ABSTRACT
BACKGROUND: Malignant adnexal tumors of the skin are a rare group of tumors that can be locally aggressive and require surgical excision with strict margin control to achieve clearance. Given the rarity of these tumors, there is a limited understanding within the medical community regarding optimal treatment approaches. OBJECTIVE: To examine surgical management trends and outcomes for patients diagnosed with cutaneous adnexal tumors from 2000 to 2020. MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results database was queried to identify biopsy-proven cases of cutaneous adnexal tumors between 2000 and 2020. Clinical and disease characteristics were examined, and disease-specific survivals were compared between surgical approaches using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: Mohs surgery demonstrated a significant increase in utilization from 2000 to 2020 (+447.1%) and improvements in disease-specific survival (mean 231.7 months; p < .001) compared with no surgery; wide local excision exhibited no improved disease-specific survival (227.7 months; p = .070). Multivariable Cox regression further highlighted that only Mohs surgery exhibited a reduced disease-specific mortality risk compared with no surgery (adjusted HR 0.49; p = .011). CONCLUSION: Given the enhanced disease-specific survival coupled with tissue preservation strategies, Mohs surgery emerges as a promising surgical approach for the treatment of malignant adnexal tumors of the skin.
ABSTRACT
BACKGROUND: Field cancerization is poorly defined in dermatology. The author group previously proposed and applied a classification system in an original cohort to risk-stratify patients with field cancerization. OBJECTIVE: Apply the authors' classification system within a validation cohort. METHODS: Patients with keratinocyte carcinoma history completed a survey regarding demographic information, medical history, and chemoprevention use. Patients were assigned a field cancerization class, and differences between validation and original cohorts were assessed. RESULTS: A total of 363 patients were enrolled (mean age 67.4; 61.7% male). After comparing validation and original cohorts, there were differences in age between class II (p = .02) and class IVb (p = .047), and differences in chemoprevention use in class III (p = .04). Similar to the original cohort, the validation cohort was associated with increases in total number of skin cancers in the last year (p < .001), 5 years (p < .001), lifetime (p < .001), years since first skin cancer (p < .001), and chemoprevention use (p < .001). In the validation cohort, there were increases in age (p = .03) and immunocompromised status (p = .04) with increasing class, which were not observed in the original cohort. CONCLUSION: Differences among field cancerization classes were similar in a validation cohort, further highlighting the importance of class-specific treatment and management.
ABSTRACT
Epithelial adenocarcinoma of the ovary and colon are associated with the highest rates of cancer-related deaths in women in the U.S. The literature supports the role of HDL-associated apolipoproteins in the treatment of cancer and other pro-inflammatory diseases. Previously, we developed a novel 20-amino acid mimetic peptide, HM-10/10, which potently inhibits tumor development and growth in colon and ovarian cancer. Here, we report the properties of HM-10/10 relative to its stability in vitro. The results demonstrated that HM-10/10 had the highest half-life in human plasma compared to plasma from other species tested. HM-10/10 demonstrated stability in human plasma and simulated gastric environment, increasing its promise as an oral pharmaceutical. However, under conditions modeling the small intestine, HM-10/10 demonstrated significant degradation, likely due to the peptidases encountered therein. Furthermore, HM-10/10 demonstrated no evidence of time-dependent drug-drug interactions, although it demonstrated CYP450 induction slightly above cutoff. As proteolytic degradation is a common limitation of peptide-based therapeutics, we are pursuing strategies to improve the stability properties of HM-10/10 by extending its bioavailability while retaining its low toxicity profile. HM-10/10 holds promise as a new agent to address the international women's health crisis of epithelial carcinomas of the ovary and colon.
Subject(s)
Neoplasms , Humans , Female , Neoplasms/drug therapy , Neoplasms/pathology , Peptides/pharmacology , Peptides/chemistry , Colon/pathologySubject(s)
Marital Status , Neoplasm Staging , SEER Program , Sebaceous Gland Neoplasms , Humans , SEER Program/statistics & numerical data , Male , Female , Sebaceous Gland Neoplasms/mortality , Sebaceous Gland Neoplasms/pathology , Sebaceous Gland Neoplasms/epidemiology , Middle Aged , Marital Status/statistics & numerical data , Aged , United States/epidemiology , Adult , Adenocarcinoma, Sebaceous/pathology , Adenocarcinoma, Sebaceous/mortality , Adenocarcinoma, Sebaceous/epidemiology , Survival Rate , Aged, 80 and overSubject(s)
United States Food and Drug Administration , Humans , United States/epidemiology , Cross-Sectional Studies , Male , Female , Middle Aged , Adverse Drug Reaction Reporting Systems/statistics & numerical data , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/administration & dosage , Glucagon-Like Peptide 1/agonists , Glucagon-Like Peptide 1/adverse effects , Diabetes Mellitus, Type 2/drug therapy , Glucagon-Like Peptide-1 Receptor/agonists , Aged , Liraglutide/adverse effects , Liraglutide/therapeutic use , Exenatide/adverse effects , Exenatide/administration & dosage , Adult , Drug Eruptions/etiology , Drug Eruptions/epidemiologyABSTRACT
We prove the existence of free objects in certain subcategories of Banach lattices, including p-convex Banach lattices, Banach lattices with upper p-estimates, and AM-spaces. From this we immediately deduce that projectively universal objects exist in each of these subcategories, extending results of Leung, Li, Oikhberg and Tursi (Israel J. Math. 2019). In the p-convex and AM-space cases, we are able to explicitly identify the norms of the free Banach lattices, and we conclude by investigating the structure of these norms in connection with nonlinear p-summing maps.