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https://www.readbyqxmd.com/read/28497252/gallbladder-cancer-presenting-with-jaundice-uniformly-fatal-or-still-potentially-curable
#1
Thuy B Tran, Jeffrey A Norton, Cecilia G Ethun, Timothy M Pawlik, Stefan Buettner, Carl Schmidt, Eliza W Beal, William G Hawkins, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Kamran Idrees, Chelsea A Isom, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, George A Poultsides
BACKGROUND: Jaundice as a presenting symptom of gallbladder cancer has traditionally been considered to be a sign of advanced disease, inoperability, and poor outcome. However, recent studies have demonstrated that a small subset of these patients can undergo resection with curative intent. METHODS: Patients with gallbladder cancer managed surgically from 2000 to 2014 in 10 US academic institutions were stratified based on the presence of jaundice at presentation (defined as bilirubin ≥4 mg/ml or requiring preoperative biliary drainage)...
May 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28230242/routine-port-site-excision-in-incidentally-discovered-gallbladder-cancer-is-not-associated-with-improved-survival-a-multi-institution-analysis-from-the-us-extrahepatic-biliary-malignancy-consortium
#2
Cecilia G Ethun, Lauren M Postlewait, Nina Le, Timothy M Pawlik, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Kenneth Cardona, Shishir K Maithel
BACKGROUND: Current data on the utility of port-site excision (PSE) during re-resection for incidentally discovered gallbladder cancer (IGBC) in the US are conflicting and limited to single-institution series. METHODS: All patients with IGBC who underwent curative re-resection at 10 institutions from 2000 to 2015 were included. Patients with and without PSE were compared. Primary outcome was overall survival (OS). RESULTS: Of 449 pts with GBC, 266 were incidentally discovered, of which 193(73%) underwent curative re-resection and had port-site data; 47 pts(24%) underwent PSE, 146(76%) did not...
February 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28017812/distal-cholangiocarcinoma-and-pancreas-adenocarcinoma-are-they-really-the-same-disease-a-13-institution-study-from-the-us-extrahepatic-biliary-malignancy-consortium-and-the-central-pancreas-consortium
#3
Cecilia G Ethun, Alexandra G Lopez-Aguiar, Timothy M Pawlik, George Poultsides, Kamran Idrees, Ryan C Fields, Sharon M Weber, Clifford Cho, Robert C Martin, Charles R Scoggins, Perry Shen, Carl Schmidt, Ioannis Hatzaras, David Bentrem, Syed Ahmad, Daniel Abbott, Hong Jin Kim, Nipun Merchant, Charles A Staley, David A Kooby, Shishir K Maithel
BACKGROUND: Distal cholangiocarcinoma (DC) and pancreatic ductal adenocarcinoma (PDAC) are often managed as 1 entity, yet direct comparisons are lacking. Our aim was to use 2 large multi-institutional databases to assess treatment, pathologic, and survival differences between these diseases. STUDY DESIGN: This study included patients with DC and PDAC who underwent curative-intent pancreaticoduodenectomy from 2000 to 2015 at 13 institutions comprising the US Extrahepatic Biliary Malignancy and Central Pancreas Consortiums...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28009746/curative-surgical-resection-of-adrenocortical-carcinoma-determining-long-term-outcome-based-on-conditional-disease-free-probability
#4
Yuhree Kim, Georgios A Margonis, Jason D Prescott, Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Tracy S Wang, Jason A Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E Phay, Kara Keplinger, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, George A Poultsides, Timothy M Pawlik
OBJECTIVE: To evaluate conditional disease-free survival (CDFS) for patients who underwent curative intent surgery for adrenocortical carcinoma (ACC). BACKGROUND: ACC is a rare but aggressive tumor. Survival estimates are usually reported as survival from the time of surgery. CDFS estimates may be more clinically relevant by accounting for the changing likelihood of disease-free survival (DFS) according to time elapsed after surgery. METHODS: CDFS was assessed using a multi-institutional cohort of patients...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27812827/a-novel-pathology-based-preoperative-risk-score-to-predict-locoregional-residual-and-distant-disease-and-survival-for-incidental-gallbladder-cancer-a-10-institution-study-from-the-u-s-extrahepatic-biliary-malignancy-consortium
#5
Cecilia G Ethun, Lauren M Postlewait, Nina Le, Timothy M Pawlik, Stefan Buettner, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Nipun Merchant, Kenneth Cardona, Shishir K Maithel
BACKGROUND: This study was designed to develop a more robust predictive model, beyond T-stage alone, for incidental gallbladder cancer (IGBC) for discovering locoregional residual (LRD) and distant disease (DD) at reoperation, and estimating overall survival (OS). T-stage alone is currently used to guide treatment for incidental gallbladder cancer. Residual disease at re-resection is the most important factor in predicting outcomes. METHODS: All patients with IGBC who underwent reoperation at 10 institutions from 2000 to 2015 were included...
May 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27784058/association-of-optimal-time-interval-to-re-resection-for-incidental-gallbladder-cancer-with-overall-survival-a-multi-institution-analysis-from-the-us-extrahepatic-biliary-malignancy-consortium
#6
Cecilia G Ethun, Lauren M Postlewait, Nina Le, Timothy M Pawlik, Stefan Buettner, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, David A Kooby, Shishir K Maithel
Importance: The current recommendation is to perform re-resection for select patients with incidentally discovered gallbladder cancer. The optimal time interval for re-resection for both patient selection and long-term survival is not known. Objective: To assess the association of time interval from the initial cholecystectomy to reoperation with overall survival. Design, Setting, and Participants: This cohort study was conducted from January 1, 2000, to December 31, 2014 at 10 US academic institutions...
February 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27770290/minimally-invasive-resection-of-adrenocortical-carcinoma-a-multi-institutional-study-of-201-patients
#7
Christina W Lee, Ahmed I Salem, David F Schneider, Glen E Leverson, Thuy B Tran, George A Poultsides, Lauren M Postlewait, Shishir K Maithel, Tracy S Wang, Ioannis Hatzaras, Rivfka Shenoy, John E Phay, Lawrence Shirley, Ryan C Fields, Linda X Jin, Timothy M Pawlik, Jason D Prescott, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, Sharon M Weber
BACKGROUND AND OBJECTIVES: Minimally invasive surgery for adrenocortical carcinoma (ACC) is controversial. We sought to evaluate the perioperative and long-term outcomes following minimally invasive (MIS) and open resection (OA) of ACC in patients treated with curative intent surgery. METHODS: Retrospective data from patients who underwent adrenalectomy for primary ACC at 13 tertiary care cancer centers were analyzed, including demographics, clinicopathological, and operative outcomes...
February 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27766557/the-impact-of-primary-care-providers-on-patient-screening-mammography-and-initial-presentation-in-an-underserved-clinical-setting
#8
Ajaratu Keshinro, Ioannis Hatzaras, Kenneth Rifkind, Shubhada Dhage, Kathie-Ann Joseph
INTRODUCTION: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS: We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis...
March 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27683047/elevated-nlr-in-gallbladder-cancer-and-cholangiocarcinoma-making-bad-cancers-even-worse-results-from-the-us-extrahepatic-biliary-malignancy-consortium
#9
Eliza W Beal, Lai Wei, Cecilia G Ethun, Sylvester M Black, Mary Dillhoff, Ahmed Salem, Sharon M Weber, Thuy Tran, George Poultsides, Andre Y Son, Ioannis Hatzaras, Linda Jin, Ryan C Fields, Stefan Buettner, Timothy M Pawlik, Charles Scoggins, Robert C G Martin, Chelsea A Isom, Kamron Idrees, Harveshp D Mogal, Perry Shen, Shishir K Maithel, Carl R Schmidt
BACKGROUND: Gallbladder and extrahepatic biliary malignancies are aggressive tumors with high risk of recurrence and death. We hypothesize that elevated preoperative Neutrophil-Lymphocyte Ratios (NLR) are associated with poor prognosis among patients undergoing resection of gallbladder or extrahepatic biliary cancers. METHODS: Patients who underwent complete surgical resection between 2000-2014 were identified from 10 academic centers (n=525). Overall (OS) and recurrence-free survival (RFS) were analyzed by stratifying patients with normal (<5) versus elevated (>5) NLR...
November 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27633419/actual-10-year-survivors-following-resection-of-adrenocortical-carcinoma
#10
MULTICENTER STUDY
Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Jason D Prescott, Tracy S Wang, Jason Glenn, John E Phay, Kara Keplinger, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, Ioannis Hatzaras, Rivfka Shenoy, Timothy M Pawlik, Jeffrey A Norton, George A Poultsides
BACKGROUND: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options beyond surgical resection. The characteristics of actual long-term survivors following surgical resection for ACC have not been previously reported. METHOD: Patients who underwent resection for ACC at one of 13 academic institutions participating in the US Adrenocortical Carcinoma Group from 1993 to 2014 were analyzed. Patients were stratified into four groups: early mortality (died within 2 years), late mortality (died within 2-5 years), actual 5-year survivor (survived at least 5 years), and actual 10-year survivor (survived at least 10 years)...
December 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27618748/clinical-score-predicting-long-term-survival-after-repeat-resection-for-recurrent-adrenocortical-carcinoma
#11
Thuy B Tran, Shishir K Maithel, Timothy M Pawlik, Tracy S Wang, Ioannis Hatzaras, John E Phay, Ryan C Fields, Sharon M Weber, Jason K Sicklick, Adam C Yopp, Quan-Yang Duh, Carmen C Solorzano, Konstantinos I Votanopoulos, George A Poultsides
BACKGROUND: Adrenocortical carcinoma (ACC) is an aggressive malignancy typically resistant to chemotherapy and radiation. Surgery, even in the setting of locally recurrent or metastatic disease, remains the only potentially curative option. However, the subset of patients who will benefit from repeat resection in this setting remains ill defined. The objective of this study was to propose a prognostic clinical score that facilitates selection of patients for repeat resection of recurrent ACC...
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27590329/lymphadenectomy-for-adrenocortical-carcinoma-is-there-a-therapeutic-benefit
#12
Jon M Gerry, Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Jason D Prescott, Tracy S Wang, Jason A Glenn, John E Phay, Kara Keplinger, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, Ioannis Hatzaras, Rivfka Shenoy, Timothy M Pawlik, Jeffrey A Norton, George A Poultsides
BACKGROUND: Lymph node metastasis is an established predictor of poor outcome for adrenocortical carcinoma (ACC); however, routine lymphadenectomy during surgical resection of ACC is not widely performed and its therapeutic role remains unclear. METHODS: Patients undergoing margin-negative resection for localized ACC were identified from a multi-institutional database. Patients were stratified into 2 groups based on the surgeon's effort or not to perform a lymphadenectomy as documented in the operative note...
December 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27549595/defining-the-chance-of-statistical-cure-among-patients-with-extrahepatic-biliary-tract-cancer
#13
Gaya Spolverato, Fabio Bagante, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Emily Winslow, Clifford Cho, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: While surgery offers the best curative-intent treatment, many patients with biliary tract malignancies have poor long-term outcomes. We sought to apply a non-mixture cure model to calculate the cure fraction and the time to cure after surgery of patients with peri-hilar cholangiocarcinoma (PHCC) or gallbladder cancer (GBC). METHODS: Using the Extrahepatic Biliary Malignancy Consortium, 576 patients who underwent curative-intent surgery for gallbladder carcinoma or peri-hilar cholangiocarcinoma between 1998 and 2014 at 10 major hepatobiliary institutions were identified and included in the analysis...
January 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27527802/rates-and-patterns-of-recurrence-after-curative-intent-resection-for-gallbladder-cancer-a-multi-institution-analysis-from-the-us-extra-hepatic-biliary-malignancy-consortium
#14
Georgios Antonios Margonis, Faiz Gani, Stefan Buettner, Neda Amini, Kazunari Sasaki, Nikolaos Andreatos, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: Gallbladder cancer is a relatively rare malignancy. The current study aimed to define the incidence and patterns of recurrence following gallbladder cancer resection. METHODS: Using a multi-institutional cohort we identified 217 patient undergoing curative intent surgery for gallbladder cancer. Patterns of recurrence were classified as locoregional and distant recurrence. RESULTS: At last follow-up, 76 patients (35.0%) had experienced a recurrence (locoregional only, n = 12, 15...
November 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27523923/use-of-the-surgical-apgar-score-to-enhance-veterans-affairs-surgical-quality-improvement-program-surgical-risk-assessment-in-veterans-undergoing-major-intra-abdominal-surgery
#15
Antonio Masi, Salvatore Amodeo, Ioannis Hatzaras, Antonio Pinna, Alan S Rosman, Steven Cohen, John K Saunders, Russell Berman, Elliot Newman, Garth H Ballantyne, Leon H Pachter, Marcovalerio Melis
BACKGROUND: We investigated whether the surgical Apgar score (SAS) may enhance the Veterans Affairs Surgical Quality Improvement Program (VASQIP) risk assessment for prediction of early postoperative outcomes. METHODS: We retrospectively evaluated demographics, medical history, procedure, SAS, VASQIP assessment, and postoperative data for patients undergoing major/extensive intra-abdominal surgery at the Manhattan Veterans Affairs between October 2006 and September 2011...
April 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/27506989/proposal-for-a-new-t-stage-classification-system-for-distal-cholangiocarcinoma-a-10-institution-study-from-the-u-s-extrahepatic-biliary-malignancy-consortium
#16
Lauren M Postlewait, Cecilia G Ethun, Nina Le, Timothy M Pawlik, Stefan Buettner, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Gerardo Vitiello, Kenneth Cardona, Shishir K Maithel
BACKGROUND: Seventh AJCC distal cholangiocarcinoma T-stage classification inadequately separates patients by survival. This retrospective study aimed to define a novel T-stage system to better stratify patients after resection. METHODS: Curative-intent pancreaticoduodenectomies for distal cholangiocarcinoma (1/2000-5/2015) at 10 US institutions were included. Relationships between tumor characteristics and overall survival (OS) were assessed and incorporated into a novel T-stage classification...
October 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27495279/changing-odds-of-survival-over-time-among-patients-undergoing-surgical-resection-of-gallbladder-carcinoma
#17
Stefan Buettner, Georgios Antonios Margonis, Yuhree Kim, Faiz Gani, Cecilia G Ethun, George A Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: While survival after malignancies is traditionally reported as actuarial survival, conditional survival (CS) may be more clinically relevant by accounting for "accrued" survival time as time progresses. We sought to compare actuarial and CS among patients with gallbladder carcinoma (GBC) . METHODS: A total of 312 patients who underwent curative intent surgery for GBC between 2000 and 2014 were identified using a multi-institutional database. Overall survival (OS) was estimated using the Kaplan-Meier method...
December 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27412318/a-comparison-of-prognostic-schemes-for-perihilar-cholangiocarcinoma
#18
Stefan Buettner, Jeroen L A van Vugt, Faiz Gani, Bas Groot Koerkamp, Georgios Antonios Margonis, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Alfredo Guglielmi, Jan N M IJzermans, Timothy M Pawlik
INTRODUCTION: Although widely used, the 7th edition American Joint Committee on Cancer (AJCC) staging system for perihilar cholangiocarcinoma (PHC) may be limited. Disease-specific nomograms have been proposed as a better means to predict long-term survival for individual patients. We sought to externally validate a recently proposed nomogram by Memorial Sloan Kettering Cancer Center (MSKCC) for PHC, as well as identify factors to improve the prediction of prognosis for patients with PHC...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27317955/conditional-probability-of-long-term-survival-after-resection-of-hilar-cholangiocarcinoma
#19
Stefan Buettner, Georgios A Margonis, Yuhree Kim, Faiz Gani, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: While traditional survival analyses focus on factors determined at the time of surgery, conditional survival (CS) estimates prognosis relative to time following treatment. We sought to compare actuarial and CS among patients undergoing curative intent surgery for hilar cholangiocarcinoma. METHODS: 242 patients undergoing surgery between 2000 and 2014 were identified using a multi-institutional database. CS was calculated as the probability of surviving an additional 3 years, given that the patient had already survived "x" years from surgery...
June 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27198742/assessing-the-impact-of-common-bile-duct-resection-in-the-surgical-management-of-gallbladder-cancer
#20
COMPARATIVE STUDY
Faiz Gani, Stefan Buettner, Georgios A Margonis, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: Although radical re-resection for gallbladder cancer (GBC) has been advocated, the optimal extent of re-resection remains unknown. The current study aimed to assess the impact of common bile duct (CBD) resection on survival among patients undergoing surgery for GBC. METHODS: Patients undergoing curative-intent surgery for GBC were identified using a multi-institutional cohort of patients. Multivariable Cox-proportional hazards regression was performed to identify risk factors for a poor overall survival (OS)...
August 2016: Journal of Surgical Oncology
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