Papers by Brendon Coventry
Annals of Surgical Oncology, Dec 20, 2019
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IEEE Access, 2019
C-reactive protein (CRP) is a biomarker of inflammation and is widely considered as an indicator ... more C-reactive protein (CRP) is a biomarker of inflammation and is widely considered as an indicator of cancer prognosis, risk, and recurrence in clinical experiments. Investigating the properties and behaviors of CRP time series has recently emerged as an area of significant interest in informing clinical decision making. The area of cancer immunotherapy is a key application where CRP forecasting is critically needed. Therefore, predicting the future values of a CRP time series can provide useful information for clinical purposes. In this paper, we focus on CRP time series forecasting, comparing autoregressive integrated moving average (ARIMA) modeling with deep learning. The CRP data are obtained from 24 patients with melanoma. This paper using CRP data indicates that deep learning provides significantly reduced prediction error compared to ARIMA modeling.
Clinical Nuclear Medicine, May 1, 2002
A 65-year-old man with several subcutaneous masses (clinically diagnosed as lipomata), underwent ... more A 65-year-old man with several subcutaneous masses (clinically diagnosed as lipomata), underwent Tc-99m tetrofosmin scanning for chest pain. One of these masses (in the right thigh) was incidentally noted to take up tetrofosmin. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a fat-containing lesion, and F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET or C-PET) showed active uptake. Biopsy showed the lesion to be a hibemoma. Hibemoma is a benign but metabolically active tumor of brown fat origin. Brown fat is a major heat producer in the newborn and contains high levels of mitochondria. This high metabolic rate probably explains the uptake of Tc-99m tetrofosmin and F-18 FDG. Nevertheless, without a biopsy, the imaging studies could not exclude liposarcoma.Barry E. Chatterton, Dominic Mensforth, Brendon J. Coventry and Penelope Cohenhttp://cat.inist.fr/?aModele=afficheN&cpsidt=13638310http://journals.lww.com/nuclearmed/Citation/2002/05000/Hibernoma__Intense_Uptake_Seen_on_Tc_99m.16.asp
European Journal of Cancer, Jul 1, 2022
Purpose: Guidelines addressing melanoma in-transit metastasis (ITM) recommend immune checkpoint i... more Purpose: Guidelines addressing melanoma in-transit metastasis (ITM) recommend immune checkpoint inhibitors (ICI) as a first-line treatment option, despite the fact that there are no efficacy data available from prospective trials for exclusively ITM disease. The study aims to analyze the outcome of patients with ITM treated with ICI based on data from a large cohort of patients treated at international referral clinics. Methods: A multicenter retrospective cohort study of patients treated between January 2015 and December 2020 from Australia, Europe, and the USA, evaluating treatment with ICI for ITM with or without nodal involvement (AJCC8 N1c, N2c, and N3c) and without distant disease (M0). Treatment was with PD-1 inhibitor (nivolumab or pembrolizumab) and/or CTLA-4 inhibitor (ipilimumab). The response was evaluated according to the RECIST criteria modified for cutaneous lesions. Results: A total of 287 patients from 21 institutions in eight countries were included. Immunotherapy was first-line treatment in 64 (22%) patients. PD-1 or CTLA-4 inhibitor monotherapy was given in 233 (81%) and 23 (8%) patients, respectively, while 31 (11%) received both in combination. The overall response rate was 56%, complete response (CR) rate was 36%, and progressive disease (PD) rate was 32%. Median PFS was ten months (95% CI 7.4-12.6 months) with a one-, two-, and five-year PFS rate of 48%, 33%, and 18%, respectively. Median MSS was not reached, and the one-, two-, and five-year MSS rates were 95%, 83%, and 71%, respectively. Conclusion: Systemic immunotherapy is an effective treatment for melanoma ITM. Future studies should evaluate the role of systemic immunotherapy in the context of multimodality therapy, including locoregional treatments such as surgery, intralesional therapy, and regional therapies.
The Breast, Aug 1, 1997
A prospective study was undertaken to locate sentinel nodes (SN) (first draining LN) using lympho... more A prospective study was undertaken to locate sentinel nodes (SN) (first draining LN) using lymphoscintigraphy (LS) and peritumoural blue dye (BD) injection at surgery in patients with breast carcinoma, and determine the accuracy of SN status in staging the axilla. 36 female patients with breast carcinoma underwent LS using yymTc labelled antimony sulphide colloid (99mTc-Sb2S3) prior to surgery. The radionuclide was injected at the tumour margin. A skin marking overlying the SN was made. The BD technique was replaced by intraoperative gamma probe for intraoperative SN localisation. The SN was resected and pathological assessment of the SN obtained. Axillary SN were identified in 30/36 (83%) of patients. The SN status predicted the axillary LN status in 28/30 (93%). There were 2 false negative cases (false negative-8.3%). Our results suggest that LS, BD and intraoperative gamma probe allow localisation of SN. The SN status is a good predictor of the axillary LN status.
The Medical Journal of Australia, Mar 1, 2005
British Journal of Cancer, Feb 1, 2002
Low CD1a-positive putative dendritic cell numbers in human breast cancer has recently been descri... more Low CD1a-positive putative dendritic cell numbers in human breast cancer has recently been described and may explain the apparent 'poor immunogenicity' previously reported in breast cancer. Little attention has been given to dendritic cell activation within the tumour microenvironment, which is another reason why the in-situ immune response may be severely deficient. We have therefore examined CD1a expression as a marker for dendritic cells, together with CMRF-44 and-56 as markers of dendritic cell activation status, in 40 human breast cancers. The results demonstrate few or no CD1a-positive putative dendritic cells and minimal or no expression of the dendritic cell activation markers. Both dendritic cell number and dendritic cell activation appear substantially deficient in human breast cancers, regardless of tumour histological grade.
Cancers, Feb 10, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
AIMS Public Health
Current public health advice is that high ultraviolet radiation (UVR) exposure is the primary cau... more Current public health advice is that high ultraviolet radiation (UVR) exposure is the primary cause of Malignant Melanoma of skin (CMM), however, despite the use of sun-blocking products incidence of melanoma is increasing. To investigate the UVR influence on CMM incidence worldwide WHO, United Nations, World Bank databases and literature provided 182 country-specific melanoma incidence estimates, daily UVR levels, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation (blonde hair colour), for parametric and non-parametric correlations, multivariate regressions and analyses of variance. Worldwide, UVR levels showed negative correlation with melanoma incidence (“rho” = −0.515, p < 0.001), remaining significant and negative in parametric partial correlation (r = −0.513, p < 0.001) with other variables kept constant. After standardising melanoma incidence f...
The Lancet
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p<0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p<0•0001), MIC (2•8 [2•0-3•7]; p<0•0001), and LIC (3•8 [1•3-6•7%]; p<0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.
European Journal of Surgical Oncology
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Annals of Surgical Oncology, 2020
Background. Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-do... more Background. Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-dose chemotherapy to extremities affected by locally advanced or in-transit melanoma. This study compared the outcomes of melanoma patients treated with ILI in the United States of America (USA) and Australia (AUS). Methods. Patients with locally recurrent in-transit melanoma treated with ILI at USA or AUS centers between 1992 and 2018 were identified. Demographic and clinicopathologic characteristics were collected. Primary outcomes of treatment response, in-field progression-free survival (IPFS), distant progression-free survival (DPFS), and overall survival (OS) were evaluated by the Kaplan-Meier method. Multivariable analysis evaluated whether availability of new systemic therapies affected outcomes. Results. More ILIs were performed in AUS (n = 411, 60 %) than in the USA (n = 276, 40 %). In AUS, more ILIs were performed for stage 3B disease than in the USA (62 % vs 46 %; p \ 0.001). The reported complete response rates were similar (AUS 30 % vs USA 29 %). Among the stage 3B patients, AUS patients had better IPFS (p = 0.001), whereas DPFS and OS were similar between the two countries. Among the stage 3C patients, the USA
Improvement of adenoviral vector-mediated gene transfer to airway epithelia by folate-modified an... more Improvement of adenoviral vector-mediated gene transfer to airway epithelia by folate-modified anionic liposomes
Annals of Surgical Oncology, 2019
Anaesthesia, 2021
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
Anaesthesia, 2021
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
European Journal of Surgical Oncology, 2020
55 patients with residual melanoma at histology and group B: 874 patients without residual melano... more 55 patients with residual melanoma at histology and group B: 874 patients without residual melanoma. Breslow, positive SLN and localization of the tumour were compared in both groups. Mann-Whitney U-Test and Xsquare Test were used. Results: In group A, the mean Breslow was 2.97 mm compared to 2,18 mm in group B (p ¼ 0.004). In group A 41% of patient had positives sentinel lymph nodes compared to 26% in group B (p ¼ 0.013). There was no difference for localization regarding upper or lower limbs. Trunk lesions were observed in 34 % of patients in group A compared to 45% in group B. In group A, 45% of patients had an ulcerated tumour versus 39% in group B p ¼ 0.67). Furthermore, 19/55 patients in group A had a distant recurrence until December 2018. Conclusions: Breslow index and positives SLN are linked with residual melanoma. As no clear risk factor allows to anticipate residual disease, safety margins are mandatory. Based on the present results, residual disease in the scar of the primary may be a risk factor for recurrence. Further evaluation should state if residual disease could be an indication for new therapies (immunotherapy), similar to patients with stage III (positive SLN).
Annals of Surgical Oncology, 2019
Purpose. Prospective data are lacking on long-term morbidity of inguinal lymphadenectomy includin... more Purpose. Prospective data are lacking on long-term morbidity of inguinal lymphadenectomy including the influence of extent of surgery, use of radiotherapy, and patient factors. The aim of this study is to evaluate the effects of these factors on patient outcome, quality of life (QOL), regional symptoms, and limb volumes after inguinal or ilio-inguinal lymphadenectomy for melanoma. Methods. Analysis of the subgroup of patients with inguinal lymph node field relapse of melanoma, treated by inguinal or ilio-inguinal lymphadenectomy in the ANZMTG/TROG randomized trial of adjuvant radiotherapy versus observation. Results. Sixty-nine patients, 46 having undergone inguinal and 23 ilio-inguinal lymphadenectomy, with median follow-up of 73 months were analyzed. Mean limb volume Electronic supplementary material The online version of this article (
Annals of Surgical Oncology, 2019
Background. Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-do... more Background. Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-dose regional chemotherapy to patients with locally advanced or intransit melanoma located on a limb. The current international multicenter study evaluated the perioperative and long-term oncologic outcomes for patients who underwent ILI for stage 3B or 3C melanoma. Methods. Patients undergoing a first-time ILI for stage 3B or 3C melanoma (American Joint Committee on Cancer [AJCC] 7th ed) between 1992 and 2018 at five Australian and four United States of America (USA) tertiary referral centers were identified. The primary outcome measures included treatment response, in-field (IPFS) and distant progression-free survival (DPFS), and overall survival (OS). Results. A total of 687 first-time ILIs were performed (stage 3B: n = 383, 56%; stage 3C; n = 304, 44%). Significant limb toxicity (Wieberdink grade 4) developed in 27 patients (3.9%). No amputations (grade 5) were performed. The overall response rate was 64.1% (complete response [CR], 28.9%; partial response [PR], 35.2%). Stable disease (SD) occurred in 14.5% and progressive disease (PD) in 19.8% of the patients. The median follow-up period was 47 months, with a median OS of 38.2 months. When stratified by response, the patients with a CR or PR had a significantly longer median IPFS (21.9 vs 3.0 months; p \ 0.0001), DPFS (53.6 vs 12.7 months; p \ 0.0001), and OS (46.5 vs 24.4 months; p \ 0.0001) than the nonresponders (SD ? PD). Conclusion. This study is the largest to date reporting long-term outcomes of ILI for locoregionally metastatic melanoma. The findings demonstrate that ILI is effective John T. Miura and Hidde M. Kroon contributed equally to this paper.
Journal of Clinical Oncology, 2014
9027 Background: The safety and efficacy of intralesional (IL) treatment of refractory cutaneous ... more 9027 Background: The safety and efficacy of intralesional (IL) treatment of refractory cutaneous melanoma with rose bengal disodium (PV-10) was evaluated in an 80 patient international, multicenter...
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Papers by Brendon Coventry