Racial differences in real-world outcomes of first-line therapies for advanced renal cell carcinoma.

Background: Given the historical underrepresentation of racial minorities in clinical trials, little is known about racial differences in outcomes of first-line therapies for advanced renal cell carcinoma (aRCC). This study described patient characteristics and clinical outcomes of first-line therapies for aRCC, including nivolumab + ipilimumab, pembrolizumab + axitinib, and tyrosine kinase inhibitors, by race in the real-world setting.

Methods: We conducted a retrospective medical chart review of patients with intermediate/poor-risk clear-cell aRCC.

Complex Nasal Reconstruction: A Methodical Approach to the Three-Stage Paramedian Forehead Flap.

Complex nasal reconstructions require adequate planning with an accurate estimation of the time necessary to perform each stage. Reconstructions of the entire nose, multiple subunits, or a substantial subunit typically require lining replacement and cartilage grafting. Securing the lining prior to a staged reconstruction is preferred, but options such as the Menick folded paramedian forehead flap (PMFF) allow for lining coverage at the time of the first stage.

Approaches to Cheek Reconstruction following Mohs Surgery.

The native features of the cheek allow for a variety of approaches when considering reconstruction following Mohs surgery. Selecting the best approach requires consideration of deficit size and location, skin laxity, surrounding anatomy, aesthetic outcomes, and specific patient factors. Reconstruction options vary based on the zone of the cheek affected, but direct closure remains the gold standard.

Facial Reconstruction: The Nuances of Managing Undesirable Results.

Given the visibility of the face and the importance of its cosmesis, undesirable results following facial reconstruction present significant challenges for both the patient and the surgeon. Intraoperative measures and postoperative management can ameliorate some unfavorable outcomes, but others may require more extensive intervention. Approaching undesirable results with a frank assessment followed by shared decision-making not only improves outcomes but is also essential for patient satisfaction.

Judging Surgical Quality in Facial Reconstruction.

Judging surgical quality within facial reconstruction is challenging for many reasons. Factors beyond the completion of surgery influence the quality of the result, demanding the surgeon to predict and mitigate potential confounders of quality. This skill is honed over years of experience and practice.