IMPORTANCEThe association and interaction of host characteristics with prognosis in patients with oral cavity squamous cell carcinoma (OSCC) are poorly understood. There is increasing evidence that host characteristics are associated with treatment outcomes of many cancers.OBJECTIVES To examine the host factors associated with prognosis in patients with OSCC and their interactions to create a numerical index that quantifies the prognostic capacity of these host characteristics.

Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles’ heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Despite a successful embolectomy at the local hospital, there was re-occlusion of the axillary artery and the limb became ischaemic. He was referred to our institution by which time the limb became gangrenous above the elbow and had to be amputated. Extensive sloughing of the nerves was also seen in the local area. Hypercoagulability presenting with various manifestations is common in COVID-19 and needs early anticoagulation. We present this asymptomatic patient who lost a limb to this COVID-19 sequelae.

Background and Objective: Nodal metastasis is one of the strongest predictors of outcomes in oral cavity squamous cell carcinomas (OSCC). The aim was to analyze the interplay of nodal characteristics in OSCC prognosis. Methods: In this retrospective cohort study we included OSCC patients treated with primary surgery including neck dissection between 2005 and 2015 (n = 619). Diseasespecific survival (DSS) was the primary endpoint. Optimal cutoffs were identified using recursive-partitioning analysis (RPA). A novel characteristic-metastatic focusto-lymph node size ratio (MLR)-was introduced. We compared the American Joint Committee on Cancer, Eighth Edition (AJCC8) pN categories to a new categorization. Results: Patients with higher neutrophil-to-lymphocyte ratio had more adverse nodal characteristics. All nodal characteristics were significant predictors of DSS in univariable analysis. In multivariable analysis, only number of positive nodes and MLR remained significant. An RPA including all nodal covariates confirmed the results. Compared with AJCC8, our RPA categorization had better hazard discrimination (0.681 vs. 0.598), but poorer balance value (0.783 vs. 0.708). Conclusion: Patients with higher neutrophil-to-lymphocyte ratio had more adverse nodal characteristics. Total number of metastatic lymph nodes is the strongest predictor of outcomes in OSCC. MLR is a more powerful predictor than metastatic lymph node size or metastatic focus size alone.

e18755 Background: The 2016 21st Century Cures Act supports the use of Real-World Data (RWD) for regulatory decision/approval. Due to technological advances, a vast amount of health-related data are now available, but most are not standardized nor readily useable for research. Also, currently available standardized RWD models are not applicable across cancer types or oncology specialties (surgery, medical oncology, radiation oncology, pathology, radiology, etc.). To address these deficiencies Memorial Sloan Kettering Cancer Center (MSKCC) built a comprehensive, pan-cancer, pan-specialty RWD model. Methods: The Core Clinical Data Element (CCDE) data model incorporates aspects of existing academic and biopharma data models, including PRISSMM framework, ASCO’s mCODE, and NAACCR tumor registry model. The data model encompasses 11 domains that are critical to the understanding of the patient’s cancer journey, including: demographic, comorbidities, diagnosis, pathology, imaging, genomics, cancer surgeries, radiation oncology treatments, medical oncology treatments, cancer status/progression, and additional health information. To align with current standards, we are using ICD-10, ICDO3, CTACE V5.0, HL7, SNOMED and LOINC code sets. Further, this adaptable model allows for 5-10 disease specific elements to accommodate for disease heterogenicity and capture the differences among cancer types. Results: The CCDE database includes 1,126 of total data elements. MSKCC has 52,704 patients with MSK-IMPACT (Next-Generation sequencing platform with 505 genes panel) testing of which, we have identified 1,132 bladder cancer patients with at-least one year of cancer care follow-up for the initial curation cohort. Patients were identified as having an OncoTree bladder tumor type code that is assigned by a pathologist who attests the diagnosis by reviewing results from clinical tests on tumor specimens. To the date, 641 patients including 46,415 curated forms have been curated (Table). Conclusions: The comprehensive MSKCC’s CCDE data model standardizes the common and critical pan-cancer and pan-specialty elements for RWD. The dataset resulting from this curation efforts will provide robust structured and unified genomic and phenomic data across tumor types for future research enabling greater collaboration across various cancer types as well as oncology specialties.[Table: see text]

Necrotising fasciitis (NF) is a rapidly progressive severe soft tissue infection of the deep fascia resulting in the destruction of overlying subcutaneous tissue and skin. We report the case of NF of the lower limb with a poor prognosis due to multidrug-resistant (MDR) Klebsiella pneumoniae (K.pneumoniae) sensitive only to colistin. In view of the worsening condition of the wound, risk of deterioration of renal function and economic constraints, it was decided to start on colistin therapy locally by colistimethate sodium (CMS). The patient responded well to the treatment and got clinically better. Subsequent culture sent for post-treatment showed no growth of the organism. The wound healed with regular dressings by 8 weeks. This was found to be a very cost-effective treatment modality. Local use of CMS was found to be a novel method of achieving infection-free wound especially against MDR K.pneumoniae.