Management and Clinico-Pathologic Aspects of Non-Melanoma Skin Cancer of the Head and Neck: A Retrospective Institutional Based Study at the Egyptian National Cancer Institute

Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012. The mean follow-up was 6 months (1 - 84 months). Results: 117 males and 83 females with 90% ≥ 50 years old. The scalp (27.5%), the periorbital region (13%), the cheek (12.5%) and the nose (12.5%) are the main anatomical sites affected. BCC represented 71.5% with nodular type (79%) predominance;SCC represented 21% with GII (61.1%) the commonest grade. Surgery was the main modality of treatment (93%) with local flaps only (63.9%) and primary closure (14.7%) were the main surgical options following wide local excision. Positive and close margins were detected in 23.5% of excised specimens. No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons.

Clinical Effect of Photodynamic Therapy Combined Cryotherapy on Nonmelanoma Skin Cancer

The purpose of this study was to investigate the clinical efficacy of photodynamic combined freezing in patients with non-melanoma skin cancer(NMSC).First,according to the treatment regimen,96 patients with NMSC were divided into study group(n=50)and control group(n=46).The control group was treated with 5-amino-ketovalic acid photodynamic therapy(ALAPDT),while the study group was treated with ala-PDT combined with cryotherapy.Visual analogue scale(VAS)scores,visual satisfaction,clinical efficacy,adverse reactions,and progression-free survival were compared between the two groups.The results showed that VAS score in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The appearance satisfaction and total effective rate of patients in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).3 years progressionfree survival time and 3 years progression-free survival rate were compared between the two groups,and the difference was not statistically significant(P>0.05).Therefore,the combination of PDT and cryotherapy for non-melanoma skin cancer has a good clinical effect,which is conducive to the recovery of skin lesions,high patient satisfaction,fewer adverse reactions,and longer progression-free survival.In addition,the combined therapy can provide a new treatment idea for non-melanoma skin cancer patients who are not suitable for surgical treatment.

An update on clinical trials for chemoprevention of human skin cancer

The pathophysiology of skin cancer is complex,with multiple factors contributing to its development.The proactive treatment of skin cancer has been investigated in the form of chemoprevention of cutaneous malignancies in clinical trials.Chemoprevention is the use of natural or pharmacologic agents that prevent or reverse skin cancer development.Multiple trials have arisen over the past decades to explore the efficacy of specific agents to halt the progression of UV radiation damage.This comprehensive review article aims to assess clinical trials performed with chemopreventive agents for melanoma and nonmelanoma skin cancers.The following compounds were most often used in these trials:nicotinamide,retinoids,polyphenolic antioxidants,COX-2 selective inhibitors,non-steroidal anti-inflammatory drugs,difluoromethylornithine,and 5-fluorouracil.Many agents show promise in their ability to prevent nonmelanoma skin cancer formation,with few melanoma trials demonstrating efficacy.The chemoprevention efforts aimed at skin cancer are complex;current and future trials will be instrumental in identifying therapeutic agents that pose efficacy in halting cancer development and assessing whether long-term administration is tolerable.

光动力治疗老年性皮肤肿瘤应用及研究进展

皮肤肿瘤好发于老年人,其中较为常见的是非黑色素瘤皮肤癌(nonmelanoma skin cancer,NMSC)。光动力疗法近乎无创不损伤其他功能器官,对老年皮肤肿瘤具有安全、可重复、无耐药等优势。光动力疗法通过直接杀伤肿瘤及脉管系统、诱导抗瘤免疫等机制治疗皮肤肿瘤,临床上光动力治疗皮肤NMSC尤其是浅表性肿瘤疗效确切,亦可用于老年皮肤肿瘤预防、联合辅助治疗及姑息治疗。本文就光动力疗法治疗NMSC的现有研究成果进行综述。

邻近皮瓣修复皮肤恶性肿瘤切除后部分外鼻缺损

目的探讨邻近皮瓣转移修复非黑色素瘤皮肤癌(NMSC)术后鼻缺损的术式选择。方法回顾性分析87例行鼻NMSC根治性切除+邻近皮瓣转移整复术患者的临床资料,其中67例(77.0%)缺损位于鼻下1/3,20例(23.0%)位于鼻中上2/3。缺损位于鼻翼37例,鼻背20例,鼻侧壁18例,鼻尖8例,累及多个鼻亚单位的复杂鼻缺损4例。分析总结患者鼻部的缺损特点、皮瓣类型及重建效果。结果鼻下1/3缺损的67例中,以鼻唇沟皮瓣修复51例,额部皮瓣8例,鼻背皮瓣7例,双叶皮瓣1例;鼻中上2/3缺损的20例中,以眉间皮瓣修复8例,双叶皮瓣7例,鼻唇沟皮瓣5例;4例复杂鼻缺损均以额部皮瓣修复,修复效果满意,术后随访2~24个月,无明显继发畸形。结论以邻近皮瓣转移修复皮肤肿瘤切除后的鼻缺损可获得可靠的手术效果。

光动力治疗遗传性皮肤病相关非黑素皮肤癌的研究进展

遗传性皮肤病相关非黑素皮肤癌(non melanoma skin cancer,NMSC)是一类继发于遗传性皮肤病的皮肤恶性肿瘤,主要包括皮肤鳞状细胞癌和基底细胞癌,一般具有家族史,且呈早发、多发和易复发的特点。目前多采用手术治疗,但存在创伤大、易复发、耐受性差等缺点。光动力治疗可以靶向杀伤肿瘤和病理性增生组织,基于其破坏小、可靶向、可重复的优势,近年来已被广泛用于NMSC的治疗。本文就光动力在遗传性皮肤病相关NMSC的治疗进展进行综述。

First in Man Topical Treatment of Melanoma with Solasodine Glycosides in a Formulation Curaderm: A Case Report

Background: There is ample evidence to support the safety and efficacy of the topical anticancer cream Curaderm in the treatment of non-melanoma skin cancers. Curaderm contains the natural glycoalkaloid solamargine in the form of BEC, which has been established as a novel antineoplastic agent. BEC is the initials of the inventor of the described technology. It is known that BEC expresses anti-melanoma properties in cell culture and animals. Because of potential metastasis, clinical work with BEC on melanoma was stalled. However, recent studies show that BEC has anti-metastatic properties and this, together with currently better understanding of the mode of anti-cancer actions of BEC, has led to the treatment of a patient who refused to have surgery for her clinically diagnosed stage II melanoma. Treatment: A 67-year woman had a birthmark that developed into a clinically diagnosed stage II melanoma and was treated with topical application of Curaderm twice daily for 7 weeks. Results: The pattern of response of the melanoma to Curaderm therapy was similar to that observed when basal cell carcinoma is treated with Curaderm. The melanoma responded rapidly to the treatment and in 7 weeks the lesion was removed with no demonstrable side effects. The cosmetic end result was very acceptable. Conclusion: The clinical resolution of the melanoma with Curaderm pharmacotherapy conforms to the cell culture and animal observations that solasodine rhamnosides, and thus Curaderm, is very specific and efficacious for the first in man treatment of melanoma, creating the possibility of a simple treatment for melanoma. Further investigations with controlled clinical trials are warranted.

Targeting obesity-related inflammation in skin cancer： molecular and epigenetic insights for cancer chemoprevention by dietary phytochemicals

Non-melanoma skin cancer(NMSC) is one of the most common cancers in the US, although the role of obesity in skin cancer remains unclear. In vivo studies have consistently demonstrated that obese mice challenged with UVB radiation show increased skin tumorigenesis in comparison with leaner control mice. Growing evidence suggests that enhanced inflammation, oxidative stress and impaired apoptosis may play important roles in the development of skin cancer. Interventions such as voluntary exercise and the surgical removal of parametrial fat have been demonstrated to be effective in reducing adipose tissue that may influence the development of skin cancer; however, these interventions are not achievable in all obese patients. Therefore, the use of dietary natural phytochemicals that may modify and reverse the deregulated molecular and epigenetic events related to obesity and cancer development might represent a potential therapeutic modality due to their potential efficacy and low toxicity. In this review, we aim to provide the molecular and epigenetic basis of the NMSC-obesity relationship and to highlight the potential anti-cancer chemopreventive benefits of dietary phytochemicals such as sulforaphane and epigallocatechin-3-gallate.