Eyelid sebaceous gland carcinoma: An assessment of the T classification of the American Joint Committee of Cancer TNM staging system 8th versus 7th edition.

PURPOSE: To assess the prognostic values of the T classification of the 8th edition of the American Joint Committee of Cancer staging system and compare it to the 7th edition. METHODS: Multicenter retrospective study of patients with eyelid sebaceous gland carcinoma. The primary outcome measure was the differences between outcomes when tumors were staged with either 7th or 8th edition. The measures evaluated included presenting features, management, histopathology, metastasis, recurrence, and mortality. RESULTS: Of the 60 patients (median age 73 years), 31 (51.7%) were females. A change in T staging occurred in 39 patients (65%) when the 8th edition was applied. Advanced categories (T3/T4) were significantly associated with nodal metastasis (p = 0.037) using the 8th edition criteria but not with the 7th edition (p = 0.066). The 8th edition T categorization significantly correlated with eye survival (p = 0.022) while the 7th edition did not (p = 0.058). Applying the 8th edition, category T4 at presentation was associated with a higher risk of nodal metastasis (p = 0.037) but not associated with local recurrence, distant metastasis, or tumor-related death (p = 0.281, p = 0.737, p = 0.319, respectively). T3/T4 category tumors were significantly associated with poor tumor differentiation (p = 0.001), and papillary histologic pattern (p = 0.024) but not with pagetoid spread (p = 0.056). CONCLUSION: The application of the 8th edition AJCC staging system for eyelid SGC may accurately predict nodal metastasis. Local recurrence and distant metastasis were not significantly associated with T classification, using either edition. Poor tumor differentiation and papillary pattern were associated with T3/T4 categories suggesting that pathological features may assist in determining prognosis.

Residents' perspectives: Does the Saudi general surgery residency training program apply CanMEDS competencies and prepare future leaders?

BACKGROUND: This study investigates leadership skills and Canadian Medical Education Directives for Specialists (CanMEDS) competencies acquisition within the General Surgery Residency Training Program (GSRTP). The Saudi Commission for Health Specialties (SCFHS) incorporates the CanMEDS Competency Framework into its curriculum to prepare the resident for healthcare needs. METHODS: This is a descriptive-analytical study. A questionnaire was used to collect data from 117 General Surgery residents (GS) at seven institutes in Jeddah, Saudi Arabia. RESULTS: The GS residents reported an acceptable self-perceived level of Clinical Leadership Skills (mean ± standard deviation). The most dominant skill was working with others (1.98 ± 1.03), followed by demonstrating personal qualities (2.07 ± 0.88), the ability to manage services (2.21 ± 1.37), improving services (2.22 ± 1.84) and last, setting directions (2.39 ± 0.95). Regarding the CanMEDS competencies, the respondents showed a generally positive perception with an "agree" level (Mean = 1.83). Of the CanMEDS competency roles, Collaborator ranked first followed by Professional and then Communicator. Leader competency ranked fourth followed by Health Advocate, Medical Expert and last, Scholar. CONCLUSION: The GSRTP residents showed satisfactory self-assessed clinical leadership skills and acquirement of the CanMEDS competencies during their training, which will prepare them to lead in the future.

CONTEXTE: Cette étude se penche sur les compétences en leadership et l'acquisition de compétences CanMEDS (Canadian Medical Education Directives for Specialists - directives canadiennes en formation médicale pour les spécialistes) au sein du GSRTP (programme de formation en résidence en chirurgie générale). La SCFHS (commission saoudienne pour les spécialistes de la santé) intègre le cadre des compétences CanMEDS dans son programme pour préparer les résidents aux besoins en matière de soins de santé. MÉTHODES: Il s'agit d'une étude descriptive et analytique. Un questionnaire a été utilisé pour collecter des données auprès de 117 résidents en chirurgie générale dans sept instituts médicaux à Djeddah, Arabie saoudite. RÉSULTATS: Les résidents en chirurgie générale ont rapporté un niveau perçu acceptable de compétences en leadership clinique (moyenne ± écart type) La compétence la plus dominante était le travail avec les autres (1,98 ± 1,03), suivi par la démonstration de qualités personnelles (2,07 ± 0,88), la capacité de gérer les services (2,1 ± 1,37), l'amélioration des services (2,22 ± 1,84) et, finalement, l'établissement des orientations (2,39 ± 0,95). En ce qui a trait aux compétences CanMEDS, les répondants ont montré une perception généralement positive avec un niveau « d'accord ¼ (moyenne = 1,83). En ce qui a trait aux rôles associés aux compétences CanMEDS, celui de collaborateur s'est classé au premier rang, suivi par celui de professionnel et ensuite de communicateur. Le rôle de chef de file s'est classée quatrième en matière de compétence, suivie de défenseur de la santé, d'expert médical et, finalement, d'érudit. CONCLUSION: Les résidents du GSRTP ont montré une satisfaction en matière de compétences de leadership clinique autoévaluées et d'acquisition des compétences CanMEDS lors de leur formation, laquelle les préparera à jouer un rôle de premier plan dans l'avenir.