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Simple Summary: Due to their high incidence, thin melanomas represent a significant portion of all melanoma-related deaths (30%). In this retrospective case–control study, metastasizing thin melanomas (≤0.8 mm) showed at least one atypical clinical–dermoscopic feature (diameter > 10 mm, at least three colors, regression structures, atypical vascular pattern and absence of a pigment network) and at least one conventional adverse histopathological feature (regression, dermal mitoses, vertical growth phase and ulceration). In thin melanomas, the identification of specific clinical–dermoscopic features (statistically significant) coupled with adverse histopathological features may suggest an early detection of potentially metastatic patients who require prolonged and close monitoring. Despite being early-stage tumors, thin cutaneous melanomas contribute significantly to mortality and have a rising incidence. A retrospective case–control study was performed to identify clinical–dermoscopic and histopathological variables linked to local and distant metastases in melanomas ≤0.8 mm. Data from 1 January 2000 to 22 June 2022 were analyzed from two Italian skin cancer referral centers. Sixteen patients with ≤0.8 mm melanomas developing metastases were studied compared to controls without metastases over 5 years. Statistical analysis involved Pearson's chi-squared test or Fisher's exact test. Of the 1396 cases, 1.1% progressed. The median diagnosis age was 49 (range 28–83), with 56.3% men and 43.7% women. The torso was the primary tumor site (43.7%). Clinically, lesions were pigmented (>10 mm diameter: 73.3%, ≥3 colors: 80%). Dermoscopically, the common features were white patches (73.3%), atypical vascular patterns (66.5%), blue-gray areas (60%) and absent pigment networks (60%). Histopathologically, all cases had adverse features like regression (87.4%), dermal mitoses (50%), a vertical growth phase (62.5%) and ulceration (12.5%). These findings were statistically significant compared to controls (p < 0.05). In ≤0.8 mm melanomas, specific clinical–dermoscopic traits might indicate higher metastatic potential when paired with adverse histopathological features. [ABSTRACT FROM AUTHOR]

Simple Summary: A big part of the increased incidence of melanoma can be attributed to thin, cutaneous melanomas (≤1 mm Breslow thickness), which can rarely progress. The aim of this study is to analyze the sequences of localizations and time intervals of thin melanomas' progressions and investigate their associations with clinicopathological features of the primary and metastatic tumors. We collected 204 eligible cases from five specialized centers across Europe. The first progressions occurred locally (24%), in regional lymph nodes (15%), and in distant sites (61%) after a median time of 3.10 years. The median elapsed time between first and second progression and between second and third was 0.82 and 0.49 years, respectively, while the median survival time was about 4 years since first progression. Our findings describe the natural history of thin melanoma and dictate optimized management and follow-up, especially for subgroups at a higher risk for metastasis. A great portion of cutaneous melanoma's diagnoses nowadays is attributed to thin tumors with up to 1 mm in Breslow thickness (hereafter thin CMs), which occasionally metastasize. The objective of this study was to identify thin CM's metastatic patterns from a topographical and chronological standpoint. A total of 204 cases of metastatic thin CMs from five specialized centers were included in the study, and corresponding data were collected (clinical, epidemiological, histopathological information of primary tumor and the number, anatomical site, and time intervals of their progressions). First progressions occurred locally, in regional lymph nodes, and in a distant site in 24%, 15% and 61% of cases, respectively, with a median time to first progression of 3.10 years (IQR: 1.09–5.24). The median elapsed time between the first and second progression and between the second and third progression was 0.82 (IQR: 0.34–1.97) and 0.49 (IQR: 0.21–2.30) years, respectively, while the median survival time was about 4 years since first progression. Furthermore, the sequences of locations and time intervals of the progressions were associated with the clinicopathological and demographic features of the primary tumors along with the features of the preceding progressions. In conclusion, the findings of this study describe the natural history of thin CMs, thus highlighting the necessity to identify subgroups of thin CMs at a higher risk for metastasis and contributing to the optimization of the management and follow-up of thin CM patients. [ABSTRACT FROM AUTHOR]

Primary cutaneous melanoma (PCM) is the most aggressive skin malignancy, with an increasing incidence and significant mortality. Tumoral invasion, expressed as Breslow thickness, is routinely assessed on hematoxylin and eosin (HE), although this stain may sometimes underestimate the tumoral depth. The aim of this study was to compare the efficiency of the immunohistochemical (IHC) markers S-100, SOX10, Melan-A, and HMB-45 with HE for the evaluation of the Breslow thickness and staging of PCM. This retrospective study included 46 cases of PCM diagnosed between 2015 and 2022; for each case, the Breslow thickness using HE, S-100, SOX10, Melan-A, and HMB-45 was measured and the appropriate T category was recorded. The highest values of the Breslow thickness were observed for S-100. However, S-100, SOX10, and Melan-A provided statistically significant higher values of the Breslow thickness compared to HE, but no difference was noted between HMB-45 and HE. S-100 was most frequently involved in increasing the T category (26.1%), the majority of cases being upstaged from T1a to T1b. The IHC markers S-100, SOX10, and Melan-A contributed to better evaluation of the melanoma invasion, especially in thin melanomas, but their impact on staging and consecutive treatment remains to be confirmed by future studies. [ABSTRACT FROM AUTHOR]

Land reclamation and drainage networks represent one of the most ancient human modifications of the Italian soilscape, where tailored land set-up systems were developed in agro- and forestecosystems in three millennia of man's activity. Most of once manually maintained land settings are currently scarcely working or even disappeared because of the cost needed for their maintenance and the advent of mechanization that have simplified the field organization. The scarce attention to the soil experienced in the last decades, has accelerated soil erosion and flooding events, which entailed high costs in terms of money and human lives, but also caused reduction of soil thickness, water holding capacity, and fertility. In view of a sustainable agriculture, it is mandatory to assess the role of land set-up systems, which for centuries have been key in protecting soil from erosion, but also in increasing soil fertility. Such an effort cannot be made without considering the different pedo-climatic conditions and land uses of the Italian territory, which is different with respect to the past because of the multiple transformations made to favour the mechanization of agriculture. In this review we discuss the main effect of Italian land settings on the soilscape and on soil physicochemical conditions. Since land settings were developed centuries ago, detailed information about their effect on specific soil parameters is scarce in the scientific literature; thus, in some case, we provide information gathered in places where land set-up systems are still present. [ABSTRACT FROM AUTHOR]

Introduction: The treatment outcomes of patients with advanced/metastatic melanoma were poor before the use of new therapeutic options. Material and methods: A retrospective analysis was conducted among 287 patients with unresectable stage III and stage IV melanoma treated at the Maria Sklodowska-Curie National Research Institute of Oncology Cracow Branch, from 2013 to 2019. All enrolled patients were treated with immunotherapy (IT; consisting of pembrolizumab/nivolumab, or ipilimumab) or target therapy (TT; consisting of vemurafenib ±cobimetinib or dabrafenib ±trametinib) in at least one treatment line. Results: mutation was detected in 152 (55%) patients. In general, the majority of patients (92%) were in very good or good condition (Eastern Cooperative Oncology Group [ECOG] 0 or 1). Brain metastasis was detected in 64 (22%) patients. Median OS and PFS in the experimental group from the beginning of the first-line treatment were 14.9 and 6.7 months, respectively. Across the study population, as a first-line treatment patients received IT, TT as well as CHT, and the median OS was 19.2, 12.6 and 15.9 months, respectively. Multivariate analysis confirmed that normal LDH levels, no brain metastases, ECOG 0, and objective response to the treatment were strong predictors of longer OS. For PFS, absence of brain metastases, ECOG 0, and treatment response were found to be predictive factors on multivariate analysis. Conclusions: The administration of new therapies for the treatment of patients with advanced/disseminated melanoma significantly prolonged survival in this group of patients. Nevertheless, further studies should be conducted to assess the effectiveness of various sequences of treatment. [ABSTRACT FROM AUTHOR]