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
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
Appendiceal Cancer in the National Cancer Database: Increasing Frequency, Decreasing Age, and Shifting Histology.
Salazar MC, Canavan ME, Chilakamarry S, Boffa DJ, Schuster KM. Appendiceal Cancer in the National Cancer Database: Increasing Frequency, Decreasing Age, and Shifting Histology. Journal Of The American College Of Surgeons 2022, 234: 1082-1089. PMID: 35703801, DOI: 10.1097/xcs.0000000000000172.Peer-Reviewed Original ResearchConceptsRight-sided colon cancerNational Cancer DatabaseAppendiceal cancerColon cancerAcute appendicitisNonoperative managementCancer DatabasePatients 49 yearsPatients 18 yearsArea of residenceLogistic regression modelsAppendiceal histologyPatients 40Appendectomy specimensPatient ageCarcinoid tumorsAppendiceal carcinoidsCancer incidenceCancer histologySmall studyAge groupsCancerCarcinoidsLogistic regressionHistology
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 study
2020
A 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 biopsiesEvaluation 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 ResearchAssociation 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 patientsSurgically 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 diseasePatterns of failure after immunotherapy with checkpoint inhibitors predict durable progression-free survival after local therapy for metastatic melanoma
Klemen ND, Wang M, Feingold PL, Cooper K, Pavri SN, Han D, Detterbeck FC, Boffa DJ, Khan SA, Olino K, Clune J, Ariyan S, Salem RR, Weiss SA, Kluger HM, Sznol M, Cha C. Patterns of failure after immunotherapy with checkpoint inhibitors predict durable progression-free survival after local therapy for metastatic melanoma. Journal For ImmunoTherapy Of Cancer 2019, 7: 196. PMID: 31340861, PMCID: PMC6657062, DOI: 10.1186/s40425-019-0672-3.Peer-Reviewed Original ResearchConceptsThree-year progression-free survivalProgression-free survivalDisease-specific survivalFive-year disease-specific survivalPatterns of failureDurable progression-free survivalLocal therapyStereotactic body radiotherapyMetastatic melanomaNew metastasesPatient selectionIndependent radiological reviewOngoing complete responseResultsFour hundred twentyEvidence of diseaseCNS metastasisCPI treatmentImmunotherapy failureCheckpoint inhibitorsMost patientsProgressive diseaseRadiological reviewComplete responsePD-1PD-L1Sternotomy for aortic dissection with substernal pull through: The importance of surgical history
Pichert M, Mori M, Boffa DJ, Mangi AA. Sternotomy for aortic dissection with substernal pull through: The importance of surgical history. Journal Of Thoracic And Cardiovascular Surgery 2019, 159: e325-e326. PMID: 31350021, DOI: 10.1016/j.jtcvs.2019.04.038.Peer-Reviewed Original Research
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