Search

Your search keyword '"Bastholt, Lar"' showing total 5 results
Start Over Author "Bastholt, Lar"
5 results on '"Bastholt, Lar"'

1. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Author

Stratigos, Alexander J, Garbe, Clau, Dessinioti, Clio, Lebbe, Celeste, Bataille, Veronique, Bastholt, Lar, Dreno, Brigitte, Concetta Fargnoli, Maria, Forsea, Ana M, Frenard, Cecille, Harwood, Catherine A, Hauschild, Axel, Hoeller, Christoph, Kandolf-Sekulovic, Lidija, Kaufmann, Roland, Kelleners-Smeets, Nicole W J, Malvehy, Josep, Del Marmol, Veronique, Middleton, Mark R, Moreno-Ramirez, David, Pellecani, Giovanni, Peris, Ketty, Saiag, Philippe, van den Beuken-van Everdingen, Marieke H J, Vieira, Ricardo, Zalaudek, Iri, Eggermont, Alexander M M, Grob, Jean-Jacques, Peris, Ketty (ORCID:0000-0002-5237-0463), Zalaudek, Iris, Stratigos, Alexander J, Garbe, Clau, Dessinioti, Clio, Lebbe, Celeste, Bataille, Veronique, Bastholt, Lar, Dreno, Brigitte, Concetta Fargnoli, Maria, Forsea, Ana M, Frenard, Cecille, Harwood, Catherine A, Hauschild, Axel, Hoeller, Christoph, Kandolf-Sekulovic, Lidija, Kaufmann, Roland, Kelleners-Smeets, Nicole W J, Malvehy, Josep, Del Marmol, Veronique, Middleton, Mark R, Moreno-Ramirez, David, Pellecani, Giovanni, Peris, Ketty, Saiag, Philippe, van den Beuken-van Everdingen, Marieke H J, Vieira, Ricardo, Zalaudek, Iri, Eggermont, Alexander M M, Grob, Jean-Jacques, Peris, Ketty (ORCID:0000-0002-5237-0463), and Zalaudek, Iris

Abstract

In order to update recommendations on treatment, supportive care, education and follow-up of patients with invasive cutaneous squamous cell carcinoma (cSCC), a multidisciplinary panel of experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer was formed. Recommendations were based on evidence-based literature review, guidelines and expert consensus. Treatment recommendations are presented for common primary cSCC (low risk, high risk), locally advanced cSCC, regional metastatic cSCC (operable or inoperable) and distant metastatic cSCC. For common primary cSCC (the most frequent cSCC type), first-line treatment is surgical excision with postoperative margin assessment or microscopically controlled sugery. Safety margins containing clinical normal-appearing tissue around the tumour during surgical excision and negative margins as reported in the pathology report are necessary to minimise the risk of local recurrence and metastasis. In case of positive margins, a re-excision shall be done, for operable cases. Lymph node dissection is recommended for cSCC with cytologically or histologically confirmed regional nodal involvement. Radiotherapy should be considered as curative treatment for inoperable cSCC, or for non-surgical candidates. Anti-PD-1 antibodies are the first-line systemic treatment for patients with metastatic or locally advanced cSCC who are not candidates for curative surgery or radiation, with cemiplimab being the first approved systemic agent for advanced cSCC by the Food and Drug Administration/European Medicines Agency. Second-line systemic treatments for advanced cSCC include epidermal growth factor receptor inhibitors (cetuximab) combined with chemotherapy or radiation therapy. Multidisciplinary board decisions are mandatory for all patients with advanced disease who require more than surgery. Patients should be engaged with informed decisions on manage

Published
2020

2. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2022

Author

Garbe, Claus, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Basset-Seguin, Nicole, Bastholt, Lars, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria C, Forsea, Ana-Maria, Grob, Jean-Jacques, Hoeller, Christoph, Kaufmann, Roland, Kelleners-Smeets, Nicole, Lallas, Aimilios, Lebbé, Celeste, Lytvynenko, Bodhan, Malvehy, Josep, Moreno-Ramirez, David, Nathan, Paul, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Van Akkooi, Alexander C J, Vieira, Ricardo, Zalaudek, Iris, Lorigan, Paul, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC), Garbe, Clau, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Basset-Seguin, Nicole, Bastholt, Lar, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria C, Forsea, Ana-Maria, Grob, Jean-Jacque, Hoeller, Christoph, Kaufmann, Roland, Kelleners-Smeets, Nicole, Lallas, Aimilio, Lebbé, Celeste, Lytvynenko, Bodhan, Malvehy, Josep, Moreno-Ramirez, David, Nathan, Paul, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Van Akkooi, Alexander C J, Vieira, Ricardo, Zalaudek, Iri, and Lorigan, Paul

Subjects
Proto-Oncogene Proteins B-raf, Cancer Research, Consensus, Skin Neoplasms, Consensu, Systemic treatment, Oxime, HIGH-RISK MELANOMA, Antineoplastic Combined Chemotherapy Protocols, Oximes, Humans, Excisional margins, Melanoma, SENTINEL-NODE BIOPSY, Tumor thickne, Neoplasm Staging, POSTOPERATIVE STEREOTACTIC RADIOSURGERY, LENTIGO MALIGNA MELANOMA, Antineoplastic Combined Chemotherapy Protocol, Manchester Cancer Research Centre, ResearchInstitutes_Networks_Beacons/mcrc, MOHS MICROGRAPHIC SURGERY, Metastasectomy, Sentinel lymph node dissection, Interferon-alpha, RANDOMIZED PHASE-III, Adjuvant treatment, Tumor thickness, Cutaneous melanoma, Interferon-α, Mutation, Systematic Reviews as Topic, SURGICAL EXCISION MARGINS, Oncology, PRIMARY CUTANEOUS MELANOMA, STAGE IV MELANOMA, Excisional margin, Settore MED/35 - MALATTIE CUTANEE E VENEREE, DABRAFENIB PLUS TRAMETINIB, Human
Abstract

A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on the systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with one to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumor thickness ≥1.0mm or ≥0.8mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team ("tumor board"). Adjuvant therapies can be proposed in stage III/completely resected stage IV patients and are primarily anti-PD-1, independent of mutational status, or alternatively dabrafenib plus trametinib for BRAF mutant patients. In distant metastases (stage IV), either resected or not, systemic treatment is always indicated. For first-line treatment particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In stage IV melanoma with a BRAF-V600E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harboring a BRAF-V600E/K mutation, this therapy shall be offered as second-line therapy. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.

Published
2022

3. European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022

Author

Garbe, Claus, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Basset-Seguin, Nicole, Bastholt, Lars, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria C, Forsea, Ana-Maria, Grob, Jean-Jacques, Höller, Christoph, Kaufmann, Roland, Kelleners-Smeets, Nicole, Lallas, Aimilios, Lebbé, Celeste, Lytvynenko, Bohdan, Malvehy, Josep, Moreno-Ramirez, David, Nathan, Paul, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Van Akkooi, Alexander C J, Vieira, Ricardo, Zalaudek, Iris, Lorigan, Paul, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC), Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), University Hospital Schleswig-Holstein [Kiel, Germany], Charles University [Prague] (CU), Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Odense University Hospital (OUH), King‘s College London, Université libre de Bruxelles (ULB), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), University of L'Aquila [Italy] (UNIVAQ), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Aix Marseille Université (AMU), Medizinische Universität Wien = Medical University of Vienna, Frankfurt University Hospital, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Aristotle University of Thessaloniki, Shupyk National Medical Academy of Postgraduate Education [Kiev] (SNMAPE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Clinic Barcelona Hospital Universitari, Hospital Universitario Virgen Macarena [Séville], Mount Vernon Cancer Centre [Northwood, UK] (MV2C), Mount Vernon Cancer Centre, University - Hospital of Modena and Reggio Emilia [Modena, Italy], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of Athens Medical School [Athens], The University of Sydney, Centro Hospitalar e Universitário [Coimbra], Università degli studi di Trieste = University of Trieste, University of Manchester [Manchester], European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC), Pecqueret, Valérie, Garbe, Clau, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Basset-Seguin, Nicole, Bastholt, Lar, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria C, Forsea, Ana-Maria, Grob, Jean-Jacque, Höller, Christoph, Kaufmann, Roland, Kelleners-Smeets, Nicole, Lallas, Aimilio, Lebbé, Celeste, Lytvynenko, Bohdan, Malvehy, Josep, Moreno-Ramirez, David, Nathan, Paul, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Van Akkooi, Alexander C J, Vieira, Ricardo, Zalaudek, Iri, and Lorigan, Paul

Subjects
Cancer Research, Sequential digital, Consensus, Skin Neoplasms, Follow-up examinations, [SDV]Life Sciences [q-bio], Consensu, Mutation testing, NEEDLE-ASPIRATION-CYTOLOGY, Primary diagnosis, MALIGNANT-MELANOMA, AJCC classification, Positron Emission Tomography Computed Tomography, Dermatoscopy, Humans, MELANOCYTIC NEVI, Follow-up examination, Imaging diagnostic, Melanoma, SENTINEL-NODE BIOPSY, ComputingMilieux_MISCELLANEOUS, Primary diagnosi, AMERICAN JOINT COMMITTEE, Neoplasm Staging, Manchester Cancer Research Centre, ResearchInstitutes_Networks_Beacons/mcrc, Confocal reflectance microscopy, Cutaneous melanoma, Imaging diagnostics, Sequential digital dermatoscopy, Total body photography, Neoplasm Recurrence, Local, [SDV] Life Sciences [q-bio], ACRAL LENTIGINOUS MELANOMA, Neoplasm Recurrence, Oncology, Local, TOTAL-BODY PHOTOGRAPHY, REFLECTANCE CONFOCAL MICROSCOPY, Settore MED/35 - MALATTIE CUTANEE E VENEREE, FOLLOW-UP, Human
Abstract

International audience; Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed with dermatoscopy. If a melanoma is suspected, a histopathological examination is always required. Sequential digital dermatoscopy and full body photography can be used in high-risk patients to improve the detection of early melanoma. Where available, confocal reflectance microscopy can also improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the American Joint Committee on Cancer classification. Thin melanomas up to 0.8 mm tumor thickness do not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC onwards whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to define the frequency and extent of examinations. A stage-based follow-up scheme is proposed which, according to the experience of the guideline group, covers the optimal requirements, but further studies may be considered. This guideline is valid until the end of 2024.

Published
2022

4. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019

Author

Garbe, Claus, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Bastholt, Lars, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria Concetta, Grob, Jean-Jacques, Höller, Christoph, Kaufmann, Roland, Lallas, Aimilios, Lebbé, Celeste, Malvehy, Josep, Middleton, Mark, Moreno-Ramirez, David, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Vieira, Ricardo, Zalaudek, Iris, Eggermont, Alexander M M, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC), Garbe, Clau, Amaral, Teresa, Peris, Ketty, Hauschild, Axel, Arenberger, Petr, Bastholt, Lar, Bataille, Veronique, Del Marmol, Veronique, Dréno, Brigitte, Fargnoli, Maria Concetta, Grob, Jean-Jacque, Höller, Christoph, Kaufmann, Roland, Lallas, Aimilio, Lebbé, Celeste, Malvehy, Josep, Middleton, Mark, Moreno-Ramirez, David, Pellacani, Giovanni, Saiag, Philippe, Stratigos, Alexander J, Vieira, Ricardo, Zalaudek, Iri, Eggermont, Alexander M M, Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU), Service de Dermatologie [AP-HP Hôpital Saint-Louis], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Ambroise Paré [AP-HP], Novartis Les Laboratories Pierre Fabre Berlin Mathematical School, BMS AbbVie Sanofi Pfizer Amgen Eisai GlaxoSmithKline, GSK Roche DUSA Pharmaceuticals Merck KGaA Meso Scale Diagnostics, MSD, C.G. reports receiving personal fees from Amgen, Pierre Fabre, Philogen and MSD, and reports receiving grants and personal fees from Novartis, NeraCare, BMS, Roche and Sanofi, outside the submitted work.T.A. reports receiving personal fees and other grants from BMS, Novartis, Pierre Fabre, Neracare and Sanofi, outside the submitted work.K.P. reports receiving personal fees from Novartis, Roche, Sanofi, Lilly, Leopharma, Pierre Fabre, Almirall and Celgene, outside the submitted work.A.H. reports receiving grants and personal fees from Amgen, BMS, MerckSerono, MSD / Merck, Philogen, Pierre Fabre, Provectus, Regeneron, Roche, Sanofi-Genzyme, and Novartis Pharma, receiving personal fees from OncoSec and Sun Pharma, outside the submitted work.P.A. reports receiving personal fees from Amgen, MSD, Novartis, BMS and Roche, outside the submitted work.L.B. reports receiving grants from BMS, during the conduct of the study, personal fees from BMS, Novartis, Merck MSD, Roche, Incyte, Bayer, outside the submitted work.V.B. reports receiving personal fees from Novartis and Merck MSD, outside the submitted work.V.d.M. reports receiving personal fees from MSD, BMS and Sanofi, grants and personal fees from ABVIE, grants from Jansen, outside the submitted work.B.M. reports grants and personal fees from BMS, Roche, Fabre and Sanofi, personal fees from MSD, outside the submitted work.M.C.F. reports receiving grants and personal fees from Almirall, Leo Pharma, Novartis, Sanofi, Abbvie and Galderma, personal fees from Janssen, Lilly, UCB, Celgene, Pierre Fabre, Mylan, Medac Pharma, Roche, Sun Pharma, outside the submitted work.J.J.G. reports receiving personal fees from Amgen, MSD, Novartis, BMS, Roche, Pierre fabre, MercK / Pfizer, outside the submitted work.C.H. reports receiving personal fees from Amgen, MSD, Novartis, Incyte, BMS, Pierre Fabre, Roche, Sanofi, outside the submitted work.R.K. reports receiving grants and personal fees from Novartis and Roche, and grants from AbbVie, Amgen, Bionteck, BMS, Celgene, Galderma, Janssen, Leo, Lilly, Merck, MSD, Pierre Fabre, Regeneron and Wyeth, outside the submitted work.A.L. reports personal fees from Amgen, Novartis, BMS and, Sanofi grants and personal fees from Roche, outside the submitted work.C.L. reports receiving grants and personal fees from Bristol-Myers Squibb and Roche, personal fees from MSD, Novartis, Amgen, Avantis Medical Systems, Pierre Fabre, Pfizer, Incyte, outside the submitted work.J.M. reports personal fees from Amgen, personal fees from MSD, grants from Novartis, grants and personal fees from BMS, grants and personal fees from Roche, grants and personal fees from Almirall, personal fees from Sun Pharma, outside the submitted work.M.M. reports receiving personal fees from Amgen and BiolineRx, grants and personal fees from Roche and GSK, grants from Astrazeneca, personal fees and other from Novartis, Eisai, Array Biopharma (now Pfizer), Rigontec (acquired by MSD), and BMS, other from Millennium, Regeneron Pfizer, personal fees, non-financial support and other from Immunocore, Replimun and Merck / MSD, outside the submitted work.G.P. reports receiving personal fees from Novartis, personal fees from Sanofi, grants from Novartis, instruments from 3Gen, Vidix, Fotofinder and MAVIG GmbH, outside the submitted work.P.S. reports receiving personal fees from Amgen, MSD and Pierre Fabre / array, grants and personal fees from Novartis, NeraCare, BMS, Roche, and Sanofi, outside the submitted work.A.J.S. reports personal fees and/or research support from Novartis, Roche, BMS, Abbvie, Sanofi, Regeneron, Genesis Pharma, outside the submitted work. Dr. Vieira has nothing to disclose.I.Z. reports receiving personal fees from Difa Cooper, MSD, Sanofi, Almirall Hermal, Novartis, Mylan and Sunpharma, grants and personal fees from Roche, outside the submitted work.A.M.M.E. reports receiving personal fees from Biocad, Biovent, BMS, CatalYm, Ellipses, GSK, Incyte, IO Biotech, ISA Pharmaceuticals, Merck GmbH, MSD, Novartis, Pfizer, Polynoma, Regeneron, Sanofi, SkylineDx, Stellas, other from RiverD, SkylineDx, Theranovir, all outside the submitted work., Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Portuguese Air Force Health Care Direction [Lisbon, Portugal] (PAFHCD), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein (UKSH), Kiel University, Charles University [Prague] (CU), Odense University Hospital (OUH), King‘s College London, Université libre de Bruxelles (ULB), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), University of L'Aquila [Italy] (UNIVAQ), Assistance Publique - Hôpitaux de Marseille (APHM), Medizinische Universität Wien = Medical University of Vienna, Frankfurt University Hospital, Aristotle University of Thessaloniki, Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), University of Oxford, Hospital Universitario Virgen Macarena [Séville], University - Hospital of Modena and Reggio Emilia [Modena, Italy], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Athens Medical School [Athens], Universidade de Coimbra [Coimbra], Università degli studi di Trieste = University of Trieste, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Princess Máxima Center for Pediatric Oncology, and Dupuis, Christine

Subjects
0301 basic medicine, Oncology, Cancer Research, [SDV]Life Sciences [q-bio], Systemic treatment, Primary diagnosis, 0302 clinical medicine, Dermatoscopy, Stage (cooking), Melanoma, Trametinib, Adjuvant treatment, Cutaneous melanoma, Excisional margins, Interferon-α, Metastasectomy, Sentinel lymph node dissection, Tumour thickness, Combined Modality Therapy, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Excisional margin, Confocal reflectance microscopy, Settore MED/35 - MALATTIE CUTANEE E VENEREE, medicine.drug, Diagnostic Imaging, medicine.medical_specialty, Consensus, Follow-up examinations, Sentinel lymph node, Mutation testing, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, AJCC classification, Internal medicine, medicine, Humans, European Union, Neoplasm Staging, Interdisciplinary Communication, Total body photography, business.industry, Cancer, Dabrafenib, Guideline, medicine.disease, Imaging diagnostics, Cancérologie, 030104 developmental biology, Sequential digital dermatoscopy, business
Abstract

A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team (“Tumor Board”). Adjuvant therapies in stage III/IV patients are primarily anti–PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2019

5. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline

Author

Ketty Peris, Céleste Lebbé, Alexander J. Stratigos, Jean-Jacques Grob, Claus Garbe, Mark R. Middleton, Philippe Saiag, Hubert Pehamberger, Juergen C. Becker, Alessandro Testori, Véronique Del Marmol, Lars Bastholt, Josep Malvehy, Iris Zalaudek, Stratigos, Alexander, Garbe, Clau, Lebbe, Celeste, Malvehy, Josep, Del Marmol, Veronique, Pehamberger, Hubert, Peris, Ketty, Becker, Jürgen C., Zalaudek, Iri, Saiag, Philippe, Middleton, Mark R., Bastholt, Lar, Testori, Alessandro, and Grob, Jean-Jacques

Subjects
Carcinoma, Squamous Cell/diagnosis, Cancer Research, Skin Neoplasms, medicine.medical_treatment, International Cooperation, Perineural invasion, Medizin, Systemic treatment, Medical Oncology, Risk Factors, Diagnosis, Pathology, Medicine, Cooperative Behavior, Skin Neoplasms/diagnosis, Lymph node, medicine.diagnostic_test, Prognosis, Management, Europe, Radiation therapy, Fine-needle aspiration, medicine.anatomical_structure, Treatment Outcome, Oncology, Carcinoma, Squamous Cell, Radiology, Settore MED/35 - MALATTIE CUTANEE E VENEREE, Cutaneous squamous cell carcinoma, Follow up, Surgical excision, Diagnosi, medicine.medical_specialty, Consensus, Prognosi, Sentinel lymph node, Lymph node biopsy, Dermatology, Predictive Value of Tests, Biopsy, Dermatology/standards, Humans, Neoplasm Staging, business.industry, Carcinoma, Cancer, medicine.disease, Surgery, Squamous Cell, Interdisciplinary Communication, Medical Oncology/standards, business
Abstract

Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in Caucasian populations, accounting for 20% of all cutaneous malignancies. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cSCC diagnosis and management, based on a critical review of the literature, existing guidelines and the expert's experience. The diagnosis of cSCC is primarily based on clinical features. A biopsy or excision and histologic confirmation should be performed in all clinically suspicious lesions in order to facilitate the prognostic classification and correct management of cSCC. The first line treatment of cutaneous SCC is complete surgical excision with histopathological control of excision margins. The EDF-EADO-EORTC consensus group recommends a standardised minimal margin of 5mm even for low-risk tumours. For tumours, with histological thickness of >6mm or in tumours with high risk pathological features, e.g. high histological grade, subcutaneous invasion, perineural invasion, recurrent tumours and/or tumours at high risk locations an extended margin of 10mm is recommended. As lymph node involvement by cSCC increases the risk of recurrence and mortality, a lymph node ultrasound is highly recommended, particularly in tumours with high-risk characteristics. In the case of clinical suspicion or positive findings upon imaging, a histologic confirmation should be sought either by fine needle aspiration or by open lymph node biopsy. In large infiltrating tumours with signs of involvement of underlying structures, additional imaging tests, such as CT or MRI imaging may be required to accurately assess the extent of the tumour and the presence of metastatic spread. Current staging systems for cSCC are not optimal, as they have been developed for head and neck tumours and lack extensive validation or adequate prognostic discrimination in certain stages with heterogeneous outcome measures. Sentinel lymph node biopsy has been used in patients with cSCC, but there is no conclusive evidence of its prognostic or therapeutic value. In the case of lymph node involvement by cSCC, the preferred treatment is a regional lymph node dissection. Radiation therapy represents a fair alternative to surgery in the non-surgical treatment of small cSCCs in low risk areas. It generally should be discussed either as a primary treatment for inoperable cSCC or in the adjuvant setting. Stage IV cSCC can be responsive to various chemotherapeutic agents; however, there is no standard regimen. EGFR inhibitors such as cetuximab or erlotinib, should be discussed as second line treatments after mono- or polychemotherapy failure and disease progression or within the framework of clinical trials. There is no standardised follow-up schedule for patients with cSCC. A close follow-up plan is recommended based on risk assessment of locoregional recurrences, metastatic spread or development of new lesions.

Published
2015

Catalog

Books, media, physical & digital resources
See catalog results