Metastasectomy for Stage IVA Colon Cancer: Does the Type of Treating Institution Make a Difference?

Treatment of metastatic colon cancer has evolved over time. More evidence has been emerging in recent years supporting metastasectomy in selected patients. We sought to elucidate whether the type of institution-community, comprehensive community, academic/research, and integrated cancer network-would have an effect on patient outcome, specifically those colon cancer patients with isolated liver metastasis.

Robotic Versus Laparoscopic Gastrectomy for Gastric Adenocarcinoma: Propensity-Matched Analysis.

. We compared the outcomes of laparoscopic-assisted (LA) and robotic-assisted (RA) gastrectomies performed for gastric adenocarcinoma in the National Cancer Database. .

Trends and Outcomes of Synchronous Resection of Colorectal Metastasis in the Modern Era-Analysis of Targeted Hepatic NSQIP Database.

Background: Previous studies using the NSQIP database to study hepatectomies lacked hepatic specific variables and outcomes. We used the targeted NSQIP hepatectomy database to examine the nationwide trend and the safety profile of synchronous liver and colorectal resection compared with hepatectomy alone for colorectal liver metastasis.

Methods: The targeted NSQIP hepatectomy database from 2014 was used to study patients who underwent hepatectomy for diagnosis of adenocarcinoma of the colon and rectum.

Racial disparities in breast cancer persist despite early detection: analysis of treatment of stage 1 breast cancer and effect of insurance status on disparities.

Purpose: Prior research demonstrates racial disparities in breast cancer treatment. Disparities are commonly attributed to more advanced stage at presentation or aggressive tumor biology. We seek to evaluate if racial disparities persist in the treatment of stage 1 breast cancer patients who by definition are not delayed in presentation.

Outcomes associated with resident involvement in ventral hernia repair: A population based study using the NSQIP database.

Introduction: This study evaluated the effect of resident involvement on patient outcomes following major ventral hernia repair (VHR).

Methods: National Surgical Quality Improvement Program database was queried to identify patients with major VHR between 2007 and 2010. Patient outcomes were compared based on presence or absence of resident in the operating room.

Preoperative Panel Testing for Hereditary Cancer Syndromes Does Not Significantly Impact Time to Surgery for Newly Diagnosed Breast Cancer Patients Compared with BRCA1/2 Testing.

Background: This study seeks to determine whether there is a delay in time to surgery in breast cancer patients with panel tests compared with traditional BRCA testing.

Methods: This study was a retrospective review of women diagnosed with breast cancer who underwent genetic evaluation from our institution's Genetic Counselor Database from January 2013 to August 2015. Patients were excluded if they were male, clinical information was unavailable, the patient underwent neoadjuvant chemotherapy, had a diagnosis of recurrent breast cancer during time of study, or had postoperative genetics evaluation.

Urinary Retention Following Colorectal Surgery.

Literature on postoperative urinary retention (POUR) after colorectal resections is limited. The aim of our study was to evaluate the incidence of and risk factors for POUR after elective colorectal resections in men ≥55 years without genitourinary issues. A retrospective review of elective colorectal resections (June 1, 2014 to June 1, 2015) in men ≥55 years without genitourinary conditions was performed at our institution.

The role of hepatic artery lymph node in pancreatic adenocarcinoma: prognostic factor or a selection criterion for surgery.

Background: Hepatic artery lymph node (HALN) metastasis in pancreatic adenocarcinoma reportedly confers a survival disadvantage. This has led some authors to propose it as an indicator against pancreaticoduodenectomy (PD).

Methods: Consecutive patients who underwent PD during 2002-2012 were identified from the University of Louisville prospective hepatopancreaticobiliary database.

Evaluation of resistance as a measure of successful tumor ablation during irreversible electroporation of the pancreas.

Background: Intraoperative evaluation of successful pancreatic tumor ablation using irreversible electroporation (IRE) is difficult secondary to lack of visual confirmation. The IRE generator provides feedback by reporting current (amperage), which can be used to calculate changes in tumor tissue resistance. The purpose of the study was to determine if resistance can be used to predict successful tumor ablation during IRE for pancreatic cancers.

Stroke volume variation in hepatic resection: a replacement for standard central venous pressure monitoring.

Background: Central venous pressure (CVP) is the standard method of volume status evaluation during hepatic resection. CVP monitoring requires preoperative placement of a central venous catheter (CVC), which can be associated with increased time, cost, and adverse events. Stroke volume variation (SVV) is a preload index that can be used to predict an individual's fluid responsiveness through an existing arterial line.

Clinical evaluation of somatostatin use in pancreatic resections: Clinical efficacy or limited benefit?

Background: The benefit of somatostatin for the prevention of pancreatic fistula has been debated widely in the literature. The aim of this study was to evaluate the efficacy of somatostatin in preventing pancreatic fistulas and improving postoperative outcomes after pancreatic resection.

Hypothesis: Somatostatin improves postoperative outcomes after pancreatectomy.

Evaluation of alpha-fetoprotein staging system for hepatocellular carcinoma in noncirrhotic patients.

The Barcelona Clinic Liver Cancer (BCLC) staging classification is commonly used for staging hepatocellular carcinoma (HCC). This system assumes the coexistence of cirrhosis; however, a significant proportion of patients with HCC present without cirrhosis. Recently, an alternative system was proposed that stratifies patients according to alpha-fetoprotein (AFP) level.

Incidence of sentinel lymph node involvement in a modern, large series of desmoplastic melanoma.

Background: Recent studies have suggested that sentinel lymph node (SLN) biopsy is of limited value in desmoplastic melanoma. This study was performed to compare the rate of positive SLN biopsy in the Surveillance, Epidemiology, and End Results (SEER) database with that of a multi-institutional clinical trial and to investigate relevant prognostic factors in desmoplastic melanoma.

Study Design: Patients with desmoplastic melanoma ≥1.

Outcomes and prognostic factors in nodular melanomas.

Background: The nodular subtype of cutaneous melanoma has a more pronounced vertical phase and less of a radial growth phase compared with other histologic subtypes. This study was performed to determine prognostic factors and outcomes for nodular melanomas.

Methods: A post hoc analysis of a prospective clinical trial was performed in all patients with nodular histologic subtype.

Clinicopathologic and survival differences between upper and lower extremity melanomas.

This analysis was performed to compare differences in clinicopathologic factors, sentinel lymph node (SLN) status, and survival between upper extremity (UE) and lower extremity (LE) melanoma patients. Post hoc analysis of a prospective clinical trial was performed of all patients with extremity melanomas with complete data. Survival was evaluated with Kaplan-Meier analysis.

Endoscopic therapy for Barrett's esophagus: a review of its emerging role in optimal diagnosis and endoluminal therapy.

Barrett's esophagus (BE) is a premalignant lesion known to sequentially progress to esophageal adenocarcinoma. Management of BE has changed significantly over the last 5 years with the development of endoscopic resection and ablation, which has replaced esophagectomy as the treatment of choice in BE with high-grade dysplasia. The aim of this review is to discuss the details of these new endotherapies in regards to response and durability and to define the role of these new therapies in the current management of BE.

Clinically unsuspected papillary microcarcinomas of the thyroid: a common finding with favorable biology?

Background: The purpose of this study was to describe the incidence and clinical/pathologic characteristics of papillary thyroid microcarcinoma (PMC) in a community hospital setting and to evaluate the frequency and characteristics of these lesions when unsuspected preoperatively.

Methods: A total of 723 patients underwent a partial or total thyroidectomy. A retrospective review was performed.

Does participation in graduate medical education contribute to improved patient outcomes as outlined by Surgical Care Improvement Project guidelines?

Background: Patient quality outcomes are a major focus of the health care industry. It is unknown what effect involvement in graduate medical education (GME) has on patient outcomes. The purpose of this study is to begin to examine whether GME involvement in postoperative care impacts patient quality outcomes.