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 use
2021
Adjuvant 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 DatabaseA Lower Tidal Volume Regimen during One-lung Ventilation for Lung Resection Surgery Is Not Associated with Reduced Postoperative Pulmonary Complications.
Colquhoun DA, Leis AM, Shanks AM, Mathis MR, Naik BI, Durieux ME, Kheterpal S, Pace NL, Popescu WM, Schonberger RB, Kozower BD, Walters DM, Blasberg JD, Chang AC, Aziz MF, Harukuni I, Tieu BH, Blank RS. A Lower Tidal Volume Regimen during One-lung Ventilation for Lung Resection Surgery Is Not Associated with Reduced Postoperative Pulmonary Complications. Anesthesiology 2021, 134: 562-576. PMID: 33635945, PMCID: PMC8274370, DOI: 10.1097/aln.0000000000003729.Peer-Reviewed Original ResearchConceptsPositive end-expiratory pressureOne-lung ventilationPostoperative pulmonary complicationsEnd-expiratory pressurePulmonary complicationsProtective ventilationTidal volumeThoracic surgeryMajor postoperative pulmonary complicationsVentilation regimenLung resection surgeryRetrospective observational analysisThoracic Surgeons databaseMedian tidal volumeLung resection proceduresUnmatched cohortMajor surgeryPrimary outcomeResection surgerySurgeons databaseIndependent associationResection proceduresDecreased oddsIntraoperative dataComplications
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 tumorsSurgically 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 recommendationsUnderstanding Entrustment Decision-Making by Surgical Program Directors
Ahle SL, Gielissen K, Keene DE, Blasberg JD. Understanding Entrustment Decision-Making by Surgical Program Directors. Journal Of Surgical Research 2020, 249: 74-81. PMID: 31926399, DOI: 10.1016/j.jss.2019.12.001.Peer-Reviewed Original ResearchConceptsNetwork of facultyCognitive competenciesTrainee supervisorsSurgical program directorsTraining programTrainee performanceReflexive trustTrainee competenceCompetenceTaskClinical tasksEntrustment decisionsTraineesInductive approachTrainingCritical themesOperating roomQualitative analysisNovel themesTrustCompetenciesPurposive samplingInterviewsProgram directorsPhysical presence
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 diseaseQuality Versus Quantity
Chiu AS, Arnold BN, Hoag JR, Herrin J, Kim CH, Salazar MC, Monsalve AF, Jean RA, Blasberg JD, Detterbeck FC, Gross CP, Boffa DJ. Quality Versus Quantity. Annals Of Surgery 2019, Publish Ahead of Print: &na;. PMID: 29697446, DOI: 10.1097/sla.0000000000002762.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer surgerySafe hospitalComplex oncologic surgeryPotential mortality reductionNational Cancer DatabaseHigh-volume hospitalsHospital quality measuresSurgical mortalityPrimary cancerHospital rating systemsOncologic surgeryCancer DatabaseMortality reductionSurgical volumeHospital safetyPatient realignmentPatientsHospitalSurgeryMeaningful reductionPublic reportingMortalityRSMRCancerDifferential 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
Motivators, Barriers, and Facilitators to Traveling to the Safest Hospitals in the United States for Complex Cancer Surgery
Resio BJ, Chiu AS, Hoag JR, Brown LB, White M, Omar A, Monsalve A, Dhanasopon AP, Blasberg JD, Boffa DJ. Motivators, Barriers, and Facilitators to Traveling to the Safest Hospitals in the United States for Complex Cancer Surgery. JAMA Network Open 2018, 1: e184595. PMID: 30646367, PMCID: PMC6324377, DOI: 10.1001/jamanetworkopen.2018.4595.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 qualityWhy Travel for Complex Cancer Surgery? Americans React to ‘Brand-Sharing’ Between Specialty Cancer Hospitals and Their Affiliates
Chiu AS, Resio B, Hoag JR, Monsalve AF, Blasberg JD, Brown L, Omar A, White MA, Boffa DJ. Why Travel for Complex Cancer Surgery? Americans React to ‘Brand-Sharing’ Between Specialty Cancer Hospitals and Their Affiliates. Annals Of Surgical Oncology 2018, 26: 732-738. PMID: 30311158, DOI: 10.1245/s10434-018-6868-9.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer HospitalCancer surgerySmall hospitalsSurgical careLocal hospitalSpecialty cancer hospitalComplex surgical careSmall local hospitalsMethodsA nationalResultsA totalCure rateGuideline complianceSurgical safetyComplex surgeryAffiliate hospitalsHospitalSurgeryLarge hospitalsHospital networkCareAmerican adultsSafetyMotivated respondentsRespondentsSurvival Rates after Thermal Ablation versus Stereotactic Radiation Therapy for Stage 1 Non-Small Cell Lung Cancer: A National Cancer Database Study.
Uhlig J, Ludwig JM, Goldberg SB, Chiang A, Blasberg JD, Kim HS. Survival Rates after Thermal Ablation versus Stereotactic Radiation Therapy for Stage 1 Non-Small Cell Lung Cancer: A National Cancer Database Study. Radiology 2018, 289: 862-870. PMID: 30226453, DOI: 10.1148/radiol.2018180979.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerStage 1 non-small cell lung cancerStereotactic radiation therapyCell lung cancerOverall survivalLung cancerThermal ablationRadiation therapySurvival ratePropensity score-matched cohortUnplanned hospital readmission ratesNational Cancer DatabaseUnplanned hospital readmissionOverall survival rateHospital readmission ratesSmaller tumor sizeMore comorbiditiesReadmission ratesHospital readmissionRetrospective studyTumor sizePotential confoundersCancer DatabasePrimary treatmentPatientsImproved discrimination between benign and malignant LDCT screening-detected lung nodules with dynamic over static 18F-FDG PET as a function of injected dose
Ye Q, Wu J, Lu Y, Naganawa M, Gallezot JD, Ma T, Liu Y, Tanoue L, Detterbeck F, Blasberg J, Chen MK, Casey M, Carson RE, Liu C. Improved discrimination between benign and malignant LDCT screening-detected lung nodules with dynamic over static 18F-FDG PET as a function of injected dose. Physics In Medicine And Biology 2018, 63: 175015. PMID: 30095083, PMCID: PMC6158045, DOI: 10.1088/1361-6560/aad97f.Peer-Reviewed Original ResearchConceptsPopulation-based input functionStandardized uptake valueImage-derived input functionLung nodulesClinical trialsTime-activity curvesLow-dose computed tomography (LDCT) screeningLung cancer mortality ratesIndeterminate lung nodulesComputed Tomography ScreeningF-FDG PETCancer mortality ratesStatic PET acquisitionVirtual clinical trialsScan durationTomography screeningFDG injectionPET scansMortality rateUptake valueAccurate diagnosisMalignant lung nodulesROC analysisPatient dataMalignant nodulesDelayed 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 studiesWhen good operations go bad: The additive effect of comorbidity and postoperative complications on readmission after pulmonary lobectomy
Jean RA, Chiu AS, Boffa DJ, Detterbeck FC, Blasberg JD, Kim AW. When good operations go bad: The additive effect of comorbidity and postoperative complications on readmission after pulmonary lobectomy. Surgery 2018, 164: 294-299. PMID: 29801731, DOI: 10.1016/j.surg.2018.03.019.Peer-Reviewed Original ResearchConceptsPostoperative complicationsReadmission ratesPulmonary lobectomyAdditional comorbiditiesThoracic surgeryCause readmission rateDays of dischargeNationwide Readmissions DatabaseNumber of comorbiditiesRisk of readmissionMajor thoracic surgeryProbability of readmissionLow risk profileHealth care deliveryHospital factorsHospital readmissionLow comorbidityElixhauser comorbiditiesThoracic lobectomyLung cancerPrimary diagnosisChronic diseasesHigh burdenMean changeValue-based reimbursementDepth of Muscularis Propria Invasion Does Not Prognosticate Survival in T2 Esophageal Adenocarcinoma
SEDER CW, MAHON B, HENNON M, THOMAS M, LEVEA CM, MATKOWSKYJ KA, KRISHNA M, MEDAIROS R, MACKE RA, BASU S, BLASBERG JD. Depth of Muscularis Propria Invasion Does Not Prognosticate Survival in T2 Esophageal Adenocarcinoma. Anticancer Research 2018, 38: 2195-2200. PMID: 29599339, DOI: 10.21873/anticanres.12461.Peer-Reviewed Original ResearchConceptsMuscularis propria invasionEsophageal adenocarcinomaPrognostic factorsCox proportional hazards regression analysisInferior long-term outcomesProportional hazards regression analysisPercent of patientsDisease-free survivalKaplan-Meier analysisRisk of lymphHazards regression analysisLong-term outcomesU.S. academic medical centersLong-term survivalAcademic medical centerInduction therapyMedian OSMedian ageNodal statusPerineural invasionTherapy statusSurvival differencesTumor gradeBlinded pathologistMedical CenterRobotic-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 experienceOutcomes