2020
Association of Treatment Inequity and Ancestry With Pancreatic Ductal Adenocarcinoma Survival
Heller DR, Nicolson NG, Ahuja N, Khan S, Kunstman JW. Association of Treatment Inequity and Ancestry With Pancreatic Ductal Adenocarcinoma Survival. JAMA Surgery 2020, 155: e195047. PMID: 31800002, PMCID: PMC6902102, DOI: 10.1001/jamasurg.2019.5047.Peer-Reviewed Original ResearchConceptsPancreatic ductal adenocarcinomaNational Cancer DatabaseWhite patientsBlack patientsAdvanced diseaseOverall survivalClinical parametersDisease stageCancer DatabaseSurgical proceduresMultivariable Cox proportional hazards regression modelingTreatment inequitiesCox proportional hazards regression modelingPancreatic ductal adenocarcinoma (PDAC) survivalUnadjusted median overall survivalYounger ageProportional hazards regression modelingMedian overall survivalModest survival advantageStage II diseaseNew cancer diagnosesLess chemotherapyResectable cancerCohort studyPrimary outcome
2018
Comparing the long‐term outcomes among patients with stomach and small intestine gastrointestinal stromal tumors: An analysis of the National Cancer Database
Giuliano K, Ejaz A, Reames BN, Choi W, Sham J, Gage M, Johnston FM, Ahuja N. Comparing the long‐term outcomes among patients with stomach and small intestine gastrointestinal stromal tumors: An analysis of the National Cancer Database. Journal Of Surgical Oncology 2018, 118: 486-492. PMID: 30129672, DOI: 10.1002/jso.25172.Peer-Reviewed Original ResearchConceptsSmall intestine gastrointestinal stromal tumorGastrointestinal stromal tumorsNational Cancer DatabaseOverall survivalStromal tumorsTumor locationCancer DatabaseLarger median tumor sizeStomach gastrointestinal stromal tumorUnadjusted median overall survivalCox proportional hazards modelNational Oncology DatabaseMedian overall survivalMedian tumor sizeWorse prognostic featuresKaplan-Meier methodLong-term prognosisTumor-related factorsLong-term outcomesCases of stomachProportional hazards modelCommon sarcomaTotal patientsPrognostic featuresOncology databaseMinimally Invasive Versus Open Primary Resection for Retroperitoneal Soft Tissue Sarcoma: A Propensity-Matched Study From the National Cancer Database
Gani F, Goel U, Blair AB, Singh J, Overton HN, Meyer CF, Canner JK, Pawlik TM, Ahuja N, Johnston FM. Minimally Invasive Versus Open Primary Resection for Retroperitoneal Soft Tissue Sarcoma: A Propensity-Matched Study From the National Cancer Database. Annals Of Surgical Oncology 2018, 25: 2209-2217. PMID: 29855832, PMCID: PMC8383095, DOI: 10.1245/s10434-018-6538-y.Peer-Reviewed Original ResearchConceptsRetroperitoneal soft tissue sarcomaNational Cancer DatabaseSoft tissue sarcomasUse of MISPostoperative mortalityPrimary resectionOverall survivalClinical outcomesTissue sarcomasCancer DatabaseCox proportional hazards modelShorter hospital lengthProportional hazards modelHospital lengthInvasive VersusMultivariable logisticPelvic cancerShorter LOSOpen surgeryOperative approachCommunity hospitalInclusion criteriaSmall tumorsTreatment groupsHazards modelExtraskeletal versus Skeletal Ewing Sarcoma in the adult population: Controversies in care
Lynch AD, Gani F, Meyer CF, Morris CD, Ahuja N, Johnston FM. Extraskeletal versus Skeletal Ewing Sarcoma in the adult population: Controversies in care. Surgical Oncology 2018, 27: 373-379. PMID: 30217290, DOI: 10.1016/j.suronc.2018.05.016.Peer-Reviewed Original ResearchConceptsExtraskeletal Ewing's sarcomaCharlson-Deyo scoreOverall survivalTriple therapyCombination therapyLocal therapyEwing's sarcomaProportional hazards regression analysisHazards regression analysisSkeletal Ewing sarcomaEwing's sarcoma patientsAdult patientsIndependent predictorsEE patientsSarcoma patientsRisk factorsTreatment characteristicsSmall tumorsOutcome differencesPatientsTherapyAdult populationLack of consensusChemotherapyRegression analysis
2017
Long‐term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer
Shrestha B, Sun Y, Faisal F, Kim V, Soares K, Blair A, Herman JM, Narang A, Dholakia AS, Rosati L, Hacker‐Prietz A, Chen L, Laheru DA, De Jesus‐Acosta A, Le DT, Donehower R, Azad N, Diaz LA, Murphy A, Lee V, Fishman EK, Hruban RH, Liang T, Cameron JL, Makary M, Weiss MJ, Ahuja N, He J, Wolfgang CL, Huang C, Zheng L. Long‐term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer. Cancer Medicine 2017, 6: 1552-1562. PMID: 28639410, PMCID: PMC5504321, DOI: 10.1002/cam4.1104.Peer-Reviewed Original ResearchConceptsMedian overall survivalUpfront chemotherapyNeoadjuvant chemotherapyNeoadjuvant therapySurgical resectionOverall survivalUpfront chemoradiationBorderline resectable pancreatic adenocarcinomaLong-term survival benefitBorderline resectable pancreatic cancerCurative surgical resectionResectable pancreatic cancerUpfront neoadjuvant chemotherapyResectable pancreatic adenocarcinomaSubpopulation of patientsJohns Hopkins HospitalLong-term survivalCurative intentNeoadjuvant chemoradiationConsecutive patientsSurvival benefitPancreatic cancerPancreatic adenocarcinomaRetrospective analysisChemoradiation
2016
Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection
Laurence G, Ahuja V, Bell T, Grim R, Ahuja N. Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection. The American Journal Of Surgery 2016, 214: 432-436. PMID: 28082009, DOI: 10.1016/j.amjsurg.2016.12.018.Peer-Reviewed Original ResearchConceptsMultivisceral resectionAdvanced colorectal cancerColorectal cancerCancer patientsYear survivalNon-metastatic colorectal cancerRadiation treatmentRecto-sigmoid cancerFive-year survivalSignificant associated morbidityKaplan-Meier analysisExtensive surgical proceduresGreatest survival advantageEligible patientsAssociated morbiditySelect patientsMeier analysisStandard surgeryRadical operationSEER dataAdjacent organsSurgical proceduresSurvival advantagePatientsSurgical specialistsCirculating Tumor Cell Phenotype Predicts Recurrence and Survival in Pancreatic Adenocarcinoma
Poruk KE, Valero V, Saunders T, Blackford AL, Griffin JF, Poling J, Hruban RH, Anders RA, Herman J, Zheng L, Rasheed ZA, Laheru DA, Ahuja N, Weiss MJ, Cameron JL, Goggins M, Iacobuzio-Donahue CA, Wood LD, Wolfgang CL. Circulating Tumor Cell Phenotype Predicts Recurrence and Survival in Pancreatic Adenocarcinoma. Annals Of Surgery 2016, 264: 1073-1081. PMID: 26756760, PMCID: PMC4936958, DOI: 10.1097/sla.0000000000001600.Peer-Reviewed Original ResearchConceptsCytokeratin-positive CTCsPancreatic adenocarcinomaMesenchymal markersVimentin-positive CTCsEpithelial tumor cells (ISET) methodFourth leading causeBetter treatment stratificationPortal blood samplesSignificant independent predictorsPotential prognostic biomarkerBiology of metastasisDetection of CTCsSurgical resectionIndependent predictorsPrognostic factorsMedian timeMultivariable analysisPDAC patientsPrognostic utilityCancer deathPatient prognosisLeading causeTreatment stratificationCancer recurrencePoor survivalPredictors of improved survival for patients with retroperitoneal sarcoma
Giuliano K, Nagarajan N, Canner JK, Wolfgang CL, Bivalacqua T, Terezakis S, Herman J, Schneider EB, Ahuja N. Predictors of improved survival for patients with retroperitoneal sarcoma. Surgery 2016, 160: 1628-1635. PMID: 27495850, DOI: 10.1016/j.surg.2016.05.041.Peer-Reviewed Original ResearchConceptsRetroperitoneal sarcomaMultivariable survival analysisSurvival analysisRetroperitoneal sarcoma patientsEnd Results (SEER) databaseOperative resectionImproved survivalLymph nodesSurvival benefitDistant metastasisHistologic typeResults databaseSarcoma patientsRare tumorCancer DatabaseLonger survivalPatientsSarcomaSurvivalParametric survival functionsLocal extensionFurther studiesHigh rateResectionRecurrencePatterns of PD-L1 expression and CD8 T cell infiltration in gastric adenocarcinomas and associated immune stroma
Thompson ED, Zahurak M, Murphy A, Cornish T, Cuka N, Abdelfatah E, Yang S, Duncan M, Ahuja N, Taube JM, Anders RA, Kelly RJ. Patterns of PD-L1 expression and CD8 T cell infiltration in gastric adenocarcinomas and associated immune stroma. Gut 2016, 66: 794. PMID: 26801886, PMCID: PMC4958028, DOI: 10.1136/gutjnl-2015-310839.Peer-Reviewed Original ResearchConceptsPD-L1 expressionProgression-free survivalEpstein-Barr virusT-cell densityImmune stromaOverall survivalPD-L1T cellsAdaptive immune resistance mechanismHigh PD-L1 expressionMembranous PD-L1 expressionStromal PD-L1 expressionCD8 T cell infiltrationWorse progression-free survivalImmune resistance mechanismsImmune checkpoint inhibitorsPD-L1 positivityPD-L1 statusGastro-oesophageal junctionImmune-based therapiesT cell infiltrationPercentage of tumorsTumor-stromal interfaceCD8 densityCD8 infiltration
2015
Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy
Hicks CW, Tosoian JJ, Craig-Schapiro R, Valero V, Cameron JL, Eckhauser FE, Hirose K, Makary MA, Pawlik TM, Ahuja N, Weiss MJ, Wolfgang CL. Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy. The American Journal Of Surgery 2015, 210: 636-642.e1. PMID: 26384793, PMCID: PMC4634566, DOI: 10.1016/j.amjsurg.2015.05.009.Peer-Reviewed Original ResearchConceptsEarly hospital readmissionHospital readmissionOverall mortalityLong-term mortalitySignificant independent predictorsBaseline group differencesPancreatectomy patientsIndependent predictorsPrognostic significanceInstitutional databaseRisk factorsPancreatectomyMultivariate analysisReadmissionMortalityComplicationsPatientsAdditional studiesGroup differencesStatewide datasetMorbiditySocial factors
2014
Role of a Multidisciplinary Clinic in the Management of Patients with Pancreatic Cysts: A Single-Center Cohort Study
Lennon AM, Manos LL, Hruban RH, Ali SZ, Fishman EK, Kamel IR, Raman SP, Zaheer A, Hutfless S, Salamone A, Kiswani V, Ahuja N, Makary MA, Weiss MJ, Hirose K, Goggins M, Wolfgang CL. Role of a Multidisciplinary Clinic in the Management of Patients with Pancreatic Cysts: A Single-Center Cohort Study. Annals Of Surgical Oncology 2014, 21: 3668-3674. PMID: 24806116, PMCID: PMC4332823, DOI: 10.1245/s10434-014-3739-x.Peer-Reviewed Original ResearchConceptsManagement of patientsPancreatic cystsSurgical resectionBranch-duct intraductal papillary mucinous neoplasmsSingle-center cohort studyIntraductal papillary mucinous neoplasmRisk categoriesPapillary mucinous neoplasmTypes of cancerCohort studyMultidisciplinary careCommon diagnosisMultidisciplinary clinicMucinous neoplasmsMalignant cystsHigh riskPatientsPatient careFurther evaluationCystsDiagnosisResectionClinicDifferent risksInstitution's recordsThe Impact of Postoperative Complications on the Administration of Adjuvant Therapy Following Pancreaticoduodenectomy for Adenocarcinoma
Wu W, He J, Cameron JL, Makary M, Soares K, Ahuja N, Rezaee N, Herman J, Zheng L, Laheru D, Choti MA, Hruban RH, Pawlik TM, Wolfgang CL, Weiss MJ. The Impact of Postoperative Complications on the Administration of Adjuvant Therapy Following Pancreaticoduodenectomy for Adenocarcinoma. Annals Of Surgical Oncology 2014, 21: 2873-2881. PMID: 24770680, PMCID: PMC4454347, DOI: 10.1245/s10434-014-3722-6.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsPrognosisRadiotherapy, AdjuvantRetrospective StudiesSurvival RateConceptsAdjuvant therapyPostoperative complicationsMedian survivalMultivariate analysisClavien-Dindo complication gradeTherapy warrants further investigationMultimodality adjuvant therapyOverall complication rateMethodsA retrospective reviewGrade of complicationsLonger median survivalLength of stayWarrants further investigationAdjuvant chemotherapyMedian TTANeoadjuvant approachComplication gradeComplication rateSevere complicationsRetrospective reviewClinicopathological dataResultsA totalPancreaticoduodenectomyRadiation therapyComplications
2013
Extrathoracic Location and “Borderline” Histology are Associated with Recurrence of Solitary Fibrous Tumors After Surgical Resection
Wilky BA, Montgomery EA, Guzzetta AA, Ahuja N, Meyer CF. Extrathoracic Location and “Borderline” Histology are Associated with Recurrence of Solitary Fibrous Tumors After Surgical Resection. Annals Of Surgical Oncology 2013, 20: 4080-4089. PMID: 24046107, PMCID: PMC4124630, DOI: 10.1245/s10434-013-3241-x.Peer-Reviewed Original ResearchConceptsExtrathoracic solitary fibrous tumorsBenign solitary fibrous tumorSolitary fibrous tumorMalignant histologyExtrathoracic locationPathologic criteriaFibrous tumorMetastatic solitary fibrous tumorPatient pathology reportsKaplan-Meier methodPredictors of recurrencePrimary care physiciansHead/neckSurgical pathology databaseMethodsWith IRB approvalSFTS patientsSurgical resectionComplete resectionCare physiciansWorse prognosisIntraabdominal sitesPathology databaseMedical recordsPathology reportsPatient historyHigh Expression of Epidermal Growth Factor Receptor Might Predict Poor Survival in Patients with Colon Cancer: A Meta-Analysis
Hong L, Han Y, Zhang H, Zhao Q, Yang J, Ahuja N. High Expression of Epidermal Growth Factor Receptor Might Predict Poor Survival in Patients with Colon Cancer: A Meta-Analysis. Genetic Testing And Molecular Biomarkers 2013, 17: 348-351. PMID: 23387315, DOI: 10.1089/gtmb.2012.0421.Peer-Reviewed Original ResearchMeSH KeywordsColonic NeoplasmsErbB ReceptorsHumansPredictive Value of TestsPrognosisSurvival RateUp-RegulationConceptsEpidermal growth factor receptorKRAS G>A mutation favors poor tumor differentiation but may not be associated with prognosis in patients with curatively resected duodenal adenocarcinoma
Fu T, Guzzetta AA, Jeschke J, Vatapalli R, Dave P, Hooker CM, Morgan R, Iacobuzio‐Donahue C, Liu B, Ahuja N. KRAS G>A mutation favors poor tumor differentiation but may not be associated with prognosis in patients with curatively resected duodenal adenocarcinoma. International Journal Of Cancer 2013, 132: 2502-2509. PMID: 23065691, PMCID: PMC3579006, DOI: 10.1002/ijc.27910.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaBiomarkers, TumorCell DifferentiationDNA, NeoplasmDuodenal NeoplasmsFemaleHumansMaleMicrosatellite RepeatsMiddle AgedMutationNeoplasm Recurrence, LocalNeoplasm StagingPolymerase Chain ReactionPrognosisProto-Oncogene ProteinsProto-Oncogene Proteins p21(ras)Ras ProteinsSurvival RateConceptsPoor tumor differentiationKRAS GPositive lymph nodesDuodenal adenocarcinomaKRAS mutationsTumor differentiationMutation carriersDistant relapseLymph nodesMultivariate logistic regression analysisShorter relapse-free survivalFuture staging systemsRelapse-free survivalShorter overall survivalPossible prognostic roleLogistic regression analysisCurative resectionPoor OSOverall survivalPrognostic roleTumor characteristicsClinical outcomesClinicopathological characteristicsPoor prognosisPrognostic significance
2012
Young Patients Undergoing Resection of Pancreatic Cancer Fare Better than their Older Counterparts
He J, Edil BH, Cameron JL, Schulick RD, Hruban RH, Herman JM, Zheng L, Iacobuzio-Donahue C, Ahuja N, Pawlik TM, Wolfgang CL. Young Patients Undergoing Resection of Pancreatic Cancer Fare Better than their Older Counterparts. Journal Of Gastrointestinal Surgery 2012, 17: 339-344. PMID: 23184271, PMCID: PMC3600849, DOI: 10.1007/s11605-012-2066-4.Peer-Reviewed Original ResearchConceptsCharlson-Age Comorbidity IndexOlder age groupsDate of surgeryYounger patientsOlder patientsAge groupsMedian agePDAC patientsPancreatic ductal adenocarcinoma patientsPatients Undergoing ResectionMedian overall survivalResectable pancreatic cancerLymph node positivityYoung patient cohortDuctal adenocarcinoma patientsYounger age groupsCurative resectionUndergoing resectionAbdominal painDistal pancreatectomyR0 resectionTotal pancreatectomyUnderwent pancreaticoduodenectomyElderly patientsNode positivityManagement and Recurrence Patterns of Desmoids Tumors: A Multi-institutional Analysis of 211 Patients
Peng PD, Hyder O, Mavros MN, Turley R, Groeschl R, Firoozmand A, Lidsky M, Herman JM, Choti M, Ahuja N, Anders R, Blazer DG, Gamblin TC, Pawlik TM. Management and Recurrence Patterns of Desmoids Tumors: A Multi-institutional Analysis of 211 Patients. Annals Of Surgical Oncology 2012, 19: 4036-4042. PMID: 22972507, PMCID: PMC3568525, DOI: 10.1245/s10434-012-2634-6.Peer-Reviewed Original ResearchConceptsRecurrence-free survivalDesmoid tumorsTumor locationWorse recurrence-free survivalRare soft tissue neoplasmMajor surgical centersR0 surgical marginsDisease-free survivalEffective adjuvant therapyManagement of patientsPredictors of recurrenceRate of recurrenceMulti-institutional analysisSoft tissue neoplasmBackgroundDesmoid tumorsResultsMedian ageAdjuvant therapyMost patientsSurgical resectionMargin statusSurgical marginsSurgical centersTreatment characteristicsRecurrence patternsAbdominal cavity
2011
Duodenal Adenocarcinoma: Clinicopathologic Analysis and Implications for Treatment
Poultsides GA, Huang LC, Cameron JL, Tuli R, Lan L, Hruban RH, Pawlik TM, Herman JM, Edil BH, Ahuja N, Choti MA, Wolfgang CL, Schulick RD. Duodenal Adenocarcinoma: Clinicopathologic Analysis and Implications for Treatment. Annals Of Surgical Oncology 2011, 19: 1928-1935. PMID: 22167476, PMCID: PMC3663711, DOI: 10.1245/s10434-011-2168-3.Peer-Reviewed Original ResearchConceptsDuodenal adenocarcinomaOverall survivalLymph nodesMultivariate analysisInvolved lymph nodesSmall bowel adenocarcinomaEffective systemic therapyFive-year survivalOnly independent predictorProlongs overall survivalAmpulla of VaterConclusionsThe prognostic significanceAdjuvant chemoradiationBowel adenocarcinomaUnderwent pancreaticoduodenectomySystemic therapyAdequate lymphadenectomyIndependent predictorsLocal recurrenceNodal metastasisClinicopathologic analysisPrognostic significanceClinicopathologic variablesRare cancersAdenocarcinomaPredicting the Risk of Perioperative Mortality in Patients Undergoing Pancreaticoduodenectomy: A Novel Scoring System
Venkat R, Puhan MA, Schulick RD, Cameron JL, Eckhauser FE, Choti MA, Makary MA, Pawlik TM, Ahuja N, Edil BH, Wolfgang CL. Predicting the Risk of Perioperative Mortality in Patients Undergoing Pancreaticoduodenectomy: A Novel Scoring System. JAMA Surgery 2011, 146: 1277-1284. PMID: 22106320, DOI: 10.1001/archsurg.2011.294.Peer-Reviewed Original ResearchConceptsTotal pancreatectomyCharlson indexInstitutional databaseRisk scorePreoperative serum albumin levelHigher Charlson indexPreoperative risk factorsHigh-risk patientsSerum albumin levelTertiary referral centerMultivariate logistic regressionHosmer-Lemeshow testNovel scoring systemSimple integer scoreHigh-volume programPerioperative mortalityReferral centerAlbumin levelsMale sexTumor sizeTraining cohortRisk factorsTherapeutic decisionsObservational studyPancreatectomyEarly-Stage Gallbladder Cancer in the Surveillance, Epidemiology, and End Results Database: Effect of Extended Surgical Resection
Downing SR, Cadogan KA, Ortega G, Oyetunji TA, Siram SM, Chang DC, Ahuja N, Leffall LD, Frederick WA. Early-Stage Gallbladder Cancer in the Surveillance, Epidemiology, and End Results Database: Effect of Extended Surgical Resection. JAMA Surgery 2011, 146: 734-738. PMID: 21690451, DOI: 10.1001/archsurg.2011.128.Peer-Reviewed Original ResearchConceptsEarly-stage gallbladder cancerEnd Results (SEER) databaseMore lymph nodesLymph nodesGallbladder cancerSurgical resectionSurvival benefitT2 lesionsResults databaseMultivariate analysisDisease-positive lymph nodesPrimary gallbladder cancerExtended surgical resectionLN excisionOverall survivalSimple cholecystectomyAdvanced cancerFemale patientsCertain patientsRetrospective analysisSurgical proceduresSurvival advantagePatientsCancerResection