IMPORTANCE Melanoma in situ (MIS) is increasing in incidence, and expert consensus opinion recommends surgical excision for therapeutic management. Currently, wide local excision (WLE) is the standard of care. However, Mohs micrographic surgery (MMS) is now used to treat a growing subset of individuals with MIS. During MMS, unlike WLE, the entire cutaneous surgical margin is evaluated intraoperatively for tumor cells.OBJECTIVE To assess the outcomes of patients with MIS treated with MMS compared with those treated with WLE. DESIGN, SETTING, AND PARTICIPANTS Retrospective review of a prospective database. The study cohort consisted of 662 patients with MIS treated with MMS or WLE per standard of care in dermatology and surgery (general surgery, otolaryngology, plastics, oculoplastics, surgical oncology) at an academic tertiary care referral center from January 1, 1978, to December 31, 2013, with follow-up through 2015. EXPOSURE Mohs micrographic surgery or WLE. MAIN OUTCOMES AND MEASURES Recurrence, overall survival, and melanoma-specific survival. RESULTS There were 277 patients treated with MMS (mean [SD] age, 64.0 [13.1] years; 62.1% male) and 385 treated with WLE (mean [SD] age, 58.5 [15.6] years; P < .001 for age; 54.8% male). Median follow-up was 8.6 (range, 0.2-37) years. Compared with WLE, MMS was used more frequently on the face (222 [80.2%] vs 141 [36.7%]) and scalp and neck (23 [8.3%] vs 26 [6.8%]; P < .001). The median (range) year of diagnosis was 2008 for the MMS group vs 2003MMS group vs (1978MMS group vs -2013 for the WLE group (P < .001). Overall recurrence rates were 5 (1.8%) in the MMS group and 22 (5.7%) in the WLE group (P = .07). Mean (SD) time to recurrence after MMS was 3.91 (4.4) years, and after WLE, 4.45 (2.7) years (P = .73). The 5-year recurrence rate was 1.1% in the MMS group and 4.1% in the WLE group (P = .07). For WLE-treated tumors, the surgical margin taken was greater for tumors that recurred compared with tumors that did not recur (P = .003). Five-year overall survival for MMS was 92% and for WLE was 94% (P = .28). Melanoma-specific mortality for the MMS group was 2 vs 13 patients for the WLE group, with mean (SD) survival of 6.5 (4.8) and 6.1 (0.8) years, respectively (P = .77).CONCLUSIONS AND RELEVANCE No significant differences were found in the recurrence rate, overall survival, or melanoma-specific survival of patients with MIS treated with MMS compared with WLE.

The incidence and patient survival rates of melanoma have increased over the last several decades, with a growing population of patients who develop multiple primary melanomas (MPMs). To determine risk factors for developing MPMs and compare the survival of patients with MPMs to those with single primary melanomas, a prospective, multidisciplinary database of patients with melanoma at a single tertiary care institution was retrospectively reviewed. From 1985 to 2013, 6,963 patients with single primary melanomas and 305 patients with MPMs were identified. Mean follow-up was 8.3 ± 6.3 years for patients with single primary melanomas and 8.8 ± 5.9 years for patients with MPMs. Risk of developing multiple melanomas increased with age at diagnosis of first melanoma (hazard ratio [HR] = 1.20 for a 10-year increase in age, 95% confidence interval [CI] = 1.11-1.29, P < 0.001), male sex (HR = 1.44, 95% CI = 1.12-1.84, P = 0.005), and white race (HR = 3.07, 95% CI = 1.45-6.51). Patients with invasive MPMs had increased risk of melanoma-specific death both before (HR = 1.47, 95% CI = 1.0-2.2) and after adjusting for age, sex, site, race, family history of melanoma, personal history of other cancer, and Surveillance, Epidemiology, and End Results Program (SEER) stage (HR = 1.44, 95% CI = 0.95-2.2); however, this result did not reach statistical significance.

The objective of this work was to evaluate the productive performance and physicochemical characteristics of the Isabel Precoce, BRS Carmem, BRS Cora, and IAC 138-22 Máximo grape (Vitis labrusca) cultivars for juice grafted onto the 'IAC 572 Jales' and 'IAC 766 Campinas' rootstocks. A randomized complete block design, in a 4×2 factorial arrangement, was used. Productive performance was evaluated through: production per plant; yield; number of clusters per vine; and physical characteristics of clusters, berries, and rachis. The physicochemical characteristics of must composition were also determined through the content of soluble solids, reducing sugars, titratable acidity, maturity index, and pH. Since there was no significant interaction between cultivars and rootstocks for most of the evaluated characteristics, each factor was analyzed separately. The 'IAC 766 Campinas' rootstock provided a higher yield and more suitable physicochemical characteristics for the four cultivars. However, regardless of the rootstock used, cultivars BRS Carmem, IAC 138-22 Máximo, and Isabel Precoce were more productive than BRS Cora.

Abstract. The objective of this work was to evaluate five varieties of white grapes destined to winemaking, grafted on the two main rootstocks used in viticulture in São Paulo, Brazil, 'IAC 766 Campinas' and 'IAC 572 Jales'. The experiment was performed on the experimental area of Centro APTA de Frutas in the Jundiaí city, São Paulo state, Brazil. The experimental design was a randomized block with split plot with five replications, the plots represented by varieties and subplots by rootstocks. We evaluated the number of days to budding (NDB), number of days to flowering (NDF) and number of days to maturation (NDM), productivity (Prod) (ton.ha −1 ), content of soluble solids (SS), titratable acidity (TA) and maturation index (MI). There was no difference between rootstocks, and there was interaction among rootstocks and varieties for SS and TA. The varieties did not show significant differences for yield, but there was a significant difference for the other variables. We can concluded that among the assessed varieties on both rootstocks, in Jundiaí / SP, the variety SR 501-17 distinguished itself due to its precocity, productivity and chemical quality of the must.

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