Matthew Harris, M.D.

Hypo-Fractionated Conformal Radiation Therapy to the Tumor Bed After Segmental Mastectomy
Formenti, Silvia C; Roses, Daniel; Harris, Matthew; Shapiro, Richard; Guth, Amber
[Ft. Belvoir, VA] : Ft. Belvoir Defense Technical Information Center, 2003,
The current trial tests a regimen of conformal hypo-fractionated radiotherapy (5 fractions) directed to the original tumor bed with margins in a selected subset of post- menopausal women with breast cancer with a very low risk for local recurrence elsewhere in the breast. We are currently reporting the feasibility results and DVH analysis of the first 4% patients accrued. After planning CT is conducted in the prone position the breast tissue and tumor bed are contoured on a 3D planning system and a 2 cm margin added to determine the PTV. A plan is generated to treat the PTV to 90% of the prescription dose. Six Gy per fraction are delivered to the 95% isodose surface in 5 fractions over ten days weeks to a total dose of 30 Gy. All patients appeared to tolerate treatment very well. DVH varied based on the position of the original tumor bed and the size of the breast. In most cases it was possible to successfully plan and treat a quadrant of the breast with parallel opposed tangent fields without exceeding 50% of the dose to 50% of the breast volume. We continue accrual as planned, to a total of 99 patients
— id: 2130, year: 2003, vol: , page: , stat: ,

Assessment of hormone receptor status and HER2 expression by fine needle aspiration biopsy in breast cancer
Hussain, M; Cangiarella, J; Volm, M; Harris, MN; Roses, DF; Berman, RS
2003 JAN ;10(1):S54-S55, Annals of surgical oncology
— id: 38553, year: 2003, vol: 10, page: S54, stat: Journal Article,

Changes in the presence of multiple markers of circulating melanoma cells correlate with clinical outcome in patients with melanoma
Reynolds, Sandra R; Albrecht, Jeff; Shapiro, Richard L; Roses, Daniel F; Harris, Matthew N; Conrad, Andrew; Zeleniuch-Jacquotte, Anne; Bystryn, Jean-Claude
2003 Apr;9(4):1497-1502, Clinical cancer research
PURPOSE: Melanoma cells can be found in the circulation of patients with melanoma. The following study was conducted to examine whether changes in their presence could provide an early marker of response to therapy. EXPERIMENTAL DESIGN: We measured the presence of several markers of melanoma cells in the peripheral blood of 118 patients with resected stage IIb, III, or IV melanoma before and after immunotherapy with a polyvalent, shed antigen, melanoma vaccine using reverse transcription-PCR assays for tyrosinase, gp100, MART-1, and MAGE-3. Assays were conducted at baseline and after 3, 5, and 11 months of therapy. RESULTS: Overall, 47% of patients were positive for at least one marker during the study. Before vaccine treatment, circulating melanoma cell markers were present in 23% of patients. After 5 and 7 months of vaccine therapy, the proportion of patients with circulating markers decreased by 27% and 55%, respectively (P for trend = 0.02). The recurrence-free survival of patients whose melanoma cell markers disappeared during vaccine treatment was significantly longer than that of patients in whom they increased, i.e., the percentage of patients who were recurrence free at 1 year was 80% versus 58% (P = 0.03). CONCLUSIONS: Therapy with a polyvalent melanoma vaccine was associated with clearance of melanoma cell markers from the circulation, and the clearance was associated with an improved prognosis. These findings suggest that the sequential assay of tumor cells in the circulation by reverse transcription-PCR may provide an early indication of the effectiveness of cancer therapy
— id: 34746, year: 2003, vol: 9, page: 1497, stat: Journal Article,

Vaccine-induced CD8+ T-cell responses to MAGE-3 correlate with clinical outcome in patients with melanoma
Reynolds, Sandra R; Zeleniuch-Jacquotte, Anne; Shapiro, Richard L; Roses, Daniel F; Harris, Matthew N; Johnston, Dean; Bystryn, Jean-Claude
2003 Feb;9(2):657-662, Clinical cancer research
PURPOSE: Vaccine-induced antitumor CD8+ T-cell responses are believed to play an important role in increasing resistance to melanoma. The following study was conducted to examine whether these responses are associated with improved clinical outcome in melanoma vaccine-treated patients. EXPERIMENTAL DESIGN: We measured CD8+ T-cell responses to gp100, MART-1, MAGE-3, and tyrosinase by enzyme-linked immunospot assay in peripheral blood of 131 HLA-A*01- or HLA-A*02-positive melanoma patients before and after immunization to a polyvalent, shed antigen, melanoma vaccine, and correlated the results with clinical outcome. RESULTS: Fifty-six percent of patients had a vaccine-induced CD8+ T-cell response to at least one of the four antigens. Recurrences were significantly reduced in patients with vaccine-induced responses to MAGE-3 (hazard ratio, 0.42; 95% confidence interval, 0.18-0.99; P = 0.03) by the Cox proportional hazard model but were unrelated to responses to the other three antigens. Patients with a preexisting response to any of the four antigens were significantly more likely to have a further vaccine-boosted response to that same antigen (P < 0.0001-0.036). CONCLUSIONS: There was a correlation between vaccine-induced CD8+ T-cell responses to melanoma-associated antigens and improved clinical outcome, but the correlation depended on the antigen against which the response is directed. The only significant correlation was with responses to MAGE-3
— id: 34747, year: 2003, vol: 9, page: 657, stat: Journal Article,

Hypo-Fractionated Conformal Radiation Therapy to the Tumor Bed After Segmental Mastectomy
Formenti, Silvia C; Roses, Daniel; Harris, Matthew; Shapiro, Richard; Guth, Amber
[Ft. Belvoir, VA] : Ft. Belvoir Defense Technical Information Center, 2002,
The current trial tests a regimen of conformal hypo-fractionated radiotherapy (5 fractions) directed to the original tumor bed with margins in a selected subset of post- menopausal women with breast cancer with a very low risk for local recurrence elsewhere in the breast. We are currently reporting the feasibility results and DVN analysis of the first 29 patients accrued. After planning CT is conducted in the prone position the breast tissue and tumor bed are contoured on a 3D planning system and a 2 cm margin added to determine the PTV. A plan is generated to treat the PTV to 90% of the prescription dose. Six Gy per fraction are delivered to the 95 isodose surface in 5 fractions over ten days weeks to a total dose of 30 Gy. All patients appeared to tolerate treatment very well. DVH varied based on the position of the original tumor bed and the size of the breast. In most cases it was possible to successfully plan and treat a quadrant of the breast with parallel opposed tangent fields without exceeding 50% of the dose to 50% of the breast volume. We continue accrual as planned, to a total of 99 patients
— id: 2129, year: 2002, vol: , page: , stat: ,

Long-term survival of stage IV melanoma patients treated with a polyvalent, shed antigen, melanoma vaccine
Laky, D; Shapiro, RL; Harris, MN; Roses, DF; Jacquotte, AZ; Reynolds, SR; Bystryn, J
2002 JUL ;119(1):240-240, Journal of investigative dermatology
— id: 55284, year: 2002, vol: 119, page: 240, stat: Journal Article,

Presence of Mab 465.12 defined cytoplasmic melanoma-associated antigen in sera of patients with melanoma and relation to prognosis
Levy, D; Reynolds, SR; Ferrone, S; Shapiro, RL; Harris, MN; Roses, DF; Bystryn, J
2002 JUL ;119(1):240-240, Journal of investigative dermatology
— id: 55283, year: 2002, vol: 119, page: 240, stat: Journal Article,

Prognostic significance of the high molecular weight-melanoma associated antigen in sera of patients with melanoma
Wainwright, BD; Reynolds, SR; Ferrone, S; Harris, RL; Harris, MN; Roses, DF; Bystryn, J
2002 JUL ;119(1):242-242, Journal of investigative dermatology
— id: 55285, year: 2002, vol: 119, page: 242, stat: Journal Article,

Serum S100 level is predictive of recurrence-free survival in patients with intermediate risk melanoma
Amin, P; Bar, A; Reynolds, S; Shapiro, R; Harris, M; Roses, D; Bystryn, J
2001 AUG ;117(2):467-467, Journal of investigative dermatology
— id: 54900, year: 2001, vol: 117, page: 467, stat: Journal Article,

Decreases in serum levels of S100 may predict response to therapy in melanoma patients treated with a polyvalent melanoma vaccine
Bar, A; Amin, P; Reynolds, S; Shapiro, R; Roses, D; Harris, M; Bystryn, J
2001 AUG ;117(2):540-540, Journal of investigative dermatology
— id: 54910, year: 2001, vol: 117, page: 540, stat: Journal Article,

Decrease in circulating tumor cells as an early marker of therapy effectiveness
Bystryn JC; Albrecht J; Reynolds SR; Rivas MC; Oratz R; Shapiro RL; Roses DF; Harris MN; Conrad A
2001 ;158:204-207, Recent results in cancer research = Fortschritte der Krebsforschung = Progres dans les recherches sur le cancer
As melanoma cells are present in the circulation of many patients with this cancer, decreases in their number could provide an early indication of therapy effectiveness. To evaluate this possibility, we examined the effect of treatment with a melanoma vaccine on the number of melanoma cells present in the circulation. PCR was used to detect melanoma cells that expressed the melanoma-associated antigens MART-1, MAGE-3, tyrosinase and/or gp100 in 91 patients with melanoma. Melanoma cells that expressed one or more of these markers were present more often in advanced disease, i.e. in 80% of patients with advanced stage IV compared to in less than one-third of patients with less advanced disease. We then measured circulating melanoma cells in a subset of 43 of these patients who were treated with a polyvalent, shed antigen, melanoma vaccine. The vaccine contains multiple melanoma-associated antigens including MART-1, MAGE-3, tyrosinase and gp100. Immunizations were given intradermally q2-3 weeks x4 and then monthly x3. Prior to vaccine treatment, circulating melanoma cells were detected in 14 (32%) patients. Following 4 and 7 months of vaccine treatment, melanoma cells that expressed any of these markers were present in only nine (21%) and three (7%) of patients, respectively. Thus, vaccine therapy was associated with clearance of melanoma cells from the circulation in 78% of initially positive patients. As the number of these cells declined steadily with increasing length of therapy, it is unlikely that this was due to a random change in their number. Rather it suggests that the decline was a result of the therapy. These observations suggest that the presence of melanoma cells in the circulation is related to the extent of the melanoma, and that their disappearance may provide an early marker of the efficacy of therapy. However, the practical utility of assaying circulating tumor cells as a guide to the effectiveness of therapy or of prognosis will need to be confirmed by correlations with clinical outcome
— id: 16214, year: 2001, vol: 158, page: 204, stat: Journal Article,

Double-blind trial of a polyvalent, shed-antigen, melanoma vaccine
Bystryn JC; Zeleniuch-Jacquotte A; Oratz R; Shapiro RL; Harris MN; Roses DF
2001 Jul;7(7):1882-1887, Clinical cancer research
A polyvalent melanoma vaccine prepared from shed antigens stimulates humoral and cellular immune responses and improves survival compared with historical controls. We conducted a double-blind, prospectively randomized, placebo-controlled trial to assess whether this vaccine could slow the progression of resected melanoma. Thirty-eight patients with resected melanoma metastatic to regional nodes (American Joint Committee on Cancer stage III) who had a particularly poor prognosis on the basis of the nodes being clinically positive or two or more histologically positive nodes were randomly assigned in a 2:1 ratio to treatment with 40 microg of melanoma or placebo (human albumin) vaccine, both of which were bound to alum as an adjuvant. Immunizations were given intradermally into the extremities every 3 weeks x 4, monthly x 3, every 3 months x 2, and then every 6 months for 5 years or until disease progression. Twenty-four patients were treated with the melanoma, and 14 patients were treated with the placebo vaccine. The groups were evenly balanced with respect to prognostic factors. Median length of observation was 2.5 years. There was no local or systemic toxicity. By Kaplan-Meier analysis, median time to disease progression was two and a half times longer in patients treated with melanoma vaccine compared with that in patients treated with placebo vaccine, i.e., 1.6 years (95% confidence interval, 1.0-3.0 years) compared with 0.6 year [95% confidence interval, 0.3-1.9 year(s)]. By Cox proportional hazards analysis, this difference was significant at P = 0.03. Overall survival was 40% longer in the melanoma vaccine-treated group (median overall survival of 3.8 years versus 2.7 years), but this difference was not statistically significant. In a double-blind and placebo-controlled trial, these results suggest that immunization with a melanoma vaccine may be able to slow the progression of melanoma. Although statistically significant, these results must be interpreted with caution because they are based on a small number of patients
— id: 21126, year: 2001, vol: 7, page: 1882, stat: Journal Article,

Low p27 in T1N0M0 breast cancers - association with other unfavorable molecular markers of prognosis
Mirchandani, D; Tang, T; Inghirami, G; Roses, D; Shapiro, R; Harris, M; Muggia, F
2001 WIN ;69(3):337-119, Breast cancer research & treatment
— id: 98269, year: 2001, vol: 69, page: 337, stat: Journal Article,

Aspiration biopsy and the clinical management of patients with malignant melanoma and palpable regional lymph nodes
Cangiarella J; Symmans WF; Shapiro RL; Roses DF; Cohen JM; Chhieng D; Harris MN; Waisman J
2000 Jun 25;90(3):162-166, Cancer
BACKGROUND: The presence of lymph node metastases in patients with malignant melanoma implies a significant decrease in survival. The authors investigated the efficacy of fine-needle aspiration biopsy (FNAB) in the diagnosis of metastatic malignant melanoma in 115 patients with melanoma and clinically suspicious regional lymph nodes. METHODS: One hundred thirty-three FNABs were performed by cytopathologists after referral from surgeons or oncologists using a 25-gauge or 27-gauge needle. RESULTS: The cytologic diagnosis was negative in 35, atypical in 1, suspicious in 2, and positive for malignant melanoma in 95. Regional lymph node dissections were performed in 78 patients. Of these, 70 positive FNABs were confirmed with no false-positive results. The atypical FNAB was proven positive for malignant melanoma at surgery. Of the two suspicious FNABs, one was confirmed as positive and one showed dermatopathic lymphadenopathy. Of the 35 negative FNAB specimens, 5 patients underwent surgery; 3 FNABs were found to be negative and 2 FNABS were falsely negative. Twenty patients with negative aspirates were followed clinically for 22-45 months (mean, 32 months); 19 patients had no evidence of disease and 1 patient died of disseminated melanoma. CONCLUSIONS: FNAB of palpable lymphadenopathy in patients with malignant melanoma can provide a rapid and accurate assessment of lymph node status and expedite the therapeutic management of these patients
— id: 11596, year: 2000, vol: 90, page: 162, stat: Journal Article,

Invasive carcinoma in clinically suspicious breast masses diagnosed as adenocarcinoma by fine-needle aspiration
Chhieng DC; Fernandez G; Cangiarella JF; Cohen JM; Waisman J; Harris MN; Roses DF; Shapiro RL; Symmans WF
2000 Apr 25;90(2):96-101, Cancer
BACKGROUND: Fine-needle aspiration (FNA) biopsy of palpable breast masses along with clinical and radiologic findings can provide rapid distinction between benign and malignant lesions. A preoperative determination of invasive or in situ carcinoma assists in the planning of definitive treatment. Previous studies have concentrated on whether cytologic features adequately distinguish invasion, but to the authors' knowledge the predictive value of clinicopathologic correlation has not been investigated. The authors attempted to determine whether a malignant cytologic diagnosis for a palpable breast mass is sufficient for its definitive surgical management as an invasive neoplasm. METHODS: The authors reviewed 351 FNAs from palpable breast lesions with a cytologic diagnosis of 'adenocarcinoma.' The presence of invasive disease was determined by histologic demonstration of invasive carcinoma in the corresponding surgical specimen or by identifying metastatic carcinoma in the absence of another primary source. RESULTS: Three hundred forty-three (97.7%) palpable tumors diagnosed as adenocarcinoma by FNA proved to be invasive adenocarcinoma. The remaining eight tumors contained high grade ductal carcinoma in situ, and two of these contained foci suggestive of microinvasion. CONCLUSIONS: A palpable breast mass with an FNA diagnosis of adenocarcinoma usually represents invasive carcinoma. A definitive treatment plan therefore can be planned based on these clinical and FNA findings
— id: 11721, year: 2000, vol: 90, page: 96, stat: Journal Article,

Patch testing for chromium sensitivity [2] (multiple letters)
Finley BL; Proctor DM; Harris M; Fowler J; Cohen DE; Brancaccio R
2000 ;11(2):121-125, American journal of contact dermatitis
— id: 25642, year: 2000, vol: 11, page: 121, stat: Journal Article,

Low-grade endometrial stromal sarcoma with intracardiac extension. Evolution of extensive smooth muscle differentiation and usefulness of immunohistochemistry for its recognition and distinction from intravenous leiomyomatosis
Mikami Y; Demopoulos RI; Boctor F; Febre EF; Harris M; Kronzen I; Scholes JV
1999 ;195(7):501-508, Pathology research & practice
This case, a rare example of low-grade endometrial stroma sarcoma with extensive smooth muscle differentiation which extended to the inferior vena cava and cardiac chambers closely resembling intravenous leiomyomatosis grossly and microscopically, illustrates the importance of extensive sectioning and the usefulness of immunohistochemistry. Although spindle cell components arranged in interlacing bundles consistent with smooth muscle differentiation were recognizable in the primary tumor (on retrospective review), extensive smooth muscle differentiation in the recurrent tumors masked prototypical morphologic features of stromal sarcoma and only small neoplastic stromal components were preserved in limited areas, leading to initial failure to distinguish the lesion from intravenous leiomyomatosis. The immunophenotyping disclosed two distinct cell populations in the tumor: i.e. vimentin-positive and smooth muscle marker negative stromal cells, and vimentin-negative spindle-shaped desmin-positive smooth muscle cells. Our observation suggests that the predominance of a smooth muscle component in such a tumor can be misleading and does not always warrant a diagnosis of intravenous leiomyomatosis, nor does it predict a benign clinical course. This case also provides an insight into the relationship of the endometrial stroma and myometrium, and their cell of origin and the histogenesis of endometrial stromal sarcoma
— id: 8481, year: 1999, vol: 195, page: 501, stat: Journal Article,

Complications of level I and II axillary dissection in the treatment of carcinoma of the breast
Roses DF; Brooks AD; Harris MN; Shapiro RL; Mitnick J
1999 Aug;230(2):194-201, Annals of surgery
OBJECTIVE: To assess the complications of level I and II axillary lymph node dissection in the treatment of stage I and II breast cancer, with breast-conservation surgery and mastectomy. SUMMARY BACKGROUND DATA: The role of axillary dissection for staging, and as an effective means of controlling regional nodal disease, has long been recognized. As small and low-grade lesions have been detected more frequently, and as its therapeutic impact has been questioned, axillary dissection has increasingly been perceived as associated with significant complications. METHODS: Two hundred patients, 112 of whom had breast-conservation surgery with axillary dissection and 88 of whom had total mastectomy with axillary dissection, were evaluated 1 year or more after surgery for arm swelling as well as nonedema complications. All patients had arm circumference measurements at the same four sites on both the operated and nonoperated sides. RESULTS: No patient had an axillary recurrence. The mean difference in circumference on the nonoperated versus operated side was 0.425 cm +/- 1.39 at the midbiceps (p < 0.001), 0.315 cm +/- 1.27 at the antecubital fossa (p < 0.001), 0.355 cm +/- 1.53 at the midforearm (p < 0.005), and 0.055 cm +/- 0.75 at the wrist (n.s.). Seven patients (3.5%) had mild swelling of the hand. Heavy and obese body habitus were the only significant predictors of edema on multivariate analysis. One hundred fifty-three (76.5%) patients had numbness or paresthesias of the medial arm and/or axilla after surgery; in 125 (82%) of these, the problem had lessened or had resolved on follow-up assessment. CONCLUSIONS: The characterization of a level I and II axillary dissection as a procedure with significant complications does not appear justified based on this experience
— id: 6178, year: 1999, vol: 230, page: 194, stat: Journal Article,

Randomized, double-blind, clinical trial of a polyvalent melanoma vaccine in patients with stage III melanoma
Bystryn, JC; Oratz, R; Shapiro, R; Harris, M; Roses, D; Jacquotte, A
1998 APR ;110(4):498-498, Journal of investigative dermatology
— id: 53522, year: 1998, vol: 110, page: 498, stat: Journal Article,

Randomized, double-blind phase III trial of a polyvalent, shed, melanoma antigen vaccine in stage III melanoma
Bystryn, JC; Oratz, R; Shapiro, RL; Harris, MN; Roses, DF; Jacquotte, A; Chen, DL; Rivas, M
1998 AUG 25 ;9(4):84-84, Annals of oncology
— id: 53387, year: 1998, vol: 9, page: 84, stat: Journal Article,

Irsogladine maleate inhibits angiogenesis in wild-type and plasminogen activator-deficient mice
Ren CJ; Ueda F; Roses DF; Harris MN; Mignatti P; Rifkin DB; Shapiro RL
1998 Jul 1;77(2):126-131, Journal of surgical research
BACKGROUND: The activation of the zymogen plasminogen to the serine protease plasmin by urokinase-type (uPA) and tissue-type (tPA) plasminogen activators (PA) is an important event in a variety of physiologic and pathophysiologic processes in mammals. Enhanced PA activity occurs during angiogenesis and has been correlated in vitro and in vivo with increased tumor aggressiveness and is an indicator of poor prognosis in a variety of tumors in humans. Preliminary studies suggest that the antiulcer drug irsogladine maleate (IM) diminishes PA activity in vitro and may inhibit angiogenesis in vivo. To define the precise mechanism of angiogenesis inhibition by IM in vivo, we tested the ability of IM to blunt angiogenesis in a mouse cornea neovascularization model performed in wild-type and PA-knockout mice. METHODS: Three days prior to pellet implantation, groups of C57Bl/6 wild-type, uPA-deficient (upA-/-), and tPA-deficient (tPA-/-) mice received IM (300 mg/kg), IM (500 mg/kg), or vehicle (0.5% carboxymethylcellulose) via oral gavage. After 3 days of treatment, hydron polymer-coated pellets of sucrose aluminum sulfate containing 100 ng of basic fibroblast growth factor (bFGF) were inserted into surgically created pockets in the cornea of each mouse. On postoperative day 6, the neovascularization of each cornea was evaluated by a blinded observer using slit lamp microscopy and photographed. Angiogenesis was quantified by calculating vascular area (mm2) +/- SEM using a modified formula for a half ellipse that incorporates calibrated vessel measurements [Vessel length (mm) x Clock hours x pi x 0.2]. RESULTS: IM treatment (300 and 500 mg/kg/day) resulted in a dose-dependent reduction of angiogenesis in wild-type mice by 21 and 45.3% (P < 0.02, P < 0.001), in tPA-deficient mice by 42.6 and 46% (P < 0.001, P < 0.001), and in uPA-deficient mice by 27.2 and 46% (P < 0.05, p < 0.001), respectively. No quantitative differences in neovascularization were observed in either treatment group between transgenic mouse strains. No toxicity was noted in any group. CONCLUSION: IM inhibits bFGF-induced angiogenesis in wild-type, tPA-knockout, and uPA-knockout mice. The observation that IM significantly diminishes angiogenesis in both PA-deficient mice and wild-type mice suggests that the mechanism of action of IM may be independent of plasminogen activation.
— id: 12076, year: 1998, vol: 77, page: 126, stat: Journal Article,

Stimulation of CD8+ T cell responses to MAGE-3 and MART-1 by immunization to a shed antigen melanoma vaccine
Bystryn, JC; Reynolds, SR; Oratz, R; Shapiro, RL; Harris, M; Roses, D
1997 APR ;108(4):113-113, Journal of investigative dermatology
— id: 53215, year: 1997, vol: 108, page: 113, stat: Journal Article,

DNA-protein cross-links produced by various chemicals in cultured human lymphoma cells
Costa M; Zhitkovich A; Harris M; Paustenbach D; Gargas M
1997 Apr 11;50(5):433-449, Journal of toxicology & environmental health
Chemicals such as cis-platinum, formaldehyde, chromate, copper, and certain arsenic compounds have been shown to produce DNA-protein cross-links in human in vitro cell systems at high doses, such as those in the cytotoxic range. Thus far there have only been a limited number of other chemicals evaluated for their ability to produce cross-links. The purpose of the work described here was to evaluate whether select industrial chemicals can form DNA-protein cross-links in human cells in vitro. We evaluated acetaldehyde, acrolein, diepoxybutane, paraformaldehyde, 2-furaldehyde, propionaldehyde, chloroacetaldehyde, sodium arsenite, and a deodorant tablet [Mega Blue; hazardous component listed as tris(hydroxymethyl)nitromethane]. Short- and long-term cytotoxicity was evaluated and used to select appropriate doses for in vitro testing. DNA-protein cross-linking was evaluated at no fewer than three doses and two cell lysate washing temperatures (45 and 65 degrees C) in Epstein-Barr virus (EBV) human Burkitt's lymphoma cells. The two washing temperatures were used to assess the heat stability of the DNA-protein cross-link, 2-Furaldehyde, acetaldehyde, and propionaldehyde produced statistically significant increases in DNA-protein cross-links at washing temperatures of 45 degrees C, but not 65 degrees C, and at or above concentrations of 5, 17.5, and 75 mM, respectively. Acrolein, diepoxybutane, paraformaldehyde, and Mega Blue produced statistically significant increases in DNA-protein cross-links washed at 45 and 65 degrees C at or above concentrations of 0.15 mM, 12.5 mM, 0.003%, and 0.1%, respectively. Sodium arsenite and chloroacetaldehyde did not produce significantly increased DNA-protein cross-links at either temperature nor at any dose tested. Excluding paraformaldehyde and 2-furaldehyde treatments, significant increases in DNA-protein cross-links were observed only at doses that resulted in complete cell death within 4 d following dosing. This work demonstrates that DNA-protein cross-links can be formed in vitro following exposure to a variety of industrial compounds and that most cross-links are formed at cytotoxic concentrations
— id: 12327, year: 1997, vol: 50, page: 433, stat: Journal Article,

Randomised double-blind trial of fixed low-dose warfarin with aspirin after myocardial infarction
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Merz RH; Martin D; Ladenheim M; LozykZehr GM; Brodsky M; Chaim S; Bersohn MM; Silbar C; Pandian MG; Eldridge P; Lob IK; Smith C
1997 ;350(9075):389-396, Lancet
Background Antiplatelet therapy with aspirin and systematic anticoagulation with warfarin reduce cardiovascular morbidity and mortality after myocardial infarction when given alone. In the Coumadin Aspirin Reinfarction Study (CARS), we aimed to find out whether a combination of low-dose warfarin and low-dose aspirin would give superior results to standard aspirin monotherapy without excessive bleeding risk. Methods We used a randomised double-blind study design. At 293 sites, we randomly assigned 8803 patients who had had myocardial infarction, treatment with 160 mg aspirin, 3 mg warfarin with 80 mg aspirin, or 1 mg warfarin with 80 mg aspirin. Patients took a single tablet daily, and attended for prothrombin time (PT) measurements at weeks 1, 2, 3, 4, 6, and 12, and then every 3 months. Patients were followed up for a maximum of 33 months (median 14 months). Findings The primary event was first occurrence of reinfarction, non-fatal ischaemic stroke, or cardiovascular death. 1-year life-table estimates for the primary event were 8.6% (95% Cl 7.6-9.6) for 160 mg aspirin, 8.4% (7.4-9.4) for 3 mg warfarin with 80 mg aspirin, and 8.8% (7.6-10) for 1 mg warfarin with 80 mg aspirin. Primary comparisons were done with all follow-up data. The relative risk of the primary event for the 160 mg aspirin group compared with the 3 mg warfarin with 80 mg aspirin group was 0.95 (0.81-1.12, p=0.57). For spontaneous major haemorrhage (not procedure related), 1-year life-table estimates were 0.74% (0.43-1.1) in the 160 mg aspirin group and 1.4% (0.94-1.8) in the 3 mg warfarin with 80 mg aspirin group (p=0.014 log rank on follow-up). For the 3382 patients assigned 3 mg warfarin with 80 mg aspirin, the INR results were: at week 1 (n=2985) median 1.51 (IQR 1.23-2.13); at week 4 (n=2701) 1.27 (1.13-1.64); at month 6 (n=2145) 1.19 (1.08-1.44). Interpretation Low, fixed-dose warfarin (1 mg or 3 mg) combined with low-dose aspirin (80 mg) in patients who have had myocardial infarction does not provide clinical benefit beyond that achievable with 160 mg aspirin monotherapy. $$:
— id: 130406, year: 1997, vol: 350, page: 389, stat: Journal Article,

Poly(ADP-ribose) polymerase in human breast cancer: a case-control analysis
Hu JJ; Roush GC; Dubin N; Berwick M; Roses DF; Harris MN
1997 Aug;7(4):309-316, Pharmacogenetics
The importance of a genetic polymorphism (A/B allele) of poly(ADP-ribose) polymerase (PARP) pseudogene on chromosome 13q34-qter, and PARP enzyme activities in the development of human breast cancer were evaluated in a cancer case-control study. A total of 309 Caucasian women (> or = 50 years old) were evaluated for the PARP genotype, 70 of whom had histologically confirmed breast cancer, 128 women with benign breast diseases as study controls, and 111 reference controls. Age was significantly associated with case-control status (p < 0.0001), but family history of breast cancer, age at menarche, age at first live birth and parity were not. The frequency of the PARP B allele was similar in breast cancer cases (0.14), study controls (0.13), and reference controls (0.15). In a subset of 14 breast cancer cases and 32 study controls, the mean PARP enzyme activities (induced by H2O2 or oligonucleotide) were observed to be lower in cancer cases; an age-adjusted odds ratio of 3.40 (95% confidence interval = 0.70-19.54) for the below-median oligonucleotide-induced PARP was suggestive of an association. In subjects with the AB or BB genotype, the mean H2O2-induced PARP enzyme activity was significantly higher (p = 0.02, adjusted for case-control status and age) compared with that in subjects with the AA genotype. These findings indicate that: (a) the genetic polymorphism of the PARP pseudogene on chromosome 13 is not associated with the development of breast cancer in our study population; (b) oligonucleotide-induced PARP activity may be useful for identifying postmenopausal women at increased risk for breast cancer; and (c) there is a possible functional link between the genotype of the PARP pseudogene and enzyme activation
— id: 25128, year: 1997, vol: 7, page: 309, stat: Journal Article,

A polyvalent melanoma vaccine induces MAGE-3 and MART-1/Melan-A specific CD8+ T cell responses that correlate with clinical outcome
Oratz R; Reynolds SR; Shapiro RL; Harris M; Roses D; Vukmanovic S; Bystryn JC
1997 ;16:A1548-A1548, Proceedings (American Society of Clinical Oncology)
A critical requirement to use tumor antigens as vaccines is that they stimulate CD8+ T cell responses. In this study, we tested the ability of a shed, polyvalent, melanoma antigen vaccine to induce such responses to the melanoma-associated antigens, MAGE-3 and MART-1/Melan-A. Fifteen HLA-A2+ patients with resected malignant melanoma were immunized to the vaccine sc every 2-3 weeks x 4, and monthly thereafter. CD8+ T cells in peripheral blood reacting to HLA-A2 restricted epitopes on MAGE-3 (FLWGPRALV) and/or MART-1/Melan-A (AAGIGILTV) were quantitated directly using a filter spot assay at baseline and following 4 immunizations. Vaccine immunization induced CD8+ T cells reacting specifically to one or both of these antigens in 9 (60%) patients. These cells were CD8+ and HLA-A2 restricted, as reactivity was abrogated by monoclonal antibodies to CD8 and to class I HLA, but not by anti-CD4. The CD8+ T cells were specifically directed to these antigens, as they did not react to the same targets pulsed with a control HLA-A2 restricted peptide recognized by T cells. All responding patients remained recurrence-free during a follow-up of 12-21 months, whereas melanoma recurred within 3-5 months in non-responders. The differences in outcome were unrelated to differences in disease-severity or overall immunological competence between CD8+ T cell responders and non-responders. These results demonstrate that a polyvalent vaccine can stimulate a CD8+ T cell response to MAGE-3 and MART-1/Melan-A in humans, and suggest that the responses are protective and surrogate markers of vaccine efficacy. (C) American Society of Clinical Oncology 1997
— id: 6031, year: 1997, vol: 16, page: A1548, stat: Journal Article,

Urokinase-type plasminogen activator-deficient mice are predisposed to staphylococcal botryomycosis, pleuritis, and effacement of lymphoid follicles
Shapiro RL; Duquette JG; Nunes I; Roses DF; Harris MN; Wilson EL; Rifkin DB
1997 Jan;150(1):359-369, American journal of pathology
Urokinase-type plasminogen activator (uPA) is thought to be an important mediator in the proteolytic degradation of extracellular matrix components observed in a wide variety of normal physiological and pathological conditions. However, the phenotype of a recently developed strain of urokinase-deficient (uPA-/-) mice appears to be normal when maintained under ideal nonstressful conditions. We report an outbreak of botryomycosis, an unusual staphylococcal infection, in a colony of uPA-deficient mice. A detailed histological examination of these uPA-deficient animals also revealed a variety of previously unreported phenotypic abnormalities such as pleuritis and the effacement of lymphoid follicles in the regional lymph nodes and spleen. Additional phenotypic abnormalities such as dystrophic calcifications and rectal prolapse were also observed in the uPA-deficient population. These abnormalities were also noted in ostensibly healthy uPA-deficient animals. Botryomycosis did not affect a colony of wild-type (uPA+/+) animals maintained concurrently under identical conditions in the same room. The peculiar predisposition of the uPA-deficient animals to this rare bacterial infection and the development of phenotypic abnormalities associated with the targeted disruption the uPA gene suggests that uPA contributes significantly to the cutaneous microenvironment and is additional evidence of the extensive involvement of the plasminogen activators in mammalian physiology
— id: 12426, year: 1997, vol: 150, page: 359, stat: Journal Article,

Axillary dissection for tubular carcinoma of the breast
Berger AC; Miller SM; Harris MN; Roses DF
1996 ;2:204-208, Breast journal
— id: 25213, year: 1996, vol: 2, page: 204, stat: Journal Article,

Potentiation of melanoma vaccine activity by IL-2 liposomes
Bystryn JC; Oratz R; Shapiro RL; Johnston D; Harris MN; Roses DF; Zeleniuch-Jacquotte A; Chen DF; Lax A
1996 ;106(4):845-845 #235, Journal of investigative dermatology
— id: 25218, year: 1996, vol: 106, page: 845, stat: Journal Article,

Use of vaccines in treatment of malignant melanoma
Bystryn JC; Shapiro RL; Harris M; Roses DF; Oratz R
1996 Jul-Aug;14(4):337-341, Clinics in dermatology
— id: 12583, year: 1996, vol: 14, page: 337, stat: Journal Article,

Potentiation of melanoma vaccine activity by IL-2 liposomes
Bystryn, JC; Oratz, R; Shapiro, R; Johnston, D; Harris, M; Roses, D; ZeleniuchJacquotte, A; Chen, DL; Lax, A
1996 APR ;106(4):235-235, Journal of investigative dermatology
— id: 98386, year: 1996, vol: 106, page: 235, stat: Journal Article,

The management of pigmented lesions of the nail bed
Glat PM; Spector JA; Roses DF; Shapiro RA; Harris MN; Beasley RW; Grossman JA
1996 Aug;37(2):125-134, Annals of plastic surgery
Pigmented lesions of the nail bed, especially without a history of trauma, represent a diagnostic challenge to the clinician. These lesions are often categorized as melanonychia striata (MS), which refers to any linear tan-brown-black pigmentation of the nail bed. The differential diagnosis of MS includes subungual hematomas, onchomycosis nigricans, junctional nevi, melanoma in situ (MIS), and malignant melanoma (MM). Our algorithm at the New York University (NYU) Medical Center for the treatment of pigmented lesions of the nail bed is presented. A histopathologic diagnosis with any evidence of melanocytic atypia, however subtle, requires absolute confirmation by complete excision. The absence of a clear margin or recurrence requires total nail bed excision and reconstruction using a full-thickness graft. The diagnosis of MIS is similarly treated. The surgical management of subungual MM is discussed. All cases of MM of the hand treated at NYU were reviewed. In all, 30 patients were treated from 1982 to 1995. Follow-up ranged from 6 months to 13 years. In our series, there were 8 cutaneous and 22 subungual melanomas. There was a marked delay in treatment of both groups, with subungual melanomas more often erroneously treated as other pathology prior to correct diagnosis. The 5-year survival rate was 100% for patients with cutaneous lesions, but only 80% for those with the subungual variety. There was a statistical difference in the depths of the lesions (subungual, 3.68 mm; cutaneous, 1.36 mm) with a p-value of 0.008. The role of elective lymph node dissection in the absence of clinical metastases as well as intraoperative sentinel lymphatic mapping remains controversial and is discussed
— id: 12566, year: 1996, vol: 37, page: 125, stat: Journal Article,

Stereotactic fine-needle aspiration biopsy for the evaluation of nonpalpable breast lesions: report of an experience based on 2,988 cases
Mitnick JS; Vazquez MF; Pressman PI; Harris MN; Roses DF
1996 Mar;3(2):185-191, Annals of surgical oncology
BACKGROUND: The increasing use of mammography has led to a significant increase in the detection of clinically occult lesions, the majority of which prove to be benign. SFNB has been suggested as a means of expediting a diagnosis for lesions that are malignant while limiting surgical biopsies for those that are benign. METHODS: Clinically occult mammographic lesions were assessed by SFNB in 2,988 patients. Definitive histologic diagnoses were made on surgical specimens in all instances in which the cytologic diagnosis was malignant, suspicious, or atypical. Patients with benign cytology were either followed with interval mammograms or underwent surgical biopsy. RESULTS: Two hundred ninety-one of the 295 lesions (99%) diagnosed as cancer via SFNB were confirmed by histopathology. Twenty-two of the 22 lesions (100%) that were diagnosed as suspicious were diagnosed on histopathology as malignant. Forty-three of the 70 lesions (61%) with cytologic atypia were diagnosed on histopathology to be malignant. CONCLUSIONS: SFNB is an accurate means of diagnosing carcinoma, but must be followed by surgical biopsy when the cytology shows atypia. For lesions diagnosed as benign by SFNB, close interval mammography is essential
— id: 56884, year: 1996, vol: 3, page: 185, stat: Journal Article,

Morphological and biological characteristics of mammogram-detected invasive breast cancer
Moezzi M; Melamed J; Vamvakas E; Inghirami G; Mitnick J; Quish A; Bose S; Zelman G; Roses D; Harris M; Feiner H
1996 Sep;27(9):944-948, Human pathology
Thirty-nine mammographically detected, (M-detected) small invasive carcinomas of the breast (< or = 5 mm) were compared with 78 consecutive clinical cancers (> or = 10 mm) for a variety of morphological and biological markers of prognostic importance. There were more tubular carcinomas in the M-detected group (12.8% v 3.8%), but this did not reach statistical significance. Incidences of other histological types were similar. The types of associated in situ component were similar in the two groups. M-detected cancers were of lower overall grade (P < .001), lower architectural and nuclear grades (P = .0164 and P < .0001 respectively), and had fewer mitotic cells (P < .0001). None showed positive lymph nodes (P < .0001). Estrogen and progesterone receptor expression was similar in both groups. M-detected cancers expressed p53 nuclear protein less frequently than clinical cancers (P = .0398), had lower levels of microvessel density (P = .0001), and were more often diploid (P = .0131). S-phase of diploid tumors in the two groups was similar, but S-phase of aneuploid tumors was lower in the M-detected group (P = .0057). Ki67 expression was lower in M-detected cancers (P < .0001). In conclusion, M-detected small breast cancers, although invasive, represent an evolutionary phase of breast cancer that generally lacks morphological and biologic markers of aggressive behavior. The presence or absence of these markers, collectively, may explain the influence of tumor size on survival in patients with breast cancer
— id: 7020, year: 1996, vol: 27, page: 944, stat: Journal Article,

Induction of primary cutaneous melanocytic neoplasms in urokinase-type plasminogen activator (uPA)-deficient and wild-type mice: cellular blue nevi invade but do not progress to malignant melanoma in uPA-deficient animals
Shapiro RL; Duquette JG; Roses DF; Nunes I; Harris MN; Kamino H; Wilson EL; Rifkin DB
1996 Aug 1;56(15):3597-3604, Cancer research
Evidence suggests that the plasminogen activators (PAs), in particular urokinase-type PA (uPA), play a pivotal role in tumor invasion and metastasis. We studied the contribution of the PAs to the malignant phenotype through the chemical induction of melanocytic neoplasms in uPA-deficient mice. Primary tumors were induced and promoted concurrently in 35 uPA-/- deficient and 35 uPA+/+ wild-type mice using a single application of 7,12-dimethylbenz(a)anthracene followed by repetitive applications of croton oil. Animals were sacrificed at 60-day intervals for 1 year. At necropsy, the four largest pigmented lesions in each animal were excised, characterized histologically, and evaluated microscopically for evidence of invasion. The regional lymph nodes, lungs, and solid abdominal visceral organs were sectioned and examined microscopically for evidence of metastatic disease. Cellular blue nevi were induced in 100% of uPA-/- and uPA+/+ promoted animals. Although a reduction in the radial and vertical progression of these lesions was noted in the uPA-deficient mice compared with the wild-type group, more than 95% of cellular blue nevi induced in both groups of animals invaded the underlying tissues. These lesions did not metastasize to the regional lymph nodes. Malignant melanoma arose in 5 of 35 (14.3%) of promoted wild-type mice. These tumors were locally aggressive, produced tissue-type PA, but were not metastatic to the regional nodes, lungs, or abdominal viscera. These results indicate that the invasive capability of melanocytic lesions may depend more on tissue-type PA than uPA activity. No melanomas were induced in the uPA-/- mice. The resistance of the uPA -/- strain to melanoma induction suggests that uPA contributes to malignant progression. We propose that the absence of uPA negatively affects tumorigenesis by decreasing the liberation and availability of growth factors such as basic fibroblast growth factor
— id: 12575, year: 1996, vol: 56, page: 3597, stat: Journal Article,

Sinus histiocytosis mimicking metastatic melanoma in lymph nodes of a patient with a large joint prosthesis: case report and review of the literature
Charny CK; Jacobowitz G; Melamed J; Tata M; Harris MN
1995 Oct;60(2):128-130, Journal of surgical oncology
Malignant melanoma metastases to regional lymph nodes may be mimicked by several non-neoplastic processes, including sinus histiocytosis induced by fragments shed from joint prostheses. A patient who had an elective lymph node dissection for malignant melanoma and was found to have 'post-prosthesis lymph node histiocytosis' resembling metastatic disease is described. Knowledge of the patient's past history of a total shoulder joint replacement along with the use of polarized light microscopy to identify birefringent particles of prosthetic debris allows for an accurate histologic diagnosis
— id: 12729, year: 1995, vol: 60, page: 128, stat: Journal Article,

Management considerations for melanonychia striata and melanoma of the hand
Glat PM; Shapiro RL; Roses DF; Harris MN; Grossman JA
1995 May;11(2):183-189, Hand clinics
This article discusses the diagnosis and management of pigmented lesions of the hand, especially the nail bed
— id: 25113, year: 1995, vol: 11, page: 183, stat: Journal Article,

Malignant melanoma. Primary surgical management (excision and node dissection) based on pathology and staging [see comments] [published erratum appears in Cancer 1995 Apr 1;75(7):1727]
Harris MN; Shapiro RL; Roses DF
1995 Jan 15;75(2 Suppl):715-725, Cancer
The diagnosis of malignant melanoma is based on clinical grounds and a properly performed biopsy, preferably excision, so that the type of melanoma and the thickness can be assessed by methods described by Clark and Breslow. These facilitate clinical and pathologic staging. Excisions with conservative margins for thin lesions (less than 1.0 mm in thickness) and more extensive margins for thicker lesions are appropriate. The issue of elective lymph node dissection is controversial. Most authors agree it is not indicated for lesions less than 1.0 mm thick and may offer little advantage for lesions greater than 4.0 mm thick. Several retrospective studies show a survival advantage in patients with 'intermediate' thickness melanomas who may have occult nodal metastases. However, there are prospective randomized clinical trials supporting the concept that positive lymph nodes are a manifestations of systemic disease, and survival is equivalent in patients who have subsequent therapeutic lymph node dissections. A procedure using intraoperative lymphatic mapping and selective lymphadenectomy may identify those patients who are likely to benefit from lymphadenectomy
— id: 12814, year: 1995, vol: 75, page: 715, stat: Journal Article,

MALIGNANT-MELANOMA - PRIMARY SURGICAL-MANAGEMENT (EXCISION AND NODE DISSECTION) BASED UPON PATHOLOGY AND STAGING - REPLY
HARRIS, MN
1995 DEC 1 ;76(11):2385-2385, Cancer
— id: 52669, year: 1995, vol: 76, page: 2385, stat: Journal Article,

Improved survival of patients with melanoma with an antibody response to immunization to a polyvalent melanoma vaccine
Miller K; Abeles G; Oratz R; Zeleniuch-Jacquotte A; Cui J; Roses DF; Harris MN; Bystryn JC
1995 Jan 15;75(2):495-502, Cancer
BACKGROUND. Melanoma vaccine treatment appears to slow the progression of melanoma in some patients, particularly in patients in whom it stimulates cellular antimelanoma immune responses. The relationship of vaccine-induced antibody responses to clinical outcome is less clear. The purpose of this study was to investigate the clinical relevance of antibody responses to melanoma vaccine immunization. METHODS. Eighty-two evaluable patients with surgically resected American Joint Committee on Cancer Stage III malignant melanoma were immunized to a partially purified, polyvalent, melanoma antigen vaccine. Antimelanoma antibodies were measured by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis before vaccine treatment and 1 week after the fourth immunization. RESULTS. Vaccine treatment induced or augmented antibody responses to melanoma in 32 (39%) of the patients. The antibodies were directed to one or more antigens of 38-43, 75, 110, 150 and/or 210 kDs, which previously have been shown to be expressed preferentially in cultured human melanoma cells. The median disease free survival of patients with a vaccine-induced antibody response to one or more of these antigens was 5.4 years compared with 1.4 years for nonresponders (P = 0.06), and 5-year overall survival was 71% compared with 44%, respectively (P = < 0.01). As determined by Cox multivariate analysis, the difference in overall survival was independent of disease severity or of immunologic competence as evaluated by ability to be sensitized to dinitrochlorobenzene. The difference in survival between antibody responders and nonresponders improved with time. CONCLUSIONS. The antibody response to vaccine treatment is an immune marker of vaccine activity that appears to be predictive of a later reduction in the recurrence of melanoma and is unrelated to the vaccine's ability to induce cellular immune responses. This finding suggests that vaccine treatment may be effective in slowing the progression of melanoma in some patients and that the protective effect is mediated partly by vaccine-induced antimelanoma antibodies
— id: 12813, year: 1995, vol: 75, page: 495, stat: Journal Article,

Alpha-interferon and cis-retinoic acid in the treatment of metastatic malignant melanoma
Oratz R; Roses D; Harris M
1995 ;14:A1313-A1313, Proceedings (American Society of Clinical Oncology)
Alpha interferon (IFN) has single agent activity in the treatment of metastatic malignant melanoma. Preclinical data suggests that cis-retinoic acid (cRA) may potentiate the activity of IFN. Clinical trials of this combination in the treatment of squamous cell carcinoma report higher response rates than that expected for IFN alone. We tested the activity of the combination of IFN and cRA in patients (pts) with metastatic malignant melanoma. 13 pts were treated with IFN 5 x 10 (6) units/m2 tiw and cRA 100 mg/kg/day. 11 pts were previously treated with chemotherapy; 2 had no prior treatment. Sites of metastases include: lung (9), liver (4), soft tissue (7), adrenals (2) nodes (2). 1 PR was seen in lung and adrenal mets (for 6 mo), 2 pts had stabilization of pulmonary mets for 2 mo. All other pts had progressive disease within 8 wk of beginning treatment. Toxicity was substantial. All pts experienced ECOG Grade 1-2 fatigue, myalgias, anorexia, stomatitis and cheilitis. Serum cholesterol and triglycerides became elevated in all pts. Dose reductions included: 1 pt 50% IFN for fatigue, 1 pt 50% cRA for stomatitis, 3 pts 50% cRA for hypertriglyceridemia. 1 pt discontinued therapy for decline in PS to ECOG Level 3. The mean duration of treatment was 8.8 wk; range (3 -28 wk). The combination of cRA and IFN in this study did not demonstrate any improvement over the single agent activity of IFN. (C) American Society of Clinical Oncology 1997
— id: 6022, year: 1995, vol: 14, page: A1313, stat: Journal Article,

Induction of cytolytic antibodies to melanoma by immunization to a polyvalent melanoma antigen vaccine
Cui J; Chen D; Oratz R; Zeleniuch-Jacquotte A; Harris M; Roses D; Bystryn J-C
1994 ;3(4):175-182, Vaccine research
This study was conducted to examine whether immunization to a melanoma vaccine can induce antibodies that are functionally effective in killing melanoma cells. A group of 79 evaluable patients with surgically resected AJCC stage III melanoma were immunized every 3 weeks to a polyvalent melanoma antigen vaccine (40 mug/immunization). Cytolytic antibodies to melanoma cells, assayed by europium-based complement-dependent cytolysis before vaccine treatment and 1 week following the fourth immunization, were detected in 7 patients (9%) before vaccine treatment but in none of 17 control individuals. Vaccine treatment induced or increased the level of these antibodies in 37 patients (47%; p = 0.0001). Vaccine-induced cytolytic antibodies were predominantly directed to melanoma cells. There was no correlation between the induction of these antibodies and improved clinical outcome. These results indicate that melanoma vaccine treatment can induce antibodies that have the functional ability to kill melanoma cells in vitro but suggest that the induction of such cytolytic antibodies is not associated with a delay in the progression of melanoma
— id: 25185, year: 1994, vol: 3, page: 175, stat: Journal Article,

Radial scar: Cytologic evaluation by stereotactic aspiration
Vazquez MF; Mitnick JS; Pressman P; Harris MN; Roses DF
1994 ;7(4):299-306, Breast disease
Radial scars are characterized by an irregular stellate pattern of mammary dysplasia frequently detected by mammography in the absence of a palpable mass. We reviewed 300 consecutive nonpalpable stellate lesions of the breast aspirated stereotactically in patients without prior surgery, and 14 were radial scars (14/300, 5%). Six radial scars showed malignant cells focally (6/14, 43%); three showed one focus each of ductal carcinoma in situ (DCIS); two showed foci of lobular carcinoma in situ; and one showed a tubular carcinoma. Eight cases were radial scars without adenocarcinoma, although three showed atypical hyperplasia. In two instances, DCIS was identified in tissue separate from the radial scar. These findings support the hypothesis that a radial scar is a form of mammary dysplasia with a tendency toward high-grade atypia, and when it is present, a radial scar may be premalignant
— id: 25183, year: 1994, vol: 7, page: 299, stat: Journal Article,

Stereotactic aspiration biopsy of nonpalpable nodules of the breast
Vazquez MF; Mitnick JS; Pressman P; Harris MN; Roses DF
1994 Jan;178(1):17-23, Journal of the American College of Surgeons
To evaluate the reliability of stereotactic aspiration biopsy (SAB) in assessing which nonpalpable nodules of the breast should be excised, SAB was performed upon 373 nodules. The nodules were classified as well-circumscribed or irregular and evaluated for the presence of microcalcifications. The cytologic diagnoses were classified as malignant, atypical or benign. Cytologically malignant and atypical nodules were excised. Benign nodules were excised if there was a family or past history of carcinoma of the breast or if they changed mammographically. Twenty-five nodules proved to be malignant. Of these, the diagnoses by stereotactic aspiration biopsy were adenocarcinoma in 20 patients, atypical in three, malignant hemangiopericytoma in one patient and benign in one. The borders of the malignant nodules were well-defined in eight patients and irregular in 17. Three malignant nodules with irregular borders had clustered microcalcifications. One false-positive instance was a sclerosing papilloma with atypical hyperplasia. Twenty-four nodules with benign cytologic diagnoses, which were excised, proved to be benign. An additional 132 nodules with benign cytologic diagnoses had six month interval mammograms for two years; 131 were without interval change and one increased in size and proved to be a carcinoma. SAB is reliable for diagnosing nonpalpable nodules. Nodules with malignant and atypical results must be excised. It is reasonable to have follow-up evaluation of well-defined nodules mammographically when the aspirate is benign
— id: 6546, year: 1994, vol: 178, page: 17, stat: Journal Article,

Improved survival of melanoma patients with antibody responses to a polyvalent melanoma vaccine
Bystryn JC; Miller K; Abeles G; Oratz R; Roses D; Harris M
1993 ;3:51-51, Melanoma research
To investigate the clinical relevance of antimelanoma antibody responses induced by melanoma vaccine immunization, we studied prospectively 81 patients with resected AJCC stage III malignant melanoma who were immunized to a partially purified, polyvalent, melanoma antigen vaccine. Antibody responses to melanoma surface antigens were measured by immunoprecipitation SDS-PAGE analysis prior to treatment and one week after the 4th immunization. Vaccine treatment induced or augmented melanoma antibodies in 33 (41%) patients. The responses were directed to one or more antigens of approximately 210, 150, 110, 75, and/or 38-43 kD. The median disease-free survival of patients with any antibody response was 47 months vs 19 months for nonresponders and median overall survival was 62 months vs 46 months. The proportion of patients that was disease-free at 4 years increased by 57% (from 33% to 52%) and overall survival by 64% (from 50% to 80%) in responders vs nonresponders. These differences in outcome were unrelated to disease severity or overall immunological competence (evaluated by response to recall antigens and ability to be sensitized to DNCB), suggesting they resulted from vaccine treatment. Thus, the antibody response to vaccine treatment is an immune marker of vaccine activity that appears to be predictive of a later reduction in the recurrence of melanoma. This finding suggests that vaccine treatment effectively slows the progression of melanoma in some patients, and that the protective effect is mediated in part by vaccine induced antimelanoma antibodies
— id: 6018, year: 1993, vol: 3, page: 51, stat: Journal Article,

Fine needle aspiration biopsy in patients with augmentation prostheses and a palpable mass
Mitnick JS; Vazquez MF; Plesser K; Pressman P; Harris MN; Roses DF
1993 Sep;31(3):241-244, Annals of plastic surgery
Six patients with augmentation prostheses presented with a firm, painless, breast mass that could not be visualized by mammography. One lesion was demonstrated to be solid by ultrasound, and the remaining sonograms were nondiagnostic. The lesions were indistinguishable from carcinoma, by physical examination. All of the patients had fine needle aspiration biopsy despite close proximity to the implant. The patients all had silicone granulomas related to silicone leakage. Our experience suggests that fine needle aspiration biopsy is a useful technique to evaluate palpable breast masses that are not visualized by mammography in patients with augmentation prostheses
— id: 56563, year: 1993, vol: 31, page: 241, stat: Journal Article,

Distinction between postsurgical changes and carcinoma by means of stereotaxic fine-needle aspiration biopsy after reduction mammaplasty
Mitnick JS; Vazquez MF; Plesser KP; Pressman PI; Harris MN; Colen SR; Roses DF
1993 Aug;188(2):457-462, Radiology
Stereotaxic fine-needle aspiration biopsy (SFNAB) was performed to evaluate suspicious mammographic findings (31 stellate lesions, 20 regions of grouped calcifications, two nodules, and one area of prominent trabecular markings) in 54 patients who had undergone reduction mammaplasty. SFNAB findings were correlated with findings in histologic specimens whenever possible; the cytologic samples were classified as malignant, atypical, or benign. In 22 lesions, the abnormalities on mammograms were considered highly suspicious for malignancy. In the 32 others, the degree of suspicion was lower, but these lesions had a change in appearance since acquisition of the first postoperative mammogram. SFNAB enabled diagnosis of adenocarcinoma in five women. Patients who have undergone mastectomy with reconstruction of one breast and mammaplasty in the other are at higher risk for development of contralateral breast cancer, as are all patients who have had such cancer. SFNAB is reliable for evaluation of suspicious mammographic abnormalities that develop after mammaplasty and findings that change after acquisition of the first postoperative mammogram
— id: 6460, year: 1993, vol: 188, page: 457, stat: Journal Article,

Stereotaxic aspiration biopsy of the breast
Mitnick JS; Vazquez MF; Roses DF; Harris MN; Waisman J
1993 Dec;189(3):924-925, Radiology
— id: 25104, year: 1993, vol: 189, page: 924, stat: Journal Article,

Surgical management of cutaneous malignant melanoma
Roses DF; Harris MN; Shapiro RL
1993 ;1:263-263, Hem/onc annals: the journal of continuing education in hematology & oncology
— id: 25199, year: 1993, vol: 1, page: 263, stat: Journal Article,

Metastatic hemangiopericytoma of the breast
Breitbart AS; Harris MN; Vazquez M; Mitnick JR
1992 Apr;92(4):158-160, New York state journal of medicine
— id: 13639, year: 1992, vol: 92, page: 158, stat: Journal Article,

Relationship between immune response to melanoma vaccine immunization and clinical outcome in stage II malignant melanoma
Bystryn JC; Oratz R; Roses D; Harris M; Henn M; Lew R
1992 Mar 1;69(5):1157-1164, Cancer
The authors investigated whether there was a relationship between the induction of a delayed-type hypersensitivity (DTH) response to melanoma vaccine immunization and disease recurrence. They studied prospectively 94 evaluable patients with surgically resected Stage II malignant melanoma who were immunized to a partially purified, polyvalent, melanoma antigen vaccine. The DTH response to skin tests to the vaccine was measured before treatment and at the fourth vaccine immunization. Vaccine treatment induced a strong DTH response in 29 (31%) patients, an intermediate response in 24 (25%), and no response in 41 (44%). The median disease-free survival (DFS) of patients with a strong, intermediate, and no DTH response to vaccine immunization was more than 72 months, 24 months, and 15 months, respectively. The relationship between an increase in the DTH response and a prolonged DFS was statistically significant (P = 0.02); clinically meaningful (the median DFS of patients with a strong DTH response was 4.7 years longer than that of nonresponders); and, by multivariate analysis, independent of disease severity or overall immune competence. These findings suggest, but do not prove, that vaccine treatment can slow the progression of melanoma in some patients
— id: 57484, year: 1992, vol: 69, page: 1157, stat: Journal Article,

Stereotactic localization for fine needle aspiration biopsy in patients with augmentation prostheses
Mitnick JS; Vazquez MF; Roses DF; Harris MN; Colen SR; Colen HS
1992 Jul;29(1):31-35, Annals of plastic surgery
Fifteen patients with augmentation mammoplasties had mammography demonstrating nonpalpable breast lesions. Of the 15 patients, three (20%) had adenocarcinoma confirmed by open biopsy and histopathology. All patients underwent stereotactic localization for fine needle aspiration biopsy. Four of the 15 patients had benign cysts (26%). None of the cysts could be diagnosed by ultrasound. The remaining eight patients had mammary dysplasia of a proliferative or nonproliferative type of fibroadenoma. These benign entities were followed with interval mammography demonstrating no change. The data suggest that fine needle aspiration biopsy is an effective technique to assess nonpalpable breast lesions in patients who have had augmentation mammoplasties
— id: 13553, year: 1992, vol: 29, page: 31, stat: Journal Article,

Recurrent breast cancer: stereotaxic localization for fine-needle aspiration biopsy. Work in progress
Mitnick JS; Vazquez MF; Roses DF; Harris MN; Schechter S
1992 Jan;182(1):103-106, Radiology
The efficacy of stereotaxic localization for fine-needle aspiration biopsy in the detection of recurrent cancer manifested as calcifications on mammograms was evaluated in 43 patients that had been treated with local resection and radiation therapy. Six patients had malignant aspirates and one had an atypical aspirate; examination of the surgical specimens revealed all seven of these to be malignant. Thirteen patients underwent surgical biopsies, the results of which were malignant in seven and benign in six. The remaining 30 patients were followed up with mammography. The follow-up mammograms were obtained at 6-month intervals and demonstrated no change in appearance. On the basis of this initial experience, stereotaxic localization for aspiration biopsy offers the potential to accurately distinguish benign from malignant lesions
— id: 13731, year: 1992, vol: 182, page: 103, stat: Journal Article,

IMPROVED SURVIVAL OF MELANOMA PATIENTS WITH DELAYED-TYPE HYPERSENSITIVITY RESPONSE TO MELANOMA VACCINE IMMUNIZATION
BYSTRYN, JC; ORATZ, R; ROSES, DF; HARRIS, MN; HENN, M; LEW, R
1991 APR ;39(2):A503-A503, Clinical research
— id: 51624, year: 1991, vol: 39, page: A503, stat: Journal Article,

IMPROVED SURVIVAL OF MELANOMA PATIENTS WITH DELAYED-TYPE HYPERSENSITIVITY RESPONSE TO MELANOMA VACCINE IMMUNIZATION
BYSTRYN, JC; ORATZ, R; ROSES, DF; HARRIS, MN; HENN, M; LEW, R
1991 APR ;96(4):549-549, Journal of investigative dermatology
— id: 51638, year: 1991, vol: 96, page: 549, stat: Journal Article,

Flow cytometric analysis of DNA ploidy and S-phase fraction in breast cancer using cells obtained by ex vivo fine-needle aspiration: an optimal method for sample collection
Eliasen CA; Opitz LM; Vamvakas EC; Espiritu EC; Marsh ER; Roses DF; Harris MN; Feiner HD
1991 Mar;4(2):196-200, Modern pathology
A total of 203 primary invasive breast cancers were sampled by ex vivo fine-needle aspiration (FNA), directly yielding adequate single cell suspensions for flow cytometric DNA analysis in 194 (96%). Labor-intensive and time-consuming steps of mechanical and enzymatic cellular disaggregation required by the use of fresh, frozen, or paraffin-embedded tissue were avoided, thereby minimizing preparation time. Conservation of tumor tissue allowed for the sampling of very small breast cancers. DNA ploidy and S-phase fraction data were comparable to flow cytometric data reported in other breast cancer studies using various sampling methods. Ex vivo FNA is the easiest and fastest method for sampling breast cancers for flow cytometric DNA analysis
— id: 14101, year: 1991, vol: 4, page: 196, stat: Journal Article,

Volume of malignant melanoma is superior to thickness as a prognostic indicator. Preliminary observation
Friedman RJ; Rigel DS; Kopf AW; Grin CM; Heilman E; Bart RS; Kamino H; Harris MN; Roses DF; Postel AH; et al
1991 Oct;9(4):643-648, Dermatologic clinics
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
— id: 13874, year: 1991, vol: 9, page: 643, stat: Journal Article,

Cancer of the skin
Friedman, Robert J.; Rigel, Darrell S.; Kopf, Alfred W.; Harris, Matthew N.; Baker, Daniel C
Philadelphia : Saunders, 1991,
— id: 244, year: 1991, vol: , page: , stat: ,

Malignant melanoma: treatment
Harris MN; Roses DF
Cancer of the skin Philadelphia : Saunders, 1991,
— id: 2714, year: 1991, vol: , page: 177, stat: Chapter,

Localization of transected wire
Mitnick JS; Vazquez MF; Harris MN; Buchbinder SS
1991 Apr;156(4):866-866, American journal of roentgenology
— id: 63012, year: 1991, vol: 156, page: 866, stat: Journal Article,

Stereotaxic localization for fine-needle aspiration breast biopsy. Initial experience with 300 patients
Mitnick JS; Vazquez MF; Roses DF; Harris MN; Gianutsos R; Waisman J
1991 Sep;126(9):1137-1140, Archives of Surgery (Chicago)
The efficacy of stereotaxic aspiration biopsy was evaluated in 300 consecutive patients with nonpalpable mammographic lesions. Sixty-eight patients (23%) had suspicious or malignant aspirates; all cases were proved malignant by subsequent examination of operative specimens. Two hundred sixteen patients (72%) had benign aspirates. Of these, 65 were confirmed by operation and 151 had subsequent mammography at 6- and 12-month intervals with no demonstrable mammographic change. In 10 instances (3%), the aspirates were atypical, and in six (2%), nondiagnostic. Biopsy specimens were obtained in all 16 instances, and eight were malignant. The sensitivity of stereotaxic breast aspiration for the diagnosis of cancer was 96%, and the specificity was 100%. Our experience confirms the efficacy of stereotaxic aspiration for the initial evaluation of mammographically detected, nonpalpable lesions
— id: 25105, year: 1991, vol: 126, page: 1137, stat: Journal Article,

Lack of effect of cyclophosphamide on the immunogenicity of a melanoma antigen vaccine
Oratz R; Dugan M; Roses DF; Harris MN; Speyer JL; Hochster H; Weissman J; Henn M; Bystryn JC
1991 Jul 15;51(14):3643-3647, Cancer research
Melanoma antigen vaccines are a conceptually attractive approach to prevent or delay disease recurrence in patients with surgically resected malignant melanoma. However, the immunogenicity of current vaccines is relatively low. Cyclophosphamide, when given in low doses prior to antigen exposure, is an immunomodulator which has been shown to enhance both humoral and cellular antitumor responses in animals and humans. We conducted a prospective, randomized, clinical trial to study whether pretreatment with cyclophosphamide augments the immunogenicity of a polyvalent, allogeneic, melanoma antigen vaccine in patients with melanoma and low tumor burden. Forty-five patients with resected stage II melanoma (regional metastases) were randomly allocated to treatment with melanoma vaccine or melanoma vaccine plus cyclophosphamide. All patients received the same dose and schedule of vaccine immunizations; those randomized to cyclophosphamide received 300 mg/m2 i.v. 3 days prior to each vaccine immunization. Cellular immune responses were evaluated by delayed-type hypersensitivity (DTH) skin reactivity to a test dose of vaccine at baseline (prior to treatment) and following the fourth immunization. Humoral immune responses were measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiographic analysis of indirect immunoprecipitates of patients' sera at the same time points. Twenty-four patients were randomized to cyclophosphamide pretreatment and 21 to vaccine alone; 22 and 18 patients were evaluable in each group, respectively. Differences were statistically nonsignificant with respect to either cellular (DTH) or humoral (antibody) responses between the two groups. DTH responses were induced in 16 of 22 (73%) and 15 of 18 (83%) patients treated with cyclophosphamide plus vaccine and vaccine alone, respectively. The mean posttreatment augmentation in DTH response in the cyclophosphamide group was 9.5 mm, compared with 9.9 mm in the vaccine-only group. Eight of 12 (66%) cyclophosphamide-pretreated patients and 9 of 12 (75%) vaccine-only patients produced increased titers of antimelanoma antibodies following treatment. No differences were observed between the groups in disease-free or overall survival. In summary, low-dose cyclophosphamide pretreatment failed to augment the immunogenicity of a polyvalent, allogeneic, melanoma vaccine in patients with completely resected early-stage melanoma
— id: 13964, year: 1991, vol: 51, page: 3643, stat: Journal Article,

Survival with regional and distant metastases from cutaneous malignant melanoma
Roses DF; Karp NS; Oratz R; Dubin N; Harris MN; Speyer J; Boyd A; Golomb FM; Ransohoff J; Dugan M; et al.
1991 Apr;172(4):262-268, Surgery, gynecology & obstetrics
The clinical course of 312 consecutive patients after initial presentation with metastatic melanoma, 165 of whom presented with regional metastases at cutaneous or subcutaneous, or both, nodal sites and 147 with metastases at distant sites, was reviewed. The five year survival rate for regional metastases was 43.4 per cent compared with a five year survival rate for distant metastases of 4.9 per cent (p less than 0.0001). Favorable prognostic variables for survival from first regional metastases included primary melanoma sites on the extremities compared with the head, neck and trunk (p = 0.043) and a disease-free interval of more than one year from primary surgical treatment to regional metastases (p = 0.0058). Favorable prognostic variables for survival from the first distant metastasis included a disease-free interval of more than one year from primary surgical treatment to distant metastases (p = 0.0092), the type of resection of metastatic disease (p = 0.00027) and the addition of systemic immunotherapy (p = 0.0011). Forty-nine patients with totally resectable distant metastases had a five year survival rate from the treatment of the initial metastasis of 13.1 per cent, whereas 33 patients having palliative resections had a five year survival rate of 7.5 per cent. All 165 patients who did not have resection for distant metastases died within five years. The results of our experience support therapeutic efforts to ablate both regional and distant metastases of malignant melanoma when feasible
— id: 25129, year: 1991, vol: 172, page: 262, stat: Journal Article,

The risk of carcinoma in wire localization biopsies for mammographically detected clustered microcalcifications
Roses DF; Mitnick J; Harris MN; Kaplon R; Karp N; Vazquez M; Dubin N
1991 Nov;110(5):877-886, Surgery
A total of 183 consecutive patients undergoing biopsies for unilateral microcalcifications concentrated in one or more segments of the breast in the absence of any palpable findings were analyzed to characterize their risk of cancer. Biopsy findings were benign in 86 patients (47%) and malignant in 97 (53%). Of the clinical and mammographic characteristics evaluated, an increasing number of linear microcalcifications, either without a dominant density (p = 0.014) or with a dominant density (p = 0.019) and the presence of heterogeneous microcalcifications (p = 0.055), were associated with a significantly increased risk of malignancy. Conversely a fibronodular parenchymal pattern (p = 0.008) was associated with a significantly decreased risk of malignancy. A high-risk group was identified, 95% (40/42) of whom had malignant biopsy findings, whose mammograms had more than 10 linear microcalcifications not associated with a dominant density (16/17) or at least one linear microcalcification associated with a dominant density (24/25). Conversely a low-risk group for cancer was identified, 88% (28/32) of whom had benign biopsy findings, whose mammograms had exclusively punctate microcalcifications within a fibronodular parenchymal milieu (26/30) or demonstrated some change in the configuration of the microcalcifications on the various mammographic views (10/10). For the remaining 109 patients there was an almost equal division between malignant and benign diagnoses (49% vs 51%)
— id: 13864, year: 1991, vol: 110, page: 877, stat: Journal Article,

Regional differences in the intranodal distribution of tumor cells
Dumont, A E; Harris, M N; Vazquez, M
1990 Oct 1;66(7):1552-1554, Cancer
The intranodal distribution of tumor cells was examined in 103 mesenteric and 135 axillary nodes to determine the frequency of a circumferential type of distribution and its relationship, if any, to central necrosis. Eighteen percent of the mesenteric nodes removed at surgery from patients with colon cancer contained a circumferential rim of viable tumor cells in an area corresponding wholly or in part to the normal location of the marginal sinus. In each case this rim of tumor cells surrounded a large central area of necrosis. In contrast, only one of the 135 axillary nodes removed from patients with breast cancer demonstrated this pattern. These findings suggest that by interrupting blood and lymph vessels, the circumferential spread of tumor cells underlies development of central necrosis. Previously described structural dissimilarities between mesenteric and axillary nodes may explain the striking difference in incidence of this pattern in these nodes
— id: 106756, year: 1990, vol: 66, page: 1552, stat: Journal Article,

FINE NEEDLE ASPIRATION (FNA) OF PRIMARY BREAST-CARCINOMA FOR FLOW CYTOMETRIC (FCM) DNA ANALYSIS
Eliasen, C; Opitz, L; Rizk, C; Vamvakas, E; Kleinberg, D; Roses, D; Harris, M; Feiner, H
1990 ;62(Suppl 1):A30-A30, Laboratory investigation
— id: 32017, year: 1990, vol: 62, page: A30, stat: Journal Article,

Thoracotomy for metastatic malignant melanoma of the lung
Karp NS; Boyd A; DePan HJ; Harris MN; Roses DF
1990 Mar;107(3):256-261, Surgery
The outcome of 29 patients who underwent lung resection for treatment of metastatic malignant melanoma from January 1976 to November 1988 was studied. Twenty-two patients underwent total resection for cure of all apparent metastatic disease, whereas seven patients did not undergo total resection. Of the 22 patients who underwent curative resection, the median survival was 11 months, with a 2-year survival of 13.6% and a 5-year survival of 4.5%. Four patients who underwent curative resection are currently alive and free of disease, with one patient surviving more than 10 years. The patients who underwent palliative resection had a median survival of 5 months, only one patient living longer than 10 months. The difference in survival of the patients who underwent curative resection compared with palliative resection was statistically significant. The thickness of the primary cutaneous malignant melanoma, the presence of regional lymph node metastases, the disease-free interval from primary diagnosis to metastatic pulmonary disease, and whether one or two metastatic nodules were removed during curative lung resection were not statistically significant in altering survival. These results demonstrate that although prolonged survival for metastatic melanoma is rare, lung resection in selected patients may be associated with long-term survival
— id: 25130, year: 1990, vol: 107, page: 256, stat: Journal Article,

Calcifications of the breast after reduction mammoplasty
Mitnick JS; Roses DF; Harris MN; Colen SR
1990 Nov;171(5):409-412, Surgery, gynecology & obstetrics
Mammograms of 152 patients after mammoplasty were studied and 37 patients were noted to have calcifications. The pattern of these calcifications was studied to determine if specific characteristics could be identified. The calcifications were found to occur within the skin of the breast, mainly at a periareolar location. The ability to identify these benign calcifications further aids in reliably monitoring patients by mammography after reduction mammoplasty
— id: 14291, year: 1990, vol: 171, page: 409, stat: Journal Article,

Invasive papillary carcinoma of the breast: mammographic appearance
Mitnick JS; Vazquez MF; Harris MN; Schechter S; Roses DF
1990 Dec;177(3):803-806, Radiology
The mammographic findings in 18 patients with invasive papillary carcinoma were studied retrospectively. The mammograms of 10 patients showed a multinodular pattern, and seven patients had solitary nodules. One patient had an irregular, ill-defined mass in the retroareolar region. Two patients were found to have carcinoma in the contralateral breast, and two patients had intraductal carcinoma adjacent to the invasive papillary carcinoma. The varied mammographic features that may occur with this rare breast malignancy are discussed
— id: 14258, year: 1990, vol: 177, page: 803, stat: Journal Article,

Vaccine immunotherapy of human malignant melanoma
Bystryn JC; Dugan M; Oratz R; Speyer J; Harris MN; Roses DF
Human tumor antigens and specific tumor therapy New York : Liss, 1989,
— id: 2722, year: 1989, vol: , page: 307, stat: Chapter,

Mammographic detection of carcinoma of the breast in patients with augmentation prostheses
Mitnick JS; Harris MN; Roses DF
1989 Jan;168(1):30-32, Surgery, gynecology & obstetrics
Evaluation of 85 patients who had augmentation mammaplasty with low-dose mammography detected microcalcifications in two patients. Both patients had biopsies that confirmed a diagnosis of intraductal carcinoma. A third patient with microcalcifications and a positive family history for carcinoma of the breast was found to have sclerosing adenosis. A fibroadenoma was visualized by mammography in a group of ten patients who were referred for the presence of palpable nodules of the breast. The remainder of the nodules were found to be related to the augmentation procedure
— id: 10834, year: 1989, vol: 168, page: 30, stat: Journal Article,

Circumscribed intraductal carcinoma of the breast [see comments]
Mitnick JS; Roses DF; Harris MN; Feiner HD
1989 Feb;170(2):423-425, Radiology
In a retrospective evaluation of 350 cases of proved intraductal carcinoma detected over a 3-year period, 13 had mammographic features similar to those of benign tumors. The carcinomas were sharply circumscribed, round or oval lesions that contained microcalcifications. These calcifications were smaller and more likely to be asymmetrically located within the nodule than those of the fibroadenomas that they mimicked. While the carcinomas appeared circumscribed on mammograms, microinvasion of surrounding tissue was proved histologically in five of 13 cases, and in another case biopsy revealed metastasis to an axillary lymph node. Although these carcinomas are relatively rare, mammographic detection is important as none were palpable at the time of diagnosis
— id: 10739, year: 1989, vol: 170, page: 423, stat: Journal Article,

Differentiation of radial scar from scirrhous carcinoma of the breast: mammographic-pathologic correlation
Mitnick JS; Vazquez MF; Harris MN; Roses DF
1989 Dec;173(3):697-700, Radiology
Radial scar, a sclerosing ductal breast lesion characterized by an irregular stellate pattern of epithelial proliferation around a central fibroelastic core, may be confused histologically with scirrhous carcinoma of the breast. Mammographic features used to distinguish these two entities were found unreliable in a retrospective review of 255 consecutive stellate lesions. Of 73 nonpalpable carcinomas, fourteen (19%) had radiographic features of radial scar. Only the presence of microcalcifications in 11 of those patients helped the authors distinguish carcinoma from radial scars. Four of nine biopsy-proved radial scars had a dense central region, simulating the appearance of scirrhous carcinoma. Stellate lesions with radiolucent centers should be considered suggestive of carcinoma, particularly if associated with microcalcifications
— id: 10419, year: 1989, vol: 173, page: 697, stat: Journal Article,

CIRCUMSCRIBED INTRADUCTAL CARCINOMA OF THE BREAST - RESPOND
Mitnick, JS; Roses, DF; Harris, MN; Feiner, HD
1989 Aug;172(2):579-580, Radiology
— id: 31681, year: 1989, vol: 172, page: 579, stat: Journal Article,

Induction of tumor-infiltrating lymphocytes in human malignant melanoma metastases by immunization to melanoma antigen vaccine
Oratz R; Cockerell C; Speyer JL; Harris M; Roses D; Bystryn JC
1989 Aug;8(4):355-358, Journal of biological response modifiers
We report a statistically significant increase in tumor-infiltrating lymphocytes in subcutaneous melanoma metastases removed from patients immunized with a melanoma vaccine. Dense cellular infiltrates were seen in 10 of 11 nodules from vaccine-immunized patients, compared with 9 of 22 nodules from non-immunized patients (p = 0.02). Furthermore, these dense lymphocytic collections more frequently infiltrated the body of tumor nodules from immunized patients, whereas in non-immunized patients, lymphocytes were more often present only in the dermal tissue at the periphery of the nodule. Thus, allogeneic melanoma vaccines may augment immune responses to a patient's own tumor
— id: 10530, year: 1989, vol: 8, page: 355, stat: Journal Article,

Immunogenicity of a polyvalent melanoma antigen vaccine in humans
Bystryn JC; Oratz R; Harris MN; Roses DF; Golomb FM; Speyer JL
1988 Mar 15;61(6):1065-1070, Cancer
Fifty-five patients with Stage II (36 patients) or Stage III (19 patients) malignant melanoma confirmed histologically received adjuvant immunotherapy with a polyvalent melanoma antigen vaccine to evaluate toxicity and immunogenicity. There was no toxicity. Antibody and/or cellular immune responses to melanoma were induced more frequently in Stage II (36 patients [69%]) than Stage III (19 patients [53%]) disease. The ability of different immunization schedules, alum, or pretreatment with low-dose cyclophosphamide to potentiate immunogenicity was compared after 2 months of immunization. Immunization biweekly with a fixed intermediate dose of vaccine was more immunogenic than immunization weekly with escalating vaccine doses. Alum increased the intensity of cellular responses slightly, whereas pretreatment with cyclophosphamide augmented both the incidence and intensity of cellular immune responses slightly. However, these changes did not reach statistical significance. There was a reciprocal relationship between the induction of humoral and cellular immune responses. These results show that (1) active immunotherapy with a polyvalent melanoma vaccine is safe in patients with minimal disease, (2) the vaccine augments immunity to melanoma in many, but not all, patients, and (3) several immunization strategies failed to potentiate immunogenicity significantly
— id: 16244, year: 1988, vol: 61, page: 1065, stat: Journal Article,

DELAYED TUMOR PROGRESSION IN MELANOMA
DUGAN, M; ORATZ, R; HARRIS, MN; ROSES, DF; SPEYER, J; GOLOMB, F; HENN, M; BYSTRYN, JC
1988 APR ;36(3):A495-A495, Clinical research
— id: 41789, year: 1988, vol: 36, page: A495, stat: Journal Article,

Differentiation of postsurgical changes from carcinoma of the breast
Mitnick J; Roses DF; Harris MN
1988 Jun;166(6):549-550, Surgery, gynecology & obstetrics
Evaluation of 486 consecutive mammograms with biopsy and excision scars revealed 25 with spiculated radiodensities on mammography. Of these 25 patients, 17 were diagnosed as having benign scars, based upon the appearance of a central lucency, representing fat in the central portion of the spiculated radiodensity. Seven patients were diagnosed as having carcinoma by the absence of lucency in the radiodensity at a biopsy or excision site
— id: 11073, year: 1988, vol: 166, page: 549, stat: Journal Article,

Extent of excision for primary malignant melanoma
Roses DF; Harris MN
1988 ;11:31-31, Surgical rounds
— id: 25209, year: 1988, vol: 11, page: 31, stat: Journal Article,

RELATIONSHIP BETWEEN IMMUNE-RESPONSES TO MELANOMA VACCINE IMMUNIZATION AND TUMOR PROGRESSION IN MAN
Dugan, M; Oratz, R; Speyer, J; Roses, DF; Harris, MN; Golomb, F; Bystryn, JC
1987 Apr;35(3):A523-A523, Clinical research
— id: 31370, year: 1987, vol: 35, page: A523, stat: Journal Article,

Subcutaneous nonparenchymal hemangioma of the breast
Mitnick JS; Harris M; Feiner H
1987 Sep;87(9):521-522, New York state journal of medicine
— id: 63013, year: 1987, vol: 87, page: 521, stat: Journal Article,

INDUCTION OF LYMPHOCYTIC CELL INFILTRATE IN HUMAN-MELANOMA NODULES BY ACTIVE IMMUNIZATION TO MELANOMA ANTIGEN VACCINE
Oratz, R; Cockerell, C; Speyer, J; Roses, DF; Harris, MN; Bystryn, JC
1987 Mar;28(3):374-374, Proceedings (American Association for Cancer Research)
— id: 31383, year: 1987, vol: 28, page: 374, stat: Journal Article,

Preparation and characterization of a polyvalent human melanoma antigen vaccine
Bystryn JC; Jacobsen S; Harris M; Roses D; Speyer J; Levin M
1986 Jun;5(3):211-224, Journal of biological response modifiers
A polyvalent melanoma tumor antigen vaccine was prepared from antigens shed by a pool of human melanoma cells cultured in serum-free medium. The vaccine contained multiple melanoma associated antigens (MAAs) and was free of detectable fetal calf serum (FCS) proteins and Dr antigens. Three batches of vaccine prepared several months apart contained the same spectrum of tumor antigens. Thirteen patients with metastatic malignant melanomas were immunized intradermally with escalating doses of the vaccine in a Phase I study. There was no toxicity other than transient urticaria at the injection site. Humoral immunity, assayed by indirect immunoprecipitation, was augmented in five (38%) patients. Cellular immunity, assayed by delayed-type cutaneous hypersensitivity, was induced in four (31%) patients. Skin tests to a control vaccine prepared from pooled allogeneic lymphocytes were negative. Cutaneous metastases regressed completely in one patient who is now disease free after 2 years, and multiple cutaneous metastases have remained stable for 14 months in another patient. These results indicate that active immunization to a partially characterized polyvalent melanoma antigen vaccine is safe and can increase immunity to melanoma in some patients
— id: 16253, year: 1986, vol: 5, page: 211, stat: Journal Article,

CELLULAR IMMUNE-RESPONSE TO A MELANOMA ANTIGEN VACCINE
Bystryn, JC; Oratz, R; Harris, M; Roses, D; Speyer, J
1986 Apr;34(2):A561-A561, Clinical research
— id: 31037, year: 1986, vol: 34, page: A561, stat: Journal Article,

Influence of anatomic location on prognosis of malignant melanoma: attempt to verify the BANS model
Rogers GS; Kopf AW; Rigel DS; Levenstein ML; Friedman RJ; Harris MN; Golomb FM; Hennessey P; Gumport SL; Roses DF; et al.
1986 Aug;15(2 Pt 1):231-237, Journal of the American Academy of Dermatology
Stage I cutaneous malignant melanomas between 0.76 and 1.69 mm thick (Breslow measurement) in BANS (upper part of the back, posterior aspects of the arms, posterior and lateral aspects of the neck, posterior aspect of the scalp) areas have been reported to portend a relatively poor prognosis compared to non-BANS sites. We were unable to confirm the 15% poorer survival for BANS area lesions (84% BANS, 99% non-BANS) originally reported. In this report of 211 patients, malignant melanomas in BANS sites had a 4.6% poorer 5-year cumulative survival rate (88.9% BANS, 93.5% non-BANS; p = 0.35). Although many more patients need to be studied, we believe this small difference in survival is insufficient to influence therapeutic management strategies
— id: 16841, year: 1986, vol: 15, page: 231, stat: Journal Article,

Malignant melanoma
Roses DF; Harris MN
Management of the patient with cancer Philadelphia : Saunders, 1986,
— id: 2721, year: 1986, vol: , page: ?, stat: Chapter,

Surgical treatment of dermatofibrosarcoma protuberans
Roses DF; Valensi Q; LaTrenta G; Harris MN
1986 May;162(5):449-452, Surgery, gynecology & obstetrics
The clinical course and histopathologic factors of 50 consecutive patients treated for dermatofibrosarcoma protuberans were reviewed. Forty-eight patients were observed until the present time or death. No patient had distant metastases develop, although 16 patients had 18 recurrences of the dermatofibrosarcoma protuberans at the site of initial therapy. There was no correlation between the diameter of the primary lesion and the incidence of recurrence. There was no correlation between the histologic pattern of invasion and recurrence. However, a trend toward decreasing recurrence was noted with increasing minimal margins of resections (41 per cent less than 2 centimeters versus 24 per cent greater than or equal to 2 centimeters). The lowest incidence of recurrence (20 per cent) was noted with minimal margins of resection greater than or equal to 3 centimeters. Five year recurrence free survival rates increased with increasing margins of resection--59 per cent less than 1 centimeter; 66 per cent greater than or equal to 1 centimeter; 70 per cent greater than or equal to 2 centimeters, and 80 per cent greater than or equal to 3 centimeters. No patient had distant metastases and no change in histologic pattern was noted with progressive local recurrence
— id: 25131, year: 1986, vol: 162, page: 449, stat: Journal Article,

EFFECTS OF A POLYVALENT TUMOR-ANTIGEN VACCINE IN HUMAN- MALIGNANT MELANOMA
Bystryn, JC; Bernstein, P; Harris, M; Roses, D; Speyer, J
1985 ;33(2):A628-A628, Clinical research
— id: 30755, year: 1985, vol: 33, page: A628, stat: Journal Article,

EFFECTS OF A POLYVALENT TUMOR-ANTIGEN VACCINE IN HUMAN- MALIGNANT MELANOMA
Bystryn, JC; Bernstein, P; Harris, M; Roses, D; Speyer, J
1985 ;84(4):338-339, Journal of investigative dermatology
— id: 30767, year: 1985, vol: 84, page: 338, stat: Journal Article,

IMMUNOGENICITY OF A POLYVALENT MELANOMA ANTIGEN VACCINE IN PATIENTS WITH EARLY MELANOMA
Bystryn, JC; Lonberg, M; Bernstein, P; Harris, M; Roses, D; Speyer, J
1985 ;26(MAR):312-312, Proceedings (American Association for Cancer Research)
— id: 30737, year: 1985, vol: 26, page: 312, stat: Journal Article,

ELECTIVE LYMPHADENECTOMIES FOR MALIGNANT-MELANOMA
Harris, MN
1985 ;11(8):792-79?, Journal of dermatologic surgery & oncology
— id: 30858, year: 1985, vol: 11, page: 792, stat: Journal Article,

Single-dose dacarbazine and dactinomycin in advanced malignant melanoma
Hochster H; Levin M; Speyer J; Dunleavy S; Harris M; Roses D; Golomb F; Muggia F
1985 Jan;69(1):39-42, Cancer treatment reports
Twenty-one patients with advanced malignant melanoma were treated with dacarbazine at a dose of 800 mg/m2 as a single infusion and dactinomycin at a dose of 1.2 mg/m2 every 3 weeks. Hematologic toxicity was mild and gastrointestinal toxicity was tolerable. The response rate for evaluable patients was 22%, which included both men and women with visceral disease. Three of the four responses were complete. Durations of response were 4, 6, 9, and 48+ months. We conclude that dacarbazine can be safely and effectively given as a single dose along with dactinomycin. The possibility that this combination may be more effective than single agents in obtaining complete responses in patients with visceral disease must be explored further
— id: 25132, year: 1985, vol: 69, page: 39, stat: Journal Article,

Male breast cancer
Roses DF; Harris MN
1985 Oct;21(10):23,27-8,33, Hospital medicine
— id: 25187, year: 1985, vol: 21, page: 23,27, stat: Journal Article,

Surgery for primary cutaneous malignant melanoma
Roses DF; Harris MN; Gumport SL
1985 Apr;3(2):315-326, Dermatologic clinics
In summary, we believe that in the following situations elective regional lymph node dissection should not usually be performed: Patients whose primary malignant melanomas are in situ or have a maximal thickness of less than 1.0 mm. The incidence of regional node metastases in the latter group is so low that regional lymph node dissection is not justified. Patients whose primary malignant melanomas are in the midline of the head and neck or the trunk. Bilateral nodal dissections in these two regions of the body in the absence of a clearly demonstrable therapeutic advantage are not justified. Whether radioisotopic localizing studies will add greater definition to this group remains to be seen. Elderly patients or those with serious intercurrent disease. They should not undergo elective nodal dissection unless the primary malignant melanoma is very thick and lies directly over its nodal group. Patients with systemic metastases. For all remaining patients, the therapeutic or at very least prognostic advantages of elective regional lymph node dissections have been outlined. Conversely, an adverse effect on the course of the disease has never been demonstrated. We adhere to a policy that includes these procedures as primary therapy, provided they are performed with minimal morbidity. Should a surgeon elect not to perform such a procedure in the absence of clinically suspicious lymphadenopathy, careful clinical evaluation at 2-month intervals for the first 2 to 3 years following primary excision, with more prolonged intervals thereafter, would appear prudent. Until such time as effective means of eradicating systemic metastatic malignant melanoma exist, surgery remains the treatment of choice for this potentially fatal neoplasm. Efforts to develop effective adjuvant treatment based on the precise means of delineating prognosis that have thus far been developed has eluded investigators. A reasoned surgical approach is still required in our judgment until the identification and treatment of premalignant precursor lesions are universal or effective systemic therapy is available
— id: 25115, year: 1985, vol: 3, page: 315, stat: Journal Article,

Prognosis of patients with pathologic stage II cutaneous malignant melanoma
Roses DF; Provet JA; Harris MN; Gumport SL; Dubin N
1985 Jan;201(1):103-107, Annals of surgery
The prognostic relevance of the extent of nodal metastases, lesion thickness, level of invasion, site of lesion, satellitosis, age, sex, and year of diagnosis and treatment were assessed in 213 consecutive patients with pathologic Stage II malignant melanoma (157 with clinical Stage I disease and 56 with clinical Stage II disease). Of these factors, only three were significant: 1) clinical status of the lymph nodes (p less than 0.0001); 2) thickness of the primary lesion in the ranges of less than 2.0 mm, 2.0 to 4.9 mm, and 5.0 mm or greater (p = 0.002); and 3) level of invasion (p = 0.0002). The extent of nodal metastases in those patients with clinical Stage I disease was not significant. The difference in survival between patients with clinically negative/histologically positive nodes (clinical Stage I) and clinically positive/histologically positive nodes (clinical Stage II) was apparent throughout the follow-up period. The 5- and 10-year survival rates for the clinical Stage I patients were 44% and 28%, respectively, and for the clinical Stage II patients 21% and 12%, respectively (p less than 0.0001). A 5-year cumulative survival rate of 65% was achieved for clinical Stage I patients having primary lesions of less than 2.0 mm in thickness, while it was 19% for patients having primary lesions of 5.0 mm or more in thickness. For pathologic Stage II malignant melanoma patients, prognosis is most dependent on the clinical status of the lymph nodes, not on the number of lymph nodes with micrometastases
— id: 25116, year: 1985, vol: 201, page: 103, stat: Journal Article,

Anaesthesia for translumbar aortography
Smith M; Myatt JK; Harris MN; Plantevin OM
1985 Jul;40(7):680-682, Anaesthesia
Fifty patients presenting for elective translumbar aortography were randomly allocated to one of two groups receiving either enflurane or isoflurane. Premedication was with oral lorazepam. The patients' tracheas were intubated and they were allowed to breathe spontaneously in the prone position during the procedure. There was no significant difference in heart rate during the investigation but there was a statistically significant fall in the blood pressure from its pre-induction level. Arterial oxygenation was adequate throughout the procedure. Arterial carbon dioxide tension was significantly lower in the isoflurane group at the beginning and at end of the procedure (p less than 0.01), but there was no significant change in carbon dioxide tension within the groups during the procedure. Spontaneous ventilation with enflurane or isoflurane is a satisfactory anaesthetic technique for translumbar aortography
— id: 65208, year: 1985, vol: 40, page: 680, stat: Journal Article,

PHASE-I TRIAL OF SPECIFIC IMMUNOTHERAPY OF MELANOMA WITH A POLYVALENT MELANOMA ANTIGEN VACCINE
BYSTRYN, JC; LEVIN, M; SPEYER, S; HARRIS, M; ROSES, D; BERNSTEIN, P
1984 ;32(2):A574-A574, Clinical research
— id: 40837, year: 1984, vol: 32, page: A574, stat: Journal Article,

PHASE-I TRIAL OF SPECIFIC IMMUNOTHERAPY OF MELANOMA WITH A POLYVALENT MELANOMA ANTIGEN VACCINE
BYSTTRYN, JC; LEVIN, M; SPEYER, S; HARRIS, M; ROSES, D; BERNSTEIN, P
1984 ;82(4):425-426, Journal of investigative dermatology
— id: 40819, year: 1984, vol: 82, page: 425, stat: Journal Article,

Anaesthesia, atracurium and Huntington's chorea
Harris MN
1984 Jan;39(1):66-66, Anaesthesia
— id: 65215, year: 1984, vol: 39, page: 66, stat: Journal Article,

Extradural analgesia and dystrophia myotonia
Harris MN
1984 Oct;39(10):1032-1033, Anaesthesia
— id: 65216, year: 1984, vol: 39, page: 1032, stat: Journal Article,

"Microscopic satellites" are more highly associated with regional lymph node metastases than is primary melanoma thickness
Harrist TJ; Rigel DS; Day CL; Sober AJ; Lew RA; Rhodes AR; Harris MN; Kopf AW; Friedman RJ; Golomb FM; et al.
1984 May 15;53(10):2183-2187, Cancer
A multivariate analysis was performed on 20 clinical and histologic variables from 327 Stage I prospectively studied melanoma patients who underwent elective regional lymph node dissection (ERLD). Primary tumor thickness, microscopic satellites, and the elapsed interval between diagnosis and ERLD, were selected as the combination of variables that were most highly associated with clinically occult regional lymph node metastases (P = 10(-15), model chi-square). Microscopic satellites were defined as tumor nests, greater than 0.05 mm in diameter, in the reticular dermis, panniculus, or vessels beneath the principal invasive tumor mass but separated from it by normal tissue on the section in which the Breslow measurement was taken. The probability of finding nodal metastases for melanomas less than 0.75 mm thick was 0% (0/41 patients); for those 0.76-1.50 mm, 4% (4/108); 1.51-3.0 mm, 14% (14/102); and greater than 3.0 mm, 39.5% (30/76). Primary melanomas greater than 1.50 mm thick with microscopic satellites were more often associated with nodal metastases than those of similar thickness without satellites (30/57 (53%) versus 14/121 (12%), P = 0.01). Some satellites probably represent intraspecimen metastases, while others do not. Any predictive model for occult regional lymph node metastases based on data from ERLD done less than 50 days after diagnosis may underestimate the prevalence of metastases
— id: 16855, year: 1984, vol: 53, page: 2183, stat: Journal Article,

Diagnosing and managing common skin cancers
Roses DF; Harris MN; Gumport SL
1984 ;112(6):5-5, Medical times & Long Island medical journal
— id: 25204, year: 1984, vol: 112, page: 5, stat: Journal Article,

Prediction of lymph node metastases from the histologic features of primary cutaneous malignant melanomas
Weissmann A; Roses DF; Harris MN; Dubin N
1984 Summer;6 Suppl(1):35-41, American journal of dermatopathology
Elective regional lymph-node dissection was performed on 98 patients with clinical Stage I cutaneous malignant melanoma and 26 of them were found to have microscopic evidence of metastases. The histology of the primary lesions was reviewed in order to find possible prognostic parameters that would allow prediction of nodal involvement. There was an increased risk of occult lymph node metastases with increasing thickness of the primary lesions. While this trend was not found to be statistically significant, no occult lymph node metastases were found for lesions less than 1.0 mm in thickness. Significant features included mitotic figures, 'prognostic index,' and plasma cells within the infiltrate. A multiple logistic regression analysis identified three groups of patients with low, medium, and high risk of occult metastases, based on thickness, location, and plasma cells. The correlation between plasma cells and the incidence of metastases in lymph nodes might represent an immunologic phenomenon
— id: 25133, year: 1984, vol: 6 Suppl, page: 35, stat: Journal Article,

HUMAN-TUMOR CLONOGENIC-ASSAY - CHEMOSENSITIVITY TESTING IN SOFT AGAR AND CLINICAL CORRELATION IN MALIGNANT-MELANOMA
CUMPS, E; BOWEN, J; HARRIS, M; ROSES, D; GOLOMB, F; VALENTINE, F; MUGGIA, F; LEVIN, M
1983 ;31(2):A405-A405, Clinical research
— id: 40682, year: 1983, vol: 31, page: A405, stat: Journal Article,

Predictors of late deaths among patients with clinical stage I melanoma who have not had bony or visceral metastases within the first 5 years after diagnosis
Day CL; Mihm MC; Sober AJ; Harris MN; Kopf AW; Fitzpatrick TB; Lew RA; Harrist TJ; Golomb FM; Postel A; Hennessey P; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Rigel D; Friedman RJ; Mintzis MM
1983 Jun;8(6):864-868, Journal of the American Academy of Dermatology
— id: 16625, year: 1983, vol: 8, page: 864, stat: Journal Article,

Favorable prognosis for malignant melanomas associated with acquired melanocytic nevi
Friedman RJ; Rigel DS; Kopf AW; Lieblich L; Lew R; Harris MN; Roses DF; Gumport SL; Ragaz A; Waldo E; Levine J; Levenstein M; Koenig R; Bart RS; Trau H
1983 Jun;119(6):455-462, Archives of dermatology
In a clinicohistopathologic study of 557 patients with primary cutaneous malignant melanoma, there were fewer metastases and/or deaths from melanoma when histologic evidence of a coexisting acquired melanocytic nevus was found. A total of 130 patients with melanocytic nevus and 427 cases of melanoma without histologic evidence of a nevus (denovo) were studied. Clinical follow-up evaluation for evidence of metastases and/or death was obtained. Only ten of the patients (7.7%) with nevus-associated melanoma had metastases and/or death v 78 (18.3%) with de novo melanoma. When stratified by lesion thickness, the logrank test for survival revealed a statistically significant difference between the two groups. An overall favorable outcome seen in patients with malignant melanomas associated with acquired melanocytic nevi was found, therefore, to be independent of lesion thickness as well as six other variables reported to be related to the biologic behavior of malignant melanoma. Thus, the presence of nevus cells in a specimen of malignant melanoma portends a better prognosis and may have important implications in the biology of this neoplasm
— id: 16858, year: 1983, vol: 119, page: 455, stat: Journal Article,

BIOPSY AND SURGICAL-MANAGEMENT OF MALIGNANT-MELANOMA
HARRIS, MN; ROSES, DF
1983 ;9(8):663-663, Journal of dermatologic surgery & oncology
— id: 40648, year: 1983, vol: 9, page: 663, stat: Journal Article,

Local and in-transit metastases following definitive excision for primary cutaneous malignant melanoma
Roses DF; Harris MN; Rigel D; Carrey Z; Friedman R; Kopf AW
1983 Jul;198(1):65-69, Annals of surgery
A total of 672 consecutive patients with clinical stage I and stage II primary cutaneous malignant melanoma were treated by excision of 3.0 to 5.0 cm of surrounding skin down to and including the underlying fascia when the lesion exceeded 0.5 mm thickness (Breslow measurement). More conservative margins were taken in locations where such excisions would result in significant cosmetic or functional morbidity and for thinner lesions (less than 0.5 mm). Seven of 658 patients with clinical stage I disease (1.1%) and three of 14 patients with clinical stage II disease (21.4%) developed histologically verified local metastases within 5 cm of the primary excision scar or skin graft. Fifteen patients with stage I disease developed in-transit metastases (2.3%) at a site more than 5.0 cm proximal to the surgical scar or skin graft but not beyond the regional nodal group. Two patients with stage II disease who had developed local metastases also developed in-transit metastases (14.3%). No patient with a lesion less than 1.0 mm thick has had a local recurrence. Nine of the ten patients (90%) who developed local metastases and 12 of the 17 patients (70.6%) who developed in-transit metastases have also developed systemic metastases to date. Local and in-transit metastases following such definitive excision is a significant indicator of disseminated systemic metastatic melanoma
— id: 25134, year: 1983, vol: 198, page: 65, stat: Journal Article,

Diagnosis and management of cutaneous malignant melanoma
Roses, Daniel F.; Harris, Matthew N.; Ackerman, A. Bernard
Philadelphia : Saunders, c1983,
— id: 226, year: 1983, vol: , page: , stat: ,

Metastases of thin melanomas
Trau H; Rigel DS; Harris MN; Kopf AW; Friedman RJ; Gumport SL; Bart RS; Grier WR
1983 Feb 1;51(3):553-556, Cancer
Although thin malignant melanomas, i.e., those less than 0.76 mm in thickness, of the skin generally do not metastasize, it has been recently reported that when histologic regression is present, such lesions may then have a greater propensity for dissemination. However, this was not apparent in this study in which only one melanoma metastasized in a consecutive series of 41 thin lesions which were step-sectioned and had evidence of regression histologically. Possible explanations for this discrepancy are the failure of other authors to include only step-sectioned specimens of the primary melanomas in their material and/or geographic differences in the biologic behavior of this malignant neoplasm
— id: 16859, year: 1983, vol: 51, page: 553, stat: Journal Article,

A multivariate analysis of prognostic factors for melanoma patients with lesions greater than or equal to 3.65 mm in thickness. The importance of revealing alternative Cox models
Day CL; Lew RA; Mihm MC; Sober AJ; Harris MN; Kopf AW; Fitzpatrick TB; Harrist TJ; Golomb FM; Postel A; Hennessey P; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Rigel D; Friedman RJ; Mintzis MM; Grier RW
1982 Jan;195(1):44-49, Annals of surgery
Fourteen prognostic factors were examined in 79 patients with clinical Stage I melanoma greater than or equal to 3.65 mm in thickness. All nine patients with melanoma of the hands or feet died of melanoma. A Cox proportional hazards (multivariate) analysis of the remaining 70 patients showed that a combination of the following four variables best predicted bony or visceral metastases: 1) a nearly absent or minimal lymphocyte response at the base of the tumor, 2) histologic type other than superficial spreading melanoma, 3) location on the trunk, and 4) positive nodes or no initial node dissection. Ulceration and/or ulceration width were not useful in predicting outcome either singly or in combination with other variables. Patients with negative lymph nodes and primary tumors of the trunk, hands, and feet did not do better than patients with positive nodes at those sites. Conversely, non of 16 patients with negative lymph nodes and extremity melanomas (excluding the hands and feet) or head and neck melanomas developed visceral or bony metastases (i.e., five-year disease-free survival rate 100%)
— id: 16628, year: 1982, vol: 195, page: 44, stat: Journal Article,

Prognostic factors for patients with clinical stage I melanoma of intermediate thickness (1.51 - 3.39 mm). A conceptual model for tumor growth and metastasis
Day CL; Mihm MC; Lew RA; Harris MN; Kopf AW; Fitzpatrick TB; Harrist TJ; Golomb FM; Postel A; Hennessey P; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Rigel D; Friedman RJ; Mintzis MM; Sober AJ
1982 Jan;195(1):35-43, Annals of surgery
Fourteen variables were tested for their ability to predict visceral or bony metastases in 177 patients with clinical Stage I melanoma of intermediate thickness (1.51 - 3.39 mm). A Cox multivariate analysis yielded a combination of four variables that best predicted bony or visceral metastases for these patients: 1) mitoses greater than 6/min 2 (p = 0.0007), 2) location other than the forearm of leg) p = 0.009, 3) ulceration width greater than 3 mm (p = 0.04), 4) microscopic satellites (p = 0.05). The overall prognostic model chi square was 32.40 with 4 degrees of freedom (p less than 10 (-5). Combinations of the above variables were used to separate these patients into at least two risk groups. The high risk patients had at least a 35% or greater chance of developing visceral metastases within five years, while the low risk group had greater than an 85% chance of being disease free at five years. Criteria for the high risk group were as follows: 1) mitoses greater than 6/mm 2 in at least one area of the tumor, irrespective of primary tumor location, or 2) a melanoma located at some site other than the forearm or leg and histologic evidence in the primary tumor of either ulceration greater than 3 mm wide or microscopic satellites. The low risk group was defined as follows: 1) mitoses less than or equal to 6/mm 2 and a location on the leg or forearm, or 2) mitoses less than or equal to 6/mm 2 and the absence in histologic sections of the primary tumor of both microscopic satellites and ulceration greater then 3 mm wide. The number of patients in this series who did not undergo elective regional node dissection (N = 47) was probably too small to detect any benefit from this procedure. Based on survival rates from this and other studies, it is estimated that approximately 1500 patients with clinical Stage I melanoma of intermediate thickness in each arm of a randomized clinical trial would be needed to detect an increase in survival rates from elective regional node dissection
— id: 16629, year: 1982, vol: 195, page: 35, stat: Journal Article,

Prognostic factors for melanoma patients with lesions 0.76 - 1.69 mm in thickness. An appraisal of "thin" level IV lesions
Day CL; Mihm MC; Sober AJ; Harris MN; Kopf AW; Fitzpatrick TB; Lew RA; Harrist TJ; Golomb FM; Postel A; Hennessey P; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Rigel D; Friedman RJ; Mintzis MM
1982 Jan;195(1):30-34, Annals of surgery
Fourteen variables were tested for their prognostic usefulness in 203 patients with clinical Stage I melanoma and primary tumor 0.76-169 mm thick. Only two variables, primary tumor location and level of invasion, were useful in predicting death from melanoma for these patients. Of the 12 deaths from melanoma, 11 occurred in patients with primary tumors located on the upper back, posterior arm, posterior neck, and posterior scalp (=BANS). There has been only one death from melanoma in 136 patients with melanoma located at other sites (11/67 vs 1/136, p less than 0.0001 Fisher's Exact Test). Of the 67 BANS patients, 51 had level II or level III lesions and five (10%0 died of melanoma. This compared with six deaths from melanoma in 16 patients (37.5%) with level IV BANS lesions (5/51 vs 6/16, p = 0.01 Fisher's Exact Test). The relatively high incidence of both melanoma deaths and regional node metastases for the BANS group merits consideration for testing the efficacy of elective regional node dissection for these patients
— id: 16630, year: 1982, vol: 195, page: 30, stat: Journal Article,

TUMOR THICKNESS IN MELANOMA - REPLY
Day, CL; Mihm, MC; Lew, RA; Harris, MN; Kopf, AW; Sober, AJ; Fitzpatrick, TB
1982 ;306(19):1179-1180, New England journal of medicine
— id: 30415, year: 1982, vol: 306, page: 1179, stat: Journal Article,

MICROSCOPIC SATELLITES ARE HIGHLY PREDICTIVE OF LYMPH-NODE METASTASES IN CLINICAL STAGE-I MELANOMA
Harrist, TJ; Rigel, D; Day, CL; Sober, AJ; Lew, RA; Harris, MN; Kopf, AW; Fitzpatrick, TB; Mihm, MC
1982 ;46(Suppl 1):A35-A35, Laboratory investigation
— id: 30586, year: 1982, vol: 46, page: A35, stat: Journal Article,

Malignant melanoma margins
Roses DF; Harris MN; Gumport SL; Ackerman AB
1982 Aug 12;307(7):439-441, New England journal of medicine
— id: 107001, year: 1982, vol: 307, page: 439, stat: Journal Article,

Primary melanoma thickness correlated with regional lymph node metastases
Roses DF; Harris MN; Hidalgo D; Valensi QJ; Dubin N
1982 Jul;117(7):921-923, Archives of Surgery (Chicago)
We studied 119 patients with stage I primary cutaneous malignant melanoma, who were undergoing regional lymph node dissection, to determine the relationship of lymph node metastases to thickness of the primary lesion. The lymph nodes in the dissection specimen were each evaluated by serial sections. None of the patients with lesions less than 1.0 mm thick had nodal micrometastases. When lesions exceeded 1.0 mm in thickness, there was no appreciable increase in the incidence of nodal metastases until a thickness greater than 4.0 mm was reached, in which cases the incidence of metastases was 50%. Predictive variables were determined by multiple logistic regression analysis. Only lesions that were at least 4.0 mm thick and were not located on the upper extremities were significant predictors of lymph node metastases; within this category there was a 64% incidence of lymph node metastases
— id: 25135, year: 1982, vol: 117, page: 921, stat: Journal Article,

The natural break points for primary-tumor thickness in clinical Stage I melanoma
Day CL Jr; Lew RA; Mihm MC Jr; Harris MN; Kopf AW; Sober AJ; Fitzpatrick TB
1981 Nov 5;305(19):1155-1155, New England journal of medicine
— id: 49437, year: 1981, vol: 305, page: 1155, stat: Journal Article,

A prognostic model for clinical stage I melanoma of the lower extremity. Location on foot as independent risk factor for recurrent disease
Day CL Jr; Sober AJ; Kopf AW; Lew RA; Mihm MC Jr; Golomb FM; Hennessey P; Harris MN; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Fitzpatrick TB; Postel A
1981 May;89(5):599-603, Surgery
Thirteen variables were studied to determine their usefulness in predicting recurrent disease in 158 patients with stage I melanoma of the lower extremity. A Cox proportional hazards analysis demonstrated that three variables were independent risk factors for recurrent disease in these patients: (1) thickness, in millimeters, of the primary tumor (P = 0.000009), (2) primary tumor location on the foot (P = 0.0003), and (3) the number of mitoses/mm2 (P = 0.0244). Life-table analyses of patient subgroups defined by different combinations of these three variables demonstrated that thick (greater than or equal to 3.0 mm) melanomas of the foot were associated with recurrent disease much more frequently than tumors of similar thickness located on the thigh or calf. These data provide guidelines that can be used to evaluate results of surgical and/or adjuvant therapy studies for patients with melanoma of the lower extremity
— id: 25111, year: 1981, vol: 89, page: 599, stat: Journal Article,

A prognostic model for clinical stage I melanoma of the trunk. Location near the midline is not an independent risk factor for recurrent disease
Day CL Jr; Sober AJ; Kopf AW; Lew RA; Mihm MC Jr; Golomb FM; Postel A; Hennessey P; Harris MN; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Fitzpatrick TB
1981 Aug;142(2):247-251, American journal of surgery
Fifteen variables were studied for their usefulness in predicting recurrent disease in 254 patients with clinical stage I melanoma of the trunk. Thickness of the primary tumor correctly predicted outcome with an accuracy of 90 percent or greater in 176 patients with melanoma primaries with a thickness of less than 1.70 mm or 5.5 mm or greater. No other variables significantly increased predictive accuracy over these ranges of thickness. A Cox proportional hazards analysis of the remaining 78 patients with primary tumors 1.70 to 5.49 mm thick demonstrated that the following four variables functioned as independent risk factors for recurrent disease: (1) thickness of the primary tumor (p = 0.0005), (2) mitoses/mm2 greater than 6 (p = 0.006), (3) a nearly absent or minimal lymphocyte response at the base of the tumor (p = 0.009), and (4) location on the upper trunk (p = 0.03). Trunk lesions located near the midline did not have a worse prognosis than more lateral melanomas of similar thickness
— id: 25110, year: 1981, vol: 142, page: 247, stat: Journal Article,

A prognostic model for clinical stage I melanoma of the upper extremity. The importance of anatomic subsites in predicting recurrent disease
Day CL Jr; Sober AJ; Kopf AW; Lew RA; Mihm MC Jr; Hennessey P; Golomb FM; Harris MN; Gumport SL; Raker JW; Malt RA; Cosimi AB; Wood WC; Roses DF; Gorstein F; Postel A; Grier WR; Mintzis MN; Fitzpatrick TB
1981 Apr;193(4):436-440, Annals of surgery
Thirteen variables were studied for their relative usefulness in predicting recurrent disease in 107 patients with clinical Stage I melanoma of the upper extremity. After a mean follow-up period of 54 months, the only patents who have had recurrent disease to date are those who primary lesions were located either on the hand or posterior upper arm. The five-year disease-free survival role for 44 patients with melanoma at these sites was 68%. None of 63 patients with melanoma located on the forearm of anterior upper arm have had recurrent disease (i.e., the five-year, disease-free survival rate was 100% (p = 0.00004), compared with the hand or posterior arm group). A Cox proportional hazards (multivariate) analysis demonstrated that two primary tumor histologic variable, thickness in millimeters and ulceration, interacted to produce the best prognostic model for those 44 patients with melanoma of the hand or posterior upper arm. Twenty-one patients with primary lesions at these sites had primary tumors less than 2.25 mm in thickness and no evidence of ulceration histologically. Their five-year, disease-free survival role was 95%. For the remaining 23 patients with primary tumors on the hand or posterior upper arm who had either histologic evidence of ulceration or primary tumors greater than or equal to 2.25 mm, the five-year disease-free survival rate was 37% (p = 0.002, compared with group nonulcerated, thin lesions). The excellent survival rate for patients with melanomas on the forearm or anterior upper arm was not completely explained by pathologic stage, by primary tumor thickness, or by histologic ulceration of the primary tumor
— id: 25112, year: 1981, vol: 193, page: 436, stat: Journal Article,

Malignant melanoma patients with positive nodes and relatively good prognoses: microstaging retains prognostic significance in clinical stage I melanoma patients with metastases to regional nodes
Day CL Jr; Sober AJ; Lew RA; Mihm MC Jr; Fitzpatrick TB; Kopf AW; Harris MN; Gumport SL; Raker JW; Malt RA; Golomb FM; Cosimi AB; Wood WC; Casson P; Lopransi S; Gorstein F; Postel A
1981 Mar 1;47(5):955-962, Cancer
Fifteen variables were tested for their value in predicting recurrent disease in 46 clinical Stage I melanoma patients with metastases to regional nodes. A stepwise proportional hazards general linear model (Cox multivariate analysis) separated these melanoma patients with regional node metastases into at least two risk groups. Twenty patients in the relatively low-risk group had a five-year disease-free survival of 80% (in spite of having nodal metastases). This compares to a five-year disease-free survival of 17.5% for 26 patients in the high-risk group (P less than 0.001, Lee-Desu Statistic). Criteria for the high-risk group required that a patient have only one of the following two values: (1) The number of regional lymph nodes that contained tumor divided by the total number of nodes removed x 100% (percentage of positive nodes) greater than or equal to 20%; or (2) a primary tumor thickness of greater than 3.5 mm (regardless of node percentage). Conversely, patients in the low-risk group had neither of the above features. The high-risk group could further be stratified by the lymphocytic response at the base of the tumor. These findings have direct immediate application to the elective regional node dissection controversy and to adjuvant therapy studies containing these patients
— id: 49444, year: 1981, vol: 47, page: 955, stat: Journal Article,

The diagnosis and management of common skin cancers
Gumport SL; Harris MN; Roses DF; Kopf AW
1981 Mar-Apr;31(2):79-90, CA: a cancer journal for clinicians
— id: 25120, year: 1981, vol: 31, page: 79, stat: Journal Article,

Mixed parathyroid-thymic cyst
Harris MN; Basuk R; Roses DF; Rabinowitz M; Feiner HD
1981 Oct;81(11):1657-1659, New York state journal of medicine
— id: 25106, year: 1981, vol: 81, page: 1657, stat: Journal Article,

Management of head and neck melanoma
Harris MN; Roses DF
Head and neck surgery Mt. Kisco, NY : Futura Publishing, 1981,
— id: 2719, year: 1981, vol: , page: ?, stat: Chapter,

Factors related to thickness of melanoma. Multifactorial analysis off variables correlated with thickness of superficial spreading malignant melanoma in man
Kopf AW; Rigel D; Bart RS; Mintzis MM; Hennessey P; Harris MN; Ragaz A; Trau H; Friedman RJ; Esrig B
1981 Aug;7(8):645-650, Journal of dermatologic surgery & oncology
Computer analyses to identify correlations between thickness of primary superficial spreading malignant melanoma and eighteen variables previously reported to be related to prognosis were performed on a series of malignant melanomas. The variables that showed statistically significant (less than or equal to 0.05) direct relationships to thickness were level (Clark), elevation of lesion, age of patient, least and greatest diameters of lesion, history of bleeding, ulceration, clinical and histologic stage, anatomic location, pedunculation, and satellitosis. The variables that did not correlate with thickness were clinical diagnosis of regional lymphadenopathy, in-transit metastasis, duration of lesion, sex, history of a previous malignant melanoma, and history of a pre-existing lesion at the site of the development of melanoma. Multiple regression analysis of the factors that showed statistically significant correlation with thickness of the primary lesion revealed a subset of six dominant variables that were most predictive of thickness, namely, level, elevation, largest diameter of lesion, ulceration, histologic stage, and age of the patient
— id: 16631, year: 1981, vol: 7, page: 645, stat: Journal Article,

Benign breast conditions
Roses DF; Harris MN
1981 ;17(11):114-127, Hospital medicine
Discussion of benign breast disease, including signs, symptoms, diagnosis, and suggested treatment, is presented. Helpful means for distinguishing between benign and malignant breast disease include biopsy, patient and family history, age, frequency of pregnancies, and timing of menstruation in relation to examination. The presence of a mass during examination, along with changes in size or firmness of one breast, skin changes, nipple discharge, or changes in nipple epithelium, may provide information helpful to establishing diagnostic procedure. Fibrocystic disease ranging from epithelium-lined cyst to sclerosing adenosis presents with symptoms of breast discomfort. Histopathological changes include hyperplasia of duct epithelium, duct papillomatosis, and blunt duct adenosis. Treatment includes aspiration and re-examination or possibly mammography. When mammography is insufficient to distinguish from carcinoma, a biopsy is indicated. Mammary duct ectasia is characterized by a yellowish-brown discharge, thickening of the duct wall, and shortening and retraction of the nipple. Ductal excision is indicated; excisional biopsy should be performed if a mass is present. Intraductal papilloma presents with bloody nipple and should be further evaluated by biopsy and possibly mammography. Fat necrosis can sometimes mimic cancer; biopsy and mammography may be needed for definitive diagnosis. Fibroadenomas are solid, rubbery, movable lesions. Re-examination during another part of the menstrual cycle and excisional biopsy are indicated for diagnosis. Accurate diagnosis and patient reassurance are necessary when dealing with benign breast disease
— id: 25188, year: 1981, vol: 17, page: 114, stat: Journal Article,

Wide and deep excision for malignant melanoma
Roses DF; Harris MN; Casson P; Gumport SL
Pathology of malignant melanoma New York : Masson Publishing, 1981,
— id: 2716, year: 1981, vol: , page: 363, stat: Chapter,

Surgical management for malignant melanoma of the trunk
Roses DF; Harris MN; Gumport SL
1981 Mar;116(3):315-317, Archives of Surgery (Chicago)
A group of 525 patients with primary cutaneous malignant melanoma of the trunk was treated by a uniform surgical approach that included regional lymph node dissection for selected patients; 266 (50.6%) had regional lymph node dissections in addition to wide and deep excision, all with primary lesions extending below the superficial papillary dermis. Of 171 patients treated over five years ago, 130 had histologically negative nodes; 94 (72%) are alive with no evidence of disease (NED). Of 41 with histologically positive nodes, 12 (29%) are alive with NED. A comparison of the 21 patients with clinically occult micrometastases shows eight (38%) alive with NED, whereas four of 20 (20%) with clinically demonstrable as well as histologically proven nodal metastases are alive with NED. Though there may be a modest benefit to lymph node dissection for microscopic rather than gross nodal metastases for invasive melanoma of the trunk, for most such patients melanoma in regional nodes indicates the presence of systemic metastatic disease
— id: 25119, year: 1981, vol: 116, page: 315, stat: Journal Article,

Regional lymph node dissection for malignant melanoma of the extremities
Roses DF; Harris MN; Gumport SL; Michelassi F; Coffey JA; Dubin N
1981 Jun;89(6):654-659, Surgery
Seven hundred thirty-nine patients with malignant melanoma of the extremities were treated with a uniform surgical approach that included wide and deep excision of the primary site and regional node dissection therapeutically and electively for invasive lesions (Clark's levels III, IV, and V). Of the 490 patients who underwent lymph node dissections, follow-up was available for 457 (93%). Life-table comparison of 362 patients with histologically negative nodes to 95 with histologically proved lymph node metastases yielded statistically significant differences in survival (P less than 0.001). Five-year cumulative survival rates were 91% in the group without and 48% in the group with nodal metastases. Among histologically positive patients, differences in life-table survival curves for the 60 clinically negative patients compared to the 35 clinically positive patients were also statistically significant (P = 0.004); 5-year cumulative survival rates were 57% for the former group and 33% for the latter. Although there appears to be an advantage to regional lymph node dissection for micrometastases as opposed to gross nodal involvement, for the majority of patients metastatic melanoma in these nodes is the major indicator of systemic disease
— id: 25118, year: 1981, vol: 89, page: 654, stat: Journal Article,

Total mastectomy with complete axillary dissection
Roses DF; Harris MN; Potter DA; Gumport SL
1981 Jul;194(1):4-8, Annals of surgery
A technique for total mastectomy with complete axillary dissection, which uses division of the insertion of the sternal portion of the pectoralis major muscle, preservation of its innervation, reconstruction after completion of the dissection and resection of the pectoralis minor muscle has been evaluated for 115 consecutive procedures. This modification facilitates a thorough axillary dissection, while preserving the cosmetic and functional benefits of the Patey operation
— id: 25117, year: 1981, vol: 194, page: 4, stat: Journal Article,

Biopsy for microcalcification detected by mammography
Roses DF; Harris MN; Gorstein F; Gumport SL
1980 Mar;87(3):248-252, Surgery
Fifty-two patients who were biopsied because of the presence of clustered microcalcifications on mammography, in the absence of any definable mass on x-ray or physical examination, were studied. Localization of the microcalcifications was obtained by measuring the area in relation to the vertical and horizontal axes from the nipple on both lateral and cephalocaudad views. Specimen radiography was obtained to ensure that the area with microcalcifications had been included in the specimen. Carcinoma was found in 17 instances (33%). In four (24%) the detected microcalcifications corresponded to fibrocystic disease, with carcinoma being found only in adjacent tissue with little or no calcifications. Precise localization and removal of only the area containing calcifications without excision of a generous margin of surrounding tissue may result in the exclusion of an adjacent carcinoma
— id: 25122, year: 1980, vol: 87, page: 248, stat: Journal Article,

Selective surgical management of cutaneous melanoma of the head and neck
Roses DF; Harris MN; Grunberger I; Gumport SL
1980 Nov;192(5):629-632, Annals of surgery
A series of 206 patients with cutaneous melanoma of the head and neck has been studied. Ninety patients had a regional lymph node dissections performed. Seventeen lymph node dissections were done therapeutically and 73 were done electively. Thirty-one patients had histologically positive lymph nodes and, of these, 30 patients have been followed to the present time or death. Twenty-nine of these patients (97%) have developed systemic melanoma. Twenty-six patients have died and three are alive with disease. No patient had local recurrence alone while four had local recurrence synchronously with systemic metastases. This contrasts with 29 patients followed for greater than five years with histologically negative nodes, 27 (93.1%) of whom are alive with no evidence of recurrent disease. Regional node metastases with melanoma of the head and neck is an almost certain indication of systemic disease. A selective surgical approach to invasive melanoma in this region is proposed based on the observation in the 31 patients who had radical neck dissections with histologically positive nodes. The metastases always involved the nodal group adjacent to the primary site. This selective approach should allow optimal local control and accurate pathologic staging while limiting the extent of the surgery
— id: 25121, year: 1980, vol: 192, page: 629, stat: Journal Article,

Assessment of biopsy techniques and histopathologic interpretations of primary cutaneous malignant melanoma
Roses DF; Ackerman AB; Harris MN; Weinhouse GR; Gumport SL
1979 Mar;189(3):294-297, Annals of surgery
The biopsy techniques utilized for diagnosis in 1,161 patients with primary cutaneous malignant melanoma treated at the New York University Medical Center were reviewed. Eight hundred sixty-four (74%) biopsies were of the excisional type and 269 (23%) were incisional. Twenty-eight biopsies (3%) could not be assessed. Two hundred fifty-two consecutive patients referred for treatment of malignant melanoma to the authors for the last three years were studied to determine whether standard techniques of biopsy and uniform criteria for histopathologic diagnosis and staging were being utilized. One hundred forty-nine of these patients (59%) had total excisional biopsies of their lesions and 103 (41%) had incisional biopsies. Of the latter group, 66 (64%) were for lesions less than 2 cm in diameter and were situated in areas other than the face. The biopsy specimens obtained from 123 patients were reviewed by at least one other pathologist as well as our own (A.B.A.). For these 123 patients a difference of histologic diagnosis between pathologists occurred in 11 (9%). In 58 (47%) there was a discrepancy in assignment of Clark levels or a failure to assess Clark levels. Tumor thicknesses as measured by Breslow were read in only 22 (18%) of these 123 patients. The inadequacies of many of the biopsy specimens and discrepancies in histopathologic interpretation indicate that acceptable biopsy techniques and reproducible diagnostic criteria have not yet been generally adapted for primary cutaneous malignant melanomas
— id: 25123, year: 1979, vol: 189, page: 294, stat: Journal Article,

Malignant melanoma. Delayed hypersensitivity skin testing
Roses DF; Campion JF; Harris MN; Gumport SL
1979 Jan;114(1):35-38, Archives of Surgery (Chicago)
One hundred eighty-two patients undergoing initial surgical therapy for primary malignant melanoma were evaluated for delayed hypersensitivity using a battery of recall antigens prior to surgery. Fifty-six patients were also sensitized with 2, 4-dinitrochlorobenzene. All tumors were classified by Clark-Mihm levels and the patients were clinically staged. They were followed up for an average period of 55 months. There was no significant difference in the ability of patients with varied Clark-Mihm level lesions to mount a delayed hypersensitivity response to the recall battery or to 2, 4-dinitrochlorobenzene. Thirteen stage I melanoma patients in whom recurrence developed at a distant site exhibited no difference in immune responsiveness when compared to 148 patients in whom recurrence did not develop when both groups were tested with recall antigens. No difference was noted in patients with stage II disease in whom recurrence developed, as measured by reaction to these same antigens. Twelve patients demonstrated anergy to recall antigens, in none of whom has recurrence developed to date. Fifty-six patients who were tested with 2, 4-dinitrochlorobenzene showed no difference in reactivity with tumors classified at any of the Clark-Mihm levels. Anergy demonstrated by delayed hypersensitivity skin testing appears to reflect increasing tumor burden, rather than a preexisting deficiency that can be used to predict patients at high risk for the development of recurrent disease
— id: 25124, year: 1979, vol: 114, page: 35, stat: Journal Article,

Cutaneous melanoma of the breast
Roses DF; Harris MN; Stern JS; Gumport SL
1979 Jan;189(1):112-115, Annals of surgery
A series of 21 patients treated surgically for primary melanoma of the skin of the breast has been studied. Melanomas in this location accounted for 1.8% of a total of 1,140 patients with primary clinical Stage I and Stage II melanomas treated during a 28 year period. Wide excision with axillary lymph node dissection in selected instances has resulted in no mortality and no local recurrence to date. This approach allowed the preservation of a major portion of the breast in eight female patients. It is emphasized that melanoma is a cutaneous lesion and considerations applying to lymphatic dissemination of parenchymal disease of the breast need not apply
— id: 25125, year: 1979, vol: 189, page: 112, stat: Journal Article,

Lymph-node dissection in melanoma
Dubin N; Pasternack BS; Roses DF; Harris MN; Gumport SL
1978 Jan 26;298(4):222-224, New England journal of medicine
— id: 107000, year: 1978, vol: 298, page: 222, stat: Journal Article,

Epidermotropically metastatic malignant melanoma. Differentiating malignant melanoma metastatic to the epidermis from malignant melanoma primary in the epidermis
Kornberg, R; Harris, M; Ackerman, A B
1978 Jan;114(1):67-69, Archives of dermatology
In four instances, metastases to epidermis from primary cutaneous malignant melanomas at different sites showed histological features similar to those of cutaneous malignant melanoma primary in the epidermis. In these metastases, atypical melanocytes were present within the epidermis and in the upper part of the dermis much as in primary cutaneous malignant melanoma. Therefore, the presence of atypical melanocytes within the epidermis is not in itself an absolute criterion of malignant melanoma primary in skin. Nor does that finding absolutely deny malignant melanoma metastastic to the skin. Features that may enable histologic differentiation of epidermotropically metastatic malignant melanoma from primary cutaneous malignant melanoma are emphasized
— id: 89307, year: 1978, vol: 114, page: 67, stat: Journal Article,

Selective surgical management of operable breast cancer
Gumport SL; Harris MN; Roses DF
1977 ;1:1-1, Cancer report (NYU School of Medicine)
— id: 25216, year: 1977, vol: 1, page: 1, stat: Journal Article,

Total mastectomy with axillary dissection. A modified radical mastectomy
Roses DF; Harris MN; Gumport SL
1977 Nov;134(5):674-677, American journal of surgery
A technic for total mastectomy with complete axillary dissection has been described. The procedure utilizes division of the pectoralis major muscle between its clavicular and sternal portions, perservation of its innervation, and reconstruction after completion of the dissection. The pectoralis minor muscle is resected. This modification facilitates a thorough axillary dissection, particularly at the apex, while preserving the cosmetic and functional benefits of the Patey operation
— id: 25126, year: 1977, vol: 134, page: 674, stat: Journal Article,

Present status of surgical management of malignant melanoma
Harris MN; Gumport SL
1976 May;2(2):129-133, Journal of dermatologic surgery
Malignant melanoma has a distinctive appearance and has been clinically and histologically classified by Clark and Mihm. Using this classification a rationale for the surgical treatment of melanoma has been developed at the New York University Medical Center. The choice and extent of surgery is described. Early detection of melanoma and prompt surgical attention can significantly reduce the mortality from this neoplasm
— id: 65217, year: 1976, vol: 2, page: 129, stat: Journal Article,

Use of a questionably viable flap as a full thickness skin graft after mastectomy
Heller KS; Slattery LR; Harris MN
1976 Jul;143(1):94-96, Surgery, gynecology & obstetrics
Questionably viable skin flaps may be used as full thickness grafts after mastectomy. It is suggested that the procedure described can help reduce the incidence of flap necrosis after mastectomy and yield a more acceptable cosmetic result
— id: 25240, year: 1976, vol: 143, page: 94, stat: Journal Article,

Biopsy technique for malignant melanoma
Harris MN; Gumport SL
1975 Mar;1(1):24-27, Journal of dermatologic surgery
— id: 65205, year: 1975, vol: 1, page: 24, stat: Journal Article,

Melanoma of the head and neck
Harris MN; Roses DF; Culliford AT; Gumport SL
1975 Jul;182(1):86-91, Annals of surgery
A series of 94 patients with cutaneous malignant melanoma of the head and neck region has been studied. Fifty-three of the patients had regional lymph node dissections performed and the results in 37 performed more than 5 years ago are presented. The policy of elective lymph node dissection for invasive melanoma of the head and neck is strongly endorsed, although not proven by the data presented in this limited series. Whenever possible, a total excisional biopsy should be performed to establish the diagnosis. It is recommended that all melanomas be classified by the method of Clark and Mihm and that the level of invasion also be determined. There is an appreciable error in the clinical evaluation of lymph nodes for metastases. In general, it is suggested that elective regional lymph node dissections be performed for invasive melanoma (levels III, IV and V). The literature pertaining to cutaneous melanoma of the head and neck has been reviewed and surgical and pathological problems peculiar to lesions of this region are emphasized
— id: 25127, year: 1975, vol: 182, page: 86, stat: Journal Article,

Results of regional lymph node dissection for melanoma
Gumport SL; Harris MN
1974 Jan;179(1):105-108, Annals of surgery
— id: 65211, year: 1974, vol: 179, page: 105, stat: Journal Article,

Diagnosis and management of common skin cancers
Gumport SL; Harris MN; Kopf AW
1974 Jul-Aug;24(4):218-228, CA: a cancer journal for clinicians
— id: 49510, year: 1974, vol: 24, page: 218, stat: Journal Article,

Streptococcal peritonitis in a patient with Hodgkin's disease and an intrauterine contraceptive device
Culliford AT; Harris MN; Porges RF; Berczeller PH; Amorosi EL; Grier WR
1973 Sep 15;117(2):288-290, American journal of obstetrics & gynecology
— id: 28953, year: 1973, vol: 117, page: 288, stat: Journal Article,

Total excision biopsy for primary malignant melanoma
Harris MN; Gumport SL
1973 Oct 15;226(3):354-355, JAMA
— id: 65210, year: 1973, vol: 226, page: 354, stat: Journal Article,

Ilioinguinal lymph node dissection for melanoma
Harris MN; Gumport SL; Berman IR; Bernard RW
1973 Jan;136(1):33-39, Surgery, gynecology & obstetrics
— id: 65209, year: 1973, vol: 136, page: 33, stat: Journal Article,

Axillary lymph node dissection for melanoma
Harris MN; Gumport SL; Maiwandi H
1972 Dec;135(6):936-940, Surgery, gynecology & obstetrics
— id: 65212, year: 1972, vol: 135, page: 936, stat: Journal Article,

Retrorectal epidermoid cyst: report of a case
Ranson JH; Harris MN
1969 Jan-Feb;12(1):26-29, Diseases of the colon & rectum
— id: 65214, year: 1969, vol: 12, page: 26, stat: Journal Article,

Superior mesenteric vein thrombosis complicating pancreatoduodenectomy: successful treatment by thrombectomy
Mergenthaler FW; Harris MN
1968 Jan;167(1):106-111, Annals of surgery
— id: 65213, year: 1968, vol: 167, page: 106, stat: Journal Article,

CHEMOTHERAPY WITH STREPTONIGRIN IN ADVANCED CANCER
HARRIS MN; MEDREK TJ; GOLOMB FM; GUMPORT SL; POSTEL AH; WRIGHT JC
1965 Jan;18:49-57, Cancer
— id: 65207, year: 1965, vol: 18, page: 49, stat: Journal Article,

Preliminary clinical study of mithramycin (nsc-24559) in primary tumors of the central nervous system
Ransohoff, J; Martin, B F; Medrek, T J; Harris, M N; Golomb, F M; Wright, J C
1965 Dec;49:51-57, Cancer chemotherapy report. Pt. 1
— id: 67780, year: 1965, vol: 49, page: 51, stat: Journal Article,

MASSIVE GASTROINTESTINAL HEMORRHAGE
HARRIS MN
1964 Jun;88:1049-1051, Archives of Surgery (Chicago)
— id: 65206, year: 1964, vol: 88, page: 1049, stat: Journal Article,