). Nodular BCCs were the most frequent (61.9%), followed by infiltrate BCCs (28.6%) and superficial BCCs (9.5%). Among the SCCs, the moderately differentiated SCCs were the most frequent (50%). More NMSCs were found on the left than on the right side of the head and neck areas in both sexes. Development of BCC (68.8%) was more frequent than that of SCC in sun-exposed areas. Conclusion: In our study, differences in the demographic variables, such as age, sex, or residence were found between the patients with multiple BCCs and SCCs. The incidence of BCC has markedly increased, which is mainly because of the increment of aged people in their residence, along with environmental factors. Further cohort studies that include cumulative lifetime sun exposure and a large sample size are needed.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

Role of dermoscopy and biopsy in the diagnosis of skin cancer: it takes two to tango (피부암 진단에서 피부확대경 및 조직검사의 역할: 상호보완적 관계)

  • Li, Kapsok
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.649-654
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    • 2018
  • Although the dermoscopy had very long history since its introduction in 17th century, only recently it has been possible to see the widespread application of dermoscopy in the dermatology clinic. One of the most promising areas where the dermoscopy can be applied is the diagnosis of skin cancer, especially malignant melanoma. Due to its inherent limitation to obtain in-depth information-literally, from more than skin-deep and more importantly, from microscopic structures-of skin cancers, dermoscopy cannot replace the present gold-standard 'biopsy' in the diagnosis of skin cancer. However, several advantages of dermoscopy over biopsy merit further considerations. For example, as a non-invasive tool, dermoscopy is best suited for the follow-up of suspicious skin lesions, and as an all-at-a-glance tool, dermoscopy can aid the selection of the best biopsy-site to obtain the most meaningful pathological information from the minimal tissue specimen. There goes a saying that 'it takes two to tango,' similarly, we might need the two (biopsy and dermoscopy) to cope rhythmically with the varying tempos of everprogressing skin tumorigenesis and to reveal the true face of skin cancers usually hidden in various disguises.

Cutaneous melanoma (피부흑색종)

  • Lee, Seok-Jong;Lee, Soo Jung
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.662-669
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    • 2018
  • The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.