Background: Recent research has shed light on the role of sarcopenia, a multifaceted condition characterized by skeletal muscle loss and dysfunction, we know that sarcopenia can lead to poor progression and overall survival in advanced solid tumours, however the role of sarcopenia in advanced melanoma is unclear. This study reviews our own population of advanced stage melanoma patients and their sarcopenia profile, how does it affect their overall survival? Methods: A retrospective cohort study of stage 2b melanoma patients and above were assessed for sarcopenia on their follow up disease monitoring CT scans and their subsequent 1,5 and 10 year survival was analysed between those with and without sarcopenia. Results: Between years 2006 and 2018, Galway University Hospital managed 150 patients with melanoma classified at stage 2B or above. The average age was 62.5years (range 19-96years), with n=73 females and n=77 males included. 114 patients (76%) had evidence of sarcopenia in the population cohort (80% (n=61) of males and 77% (n=56) females). At time of data retrieval 65% (n=97) of the patient group had died. Less than '1 year survival' was found in 13% (n=20)(n=9 females v n=11 males), '2-5 year survival' only was found in 43% of this patient group (n=29 females v n=36 males) and 39% (n=58)(n=34 females v n=24males) had over ten year survival with 4% lost to follow up (n=7, n=1 female, n=6 males). In the 1,5 and 10 year survival groups we found that 95% (n=19), 76% (n=50) and 67% (n=39) had evidence of sarcopenia respectively. Conclusions: Sarcopenia has been linked to poorer response rates to immunotherapy and targeted therapies, suggesting its potential role as a predictive biomarker in treatment selection. Our results demonstrate that sarcopenia is a poor prognostic indicator for survival in advanced melanoma, with the rate of sarcopenia decreasing in those who survived for 10 years or longer. We therefore propose and highlight the importance of comprehensive assessment tools for sarcopenia in the context of melanoma. To conclude, we emphasize the emerging significance of sarcopenia in melanoma, highlighting its potential as a novel prognostic factor and therapeutic target. Understanding the complex relationship between sarcopenia and melanoma may lead to the development of personalized treatment strategies aimed at mitigating muscle loss, improving treatment outcomes, and enhancing the quality of life for patients with melanoma

The Bosniak classification is a CT classification which stratifies renal cysts based on imaging appearances and therefore associated risk of malignancy. Bosniak IIf cysts are renal which have complex features and therefore require surveillance. The aim of this study is to assess the economic and workload burden of diagnosing and following up Bosniak IIf cysts on the urology service in a tertiary hospital in the West of Ireland. All patients with a diagnosis of Bosniak IIf renal cysts attending our urology service between 1st of January 2012 and 31st December 2020 were analysed. The following data were collected: number and modality of follow up scans, number of MDT discussions, number and type of outpatient appointments, surgical intervention, and length of follow up. Financial data were provided by the hospital finance department. One hundred and sixty-two patients were included. Total cost of follow up was €164,056, costing €1,012.7 per patient. Cost of outpatient visits was €77,850. Follow-up length ranged from 1 to 109 months, median follow up time 17.5 months. Overall cost of imaging was €74,518. There were a total of 80 MDT discussions at an overall cost of €11,688. This study demonstrates that surveillance of patients with Bosniak IIf renal cysts represents a significant burden upon both radiology and urology services. Surveillance for these patients could be streamlined in the future through a number of initiatives such as virtual OPDs and dedicated MDTs.