Publications by authors named "Shishir K Maithel"
Background: Lymph node metastasis (LNM) is among the most important predictors of poor prognosis after surgery for gallbladder cancer (GBC). Traditionally, staging has been based on the raw count of LNM, with a high risk of understaging patients who undergo inadequate lymph node dissection (LND). The log odds of metastatic lymph nodes (LODDS) may represent an alternative staging approach to stratify patients more accurately after resection of GBC.
View Article and Find Full Text PDFBackground: Adjuvant chemotherapy offers survival benefit to patients with gastric cancer. Only 50-65% of patients who undergo neoadjuvant chemotherapy and gastrectomy are able to receive adjuvant therapy. It is optimal to start adjuvant therapy within 8 weeks after gastrectomy.
View Article and Find Full Text PDFBackground: The prognostic role of the fibrosis-4 (FIB-4) index relative to intrahepatic cholangiocarcinoma (ICC) after hepatectomy remains unclear. This study sought to characterize the impact of the FIB-4 index and tumor burden score (TBS) on recurrence and overall survival (OS).
Methods: ICC patients undergoing hepatectomy (2000-2020) were identified using a multi-institutional database.
Article Synopsis
- The advanced lung cancer inflammation index (ALI) combines inflammation and nutrition data to predict overall survival (OS) in patients with intrahepatic cholangiocarcinoma (ICC) who have undergone surgery.
- In a study of 1,045 patients, low ALI was found to be an independent risk factor for worse OS, with those having low ALI showing significantly lower 5-year survival rates.
- ALI performed comparably to other inflammatory markers in predicting survival while demonstrating slightly better model fit and accuracy, indicating the value of integrating nutritional and inflammatory data in prognostic assessments.
Article Synopsis
- Hepatitis C virus-related liver cancer affects minorities in the U.S. the hardest due to socioeconomic barriers, prompting a study on treatment outcomes among different racial and ethnic groups.
- A study of 666 patients who completed antiviral therapy and underwent liver transplantation found no significant differences in 5-year recurrence-free survival or overall survival among White, Black, Hispanic, and Other racial/ethnic groups.
- The findings indicate that when treatment barriers are removed, race/ethnicity does not impact cancer outcomes, highlighting the need to prioritize eliminating access obstacles for minority populations.
Background: Despite the well-known prognostic role of lymph node metastasis (LNM) in pNETs, less is known about the importance of lymphovascular invasion (LVI) among patients with these tumors.
Methods: Patients undergoing pancreatectomy for pNET between 2002 and 2020 were identified in the US Neuroendocrine Tumor Study Group database. Cox regression analysis was utilized to identify the impact of LVI on recurrence-free survival (RFS) among patients with node-negative pNET.
Article Synopsis
- Gallbladder cancer (GBC) typically has a high risk of recurrence and poor outcomes even after surgery aimed at curing it, and the effectiveness of the modified ALBI (mALBI) score in predicting patient prognosis after surgery hadn’t been fully explored.
- A study examined the mALBI scores of 269 patients who had radical resection for GBC, finding that those with higher mALBI scores (grades 2b/3) had significantly worse 5-year overall survival (OS) and recurrence-free survival (RFS) compared to those with lower scores (grades 1/2a).
- The mALBI score may serve as a valuable tool for assessing liver function and predicting
Background: To investigate the impact of preoperative glycosylated hemoglobin A1C (HbA1c) among patients following curative-intent resection of nonfunctional gastroentropancreatic neuroendocrine tumors (GEP-NETs).
Methods: Patients who underwent curative-intent resection for GEP-NETs from 2000 to 2020 were identified from the US Neuroendocrine Tumor Study Group (US-NETSG). Preoperative blood HbA1c levels were defined as high HbA1c (≥ 6.
Objective: We sought to identify patients at risk of "futile" surgery for intrahepatic cholangiocarcinoma using an artificial intelligence (AI)-based model based on preoperative variables.
Methods: Intrahepatic cholangiocarcinoma patients who underwent resection between 1990 and 2020 were identified from a multi-institutional database. Futility was defined either as mortality or recurrence within 12 months of surgery.
Background And Objectives: Among patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC), perioperative bleeding requiring blood transfusion is a common complication, yet preoperative identification of patients at risk for transfusion remains challenging. The objective of this study was to develop a preoperative risk score for blood transfusion requirement during surgery for ICC.
Methods: Patients undergoing curative-intent liver surgery for ICC (1990-2020) were identified from a multi-institutional database.
With improvements in surgical technique and advances in pancreatic endocrine and exocrine replacement therapy, the indications for, and threshold to perform, total or completion pancreatectomy in the modern surgical era are ever evolving. The following review will evaluate such indications for pancreatic cancer including pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasms. The authors also review the literature on oncologic outcomes of total and completion pancreatectomy for pancreatic cancer.
View Article and Find Full Text PDFPurpose: We sought to develop an artificial intelligence (AI)-based model to predict early recurrence (ER) after curative-intent resection of neuroendocrine liver metastases (NELMs).
Methods: Patients with NELM who underwent resection were identified from a multi-institutional database. ER was defined as recurrence within 12 months of surgery.
Background: Incisional hernia (IH) results in significant morbidity to patients and financial burden to healthcare systems. We aimed to determine the incidence of IH in distal pancreatectomy (DP) patients, stratified by specimen extraction sites.
Method: Imaging in DP patients in our institution from 2016 to 2021 were reviewed by radiologists blinded to the operative approach.