2021
A 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 tumorsInvasive 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 diseaseShort Tandem Repeats Define a Gestational Origin for Metastatic Choriocarcinoma
Brown K, Homer R, Baine M, Blasberg JD. Short Tandem Repeats Define a Gestational Origin for Metastatic Choriocarcinoma. The Annals Of Thoracic Surgery 2019, 108: e115-e117. PMID: 30685255, DOI: 10.1016/j.athoracsur.2018.12.038.Peer-Reviewed Original ResearchConceptsPlacenta accretaSpontaneous hemothoraxGestational choriocarcinomaLower lobe massMetastatic gestational choriocarcinomaHealthy female patientsAdjuvant therapyMetastatic choriocarcinomaSurgical explorationChief complaintFemale patientsOutside hospitalRare consequenceUnreported causeGestational originClinical implicationsChoriocarcinomaAccretaHemothoraxResectionPatientsPrognosisHospitalShortnessTherapy
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 historyPatientsMotivators, 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 ResearchWhy 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 utilizationWhen 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 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 predictorsPrimary Salivary Type Lung Cancers in the National Cancer Database
Resio BJ, Chiu AS, Hoag J, Dhanasopon AP, Blasberg JD, Boffa DJ. Primary Salivary Type Lung Cancers in the National Cancer Database. The Annals Of Thoracic Surgery 2018, 105: 1633-1639. PMID: 29486180, DOI: 10.1016/j.athoracsur.2018.01.055.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCarcinoma, Adenoid CysticCarcinoma, MucoepidermoidConfidence IntervalsDatabases, FactualFemaleFollow-Up StudiesHumansLung NeoplasmsMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPneumonectomyProportional Hazards ModelsRetrospective StudiesRisk AssessmentSalivary Gland NeoplasmsSurvival AnalysisConceptsNational Cancer DatabaseAdenoid cystic carcinomaMucoepidermoid carcinomaLung cancerCancer DatabaseMEC patientsACC patientsMortality riskMultivariable Cox proportional hazards regression modelsCox proportional hazards regression modelProportional hazards regression modelsAdjusted mortality riskPulmonary mucoepidermoid carcinomaLymph node metastasisPrimary lung tumorsIncomplete tumor resectionRisk of deathHazards regression modelsHigh tumor gradeOverall prognosisPrimary lungPulmonary malignancyWedge resectionNode metastasisDistant metastasis
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 therapy