Background Adult cancer patients are at higher risk of morbidity and mortality following COVID-19 infection. Being on the front lines, it is crucial for emergency physicians to identify those who are at higher risk of mortality. The aim of our study was to determine the predictors of in-hospital mortality in COVID-19 positive cancer patients who present to the emergency department. Methods This is a retrospective cohort study conducted on adult cancer patients who presented to the ED of the American university of Beirut medical center from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data was extracted and analyzed. The association between different variables and in-hospital mortality was tested using Student’s t test and Fisher’s exact test or Pearson’s Chi-square where appropriate. Logistic regression was applied to factors with p <0.2 in the univariate models. Results The study included 89 distinct patients with an average age of 66 years (± 13.6). More than half of them were smokers (52.8%) and had received chemotherapy within 1 month of presentation (52.8%). About one third of the patients died (n = 31, 34.8%). Mortality was significantly higher in patients who had recently received chemotherapy (67.7% vs 44.8%, p = .039), a history of congestive heart failure (CHF)(p = .04), higher levels of CRP (p = 0.048) and/or PCT(p<0.04) or were tachypneic in the ED (P = 0.016). Conclusions Adult cancer patients with COVID-19 infection are at higher risks of mortality if they presented with tachypnea, had a recent chemotherapy, history of CHF, high CRP, and high procalcitonin levels at presentation.

Purpose The ACOSOG-Z0011 clinical trial introduced drastic changes to the traditional surgical practice for early breast cancer with positive sentinel lymph nodes. This study evaluates how these changes have affected the surgical management of early breast cancer at our institution. Methods A retrospective chart review was conducted for Lebanese women with a diagnosis of invasive breast cancer and who were ≥18 years of age, had undergone upfront breast-conserving surgery, and SLNB without any prior chemotherapy had no distant metastasis and had one or more positive SLNs, between 2011 and 2016. Results Data from our cohort shows that 78% of patients out of the 233 with clinically negative nodes go on to have negative nodes on surgical sentinel pathology as well. However, the incidence of micromets is 5.5% amongst positive SLNs versus 94% of positive SLNs having macromets. Survival data analysis showed a 5-year and 10-year locoregional recurrence rates of 1.72% and 2.15%, respectively. At 3-years follow-up, distant metastasis occurred in 3.4% of cases. Additionally, the 10-year overall survival is 98.7% and disease-free survival is 95.3%. The rates of ALND decreased from 46.7% to 18.2% in patients with 2 or less positive sentinel nodes between the two time periods 2011-2013 and 2014-2016. Conclusion With a follow-up period extending more than five years, our study shows that ALND offers no superiority to SLNB alone in terms of overall survival and disease-free survival. This does not only conform with the findings of Z0011 but adds to its generalizability to populations of different ethnicities.