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Background: The recently implemented AJCC 8th edition TNM staging system for malignant melanoma (MM) changed the definition for T1a and T1b tumours., Objectives: To analyse differences in disease-free survival (DFS) among patients with thin MM staged according to both AJCC 7th and 8th editions., Methods: An observational study including 285 patients with cutaneous thin MM (thickness ≤1 mm). Cases were staged as T1a and T1b using both 7th and 8th editions. Neither regional nor visceral diseases were present at diagnosis. DFS curves were generated according to the Kaplan-Meier method., Results: An 8% shift of patients from a T1a towards a T1b stage group was observed after applying the AJCC 8th edition. According to this 8th edition, DFS for T1a patients was significantly longer than for T1b patients (log-rank test; p = 0.005); 5-year DFS for T1a and T1b was 100 and 95%, respectively (Wilcoxon test; p = 0.002). According to the AJCC 7th edition, DFS did not significantly differ for T1a and T1b patients; 5-year DFS for T1a and T1b was 99 and 97%, respectively (p > 0.05)., Conclusions: The AJCC 8th edition seems to be a better tool for staging thin melanomas., (© 2019 S. Karger AG, Basel.)

Background: Despite suffering high ultraviolet radiation levels, few data on malignant melanoma (MM) in Macaronesia are available., Methods: Observational study of cutaneous MM cases diagnosed during a period of 12 years at a tertiary hospital in Canary Islands., Results: A total of 532 patients (female/male = 1.4) with an average age of 56 years were included; 5% developed more than one MM, and 7% reported family history of MM. Phototype II (43%), dark eyes (41%), and dark hair (41%) predominated. There was a lower frequency of light-colored hair and eyes in those born in the Canary Islands. The most frequent locations of MM were on the back for men (37%) and on the lower extremities for women (35%). Among the infiltrating tumors (83%), the (median) thickness was 1.07 mm (women, 0.90 mm; men, 1.21 mm). Anatomopathological ulceration (AU) and a mitotic rate ≥1 mitosis/mm 2 (HMR) were recorded in 27% of patients. Patients with regional disease constituted 12% of the population. The most common stage was IA (34%). Melanoma-specific survival (MSSV) decreased significantly with thickness, presence of AU, HMR, and sentinel lymph node disease. These four variables were independent prognostic factors. The five-year MSSV varied between 100% (stage IA) and 39% (stage IIIC)., Conclusions: The characteristics of the patients were similar to those published in datasets from continental Europe, although the pigmentary features were darker in those originating from Macaronesia. The prognostic parameters described in the 7th edition of the American Joint Committee on Cancer (AJCC) independently predict MSSV in our patients., (© 2017 The International Society of Dermatology.)

A 50-year-old woman with a history of bilateral lobular carcinoma of the breast in 1995 and 2001 was treated with mastectomy, axillary lymphadenectomy, chemotherapy, and hormone therapy which achieved a complete response. In 2009, the patient developed a progressive elevation of tumor markers. A CT scan was performed showing no suspicious malignant lesions. She was referred for (18)F-FDG PET/CT and the images revealed highly increased tracer uptake in the uterus suggestive of malignancy. The patient underwent hysterectomy with bilateral double adnexectomy and a histopathological diagnosis of massive carcinomatous infiltration of breast lobular carcinoma was done.

Objective: To evaluate the efficacy of (18)F-FDG PET-CT in the diagnosis of recurrence of colorectal cancer (CRC) in patients with elevated values of carcinoembryonic antigen (CEA) and/or signs of recurrence in the multidetector CT (MDCT), and to demonstrate that good results can be obtained applying the ALARA principles., Material and Methods: A retrospective study of 54 patients with suspected CRC, who underwent an (18)F-FDG PET-CT, administering a mean dose of 222 MBq (6 mCi) of (18)F-FDG, from 07/2007 to 01/2011 was carried out. Seven patients were excluded, thus studying 47 (27 males, 20 females, mean age 63 years). Recurrence was confirmed by histopathology study in 14 cases and by clinical evolution in 33. The patients were divided into 4 groups. A: patients with elevation of CEA and suspected recurrence in the MDCT. B: elevation of CEA, without suspicious lesions in the MDCT. C: normal levels of CEA and positive MDCT. D: normal levels of CEA and uncertain MDCT., Results: We found sensitivity, specificity, PPV, NPV and overall accuracy of 91%, 69%, 89%, 75% and 85% respectively. For group A, we found 100% sensitivity, in group B, 75% sensitivity with 100% specificity%, for C, sensitivity was 89% with 71% specificity. Finally, in group D, sensitivity was 100% and specificity 60%, respectively., Conclusion: Applying a low dose, the (18)F-FDG PET-CT has high diagnostic performance in patients with suspicion of CRC, approaching in a higher grade the ALARA criteria., (Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.)