Individualized Prediction for Risk of Recurrence in Stage I/II Melanoma Patients With Negative Sentinel Lymph Node.

Background: Despite the favorable prognosis of AJCC stage I/II melanoma patients, up to 20%-30% will develop metastases. Our objective is to predict long-term risk (probability) of recurrence in early-stage melanoma patients.

Methods: A Risk Score to predict long-term recurrence was developed using Cox regression based on 2668 patients.

Propensity scores used as overlap weights provide exact covariate balance.

Overlap weighting, using weights defined as the probability of receiving the opposite treatment, is a relatively new, alternative propensity score-based weighting technique used to adjust for confounding when estimating causal treatment effects. It has preferable properties compared to inverse probability of treatment weighting, such as exact covariate balance, safeguards against extreme weights and emphasis on medical equipoise, where treatment decisions are most uncertain. In this article, we introduce the overlap weighting methodology, compare it to inverse probability of treatment weighting and provide some strategies for assessing weighting impact, through an applied example of hospital mortality.

A simplified pneumonia severity index (PSI) for clinical outcome prediction in COVID-19.

Background: The Pneumonia Score Index (PSI) was developed to estimate the risk of dying within 30 days of presentation for community-acquired pneumonia patients and is a strong predictor of 30-day mortality after COVID-19. However, three of its required 20 variables (skilled nursing home, altered mental status and pleural effusion) are not discreetly available in the electronic medical record (EMR), resulting in manual chart review for these 3 factors. The goal of this study is to compare a simplified 17-factor version (PSI-17) to the original (denoted PSI-20) in terms of prediction of 30-day mortality in COVID-19.

Characterization of Lymph Node Tumor Burden in Node-Positive Prostate Cancer Patients after Robotic-Assisted Radical Prostatectomy with Extended Pelvic Lymph Node Dissection.

Background: Prostate cancer (PCa) nodal staging does not account for lymph node (LN) tumor burden. The LN anatomical compartment involved with the tumor or the quantified extent of extranodal extension (ENE) have not yet been studied in relation to biochemical recurrence-free survival (BRFS).

Methods: Histopathological slides of 66 pN1 PCa patients who underwent extended pelvic lymph node dissection were reviewed.

Impact of Adherence to Operative Standards and Stage-Specific Guideline-Recommended Therapy in Nonmetastatic Pancreatic Adenocarcinoma.

Background: Achieving optimal surgical outcomes in pancreatic adenocarcinoma requires a combination of both curative-intent resection to oncologic standards and stage-specific neoadjuvant or adjuvant therapy. This investigation sought to examine factors associated with receipt of standard-adherent surgery (SAS) and guideline-recommended therapy (GRT) and determine the impact of compliance on patient survival.

Patients And Methods: From the 2006-2016 National Cancer Database, 21,304 patients underwent resection for nonmetastatic pancreatic adenocarcinoma.