<p>Melanoma initiating cell frequency.</p>

Comparison of different methods previously used to test the CD271-based cancer stem cell model in human melanoma.

<p>Genomic copy number differences among sibling PDX melanomas.</p>

Typical sorting strategy used to isolate viable melanoma cells from cell suspensions derived by dissociation from patient tumors.

Description of additional methods and procedures used in the study.

Genomic copy number differences among CD271- and CD271+ cells from PDX melanomas.

Legend for Supplementary Figures S1-S8.

<p>Marker expression patterns in PDX tumors grown from CD271- and CD271+ cells.</p>

<p>Melanoma initiating cell frequency.</p>

Clinico-pathological characteristics of patients who donated melanomas.

Variable re-expression patterns in PDX tumors generated from CD271- and CD271+ cells.

Background:As early detection of recurrent melanoma maximizes treatment options, patients usually undergo post-operative imaging surveillance, increasingly with FDG-PET/CT (PET). To assess this, we evaluated stage 3 melanoma patients who underwent prospectively applied and sub-stage-specific schedules of PET surveillance.Patients and methods:From 2009, patients with stage 3 melanoma routinely underwent PET +/- MRI brain scans via defined schedules based on sub-stage-specific relapse probabilities. Data were collected regarding patient characteristics and outcomes. Contingency analyses were carried out of imaging outcomes.Results:One hundred and seventy patients (stage 3A: 34; 3B: 93; 3C: 43) underwent radiological surveillance. Relapses were identified in 65 (38%) patients, of which 45 (69%) were asymptomatic. False-positive imaging findings occurred in 7%, and 6% had treatable second (non-melanoma) malignancies. Positive predictive values (PPV) of individual scans were 56%-83%. Negative scans had predictive values of 89%-96% for true non-recurrence [negative predictive values (NPV)] until the next scan. A negative PET at 18 months had NPVs of 80%-84% for true non-recurrence at any time in the 47-month (median) follow-up period. Sensitivity and specificity of the overall approach of sub-stage-specific PET surveillance were 70% and 87%, respectively. Of relapsed patients, 33 (52%) underwent potentially curative resection and 10 (16%) remained disease-free after 24 months (median).Conclusions:Application of sub-stage-specific PET in stage 3 melanoma enables asymptomatic detection of most recurrences, has high NPVs that may provide patient reassurance, and is associated with a high rate of detection of resectable and potentially curable disease at relapse.

Abstract The stability of markers that identify cancer cells that propagate disease is important to the outcomes of targeted therapy strategies. In human melanoma, conflicting data exist as to whether hierarchical expression of CD271/p75/NGFR (nerve growth factor receptor) marks cells with enriched tumorigenicity, which would compel their specific targeting in therapy. To test whether these discrepancies relate to differences among groups in assay approaches, we undertook side-by-side testing of published methods of patient-derived melanoma xenografting (PDX), including comparisons of tissue digestion procedures or coinjected Matrigel formulations. We found that CD271− and CD271+ melanoma cells from each of seven patients were similarly tumorigenic, regardless of assay variations. Surprisingly variable CD271 expression patterns were observed in the analyses of sibling PDX tumors (n = 68) grown in the same experiments from either CD271− or CD271+ cells obtained from patients. This indicates unstable intratumoral lineage relationships between CD271− and CD271+ melanoma cells that are inconsistent with classical, epigenetically based theories of disease progression, such as the cancer stem cell and plasticity models. SNP genotyping of pairs of sibling PDX tumors grown from phenotypically identical CD271− or CD271+ cells showed large pairwise differences in copy number (28%–48%). Differences were also apparent in the copy number profiles of CD271− and CD271+ cells purified directly from each of the four melanomas (1.4%–23%). Thus, CD271 expression in patient melanomas is unstable, not consistently linked to increased tumorigenicity and associated with genetic heterogeneity, undermining its use as a marker in clinical studies. Cancer Res; 76(13); 3965–77. ©2016 AACR.

ABSTRACT Background Recommended margins for thick cutaneous melanoma (Breslow thickness >4 mm; T4) have decreased over recent decades. Optimal margins and the role of sentinel node biopsy (SNB) in thick head and neck melanoma remain controversial. Methods A single‐center review was conducted of patients treated between 2002 and 2012 assessing the impact of excision margins and sentinel lymph node status on locoregional recurrence and melanoma‐specific survival (MSS). Results One hundred eight patients were identified. Median age was 71.1 years and median Breslow thickness was 6.0 mm. Median follow‐up was 40 months. Locoregional recurrence occurred in 27% and there was no significant reduction in recurrence with margins ≥2 cm ( p = .17). Increasing margins did not improve survival ( p = .58). Fifty‐nine patients (55%) underwent SNB, of which 27% were positive. There was a trend toward longer survival for patients who were sentinel lymph node‐negative ( p = .097). Conclusion Wider margins do not significantly improve locoregional recurrence or MSS. Sentinel lymph node involvement reflects a poor prognosis. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1373–1379, 2016

ANZ Journal of SurgeryVolume 83, Issue 7-8 p. 589-589 MEDIA REVIEW The Keystone Perforator Island Flap, Concept. Edited by F. Behan, M. Findlay and C. H. Lo. Sydney: Churchill Livingstone, 2012. 227 pages. ISBN 9780729539715. Price: AUD262.50. Miklós J. Pohl OAM, FRCS (Eng), FRACS, Miklós J. Pohl OAM, FRCS (Eng), FRACS Former Head Plastic and Reconstructive Surgeon, Melbourne, Australia Department of Plastic Surgery, Western Health, Footscray, Victoria, AustraliaSearch for more papers by this author Miklós J. Pohl OAM, FRCS (Eng), FRACS, Miklós J. Pohl OAM, FRCS (Eng), FRACS Former Head Plastic and Reconstructive Surgeon, Melbourne, Australia Department of Plastic Surgery, Western Health, Footscray, Victoria, AustraliaSearch for more papers by this author First published: 28 July 2013 https://doi.org/10.1111/ans.12337Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume83, Issue7-8July-August 2013Pages 589-589 RelatedInformation

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Introduction: The closure of abdominal wall defect after tumour ablation can be a challenging problem. The component that requires reconstruction may only consist of skin or fascia; or it could consist of a combination of these. The pedicled tensor fascia lata flap is a useful option as it could be harvested as either a fascial or fasciocutaneous flap. When the size of the defect is significant, bilateral TFL flaps could be utilised.Methods and Results: To illustrate the flexibility provided by the pedicled TFL flap in abdominal wall reconstruction, two cases are presented in which the nature of abdominal wall defect were different. The first patient had a large fascial defect in the lower abdominal wall and bilateral pedicled TFL fascial flaps were used for reconstruction. The second patient had a full thickness defect and the TFL was harvested as a fasciocutaneous flap for reconstruction. Both defects were repaired satisfactorily without herniation.Conclusion: TFL is a versatile flap and should be the method of choice for lower abdominal wall reconstruction.

Sentinel lymph node biopsy for malignant melanoma has been performed as day surgery at our hospital since August 2002. The aim of this retrospective study was to assess its feasibility compared to the inpatient procedure.Methods: A telephone survey and review of medical records was carried out for patients who had daycase, nonhead and neck sentinel lymph node biopsy for malignant melanoma over an 18-month period. A similar matched number of inpatients were reviewed, comparing waiting times, prolonged hospital stay, complication rates and overall satisfaction.Results: There were no significant differences between the two groups in terms of time from diagnosis to surgery, prolonged hospital stay and complication rates. However, in terms of overall satisfaction, 86.3% of daycase patients preferred their mode of admission whereas 52.9% of inpatients preferred their mode of admission (P = 0.0003).Conclusions: Sentinel lymph node biopsy (nonhead and neck) for malignant melanoma as day surgery is feasible and confers greater patient satisfaction, increased availability of inpatient beds and cost savings without compromising patient care. (c) 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.