Rowan Pritchard-Jones | University of Liverpool (original) (raw)

Papers by Rowan Pritchard-Jones

British Journal of Surgery

Aims The hand, as the primary executing organ, is at the centre of nearly all daily activities. I... more Aims The hand, as the primary executing organ, is at the centre of nearly all daily activities. In the anatomical extremity, the hand is frequently exposed to the potential risk of injury. If a flexor tendon is injured and recognized as needing surgical intervention, two main options are available; Two-stage Flexor Tendon (TSFT) repair or Primary repair. We evaluated the subjective and functional outcomes of the two surgical methods described above in patients presenting with flexor tendon injury in Zone I or II over a 5-year period. Methodology A retrospective study employing 35 patients (and a total of 42 tendon injuries) requiring TSFT repair over a 5-year period and 190 patients requiring primary flexor tendon repair between 2012-2014. Data collected included patient demographics, injury details, intraoperative findings and post-operative outcomes. Results Of the 35 digital injuries assessed, 15.8% had a good outcome, 21.1% with a fair outcome and 63.2% with a poor outcome, base...

British Journal of Surgery, Oct 1, 2022

British Journal of Surgery, Oct 1, 2022

Aim: Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of th... more Aim: Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of this study was to analyse the impact and outcomes of abdominal wall reconstruction (AWR) performed during the COVID-19 pandemic, assessing safety and sustainability. Material and Methods: A retrospective review of all patients undergoing AWR in a single NHS trust, multiple surgeons, between 23 rd March 2020 and 22 rd March 2022, the 2 years following U.K. Government imposed lockdown, was undertaken and compared with the pre-pandemic AWR activity. Procedures were initially undertaken at a cold site and when demonstrated to be safe, main site operating restarted. The primary outcome was 90 day mortality, secondary outcomes of COVID-19 infection within 7 days, length of stay, critical care requirement, and complication rate. Results: In the study period, 173 patients underwent AWR, compared with 99 cases in a single year preceding lockdown. 90 day mortality rate was zero. No patients returned positive COVID tests to the trust within 7 days of AWR, and no patients were readmitted for COVID related symptoms. Critical care admission was required in 7 patients, 3 of these were planned admissions pre-operatively. The surgical site occurrence rate was 9.8% (17), infection 5.8% (10), seroma 2.3% (4) and haematoma 1.7% (3). There were no recurrences reported, with follow up ranging between 1 and 18 months. Conclusion: Continuing AWR services during the COVID pandemic is feasible and safe. Peri-operative COVID infection rates are low, critical care requirements minimal, and there is no impact on patient morbidity or mortality.

PubMed, 2011

The effective management of malignant melanoma has remained centred around the surgeon. The arriv... more The effective management of malignant melanoma has remained centred around the surgeon. The arrival of anti-angiogenic agents as the 'fourth' cancer treatment joining the ranks of surgery, chemotherapy and radiotherapy has been a source of renewed hope. This article provides an up-to-date review of the focus, state and rationale of clinical trials of anti-angiogenic therapies in metastatic malignant melanoma. Vascular Endothelial Growth Factor (VEGF) is by no means the only target, although perhaps the most extensively studied following the successful introduction of the anti-VEGF Antibody bevacizumab. This has been combined with other established therapies to try and improve outcomes in metastatic disease, and is being trialled in the UK to prevent metastasis in high-risk patients. We describe the encouraging preclinical work that lead to great enthusiasm for these agents, assess the key trials and their outcomes, discuss why these therapies have not revolutionised melanoma care and explore how they might be better targeted in the future.

Annals of The Royal College of Surgeons of England, Mar 1, 2014

Protective eye protection (PEP), including surgical loupes, is essential in many surgical special... more Protective eye protection (PEP), including surgical loupes, is essential in many surgical specialties. During non-medical use of PEP, the problem of 'fogging' has resulted in reduced visual acuity 1 and this is cited as the main reason for non-compliance. 2 This is reflected with its use in surgery, where fogging of a surgeon's PEP represents a hazard to patient safety. Multiple attempts have been made to solve this problem, including PEP washing prior to application, 3 adding tape 4 or the use of several masks, 5 but we believe this to be the first description of a novel method that does not involve any further cost or instrumentation.

Journal of the Royal Naval Medical Service, Mar 1, 2006

Annals of The Royal College of Surgeons of England, Mar 1, 2014

Oxford University Press eBooks, Mar 1, 2019

Background: Optimal fluid resuscitation in children with major burns is crucial to prevent or min... more Background: Optimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation. Objectives: To identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome. Design: Systematic review. Methods: Medline, Embase, Cinahl and the Cochrane Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed. Results: Following screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, whilst the remainder targeted a range from 0.5-1.0ml/kg/hr to 2-3ml/kg/hr. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between UO targets. One study targeted invasive haemodynamic variables but this did not significantly affect patient outcome. Conclusions: Few studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

Cancers

Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of vari... more Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of various cancers. Data on breast cancer (BC) patients with cutaneous metastases were retrieved from the INSPECT database. Patients were divided by their receptor status: HER2+, HR+ (ER/PgR+), and TN (triple negative). Groups were similar for histological subtype and location of the nodules. Most patients were previously treated with surgery/systemic therapy/radiotherapy. We found no differences in the three groups in terms of response ratio (OR per patient 86% HER2+, 80% HR+, 76% TN, p = 0.8664). The only factor positively affecting the complete response rate in all groups was small tumor size (<3 cm, p = 0.0105, p = 0.0001, p = 0.0266, respectively). Local progression-free survival was positively impacted by the achievement of complete response in HER2+ (p = 0.0297) and HR+ (p = 0.0094), while overall survival was affected by time to local progression in all groups (p = 0.0065 in HER2+, p...

BMJ health & care informatics, 2023

Study objective The objective of this study was to evaluate the accuracy of a new elective surger... more Study objective The objective of this study was to evaluate the accuracy of a new elective surgery clinical decision support system, the 'Patient Tacking List' (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. Methods We constructed ROC curves based on risk predictions produced by the tool and compared these with actual patient outcomes on a retrospective cohort of patients awaiting elective surgery. Results A total of 11 837 patients were included across three National Health Service (NHS) hospitals in England. ROC analysis revealed an area under the curve of 0.95 (95% CI 0.92 to 0.98) for mortality and 0.8 (95% CI 0.78 to 0.82) for complications. Discussion The PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes. Conclusions The high level of accuracy for predicating mortality and complications after elective surgery using the PTL tool indicates the potential for clinical decision support tools to help tackle rising waiting lists and improve surgical planning.

Academy of Marketing 2016 Conference, 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2019

Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients... more Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients for the past 15 years. The high accuracy of this prognostic staging procedure is now recognised in all international guidelines for melanoma. However during this period there have been a number of important changes in the management of melanoma, many occurring within the past five years. The outcomes of five recent randomised Phase 3 trials have This consensus position is due to be discussed at the Melanoma Focus meeting in Leeds-17/05/19.

The British journal of dermatology, Jan 24, 2017

Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment inv... more Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors which affect (beneficially or adversely) the outcome. 13 cancer centres in the International Network for Sharing Practices on Electrochemotherapy (INSPECT) consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoural or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. 151 patients with metastatic melanoma were identified from the database, 114 of which had follow-up data of 60 days or more. 80 of these patients (73%) experienced an overall response (complete response + partial response = OR). 394 lesions were treated, of which 306 (77%) revealed an OR, 229...

Annals of Surgical Oncology, 2019

Journal of Clinical Oncology

PURPOSE Indications for offering adjuvant systemic therapy for patients with early-stage melanoma... more PURPOSE Indications for offering adjuvant systemic therapy for patients with early-stage melanomas with low disease burden sentinel node (SN) micrometastases, namely, American Joint Committee on Cancer (AJCC; eighth edition) stage IIIA disease, are presently controversial. The current study sought to identify high-risk SN-positive AJCC stage IIIA patients who are more likely to derive benefit from adjuvant systemic therapy. METHODS Patients were recruited from an intercontinental (Australia/Europe/North America) consortium of nine high-volume cancer centers. All were adult patients with pathologic stage pT1b/pT2a primary cutaneous melanomas who underwent SN biopsy between 2005 and 2020. Patient data, primary tumor and SN characteristics, and survival outcomes were analyzed. RESULTS Three thousand six hundred seven patients were included. The median follow-up was 34 months. Pairwise disease comparison demonstrated no significant survival difference between N1a and N2a subgroups. Surv...

Frontiers in Oncology

IntroductionCutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk o... more IntroductionCutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk of recurrence characterized by tumor infiltration and, in advanced cases, a poor prognosis. ECT (electrochemotherapy) is an alternative treatment option for locally advanced or recurrent cSCC that is unsuitable for surgical resection. In this study, we aimed to evaluate the data in the InspECT (International Network for Sharing Practice on ECT) registry of the referral centers and to clarify the indications for the use of ECT as a treatment modality for cSCC.Materials and methodsPatients with primary, recurrent or locally advanced cSCC from 18 European centers were included. They underwent at least one ECT session with bleomycin between February 2008 and November 2020, which was performed following the European Standard Operating Procedures.ResultsThe analysis included 162 patients (mean age of 80 years; median, 1 lesion/patient). Side effects were mainly local and mild (hyperpigmentation...

Annals of Surgical Oncology

Background Patients presenting with early-stage melanoma (AJCC pT1b-pT2a) reportedly have a relat... more Background Patients presenting with early-stage melanoma (AJCC pT1b-pT2a) reportedly have a relatively low risk of a positive SNB (~5–10%). Those patients are usually found to have low-volume metastatic disease after SNB, typically reclassified to AJCC stage IIIA, with an excellent prognosis of ~90% 5-year survival. Currently, adjuvant systemic therapy is not routinely recommended for most patients with AJCC stage IIIA melanoma. The purpose was to assess the SN-positivity rate in early-stage melanoma and to identify primary tumor characteristics associated with high-risk nodal disease eligible for adjuvant systemic therapy Methods An international, multicenter retrospective cohort study from 7 large-volume cancer centers identified 3,610 patients with early primary cutaneous melanomas 0.8–2.0 mm in Breslow thickness (pT1b-pT2a; AJCC 8th edition). Patient demographics, primary tumor characteristics, and SNB status/details were analyzed. Results The overall SNB-positivity rate was 11....

▸ Additional material is published online only. To view please visit the journal online

▸ Additional material is published online only. To view please visit the journal online

Introduction: UK melanoma incidence is continuing to rise, resulting in a growing economic burden... more Introduction: UK melanoma incidence is continuing to rise, resulting in a growing economic burden to the NHS and wider economy. Public awareness campaigns have aimed to tackle this issue, yet the real-world impact on the UK population is poorly understood. Google Trends is a tool that identifies search interest patterns by keywords, incidence and geography. The study aim is to characterise UK and international search trends for skin cancer, tanning methods and sun protection. Methods: Google Trends was systematically searched using terms associated with artificial UV tanning, sun protection and skin lesions, including cancer. The searches compared the UK to Australia and the USA (2004-2018). Results: Search terms of artificial UV tanning (“sunbed”, “tanning bed” and “tanning salon”) peak annually during May, whereas the highest volume of searches for sun prophylaxis (“sun cream”, “sunscreen”, “sun protection”) and skin lesions (“mole”, “skin cancer”) occurs during June. Troughs appe...

British Journal of Surgery

Aims The hand, as the primary executing organ, is at the centre of nearly all daily activities. I... more Aims The hand, as the primary executing organ, is at the centre of nearly all daily activities. In the anatomical extremity, the hand is frequently exposed to the potential risk of injury. If a flexor tendon is injured and recognized as needing surgical intervention, two main options are available; Two-stage Flexor Tendon (TSFT) repair or Primary repair. We evaluated the subjective and functional outcomes of the two surgical methods described above in patients presenting with flexor tendon injury in Zone I or II over a 5-year period. Methodology A retrospective study employing 35 patients (and a total of 42 tendon injuries) requiring TSFT repair over a 5-year period and 190 patients requiring primary flexor tendon repair between 2012-2014. Data collected included patient demographics, injury details, intraoperative findings and post-operative outcomes. Results Of the 35 digital injuries assessed, 15.8% had a good outcome, 21.1% with a fair outcome and 63.2% with a poor outcome, base...

British Journal of Surgery, Oct 1, 2022

British Journal of Surgery, Oct 1, 2022

Aim: Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of th... more Aim: Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of this study was to analyse the impact and outcomes of abdominal wall reconstruction (AWR) performed during the COVID-19 pandemic, assessing safety and sustainability. Material and Methods: A retrospective review of all patients undergoing AWR in a single NHS trust, multiple surgeons, between 23 rd March 2020 and 22 rd March 2022, the 2 years following U.K. Government imposed lockdown, was undertaken and compared with the pre-pandemic AWR activity. Procedures were initially undertaken at a cold site and when demonstrated to be safe, main site operating restarted. The primary outcome was 90 day mortality, secondary outcomes of COVID-19 infection within 7 days, length of stay, critical care requirement, and complication rate. Results: In the study period, 173 patients underwent AWR, compared with 99 cases in a single year preceding lockdown. 90 day mortality rate was zero. No patients returned positive COVID tests to the trust within 7 days of AWR, and no patients were readmitted for COVID related symptoms. Critical care admission was required in 7 patients, 3 of these were planned admissions pre-operatively. The surgical site occurrence rate was 9.8% (17), infection 5.8% (10), seroma 2.3% (4) and haematoma 1.7% (3). There were no recurrences reported, with follow up ranging between 1 and 18 months. Conclusion: Continuing AWR services during the COVID pandemic is feasible and safe. Peri-operative COVID infection rates are low, critical care requirements minimal, and there is no impact on patient morbidity or mortality.

PubMed, 2011

The effective management of malignant melanoma has remained centred around the surgeon. The arriv... more The effective management of malignant melanoma has remained centred around the surgeon. The arrival of anti-angiogenic agents as the 'fourth' cancer treatment joining the ranks of surgery, chemotherapy and radiotherapy has been a source of renewed hope. This article provides an up-to-date review of the focus, state and rationale of clinical trials of anti-angiogenic therapies in metastatic malignant melanoma. Vascular Endothelial Growth Factor (VEGF) is by no means the only target, although perhaps the most extensively studied following the successful introduction of the anti-VEGF Antibody bevacizumab. This has been combined with other established therapies to try and improve outcomes in metastatic disease, and is being trialled in the UK to prevent metastasis in high-risk patients. We describe the encouraging preclinical work that lead to great enthusiasm for these agents, assess the key trials and their outcomes, discuss why these therapies have not revolutionised melanoma care and explore how they might be better targeted in the future.

Annals of The Royal College of Surgeons of England, Mar 1, 2014

Protective eye protection (PEP), including surgical loupes, is essential in many surgical special... more Protective eye protection (PEP), including surgical loupes, is essential in many surgical specialties. During non-medical use of PEP, the problem of 'fogging' has resulted in reduced visual acuity 1 and this is cited as the main reason for non-compliance. 2 This is reflected with its use in surgery, where fogging of a surgeon's PEP represents a hazard to patient safety. Multiple attempts have been made to solve this problem, including PEP washing prior to application, 3 adding tape 4 or the use of several masks, 5 but we believe this to be the first description of a novel method that does not involve any further cost or instrumentation.

Journal of the Royal Naval Medical Service, Mar 1, 2006

Annals of The Royal College of Surgeons of England, Mar 1, 2014

Oxford University Press eBooks, Mar 1, 2019

Background: Optimal fluid resuscitation in children with major burns is crucial to prevent or min... more Background: Optimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation. Objectives: To identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome. Design: Systematic review. Methods: Medline, Embase, Cinahl and the Cochrane Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed. Results: Following screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, whilst the remainder targeted a range from 0.5-1.0ml/kg/hr to 2-3ml/kg/hr. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between UO targets. One study targeted invasive haemodynamic variables but this did not significantly affect patient outcome. Conclusions: Few studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

Cancers

Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of vari... more Electrochemotherapy has been proven to be an efficient treatment for cutaneous metastases of various cancers. Data on breast cancer (BC) patients with cutaneous metastases were retrieved from the INSPECT database. Patients were divided by their receptor status: HER2+, HR+ (ER/PgR+), and TN (triple negative). Groups were similar for histological subtype and location of the nodules. Most patients were previously treated with surgery/systemic therapy/radiotherapy. We found no differences in the three groups in terms of response ratio (OR per patient 86% HER2+, 80% HR+, 76% TN, p = 0.8664). The only factor positively affecting the complete response rate in all groups was small tumor size (<3 cm, p = 0.0105, p = 0.0001, p = 0.0266, respectively). Local progression-free survival was positively impacted by the achievement of complete response in HER2+ (p = 0.0297) and HR+ (p = 0.0094), while overall survival was affected by time to local progression in all groups (p = 0.0065 in HER2+, p...

BMJ health & care informatics, 2023

Study objective The objective of this study was to evaluate the accuracy of a new elective surger... more Study objective The objective of this study was to evaluate the accuracy of a new elective surgery clinical decision support system, the 'Patient Tacking List' (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. Methods We constructed ROC curves based on risk predictions produced by the tool and compared these with actual patient outcomes on a retrospective cohort of patients awaiting elective surgery. Results A total of 11 837 patients were included across three National Health Service (NHS) hospitals in England. ROC analysis revealed an area under the curve of 0.95 (95% CI 0.92 to 0.98) for mortality and 0.8 (95% CI 0.78 to 0.82) for complications. Discussion The PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes. Conclusions The high level of accuracy for predicating mortality and complications after elective surgery using the PTL tool indicates the potential for clinical decision support tools to help tackle rising waiting lists and improve surgical planning.

Academy of Marketing 2016 Conference, 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2019

Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients... more Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients for the past 15 years. The high accuracy of this prognostic staging procedure is now recognised in all international guidelines for melanoma. However during this period there have been a number of important changes in the management of melanoma, many occurring within the past five years. The outcomes of five recent randomised Phase 3 trials have This consensus position is due to be discussed at the Melanoma Focus meeting in Leeds-17/05/19.

The British journal of dermatology, Jan 24, 2017

Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment inv... more Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors which affect (beneficially or adversely) the outcome. 13 cancer centres in the International Network for Sharing Practices on Electrochemotherapy (INSPECT) consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoural or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. 151 patients with metastatic melanoma were identified from the database, 114 of which had follow-up data of 60 days or more. 80 of these patients (73%) experienced an overall response (complete response + partial response = OR). 394 lesions were treated, of which 306 (77%) revealed an OR, 229...

Annals of Surgical Oncology, 2019

Journal of Clinical Oncology

PURPOSE Indications for offering adjuvant systemic therapy for patients with early-stage melanoma... more PURPOSE Indications for offering adjuvant systemic therapy for patients with early-stage melanomas with low disease burden sentinel node (SN) micrometastases, namely, American Joint Committee on Cancer (AJCC; eighth edition) stage IIIA disease, are presently controversial. The current study sought to identify high-risk SN-positive AJCC stage IIIA patients who are more likely to derive benefit from adjuvant systemic therapy. METHODS Patients were recruited from an intercontinental (Australia/Europe/North America) consortium of nine high-volume cancer centers. All were adult patients with pathologic stage pT1b/pT2a primary cutaneous melanomas who underwent SN biopsy between 2005 and 2020. Patient data, primary tumor and SN characteristics, and survival outcomes were analyzed. RESULTS Three thousand six hundred seven patients were included. The median follow-up was 34 months. Pairwise disease comparison demonstrated no significant survival difference between N1a and N2a subgroups. Surv...

Frontiers in Oncology

IntroductionCutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk o... more IntroductionCutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk of recurrence characterized by tumor infiltration and, in advanced cases, a poor prognosis. ECT (electrochemotherapy) is an alternative treatment option for locally advanced or recurrent cSCC that is unsuitable for surgical resection. In this study, we aimed to evaluate the data in the InspECT (International Network for Sharing Practice on ECT) registry of the referral centers and to clarify the indications for the use of ECT as a treatment modality for cSCC.Materials and methodsPatients with primary, recurrent or locally advanced cSCC from 18 European centers were included. They underwent at least one ECT session with bleomycin between February 2008 and November 2020, which was performed following the European Standard Operating Procedures.ResultsThe analysis included 162 patients (mean age of 80 years; median, 1 lesion/patient). Side effects were mainly local and mild (hyperpigmentation...

Annals of Surgical Oncology

Background Patients presenting with early-stage melanoma (AJCC pT1b-pT2a) reportedly have a relat... more Background Patients presenting with early-stage melanoma (AJCC pT1b-pT2a) reportedly have a relatively low risk of a positive SNB (~5–10%). Those patients are usually found to have low-volume metastatic disease after SNB, typically reclassified to AJCC stage IIIA, with an excellent prognosis of ~90% 5-year survival. Currently, adjuvant systemic therapy is not routinely recommended for most patients with AJCC stage IIIA melanoma. The purpose was to assess the SN-positivity rate in early-stage melanoma and to identify primary tumor characteristics associated with high-risk nodal disease eligible for adjuvant systemic therapy Methods An international, multicenter retrospective cohort study from 7 large-volume cancer centers identified 3,610 patients with early primary cutaneous melanomas 0.8–2.0 mm in Breslow thickness (pT1b-pT2a; AJCC 8th edition). Patient demographics, primary tumor characteristics, and SNB status/details were analyzed. Results The overall SNB-positivity rate was 11....

▸ Additional material is published online only. To view please visit the journal online

▸ Additional material is published online only. To view please visit the journal online

Introduction: UK melanoma incidence is continuing to rise, resulting in a growing economic burden... more Introduction: UK melanoma incidence is continuing to rise, resulting in a growing economic burden to the NHS and wider economy. Public awareness campaigns have aimed to tackle this issue, yet the real-world impact on the UK population is poorly understood. Google Trends is a tool that identifies search interest patterns by keywords, incidence and geography. The study aim is to characterise UK and international search trends for skin cancer, tanning methods and sun protection. Methods: Google Trends was systematically searched using terms associated with artificial UV tanning, sun protection and skin lesions, including cancer. The searches compared the UK to Australia and the USA (2004-2018). Results: Search terms of artificial UV tanning (“sunbed”, “tanning bed” and “tanning salon”) peak annually during May, whereas the highest volume of searches for sun prophylaxis (“sun cream”, “sunscreen”, “sun protection”) and skin lesions (“mole”, “skin cancer”) occurs during June. Troughs appe...