2018
Expert Consensus Document on Pulmonary Metastasectomy
Handy JR, Bremner RM, Crocenzi TS, Detterbeck FC, Fernando HC, Fidias PM, Firestone S, Johnstone CA, Lanuti M, Litle VR, Kesler KA, Mitchell JD, Pass HI, Ross HJ, Varghese TK. Expert Consensus Document on Pulmonary Metastasectomy. The Annals Of Thoracic Surgery 2018, 107: 631-649. PMID: 30476477, DOI: 10.1016/j.athoracsur.2018.10.028.Peer-Reviewed Original ResearchIdentifying Drivers of Multiple Readmissions After Pulmonary Lobectomy
Jean RA, Chiu AS, Hoag JR, Blasberg JD, Boffa DJ, Detterbeck FC, Kim AW. Identifying Drivers of Multiple Readmissions After Pulmonary Lobectomy. The Annals Of Thoracic Surgery 2018, 107: 947-953. PMID: 30336117, DOI: 10.1016/j.athoracsur.2018.08.070.Peer-Reviewed Original ResearchConceptsPulmonary lobectomyMultiple readmissionsSecond readmissionFirst readmissionIndex hospitalizationPostoperative infectionLung cancerPrimary diagnosisHeart diseaseClinical Classification Software codesNationwide Readmissions DatabaseTime of readmissionPostoperative arrhythmiasPostoperative complicationsPostoperative sepsisPerioperative periodPostoperative periodClinical factorsReadmissionLobectomyPatientsStudy periodImportant markerDiagnosisHealthcare qualityDelayed discharge does not decrease the cost of readmission after pulmonary lobectomy
Jean RA, Chiu AS, Boffa DJ, Detterbeck FC, Kim AW, Blasberg JD. Delayed discharge does not decrease the cost of readmission after pulmonary lobectomy. Surgery 2018, 164: 1294-1299. PMID: 30064733, DOI: 10.1016/j.surg.2018.05.049.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesReadmission ratesLate dischargeDischarge groupPulmonary lobectomyCostly readmissionsLung cancerHospital costsOverall health care utilizationExcess health care costsRoutine dischargeCosts of readmissionIndex hospital costsLate discharge groupRoutine discharge groupPatients 65 yearsNationwide Readmissions DatabaseHospital day 1Hospital day 4Health care utilizationCases of lobectomyHealth care costsIndex hospitalHospital durationCare utilizationDefining the learning curve in robot-assisted thoracoscopic lobectomy
Arnold BN, Thomas DC, Bhatnagar V, Blasberg JD, Wang Z, Boffa DJ, Detterbeck FC, Kim AW. Defining the learning curve in robot-assisted thoracoscopic lobectomy. Surgery 2018, 165: 450-454. PMID: 30061043, DOI: 10.1016/j.surg.2018.06.011.Peer-Reviewed Original ResearchConceptsLength of stayRobot-assisted thoracoscopic lobectomyChest tube durationThoracoscopic lobectomyPostoperative complicationsTube durationBlood lossLearning curveSignificant differencesCumulative sum analysisPhase 1Complication ratePatient demographicsPulmonary lobectomySingle institutionLobectomyRATS lobectomySafe approachStayCase 1Cases 23Operating timeComorbiditiesComplicationsFurther studiesRobotic-Assisted Lobectomies in the National Cancer Database
Arnold BN, Thomas DC, Narayan R, Blasberg JD, Detterbeck FC, Boffa DJ, Kim AW. Robotic-Assisted Lobectomies in the National Cancer Database. Journal Of The American College Of Surgeons 2018, 226: 1052-1062.e15. PMID: 29574177, DOI: 10.1016/j.jamcollsurg.2018.03.023.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseRobotic lobectomyLung cancerCancer DatabaseOutcomes of patientsPropensity-matched analysisThoracoscopic surgery lobectomyExperienced hospitalsOverall conversion ratePerioperative morbidityPrimary outcomePatient selectionAttendant sequelaeOpen procedureLobectomyAssisted LobectomyHigh mortalityHospitalPatientsMortalityIndividual hospitalsRate of conversionSignificant differencesYears of experienceOutcomesTiming and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection
Thomas DC, Arnold BN, Hoag JR, Salazar MC, Detterbeck FC, Boffa DJ, Kim AW, Blasberg JD. Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection. The Annals Of Thoracic Surgery 2018, 105: 1469-1475. PMID: 29501644, DOI: 10.1016/j.athoracsur.2018.01.072.Peer-Reviewed Original ResearchConceptsPostdischarge venous thromboembolismVenous thromboembolismHospital dischargeOperative timeRisk factorsPostdischarge prophylaxisVTE eventsMultivariable analysisLung cancerNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseExtended VTE prophylaxisLung cancer resectionImprovement Program databaseShorter operative timeLengthy resectionsVTE prophylaxisAnatomic resectionClinical characteristicsInvasive resectionLung resectionOlder patientsOpen resectionCancer resectionIndependent predictors
2017
Fate of Pneumonectomy Patients Variably Captured by Non-Small Cell Lung Cancer Staging System
Dhanasopon AP, Salazar MC, Hoag JR, Rosen JE, Kim AW, Detterbeck FC, Blasberg JD, Boffa DJ. Fate of Pneumonectomy Patients Variably Captured by Non-Small Cell Lung Cancer Staging System. The Annals Of Thoracic Surgery 2017, 104: 1829-1836. PMID: 29074151, DOI: 10.1016/j.athoracsur.2017.06.073.Peer-Reviewed Original ResearchConceptsLung cancer staging systemCancer (AJCC) staging systemPneumonectomy patientsLung cancerMortality riskStage IStaging systemLobectomy patientsCox modelNon-small cell lung cancerMultivariable Cox modelNational Cancer DatabaseTreatment-naive patientsOverall survival curvesCell lung cancerLung cancer patientsBenefits of treatmentHigher mortality riskStage-specific survivalRight pneumonectomyLeft pneumonectomyCancer patientsCancer DatabaseInclusion criteriaPneumonectomyThe Significance of Upfront Knowledge of N2 Disease in Non‐small Cell Lung Cancer
Thomas DC, Arnold BN, Rosen JE, Salazar MC, Detterbeck FC, Blasberg JD, Boffa DJ, Kim AW. The Significance of Upfront Knowledge of N2 Disease in Non‐small Cell Lung Cancer. World Journal Of Surgery 2017, 42: 161-171. PMID: 28799084, DOI: 10.1007/s00268-017-4165-6.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerUnsuspected N2 diseaseIII-N2 non-small cell lung cancerN2 diseaseCell lung cancerSurgical resectionAdjuvant chemotherapyAdjuvant therapyOverall survivalPathologic stageLung cancerMultivariate analysisCurative-intent surgical resectionStage IIIA NSCLCHigher comorbidity scoreNational Cancer DatabaseIndependent risk factorKaplan-Meier analysisCN2 diseaseIIIA NSCLCComorbidity scoreCancer DatabaseRisk factorsRetrospective analysisRadiation therapyEffectiveness of local therapy for stage I non–small-cell lung cancer in nonagenarians
Arnold BN, Thomas DC, Rosen JE, Salazar MC, Detterbeck FC, Blasberg JD, Boffa DJ, Kim AW. Effectiveness of local therapy for stage I non–small-cell lung cancer in nonagenarians. Surgery 2017, 162: 640-651. PMID: 28697883, DOI: 10.1016/j.surg.2017.04.025.Peer-Reviewed Original ResearchMeSH KeywordsAged, 80 and overCarcinoma, Non-Small-Cell LungConfidence IntervalsDatabases, FactualDisease-Free SurvivalFemaleGeriatric AssessmentHumansKaplan-Meier EstimateLogistic ModelsLung NeoplasmsMaleMultivariate AnalysisNeoplasm InvasivenessNeoplasm StagingOdds RatioPneumonectomyProportional Hazards ModelsRadiotherapyRegistriesRisk AssessmentSecondary PreventionSurvival AnalysisConceptsCell lung cancerLocal therapyLung cancerStage IRelative survivalStereotactic body radiation therapyNational Cancer DatabaseBetter overall survivalBody radiation therapyOlder patientsOverall survivalPatient ageYounger patientsOverall mortalityPrimary outcomeCancer DatabaseTreatment outcomesTreatment decisionsRadiation therapyPatientsTherapyCancerNonagenariansTreatmentSurvivalValidating the Thoracic Revised Cardiac Risk Index Following Lung Resection
Thomas DC, Blasberg JD, Arnold BN, Rosen JE, Salazar MC, Detterbeck FC, Boffa DJ, Kim AW. Validating the Thoracic Revised Cardiac Risk Index Following Lung Resection. The Annals Of Thoracic Surgery 2017, 104: 389-394. PMID: 28499655, DOI: 10.1016/j.athoracsur.2017.02.006.Peer-Reviewed Original ResearchConceptsAdditional cardiac evaluationIschemic heart diseaseLarger multi-institutional datasetsCardiac complicationsLung resectionRenal comorbiditiesCardiac evaluationCerebrovascular diseaseHeart diseaseRisk factorsMulti-institutional datasetSurgeons National Surgical Quality Improvement Program datasetNational Surgical Quality Improvement Program datasetCardiac complication ratesMajor cardiac complicationsPreoperative risk factorsUnderwent pneumonectomyCardiac indexComplication ratePrimary outcomeRisk classesMalignant diseaseOpen procedureAmerican CollegeHigh riskAssociation of Delayed Adjuvant Chemotherapy With Survival After Lung Cancer Surgery
Salazar MC, Rosen JE, Wang Z, Arnold BN, Thomas DC, Herbst RS, Kim AW, Detterbeck FC, Blasberg JD, Boffa DJ. Association of Delayed Adjuvant Chemotherapy With Survival After Lung Cancer Surgery. JAMA Oncology 2017, 3: 610-619. PMID: 28056112, PMCID: PMC5824207, DOI: 10.1001/jamaoncol.2016.5829.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungChemotherapy, AdjuvantDrug Administration ScheduleFemaleHumansLung NeoplasmsMaleMiddle AgedNeoplasm GradingNeoplasm StagingPneumonectomyPostoperative PeriodProportional Hazards ModelsRetrospective StudiesTreatment OutcomeUnited StatesConceptsLung cancer surgeryCell lung cancer resectionAdjuvant chemotherapyLung cancer resectionNational Cancer DatabaseCell lung cancerLower mortality riskCancer surgeryCox modelCancer resectionLung cancerCancer DatabaseMortality riskCell lung cancer surgeryHospital-based tumor registryIncident lung cancer casesPostoperative multiagent chemotherapyInitiation of chemotherapyTreatment-naive patientsPropensity-matched pairsRetrospective observational studyLymph node metastasisLung cancer casesChemotherapy initiationPostoperative chemotherapy
2016
Defining outcomes of patients with clinical stage I small cell lung cancer upstaged at surgery
Thomas DC, Arnold BN, Rosen JE, Salazar MC, Blasberg JD, Detterbeck FC, Boffa DJ, Kim AW. Defining outcomes of patients with clinical stage I small cell lung cancer upstaged at surgery. Lung Cancer 2016, 103: 75-81. PMID: 28024700, DOI: 10.1016/j.lungcan.2016.11.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCarcinoma, Non-Small-Cell LungChemotherapy, AdjuvantCombined Modality TherapyDatabases, FactualFemaleGuidelines as TopicHumansLung NeoplasmsLymphatic MetastasisMaleMiddle AgedNeoplasm StagingOutcome Assessment, Health CarePneumonectomyPostoperative PeriodRadiotherapySmall Cell Lung CarcinomaSurvival AnalysisConceptsStage I small cell lung cancerClinical stage ISmall cell lung cancerCell lung cancerAdjuvant chemotherapySurgical resectionPathologic upstagingStage IRadiation therapyNodal diseaseLung cancerPositive lymph node involvementNational Cancer DatabaseOutcomes of patientsLymph node involvementProportion of patientsCurative intentNodal upstagingSCLC patientsUpstaged patientsAdjuvant therapyNode involvementIndependent predictorsInferior survivalT descriptorRole of Adjuvant Therapy for Node-Negative Lung Cancer Invading the Chest Wall
Gao SJ, Corso CD, Blasberg JD, Detterbeck FC, Boffa DJ, Decker RH, Kim AW. Role of Adjuvant Therapy for Node-Negative Lung Cancer Invading the Chest Wall. Clinical Lung Cancer 2016, 18: 169-177.e4. PMID: 27890561, DOI: 10.1016/j.cllc.2016.08.005.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerAdjuvant chemotherapyAdjuvant chemoradiation therapyUnderwent surgeryChemoradiation therapyChest wall resectionRadiation therapyMargin statusTumor sizeLung cancerWall resectionNode-negative lung cancerNational Cancer Data BaseCox proportional hazards modelMargin-positive patientsChest wall invasionCell lung cancerLog-rank testStage IIB tumorsProportional hazards modelAdjuvant therapyAdjuvant treatmentOverall survivalMultivariable analysisIIB tumorsTiming of Surgery after Neoadjuvant Chemoradiation in Locally Advanced Non–Small Cell Lung Cancer
Gao SJ, Corso CD, Wang EH, Blasberg JD, Detterbeck FC, Boffa DJ, Decker RH, Kim AW. Timing of Surgery after Neoadjuvant Chemoradiation in Locally Advanced Non–Small Cell Lung Cancer. Journal Of Thoracic Oncology 2016, 12: 314-322. PMID: 27720827, DOI: 10.1016/j.jtho.2016.09.122.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaCarcinoma, Large CellCarcinoma, Non-Small-Cell LungCarcinoma, Squamous CellChemoradiotherapy, AdjuvantCombined Modality TherapyFemaleFollow-Up StudiesHumansLung NeoplasmsMaleMiddle AgedNeoadjuvant TherapyNeoplasm StagingPneumonectomyPrognosisRetrospective StudiesSurvival RateTime FactorsConceptsNational Cancer Data BaseNeoadjuvant chemoradiationTiming of surgeryOverall survivalAdvanced non-small cell lung cancerNon-small cell lung cancerStage IIIA-N2 NSCLCStage IIIA NSCLCKaplan-Meier methodOverall survival rateSubset of patientsCell lung cancerLog-rank testMultivariate survival analysisProportional hazards modelIIIA NSCLCN2 NSCLCNeoadjuvant therapyTrimodality therapySurgical resectionClinical stageRetrospective studyLung cancerHazards modelSurvival rateHospital Volume and Outcomes of Robot-Assisted Lobectomies
Tchouta LN, Park HS, Boffa DJ, Blasberg JD, Detterbeck FC, Kim AW. Hospital Volume and Outcomes of Robot-Assisted Lobectomies. CHEST Journal 2016, 151: 329-339. PMID: 27687847, DOI: 10.1016/j.chest.2016.09.008.Peer-Reviewed Original ResearchMeSH KeywordsAgedCase-Control StudiesCohort StudiesDatabases, FactualFemaleHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHumansLength of StayLinear ModelsLogistic ModelsLungLung NeoplasmsMaleMiddle AgedMultivariate AnalysisPneumonectomyPostoperative ComplicationsRetrospective StudiesRobotic Surgical ProceduresThoracic Surgery, Video-AssistedTreatment OutcomeConceptsLength of stayLow-volume centersHospital volumeClinical impactHealth care system-related factorsShorter mean LOSUtilization Project National Inpatient Sample databaseVolume/outcome relationshipLong-term clinical impactMean LOSNational Inpatient Sample databaseShorter LOSVideo-assisted thoracoscopic surgeryHospital operative volumeHigh-volume hospitalsIncidence of complicationsHigher hospital volumeThoracoscopic surgery lobectomyAnnual case volumeSystem-related factorsOutcomes of interestLOS outcomesInfectious complicationsInpatient mortalityIndependent predictorsThe 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 outcomesEstimating the Annual Incremental Cost of Several Complications Following Pulmonary Lobectomy
Jawitz OK, Boffa DJ, Detterbeck FC, Wang Z, Kim AW. Estimating the Annual Incremental Cost of Several Complications Following Pulmonary Lobectomy. Seminars In Thoracic And Cardiovascular Surgery 2016, 28: 531-540. PMID: 28043473, DOI: 10.1053/j.semtcvs.2016.06.001.Peer-Reviewed Original ResearchConceptsAcute respiratory failureLength of hospitalizationPulmonary lobectomyHospital stayRespiratory failureMajor complicationsAir leakAnnual health care expendituresRetrospective cohort analysisNational Inpatient SampleLength of stayPostoperative air leaksUtilization Project databaseAnnual incremental costMultivariable quantile regression modelsAggregate national costHealth care expendituresHealth care qualityLarge national datasetCommon complicationVATS lobectomyCostly complicationInpatient SampleHospital costsClinical dataA model for predicting prolonged length of stay in patients undergoing anatomical lung resection: a National Surgical Quality Improvement Program (NSQIP) database study
DeLuzio MR, Keshava HB, Wang Z, Boffa DJ, Detterbeck FC, Kim AW. A model for predicting prolonged length of stay in patients undergoing anatomical lung resection: a National Surgical Quality Improvement Program (NSQIP) database study. Interdisciplinary CardioVascular And Thoracic Surgery 2016, 23: 208-215. PMID: 27073262, DOI: 10.1093/icvts/ivw090.Peer-Reviewed Original ResearchConceptsAnatomical lung resectionProlonged lengthLung resectionRisk factorsRisk stratificationNational Surgical Quality Improvement Program database studyAnatomical pulmonary resectionBetter risk stratificationOverall patient outcomesHigh-risk populationLength of stayExternal validation groupLogistic regression analysisPostoperative complicationsPostoperative variablesPulmonary resectionNSQIP databaseComparison of receiverPatient outcomesDatabase studyResectionPatientsStayValidation groupScoring systemLobectomy versus stereotactic body radiotherapy in healthy patients with stage I lung cancer
Rosen JE, Salazar MC, Wang Z, Yu JB, Decker RH, Kim AW, Detterbeck FC, Boffa DJ. Lobectomy versus stereotactic body radiotherapy in healthy patients with stage I lung cancer. Journal Of Thoracic And Cardiovascular Surgery 2016, 152: 44-54.e9. PMID: 27131846, DOI: 10.1016/j.jtcvs.2016.03.060.Peer-Reviewed Original ResearchConceptsStage I lung cancerStereotactic body radiotherapyI lung cancerNational Cancer DatabaseClinical stage I lung cancerNon-small cell lung cancerCell lung cancerBody radiotherapyHealthy patientsLung cancerCancer DatabaseClinical stage I non-small cell lung cancerStage I non-small cell lung cancerBetter outcomesEarly-stage non-small cell lung cancerPatient healthCox proportional hazards modelComorbidity-free patientsClinical stage IPropensity-matched analysisProportional hazards modelLong-term survivalHealth-related reasonsStereotactic patientsT1N0M0 tumorsThe Natural History of Operable Non-Small Cell Lung Cancer in the National Cancer Database
Rosen JE, Keshava HB, Yao X, Kim AW, Detterbeck FC, Boffa DJ. The Natural History of Operable Non-Small Cell Lung Cancer in the National Cancer Database. The Annals Of Thoracic Surgery 2016, 101: 1850-1855. PMID: 27041452, DOI: 10.1016/j.athoracsur.2016.01.077.Peer-Reviewed Original ResearchConceptsOperable non-small cell lung cancerNon-small cell lung cancerNational Cancer DatabaseUntreated NSCLC patientsClinical stage ICell lung cancerNSCLC patientsNatural historyStage ILung cancerCancer DatabaseUntreated non-small cell lung cancerIIIA non-small cell lung cancerMultivariable Cox regression modelsLarge cell histologyNatural history cohortOperable NSCLC patientsCox regression modelMedian survivalUntreated patientsCell histologyMeier estimatesSurgical resectionClinical stageSquamous cells