2024
American College of Surgeons Operative Standards and Breast Cancer Outcomes
Taylor C, Wang T, Baskin A, Sinco B, Hughes T, Boffa D, Boughey J, Dossett L. American College of Surgeons Operative Standards and Breast Cancer Outcomes. JAMA Network Open 2024, 7: e2446345. PMID: 39565622, PMCID: PMC11579798, DOI: 10.1001/jamanetworkopen.2024.46345.Peer-Reviewed Original ResearchConceptsAmerican College of SurgeonsSentinel lymph node biopsyAxillary lymph node dissectionInvasive breast cancerLymph node yieldNodal positivity rateShort-term oncological outcomesBreast cancerCohort studyNational Cancer DatabaseNodal yieldAmerican CollegeFacility-level variationNodal upstaging rateCohort study of womenUpstaging rateOncological outcomesNode yieldHospital registry dataPotential associationStudy of womenAxillary surgeryCollege of SurgeonsMain OutcomesPoisson regressionAssociation 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 regressionMedicaid Expansion Under the Affordable Care Act and Early Mortality Following Lung Cancer Surgery
Nogueira L, Boffa D, Jemal A, Han X, Yabroff K. Medicaid Expansion Under the Affordable Care Act and Early Mortality Following Lung Cancer Surgery. JAMA Network Open 2024, 7: e2351529. PMID: 38214932, PMCID: PMC10787311, DOI: 10.1001/jamanetworkopen.2023.51529.Peer-Reviewed Original ResearchConceptsMedicaid expansion statusNon-small cell lung cancerMedicaid expansion statesMedicaid expansionSurgical resection of non-small cell lung cancerResection of non-small cell lung cancerDifference-in-differencesExpansion statesPatients' state of residenceNonexpansion statesCohort studyAssociation of Medicaid expansionExpansion statusPostoperative mortalityDifference-in-differences analysisStudy population characteristicsState of residenceAffordable Care ActHealth insurance coverageCohort study of patientsSurgical resectionEarly mortalityMain OutcomesAssociated with declinesCancer outcomes
2022
Acceptance 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 characteristicsUnderstanding the Implications of Medicaid Expansion for Cancer Care in the US
Ermer T, Walters SL, Canavan ME, Salazar MC, Li AX, Doonan M, Boffa DJ. Understanding the Implications of Medicaid Expansion for Cancer Care in the US. JAMA Oncology 2022, 8: 139-148. PMID: 34762101, DOI: 10.1001/jamaoncol.2021.4323.Peer-Reviewed Original ResearchConceptsUS cancer populationCancer careMedicaid expansionCancer populationEligibility criteriaHealth policy initiativesHealth policy factorsOncology teamAffordable Care ActInsurance statusOncological careMedicaid coverageExpansion of MedicaidUninsured individualsCancer treatmentInsurance profileCareInterpretation of findingsPatient ProtectionHealth insuranceMedicaidCare ActSignificant changes
2021
Baseline Evaluation of Cancer Mortality in US States that Expanded Medicaid vs Nonexpansion States
Salazar MC, Kaminski MF, Canavan ME, Maduka RC, Li AX, Ermer T, Boffa DJ. Baseline Evaluation of Cancer Mortality in US States that Expanded Medicaid vs Nonexpansion States. JAMA Oncology 2021, 7: 1394-1395. PMID: 34292299, PMCID: PMC8299357, DOI: 10.1001/jamaoncol.2021.2582.Peer-Reviewed Original ResearchTrends 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 DatabaseAdjuvant 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 tumorsWhere 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 safetySurgeryPatientsMortalityEvaluation of Cancer Care After Medicaid Expansion Under the Affordable Care Act
Salazar MC, Canavan ME, Walters SL, Herrin J, Schwartz JL, Leapman M, Boffa DJ. Evaluation of Cancer Care After Medicaid Expansion Under the Affordable Care Act. JAMA Network Open 2020, 3: e2017544. PMID: 32990734, PMCID: PMC7525361, DOI: 10.1001/jamanetworkopen.2020.17544.Peer-Reviewed Original ResearchSurvival 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 advantageEquivalent 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 survival
2019
The Society of Thoracic Surgeons General Thoracic Surgery Database: 2019 Update on Research
Crabtree TD, Boffa DJ, Lobdell KW, Habib RH, Gaissert HA. The Society of Thoracic Surgeons General Thoracic Surgery Database: 2019 Update on Research. The Annals Of Thoracic Surgery 2019, 108: 1293-1298. PMID: 31520641, DOI: 10.1016/j.athoracsur.2019.09.001.Peer-Reviewed Original ResearchDifferential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery
Hoag JR, Resio BJ, Monsalve AF, Chiu AS, Brown LB, Herrin J, Blasberg JD, Kim AW, Boffa DJ. Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery. JAMA Network Open 2019, 2: e191912. PMID: 30977848, PMCID: PMC6481444, DOI: 10.1001/jamanetworkopen.2019.1912.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer surgeryCancer HospitalMedicare beneficiariesCancer NetworkRelative safetyStandardized mortality ratioComplex cancer careCross-sectional studyTop-ranked hospitalsMedicaid Services 100Hierarchical logistic regressionPerioperative mortalityAffiliated HospitalCancer careMortality ratioOdds ratioMAIN OUTCOMESurgeryHospitalReview filesDifferential safetyLogistic regressionMortalityMedicare providers
2018
Variable impact of prior cancer history on the survival of lung cancer patients
Monsalve AF, Hoag JR, Resio BJ, Chiu AS, Brown LB, Detterbeck FC, Blasberg JD, Boffa DJ. Variable impact of prior cancer history on the survival of lung cancer patients. Lung Cancer 2018, 127: 130-137. PMID: 30642541, DOI: 10.1016/j.lungcan.2018.11.040.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerPrior cancer historyNational Cancer DatabaseCancer historyOverall survivalNSCLC patientsMultivariable Cox proportional hazards regression modelsTreatment approachesCox proportional hazards regression modelProportional hazards regression modelsKaplan-Meier survival curvesNSCLC patient survivalCell lung cancerHazards regression modelsLung cancer patientsPrior cancerPrior malignancyNSCLC survivalPatient survivalCancer patientsLung cancerCancer DatabasePatient's potentialPrior historyPatients
2017
Using the National Cancer Database for Outcomes Research: A Review
Boffa DJ, Rosen JE, Mallin K, Loomis A, Gay G, Palis B, Thoburn K, Gress D, McKellar DP, Shulman LN, Facktor MA, Winchester DP. Using the National Cancer Database for Outcomes Research: A Review. JAMA Oncology 2017, 3: 1722-1728. PMID: 28241198, DOI: 10.1001/jamaoncol.2016.6905.Peer-Reviewed Original Research
2016
The differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies
Jawitz OK, Wang Z, Boffa DJ, Detterbeck FC, Blasberg JD, Kim AW. The differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies. European Journal Of Cardio-Thoracic Surgery 2016, 51: 169-174. PMID: 27458143, DOI: 10.1093/ejcts/ezw239.Peer-Reviewed Original ResearchConceptsNationwide Inpatient SampleOpen lobectomyPostoperative lengthVATS lobectomyLobectomy patientsVideo-assisted thoracoscopic surgery lobectomyBenign lung conditionsOpen lobectomy patientsPerioperative pulmonary complicationsVATS lobectomy patientsNumber of comorbiditiesNon-elective admissionsCell lung cancerMultivariable logistic regressionThoracoscopic surgery lobectomyStandard of careUtilization Project databasePreoperative patient comorbiditiesCumulative incidence modelsLogistic regression modellingHospital mortalityPreoperative comorbiditiesPulmonary complicationsGreater comorbidityPerioperative outcomes