2024
Association of patient socioeconomic status with outcomes after palliative treatment for disseminated cancer
Maduka R, Canavan M, Walters S, Ermer T, Zhan P, Kaminski M, Li A, Pichert M, Salazar M, Prsic E, Boffa D. Association of patient socioeconomic status with outcomes after palliative treatment for disseminated cancer. Cancer Medicine 2024, 13: e7028. PMID: 38711364, PMCID: PMC11074703, DOI: 10.1002/cam4.7028.Peer-Reviewed Original ResearchConceptsOptimal quality of careQuality of carePatient socioeconomic statusAssociated with improved qualityAssociated with improved quality of lifeEnd-of-lifeUS cancer populationPalliative treatmentQuality of lifeCox proportional hazards modelsMultivariate logistic regressionInformed decision makingProportional hazards modelFacility characteristicsNon-HispanicAssociated with lower ratesInsurance payer statusImproving informed decision makingCancer populationSocioeconomic statusHispanic ethnicityTreatment usePayer statusBlack raceLogistic regression
2023
Alterations in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US
Janczewski L, Cotler J, Merkow R, Palis B, Nelson H, Mullett T, Boffa D. Alterations in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US. JAMA Network Open 2023, 6: e2340148. PMID: 37902756, PMCID: PMC10616721, DOI: 10.1001/jamanetworkopen.2023.40148.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseCancer treatmentAcademic hospitalCommunity hospitalMAIN OUTCOMECOVID-19 pandemicProportion of patientsRetrospective cohort studyAvailability of treatmentFirst yearUnderwent surgeryCohort studyMedian ageCancer surgeryMedian timeTreatment of cancerCancer careTreatment modalitiesCancer screeningCancer DatabaseMedian travel distancePatientsHospitalSurgeryCancer
2022
Immunotherapy After Chemotherapy and Radiation for Clinical Stage III Lung Cancer
Pichert MD, Canavan ME, Maduka RC, Li AX, Ermer T, Zhan PL, Kaminski M, Udelsman BV, Blasberg JD, Park HS, Goldberg SB, Boffa DJ. Immunotherapy After Chemotherapy and Radiation for Clinical Stage III Lung Cancer. JAMA Network Open 2022, 5: e2224478. PMID: 35925606, PMCID: PMC9353596, DOI: 10.1001/jamanetworkopen.2022.24478.Peer-Reviewed Original ResearchConceptsStage III non-small cell lung cancerNon-small cell lung cancerClinical stage III non-small cell lung cancerUnresectable stage III non-small cell lung cancerPropensity-matched sampleGeneral US populationSurvival advantageCohort studyLung cancerMultivariable Cox proportional hazards modelsUS populationStage III lung cancerMedian age 66 yearsCox proportional hazards modelNational Cancer DatabaseEfficacy of immunotherapyAge 66 yearsProtocol rangesCell lung cancerClinical trial populationsProportional hazards modelTerms of ageImmunotherapy initiationImmunotherapy recipientsImmunotherapy useAcceptance of Simulated Adult Patients With Medicaid Insurance Seeking Care in a Cancer Hospital for a New Cancer Diagnosis
Marks VA, Hsiang WR, Nie J, Demkowicz P, Umer W, Haleem A, Galal B, Pak I, Kim D, Salazar MC, Berger ER, Boffa DJ, Leapman MS. Acceptance of Simulated Adult Patients With Medicaid Insurance Seeking Care in a Cancer Hospital for a New Cancer Diagnosis. JAMA Network Open 2022, 5: e2222214. PMID: 35838668, PMCID: PMC9287756, DOI: 10.1001/jamanetworkopen.2022.22214.Peer-Reviewed Original ResearchConceptsNew cancer diagnosesMedicaid insuranceCancer careAdult patientsSkin cancerComprehensive community cancer programsMultivariable logistic regression modelMedicaid acceptanceCancer-accredited facilitiesCancer diagnosisCommunity cancer programsBreast cancer carePopulation of patientsState Medicaid expansion statusCancer care servicesFacility-level factorsAbility of patientsAmerican Hospital Association Annual SurveyMedicaid expansion statusHigh-quality careLogistic regression modelsCancer HospitalCommon cancerFindings highlight gapsCancer programsAssociation Between Food and Drug Administration Approval and Disparities in Immunotherapy Use Among Patients With Cancer in the US
Ermer T, Canavan ME, Maduka RC, Li AX, Salazar MC, Kaminski MF, Pichert MD, Zhan PL, Mase V, Kluger H, Boffa DJ. Association Between Food and Drug Administration Approval and Disparities in Immunotherapy Use Among Patients With Cancer in the US. JAMA Network Open 2022, 5: e2219535. PMID: 35771575, PMCID: PMC9247736, DOI: 10.1001/jamanetworkopen.2022.19535.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerRenal cell carcinomaUse of immunotherapyFDA approvalImmunotherapy useCohort studyClinical trialsNovel therapiesStage IV non-small cell lung cancerMultivariable logistic regression modelingFirst checkpoint inhibitorCheckpoint inhibitor therapyNational Cancer DatabasePatients 20 yearsCell lung cancerSocioeconomic strataTreatment of patientsDrug Administration approvalLife-saving treatmentReceipt of immunotherapyLogistic regression modelingSocioeconomic characteristicsImmunotherapy administrationCheckpoint inhibitorsPatient characteristics
2021
Trends in Patient Volume by Hospital Type and the Association of These Trends With Time to Cancer Treatment Initiation
Frosch ZAK, Illenberger N, Mitra N, Boffa DJ, Facktor MA, Nelson H, Palis BE, Bekelman JE, Shulman LN, Takvorian SU. Trends in Patient Volume by Hospital Type and the Association of These Trends With Time to Cancer Treatment Initiation. JAMA Network Open 2021, 4: e2115675. PMID: 34241630, PMCID: PMC8271360, DOI: 10.1001/jamanetworkopen.2021.15675.Peer-Reviewed Original ResearchConceptsTreatment initiationCross-sectional studyCommunity hospitalHospital typeAcademic centersPatient volumeNCI centersMAIN OUTCOMETimely treatmentMean annual rateCancer treatmentCancer treatment initiationCancer-accredited hospitalsCommon incident cancerFirst cancer treatmentNational Cancer DatabaseTime interaction termNational Cancer InstituteMean annual changeAdult patientsIncident cancerReferral centerTreatment delayCancer careCancer DatabaseRandomized Phase II Study of PET Response–Adapted Combined Modality Therapy for Esophageal Cancer: Mature Results of the CALGB 80803 (Alliance) Trial
Goodman KA, Ou FS, Hall NC, Bekaii-Saab T, Fruth B, Twohy E, Meyers MO, Boffa DJ, Mitchell K, Frankel WL, Niedzwiecki D, Noonan A, Janjigian YY, Thurmes PJ, Venook AP, Meyerhardt JA, O'Reilly EM, Ilson DH. Randomized Phase II Study of PET Response–Adapted Combined Modality Therapy for Esophageal Cancer: Mature Results of the CALGB 80803 (Alliance) Trial. Journal Of Clinical Oncology 2021, 39: 2803-2815. PMID: 34077237, PMCID: PMC8407649, DOI: 10.1200/jco.20.03611.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCarboplatinChemoradiotherapyCombined Modality TherapyEsophageal NeoplasmsFemaleFluorodeoxyglucose F18FluorouracilFollow-Up StudiesHumansLeucovorinMaleMiddle AgedOxaliplatinPositron-Emission TomographyPrognosisRadiopharmaceuticalsSurvival RateYoung AdultConceptsPositron emission tomographyRepeat positron emission tomographyPET respondersEsophagogastric junction adenocarcinomaStandardized uptake valueInduction FOLFOXPET nonrespondersPCR rateOverall survivalJunction adenocarcinomaPathologic complete response rateRandomized phase II studyBaseline positron emission tomographyMaximum standardized uptake valueInduction chemotherapy regimenComplete response rateEarly response assessmentMedian overall survivalPhase II studyPrimary end pointCombined modality therapySame chemotherapyChemotherapy regimenEligible patientsII studyAdjuvant Chemotherapy for T4 Non-Small Cell Lung Cancer with Additional Ipsilateral Lung Nodules
Li AX, Flores K, Canavan ME, Boffa DJ, Blasberg JD. Adjuvant Chemotherapy for T4 Non-Small Cell Lung Cancer with Additional Ipsilateral Lung Nodules. The Annals Of Thoracic Surgery 2021, 113: 421-428. PMID: 33684345, DOI: 10.1016/j.athoracsur.2021.02.042.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerDifferent ipsilateral lobeCell lung cancerAdditional tumor nodulesT4 non-small cell lung cancerAdjuvant chemotherapyIpsilateral lobeT4 diseaseTumor nodulesLung cancerT4 tumorsOverall survivalSurgical resectionIIIA non-small cell lung cancerAdjuvant multiagent chemotherapyResectable stage IINational Cancer DatabaseFurther prospective studiesLymph node metastasisMultiagent chemotherapyNode metastasisPrimary outcomeProspective studyPatient populationCancer Database
2020
Costs Associated With Lobectomy for Lung Cancer: An Analysis Merging STS and Medicare Data
Medbery RL, Fernandez FG, Kosinski AS, Tong BC, Furnary AP, Feng L, Onaitis M, Boffa D, Wright CD, Cowper P, Jacobs JP, Putnam JB, Habib RH. Costs Associated With Lobectomy for Lung Cancer: An Analysis Merging STS and Medicare Data. The Annals Of Thoracic Surgery 2020, 111: 1781-1790. PMID: 33188754, DOI: 10.1016/j.athoracsur.2020.08.073.Peer-Reviewed Original ResearchConceptsLung cancerHospital characteristicsMedicare dataClinical stage I lung cancerCare costsRecurrent laryngeal nerve paresisStage I lung cancerEarly-stage lung cancerThoracic Surgeons General Thoracic Surgery DatabaseI lung cancerPreoperative patient factorsChronic kidney diseaseGeneral Thoracic Surgery DatabaseLaryngeal nerve paresisSeverity of complicationsBody mass indexCase-mix factorsCare of patientsNumber of complicationsThoracic Surgery DatabaseNerve paresisPerioperative outcomesPostoperative complicationsRespiratory failureExpiratory volumeA National Study of Surgically Managed Atypical Pulmonary Carcinoid Tumors
Walters SL, Canavan ME, Salazar MC, Resio BJ, Blasberg JD, Mase V, Boffa DJ. A National Study of Surgically Managed Atypical Pulmonary Carcinoid Tumors. The Annals Of Thoracic Surgery 2020, 112: 921-927. PMID: 33159862, DOI: 10.1016/j.athoracsur.2020.09.029.Peer-Reviewed Original ResearchConceptsAtypical pulmonary carcinoid tumorsPulmonary carcinoid tumorsCarcinoid tumorsCarcinoid patientsAtypical carcinoidStage IMultivariable Cox proportional hazards regressionNon-small cell lung cancerCox proportional hazards regressionAtypical carcinoid patientsTypical pulmonary carcinoidNational Cancer DatabasePredictors of survivalOptimal surgical managementAtypical carcinoid tumorCell lung cancerProportional hazards regressionKaplan-Meier survivalLong-term survivalNodal upstagingSurgical resectionMultivariable analysisSurgical managementHazards regressionLarge tumorsResults of COVID-minimal Surgical Pathway During Surge-phase of COVID-19 Pandemic
Boffa DJ, Judson BL, Billingsley KG, Del Rossi E, Hindinger K, Walters S, Ermer T, Ratner E, Mitchell MR, Laurans MS, Johnson DC, Yoo PS, Morton JM, Zurich HB, Davis K, Ahuja N. Results of COVID-minimal Surgical Pathway During Surge-phase of COVID-19 Pandemic. Annals Of Surgery 2020, 272: e316-e320. PMID: 33086321, PMCID: PMC7668334, DOI: 10.1097/sla.0000000000004455.Peer-Reviewed Original ResearchConceptsHospital-acquired COVID-19 infectionCOVID-19 infectionSurgical pathwayCOVID-19 hospital admissionsCOVID-19 pandemicCommon surgical indicationsUrgent cancer treatmentOutcomes of patientsCOVID-19 patientsCOVID-19 testingCOVID-19 positive peoplePathway patientsPostoperative periodTimely surgeryHospital admissionMedian ageSurgical indicationsUrgent operationMedian lengthCancer patientsGenitourinary tractEmergency roomBACKGROUND DATASurgical proceduresPatient statusIntestinal metaplasia around the gastroesophageal junction is frequently associated with antral reactive gastropathy: implications for carcinoma at the gastroesophageal junction
Vyas M, Celli R, Singh M, Patel N, Aslanian HR, Boffa D, Deng Y, Ciarleglio MM, Laine L, Jain D. Intestinal metaplasia around the gastroesophageal junction is frequently associated with antral reactive gastropathy: implications for carcinoma at the gastroesophageal junction. Human Pathology 2020, 105: 67-73. PMID: 32941964, PMCID: PMC11152084, DOI: 10.1016/j.humpath.2020.08.007.Peer-Reviewed Original ResearchConceptsNonsteroidal anti-inflammatory drugsBile refluxIntestinal metaplasiaReactive gastropathyGEJ regionMucosal injuryMucosal changesGastroesophageal junctionAntral intestinal metaplasiaDistal esophageal adenocarcinomaDetailed clinical historySex-matched patientsGastric antral biopsiesAnti-inflammatory drugsGastric bile refluxMucosal inflammationProximal stomachDistal esophagusMedication usePancreatic metaplasiaPathology databaseProximal gastricAntral biopsiesClinical historyGastric biopsiesWhere the Other Half Dies: Analysis of Mortalities Occurring More Than 30 Days After Complex Cancer Surgery
Resio BJ, Gonsalves L, Canavan M, Mueller L, Phillips C, Sathe T, Swett K, Boffa DJ. Where the Other Half Dies: Analysis of Mortalities Occurring More Than 30 Days After Complex Cancer Surgery. Annals Of Surgical Oncology 2020, 28: 1278-1286. PMID: 32885398, DOI: 10.1245/s10434-020-09080-7.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCause of deathCancer surgeryLate mortalityNursing facilitiesTumor registry databaseLate postoperative periodDay of surgeryLocation of deathAnalysis of mortalityCircumstances of deathIndex admissionPulmonary causesCardiac causesOperative mortalityFatal complicationPostoperative periodThromboembolic diseaseNonmetastatic cancerRegistry databaseDeath documentationSurgical safetySurgeryPatientsMortalityAssociation of Programmed Cell Death Ligand 1 Expression Status With Receipt of Immune Checkpoint Inhibitors in Patients With Advanced Non–Small Cell Lung Cancer
Leapman MS, Presley CJ, Zhu W, Soulos PR, Adelson KB, Miksad RA, Boffa DJ, Gross CP. Association of Programmed Cell Death Ligand 1 Expression Status With Receipt of Immune Checkpoint Inhibitors in Patients With Advanced Non–Small Cell Lung Cancer. JAMA Network Open 2020, 3: e207205. PMID: 32511721, PMCID: PMC7280954, DOI: 10.1001/jamanetworkopen.2020.7205.Peer-Reviewed Original ResearchConceptsAdvanced non-small cell lung cancerNon-small cell lung cancerFirst-line ICI treatmentImmune checkpoint inhibitorsPD-L1 expressionPD-L1 testingNegative PD-L1 expressionHigh PD-L1 expressionCell lung cancerICI treatmentCheckpoint inhibitorsLung cancerDeath ligand 1 (PD-L1) expression statusElectronic health record-derived databaseFirst-line immune checkpoint inhibitorsCell death ligand 1 (PD-L1) expressionExpression statusLow PD-L1 expressionPD-L1 expression statusDeath ligand 1 (PD-L1) expressionRetrospective cohort studyFirst-line treatmentLigand 1 expressionProportion of patientsReal-world careSurvival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals
Boffa DJ, Mallin K, Herrin J, Resio B, Salazar MC, Palis B, Facktor M, McCabe R, Nelson H, Shulman LN. Survival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals. JAMA Network Open 2020, 3: e203942. PMID: 32453382, PMCID: PMC7251445, DOI: 10.1001/jamanetworkopen.2020.3942.Peer-Reviewed Original ResearchConceptsLong-term survivalCancer HospitalSurgical treatmentShort-term survivalComplex cancer treatmentAffiliate hospitalsCancer treatmentCancer careAdjusted long-term survivalNational Cancer DatabaseAnnual surgical volumeComplex cancer careIndividuals 18 yearsComplex surgical proceduresPerioperative mortalityCohort studyAffiliated HospitalPooled analysisBladder cancerCancer DatabasePatient outcomesSurgical volumeSurgical proceduresMAIN OUTCOMESurvival advantageInvasive Staging Procedures Do Not Prevent Nodal Metastases From Being Missed in Stage I Lung Cancer
Resio BJ, Canavan M, Mase V, Dhanasopon AP, Blasberg JD, Boffa DJ. Invasive Staging Procedures Do Not Prevent Nodal Metastases From Being Missed in Stage I Lung Cancer. The Annals Of Thoracic Surgery 2020, 110: 390-397. PMID: 32283084, DOI: 10.1016/j.athoracsur.2020.03.026.Peer-Reviewed Original ResearchConceptsStage I lung cancerI lung cancerMissed nodal metastasisClinical stage I lung cancerNodal metastasisLung cancerPositron emission tomographyStaging evaluationCancer patientsEndobronchial ultrasoundInvasive nodalClinical stage I patientsEarly-stage lung cancer patientsOccult lymph node metastasisEmission tomographyThoracic Surgeons General Thoracic Surgery DatabaseInvasive staging proceduresClinical stage IStage I patientsTreatment-naive patientsGeneral Thoracic Surgery DatabaseLow-risk cohortOccult nodal metastasisLymph node metastasisLung cancer patientsEquivalent Survival Between Lobectomy and Segmentectomy for Clinical Stage IA Lung Cancer
Onaitis MW, Furnary AP, Kosinski AS, Feng L, Boffa D, Tong BC, Cowper P, Jacobs JP, Wright CD, Habib R, Putnam JB, Fernandez FG. Equivalent Survival Between Lobectomy and Segmentectomy for Clinical Stage IA Lung Cancer. The Annals Of Thoracic Surgery 2020, 110: 1882-1891. PMID: 32119855, DOI: 10.1016/j.athoracsur.2020.01.020.Peer-Reviewed Original ResearchConceptsThoracic Surgeons databaseSurgeons databaseLung cancerSimilar survivalClinical stage IA lung cancerClinical stage IA diseaseStage IA lung cancerEarly-stage lung cancerPositron emission tomography resultsThoracic Surgeons General Thoracic Surgery DatabaseStage IA diseaseGeneral Thoracic Surgery DatabaseLung cancer patientsMediastinal staging proceduresThoracic Surgery DatabaseLong-term survivalIA diseaseN0 patientsStaging procedureOncologic efficacyCox regressionEntire cohortCancer patientsClinical variablesEquivalent survivalSurgically Managed Signet Ring Cell Esophageal Carcinomas in the National Cancer Database
Sathe TS, Resio BJ, Hoag JR, Monsalve AF, Pathak R, Blasberg JD, Mase V, Dhanasopon A, Boffa DJ. Surgically Managed Signet Ring Cell Esophageal Carcinomas in the National Cancer Database. The Annals Of Thoracic Surgery 2020, 109: 1656-1662. PMID: 32109449, DOI: 10.1016/j.athoracsur.2020.01.021.Peer-Reviewed Original ResearchConceptsSignet ring cell adenocarcinomaNational Cancer DatabaseSRC tumorsACA patientsCancer DatabaseProportional hazards regression modelsCommon histologic variantRole of esophagectomyClinical stage IRole of surgeryHazards regression modelsHigh-grade tumorsSRC histologySRC patientsAdult patientsComplete resectionWorse prognosisCell adenocarcinomaEsophageal cancerEsophageal carcinomaHistologic variantsSuperior survivalEsophageal adenocarcinomaTreatment characteristicsClinical recommendations
2019
Digital Inference of Immune Microenvironment Reveals Low-Risk Subtype of Early Lung Adenocarcinoma
Kurbatov V, Balayev A, Saffarzadeh A, Heller DR, Boffa DJ, Blasberg JD, Lu J, Khan SA. Digital Inference of Immune Microenvironment Reveals Low-Risk Subtype of Early Lung Adenocarcinoma. The Annals Of Thoracic Surgery 2019, 109: 343-349. PMID: 31568747, DOI: 10.1016/j.athoracsur.2019.08.050.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinoma of LungAdultAgedCohort StudiesDatabases, FactualDisease-Free SurvivalFemaleHumansImmunotherapyKaplan-Meier EstimateLung NeoplasmsMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPneumonectomyPrognosisProportional Hazards ModelsRetrospective StudiesRisk AssessmentSurvival AnalysisTumor MicroenvironmentConceptsTumor immune microenvironmentImmune microenvironmentLung adenocarcinomaOverall survivalRisk groupsMast cellsCox proportional hazard modelingEarly-stage lung adenocarcinomaLow-risk subtypesKaplan-Meier analysisPathological staging systemProportional hazard modelingImproved clinical outcomesCancer immune microenvironmentImmune cell typesEarly lung adenocarcinomaActivation stateClinical outcomesValidation cohortMacrophage contentStaging systemMultivariable modelCIBERSORT analysisPatientsClinical decisionComparison of Survival Rates After a Combination of Local Treatment and Systemic Therapy vs Systemic Therapy Alone for Treatment of Stage IV Non–Small Cell Lung Cancer
Uhlig J, Case MD, Blasberg JD, Boffa DJ, Chiang A, Gettinger SN, Kim HS. Comparison of Survival Rates After a Combination of Local Treatment and Systemic Therapy vs Systemic Therapy Alone for Treatment of Stage IV Non–Small Cell Lung Cancer. JAMA Network Open 2019, 2: e199702. PMID: 31433481, PMCID: PMC6707019, DOI: 10.1001/jamanetworkopen.2019.9702.Peer-Reviewed Original ResearchMeSH KeywordsAblation TechniquesAdolescentAdultAgedAged, 80 and overAntineoplastic AgentsCarcinoma, Non-Small-Cell LungChemotherapy, AdjuvantComparative Effectiveness ResearchDatabases, FactualFemaleFollow-Up StudiesHumansLung NeoplasmsMaleMiddle AgedNeoplasm MetastasisNeoplasm StagingPneumonectomyProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSurvival RateTreatment OutcomeYoung AdultConceptsStage IV non-small cell lung cancerNon-small cell lung cancerPrimary tumor siteSuperior overall survivalSystemic therapySurgical resectionCell lung cancerExternal beam radiotherapyOverall survivalSurvival benefitLocal treatmentTumor siteTumor characteristicsLung cancerTreatment groupsMultivariable Cox proportional hazards regression modelsOligometastatic non-small cell lung cancerStage IV squamous cell carcinomaSurvival rateCox proportional hazards regression modelProportional hazards regression modelsComparative effectiveness research studyCancer-specific factorsNational Cancer DatabaseStage IV disease