Calcium electroporation (Ca-EP) is a new anticancer treatment providing similar features to electrochemotherapy (ECT). The aim of our study is to compare the efficacy of Ca-EP with bleomycin-based ECT. This double-blinded randomized controlled phase II study was conducted at the Medical University of Szeged, Hungary. During this once only treatment up to ten measurable cutaneous metastases per patient were separately block randomized for intratumoral delivery of either calcium or bleomycin, which was followed by reversible electroporation. Tumour response was evaluated clinically and histologically six months after treatment. (ClinicalTrials.gov: NCT03628417, closed). Seven patients with 44 metastases (34 from malignant melanoma, 10 from breast cancer) were included in the study. Eleven metastases were taken for biopsies, and 33 metastases were randomised and treated once. The objective response rates were 33% (6/18) for Ca-EP and 53% (8/15) for bleomycin-based ECT, with 22% (4/18) and 40% (6/15) complete response rates, respectively. The CR was confirmed histologically in both arms. Serious adverse events were not registered. Ulceration and hyperpigmentation, both CTCA criteria grade I side effects, were observed more frequently after bleomycin-based ECT than for Ca-EP. Ca-EP was non-inferior to ECT, therefore, it should be considered as a feasible, effective and safe treatment option.

Background: Acral lentiginous melanoma (ALM) occurs on the palms, soles and subungual surface and has poor prognosis. It is uncommon in the Caucasian population and has remained unreported in East‐Central Europe.Objectives: Our aim was to collect data from East‐Central Europe by analysing the demographic and clinicopathologic features of patients with ALM and comparing data with the reports in literature.Methods: We conducted a single‐centre, retrospective review between 1976 and 2016 at one of the largest melanoma referral centres in Hungary.Results: We identified 176 patients with ALM (3.83%) from 4593 patients with melanoma (mean age: 66.2 years). The tumours were mainly located on the lower extremities (88.63%). The mean Breslow tumour thickness was 3.861 mm, 37.50% of the tumours were thicker than 4.00 mm, and 71.6% exhibited microscopic ulceration. Nearly one‐third of the patients underwent sentinel lymph node (SLN) biopsy, and 60.3% of the biopsies were positive for metastasis. The positive SLN status was associated with significantly thick tumours and reduced survival. Patients with ALM had 5‐ and 10‐year overall survival rates of 60.5% and 41.6%, respectively. The mean delay in diagnosis was 18 months after the discovery of skin tumours. In multivariate analyses, age, tumour thickness and distant metastasis were independent risk factors for poor survival (P < 0.001).Conclusions: Our study, which is the first single‐centre report in East‐Central Europe focusing on ALM, confirms that patient and tumour characteristics and prognostic factors are similar with previous literature data involving Caucasians; however, tumour thickness and survival suggest even worse prognosis.

Is missing (Short communication)...

Familiar controversies in the management of head and neck melanomas are more remarkable in locally advanced cases, and they represent a treatment challenge both surgically and oncologically. In our retrospective study, patients with surgically treated primary malignant melanoma of the head and neck region larger than 3 cm in diameter were included. Five patients met our inclusion criteria. In all cases, wide excision and immediate reconstruction were performed without sentinel lymph node biopsy. The defect on the scalp was covered by a split skin graft, with local flaps chosen for reconstruction on the face on an individual basis. After a 2–6 year follow-up, a good oncological, functional, and esthetic result was achieved. Our results show that in the case of large, locally advanced melanomas, surgical treatment still plays a crucial role that can provide long-term local control and support the effect of systemic treatment.

Introduction: Immunosuppressed patients face a significantly higher risk of developing malignant skin tumors compared to the general population, often presenting with numerous, rapidly growing, and aggressive lesions. It can be particularly challenging to treat these tumors, especially in the head and neck region. Electrochemotherapy (ECT) emerges as a viable option for treating multiple tumors simultaneously. This study aims to compare the efficacy, toxicity, and impacts on the quality of life of ECT of nonmelanoma skin cancers (NMSCs) in immunosuppressed patients and nonimmunosuppressed patients. Materials and Methods: A total of 156 tumors (82 target lesions) in 14 immunosuppressed patients and 183 tumors (157 target lesions) in 30 nonimmunosuppressed patients were treated with ECT using intravenous bleomycin according to the European Standard Operating Procedures of ECT (ESOPE) guidelines. Patients were monitored for at least 6 months. A prospective cohort analysis was carried out to compare tumor response, side effects, and quality of life in the two groups. Results: 3 months after ECT, nonimmunosuppressed patients showed a significantly higher tumor response rate ( p = 0.001). After 6 months, a statistically significant difference was not observed between the two groups regarding tumor response. After 3 and 6 months, there was no difference in toxicity, pain, and EQ‐VAS values. Conclusions: Our results suggest that the effectiveness and safety of ECT for treating NMSCs in immunosuppressed patients seems to be comparable to the nonimmunosuppressed patients. The emphasis on prevention, adopting a multidisciplinary approach, and optimizing immunosuppression are crucial to improving the care and management of this patient cohort.

Background/Objectives: SNMM is a rare and aggressive malignancy with a poor prognosis. The current staging systems fail to adequately stratify patient risk. This study aimed to evaluate the prognostic impact of tumor location and extension on overall survival (OS) in SNMM. Methods: A systematic literature search of Medline, Web of Science, and Embase was performed to identify studies assessing the prognostic significance of tumor location and extension. Study quality was evaluated using the Quality in Prognosis Studies (QUIPS-2) tool. Meta-analyses were conducted to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Eligible studies included primary SNMM reporting tumor location/extension and survival; observational designs (case series ≥ 5 patients) were eligible with no language restrictions. Searches covered MEDLINE, Web of Science, and Embase and were last updated on 10 Jan 2025; reference lists were also screened. Results: Thirty-four studies were included in the systematic review, of which ten met criteria for meta-analysis. Tumors located in the paranasal sinuses (HR = 2.89, 95% CI: 1.63–5.14) and those with orbital involvement (HR = 1.92, 95% CI: 1.34–2.73) were associated with significantly poorer OS. Maxillary and ethmoid sinus involvement showed no statistically significant difference compared with nasal cavity tumors. Conclusions: Tumor location and extension are significant prognostic indicators in SNMM. Patients with paranasal sinus tumors or orbital invasion have worse outcomes, supporting inclusion of these factors in future staging systems for better clinical decision-making. Limitations include the observational nature of the evidence, heterogeneity across definitions and analyses, and underpowered publication-bias tests; certainty of evidence was not formally graded.