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Malignant Nonmelanocytic Tumors
Published in Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou, Dermatoscopy A–Z, 2019
Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou
Actinic keratoses (AKs) are the most common neoplasms within the spectrum of keratinocyte skin cancer. They are defined as the earliest form of SCC (squamous cell carcinoma in situ). AKs rarely develop as single lesions. Usually, multiple lesions affect an entire field of chronically sun-damaged skin (Figure 5.22). This led to the concept of “field cancerization,” which refers to the presence of genetically altered cell clones in normal-appearing skin contiguous to fields of neoplastic cells, which have the potential for clonal expansion and, therefore, lead to constant and consequent development of new tumors within this field.
Neoplastic Reactions
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
Recommendations for the management and prevention of SCPLs in patients treated with RAF inhibitors include regular skin monitorings every 4–6 weeks and strict sun precautions. With regard to therapy of RAF inhibitor–induced neoplastic reactions, a complete surgical excision of suspect lesions is recommended (32). Yet, patients presenting with multiple lesions can also be treated with directed destructive measures, such as cryotherapy, as well as established therapies for the management of actinic field cancerization, such as topical 5-FU, ingenol mebutate, or photodynamic therapy (PDT), or combinations thereof, such as Lesion intensified field therapy (LIFT)–PDT (22,33). Finally, successful treatments have been demonstrated for oral acitretin (28). Regarding the efficacy of acitretin, it is proposed that retinoids directly interact with components of RAF/MEK/ERK and PTEN/PI13/AKT/mTOR pathways and reduce both Erk1 activity and secretion of EGF (34).
Where Cancer and Bacteria Meet
Published in Ananda M. Chakrabarty, Arsénio M. Fialho, Microbial Infections and Cancer Therapy, 2019
Alexandra Merlos, Ricardo Perez-Tomás, José López-López, Miguel Viñas
Over 700 bacterial species inhabit the oral cavity, with most living in a more or less symbiotic relationship with host cells and the host immune system [25, 26]. However, there is increasing evidence of a link between the oral microbiota and several systemic pathologies, including cancer and especially oral squamous cell carcinoma (OSCC). Between 350,000 and 400,000 new cases of head and neck cancer are diagnosed every year throughout the world, and the incidence is rising as tobacco and alcohol consumption is increasing, particularly among young populations [27]. Nonetheless, although smoking and alcohol are the main factors contributing to the development of carcinoma in the oral cavity, their effects do not suffice to explain “field cancerization” [28, 29]. Furthermore, oral cancer is frequently diagnosed in non-smoking, non-alcohol-consuming individuals [30].
Creation of a Continent Urinary Bladder Reservoir Vascularized by Omentum as a Possible Surgical Option for Canine Trigonal/Urethral Urothelial Carcinoma
Published in Journal of Investigative Surgery, 2022
Annemarieke de Vlaming, Kyle G. Mathews, Jonathan A. Hash, Erin K. Keenihan, Samantha Sommer, Luke Borst, Shelly L. Vaden
Regardless of high recurrence rates historically reported after surgery, surgery is still considered of benefit due to improve survival rates [1, 4, 44, 46]. Median survival times (MST) of 1 year have been reported after complete surgical excision of the primary tumor with or without chemotherapy [1, 44]. In a review of 37 dogs with partial cystectomy, MST was 348 days for all cases regardless of adjuvant therapy; however, those with partial cystectomy and at least daily piroxicam with/without chemotherapy reached MST of 772 [46]. Although “field cancerization” may result in recurrence even with the proposed technique, prognosis is suspected to still be improved. Adjuvant chemotherapy would be recommended after the proposed procedure. In addition to systemic chemotherapy, local adjuvant therapy administered via the cystostomy tube could be considered.
Effects of topical piroxicam and sun filters in actinic keratosis evolution and field cancerization: a two-center, assessor-blinded, clinical, confocal microscopy and dermoscopy evaluation trial
Published in Current Medical Research and Opinion, 2019
Marina Agozzino, Teresa Russo, Chiara Franceschini, Sara Mazzilli, Virginia Garofalo, Elena Campione, Luca Bianchi, Massimo Milani, Giuseppe Argenziano
Actinic keratosis (AK) is considered an “in situ” non-melanoma skin cancer induced by ultraviolet chronic exposure1. In general, several lesions are present in the same subject2, increasing the risk of malignant transformation3. The concept of field cancerization refers to the development of multiple lesions which derive from preneoplastic changes due to a cumulative exposure to carcinogenic agents4. The combined treatment of AK lesions and field cancerization is considered the gold standard in this clinical setting5. In the pathogenesis of AK, an increased activity of cyclooxygenase (COX) enzymes (both COX-2 and COX-1), at the keratinocyte level, plays a relevant role6,7. Topical anti-inflammatory agents, like diclofenac, could improve the evolution of this kind of lesion8. A topical product containing piroxicam 0.8% and sun filters (50 SPF) (ACTX) has been shown to be very effective in reducing AK lesions9–12. Non-invasive tools like dermoscopy and reflectance confocal microscopy (RCM) are considered effective alternatives to biopsy for the characterization of actinic damage and field cancerization13. So far, no data are available regarding the effects of this product on skin modifications evaluated by RCM and dermoscopy at the target lesion sites and on field cancerization.
Genomic-based treatment of patients with head and neck cancer
Published in Expert Review of Precision Medicine and Drug Development, 2020
Arpan Patel, Seyed Mohammad Abedi, Manidhar Lekkala, Megan Baumgart
In 1953, the concept of ‘field cancerization’ was first described after it was noted that dysplastic cells and carcinoma in situ often surround HNSCC tumors, consistent with diffuse mucosal damage [11]. Exposure to risk factors such as smoking and excessive alcohol consumption leads to accumulating genetic and epigenetic changes in signaling pathways and inactivating mutations in tumor suppressor genes (Figure 1), which results in formation of dysplastic epithelium [12,13]. Carcinogenesis of HPV-negative tumors is attributed to accumulating genetic alterations, often with loss of function of tumor suppressor genes [6]. Field cancerization also explains the high risk for local cancer recurrence or development of second primary cancers associated with HNSCC [3].