CURRENT ISSUES IN TRANSPLANT DERMATOLOGY
|
|
- Rosaline Carroll
- 6 years ago
- Views:
Transcription
1 CURRENT ISSUES IN TRANSPLANT DERMATOLOGY
2 NO CONFLICTS OF INTEREST TO DISCLOSE
3 SOLID ORGAN TRANSPLANTATION: 2015 As of April 10, ,319 patients waiting for an organ transplant 2,557 performed this year 1,257 donors 21 patients die each day waiting for a transplant Herrick twins 1st kidney transplant Boston, 1954
4 Breast cancer RECOMMENDED WAIT-TIMES TYPE OF CANCER RECOMMENDATION (years) >5 (>2 for early disease) Colorectal cancer >5 (>2 for Dukes Stage A or B1) Uterine cervical cancer Renal cell carcinoma/wilm s tumor Bladder cancer >2 Kaposi s sarcoma >2 Lung cancer >2 Testicular cancer >2 Thyroid cancer >2 Prostate cancer Leukemia/lymphoma >2 (>5 for more advanced cervical cancer) >2 (>5 for large cancers; no wait for incidental tumor <5cm) >2 (possibly less for localized disease) >2 (limited data) Adapted from: Kasiske BL, et al. The Evaluation of Renal Transplant Candidates: Clinical Practice Guidelines. Am J Transpl 2001; 1: Suppl 2
5 WHAT ARE THE CURRENT GUIDELINES? The high recurrence rate of non-melanoma skin cancers occurs irrespective of the time of removal of the lesions before renal transplantation. Nevertheless, the majority of patients with recurrence of non-melanoma skin cancers have been treated less than 2 years before transplantation. A waiting period of 2 years may eliminate some recurrent skin cancers although the impact of this intervention is not established. Kasiske BL, et al. The Evaluation of Renal Transplant Candidates: Clinical Practice Guidelines. Am J Transpl 2001; 1: Suppl 2
6 SKIN CANCER IN ORGAN TRANSPLANT RECIPIENTS SKIN CANCER Squamous cell carcinoma Squamous cell carcinoma of the lip Basal cell carcinoma Melanoma Kaposi sarcoma INCREASE IN INCIDENCE 65-fold 20-fold 10-fold Threefold 84-fold Actinic Keratoses (precancers) 250-fold Table modified from: Zwald FO, Brown M. Skin Cancers in solid organ transplant recipients. JAAD. Aug
7 SCC: THE MOST COMMON SKIN CANCER IN ORGAN TRANSPLANT RECIPIENTS Squamous Cell and Basal Cell Carcinoma account for 95% of skin cancers in transplant patients 75% occur in photo-distributed areas SCCs are more aggressive in transplant patients Risk of metastases of SCC in transplant patients is 8-13% Compared to 0.5-5% in the general population If you have a skin cancer before transplant, you have nearly 100% chance of getting another after transplant Zwald FO, Brown M. Skin cancers in solid organ transplant recipients. JAAD. Aug 2011
8 WHAT CONSTITUTES A HIGH-RISK SCC? 2010: AJCC CUTANEOUS SCC STAGING, 7 TH EDITION Clinical Features Large size >2cm Special sites Ear Lip Scalp, temple Over parotid gland Multiple SCCs Rapidly growing lesions In-transit metastases Recurrence Pathologic Features >2mm thickness Clark level 4mm (invasion of reticular dermis) Perineural invasion Poorly or undifferentiated Deep invasion National Cancer Institute; 7 th edition AJCC staging for cutaneous SCC O Reilly et al. Skin Cancer in solid organ transplant patients: advances in therapy and management- Part II. JAAD Aug 2011.
9 CLINICAL IMPLICATIONS OF HIGH-RISK SCC SQUAMOUS CELL CARCINOMA Local Recurrence Local Metastases Distant Metastases Disease-Specific Death 5% 5% 1% 1% RATE OF METASTASES MAY EXCEED 20% IN SELECTED HIGH-RISK FEATURES OVERALL SURVIVAL DECLINES TO BETWEEN 46% and 70% AT 5 YEARS
10 ARE ALL HIGH-RISK FEATURES EQUAL IN RATE OF METASTASES AND SURVIVAL? Prospective analysis, N=615 Increased tumor thickness Immunosuppression Localization to the ear Increased horizontal size 4% developed metastases 73% within first year none after 4years Retrospective study, N=6160 Perineural invasion Anatomic site cheek, lip, ear Maximum clinical diameter Poor histological differentiation 44% developed metastases within first year average interval to metastases = 26 months Brantsch KD et al. Analysis of risk factors determining prognosis of cutaneous squamous cell carcinoma: A prospective study. Lancet Aug 2008 Brougham N, Dennett ER, Cameron R, Tan ST. The incidence of metastasis From cutaneous squamous cell carcinoma and the impact of its risk factors. J Surg Oncol Dec 2012
11 SURVIVAL OUTCOMES IN HIGH-RISK SCC Recurrent Disease Deep Invasion Perineural Invasion Lesion Size Lympho-Vascular Invasion Inflammation Nodal Involvement Kyrgidis A, et al. Cutaneous Squamous Cell Carcinoma (SCC) of the Head and Neck: Risk Factors of Overall and Recurrence-Free Survival. European Journal of Cancer 2010 Clayman GL, et al. Mortality Risk from Squamous Cell Skin Cancer. J Clin Oncol 2005 Rowe, DE, et al. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection.jaad 1992.
12 SCC STAGING + PROGNOSIS/SURVIVAL DATA = WAIT PERIOD GUIDELINES AJCC 7 TH ED STAGING SYSTEM STAGE T N M 0 In-situ N0 M0 I T1 N0 MO II T2 N0 M0 III T3 N0/1 M0 T1/2 N1 M0 IV T1/2/3 N2 M0 ANY T N3 M0 T4 ANY N M0 ANY T ANY N M1 BWH STAGING SYSTEM ALTERNATIVE T T0 T1 T2a T2b T3 DEFINITION In-situ 0 risk factors 1-2 risk factors 3 risk factors 4 risk factors -orbony invasion Risk factors: Tumor diameter >2 cm or greater, poorly differentiated histologic characteristics, perineural invasion, and tumor invasion beyond the subcutaneous fat (excluding bone invasion) T1: Tumor 2 cm in greatest dimension with <2 high-risk features T2: Tumor >2 cm in greatest dimension with or without one additional high-risk feature, or any size with 2 high-risk features
13 HIGH-RISK SCC WITH LOCAL METASTASES High-risk SCC metastasizes to parotid/cervical lymph nodes incidence 5%, up to 21% in immunocompromised Risk factors: Recurrent lesions, lymphovascular invasion, inflammation, poor histologic differentiation, invasion into the subcutaneous tissues, PNI, and larger size Predictors of poor outcome: Single-modality treatment, increasing node size, multiple nodes, positive nodal margins, extra-capsular spread, immunosuppression Frank Netter Veness MJ, et al. Surgery and adjuvant radiotherapy in patients with cutaneous head and neck squamous cell carcinoma metastatic to lymph nodes; combined treatment should be considered best practice. Laryngoscope 2005 Ch ng S, et al. Parotid and Cervical Nodal Status Predict Prognosis for Patients With Head and Neck Metastatic Cutaneous Squamous Cell Carcinoma. J Surg Oncol 2008 Moore BA, et al. Lymph Note Metastases from Cutaneous Squamous Cell Carcinoma of the Head and Neck. Laryngoscope 2005 O Brien CJ, et al. Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head and Neck 2002
14 LOW-RISK NODAL DISEASE: DOES THIS EXIST? Definition O Brien of cutaneous Clinical Staging squamous System cell for carcinoma Metastatic nodal Cutaneous (N) staging Squamous for 7th Cell edition of Carcinoma American Joint of the Committee Parotid and/or on Cancer Neck NX Parotid Regional lymph node cannot be assessed N0 P0 No regional No lymph clinical node disease metastasis in the parotid N1 P1 Metastasis Metastatic in single ipsilateral node up lymph to 3cm node in diameter N2 P2 Metastasis Metastatic in single ipsilateral node >3cm lymph and node, up to >3 6cm in but diameter not >6 cm or in multiple greatest dimension; nodes or in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none >6 cm in greatest P3 Metastatic node >6cm in diameter or disease involving facial dimension nerve or skull base N2a Metastasis in single ipsilateral lymph node, >3 cm but not >6 cm in greatest dimension Neck N2 Metastasis in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension N0 Single lymph node measuring 3cm b N2c N1 Single lymph node measuring >3cm or multiple lymph nodes Metastasis in bilateral or contralateral lymph nodes, none >6 cm in greatest dimension measuring 3cm N3 Metastasis in lymph node, >6 cm in greatest dimension N2 Multiple lymph nodes measuring>3cm O Brien CJ, et al. Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head and Neck 2002
15 Forest VI, et al. N1S3: A Revised Staging System for Head and Neck Cutaneous Squamous Cell Carcinoma with Lymph Node Metastases. Cancer 2010 LOW-RISK NODAL DISEASE: SEARCHING FOR A DEFINITION N1S3 Staging System Stage I II III Single lymph node measuring 3cm Single lymph node measuring >3cm or multiple lymph nodes measuring 3cm Multiple lymph nodes measuring >3cm
16 CONSIDERATIONS INDIVIDUAL: Organ to be transplanted Patients who are recipients of a living-related renal or liver allograft Patient s inherent predisposition to further skin cancer development FUTURE DEVELOPMENTS: Sentinel lymph node biopsy
17 References: Veness MJ, Palme CE, Morgan GJ. High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: Results from 266 Treated Patients with Metastatic Lymph Node Disease. Cancer. 2006;106(11): doi: /cncr.2198 Jambusaria-Pahlajani A, Kanetsky PA, Karia PS, et al. Evaluation of AJCC Tumor Staging for Cutaneous Squamous Cell Carcinoma and a Proposed Alternative Tumor Staging System. JAMA Dermatol. 2013;149(4): doi: /jamadermatol Brantsch AD, Meisner C, Schönfisch B et al. Analysis of risk factors determing prognosis of cutaneous squamous cell carcinoma: a prospective study. Lancet. 2008;9: doi: /s (08) Clayman GL, Lee JJ, Holsinger FC, et al. Mortality Risk from Squamous Cell Skin Cancer. J Clin Oncol. 2005; 23(4): doi: /jco Kyrgidis A, Tzellos TG, Kechagias N, et al. Cutaneous squamous cell carcinoma (SCC) of the head of neck: Risk factors of overall and recurrence-free survival. European Journal of Cancer. 2010;46: doi: /j.ejca Brougham N, Dennett ER, Cameron R, Tan ST. The Incidence of Metastasis From Cutaneous Squamous Cell Carcinoma and the Impact of its Risk Factors. J Surg Oncol. 2012;106: doi: /jso Veness MJ, Morgan GJ, Palme CE, Gebski V. Surgery and Adjuvant Radiotherapy in Patients with Cutaneous Head and Neck Squamous Cell Carcinoma Metastatic to the Lymph Nodes: Combined Treatment Should be Considered Best Practice. Laryngoscope. 2005;115: doi: /01.mlg ed Andruchow JL, Veness MJ, Morgan GJ, et al. Implications for Clinical Staging of Metastatic Cutaneous Squamous Carcinoma of the Head and Neck Based on a Multicenter Study of Treatment Outcomes. Cancer. 2006;106(5): doi: /cncr Palme CE, O Brien CJ, Veness MJ, et al. Extend of Parotid Disease Influences Outcome on Patients With Metastatic Cutaneous Squamous Cell Carcinoma. Arch Otolaryngol Head Neck Surg. 2003;129: Ch ng S, Maitra A, Allison RS, et al. Parotid and Cervical Nodal Status Predict Prognosis for Patients With Head and Neck Metastatic Cutaneous Squamous Cell Carcinoma. J Surg Oncol. 2008;98: doi: /jso Southwell KE, Chaplin JM, Eisenberg RL, et al. Effect of Immunocompromise on Metastatic Cutaneous Squamous Cell Carcinoma in the Parotid and Neck. Head and Neck. 2006;28: doi: /hed Ebrahimi A, Clark JR, Ahmadi N, et al. Prognostic significance of disease-free interval in head and neck cutaneous squamous cell carcinoma with nodal metastases. Head and Neck. 2012;00:1-6.doi: /hed23096 Forest VI, Clark JJ, Veness MJ, Milross C. N1S3: A Revised Staging System for Head and Neck Cutaneous Squamous Cell Carcinoma with Lymph Node Metastases. Cancer. 2010;116: doi: /cncr Moore BA, Weber RS, Prieto V, et al. Lymph Note Metastases from Cutaneous Squamous Cell Carcinoma of the Head and Neck. Laryngoscope 2005;115: doi: /01.mlg f Ebrahimi A, Clark JR, Lorincz BB, et al. Metastatic Head and Neck Cutaneous Squamous Cell CarcinomaL Defining a Low-Risk Patient. Head and Neck. 2012;34: doi: /hed O Brien CJ, et al. Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head and Neck 2002
18 INTERNATIONAL TRANSPLANT SKIN CANCER
Poor Outcomes in Head and Neck Non-Melanoma Cutaneous Carcinomas
10 The Open Otorhinolaryngology Journal, 2011, 5, 10-14 Open Access Poor Outcomes in Head and Neck Non-Melanoma Cutaneous Carcinomas Kevin C. Huoh and Steven J. Wang * Head and Neck Surgery and Oncology,
More informationProposal for a 2-stage RCT in high risk primary SCC: COMMISSAR Catherine Harwood Barts Health NHS Trust / QMUL
Proposal for a 2-stage RCT in high risk primary SCC: COMMISSAR Catherine Harwood Barts Health NHS Trust / QMUL on behalf of Dr Louise Lansbury, Prof Fiona Bath-Hextall Nottingham Centre for Evidence Based
More informationAnalysis of selected risk factors for nodal metastases in head and neck cutaneous squamous cell carcinoma
Eur Arch Otorhinolaryngol (2015) 272:3007 3012 DOI 10.1007/s00405-014-3261-6 HEAD AND NECK Analysis of selected risk factors for nodal metastases in head and neck cutaneous squamous cell carcinoma Mateusz
More informationEfficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp
Wray et al. Radiation Oncology (2015) 10:199 DOI 10.1186/s13014-015-0509-2 RESEARCH Open Access Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp Justin
More informationORIGINAL RESEARCH. Chance Matthiesen & Spencer Thompson & Salahuddin Ahmad & Elizabeth Syzek & Daniel Zhao & Terence Herman & Carl Bogardus
J Radiat Oncol (2013) 2:79 85 DOI 10.1007/s13566-012-0070-7 ORIGINAL RESEARCH A comparison of the sixth and seventh editions of the AJCC TNM systems for T classification and predicting the outcomes of
More informationCutaneous Melanoma: Epidemiology (USA) The Sentinel Node in Head and Neck Melanoma. Cutaneous Melanoma: Epidemiology (USA)
The Sentinel Node in Head and Neck Melanoma Cutaneous Melanoma: Epidemiology (USA) 6 th leading cause of cancer among men and women 68,720 new cases of invasive melanoma in 2009 8,650 deaths from melanoma
More informationRelevance of the primary lesion in the prognosis of metastatic cutaneous squamous cell carcinoma
ORIGINAL ARTICLE Relevance of the primary lesion in the prognosis of metastatic cutaneous squamous cell carcinoma Sydney Ch ng, MBBS, FRACS, 1 Jonathan R. Clark, MBBS, FRACS, 1 Markus Brunner, MD, 1 Carsten
More informationPrognostic factors for metastatic cutaneous squamous cell carcinoma of the parotid
Makki et al. Journal of Otolaryngology - Head and Neck Surgery 2013, 42:14 ORIGINAL RESEARCH ARTICLE Open Access Prognostic factors for metastatic cutaneous squamous cell carcinoma of the parotid Fawaz
More informationCUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK METASTASIZING TO THE PAROTID GLAND A REVIEW OF CURRENT RECOMMENDATIONS
CLINICAL REVIEW David W. Eisele, MD, CUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK METASTASIZING TO THE PAROTID GLAND A REVIEW OF CURRENT RECOMMENDATIONS James O Hara, FRCS, 1 Alfio Ferlito, MD,
More informationORIGINAL ARTICLE. Regional Lymph Node Metastasis From Cutaneous Squamous Cell Carcinoma
ORIGINAL ARTICLE Regional Lymph Node Metastasis From Cutaneous Squamous Cell Carcinoma Dennis H. Kraus, MD; John F. Carew, MD; Louis B. Harrison, MD Objective: To characterize clinical presentation and
More informationOral cancer: Prognosis & Treatment. Dr. Hani Al Sheikh Radhi
Oral cancer: Prognosis & Treatment Dr. Hani Al Sheikh Radhi Prognostic factors in Oral caner TNM staging T stage N stage M stage Site Histological Factors Vascular & Perineural Invasion Surgical Margins
More informationAccepted 19 May 2008 Published online 2 September 2008 in Wiley InterScience (www.interscience.wiley.com). DOI: /hed.20912
ORIGINAL ARTICLE OUTCOMES FOLLOWING PAROTIDECTOMY FOR METASTATIC SQUAMOUS CELL CARCINOMA WITH MICROSCOPIC RESIDUAL DISEASE: IMPLICATIONS FOR FACIAL NERVE PRESERVATION N. Gopalakrishna Iyer, MBBS (Hons),
More informationClinical Study Outcomes of Recurrent Head and Neck Cutaneous Squamous Cell Carcinoma
Skin Cancer Volume 2011, Article ID 972497, 6 pages doi:10.1155/2011/972497 Clinical Study Outcomes of Recurrent Head and Neck Cutaneous Squamous Cell Carcinoma Nichole R. Dean, 1 Larissa Sweeny, 1 J.
More informationSection 1: Personal information
A survey on the use of ultrasound examination of the regional lymph nodes in the follow up of patients with high-risk cutaneous squamous cells carcinomas (SCCs). Note: In the definition of cutaneous squamous
More informationOutcomes of nodal metastatic cutaneous squamous cell carcinoma of the head and neck treated in a regional center
ORIGINAL ARTICLE Outcomes of nodal metastatic cutaneous squamous cell carcinoma of the head and neck treated in a regional center Campbell Schmidt, MBBS(Hons), 1 * Jarad M. Martin, DMed(Res), FRANZCR,
More informationAJCC Staging of Head & Neck Cancer (7 th edition, 2010) -LIP & ORAL CAVITY-
TX: primary tumor cannot be assessed T0: no evidence of primary tumor Tis: carcinoma in situ. T1: tumor is 2 cm or smaller AJCC Staging of Head & Neck Cancer (7 th edition, 2010) -LIP & ORAL CAVITY- T2:
More informationThis form may provide more data elements than required for collection by standard setters such as NCI SEER, CDC NPCR, and CoC NCDB.
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationThyroid INTRODUCTION ANATOMY SUMMARY OF CHANGES
AJC 7/14/06 1:19 PM Page 67 Thyroid C73.9 Thyroid gland SUMMARY OF CHANGES Tumor staging (T) has been revised and the categories redefined. T4 is now divided into T4a and T4b. Nodal staging (N) has been
More informationLYMPHATIC DRAINAGE IN THE HEAD & NECK
LYMPHATIC DRAINAGE IN THE HEAD & NECK Like other parts of the body, the head and neck contains lymph nodes (commonly called glands). Which form part of the overall Lymphatic Drainage system of the body.
More information6. Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationIntroduction. radiological findings mimicked that of primary MEC. Special attention should be paid to the potential cause of diagnostic pitfalls.
Case Report Page 1 of 5 Cutaneous squamous cell carcinoma of the head and neck with parotid gland metastasis mimicking mucoepidermoid carcinoma: a potential diagnostic pitfall Ming-Yueh Liu 1, Cheng-Hsiang
More informationUICC TNM 8 th Edition Errata
UICC TNM 8 th Edition Errata ions are in italics Page 28 Oropharynx p16 positive Pathological Stage II,T2 N2 M0 T3 N0,N1 M0 Stage II,T2 N2 M0 T3,T4 N0,N1 M0 Page 61 Oesophagus Adenocarcinoma Pathological
More informationTranslating Evidence into Practice: Primary Cutaneous Melanoma Guidelines. Sentinel Lymph Node Biopsy
American Academy of Dermatology 2018 Annual Meeting San Diego, CA, February 17, 2018 Translating Evidence into Practice: Primary Cutaneous Melanoma Guidelines. Sentinel Lymph Node Biopsy Christopher Bichakjian,
More informationRecurrent and metastatic squamous cell carcinoma in lung transplant recipient on voriconazole: Lessons learned
Recurrent and metastatic squamous cell carcinoma in lung transplant recipient on voriconazole: Lessons learned Shali Zhang, Emory University David Neujahr, Emory University Fiona O. Zwald, Piedmont Transplant
More informationThis form may provide more data elements than required for collection by standard setters such as NCI SEER, CDC NPCR, and CoC NCDB.
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationCollaborative Stage for TNM 7 - Revised 12/02/2009 [ Schema ]
CS Tumor Size Collaborative Stage for TNM 7 - Revised 12/02/2009 [ Schema ] Note: the specific tumor size as documented in the medical record. If the ONLY information regarding tumor size is the physician's
More information(loco-regional disease)
(loco-regional disease) (oral cavity) (circumvillae papillae) (subsite) A (upper & lower lips) B (buccal membrane) C (mouth floor) D (upper & lower gingiva) E (hard palate) F (tongue -- anterior 2/3 rds
More informationSKIN CANCER AFTER HSCT
SKIN CANCER AFTER HSCT David Rice, PhD, MSN, RN, NP, NEA-BC Director, Education, Evidence-based Practice and Research City of Hope National Medical Center HOW THE EXPERTS TREAT HEMATOLOGIC MALIGNANCIES
More informationCODING STAGE: TNM AND OTHER STAGING SYSTEMS. Liesbet Van Eycken Otto Visser
CODING STAGE: TNM AND OTHER STAGING SYSTEMS Liesbet Van Eycken Otto Visser OVERVIEW PART I Introduction What is stage? Why stage? History and publications of TNM Classification Clinical and pathologic
More informationSTUDY. Outcomes of Primary Cutaneous Squamous Cell Carcinoma With Perineural Invasion
STUDY Outcomes of Primary Cutaneous Squamous Cell Carcinoma With Perineural Invasion An 11-Year Cohort Study Joi B. Carter, MD; Matthew M. Johnson, MD; Tiffany L. Chua, MA, MPH; Pritesh S. Karia, MPH;
More informationUICC TNM 8 th Edition Errata
UICC TNM 8 th Edition Errata ions are in italics Head and Neck Tumours Pages 20, p27, p34, p38, p41, and p49 ly pn2a Metastasis in a single ipsilateral lymph node, less than 3cm in greatest dimension with
More informationCutaneous squamous cell carcinoma metastatic to parotid - analysis of prognostic factors and treatment outcome
Goh et al. World Journal of Surgical Oncology 2012, 10:117 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Cutaneous squamous cell carcinoma metastatic to parotid - analysis of prognostic factors
More informationCollaborative Staging Manual and Coding Instructions Part II: Primary Site Schema
C44.0-C44.9, C51.0-C51.2, C51.8-C51.9, C60.0-C60.2, C60.8-C60.9, C63.2 (M-8720-8790) C44.0 Skin of lip, NOS C44.1 Eyelid C44.2 External ear C44.3 Skin of ear and unspecified parts of face C44.4 Skin of
More informationAdenoid Cystic Carcinoma Minor Salivary Gland Origin
Adenoid Cystic Carcinoma Minor Salivary Gland Origin Educational Session Presenter: Smith JA Supervisors: Palme CE, Gupta R Content Case report Imaging Primary Therapy Surgery Adjuvant Therapy Radiotherapy
More informationOriginal article. Parotid squamous cell carcinoma: Is it a primary or secondary? Aboziada A Mohamed and Eisbruch, Avraham.
Original article Kasr El-aini J. Clin. Oncol. nucl. med. vol. 7, no. -2, Jan.-April. 2:57-6 Parotid squamous cell carcinoma: Is it a primary or secondary? Aboziada A Mohamed and Eisbruch, Avraham. Department
More informationPrimary Cutaneous Melanoma Pathology Reporting Proforma DD MM YYYY. *Tumour site. *Specimen laterality. *Specimen type
Primary Cutaneous Melanoma Pathology Reporting Proforma Includes the International Collaboration on Cancer reporting dataset denoted by * Family name Given name(s) Date of birth DD MM YYYY Sex Male Female
More informationCatholic University of Louvain, St - Luc University Hospital Head and Neck Oncology Programme. Anatomopathology. Pathology 1 Sept.
Anatomopathology Pathology 1 Anatomopathology Biopsies Frozen section Surgical specimen Peculiarities for various tumor site References Pathology 2 Biopsies Minimum data, which should be given by the pathologist
More informationClinical Pathological Conference. Malignant Melanoma of the Vulva
Clinical Pathological Conference Malignant Melanoma of the Vulva History F/48 Chinese Married Para 1 Presented in September 2004 Vulval mass for 2 months Associated with watery and blood stained discharge
More informationOncology and surgery. Dra. Irene Palacios. Clínica Universidad de Navarra
Oncology and surgery Dra. Irene Palacios. Clínica Universidad de Navarra HOW TO MANAGE HIGH RISK SCC Yaouhi Gloria Xu Anokhi Jambusaria-Pahlajani HOW TO STAGE SCC Problem with tumor depth Often not posible
More informationWorld Articles of Ear, Nose and Throat Page 1
World Articles of Ear, Nose and Throat ---------------------Page 1 Primary Malignant Melanoma of the Tongue: A Case Report Authors: Nanayakkara PR*, Arudchelvam JD** Ariyaratne JC*, Mendis K*, Jayasekera
More informationRebecca Vogel, PGY-4 March 5, 2012
Rebecca Vogel, PGY-4 March 5, 2012 Historical Perspective Changes In The Staging System Studies That Started The Talk Where We Go From Here Cutaneous melanoma has become an increasingly growing problem,
More informationI have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a product in my presentation.
Prostate t Cancer MR Report Disclosure Information Vikas Kundra, M.D, Ph.D. I have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a g product
More informationPhysician to Physician AJCC 8 th Edition. Head and Neck. Summary of Changes. AJCC Cancer Staging Manual, 7 th Ed. Head and Neck Chapters
Physician to Physician Head and Neck William M. Lydiatt, MD Chair of Surgery Nebraska Methodist Hospital Clinical Professor of Surgery, Creighton University Validating science. Improving patient care.
More information1. Written information to patient /GP: fax ASAP to GP & offer copy of consultation letter.
Skin Cancer follow up guidelines If NEW serious diagnosis given: 1. Written information to patient /GP: fax ASAP to GP & offer copy of consultation letter. 2. Free prescription information details. 3.
More informationSKIN CANCER. Most common cancer diagnosis 40% of all cancers
SKIN CANCER Most common cancer diagnosis 40% of all cancers OBJECTIVES Review common and uncommon cancers of the skin. Special emphasis on melanoma and dysplastic nevus Review pathology/tnm/staging, which
More informationDa Costa was the first to coin the term. Marjolin s Ulcer: A Case Report and Literature Review. Case Report. Introduction
E-Da Medical Journal 2016;3(2):24-28 Case Report Marjolin s Ulcer: A Case Report and Literature Review Yue-Chiu Su 1, Li-Ren Chang 2 Marjolin s ulcer is an aggressive cutaneous malignancy, which is common
More informationGenetic Testing: When should it be ordered? Julie Schloemer, MD Dermatology
Genetic Testing: When should it be ordered? Julie Schloemer, MD Dermatology Outline Germline testing CDKN2A BRCA2 BAP1 Somatic testing Gene expression profiling (GEP) BRAF Germline vs Somatic testing
More informationEvaluation of AJCC, UICC, and Brigham and Women's Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma
Evaluation of AJCC, UICC, and Brigham and Women's Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Karia, et al Methods Details of data collectionfeatures of primary tumors including anatomic
More informationMolecular Enhancement of Sentinel Node Evaluation
Cochran Illustrations 060104 Molecular Enhancement of Sentinel Node Evaluation Alistair Cochran, MD and Rong Huang MD Departments of Pathology and Laboratory Medicine and Surgery, David Geffen School of
More informationDesmoplastic Melanoma: Clinical Behavior and Management Implications
Desmoplastic Melanoma: Clinical Behavior and Management Implications Collier S. Pace, MD, a Jyoti P. Kapil, MD, b Luke G. Wolfe, MS, c Brian J. Kaplan, MD, c and James P. Neifeld, MD c a Division of Plastic
More informationRefresher Course EAR TUMOR. Sasikarn Chamchod, MD Chulabhorn Hospital
Refresher Course EAR TUMOR Sasikarn Chamchod, MD Chulabhorn Hospital Reference: Perez and Brady s Principles and Practice of radiation oncology sixth edition Outlines Anatomy Epidemiology Clinical presentations
More informationOncology 101. Cancer Basics
Oncology 101 Cancer Basics What Will You Learn? What is Cancer and How Does It Develop? Cancer Diagnosis and Staging Cancer Treatment What is Cancer? Cancer is a group of more than 100 different diseases
More information46. Merkel Cell Carcinoma
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationMUSCLE - INVASIVE AND METASTATIC BLADDER CANCER
10 MUSCLE - INVASIVE AND METASTATIC BLADDER CANCER Recommendations from the EAU Working Party on Muscle Invasive and Metastatic Bladder Cancer G. Jakse (chairman), F. Algaba, S. Fossa, A. Stenzl, C. Sternberg
More informationManagement of Neck Metastasis from Unknown Primary
Management of Neck Metastasis from Unknown Primary.. Definition Histologic evidence of malignancy in the cervical lymph node (s) with no apparent primary site of original tumour Diagnosis after a thorough
More informationMelanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG
Melanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG At tumor board, a surgeon insists that all level II melanomas are invasive since they have broken through the
More informationMUSCLE-INVASIVE AND METASTATIC BLADDER CANCER
MUSCLE-INVASIVE AND METASTATIC BLADDER CANCER (Text update March 2008) A. Stenzl (chairman), N.C. Cowan, M. De Santis, G. Jakse, M. Kuczyk, A.S. Merseburger, M.J. Ribal, A. Sherif, J.A. Witjes Introduction
More information2018 Grade PEGGY ADAMO, RHIT, CTR OCTOBER 11, 2018
1 2018 Grade PEGGY ADAMO, RHIT, CTR ADAMOM@MAIL.NIH.GOV OCTOBER 11, 2018 2 Acknowledgements Donna Hansen, CCR Jennifer Ruhl, NCI SEER Introduction 3 Histologic Type vs. Grade Credit: Dr. Kay Washington
More informationDesmoplastic Melanoma: Surgical Management and Adjuvant Therapy
Desmoplastic Melanoma: Surgical Management and Adjuvant Therapy Dale Han, MD Assistant Professor Department of Surgery Section of Surgical Oncology No disclosures Background Desmoplastic melanoma (DM)
More informationPatient age and cutaneous malignant melanoma: Elderly patients are likely to have more aggressive histological features and poorer survival
MOLECULAR AND CLINICAL ONCOLOGY 7: 1083-1088, 2017 Patient age and cutaneous malignant melanoma: Elderly patients are likely to have more aggressive histological features and poorer survival FARUK TAS
More informationQuiz. b. 4 High grade c. 9 Unknown
Quiz 1. 10/11/12 CT scan abdomen/pelvis: Metastatic liver disease with probable primary colon malignancy. 10/17/12 Colonoscopy with polypectomy: Adenocarcinoma of sigmoid colon measuring at least 6 mm
More informationCancer Research Group Version Date: November 5, 2015 NCI Update Date: January 15, Schema. L O Step 1 1,2
Cancer esearch roup ev. 6/14, 2/15, 1/16 Step 2 Schema 5 Arm A: (7 weeks) Step 1 1,2 N Accrual: 515 S Arm S ransoral esection dissections S A N D M Z 4 ntermediate isk 7 Stratify: = 10 pk-yr vs. > 10 pk-yr
More informationAJCC 8 Implementation January 1, 2018 Melanoma of the Skin. Suraj Venna
AJCC 8 Implementation January 1, 2018 Melanoma of the Skin Suraj Venna Personalized Medicine AJCC 8 th Edition This Time It s Personal Traditional AJCC (TNM) population-based analyses of large databases
More informationIndex. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type.
Surg Oncol Clin N Am 16 (2007) 465 469 Index Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, preoperative for gastric cancer, staging and, 339 B Breast cancer, metabolic
More informationCase Scenario 1 Worksheet. Primary Site C44.4 Morphology 8743/3 Laterality 0 Stage/ Prognostic Factors
CASE SCENARIO 1 9/10/13 HISTORY: Patient is a 67-year-old white male and presents with lesion located 4-5cm above his right ear. The lesion has been present for years. No lymphadenopathy. 9/10/13 anterior
More informationSkin Cancer. 5 Warning Signs. American Osteopathic College of Occupational and Preventive Medicine OMED 2012, San Diego, Monday, October 8, 2012 C-1
Skin Cancer AMERICAN OSTEOPATHIC COLLEGE OF OCCUPATIONAL & PREVENTIVE MEDICINE OMED 2012 October 8, 2012 E. Robert Wanat II, D.O., M.P.H. Learning Objectives: Identify the 3 Basic Types of Skin Cancer
More informationORIGINAL ARTICLE. Predicting the Prognosis of Oral Squamous Cell Carcinoma After First Recurrence
ORIGINAL ARTICLE Predicting the Prognosis of Oral Squamous Cell Carcinoma After First Recurrence Michael D. Kernohan, FDSRCS, FRCS, MSc; Jonathan R. Clark, FRACS; Kan Gao, BEng; Ardalan Ebrahimi, FRACS;
More information25 TH ICRO DEHRADUN STAGING OF GENITOURINARY MALIGNANCIES
25 TH ICRO DEHRADUN STAGING OF GENITOURINARY MALIGNANCIES SPEAKER DR DEEPAK ABROL CLINICAL ONCOLOGIST JAND K HEALTH SERVICES CONSULTANT ONCOLOGIST MAHARISHI DAYANAND HOSPITAL AND MEDICAL RESEARCH CENTER
More informationRadiology- Pathology Conference 4/29/2012. Lymph Nodes. John McGrath
Radiology- Pathology Conference 4/29/2012 Lymph Nodes John McGrath 1 Presentation material is for education purposes only. All rights reserved. 2012 URMC Radiology Page 1 of 24 Case 1: 51 year-old male
More informationIdentifying Skin Cancer. Mary S. Stone MD Professor of Dermatology and Pathology University of Iowa Carver College of Medicine March, 2018
Identifying Skin Cancer Mary S. Stone MD Professor of Dermatology and Pathology University of Iowa Carver College of Medicine March, 2018 American Cancer Society web site Skin Cancer Melanoma Non-Melanoma
More information14. Mucosal Melanoma of the Head and Neck
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationSkin Malignancies Non - Melanoma & Melanoma Marilyn Ng, MD Dept. of Surgery M&M Conference Downstate Medical Center July 19, 2012
Skin Malignancies Non - Melanoma & Melanoma Marilyn Ng, MD Dept. of Surgery M&M Conference Downstate Medical Center July 19, 2012 Case Presentation 57 yo man with 3 month hx of a nonhealing < 1 cm right
More informationStaging for Residents, Nurses, and Multidisciplinary Health Care Team
Staging for Residents, Nurses, and Multidisciplinary Health Care Team Donna M. Gress, RHIT, CTR Validating science. Improving patient care. Learning Objectives Introduce the concept and history of stage
More informationCutaneous malignancy is a common disease in
ORIGINAL ARTICLE PATTERNS OF LYMPH NODE SPREAD OF CUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK Tom J. Vauterin, MD, 1 Michael J. Veness, MMed (Clin Epi), FRANZCR, 2 Garry J. Morgan, FRACDS, FRACS,
More informationSquamous Cell Carcinoma. Basal Cell Carcinoma. Regional Follow-up Guidelines
West of Scotland Cancer Network Skin Cancer Managed Clinical Network Squamous Cell Carcinoma Basal Cell Carcinoma Regional Follow-up Guidelines Prepared by Dr M Porter, Dr A Matthews Approved by Skin Cancer
More informationMetastatic Squamous Cell Carcinoma: Epidemiology and Available Systemic Therapies
Curr Derm Rep (2013) 2:118 124 DOI 10.1007/s13671-013-0047-9 MEDICAL SURGERY (CJ MILLER, SECTION EDITOR) Metastatic Squamous Cell Carcinoma: Epidemiology and Available Systemic Therapies Allison Hanlon
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More informationGerard M. Doherty, MD
Surgical Management of Differentiated Thyroid Cancer: Update on 2015 ATA Guidelines Gerard M. Doherty, MD Chair of Surgery Utley Professor of Surgery and Medicine Boston University Surgeon-in-Chief Boston
More informationCancer of the head and neck region in solid organ transplant recipients
ORIGINAL ARTICLE Cancer of the head and neck region in solid organ transplant recipients Naomi Rabinovics, MD, 1 * Aviram Mizrachi, MD, 1 Tuvia Hadar, MD, 1 Dean Ad-El, MD, 2 Raphael Feinmesser, MD, 1
More informationSalivary Glands tumors
Salivary Glands tumors Sal.Gl. 1 Salivary Glands tumors Work-up procedure TNM staging Primary treatment Follow-up Treatment of recurrent and/or metastatic disease References Sal.Gl. 2 Standard clinical
More informationCase #1: 75 y/o Male (treated and followed by prostate cancer oncology specialist ).
SOLID TUMORS WORKSHOP Cases for review Prostate Cancer Case #1: 75 y/o Male (treated and followed by prostate cancer oncology specialist ). January 2009 PSA 4.4, 20% free; August 2009 PSA 5.2; Sept 2009
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More informationYou Are Going to Cut How Much Skin? Locoregional Surgical Treatment. Justin Rivard MD, MSc, FRCSC September 21, 2018
You Are Going to Cut How Much Skin? Locoregional Surgical Treatment Justin Rivard MD, MSc, FRCSC September 21, 2018 Presenter Disclosure Faculty/Speaker: Justin Rivard Relationships with financial sponsors:
More informationModalities of Radiation
Modalities of Radiation Superficial radiotherapy Orthovoltage Megavoltage Photons Electrons Brachytherapy Interstitial Moulds When to refer? The vast majority of skin cancers will be managed without any
More informationNeck Dissection. Asst Professor Jeeve Kanagalingam MA (Cambridge), BM BCh (Oxford), MRCS (Eng), DLO, DOHNS, FRCS ORL-HNS (Eng), FAMS (ORL)
Neck Dissection Asst Professor Jeeve Kanagalingam MA (Cambridge), BM BCh (Oxford), MRCS (Eng), DLO, DOHNS, FRCS ORL-HNS (Eng), FAMS (ORL) History radical neck Henry Butlin proposed enbloc removal of upper
More informationAJCC Cancer Staging 8 th edition. Lip and Oral Cavity Oropharynx (p16 -) and Hypopharynx Larynx
AJCC Cancer Staging 8 th edition Lip and Oral Cavity Oropharynx (p16 -) and Hypopharynx Larynx AJCC 7 th edition Lip and Oral cavity Pharynx Larynx KEY CHANGES Skin of head and neck (Vermilion of the lip)
More informationClinical Findings, Treatments and Outcomes of Transplant Recipients with Metastatic Skin Cancer
ARC Journal of Dermatology Volume 2, Issue 1, 2017, PP 1-10 ISSN No. (Online) 2456-0022 http://dx.doi.org/10.20431/2456-0022.0201001 www.arcjournals.org Clinical Findings, Treatments and Outcomes of Transplant
More informationINTRODUCTION TO CANCER STAGING
INTRODUCTION TO CANCER STAGING Patravoot Vatanasapt, MD Dept. Otorhinolaryngology Khon Kaen Cancer Registry Faculty of Medicine Khon Kaen University THAILAND Staging is the attempt to assess the size
More informationEVERYTHING YOU WANTED TO KNOW ABOUT. Robin Billet, MA, CTR, Head & Neck CTAP Member May 9, 2013
EVERYTHING YOU WANTED TO KNOW ABOUT. Robin Billet, MA, CTR, Head & Neck CTAP Member May 9, 2013 Head and Neck Coding and Staging Head and Neck Coding and Staging Anatomy & Primary Site Sequencing and MPH
More informationL ARYNX S TAGING F ORM
CLI N I CA L Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery TX T0 Tis a b L ARYNX S TAGING F ORM LATERALITY: TUMOR SIZE: left
More informationBenign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc
1 Benign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc Benign lesions Seborrheic Keratoses: Warty, stuck-on Genetics and birthdays Can start in late
More informationMelanoma Patients and the Sentinel Lymph Node (SLN) Procedure: An Oncologic Surgeon s Perspective
Melanoma Patients and the Sentinel Lymph Node (SLN) Procedure: An Oncologic Surgeon s Perspective Giorgos C. Karakousis, M.D. Associate Professor of Surgery Hospital of the University of Pennsylvania Disclosures
More informationCollaborative Stage for TNM 7 - Revised 07/14/2009 [ Schema ]
MelanomaSkin CS Tumor Size Collaborative Stage for TNM 7 - Revised 07/14/2009 [ Schema ] Code 000 No mass/tumor found Description 001-988 001-988 millimeters (code exact size in millimeters) 989 989 millimeters
More information4/22/2010. Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey.
Management of Differentiated Thyroid Cancer: Head Neck Surgeon Perspective Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey Thyroid gland Small endocrine gland:
More informationCompartmentalization of the larynx Sites and subsites Supraglottis Glottis subglottis Spaces Pre-epiglottic epiglottic space Para-glottic space
Stroboscopy Rounds February 8, 2008 C. Matt Stewart, M.D.,Ph.D. Compartmentalization of the larynx Sites and subsites Supraglottis Glottis subglottis Spaces Pre-epiglottic epiglottic space Para-glottic
More informationProstate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017
Prostate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017 Dr Puay Hoon Tan Division of Pathology Singapore General Hospital Prostate cancer (acinar adenocarcinoma) Invasive carcinoma composed
More informationCase Scenario 1. 7/13/12 Anterior floor of mouth biopsy: Infiltrating squamous cell carcinoma, not completely excised.
Case Scenario 1 7/5/12 History A 51 year old white female presents with a sore area on the floor of her mouth. She claims the area has been sore for several months. She is a current smoker and user of
More informationTalk to Your Doctor. Fact Sheet
Talk to Your Doctor Hearing the words you have skin cancer is overwhelming and would leave anyone with a lot of questions. If you have been diagnosed with Stage I or II cutaneous melanoma with no apparent
More information