BACKGROUND The 8th edition of the AJCC manual for melanoma includes many changes leading to major... more BACKGROUND The 8th edition of the AJCC manual for melanoma includes many changes leading to major substage migrations, which could lead to important clinical reassessments. OBJECTIVES To evaluate the differences and prognostic value of the 8th AJCC classification in comparison with the 7th edition. METHODS Clinical and histopathological data were retrieved from five melanoma referral centers including 7815 melanoma patients diagnosed between January 1998 and December 2018. All patients were reclassified and compared using the 7th and 8th classifications of the AJCC. Sankey plots were used to evaluate the migration of patients between the different versions. The primary outcome was overall survival (OS), and curves based on the Kaplan-Meier method were used to investigate survival differences between the 7th and 8th editions. RESULTS The number of patients classified as stages IB, IIIA, and IIIB decreased while the patients classified as stages IA and IIIC increased notably. Migration analysis showed that many patients in group I were understaged whereas a significant percentage of patients in group III were upstaged. Indirect OS analysis showed a loss in the linearity in the AJCC 8th edition and the groups tended to overlap. Direct OS analysis between groups and versions of the AJCC showed a better prognosis within the new stage III patients, with no effect on those in stages I and II. CONCLUSION The 8th AJCC edition represents an important change in the classification of patients. We observe that the main migratory changes occur in stage I and III, that severity linearity is lost and groups overlap, and that a more advanced stage does not mean a worse prognosis.
Mutations within the promoter of gene encoding telomerase reverse transcriptase subunit are frequ... more Mutations within the promoter of gene encoding telomerase reverse transcriptase subunit are frequent in many cancers including melanoma. Previously, the TERT promoter mutations were shown to associate with markers of poor outcome and reduced survival in patients with primary melanoma. In this study, we investigated the impact of the subtypes of TERT mutations on disease-free and melanoma-specific survival in 287 patients with stage I/II non-acral melanoma. Our results showed that of the three TERT promoter mutation subtypes, in multivariate models, the -138/-139 CC>TT tandem mutation associated with worst disease-free and melanoma-specific survival. In particular, in combination with BRAF/NRAS mutations, the -138/-139 CC>TT TERT promoter mutation associated with statistically significant poor disease-free and melanoma-specific survival with hazard ratios of 6.04 (95% CI 2.03-17.94, p = 0.001) and 12.59 (95% CI 2.18-72.70, p = 0.005), respectively. In contrast to the survival d...
ABSTRACT RESUMEN: Se ha realizado un inventario de los invertebrados del complejo subterráneo del... more ABSTRACT RESUMEN: Se ha realizado un inventario de los invertebrados del complejo subterráneo del Calar del Mundo (Albacete, España). Se censan 55 especies pertenecientes a tres phyla y 16 órdenes, incluyendo cinco species que han sido descritas en trabajos precedentes como nuevas para la ciencia: Ceratosphys solanasi Mauriès & Vicente 1977, Plusiocampa lagari Sendra & Condé 1987, Trechus lencinai (Mateu & Ortuño 2006), Damaeus gevi Subías, 2012 y Domene lencinai Vives 2010. ABSTRACT: An inventory of fifty-five species of invertebrates recorded from the cavities of the subterranean complex of Calar del Mundo (Albacete, Spain) is presented. These records comprise three phyla and 16 orders, including five new species that were previously described as endemic to these cavities: Ceratosphys solanasi Mauriès & Vicente 1977, Plusiocampa lagari Sendra & Condé 1987, Trechus lencinai (Mateu & Ortuño 2006), Damaeus gevi Subías, 2012 y Domene lencinai Vives 2010.
Se ha elaborado una versión nueva del Catálogo de los coleópteros caraboideos de la región de Mur... more Se ha elaborado una versión nueva del Catálogo de los coleópteros caraboideos de la región de Murcia, gracias a miles de nuevas aportaciones sobre la distribución regional de estos insectos. Se conocen 372 especies, cifra que duplica la conocida del catálogo de 1987. En esta versión se incluye el mapa de citas de cada especie, la descripción de las comunidades que ocupan los biotopos más característicos de la Región y un análisis biogeográfico sobre la composición faunística y el origen histórico del poblamiento de Murcia por parte de estos coleópteros tan diversos. La obra proporciona además los datos fundamentales para estudios futuros sobre conservación de la biodiversidad y las respuestas de la fauna a un ambiente que está cambiando con gran celeridad.
A new, updated AEDV Psoriasis Group (GPs) consensus document on the treatment of moderate to seve... more A new, updated AEDV Psoriasis Group (GPs) consensus document on the treatment of moderate to severe psoriasis was needed owing to the approval, in recent years, of a large number of new drugs and changes in the treatment paradigm. The consensus document was developed using the nominal group technique and a scoping review. First, a designated coordinator selected a group of Psoriasis Group members for the panel. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. Based on these reviews, the coordinator drew up a set of proposed recommendations, which were then discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. The present guidelines include general principles for the treatment of patients with moderate to severe psoriasis and also define treatment goals and criteria for the indication of biologic therapy and the selection of initial and subsequent therapies. Practical issues, such as treatment failure and maintenance of response, are also addressed.
BACKGROUND The 8th edition of the AJCC manual for melanoma includes many changes leading to major... more BACKGROUND The 8th edition of the AJCC manual for melanoma includes many changes leading to major substage migrations, which could lead to important clinical reassessments. OBJECTIVES To evaluate the differences and prognostic value of the 8th AJCC classification in comparison with the 7th edition. METHODS Clinical and histopathological data were retrieved from five melanoma referral centers including 7815 melanoma patients diagnosed between January 1998 and December 2018. All patients were reclassified and compared using the 7th and 8th classifications of the AJCC. Sankey plots were used to evaluate the migration of patients between the different versions. The primary outcome was overall survival (OS), and curves based on the Kaplan-Meier method were used to investigate survival differences between the 7th and 8th editions. RESULTS The number of patients classified as stages IB, IIIA, and IIIB decreased while the patients classified as stages IA and IIIC increased notably. Migration analysis showed that many patients in group I were understaged whereas a significant percentage of patients in group III were upstaged. Indirect OS analysis showed a loss in the linearity in the AJCC 8th edition and the groups tended to overlap. Direct OS analysis between groups and versions of the AJCC showed a better prognosis within the new stage III patients, with no effect on those in stages I and II. CONCLUSION The 8th AJCC edition represents an important change in the classification of patients. We observe that the main migratory changes occur in stage I and III, that severity linearity is lost and groups overlap, and that a more advanced stage does not mean a worse prognosis.
Mutations within the promoter of gene encoding telomerase reverse transcriptase subunit are frequ... more Mutations within the promoter of gene encoding telomerase reverse transcriptase subunit are frequent in many cancers including melanoma. Previously, the TERT promoter mutations were shown to associate with markers of poor outcome and reduced survival in patients with primary melanoma. In this study, we investigated the impact of the subtypes of TERT mutations on disease-free and melanoma-specific survival in 287 patients with stage I/II non-acral melanoma. Our results showed that of the three TERT promoter mutation subtypes, in multivariate models, the -138/-139 CC>TT tandem mutation associated with worst disease-free and melanoma-specific survival. In particular, in combination with BRAF/NRAS mutations, the -138/-139 CC>TT TERT promoter mutation associated with statistically significant poor disease-free and melanoma-specific survival with hazard ratios of 6.04 (95% CI 2.03-17.94, p = 0.001) and 12.59 (95% CI 2.18-72.70, p = 0.005), respectively. In contrast to the survival d...
ABSTRACT RESUMEN: Se ha realizado un inventario de los invertebrados del complejo subterráneo del... more ABSTRACT RESUMEN: Se ha realizado un inventario de los invertebrados del complejo subterráneo del Calar del Mundo (Albacete, España). Se censan 55 especies pertenecientes a tres phyla y 16 órdenes, incluyendo cinco species que han sido descritas en trabajos precedentes como nuevas para la ciencia: Ceratosphys solanasi Mauriès & Vicente 1977, Plusiocampa lagari Sendra & Condé 1987, Trechus lencinai (Mateu & Ortuño 2006), Damaeus gevi Subías, 2012 y Domene lencinai Vives 2010. ABSTRACT: An inventory of fifty-five species of invertebrates recorded from the cavities of the subterranean complex of Calar del Mundo (Albacete, Spain) is presented. These records comprise three phyla and 16 orders, including five new species that were previously described as endemic to these cavities: Ceratosphys solanasi Mauriès & Vicente 1977, Plusiocampa lagari Sendra & Condé 1987, Trechus lencinai (Mateu & Ortuño 2006), Damaeus gevi Subías, 2012 y Domene lencinai Vives 2010.
Se ha elaborado una versión nueva del Catálogo de los coleópteros caraboideos de la región de Mur... more Se ha elaborado una versión nueva del Catálogo de los coleópteros caraboideos de la región de Murcia, gracias a miles de nuevas aportaciones sobre la distribución regional de estos insectos. Se conocen 372 especies, cifra que duplica la conocida del catálogo de 1987. En esta versión se incluye el mapa de citas de cada especie, la descripción de las comunidades que ocupan los biotopos más característicos de la Región y un análisis biogeográfico sobre la composición faunística y el origen histórico del poblamiento de Murcia por parte de estos coleópteros tan diversos. La obra proporciona además los datos fundamentales para estudios futuros sobre conservación de la biodiversidad y las respuestas de la fauna a un ambiente que está cambiando con gran celeridad.
A new, updated AEDV Psoriasis Group (GPs) consensus document on the treatment of moderate to seve... more A new, updated AEDV Psoriasis Group (GPs) consensus document on the treatment of moderate to severe psoriasis was needed owing to the approval, in recent years, of a large number of new drugs and changes in the treatment paradigm. The consensus document was developed using the nominal group technique and a scoping review. First, a designated coordinator selected a group of Psoriasis Group members for the panel. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. Based on these reviews, the coordinator drew up a set of proposed recommendations, which were then discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. The present guidelines include general principles for the treatment of patients with moderate to severe psoriasis and also define treatment goals and criteria for the indication of biologic therapy and the selection of initial and subsequent therapies. Practical issues, such as treatment failure and maintenance of response, are also addressed.
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