Recurrence Patterns and Survival Outcomes in Clinical Stage IIB/IIC Melanoma: Can We Stratify Patients for Consideration of Neoadjuvant Immunotherapy?

Background: Interest in evaluating neoadjuvant immunotherapy for stage IIB/IIC melanoma is growing, but studies assessing long-term outcomes generally report data based on pathologic stage after sentinel lymph node microstaging. This study therefore aimed to characterize real-world recurrence patterns and survival specifically in clinical stage IIB/IIC melanoma to contextualize outcomes for selection of patients to undergo neoadjuvant immunotherapy.

Methods: This single-institution retrospective cohort study included patients who received a diagnosis of American Joint Committee on Cancer eighth-edition clinical stage IIB/IIC cutaneous melanoma from 2006 to 2019.

Impact of Patient Income and Insurance on Postoperative Mortality After Total Pancreatectomy for Pancreatic Neoplasms.

Background: Total pancreatectomies (TP) are rare high-risk operations requiring complex postoperative management. Hospital factors are known to impact pancreatectomy outcomes, but the role of patient socioeconomic status on TP outcomes remains poorly understood. This retrospective study assesses the impact of income and insurance on 90-day mortality after TP.

Margins for Melanoma: Extent of Resection, Alternative Approaches, and Future Considerations.

Melanoma surgical margins have undergone significant evolution over the past century. Wide local excision (WLE) remains the established standard-of-care for localized cutaneous melanoma and guidelines have been established via multiple randomized-controlled trials (RCTs). Mohs micrographic surgery (MMS) has gained popularity in the past 2 decades, and while data are promising with regards to recurrence rates and survival, the data remain largely retrospective.

Neoadjuvant Therapy in Melanoma: Current Evidence and Future Directions of Investigation.

Neoadjuvant therapy for advance-stage melanoma has had increasing momentum over the past decade owing to several landmark clinical trials. Neoadjuvant therapy has now been shown to confer multiple advantages over adjuvant therapy, including more robust antitumor immunity, improved prognostication, and ability to personalize surgical and medical therapy based on therapeutic response. Neoadjuvant therapy has led to a major shift in clinical and surgical practice for melanoma, and future trials will give further insight into improving patient outcomes.

Neoadjuvant Immunotherapy for Resectable Dedifferentiated Liposarcoma: A National Cohort Analysis.

Background: Neoadjuvant immunotherapy (NIT) with checkpoint blockade has been increasingly studied for soft tissue sarcomas, however, survival outcomes data are limited, and dedifferentiated liposarcoma (DDLPS) histology remains underrepresented in recent trial cohorts. We assessed the impact of NIT with or without radiation therapy (RT) on overall survival (OS) for resectable DDLPS.

Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with nonmetastatic DDLPS who received NIT and underwent surgical resection between 2016 and 2022.

Lymph Node Dissection for Melanoma: Contemporary Trends in Postoperative Outcomes and Patient Selection With Reduced Case Volumes in the Post-MSLT2 Era.

Background And Objectives: Since the publication of the German Cooperative Oncology Group Selective Lymphadenectomy Trial and Multicenter Selective Lymphadenectomy Trial II (MSLT2) trials, the treatment paradigm for node-positive melanoma has shifted from completion lymph node dissection (LND) to nodal ultrasound surveillance. We sought to identify the impact of this practice change on postoperative outcomes in a national cohort.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients diagnosed with truncal/extremity malignant melanoma who underwent axillary/inguinal LND.

Sequencing of Immunotherapy and Outcomes in Operable Clinical Stage III Melanoma: A National Cohort Study.

Background And Objectives: The impact of neoadjuvant immunotherapy (NIT) on overall survival (OS) in patients with resectable stage III melanoma remains unknown. We sought to identify factors associated with receipt of NIT and survival outcomes in patients with clinical stage III melanoma undergoing surgery.

Methods: The National Cancer Database (2016-2020) was used to identify patients with clinical stage III melanoma who underwent surgery and received either NIT or adjuvant immunotherapy (AIT) only.

Adjuvant Therapy for High-Risk Stage II Melanoma: Current Paradigms in Management and Future Directions.

Melanoma is the fifth most common cancer in the United States and accounts for the majority of all skin cancer-related deaths, making it the most lethal cutaneous malignancy. Systemic adjuvant therapy for stage IIB-IV melanoma is now approved for patients who have undergone surgical resection, given the appreciable risk of recurrence and mortality in this patient population. Despite the lower stage, high-risk stage II melanoma (stage IIB/IIC) can often exhibit an even more aggressive course when compared to stage IIIA/IIIB disease, thus justifying consideration of adjuvant therapy in these patients.

Nuclear pore protein POM121 regulates subcellular localization and transcriptional activity of PPARγ.

Manipulation of the subcellular localization of transcription factors by preventing their shuttling via the nuclear pore complex (NPC) emerges as a novel therapeutic strategy against cancer. One transmembrane component of the NPC is POM121, encoded by a tandem gene locus POM121A/C on chromosome 7. Overexpression of POM121 is associated with metabolic diseases (e.

BTLACD200 B cells dictate the divergent immune landscape and immunotherapeutic resistance in metastatic vs. primary pancreatic cancer.

Response to cancer immunotherapy in primary versus metastatic disease has not been well-studied. We found primary pancreatic ductal adenocarcinoma (PDA) is responsive to diverse immunotherapies whereas liver metastases are resistant. We discovered divergent immune landscapes in each compartment.

PD-L1 engagement on T cells promotes self-tolerance and suppression of neighboring macrophages and effector T cells in cancer.

Programmed cell death protein 1 (PD-1) ligation delimits immunogenic responses in T cells. However, the consequences of programmed cell death 1 ligand 1 (PD-L1) ligation in T cells are uncertain. We found that T cell expression of PD-L1 in cancer was regulated by tumor antigen and sterile inflammatory cues.

γδ T Cells Promote Steatohepatitis by Orchestrating Innate and Adaptive Immune Programming.

Background And Aims: The recruitment and activation of inflammatory cells in the liver delineates the transition from hepatic steatosis to steatohepatitis (SH).

Approach And Results: We found that in SH, γδT cells are recruited to the liver by C-C chemokine receptor (CCR) 2, CCR5, and nucleotide-binding oligomerization domain-containing protein 2 signaling and are skewed toward an interleukin (IL)-17A phenotype in an inducible costimulator (ICOS)/ICOS ligand-dependent manner. γδT cells exhibit a distinct Vγ4 , PD1 , Ly6C CD44 phenotype in SH.

NLRP3 signaling drives macrophage-induced adaptive immune suppression in pancreatic carcinoma.

The tumor microenvironment (TME) in pancreatic ductal adenocarcinoma (PDA) is characterized by immune tolerance, which enables disease to progress unabated by adaptive immunity. However, the drivers of this tolerogenic program are incompletely defined. In this study, we found that NLRP3 promotes expansion of immune-suppressive macrophages in PDA.

Case Report of Ectopic Liver on Gallbladder Serosa with a Brief Review of the Literature.

This case describes an intraoperative incidental finding and surgical removal of ectopic liver tissue attached to the gallbladder during a standard laparoscopic cholecystectomy for acute cholecystitis. These anomalies are rare, with interesting associations and possible clinically relevant complications. The details of the case, along with a brief literature review of embryology, common ectopic sites, and associations/complications, are presented in this paper.