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Biomedical subjects

A W Kopf

Publications and source records attributed to A W Kopf.

At least 91 records · Page 5Linked to original sources
PubMed1991

Recurrence rates of treated basal cell carcinomas. Part 1: Overview.

This is the first article in a series reviewing the extensive experience of the Oncology Section of the Skin and Cancer Unit, from 1955 through 1982, with 5755 basal cell carcinomas (BCCs) treated by curettage-electrodesiccation, surgical excision, or x-ray therapy. Recurrence rates were calculated by three methods for each of the treatment modalities: 1) by the raw recurrence rate method; 2) by the "strict" 5-year recurrence rate method; and 3) by modification of the life-table method. Our analyses show that the last method best approximates the true recurrence rate. Primary (previously untreated) BCCs had a 5-year recurrence rate of 10.6% (standard error 0.6%), and previously treated BCCs had a rate of 15.4% (standard error 1.3%) (P = .0002). The greatest risk for recurrence of treated primary BCCs occurred 1 to 4 years after therapy. It is concluded that recurrence rates of primary BCCs should be reported separately from those of previously treated BCCs and that the modified life-table method is best suited to calculate 5-year recurrence rates.

Adolescent↗
PubMed1991

Recurrence rates of treated basal cell carcinomas. Part 2: Curettage-electrodesiccation.

This is the second article in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). This report deals with 2314 previously untreated (primary) BCCs removed by curettage-electrodesiccation. Multivariate analysis showed that increasing lesion diameter (P less than .001), high-risk anatomic sites (nose, paranasal, nasal-labial groove, ear, chin, mandibular, peri-oral, and peri-ocular areas) (P less than .001), middle-risk anatomical sites (scalp, forehead, pre- and post-auricular, and malar areas) (P less than .001), and time-span treated (1955 to 1963) (P = .012) were independent risk factors for high recurrence rates. The patient's age, sex, and lesion duration before treatment did not affect the recurrence rates. In order to best illustrate our current experience with BCCs, the last time-span (1973 to 1982) was examined in detail. For the low-risk sites (neck, trunk, and four extremities), BCCs of all diameters responded well to curettage-electrodesiccation with an overall 5-year recurrence rate of 3.3% (SE = 1.5%) determined by the modified life-table method. In the middle-risk sites BCCs less than 10 mm in diameter had a recurrence rate of 5.3% (SE = 2.7%). Finally, in the high-risk sites, lesions less than 6 mm in diameter had a recurrence rate of 4.5% (SE = 2.6%). Thus, BCCs less than 6 mm in diameter, regardless of anatomic site, as well as selected larger BCCs depending on their anatomic site, are effectively treated by currettage-electrodesiccation.

Adult↗
PubMed1991

Factors influencing survival in melanoma.

Multiple factors appear to influence survival of patients with MM. As computer and mathematic analysis techniques advance, the specific effects of these variables, in terms of their impact on survival rates, will be delineated better.

Humans↗
PubMed1991

Volume of malignant melanoma is superior to thickness as a prognostic indicator. Preliminary observation.

There are many clinical and histologic factors that are known to be valuable in predicting survival rates for patients with cutaneous malignant melanomas. Breslow thickness is considered to be the most reliable prognostic factor; however, thickness is a unidimensional measurement. A more accurate mensuration to predict biologic behavior might be one that takes into account the three-dimensional volume of the neoplasm. In a study of 35 primary malignant melanomas, the volumes of the dermal components of the tumors were calculated. Those patients with tumor volumes of 200 mm3 or less had a 91.4% 5-year disease-free survival rate, compared with survival rate of only 16.7% for those patients whose lesions had tumor volumes exceeding 200 mm3. On multivariate analysis, tumor volume exceeded thickness as a prognostic indicator. Thus, measurement of tumor volume proved to be of greater significance than thickness in predicting the outcome for patients with malignant melanomas.

Humans↗
PubMed1991

Distinguishing benign and malignant melanocytic lesions with the AgNOR method.

A silver staining technique has recently been devised to aid in the differentiation between benign and malignant melanocytic lesions. This study showed a statistically significant difference between the staining of silver-nucleolar organizer regions (AgNORs) in melanocytic nevi and that of AgNORs in malignant melanomas.

Diagnosis, Differential↗
PubMed1991

Clinical features of dysplastic nevi.

The clinical features of 100 dysplastic nevi were tabulated. Although certain characteristics were present in most or all of these melanocytic nevi, there was a marked heterogeneity of other clinical features. The preponderant type of large (greater than or equal to 8 mm) melanocytic nevus in patients with classic dysplastic nevi is a papule or plaque with the following characteristics: multicoloration (various shades of tans, browns, reds, or black); slightly raised height for its broad diameter; mamillated surface; and lack of hypertrichosis. An atlas illustrates some of the clinical varieties of melanocytic nevi in this syndrome.

Dysplastic Nevus Syndrome↗
PubMed1991

Familial multiple desmoplastic trichoepitheliomas.

A kindred with familial multiple desmoplastic trichoepitheliomas is described. Desmoplastic trichoepitheliomas should be added to the group of lesions that indicate an inherited pattern when they occur as multiple primary tumors. The implications for nosologic status and treatment of desmoplastic trichoepitheliomas are considered.

Adult↗
PubMed1990

Clinical characteristics of malignant melanomas developing in persons with dysplastic nevi.

A total of 452 patients with dysplastic nevi (DN) were followed prospectively by repetitive, complete cutaneous examinations in order to determine the clinical features of early malignant melanomas (MM) arising in them. Sixteen patients (3.5%) developed 18 newly diagnosed MM during an average follow-up period of 27 months. Twelve of the 18 MM were in situ and all of the primary invasive MM diagnosed prospectively in this follow-up were less than 0.89 mm in Breslow thickness, implying an excellent prognosis. The principal clinical clue to the diagnosis of MM was change in a preexisting pigmented lesion. Total-body photographs were very useful in helping to identify the early MM in these patients.

Adolescent↗
PubMed1990

Quantification of histologic features of dysplastic nevi.

We quantified the histologic features of 100 consecutive dysplastic nevi. Although there is heterogeneity in the microscopic attributes of dysplastic nevi, certain features that are seen repeatedly should enable the histologic identification of these melanocytic neoplasms. These features include a central dermal nevocytic component with a peripheral extension of a junctional component, elongated epidermal rete ridges, bridging of nests of melanocytes at the dermo-epidermal junction, nests of melanocytes at the sides of rete ridges as well as at their bases, and concentric eosinophilic fibrosis. Cytologic features of melanocytes were not as valuable as architectural features of individual nevi in classifying these lesions. We also provide an atlas of selected histologic features that depicts some aspects of this heterogeneity.

Adolescent↗
PubMed1990

Does a history of melanoma correlate with the clinical presentation of dysplastic nevi?

In order to determine the prevalence of key features concerning nevocytic nevi (NN) in 150 consecutive Caucasian patients with dysplastic nevi (DN), total-body photographs were reviewed that revealed the following: 74% had greater than or equal to 100 NN, 73% had NN 8 mm or more in diameter, and 81% had atypical NN. The patients were then divided into two subsets, those with a personal and/or family history of malignant melanoma (MM) and those without, to see if the proportion of these three features differed in these two groups. There were no statistically significant differences between the MM-history-positive and MM-history-negative subsets.

Adult↗
PubMed1990

Accuracy in the clinical diagnosis of malignant melanoma.

The computerized database (1955 through 1982) of the Oncology Section of the Skin and Cancer Unit of New York (NY) University Medical Center includes data on 13,878 lesions. Of these lesions, 214 were diagnosed clinically and histologically as malignant melanoma (MM). An additional 51 lesions, diagnosed clinically as other than MMs, were found histologically to be MM. Seventy-nine lesions were clinically diagnosed as MM but were found histologically to be other entities. An analysis of the clinical diagnostic accuracy showed some improvement over the three periods studied (1955 through 1963, 1964 through 1973, and 1974 through 1982). Although the diagnostic accuracy for the best period (1974 through 1982) was only 64%, the diagnosis of MM was made in 84.5% of the histologically proved cases of MM, reflecting a high degree of sensitivity.

Biopsy↗
PubMed1989

Dysplastic nevi. Markers for increased risk for melanoma.

A total of 452 white patients, classified into four dysplastic nevi groups, were followed prospectively by repetitive, complete cutaneous examinations using total-body photographs taken on entry into the study. Sixteen patients (3.5%) developed 18 newly diagnosed malignant melanomas (MM) during an average follow-up period of 27 months. Twelve of the 18 MM were in situ, and all of the six primary invasive MM diagnosed prospectively in this follow-up were less than 0.89 mm in Breslow thickness, implying an excellent prognosis. Compared with reference populations, the number of MM detected significantly exceeded the number estimated to occur in the comparable age-matched control groups. These data support the concept of repetitive follow-ups of all groups of patients with dysplastic nevi.

Adult↗
PubMed1989

Age and malignant melanoma: comparison of variables in different age-groups.

Variables were compared in patients with clinical stage I superficial spreading melanoma who had been divided into three age-groups. The study included 736 consecutive patients who were prospectively entered into the data base of the Melanoma Cooperative Group of New York University Medical Center. Compared with the younger patients ( less than 40 years), older patients (greater than or equal to 60 years) had superficial spreading melanomas that were, on average, of greater thickness, level, and diameter. Younger patients were more likely than older patients to show evidence that their melanomas arose from preexisting nevocytic nevi. There was no difference in the 10-year survival between groups when melanomas were matched by thickness. Thus it is as important to perform periodic total cutaneous examinations in the elderly as it is in younger persons, and age alone should not determine management strategies.

Adult↗
PubMed1988

Prevention and early detection of skin cancer/melanoma.

In the USA malignant neoplasms of the skin are the most common cancers of man. Annually, over 500,000 new cutaneous cancers are diagnosed. Of particular concern is the inexorable increase in the incidence and mortality rate of malignant melanoma (in 1978: 25,000 new cases; 5800 deaths). There are substantial data that (1) implicate sunlight as the probable cause of many cancers of the skin, and that, (2) indicate early diagnosis and prompt treatment results in cure in most instances. The time has come to create, implement, and evaluate a National Program on Education of the Medical Profession and the Public on Cancers of the Skin with emphasis on cutaneous malignant melanoma.

Humans↗