Medicine and Health Sciences Commons^™

Optimizing Cancer Cure Dialog: An Analysis Of Pancreatic Cancer Patients' Views Regarding Survival And Cure., Avinoam Nevler, Scott W. Keith, Harish Lavu, Theresa P. Yeo, Shawnna Cannaday, Charles J. Yeo, Jordan M. Winter

Department of Surgery Faculty Papers

BACKGROUND: Pancreatic ductal adenocarcinoma (PDA) is a highly lethal cancer. Clinicians commonly refer to surgical therapy as resection with curative intent. However, PDA cure rates after resection remain unknown and the definition of cure remains vague. We investigated how patients (the majority undergoing resection), family members, and clinicians understand the concept of cure, to better inform discussions with patients regarding PDA prognosis.

METHODS: In a prospective survey, cohorts were asked to indicate the best definition of cure from three choices: 5-year survival endpoint (typically used in the literature), a biological endpoint without biochemical or radiographic signs of disease (similar to …

False In Name Only-Gastroduodenal Artery Pseudoaneurysm In A Recurrently Bleeding Patient: Case Report And Literature Review., M. Binetti, A. Lauro, R. Golfieri, S Vaccari, V D'Andrea, I. R. Marino, M. Cervellera, M. Renzulli, V. Tonini

Department of Surgery Faculty Papers

INTRODUCTION: Although the diagnosis of visceral pseudoaneurysm is unusual, it requires emergent attention due to the risk of rupture. We describe a 70-year old man with a gastroduodenal artery (GDA) pseudoaneurysm manifest as recurrent hæmorrhage.

AREAS COVERED: We highlight the possible ætiologies, clinical presentations, diagnostic tools and treatment options for this condition. In this instance, the patient was successfully treated by selective angio-embolization.

EXPERT COMMENTARY: A visceral pseudoaneurysm should be considered in patients with abdominal pain and GI hæmorrhage. At present, angio-embolization is first-line therapy.

Ethical Standards For Cardiothoracic Surgeons' Participation In Social Media., Thomas K. Varghese, John W. Entwistle, John E. Mayer, Susan D. Moffatt-Bruce, Robert M. Sade

Department of Surgery Faculty Papers

No abstract provided.

Optimal Timing And Route Of Nutritional Support After Esophagectomy: A Review Of The Literature., Richard Zheng, Courtney L. Devin, Michael J. Pucci, Adam C. Berger, Ernest L. Rosato, Francesco Palazzo

Department of Surgery Faculty Papers

Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy. Variation in practices during the perioperative period exists including the type of nutrition started, the delivery route, and its timing. Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery, which can affect their ability to regain or maintain weight. Methods of feeding after an esophagectomy include total parenteral nutrition, nasoduodenal/nasojejunal tube feeding, jejunostomy tube feeding, and oral feeding. Recent evidence suggests that early oral feeding is associated with shorter LOS, faster return of …

Guidance Of Sentinel Lymph Node Biopsy Decisions In Patients With T1-T2 Melanoma Using Gene Expression Profiling., John T. Vetto, Eddy C. Hsueh, Brian R. Gastman, Larry D. Dillon, Federico A. Monzon, Robert W. Cook, Jennifer Keller, Xin Huang, Andrew Fleming, Preston Hewgley, Pedram Gerami, Sancy Leachman, Jeffrey D. Wayne, Adam C. Berger, Martin D. Fleming

Department of Surgery Faculty Papers

AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?

PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.

RESULTS: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.

CONCLUSION: The 31-gene expression profile test identifies patients …

Nelfe-Dependent Myc Signature Identifies A Unique Cancer Subtype In Hepatocellular Carcinoma., Hien Dang, Yotsawat Pomyen, Sean P. Martin, Dana A. Dominguez, Sun Young Yim, Ju-Seog Lee, Anuradha Budhu, Ashesh P. Shah, Adam S. Bodzin, Xin Wei Wang

Department of Surgery Faculty Papers

The MYC oncogene is dysregulated in approximately 30% of liver cancer. In an effort to exploit MYC as a therapeutic target, including in hepatocellular carcinoma (HCC), strategies have been developed on the basis of MYC amplification or gene translocation. Due to the failure of these strategies to provide accurate diagnostics and prognostic value, we have developed a Negative Elongation Factor E (NELFE)-Dependent MYC Target (NDMT) gene signature. This signature, which consists of genes regulated by MYC and NELFE, an RNA binding protein that enhances MYC-induced hepatocarcinogenesis, is predictive of NELFE/MYC-driven tumors that would otherwise not be identified by gene amplification …

Who Is Pirating Medical Literature? A Bibliometric Review Of 28 Million Sci-Hub Downloads., Brian M. Till, Niclas Rudolfson, Saurabh Saluja, Jesudian Gnanaraj, Lubna Samad, David Ljungman, Mark Shrime

Department of Surgery Faculty Papers

We aimed to define the proportion of downloads on Sci-Hub that are medical in nature and to consider these data at the national level, evaluating the relation between density of medical literature downloads and scientific output, national income classifications, and indicators of internet penetrance.