Publications by authors named "Agala C"
Introduction: Patients with metastatic melanoma to the lung typically have poor outcomes. Although a pulmonary metastasectomy for selected patients has been shown to improve survival, the role of surgical resection following the introduction of immunotherapy for metastatic melanoma is unknown. The objective of this study was to determine predictors of survival for patients with melanoma metastatic to the lung in the era of immunotherapy.
View Article and Find Full Text PDFBackground: Serious mental illness (SMI) is associated with increased complications and worse outcomes in a variety of surgical diseases, however, SMI as a risk factor in thoracic surgery patients is incompletely understood. We aimed to investigate if comorbid SMI would impact mortality and morbidity following lung cancer resection.
Methods: We identified 615 patients from the Society of Thoracic Surgery (STS) database at the University of North Carolina - Chapel Hill (January 2013-June 2021) who underwent lung cancer resection for non-small cell lung cancer (NSCLC).
Background: There is limited data regarding sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for cN3b patients, who present with both axillary and ipsilateral internal mammary node involvement. We examined trends in the use of SLNB in cN3b patients and survival by axillary procedure for those with nodal pathologic complete response (nPCR).
Methods: Adult women with nonmetastatic cN3b invasive breast carcinoma between 2012 and 2021 were selected from the National Cancer Database.
Objective: To assess survival outcomes for patients with stage IIIA (T1N2M0) non-small cell lung cancer (NSCLC) using the National Cancer Database (NCDB).
Methods: Patients with T1N2M0 NSCLC undergoing lobectomy or segmentectomy were identified in the NCDB from 2004 to 2019. Patient characteristics were compared using χ and Fisher exact tests.
Objective: The goal of this study was to assess predictive factors for receiving interviews and matching in general surgery (GS), cardiothoracic surgery (TS), vascular surgery (VS), and plastic surgery (PS).
Design: The Texas Seeking Transparency in Applications to Residency (STAR) survey was analyzed for match years 2018-2023. Chi-Square Tests of Independence were used to assess differences among participants who received ≥16 vs <16 interviews and, separately, participants who matched vs went unmatched.
Introduction: The impact of diverting ileostomy in adults with ulcerative colitis (UC) undergoing ileal pouch-anal anastomosis (IPAA) is unclear. This study uses a novel approach with population-level data to identify patients with diverting ileostomy at the time of IPAA and determine the impact of diverting ileostomy on postoperative outcomes.
Methods: Using the International Business Machines (IBM) MarketScan® database, adults (18-64 years old) with a diagnosis of UC who underwent IPAA between 2000 and 2019 were examined.
Trends in management and related outcomes for occult primary breast cancer.
Breast Cancer Res Treat
October 2024
Purpose: Occult Primary Breast Cancer (OPBC) is a rare clinical condition in which breast cancer is located within the axillary lymph nodes, but no primary tumor is identified in the breast. We evaluated trends of neoadjuvant chemotherapy (NAC) use and subsequent axillary procedures in OPBC as well as outcomes for these patients.
Methods: The National Cancer Database was used to identify adult women with cT0N1-3M0 breast cancer between 2012 to 2021 that underwent axillary lymph node surgery.
Myocardial infarction (MI) is a leading cause of mortality globally and is predominantly attributed to coronary artery disease (CAD). MI is categorized as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI), each with distinct etiologies and treatment pathways. The goal in treatment for both is restoring blood flow back to the myocardium.
View Article and Find Full Text PDFPurpose: Residual cancer burden (RCB) index after neoadjuvant chemotherapy (NAC) is highly prognostic in patients with breast cancer (BC) but does not account for subtype or the precise impact of residual nodal burden (RNB). We aimed to precisely de ne the effect of RNB on survival by subtypes.
Methods: Adult women with non-metastatic BC diagnosed from 2006-2021 in the National Cancer Database (NCDB) who received NAC followed by surgery within 8 months were included.
Differential prognostic value of residual nodal burden in breast cancer subtypes.
Breast Cancer Res Treat
September 2024
Article Synopsis
- - The study investigates how residual nodal burden (RNB) after neoadjuvant chemotherapy (NAC) affects survival rates in breast cancer patients, particularly focusing on different cancer subtypes.
- - Analyzing data from over 51,000 patients, researchers found that increased RNB significantly raises the risk of mortality, with triple-negative breast cancer (TNBC) showing the most substantial decrease in 5-year survival rates compared to other subtypes.
- - The findings highlight the importance of considering breast cancer subtypes when assessing prognosis and developing future treatment strategies for patients with residual disease after chemotherapy.
Article Synopsis
- The study examines the evolution of morbidity and mortality conferences (MMCs) in surgery, shifting from identifying individual surgeon errors to addressing hospital-level factors affecting patient outcomes.
- A survey distributed to members of the American College of Surgeons revealed insights from 1,396 participants, predominantly surgical trainees, indicating common scheduling patterns and a lack of structured formats in MMCs.
- Findings suggest that increased engagement from attending surgeons could enhance the educational value of MMCs, despite existing geographic and institutional differences in how they are conducted.
Objectives: Surgical resection remains the primary treatment for early-stage non-small cell lung cancer (NSCLC), with lobectomy considered the standard approach. However, recent evidence suggests that sublobar resection may be an alternative option for select patients.
Materials And Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines.
Introduction: Axillary response to neoadjuvant endocrine therapy (NET) for the treatment of hormone receptor-positive breast cancer (HR+ BC) is not well-described. This study was designed to characterize nodal response after NET.
Methods: Patients receiving NET followed by curative intent surgery at a comprehensive cancer center from 1998 to 2022 in a prospectively collected registry were included.
Background: Bariatric surgery has been proven safe in end-stage kidney disease (ESKD); however, few studies have evaluated whether a history of bariatric surgery impacts transplant-specific outcomes. We hypothesize that a history of bariatric surgery at the time of transplant does not adversely impact transplant-specific outcomes.
Methods: The IBM MarketScan Commercial Claims and Encounters database was queried for patients with a history of kidney transplant between 2000 and 2021.
Surgical margins following rectal cancer resection impact oncologic outcomes. We examined the relationship between margin status and race, ethnicity, region of care, and facility type. Patients undergoing resection of a stage II-III locally advanced rectal cancer (LARC) between 2004 and 2018 were identified through the National Cancer Database.
View Article and Find Full Text PDFBackground: Pulmonary hypertension (PHTN) causes significant morbidity and mortality in patients with congenital diaphragmatic hernia (CDH). Currently, there is no routinely obtained prenatal prognostic marker to reliably predict postnatal CDH-associated PHTN severity.
Methods: The CDH Study Group (CDHSG) registry was queried for infants born from 2015 to 2021 with a graded (1-4) PHTN diagnosis.
Background: The current National Comprehensive Cancer Network advises neoadjuvant chemoradiotherapy followed by surgery for locally advanced cases of esophageal cancer. The role of immunotherapy in this context is under heavy investigation.
Methods: Patients with esophageal adenocarcinoma were identified in the National Cancer Database (NCDB) from 2004 to 2019.
Background: Sleeve gastrectomy (SG) increased in popularity after 2010 but recent data suggest it has concerning rates of gastroesophageal reflux and need for conversions. This study aims to evaluate recent trends in the utilization of bariatric procedures, associated complications, and conversions using an administrative claims database in the United States.
Methods: We included adults who had bariatric procedures from 2000 to 2020 with continuous enrollment for at least 6 months in the MarketScan Commercial Claims and Encounters database.
Article Synopsis
- The study looked at how often immune-oncology (IO) therapy is used for patients with soft tissue sarcoma (STS), which is a type of cancer.
- Out of over 103,000 patients studied, only about 1,935 (or 1.9%) received IO therapy, but the use of it has increased a lot over the years.
- Patients with more serious tumors or who went to research hospitals were more likely to receive IO therapy, and further research is needed to understand how to improve its use in treating STS.
Background: In patients with severe cleft deformities, nasoalveolar molding (NAM) can improve long-term lip and nasal symmetry by reducing the size of the cleft, better aligning the alveolus, lip, and nose, and making the primary lip repair more predictable. Despite the increasing number of published studies on modified NAM techniques, the effects of NAM on weight gain and time to primary lip repair remain less studied.
Purpose: This study aims to evaluate the effect of NAM on feeding, weight gain, growth velocity, and time to primary lip repair in patients with complete unilateral and bilateral cleft lip and palate (BCLP).
Thoracic aortic aneurysms (TAAs) associated with Marfan syndrome (MFS) are unique in that extracellular matrix metalloproteinase inducer (EMMPRIN) levels do not behave the way they do in other cardiovascular pathologies. EMMPRIN is shed into the circulation through the secretion of extracellular vesicles. This has been demonstrated to be dependent upon the Membrane Type-1 MMP (MT1-MMP).
View Article and Find Full Text PDFImportance: With the increasing prevalence of hepatocellular carcinoma (HCC), ablative therapy is a critical treatment option to achieve a cancer-free state. The anatomic location of the tumor can be a challenge, and select hepatic locations of a tumor require laparoscopic-assisted strategies to safely reach and treat the lesion.
Objective: To assess the association of real-time ultrasonography-augmented navigation for HCC ablation with patient survival, operative time, and rate of incomplete ablations.
Introduction: Parental health literacy and neighborhood socioeconomic disadvantage are associated with adverse health outcomes and increased health-care resource utilization in children. We sought to evaluate the association between community-level health literacy and neighborhood socioeconomic disadvantage and their relationships with outcomes of pediatric patients undergoing gastrostomy tube (GT) placement.
Methods: Pediatric patients who underwent GT placement from 2000 to 2019 were identified using the IBM MarketScan Research database.