Citations

Abstract Introduction Synchronous carcinomas are second neoplasms that occur within 6 months of the primary lesion. After this period, they are considered metachronous neoplasms. Literature reported the incidence of synchronous and metachronous carcinoma in the oral cavity from 8% to 21% which is a poor prognostic factor with a subsequently poor overall survival rate. Case Report A 57-year-old male presented with ulcerative lesions in the oral cavity for the last 2 years. He had 25-year history of betel nut chewing. On examination, two ulcerative lesions noted in the oral cavity: on the right upper gingival area measuring approximately 1 x 1 cm with the exposed underlying bone, and another on the left lower gingival area measuring 2 x 2 cm from canine to premolar, subsequently confirmed with MRI. Biopsy confirmed squamous cell carcinoma (SCC). After discussion in the multidisciplinary meeting, he underwent right partial maxillectomy, left marginal mandibulectomy, bilateral neck dissection, and dental extractions, with uneventful post-operative recovery. Histopathology of right partial maxillectomy was moderately differentiated SCC (pT4a), Left marginal mandibulectomy; well-differentiated SCC in the canine area, as well as molar teeth area, and no involved lymph nodes (0/88). All resection margins were free of tumour. Radiotherapy was given to the right maxilla postoperatively. Conclusions To our knowledge, this is the first reported case of triple synchronous SCC oral cavity in our country. Detection of three Synchronous SCCs in the oral cavity follows the concept of field cancerization. A multidisciplinary treatment strategy in a high-volume cancer-dedicated centre is required to aggressively treat such tumours.

Maintenance therapy after autologous stem cell transplant (ASCT) in multiple myeloma (MM) is the standard treatment and recommended to be continued until disease progression. However, in the real world, patients discontinue treatment due to various reasons. We sought to determine the effect of early versus late discontinuation on survival outcomes in MM patients who underwent ASCT at The Ohio State University. We retrospectively reviewed 340 patients who underwent ASCT from 2005 to 2016 and received maintenance therapy for at least six months without progression. We compared the outcomes of patients who received maintenance for three years or less (early group) to the patients who continued maintenance beyond three years (late group). Lenalidomide (89%) and bortezomib (10%) were the most common agents used for maintenance chemotherapy. In Kaplan–Meier analysis, patients in the late group had prolonged progression-free (PFS) (p < 0.001) and overall survival (OS) (p < 0.001). The 5-year estimated OS in late group was 96% vs. 79% in the early group and 5-year PFS was 80% in late group vs. 50% in the early group. The most common reasons for discontinuation of maintenance in early group were adverse events (55.9%) and patient preference (22.5%). For the late group, it was disease progression (23.9%) and adverse events (14.3%). Fifty-five percent of patients in the late group were still on maintenance treatment at the last follow-up. Continuation of maintenance therapy was thus associated with improved outcomes, while adverse events prevented most patients from continuing treatment.

11034 Background: While resources exist to address the needs of graduate medical trainees, online resources to assist trainees with specialty-specific professional development have not been fully developed or described in the past. The Hem-Onc Fellows Network (@HemOncFellows) is an online community for hematology-oncology trainees in all stages of training, including medical students, residents, fellows, and doctoral students. The network's goals are to provide professional development in hematology-oncology, create a community and safe space for hematology-oncology trainees, and amplify the voices and needs of trainees. Methods: The @HemOncFellows Twitter account was created in February of 2021. The hashtag #HOFellows was registered and certified with healthcare Symplur. The network hosts Twitter Spaces (TS) with guests every two weeks and distributes a newsletter. Fifteen TS were held between July 2021 and February 2022. For each TS, a specific topic of professional development was discussed. At least one content expert was invited to each TS to provide additional commentary. Demographics of TS participants and newsletter subscribers were gathered and qualitative and quantitative analysis was performed. Results: Since its inception, the Hem-Onc Fellows Network has grown to more than 2200 followers. Symplur has over 500 #HOFellows tweets from November of 2021 to early February of 2022. The network organized 15 TS: 14 in professional development topics and one meet-and-greet for new matched fellows in December. TS had an average of 41 participants per event. Most participants were United States-based but there were participants from 21 countries worldwide. Forty-eight participants attended three or more spaces, including 15 hem-onc fellows and 17 internal medicine residents. The newsletter has 48 subscribers. Conclusions: We demonstrate that implementing a trainee network on Twitter attracted participation and engagement from a diverse pool of trainees worldwide. TS represents a novel educational tool for engaging trainees and facilitating professional development.