Relationship of Time to First Therapy and Survival Outcomes of Neoadjuvant Chemotherapy Versus Upfront Surgery Approach in Resectable Pancreatic Ductal Adenocarcinoma.

Introduction: Evidence demonstrating overall survival benefit of neoadjuvant chemotherapy (NAC) followed by surgical resection over upfront surgical resection for resectable pancreatic ductal adenocarcinoma (PDAC) has been mixed. The time to first therapy (TTFT) variable has not been studied as a contributing factor.

Methods: A nationwide retrospective analysis using the National Cancer Database to evaluate patients with clinical stage T1 and T2 PDACs from 2010 to 2020.

Impact of American College of Surgeons Geriatric Surgery Verification Program in Patients Undergoing Major Abdominal Oncologic Operation at a Cancer Center.

Background: Patients older than 65 years have unique needs and treatment outcomes goals. The objective of this study was to evaluate the impact of Geriatric Surgery Verification (GSV) initiative in oncology patients ≥65 years undergoing major abdominal surgeries.

Study Design: We implemented the American College of Surgeons' GSV program protocols for patients 65 and older starting in 2022.

Impact of Medicaid Expansion on Screenable versus Non-Screenable Gastrointestinal Cancers.

Background: Medicaid expansion afforded increased healthcare access to low-income Americans contributing to a positive impact on cancer outcomes. However, it is unclear if these benefits were mainly due to enhanced access to cancer screening and earlier diagnosis versus access to cancer treatment METHODS: The National Cancer Database (NCDB) was queried between 2010-2021 for Medicaid and uninsured patients with GI malignancies. Patients were stratified by screenable (SGI) and non-screenable (NGI) cancers and expansion state (ES) categories: early (EES) and late (LES) adopters, and non-expansion state (NES) cohorts.

Review of frailty in geriatric surgical oncology.

Frailty is a common phenomenon in older adult population and associated with an elevated risk of adverse health outcomes. Recent studies have demonstrated that patients with frailty undergoing surgery had a significantly higher morbidity and mortality compared to those without frailty. This is particularly important in patients with cancer because the prevalence of frailty is persistently high across a spectrum of primary cancers.

Negative Impact of Systemic Therapy on Survival in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Low-Grade Metastatic Appendiceal Adenocarcinoma.

Background: Despite studies demonstrating that patients with peritoneal metastases from low-grade appendiceal adenocarcinoma (AA) do not respond well to systemic chemotherapy (SC), patients frequently undergo combination of SC with cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) regardless of grade.

Methods: A nationwide retrospective analysis using the National Cancer Database evaluated patients with AA with peritoneal metastasis from 2016 to 2021. Cox proportional hazards model was used to evaluate the impact of SC in addition to CRS/HIPEC on overall survival (OS) stratified by tumor grade.

Impact of Cancer on Nutrition in the Geriatric Cancer Population.

Malnutrition in geriatric cancer patients is a leading cause of morbidity and mortality. A nutrition risk assessment should be done early to identify and treat those at risk for cancer-related malnutrition. The goal of this study was to assess nutritional status in geriatric patients diagnosed with all cause cancer.

Analysis of Uveal Melanoma 5-Year Survival Rates by Medicaid Status: A Nationwide Analysis.

Purpose: The survival outcomes of patients with primary uveal melanomas based on Medicaid status have not been previously discussed in the literature.

Methods: The Surveillance, Epidemiology, and End Results Medicaid database were utilized to identify patients with primary uveal melanomas diagnosed between 2006 and 2013. The Kaplan-Meier method was utilized to construct 5-year survival curves in adult, non-elderly patients.

Disparities in Primary Spinal Osseous Malignant Bone Tumor Survival by Medicaid Status: A National Population-Based Risk Analysis.

Background: The impact of Medicaid status on survival outcomes of patients with spinal primary malignant bone tumors (sPMBT) has not been investigated.

Methods: Using the SEER-Medicaid database, adults diagnosed between 2006 and 2013 with sPMBT including chordoma, osteosarcoma, chondrosarcoma, Ewing sarcoma, or malignant giant cell tumor (GCT) were studied. Five-year survival analysis was performed using the Kaplan-Meier method.

Disparities in primary pancreatic adenocarcinoma survival by Medicaid-status: A national population-based risk analysis.

Background: Pancreatic adenocarcinoma (PAC) has one of the highest mortality rates among all malignancies. While previous research has analyzed socioeconomic factors' effect on PAC survival, outcomes of Medicaid patients are understudied.

Methods: Using the SEER-Medicaid database, we studied non-elderly, adult patients with primary PAC diagnosed between 2006 and 2013.

Disparities in hepatocellular carcinoma survival by Medicaid-status: A national population-based risk analysis.

Background: Previous studies have demonstrated disparities in survival surrounding hepatocellular carcinoma (HCC) across a variety of socio-demographic factors; however, the relationship between Medicaid-status and HCC survival is poorly understood.

Methods: We constructed 5-year, disease-specific survival curves using the Kaplan-Meier method and performed an adjusted survival analysis using multivariate Cox-proportional hazard regression.

Results: We analyzed 17,059 non-elderly patients (12,194 non-Medicaid, 4875 Medicaid) diagnosed between 2006 and 2013 and found that Medicaid status was not associated with higher risk of diseases-specific death compared to other insurance types (p = .

Quality of Life in Older Adults After Major Cancer Surgery: The GOSAFE International Study.

Background: Accurate quality of life (QoL) data and functional results after cancer surgery are lacking for older patients. The international, multicenter Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) Study compares QoL before and after surgery and identifies predictors of decline in QoL.

Methods: GOSAFE prospectively collected data before and after major elective cancer surgery on older adults (≥70 years).

Prognostic Impact of Tumor Status, Nodal Status and Tumor Sidedness in Metastatic Colon Cancer.

Background Locally advanced primary tumors have been associated with poor overall survival (OS) in non-metastatic colon cancer. However, their impact on metastatic colon cancer (mCC) is not fully defined. The association between primary tumor location and prognosis in mCC is also evolving.

Adjuvant Chemotherapy and Tumor Sidedness in Stage II Colon Cancer: Analysis of the National Cancer Data Base.

Current guidelines recommend discussion of adjuvant chemotherapy (AC) for stage II colon cancer (CC) with high-risk features despite lacking conclusive randomized trial data. We examined AC administration in this population and its effect on overall survival (OS) for available patient, tumor, and treatment characteristics Using National Cancer Data Base, a cohort of 42,971 stage II CC patients diagnosed from 2004 to 2009, who underwent surgery with curative intent, was identified. Chi-square test and multivariate logistic regression were used to analyze baseline characteristics and to calculate odds of chemotherapy administration, respectively.

GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery: early analysis on 977 patients.

Objective: Older patients with cancer value functional outcomes as much as survival, but surgical studies lack functional recovery (FR) data. The value of a standardized frailty assessment has been confirmed, yet it's infrequently utilized due to time restrictions into everyday practice. The multicenter GOSAFE study was designed to (1) evaluate the trajectory of patients' quality of life (QoL) after cancer surgery (2) assess baseline frailty indicators in unselected patients (3) clarify the most relevant tools in predicting FR and clinical outcomes.

Adequate lymph node evaluation in the elderly is associated with improved survival in patients with stage I-III colon cancer: A validation study using the National Cancer Data Base.

Background: Lymph node involvement (LNI) is an important prognostic factor in colon cancer. But, variations in LNI among different age groups are less known. Adequate lymph node evaluation (LNE) requires assessment of ≥12 nodes.

Advances in geriatric oncology: a multidisciplinary perspective.

A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians.

Association of primary tumor lymph node ratio with burden of liver metastases and survival in stage IV colorectal cancer.

Background: The primary objective of our study was to assess the association of primary tumor lymph node ratio (LNR) in stage IV colorectal adenocarcinomas (CRC) with overall survival (OS) and the extent of metastatic disease in the liver.

Methods: We analyzed data on 53 stage IV CRC patients who underwent surgical resection of the primary tumor. The median LNR of 0.

Portomesenteric venous thrombosis complicated by a haemorrhagic shock: a rare complication of laparoscopic gastrectomy.

Portomesenteric venous thrombosis is a rare complication reported in only a few cases involving laparoscopic bariatric surgery. We report a case of a 44-year-old woman who presented 14 days after recent laparoscopic sleeve gastrectomy with the chief complaint of abdominal pain and associated nausea. Abdominal CT demonstrated thrombi in her superior mesenteric, portal and splenic veins.

Frontline Science: Functionally impaired geriatric CAR-T cells rescued by increased α5β1 integrin expression.

Chimeric antigen receptor expressing T cells (CAR-T) are a promising form of immunotherapy, but the influence of age-related immune changes on CAR-T production remains poorly understood. We showed that CAR-T cells from geriatric donors (gCAR-T) are functionally impaired relative to CAR-T from younger donors (yCAR-T). Higher transduction efficiencies and improved cell expansion were observed in yCAR-T cells compared with gCAR-T.

Skilled nursing facility placement in hospitalized elderly patients with colon cancer.

Background: The current study sought to determine predictive risk factors and inpatient resource utilization associated with discharge to skilled nursing facility (SNF) in hospitalized elderly patients with colon cancer.

Materials And Methods: Inpatient data from U.S.

Predictors of surgical non-referral for colorectal liver metastases.

Background: Surgical resection is the only curative option for patients with colorectal liver metastases (CRLM). The objective of our study was to identify factors associated with failure to refer patients with CRLM to a surgeon with oncologic and hepatobiliary expertise.

Materials And Methods: Data were retrospectively reviewed on 75 patients with CRLM treated at our institution.

The impact of age on nodal metastases and survival in gastric cancer.

Background: In gastric adenocarcinoma, the disparity in lymph node involvement between different age groups has not been thoroughly investigated. The objective of our study was to compare age-associated differences in adequate lymph node harvest and nodal involvement in gastric adenocarcinoma patients.

Methods: We analyzed data extracted from the Surveillance, Epidemiology and End Results database on 13,165 patients diagnosed with stage I-III gastric adenocarcinoma between 2004 and 2011.