2023
Surgical treatment of stage IV gastroenteropancreatic neuroendocrine carcinoma: Experience and outcomes in the United States
Kerekes D, Frey A, Bakkila B, Kunstman J, Khan S. Surgical treatment of stage IV gastroenteropancreatic neuroendocrine carcinoma: Experience and outcomes in the United States. Journal Of Surgical Oncology 2023, 128: 790-802. PMID: 37435780, DOI: 10.1002/jso.27392.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, NeuroendocrineHumansNeuroendocrine TumorsPancreatic NeoplasmsPrognosisRetrospective StudiesUnited StatesConceptsGastroenteropancreatic neuroendocrine carcinomasGEP-NECSingle-site surgeryOverall survivalSurgical treatmentNeuroendocrine carcinomaMortality reductionSite surgeryPrimary siteNational Cancer DatabaseRetrospective cohort studyPrimary tumor typeSurgical resectionCohort studyAggressive diseaseSurgical interventionSurvival outcomesTreatment optionsCancer DatabaseSurgeryPatientsTumor typesNECStrongest predictorCarcinomaUtility of promoter hypermethylation in malignant risk stratification of intraductal papillary mucinous neoplasms
Chhoda A, Sharma A, Sailo B, Tang H, Ruzgar N, Tan W, Ying L, Khatri R, Narayanan A, Mane S, De Kumar B, Wood L, Iacobuzio-Donahue C, Wolfgang C, Kunstman J, Salem R, Farrell J, Ahuja N. Utility of promoter hypermethylation in malignant risk stratification of intraductal papillary mucinous neoplasms. Clinical Epigenetics 2023, 15: 28. PMID: 36803844, PMCID: PMC9942382, DOI: 10.1186/s13148-023-01429-5.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkers, TumorDNADNA MethylationHumansNeoplasms, Cystic, Mucinous, and SerousPancreatic Intraductal NeoplasmsPancreatic NeoplasmsRisk AssessmentConceptsPapillary mucinous neoplasmMalignant risk stratificationCACNA1G geneRisk stratificationMucinous neoplasmsBiomarker panelBackgroundIntraductal papillary mucinous neoplasmIntraductal papillary mucinous neoplasmEarly detectionPrevious case-control studyHigh-grade dysplasiaCase-control studyPancreatic cancer precursorsReceiver Operating Characteristic (ROC) curve analysisSignificant diagnostic challengeCross-sectional imagingCharacteristic curve analysisOperating Characteristic curve analysisG geneHigh diagnostic specificityPrior validation studiesSignificant procedural riskIPMN tissuesSurgical resectionAdvanced neoplasia
2020
Comorbidities Drive the Majority of Overall Mortality in Low-Risk Mucinous Pancreatic Cysts Under Surveillance
Chhoda A, Yousaf MN, Madhani K, Aslanian H, Jamidar PA, Suarez AL, Salem R, Muniraj T, Kunstman J, Farrell JJ. Comorbidities Drive the Majority of Overall Mortality in Low-Risk Mucinous Pancreatic Cysts Under Surveillance. Clinical Gastroenterology And Hepatology 2020, 20: 631-640.e1. PMID: 33309984, DOI: 10.1016/j.cgh.2020.12.008.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityHumansPancreatic CystPancreatic NeoplasmsProspective StudiesRetrospective StudiesConceptsCharlson Comorbidity IndexHigh-risk stigmataMucinous pancreatic cystsOverall mortalityWorrisome featuresPancreatic cystsComorbidity burdenAge-adjusted Charlson comorbidity indexKaplan-Meir survival analysisLow-risk cystsSingle-center studyHigher overall mortalityElectronic medical recordsComorbidity indexProspective surveillanceCenter studyMortality outcomesMedical recordsMucinous cystsPatient outcomesSerial imagingSurveillance populationCohort stratificationSurvival analysisAbstractTextAssociation 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
2013
Nasogastric Drainage May Be Unnecessary after Pancreaticoduodenectomy: A Comparison of Routine vs Selective Decompression
Kunstman JW, Klemen ND, Fonseca AL, Araya DL, Salem RR. Nasogastric Drainage May Be Unnecessary after Pancreaticoduodenectomy: A Comparison of Routine vs Selective Decompression. Journal Of The American College Of Surgeons 2013, 217: 481-488. PMID: 23891073, DOI: 10.1016/j.jamcollsurg.2013.04.031.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overComorbidityConnecticutDecompression, SurgicalDrainageFemaleGastroparesisHumansIntubation, GastrointestinalMaleMiddle AgedMultivariate AnalysisPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsRetrospective StudiesTreatment OutcomeUnnecessary ProceduresConceptsLength of stayNasogastric decompressionNGT insertionPostoperative nasogastric tube useRoutine postoperative nasogastric decompressionNasogastric tube useOverall surgical morbidityPostoperative nasogastric decompressionOverall complication rateStandard of careAppropriate treatment strategyFirst patient cohortDietary toleranceSelective groupComparison of RoutineTreat mannerComplication rateNasogastric drainagePatient agePostoperative courseCommon indicationPrimary outcomeRoutine groupSingle surgeonSurgical morbidity
2012
Comprehensive Analysis of Variables Affecting Delayed Gastric Emptying Following Pancreaticoduodenectomy
Kunstman JW, Fonseca AL, Ciarleglio MM, Cong X, Hochberg A, Salem RR. Comprehensive Analysis of Variables Affecting Delayed Gastric Emptying Following Pancreaticoduodenectomy. Journal Of Gastrointestinal Surgery 2012, 16: 1354-1361. PMID: 22450953, DOI: 10.1007/s11605-012-1873-y.Peer-Reviewed Original ResearchConceptsIndependent risk factorDGE incidenceConsensus guidelinesRisk factorsComplicated post-operative courseDGE developmentAcademic tertiary centerPeri-operative variablesPost-operative abscessIntraoperative blood lossPost-operative eventsPost-operative courseSingle-surgeon databasePancreatic fistula formationInternational Consensus GroupPulmonary comorbiditiesBlood lossPylorus preservationTertiary centerFistula formationSecondary complicationsOperative bedOperative techniquePancreaticoduodenectomyConsensus group