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Objectives: The incidence of young‐onset oral squamous cell carcinoma (OSCC) is growing, even among non‐smokers/drinkers. The effects of adverse histopathological features on long‐term oncologic outcomes between the young and old are controversial and confounded by significant heterogeneity. Few studies have evaluated the socio‐economic impact of premature mortality from OSCC. Our study seeks to quantify these differences and their economic impact on society. Materials and Methods: Four hundred and seventy‐eight young (<45 years) and 1660 old patients (≥45 years) with OSCC were studied. Logistic regression determined predictors of recurrence and death. Survival analysis was calculated via the Kaplan–Meier method. A separate health economic analysis was conducted for India and Singapore. Years of Potential Productive Life Lost (YPPLL) were estimated with the Human Capital Approach, and premature mortality cost was derived using population‐level data. Results: Adverse histopathological features were seen more frequently in young OSCC: PNI (42.9% vs. 35%, p = 0.002), LVI (22.4% vs. 17.3%, p = 0.013) and ENE (36% vs. 24.5%, p < 0.001). Although 5‐year OS/DSS were similar, the young cohort had received more intensive adjuvant therapy (CCRT 26.9% vs. 16.6%, p < 0.001). Among Singaporean males, the premature mortality cost per death was US $396,528, and per YPPLL was US $45,486. This was US $397,402 and US $38,458 for females. Among Indian males, the premature mortality cost per death was US $30,641, and per YPPLL was US $595. This was US $ 21,038 and US $305 for females. Conclusion: Young‐onset OSCC is an aggressive disease, mitigated by the ability to receive intensive adjuvant treatment. From our loss of productivity analysis, the socio‐economic costs from premature mortality are substantial. Early cancer screening and educational outreach campaigns should be tailored to this cohort. Alongside, more funding should be diverted to genetic research, developing novel biomarkers and improving the efficacy of adjuvant treatment in OSCC. [ABSTRACT FROM AUTHOR]

Background: Despite revised staging criteria, stratification of patients with advanced oral squamous cell carcinoma (OSCC) remains difficult. Well‐established features like perineural invasion (PNI), differentiation, and lymphovascular‐invasion (LVI) are controversial, and hence omitted from staging. We endeavor to better stratify this cohort by identifying predictors of survival in advanced OSCC (T3‐4). Methods: Seven hundred and forty‐two patients with T3‐4 OSCC underwent surgery from 2006 to 2013. Cox regression was performed to determine predictors of overall survival (OS). Results: OS was adversely impacted by PNI (p = 0.046), LVI (p = 0.038), moderate/poor differentiation (p = 0.001), close/involved surgical margins (p = 0.002), pT (p = 0.034), and pN (p < 0.001). The cumulative number of adverse histopathological features predicted poorer OS; HR 2.64 (CI 1.42–4.90) for one adverse feature and HR 4.23 (CI 2.34–7.67) for ≥2. Conclusion: In advanced OSCC, stratification with histopathologic risk factors can predict survival even in maximally treated patients; adjuvant therapies are unable to entirely mitigate this risk. Incorporation of adverse features into future editions of TNM can improve precision in staging and identify candidates for treatment escalation. [ABSTRACT FROM AUTHOR]

Background and Study Objective: The COVID-19 pandemic has forced assisted living facilities (ALF) to implement strict social isolation for residents. Social isolation in the geriatric population is known to negatively impact health. Here, we describe how ALFs in Rhode Island utilized device donations received from Connect for COVID-19, a nationwide nonprofit organization which has mobilized medical students to gather devices for donations to care centers., Methods: Rhode Island ALFs were contacted to determine if they were interested in receiving smart device donations. After donations were made, an impact survey was electronically administered. Primary Results: A total of 11 facilities completed the survey with a response rate of 24% (11/46). The facilities were located throughout all five counties in Rhode Island, with the majority located in Providence County. All but one of the facilities that responded to the survey (n=10, 90.9%) have used the devices to allow residents to video-call their family members. Seven responses (63.6%) indicated that devices were used for more than one purpose. Primary Conclusions: Smart devices were well received by Rhode Island ALFs and used for purposes beyond video conference calls. ALFs should consider advertising the need for devices to encourage community donations. Future studies should investigate the direct impact that digital connectivity has had on Rhode Island ALF residents.

Aim: To evaluate the long-term clinical and oncological outcomes of laparoscopic rectal resection (LRR) and the impact of conversion in patients with rectal cancer., Methods: An analysis was performed on a prospective database of 633 consecutive patients with rectal cancer who underwent surgical resection. Patients were compared in three groups: Open surgery (OP), laparoscopic surgery, and converted laparoscopic surgery. Short-term outcomes, long-term outcomes, and survival analysis were compared., Results: Among 633 patients studied, 200 patients had successful laparoscopic resections with a conversion rate of 11.1% (25 out of 225). Factors predictive of survival on univariate analysis include the laparoscopic approach (P = 0.016), together with factors such as age, ASA status, stage of disease, tumor grade, presence of perineural invasion and vascular emboli, circumferential resection margin < 2 mm, and postoperative adjuvant chemotherapy. The survival benefit of laparoscopic surgery was no longer significant on multivariate analysis (P = 0.148). Neither 5-year overall survival (70.5% vs 61.8%, P = 0.217) nor 5-year cancer free survival (64.3% vs 66.6%, P = 0.854) were significantly different between the laparoscopic group and the converted group., Conclusion: LRR has equivalent long-term oncologic outcomes when compared to OP. Laparoscopic conversion does not confer a worse prognosis.