Defining Melanoma Immune Biomarkers-Desert, Excluded, and Inflamed Subtypes-Using a Gene Expression Classifier Reflecting Intratumoral Immune Response and Stromal Patterns.

The spatial distribution of tumor infiltrating lymphocytes (TILs) defines several histologically and clinically distinct immune subtypes-desert (no TILs), excluded (TILs in stroma), and inflamed (TILs in tumor parenchyma). To date, robust classification of immune subtypes still requires deeper experimental evidence across various cancer types. Here, we aimed to investigate, define, and validate the immune subtypes in melanoma by coupling transcriptional and histological assessments of the lymphocyte distribution in tumor parenchyma and stroma. We used the transcriptomic data from The Cancer Genome Atlas melanoma dataset to screen for the desert, excluded, and inflamed immune subtypes. We defined subtype-specific genes and used them to construct a subtype assignment algorithm. We validated the two-step algorithm in the qPCR data of real-world melanoma tumors with histologically defined immune subtypes. The accuracy of a classifier encompassing expression data of seven genes (immune response-related: CD2, CD53, IRF1, and CD8B; and stroma-related: COL5A2, TNFAIP6, and INHBA) in a validation cohort reached 79%. Our findings suggest that melanoma tumors can be classified into transcriptionally and histologically distinct desert, excluded, and inflamed subtypes. Gene expression-based algorithms can assist physicians and pathologists as biomarkers in the rapid assessment of a tumor immune microenvironment while serving as a tool for clinical decision making.

Cutaneous Melanoma with Tonsillar Metastasis: Treatment with Cryoablation.

Metastasis of cutaneous melanoma to the oral cavity is a rare condition. Male patient with cutaneous melanoma metastasis to right tonsil 2 years after radical skin lesion resection was treated with surgery: tonsillectomy and later resection of soft palate were performed. Two years later the patient was diagnosed with progressive disease to right tonsil and soft palate. Rapid inoperable relapse was detected six months later. The patient underwent two procedures of palliative cryoablation of the metastasis. Postoperative course was uneventful. Patient died 7 months later due to progression of the disease. Cryoablation alone or together with surgery may be a relatively safe option for treatment of inoperable disease of head and neck tumours.

The Impact of the COVID-19 Pandemic on Cancer Patient's Management-Lithuanian Cancer Center Experience.

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (-16%) and endoscopy (-29%) procedures were accompanied by a decreased number of patients with ongoing medical (-30%), radiation (-6%) or surgical (-10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (-14%) and disease follow-up visits (-16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.

Facial perception, self-esteem and psychosocial well-being in patients after nasal surgery due to trauma, cancer and aesthetic needs (cluster analysis of multiple interrelations).

Background: Facial anthropometric measurements in relation to self-esteem and self-perception have become a very popular topic, not only in anthropological and psychological research, but also in plastic reconstructive surgery.Aim: To compare the interrelations between facial perception, self-esteem and psychosocial well-being in patients after nasal surgery due to trauma, cancer and aesthetic needs.Subjects and methods: In total, ninety patients after nasal surgery (due to trauma, cancer and aesthetic reasons), and thirty control persons underwent facial anthropometry and answered questions related to facial perception (FP), self-esteem (SE) and psychosocial well-being (PW). Cluster analysis was performed.Results: Facial measurements were not related to the perception of the whole face in all investigated persons. The whole face and nasal perception were interrelated in the majority of male groups and in the control female group. SE in females from the control and cancer groups was not related to real facial parameters or FP, however, in females after aesthetic surgery it was related to nasal tip protrusion. SE in females after nasal surgery due to trauma was strongly related to FP. SE in almost all groups of males was related to real facial parameters, and in males after aesthetic surgery it was related to FP. PW was mostly linked to SE in males and females after aesthetic surgery, in other groups it was related to FP.Conclusions: FP was most frequently not related to real facial measurements; however, it was related to PW. Patients after aesthetic nasal surgery had specific relations between FP, SE and PW.