84 results on '"S.G. Swisher"'
Search Results
2. Analysis of trimodal and bimodal therapy in a selective-surgery paradigm for locally advanced oesophageal squamous cell carcinoma
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Erin M. Corsini, Ara A. Vaporciyan, Jaffer A. Ajani, R. Mehran, David C. Rice, V T T Truong, Wayne L. Hofstetter, Kyle G. Mitchell, Ravi Rajaram, Mara B. Antonoff, Nicolas Zhou, Jack A. Roth, Garrett L. Walsh, S.G. Swisher, and Boris Sepesi
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Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Locally advanced ,Standardized uptake value ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Clinical complete response ,Medicine ,Humans ,Basal cell ,030212 general & internal medicine ,Stage (cooking) ,Neoplasm Metastasis ,Survival analysis ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Salvage Therapy ,business.industry ,Hazard ratio ,Chemoradiotherapy, Adjuvant ,Middle Aged ,Neoadjuvant Therapy ,Surgery ,Esophagectomy ,030220 oncology & carcinogenesis ,Female ,Esophageal Squamous Cell Carcinoma ,Neoplasm Recurrence, Local ,business - Abstract
Background Long-term survival outcomes of trimodal therapy (TMT; chemoradiation plus surgery) and bimodal therapy (BMT; chemoradiation) have seldom been analysed. In a selective-surgery paradigm, the benefit of TMT in patients with a complete clinical response is controversial. Factors associated with survival in patients with a clinical complete response to chemoradiation were evaluated. Methods Patients with stage II–III oesophageal squamous cell carcinoma treated with TMT or BMT from 2002 to 2017 were evaluated. The BMT group consisted of patients who were otherwise eligible for surgery but underwent chemoradiation alone followed by observation. This group included patients who later had salvage oesophagectomy. Survival was evaluated and compared between TMT and BMT groups. Elastic net regularization was performed to select co-variables for Cox multivariable survival analysis in patients with a clinical complete response. Results Of 143 patients, 60 (41.9 per cent) underwent TMT and 83 (58.0 per cent) BMT. Patients who underwent TMT had longer median overall survival than those who had BMT (77 versus 33 months; P = 0.019). For patients with a clinical complete response, TMT achieved longer median overall survival than BMT (123 versus 55 months; P = 0.04). BMT had a high locoregional recurrence rate (48 versus 6 per cent; P Conclusion In patients who achieve a clinical complete response, TMT reduces locoregional recurrence but may not prolong survival. The differences in survival outcomes may be due to patient selection; therefore, a selective-surgery strategy in oesophageal squamous cell carcinoma is a reasonable approach.
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- 2020
3. 79 PREOPERATIVE TOBACCO CESSATION AND MAJOR POSTOPERATIVE MORBIDITY IN PATIENTS UNDERGOING ESOPHAGECTOMY
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Mara B. Antonoff, Boris Sepesi, Garrett L. Walsh, M Karam-Hage, Jack A. Roth, Wayne L. Hofstetter, Nicolas Zhou, S.G. Swisher, Ara A. Vaporciyan, R. Mehran, Kyle G. Mitchell, Erin M. Corsini, and David C. Rice
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medicine.medical_specialty ,Esophagectomy ,business.industry ,medicine.medical_treatment ,Gastroenterology ,medicine ,In patient ,General Medicine ,business ,Surgery - Abstract
While preoperative tobacco cessation has been associated with decreased pulmonary complications in lung cancer patients in the postoperative period, this relationship has not been explored among patients undergoing esophagectomy in this era of increasingly prevalent tobacco cessation campaigns and enhanced recovery after surgery. Methods We reviewed ever-smokers who underwent esophagectomy at a single institution from January 2004 through June 2019 for esophageal cancer. Occurrence of Clavien-Dindo classification ≥3 major postoperative morbidity (MPM), including anastomotic leak, chylothorax, reoperation, organ dysfunction, respiratory failure, and ICU readmission was calculated. In an effort to evaluate an effect of smoking cessation on outcome, never-smokers were excluded from analyses. Multivariable logistic regression with backwards stepwise elimination was completed to determine the optimal cessation interval associated with reduction in MPM. Robust standard errors were used to account for clustering among surgeons. Results 725 patients met inclusion criteria, including 666 (92%) with adenocarcinoma and a smaller proportion with squamous cell carcinoma. Most patients were male (650, 90%), and the median age was 63 years (IQR 57–69). Records showed that 505 patients (60%) had quit >5 years prior to esophagectomy, and 82 (11%) were current smokers or had quit within the month preceding esophagectomy. MPM occurred in 213 (29%). After univariate regression, age, gender, pack-year history, operative duration, and FEV1 were included in a multivariable model. While age remained associated wtih MPM, preoperative tobacco cessation of any interval was not associated with outcomes. Conclusion Our previous publication showed increased complication risk for smokers undergoing esophagectomy compared to non-smokers. However, among ever-smokers, no specific interval of preoperative cessation demonstrated decreased MPM. In a setting of active tobacco cessation programs, patients who have not completely achieved abstinence may still be offered surgery with equivalent perioperative outcomes.
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- 2020
4. 78 INTESTINAL METAPLASIA IN THE ESOPHAGEAL REMNANT IS RARE AFTER IVOR LEWIS ESOPHAGECTOMY
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Mara B. Antonoff, Erin M. Corsini, Wayne L. Hofstetter, Ravi Rajaram, R. Mehran, David C. Rice, Boris Sepesi, Nicolas Zhou, Kyle G. Mitchell, Jack A. Roth, Ara A. Vaporciyan, Garrett L. Walsh, and S.G. Swisher
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medicine.medical_specialty ,business.industry ,Internal medicine ,Gastroenterology ,Ivor lewis ,Medicine ,Intestinal metaplasia ,General Medicine ,business ,medicine.disease - Abstract
Most patients undergoing esophagectomy will experience intermittent reflux of gastric and biliary content into the remnant esophagus over the course of their lives. The incidence of new or recurrent intestinal metaplasia (IM) following chemoradiation and surgery has not been well-described. Furthermore, post-resection guidelines do not exist regarding surveillance for IM in the esophageal remnant. We hypothesized that the incidence of IM in patients who underwent active post-treatment surveillance would be low. Methods Patients undergoing Ivor Lewis esophagectomy after concurrent chemoradiation for a diagnosis of esophageal adenocarcinoma at a single institution from 2006–2018 were identified. Pathology records were reviewed for the presence of IM on pretreatment biopsies, surgical specimen, or post-resection biopsies. Categorical variables were compared using Pearson’s chi-square test or Fisher’s exact test, where appropriate, and continuous variables were compared using Kruskal-Wallis test. Time-to-event outcomes were assessed using the Kaplan–Meier method. Results 621 patients were included, and 242 (39%) were known to have had IM prior to esophagectomy. An additional 26 (4%) patients without a preexisting diagnosis of IM were found to have IM in the surgical specimen. During a median follow-up of 62 months, development of new IM was rare, occurring only in 12 (2%) patients, 7 of whom had a prior history of IM(Table); incidence was 0.6 cases per patient-years. Of these 12, 3 (25%) developed local adenocarcinoma recurrence. Overall, local recurrence of adenocarcinoma was uncommon, and occurred at similar rates in patients with and without a history of IM(p = 0.774). Conclusion Despite several factors predisposing to mucosal damage following esophagectomy, occurrence of new IM after trimodality therapy in our patient population appears to be rare, even among patient with a previous history of metaplasia.
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- 2020
5. Biomarker-Integrated Neoadjuvant Dasatinib Trial in Resectable Malignant Pleural Mesothelioma
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Monique B. Nilsson, John V. Heymach, Reza J. Mehran, Brett W. Carter, Ignacio I. Wistuba, Lixia Diao, Maria I. Nunez, Jing Wang, Youhong Fan, J. Jack Lee, Heather Lin, Junya Fujimoto, Anne S. Tsao, S.G. Swisher, Ara Vaporcyan, David C. Rice, and Waun Ki Hong
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Male ,Mesothelioma ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,Pleural Neoplasms ,medicine.medical_treatment ,Dasatinib ,Antineoplastic Agents ,PDGFRB ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,Humans ,Aged ,business.industry ,Mesothelioma, Malignant ,Hazard ratio ,Middle Aged ,medicine.disease ,Radiation therapy ,030104 developmental biology ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Female ,business ,Tyrosine kinase ,medicine.drug - Abstract
Introduction Window of opportunity trials in malignant pleural mesothelioma (MPM) are challenging but can yield important translational information about a novel agent. Methods We treated patients with MPM (N = 24) with 4 weeks of oral dasatinib followed by surgery with or without radiotherapy and then an optional 2 years of maintenance dasatinib. The primary end point was biomarker modulation of phosphorylated (p) Src Tyr419 . Results For all patients, the median progression-free survival (PFS) was 7.5 months and the median overall survival was 19.1 months. No significant responses were seen after 4 weeks of dasatinib therapy; however, modulation of median p-Src Tyr419 immunohistochemistry (IHC) scores was seen: the median pretreatment score was 70 (interquartile range 37.5–110), and the median posttreatment score was 41.9 (interquartile range 4.2–60) ( p = 0.004). A decrease in p-Src Tyr419 levels after dasatinib correlated with improved median PFS (6.9 months versus 0.94 months [ p = 0.03]), suggesting that p-Src Tyr419 is a viable pharmacodynamic biomarker for dasatinib in MPM. Platelet-derived growth factor receptor (PDGFR) pathway analysis correlated high PDGFR beta [PDGFRB) level (in the cytoplasm [hazard ratio] (HR) = 2.54, p = 0.05], stroma [HR = 2.79, p = 0.03], and nucleus [HR = 6.79, p = 0.023]) with a shorter PFS. Low (less than the median) cytoplasmic p-PDGFR alpha IHC levels were predictive of a decrease in positron emission tomography/computed tomography standard uptake values levels after dasatinib therapy ( p = 0.04), whereas higher-than-median IHC scores of PDGFRB (cytoplasmic [HR = 2.8, p = 0.03] and nuclear [HR = 6.795, p = 0.02]) were correlated with rising standard uptake values levels. Conclusions In conclusion, there was no significant efficacy signal, and dasatinib monotherapy will not continue to be studied in MPM. However, our study demonstrated that PDGFR subtypes (platelet-derived growth factor receptor alpha and PDGFRB) may have differential roles in prognosis and resistance to antiangiogenic tyrosine kinase inhibitors and are important potential therapeutic targets that require further investigation.
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- 2018
6. OA13.06 Surgical Outcomes Following Neoadjuvant Nivolumab or Nivolumab Plus Ipilimumab in Non-Small Cell Lung Cancer - NEOSTAR Study
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David C. Rice, H. Lin, Wayne L. Hofstetter, John V. Heymach, Anne Tsao, Tina Cascone, Annikka Weissferdt, Jack A. Roth, S.G. Swisher, Charles Lu, A. Vaporciyan, Bonnie S. Glisson, Mara B. Antonoff, Lauren Averett Byers, Vincent K. Lam, Vassiliki A. Papadimitrakopoulou, Jangsoon Lee, Yasir Elamin, Frank V. Fossella, J. Zhang, Xiuning Le, Jonathan M. Kurie, Boris Sepesi, William N. William, Don L. Gibbons, Mehmet Altan, Garrett L. Walsh, Ferdinandos Skoulidis, George R. Blumenschein, R. Mehran, Frank E. Mott, and Cheuk Hong Leung
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Ipilimumab ,medicine.disease ,Internal medicine ,medicine ,Non small cell ,Nivolumab ,Lung cancer ,business ,medicine.drug - Published
- 2019
7. Immune and Circulating Tumor DNA Profiling After Radiation Treatment for Oligometastatic Non-Small Cell Lung Cancer: Translational Correlatives from a Mature Randomized Phase II Trial
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Andrew Futreal, Won-Chul Lee, Hai T. Tran, Curtis Gumbs, Xuefeng Xia, S.G. Swisher, Alexandre Reuben, Chad Tang, Daniel R. Gomez, Latasha Little, Xin Yi, Lianpeng Chang, John V. Heymach, Zhongxing Liao, Jianjun Zhang, and Jennifer A. Wargo
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Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Time Factors ,T-Lymphocytes ,Enzyme-Linked Immunosorbent Assay ,Gastroenterology ,030218 nuclear medicine & medical imaging ,Circulating Tumor DNA ,Translational Research, Biomedical ,03 medical and health sciences ,0302 clinical medicine ,Maintenance therapy ,Interquartile range ,Internal medicine ,Carcinoma, Non-Small-Cell Lung ,medicine ,Carcinoma ,Biomarkers, Tumor ,Humans ,Radiology, Nuclear Medicine and imaging ,Progression-free survival ,Prospective Studies ,Gene Rearrangement, beta-Chain T-Cell Antigen Receptor ,Lung cancer ,Prospective cohort study ,Watchful Waiting ,Alleles ,Radiation ,business.industry ,Gene Expression Profiling ,Hazard ratio ,High-Throughput Nucleotide Sequencing ,Gene rearrangement ,medicine.disease ,DNA Fingerprinting ,Progression-Free Survival ,Oncology ,030220 oncology & carcinogenesis ,Mutation ,Cytokines ,business ,Follow-Up Studies - Abstract
Purpose NCT01725165 was a phase II prospective trial in which patients with non-small cell lung cancer were randomized to local consolidative therapy (LCT) versus maintenance therapy or observation (MT/O). Methods and Materials Peripheral blood from patients enrolled on NCT01725165 were labeled as (1) baseline, (2) early follow-up (FU) if obtained in the first or second FU evaluation (6-18 weeks), and (3) late FU if obtained in the third to sixth FU evaluations (22-50 weeks). All patients who underwent LCT and were included in this analysis received radiation. Among 49 randomized patients, 21 patients underwent T cell CDR3 variable region sequencing using immunoSEQ, 31 patients underwent circulating tumor DNA (ctDNA) analysis using next-generation sequencing with a 1021 cancer gene panel, and cytokine concentration was assayed in 19 patients using enzyme-linked immunosorbent assay. All analyses were exploratory and not corrected for multiple testing. Results No associations were identified between baseline T cell repertoire and ctDNA metrics with patient outcomes. Among baseline cytokines, interleukin 1α was the only cytokine associated with both overall survival (hazard ratio, 0.02; 95% confidence interval, 0.1-0.5; P = .0006) and progression-free survival (hazard ratio, 0.5; 95% confidence interval, 0.2-0.9; P = .03). At early FU, LCT was associated with decreased ctDNA burden, including lower number of detected mutations (median, 2 [interquartile range {IQR}, 1-6] vs 6 [IQR, 4-18]) and decreased average variable allele frequency (VAF; median, 0.006 [IQR, 0.003-0.010] vs 0.011 [IQR, 0.007-0.014]) compared with MT/O. Among 6 patients with serial ctDNA analysis, a rise in ctDNA detected mutation burden preceded clinical progression by 6.7 months. At early FU, LCT was associated with changes in T cell clonality that suggested oligoclonal expansion specifically increased T cell clonality (median, 0.15 [IQR, 0.12-0.24] vs 0.10 [IQR, 0.05-0.13]) and frequency of top 10 clones (median, 0.14 [IQR, 0.06-0.18] vs 0.21[IQR, 0.19-0.28]). Conclusion LCT was associated with decreased ctDNA burden and oligoclonal expansion at early FU timepoints. Baseline interleukin 1α was associated with improved patient outcomes.
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- 2019
8. Morbidity following salvage esophagectomy for squamous cell carcinoma: the MD Anderson experience
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Garrett L. Walsh, Kyle G. Mitchell, Erin M. Corsini, David B. Nelson, C. C. Wu, Mara B. Antonoff, Boris Sepesi, Dipen M. Maru, S.G. Swisher, Jaffer A. Ajani, Reza J. Mehran, Wayne L. Hofstetter, Ara A. Vaporciyan, Manoop S. Bhutani, David C. Rice, Quynh-Nhu Nguyen, and Jack A. Roth
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Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,medicine ,Humans ,Basal cell ,Esophagus ,education ,Neoplasm Staging ,Salvage Therapy ,education.field_of_study ,business.industry ,Gastroenterology ,General Medicine ,Chemoradiotherapy ,Middle Aged ,Salvage esophagectomy ,Combined Modality Therapy ,Surgery ,Esophagectomy ,medicine.anatomical_structure ,Outcome and Process Assessment, Health Care ,030220 oncology & carcinogenesis ,Cohort ,Female ,Esophageal Squamous Cell Carcinoma ,business - Abstract
SUMMARY The survival advantage associated with the addition of surgical therapy in esophageal squamous cell carcinoma (ESCC) patients who demonstrate a complete clinical response to chemoradiotherapy is unclear, and many institutions have adopted an organ-preserving strategy of selective surgery in this population. We sought to characterize our institutional experience of salvage esophagectomy (for failure of definitive bimodality therapy) and planned esophagectomy (as a component of trimodality therapy) by retrospectively analyzing patients with ESCC of the thoracic esophagus and GEJ who underwent esophagectomy following chemoradiotherapy between 2004 and 2016. Of 76 patients who met inclusion criteria, 46.1% (35) underwent salvage esophagectomy. Major postoperative complications (major cardiovascular and pulmonary events, anastomotic leak [grade ≥ 2], and 90-day mortality) were frequent and occurred in 52.6% of the cohort (planned resection: 36.6% [15/41]; salvage esophagectomy: 71.4% [25/35]). Observed rates of 30- and 90-day mortality for the entire cohort were 7.9% (planned: 7.3% [3/41]; salvage: 8.6% [3/35]) and 13.2% (planned: 9.8% [4/41]; salvage: 17.1% [6/35]), respectively. In summary, esophagectomy following chemoradiotherapy for ESCC at our institution has been associated with frequent postoperative morbidity and considerable rates of mortality in both planned and salvage settings. Although a selective approach to surgery may permit organ preservation in many patients with ESCC, these results highlight that salvage esophagectomy for failure of definitive-intent treatment of ESCC may also constitute a difficult clinical undertaking in some cases.
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- 2019
9. FP04.04 EGFR Mutations Predict Superior Survival of NSCLC Patients with Oligometastatic Disease Treated with Local Consolidative Therapy
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John V. Heymach, A. Vaporciyan, Ahsan Farooqi, David Boyce-Fappiano, Xiuning Le, Yasir Elamin, Daniel R. Gomez, S.G. Swisher, J. Zhang, S. Gandhi, Mara B. Antonoff, Kyle G. Mitchell, and Ethan B. Ludmir
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Egfr mutation ,Internal medicine ,medicine ,business ,Oligometastatic disease - Published
- 2021
10. MA19.03 Differences in Symptom Burden Between Responsive and Progressive Disease in Advanced Non-Small Cell Lung Cancer (aNSCLC)
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J. Zhang, Seyedeh Dibaj, Charles S. Cleeland, J. Lee, Emily Roarty, Jack A. Roth, J. Heymach, Q. Shi, Thomas Burke, Waree Rinsurongkawong, S.G. Swisher, B. El Ferjani, Jeff Lewis, George R. Simon, M. Hirschmann, D. Ponce, Loretta A. Williams, and Sheenu Chandwani
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Symptom burden ,Non small cell ,medicine.disease ,Lung cancer ,business ,Progressive disease - Published
- 2019
11. P1.16-31 Body Mass Index Relating to Patient-Reported Symptoms in First-Line Treatment of Metastatic Non-Small Cell Lung Cancer
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Thomas Burke, Sheenu Chandwani, J. Heymach, Emily Roarty, B. El Ferjani, George R. Simon, J. Lee, M. Hirschmann, Waree Rinsurongkawong, Loretta A. Williams, Q. Shi, J. Zhang, Jeff Lewis, Seyedeh Dibaj, Jack A. Roth, S.G. Swisher, Charles S. Cleeland, and D. Ponce
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Pulmonary and Respiratory Medicine ,First line treatment ,Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Non small cell ,Lung cancer ,medicine.disease ,business ,Body mass index - Published
- 2019
12. MA14.10 Clinical Outcomes in Metastatic Squamous Lung Cancer with Targetable Driver Alterations
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Waree Rinsurongkawong, Frank E. Mott, Jack A. Roth, J. Heymach, Vincent K. Lam, J. Lee, George R. Simon, W. Lewis, S.G. Swisher, Jeff Lewis, Vassiliki A. Papadimitrakopoulou, and J. Zhang
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Lung cancer ,medicine.disease ,business - Published
- 2019
13. Multidisciplinary Treatment of Thymic Neuroendocrine Tumors: Evaluation of the Impact of Surgery, Chemotherapy, and Radiation
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S.G. Swisher, David C. Rice, R. Mehran, Kyle G. Mitchell, Erin M. Corsini, Jack A. Roth, Mara B. Antonoff, Garrett L. Walsh, Wayne L. Hofstetter, Boris Sepesi, and A. Vaporciyan
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Oncology ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Radiation ,business.industry ,medicine.medical_treatment ,Neuroendocrine tumors ,medicine.disease ,Multidisciplinary approach ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2019
14. F-028PREDICTORS OF TRIMODALITY THERAPY AND TRENDS IN THERAPY FOR MALIGNANT PLEURAL MESOTHELIOMA
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Jiangong Niu, A. Vaporciyan, S.G. Swisher, David B. Nelson, R. Mehran, Wayne L. Hofstetter, Sharon H. Giordano, Boris Sepesi, Garrett L. Walsh, David C. Rice, Mara B. Antonoff, and Jack A. Roth
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pleural mesothelioma ,business.industry ,Medicine ,Surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2017
15. OA03.05 Characterization of the Immunologic Intra-Tumor Heterogeneity in Early Stages of Non-Small Cell Lung Cancer by Multiplex Immunofluorescence
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Annikka Weissferdt, Carmen Behrens, Arvind Rao, John V. Heymach, Cesar A. Moran, Boris Sepesi, Chi-Wan Chow, P.A. Futreal, S.G. Swisher, A. Francisco Cruz, Santhoshi N. Krishnan, Edwin R. Parra, James G. Fujimoto, Mei Jiang, Jangsoon Lee, J. Zhang, I. I. Wistuba, Neda Kalhor, and Souptik Barua
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Immunofluorescence ,medicine.disease ,Tumor heterogeneity ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,medicine ,Multiplex ,Non small cell ,Lung cancer ,business - Published
- 2018
16. P3.01-109 Real-World Patient-Reported Outcome Assessment of Patients with Metastatic Non-Small Cell Lung Cancer
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Seyedeh Dibaj, Jangsoon Lee, Loretta A. Williams, John V. Heymach, George R. Simon, W. Rinsurnogkawong, Jeff Lewis, M. Hirschmann, Sheenu Chandwani, Q. Shi, Viralkumar Vaghani, Charles S. Cleeland, L.L. Landry, S.G. Swisher, Thomas Burke, Jack A. Roth, Emily Roarty, and J. Zhang
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Patient-reported outcome ,Non small cell ,business ,Lung cancer - Published
- 2018
17. Long-Term Follow-up of a Prospective Study of Simultaneous Integrated Boost for Dose Escalation in Locally Advanced Esophageal Cancer
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Mariela A. Blum, James W. Welsh, Dawei Chen, Ahmed I. Younes, S.G. Swisher, Daniel R. Gomez, Manoop S. Bhutani, J.Y. Chang, Jaffer A. Ajani, Steven N. Seyedin, Wayne L. Hofstetter, Jeremy J. Erasmus, Quynh-Nhu Nguyen, Hari Menon, and Arya Amini
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Simultaneous integrated boost ,Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,Long term follow up ,business.industry ,Locally advanced ,Esophageal cancer ,medicine.disease ,Internal medicine ,medicine ,Dose escalation ,Radiology, Nuclear Medicine and imaging ,business ,Prospective cohort study - Published
- 2019
18. Improved Overall Survival with Local Consolidative Therapy in Oligometastatic Non-Small Cell Lung Cancer: Results from a Cohort of 194 Patients with Synchronous Disease
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Ara A. Vaporciyan, J. Zhang, Daniel R. Gomez, Ethan B. Ludmir, Erin M. Corsini, John V. Heymach, Ahsan Farooqi, Mara B. Antonoff, Kyle G. Mitchell, and S.G. Swisher
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Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,Disease ,medicine.disease ,Internal medicine ,Cohort ,medicine ,Overall survival ,Radiology, Nuclear Medicine and imaging ,Non small cell ,business ,Lung cancer - Published
- 2019
19. Results of the baseline positron emission tomography can customize therapy of localized esophageal adenocarcinoma patients who achieve a clinical complete response after chemoradiation
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David C. Rice, R.U. Komaki, Manoop S. Bhutani, Takashi Taketa, Kazuki Sudo, J. H. Lee, Heath D. Skinner, Mariela A. Blum, Roopma Wadhwa, Jaffer A. Ajani, Dipen M. Maru, Lianchun Xiao, Wayne L. Hofstetter, Jeremy J. Erasmus, Brian Weston, Akihiro Suzuki, and S.G. Swisher
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Male ,Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,Esophageal adenocarcinoma ,Standardized uptake value ,Adenocarcinoma ,Gastroenterology ,Disease-Free Survival ,Clinical complete response ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,Pathological ,Aged ,medicine.diagnostic_test ,business.industry ,Remission Induction ,Cancer ,Chemoradiotherapy ,Hematology ,Middle Aged ,Esophageal cancer ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Confidence interval ,Radiography ,Treatment Outcome ,Positron emission tomography ,Positron-Emission Tomography ,Female ,business - Abstract
BACKGROUND Patients with localized esophageal adenocarcinoma (EAC) who achieve a clinical complete response (clinCR) after preoperative chemoradiation (trimodality therapy; TMT) or definitive chemoradiation (bimodality therapy; BMT) live longer than those who achieve a
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- 2013
20. Concordance of studies for nodal staging is prognostic for worse survival in esophageal cancer
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S.G. Swisher, Wayne L. Hofstetter, Sonia L. Betancourt, Arlene M. Correa, Jaffer A. Ajani, Reza J. Mehran, and R. Dhupar
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Endoscopic ultrasound ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Concordance ,Gastroenterology ,Retrospective cohort study ,General Medicine ,Disease ,Esophageal cancer ,medicine.disease ,Esophagectomy ,Positron emission tomography ,medicine ,Radiology ,Prospective cohort study ,business - Abstract
Summary Pretreatment clinical staging in esophageal cancer influences prognosis and treatment strategy. Current staging strategies utilize multiple imaging modalities, and often the results are contradictory. No studies have examined the implications of concordance of computed tomography (CT), positron emission tomography (PET), and endoscopic ultrasound (EUS) when used for the evaluation of nodal disease. The objective of this study was to determine if concordance of CT, PET, or EUS for nodal disease predicts worse overall survival. We reviewed 615 esophageal cancer patients with pretreatment CT, PET, and EUS that underwent esophagectomy for survival outcomes based on concordance of studies for nodal disease. Concordant N+ is defined as two or three studies positive for nodal disease; non-concordant N+ is defined as only one positive study. Node-positive disease by any study predicted shorter survival than node-negative disease (42% vs. 73% 5-year survival; P < 0.001). Additionally, non-concordant N+ patients had shorter survival than N− patients (52% vs. 73% 5-year survival; P < 0.001). Concordant N+ patients had shorter survival than non-concordant N+ patients (38- vs. 61-month median survival; P = 0.017). There were no statistically significant differences in survival based on specific combinations of studies. When PET was disregarded, patients with both CT+ and EUS+ had shorter survival than patients with either CT+ or EUS+ (39- vs. 58-month median survival; P = 0.029). Pretreatment CT, PET, or EUS concordance for node-positive disease predicts shorter overall survival in patients that undergo esophagectomy for esophageal cancer. Predicting survival in esophageal cancer should consider the synergistic capabilities of CT, PET, and EUS in evaluating nodal status.
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- 2013
21. Diaphragmatic Hernia After Esophagectomy in 440 Patients With Long-Term Follow-Up
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David C. Rice, S.G. Swisher, Dhakshinamoorthy Ganeshan, Ara A. Vaporciyan, Garrett L. Walsh, Priya Bhosale, Reza J. Mehran, Wayne L. Hofstetter, Arlene M. Correa, Jack A. Roth, and Revathy B. Iyer
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Time Factors ,Long term follow up ,medicine.medical_treatment ,Logistic regression ,Single Center ,Young Adult ,medicine ,Humans ,Diaphragmatic hernia ,Hernia ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hernia, Diaphragmatic ,business.industry ,Incidence ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Surgery ,Esophagectomy ,Cohort ,Female ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background Postesophagectomy diaphragmatic hernia (PDH) is a recognized but severely under-reported and potentially hazardous event. Information regarding the natural course of this condition and guidelines regarding indications for reoperative intervention are lacking. In this study we aim to describe the frequency, predictors of incidence, and indications for repair. Methods Cross-sectional imaging (computed tomography scan) from patients who underwent esophagectomy between January 2001 and December 2007 at a single center were reviewed by two radiologists blinded to previous reports and clinical outcomes. Patients with PDH were compared with a similar cohort who did not have hernia. Patient characteristics, outcomes, and hernia descriptors including longitudinal progression were recorded. Multivariable logistic regression analyses identified predictors of PDH and need for repair. Results Of a total of 440 patients who underwent esophagectomy, 67 (15%) were radiologically diagnosed with PDH. Of these, only 7 of 67 cases (10%) were prospectively reported by the radiologist. Median time interval from esophagectomy to hernia was 2 years. Type of esophagectomy was an independent predictor for hernia developing ( p = 0.027). Patients with high body mass index were less prone to have PDH ( p = 0.043). Thus far, 9 patients (2%) have required surgical intervention, all for hernia-related symptoms or progression. Despite mesh repair, 4 of 9 have recurred and 2 were re-repaired. There was 1 PDH-associated death, 8 years after transhiatal resection. Conclusions Variables contributing to PDH are both technical and patient dependent. Whereas the majority of patients with PDH have not required repair, a small portion who became symptomatic or had large, progressive hernia required remedial surgery. Postesophagectomy patients require long-term surveillance for PDH.
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- 2013
22. Local Consolidative Therapy (LCT) Improves Overall Survival (OS) Compared to Maintenance Therapy/Observation in Oligometastatic Non-Small Cell Lung Cancer (NSCLC): Final Results of a Multicenter, Randomized, Controlled Phase 2 Trial
- Author
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Anne Tsao, John V. Heymach, Jose A. Karam, Boris Sepesi, Chad Tang, Brian D. Kavanagh, J. Jack Lee, Laurie E. Gaspar, Alexander V. Louie, Daniel R. Gomez, Ferdinandos Skoulidis, S.G. Swisher, George R. Blumenschein, Robert C. Doebele, Mike Hernandez, D.R. Camidge, Rui Ye, Don L. Gibbons, J. Zhang, and David A. Palma
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,non-small cell lung cancer (NSCLC) ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Maintenance therapy ,030220 oncology & carcinogenesis ,Internal medicine ,Overall survival ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2018
23. P3.09-27 Histopathologic Parameters Define Features of Treatment Response to Neoadjuvant Chemotherapy in Non-Small Cell Lung Cancer
- Author
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Garrett L. Walsh, Tina Cascone, L.L. Landry, Annikka Weissferdt, J. Zhang, Mara B. Antonoff, A. Vaporciyan, Neda Kalhor, J. Heymach, Don L. Gibbons, Jack A. Roth, Chantale Bernatchez, Apar Pataer, Boris Sepesi, I. I. Wistuba, Emily Roarty, Cesar A. Moran, and S.G. Swisher
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Treatment response ,Chemotherapy ,business.industry ,medicine.medical_treatment ,medicine.disease ,Internal medicine ,medicine ,Non small cell ,Lung cancer ,business - Published
- 2018
24. Pathologic assessment following neoadjuvant immunotherapy or chemotherapy demonstrates similar patterns in non-small cell lung cancer (NSCLC)
- Author
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Mehmet Altan, Boris Sepesi, A. Vaporciyan, Annikka Weissferdt, Ji-Sun Lee, John V. Heymach, Roxana Mehran, Apar Pataer, J. Zhang, Neda Kalhor, George R. Blumenschein, Xiuning Le, William N. William, Don L. Gibbons, Bonnie S. Glisson, David C. Rice, Ferdinandos Skoulidis, S.G. Swisher, Cesar A. Moran, and Tina Cascone
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Chemotherapy ,business.industry ,medicine.medical_treatment ,non-small cell lung cancer (NSCLC) ,Hematology ,Immunotherapy ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,business - Published
- 2018
25. Randomized phase II trial of osimertinib with or without local consolidation therapy (LCT) for patients with EGFR-mutant metastatic NSCLC (NORTHSTAR)
- Author
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John V. Heymach, Collin M. Blakely, Chad G. Rusthoven, Robert C. Doebele, Yasir Elamin, Peter P. Lee, S.G. Swisher, M. Baggstorm, Alexander V. Louie, Daniel R. Gomez, Vassiliki A. Papadimitrakopoulou, Ramaswamy Govindan, Trever G. Bivona, Xiuning Le, and Mara B. Antonoff
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Mutant ,Hematology ,030204 cardiovascular system & hematology ,Consolidation therapy ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Internal medicine ,medicine ,Osimertinib ,business - Published
- 2018
26. P2.01-87 Profiling the Symptom Burden of Patients with Metastatic NSCLC Receiving Either Chemotherapy or Targeted Therapy: Real-World Data
- Author
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Viralkumar Vaghani, W. Rinsurnogkawong, S.G. Swisher, Jeff Lewis, Q. Shi, J. Lee, Jack A. Roth, J. Zhang, Charles S. Cleeland, Emily Roarty, M. Hirschmann, J. Heymach, L.L. Landry, George R. Simon, and Loretta A. Williams
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Symptom burden ,Targeted therapy ,Internal medicine ,medicine ,Profiling (information science) ,business ,Real world data - Published
- 2018
27. Neoadjuvant nivolumab (N) or nivolumab plus ipilimumab (NI) for resectable non-small cell lung cancer (NSCLC)
- Author
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J. Jack Lee, Cheuk Hong Leung, Lauren Averett Byers, Annikka Weissferdt, Myrna C.B. Godoy, William N. William, John V. Heymach, Don L. Gibbons, Vincent K. Lam, Lorenzo Federico, Boris Sepesi, Ara A. Vaporciyan, Tina Cascone, Brett W. Carter, Vassiliki A. Papadimitrakopoulou, Cara Haymaker, Chantale Bernatchez, Frank E. Mott, S.G. Swisher, and Frank V. Fossella
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,non-small cell lung cancer (NSCLC) ,Ipilimumab ,Hematology ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Medicine ,Nivolumab ,business ,Neoadjuvant therapy ,medicine.drug - Published
- 2018
28. P1.04-08 Co-Residence of Patient-Derived Immune Cells in Patient-Derived Xenografts from Lung Cancer Patients
- Author
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X. Pu, Jack A. Roth, Bingliang Fang, Yungchang Chen, Lin Wu, John V. Heymach, Weimin Mao, Ismail M. Meraz, Ran Zhang, Apar Pataer, Dan Su, Xiang Zhang, Shuhong Wu, Linghua Wang, and S.G. Swisher
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Immune system ,business.industry ,Internal medicine ,medicine ,Residence ,In patient ,Lung cancer ,medicine.disease ,business - Published
- 2018
29. Association between clinical complete response and pathological complete response after preoperative chemoradiation in patients with gastroesophageal cancer: analysis in a large cohort
- Author
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Kazuki Sudo, A. Vaporciyan, Jaffer A. Ajani, Dipen M. Maru, Manoop S. Bhutani, Lianchun Xiao, J. H. Lee, David C. Rice, Wayne L. Hofstetter, Mariela A. Blum, J. Welch, Naga Cheedella, Takashi Taketa, Akihiro Suzuki, S.G. Swisher, and S.H. Lin
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Preoperative care ,Cohort Studies ,Stomach Neoplasms ,medicine ,Humans ,Combined Modality Therapy ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Remission Induction ,Cancer ,Retrospective cohort study ,Chemoradiotherapy ,Original Articles ,Hematology ,Middle Aged ,Esophageal cancer ,medicine.disease ,Surgery ,Treatment Outcome ,Oncology ,Positron emission tomography ,Positron-Emission Tomography ,Female ,Radiology ,business ,Cohort study - Abstract
Chemoradiation followed by surgery is the preferred treatment of localized gastroesophageal cancer (GEC). Surgery causes considerable life-altering consequences and achievement of clinical complete response (clinCR; defined as postchemoradiation [but presurgery] endoscopic biopsy negative for cancer and positron emission tomographic (PET) scan showing physiologic uptake) is an enticement to avoid/delay surgery. We examined the association between clinCR and pathologic complete response (pathCR).Two hundred eighty-four patients with GEC underwent chemoradiation and esophagectomy. The chi-square test, Fisher exact test, t-test, Kaplan-Meier method, and log-rank test were used.Of 284 patients, 218 (77%) achieved clinCR. However, only 67 (31%) of the 218 achieved pathCR. The sensitivity of clinCR for pathCR was 97.1% (67/69), but the specificity was low (29.8%; 64/215). Of the 66 patients who had less than a clinCR, only 2 (3%) had a pathCR. Thus, the rate of pathCR was significantly different in patients with clinCR than in those with less than a clinCR (P0.001).clinCR is not highly associated with pathCR; the specificity of clinCR for pathCR is too low to be used for clinical decision making on delaying/avoiding surgery. Surgery-eligible GEC patients should be encouraged to undergo surgery following chemoradiation despite achieving a clinCR.
- Published
- 2013
30. Esophageal Cancer Dose Escalation Using a Simultaneous Integrated Boost Technique
- Author
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Daniel R. Gomez, Steven H. Settle, Ritsuko Komaki, S.G. Swisher, James W. Welsh, James D. Cox, Anna Likhacheva, Jaffer A. Ajani, Wayne L. Hofstetter, M.B. Palmer, Zhongxing Liao, and Pamela K. Allen
- Subjects
Organs at Risk ,Cancer Research ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Adenocarcinoma ,Article ,medicine ,Humans ,Dosimetry ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Radiation Injuries ,Lung ,neoplasms ,Retrospective Studies ,Radiation ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Dose fractionation ,Heart ,Retrospective cohort study ,Esophageal cancer ,medicine.disease ,Tumor Burden ,Radiography ,Radiation therapy ,medicine.anatomical_structure ,Liver ,Spinal Cord ,Oncology ,Dose Fractionation, Radiation ,Radiotherapy, Intensity-Modulated ,Radiology ,Radiotherapy, Conformal ,Nuclear medicine ,business ,therapeutics - Abstract
Purpose We previously showed that 75% of radiation therapy (RT) failures in patients with unresectable esophageal cancer are in the gross tumor volume (GTV). We performed a planning study to evaluate if a simultaneous integrated boost (SIB) technique could selectively deliver a boost dose of radiation to the GTV in patients with esophageal cancer. Methods and Materials Treatment plans were generated using four different approaches (two-dimensional conformal radiotherapy [2D-CRT] to 50.4 Gy, 2D-CRT to 64.8 Gy, intensity-modulated RT [IMRT] to 50.4 Gy, and SIB-IMRT to 64.8 Gy) and optimized for 10 patients with distal esophageal cancer. All plans were constructed to deliver the target dose in 28 fractions using heterogeneity corrections. Isodose distributions were evaluated for target coverage and normal tissue exposure. Results The 50.4 Gy IMRT plan was associated with significant reductions in mean cardiac, pulmonary, and hepatic doses relative to the 50.4 Gy 2D-CRT plan. The 64.8 Gy SIB-IMRT plan produced a 28% increase in GTV dose and comparable normal tissue doses as the 50.4 Gy IMRT plan; compared with the 50.4 Gy 2D-CRT plan, the 64.8 Gy SIB-IMRT produced significant dose reductions to all critical structures (heart, lung, liver, and spinal cord). Conclusions The use of SIB-IMRT allowed us to selectively increase the dose to the GTV, the area at highest risk of failure, while simultaneously reducing the dose to the normal heart, lung, and liver. Clinical implications warrant systematic evaluation.
- Published
- 2012
31. Minimally invasive esophagectomy versus open esophagectomy, a symptom assessment study
- Author
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Garrett L. Walsh, A. Goodyear, Jack A. Roth, Arlene M. Correa, R. Mehran, Jing Huang, David C. Rice, Randa El-Zein, S.G. Swisher, Wayne L. Hofstetter, Ara A. Vaporciyan, and A. Mehta
- Subjects
Myotomy ,medicine.medical_specialty ,Performance status ,business.industry ,medicine.medical_treatment ,General surgery ,Gastroenterology ,General Medicine ,Esophageal cancer ,medicine.disease ,Preoperative care ,Pyloroplasty ,Surgery ,Esophagectomy ,Propensity score matching ,medicine ,Dumping syndrome ,business - Abstract
Minimally invasive esophagectomy (MIE) is used with hope to decrease the morbidity associated with an open esophagectomy. Reflux and dumping syndromes are the most important functional complaints in patients after esophagectomy. This study compares the functional benefits of MIE with open esophagectomy. The study enrolled patients who underwent either minimally invasive or open esophagectomy for cancer between 2004 and 2009. No patients in the MIE group had a pyloroplasty or myotomy. Each patient in the MIE group was paired to a patient in the open esophagectomy group via propensity matching. Matching variables included age, race, gender, preoperative treatment, history of prior cancer, American Society of Anesthesiologists Risk Scale, performance status, clinical stage, body mass index, histology, level of anastomosis, and time elapsed since surgery. The patients were asked to answer 26 questions about their reflux and dumping using validated questionnaires. A total of 181 patients were included in the study. From this group, 44 pairs of patients were created and used for the analysis. The median follow-up was 12.1 months for the MIE group and 18.3 months for the open group. The reflux score was slightly worse in the MIE group (5.5 versus 3.5, P= 0.021). There was no difference in the dumping symptoms between the two groups. The most common complaints seen in the dumping questionnaire in almost one-third of all patients were early satiety, abdominal discomfort, nausea, and diarrhea. Of the patients, 77% were satisfied or very satisfied with their condition in the MIE group compared with 93% in the open group (P= 0.287). Reflux, dumping, and overall satisfaction after MIE without pyloroplasty are comparable with those obtained after open esophagectomy with a pyloric drainage procedure.
- Published
- 2010
32. Whole-exome sequencing and immune profiling of early-stage lung adenocarcinoma with fully annotated clinical follow-up
- Author
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Chi-Wan Chow, Edward Kaftan, Stephen G. Gaffney, J. Zhang, Neda Kalhor, Richard P. Lifton, Don L. Gibbons, Je Sang Lee, S.G. Swisher, James G. Fujimoto, David L. Rimm, Humam Kadara, Zi-Ming Zhao, Murim Choi, John V. Heymach, Roy S. Herbst, Cesar A. Moran, Carmen Behrens, Jeffrey P. Townsend, Yongjin Yoo, I. I. Wistuba, Jaime Rodriguez-Canales, Thomas J. Lynch, Edwin Roger Parra, and Joseph Schlessinger
- Subjects
Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,DNA Mutational Analysis ,STK11 ,Adenocarcinoma of Lung ,Kaplan-Meier Estimate ,Adenocarcinoma ,Disease-Free Survival ,Pathogenesis ,Immune profiling ,03 medical and health sciences ,Immune system ,0302 clinical medicine ,Internal medicine ,Adjuvant therapy ,Biomarkers, Tumor ,medicine ,Humans ,Exome ,Stage (cooking) ,Lung cancer ,Exome sequencing ,Neoplasm Staging ,Proportional Hazards Models ,Lung ,business.industry ,FOXP3 ,Original Articles ,Hematology ,Prognosis ,medicine.disease ,Immunohistochemistry ,Corrigenda ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Mutation ,Cancer research ,Female ,business ,Follow-Up Studies ,Genome-Wide Association Study - Abstract
Background Lung adenocarcinomas (LUADs) lead to the majority of deaths attributable to lung cancer. We performed whole-exome sequencing (WES) and immune profiling analyses of a unique set of clinically annotated early-stage LUADs to better understand the pathogenesis of this disease and identify clinically relevant molecular markers. Methods We performed WES of 108 paired stage I-III LUADs and normal lung tissues using the Illumina HiSeq 2000 platform. Ten immune markers (PD-L1, PD-1, CD3, CD4, CD8, CD45ro, CD57, CD68, FOXP3 and Granzyme B) were profiled by imaging-based immunohistochemistry (IHC) in a subset of LUADs (n = 92). Associations among mutations, immune markers and clinicopathological variables were analyzed using ANOVA and Fisher’s exact test. Cox proportional hazards regression models were used for multivariate analysis of clinical outcome. Results LUADs in this cohort exhibited an average of 243 coding mutations. We identified 28 genes with significant enrichment for mutation. SETD2-mutated LUADs exhibited relatively poor recurrence- free survival (RFS) and mutations in STK11 and ATM were associated with poor RFS among KRAS-mutant tumors. EGFR, KEAP1 and PIK3CA mutations were predictive of poor response to adjuvant therapy. Immune marker analysis revealed that LUADs in smokers and with relatively high mutation burdens exhibited increased levels of immune markers. Analysis of immunophenotypes revealed that LUADs with STK11 mutations exhibited relatively low levels of infiltrating CD4+/CD8+ T-cells indicative of a muted immune response. Tumoral PD-L1 was significantly elevated in TP53 mutant LUADs whereas PIK3CA mutant LUADs exhibited markedly down-regulated PD-L1 expression. LUADs with TP53 or KEAP1 mutations displayed relatively increased CD57 and Granzyme B levels indicative of augmented natural killer (NK) cell infiltration. Conclusion(s) Our study highlights molecular and immune phenotypes that warrant further analysis for their roles in clinical outcomes and personalized immune-based therapy of LUAD.
- Published
- 2018
33. P2.04-014 Computing the Impact of Immunotherapy on NSCLC Landscape: The Advanced Non-Small Cell Lung Cancer Holistic Registry (ANCHoR)
- Author
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M. Hirschmann, W. Rinsurnogkawong, Viralkumar Vaghani, Jeff Lewis, Thomas Burke, J. Jack Lee, Q. Shi, Sheenu Chandwani, Emily Roarty, Jack A. Roth, George R. Simon, Loretta A. Williams, L. Lacerda Landry, John V. Heymach, Jianhua Zhang, S.G. Swisher, and Charles S. Cleeland
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Internal medicine ,Medicine ,Non small cell ,Immunotherapy ,business ,Lung cancer ,medicine.disease - Published
- 2017
34. OA 07.02 Characteristics of Lung Cancer Cell-Free Tumor DNA (CfDNA) Shedding and Correlation with Tumor Burden as Measured by RECIST
- Author
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J. Jack Lee, Vincent K. Lam, Hai T. Tran, J. Wang, Lerong Li, Jeff Lewis, Jack A. Roth, Waree Rinsurongkawong, Richard B. Lanman, Vassiliki A. Papadimitrakopoulou, J. Zhang, John V. Heymach, and S.G. Swisher
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,chemistry.chemical_compound ,Lung cancer cell ,chemistry ,business.industry ,Internal medicine ,Tumor burden ,Medicine ,business ,DNA - Published
- 2017
35. RAD50 Expression Is Associated with Poor Clinical Outcomes after Radiotherapy in Resected Non–Small Cell Lung Cancer
- Author
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Yifan Wang, J. Heymach, Wen Jiang, J. Yan, Weiye Deng, Jayanthi Gudikote, S.G. Swisher, James G. Fujimoto, S.H. Lin, I. I. Wistuba, Brian P. Hobbs, R.U. Komaki, and J. Wang
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,medicine.disease ,Radiation therapy ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Non small cell ,Lung cancer ,business - Published
- 2017
36. Significance of thromboembolic phenomena occurring before and during chemoradiotherapy for localized carcinoma of the esophagus and gastroesophageal junction
- Author
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E. D. Tetzlaff, R.U. Komaki, William A. Ross, Jaffer A. Ajani, Dipen M. Maru, S.G. Swisher, and Arlene M. Correa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Antineoplastic Agents ,Adenocarcinoma ,Cohort Studies ,Thromboembolism ,medicine ,Humans ,Esophagus ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Hazard ratio ,Gastroenterology ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Pulmonary embolism ,Survival Rate ,Radiation therapy ,medicine.anatomical_structure ,Carcinoma, Squamous Cell ,Female ,Radiotherapy, Adjuvant ,Esophagogastric Junction ,business ,Complication ,human activities ,Chemoradiotherapy - Abstract
SUMMARY. Thromboembolic event (TEE) is the most common complication and a second cause of mortality in cancer patients. Multiple hypotheses for occurrence of TEE have been proposed. There are no reports on the frequency/impact of TEE in localized gastroesophageal cancer patients. We hypothesized that TEE at baseline and during chemoradiotherapy (CTRT) in gastroesophageal cancer patients would have an impact on overall survival (OS) of these patients. All consecutive patients with gastroesophageal cancer undergoing CTRT from 2001 to 2004 were eligible for this analysis. Baseline and subsequent TEEs were documented and correlated with patient characteristics and OS. One hundred ninety-eight patients were analyzed. TEEs were documented in 9.6% of the patients. At baseline, TEEs were documented in 4.0% of the patients. During CTRT, TEEs were documented in 6.1% of the patients. Pulmonary embolism (43.5%) and lower extremity venous thromboses (39%) were the most frequent TEEs. Median OS for patients with a TEE occurring at anytime was 17.7 versus 32.0 months for patients who never developed a TEE (P = 0.014). TEEs at baseline correlated with poor median survival: 13.1 versus 30.7 months for those without a TEE (P = 0.029). In a multivariable analysis, TEE at baseline and/or during CTRT was an independent predictor of OS (hazard ratio, 1.818; P = 0.040). Our data are the first to document the frequency of TEE in gastroesophageal cancer patients undergoing CTRT, and that TEE is an independent prognosticator of OS. Active research to prevent and treat TEEs is needed to improve survival of patients with localized gastroesophageal cancer.
- Published
- 2008
37. A Prospective Analysis of Factors Affecting Successful Clinical Trial Enrollment and Randomization in the Context of a Randomized Study of Aggressive Local Therapy in Oligometastatic Non-Small Cell Lung Cancer
- Author
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S.H. Lin, Daniel R. Gomez, John V. Heymach, Z. Liao, Jennifer Logan, Chad Tang, and S.G. Swisher
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,Randomization ,business.industry ,Context (language use) ,medicine.disease ,law.invention ,Clinical trial ,Prospective analysis ,Oncology ,Randomized controlled trial ,law ,medicine ,Radiology, Nuclear Medicine and imaging ,Non small cell ,Lung cancer ,business ,Intensive care medicine - Published
- 2015
38. Prospective Phase 1/2 Clinical Trial: Evaluating Dose-Escalation for Esophageal Cancer
- Author
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Ji-Hyun Lee, S.G. Swisher, Wayne L. Hofstetter, Jaffer A. Ajani, Manoop S. Bhutani, Quynh-Nhu Nguyen, James W. Welsh, Jeremy J. Erasmus, R.U. Komaki, J.Y. Chang, Daniel R. Gomez, Bruce D. Minsky, Steven N. Seyedin, and Mariela A. Blum
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,Esophageal cancer ,medicine.disease ,Clinical trial ,Internal medicine ,medicine ,Dose escalation ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2015
39. Validation of the 12-Gene Predictive Signature for Adjuvant Chemotherapy Response in Lung Cancer
- Author
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Hao Tang, Shan Wang, John D. Minna, Yang Xie, David H. Johnson, Cesar A. Moran, John V. Heymach, Carmen Behrens, Yunyun Zhou, S.G. Swisher, Guanghua Xiao, Wei Lu, Jack A. Roth, Vassiliki A. Papadimitrakopoulou, Ximing Tang, and I. I. Wistuba
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Adjuvant chemotherapy ,business.industry ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Lung cancer ,business ,Gene - Published
- 2017
40. Tumor-Infiltrating Lymphocytes and Overall Survival in Surgically Resected Stage II and III Non–Small Cell Lung Cancer
- Author
-
Cesar A. Moran, Wayne L. Hofstetter, A.M. Correa, I. I. Wistuba, Boris Sepesi, Jack A. Roth, Annikka Weissferdt, E. Parra Cuentes, John V. Heymach, Carmen Behrens, Jaime Rodriguez Canales, David C. Rice, Neda Kalhor, Ara A. Vaporciyan, Don L. Gibbons, Mara B. Antonoff, Garrett L. Walsh, S.G. Swisher, and R. Mehran
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,Pathology ,medicine.medical_specialty ,Radiation ,Tumor-infiltrating lymphocytes ,business.industry ,Stage ii ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Overall survival ,Radiology, Nuclear Medicine and imaging ,Non small cell ,Lung cancer ,business - Published
- 2017
41. Patient-Reported Symptoms: Differences Between Men and Women Following Pulmonary Resection
- Author
-
R. Mehran, A. Vaporciyan, David C. Rice, Garrett L. Walsh, Mara B. Antonoff, Boris Sepesi, S.G. Swisher, William S. Ragalie, Wayne L. Hofstetter, and Jack A. Roth
- Subjects
Cancer Research ,medicine.medical_specialty ,Radiation ,Oncology ,business.industry ,medicine ,Radiology, Nuclear Medicine and imaging ,Pulmonary resection ,business ,Surgery - Published
- 2017
42. RAD50 Expression Predicts for Locoregional Failure and Distant Metastatic Recurrence After Postoperative Radiation Therapy in Resected Non-Small Cell Lung Cancer
- Author
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John V. Heymach, Jayanthi Gudikote, R.U. Komaki, Ignacio I. Wistuba, Uma Giri, J. Wang, Huiqin Chen, Benjamin Farnia, Daniel R. Gomez, Michael D. Story, C. Wei, S.G. Swisher, James G. Fujimoto, and S.H. Lin
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,Locoregional failure ,business.industry ,Postoperative radiation ,medicine.disease ,Rad50 ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Non small cell ,business ,Lung cancer - Published
- 2014
43. Population-Based Analysis of Cause-Specific Mortality in Older Esophageal Cancer Patients Treated With Conformal Radiation Therapy or Intensity Modulated Radiation Therapy
- Author
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Sharon H. Giordano, Linus Ho, Wayne L. Hofstetter, J. Wang, Joy Godby, S.H. Lin, Z. Liao, R.U. Komaki, S.G. Swisher, Gary D. Marsh, Ning Zhang, and Linda S. Elting
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,Cause specific mortality ,Conformal radiation therapy ,Population based ,Intensity-modulated radiation therapy ,Esophageal cancer ,medicine.disease ,Radiation therapy ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2014
44. Validation of a proliferation-based expression signature as prognostic marker in early stage lung adenocarcinoma
- Author
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Lorenzo Spaggiari, Robyn Riley, Ignacio I. Wistuba, Susanne Wagner, Cesar A. Moran, Elisha Hughes, Zaina Sangale, Neda Kalhor, Julia Reid, M. Gabriela Raso, Jerry S. Lanchbury, Junya Fujimoto, S.G. Swisher, Domenico Galetta, Edward S. Kim, Carmen Behrens, Alexander Gutin, Massimo Barberis, and Francesca Lombardi
- Subjects
Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Lung Neoplasms ,Adenocarcinoma of Lung ,Adenocarcinoma ,Bioinformatics ,Article ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,RNA, Messenger ,Stage (cooking) ,Lung cancer ,Aged ,Cell Proliferation ,Neoplasm Staging ,Univariate analysis ,Proportional hazards model ,business.industry ,Cell Cycle ,Cancer ,Middle Aged ,medicine.disease ,Prognosis ,Gene Expression Regulation, Neoplastic ,Treatment Outcome ,Chemotherapy, Adjuvant ,Cohort ,Female ,business - Abstract
Purpose: New prognostic markers to guide treatment decisions in early stage non–small cell lung cancer are necessary to improve patient outcomes. In this report, we assess the utility of a predefined mRNA expression signature of cell-cycle progression genes (CCP score) to define 5-year risk of lung cancer–related death in patients with early stage lung adenocarcinoma. Experimental Design: A CCP score was calculated from the mRNA expression levels of 31 proliferation genes in stage I and stage II tumor samples from two public microarray datasets [Director's Consortium (DC) and GSE31210]. The same gene set was tested by quantitative PCR in 381 formalin-fixed paraffin-embedded (FFPE) primary tumors. Association of the CCP score with outcome was assessed by Cox proportional hazards analysis. Results: In univariate analysis, the CCP score was a strong predictor of cancer-specific survival in both the Director's Consortium cohort (P = 0.00014; HR = 2.08; 95% CI, 1.43–3.02) and GSE31210 (P = 0.0010; HR = 2.25; 95% CI, 1.42–3.56). In multivariate analysis, the CCP score remained the dominant prognostic marker in the presence of clinical variables (P = 0.0022; HR = 2.02; 95% CI, 1.29–3.17 in Director's Consortium, P = 0.0026; HR = 2.16; 95% CI, 1.32–3.53 in GSE31210). On a quantitative PCR platform, the CCP score maintained highly significant prognostic value in FFPE-derived mRNA from clinical samples in both univariate (P = 0.00033; HR = 2.10; 95% CI, 1.39–3.17) and multivariate analyses (P = 0.0071; HR = 1.92; 95% CI, 1.18–3.10). Conclusions: The CCP score is a significant predictor of lung cancer death in early stage lung adenocarcinoma treated with surgery and may be a valuable tool in selecting patients for adjuvant treatment. Clin Cancer Res; 19(22); 6261–71. ©2013 AACR.
- Published
- 2013
45. Utilization of surgery in trimodality-eligible patients with locally advanced esophageal adenocarcinoma in a nonprotocol setting
- Author
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Wayne L. Hofstetter, Caitlin C. Murphy, R.U. Komaki, Arlene M. Correa, S.G. Swisher, and Jaffer A. Ajani
- Subjects
medicine.medical_specialty ,Performance status ,business.industry ,medicine.medical_treatment ,Gastroenterology ,General Medicine ,Odds ratio ,Esophageal cancer ,medicine.disease ,Comorbidity ,Surgery ,Clinical trial ,Medicine ,Adenocarcinoma ,Stage (cooking) ,business ,Neoadjuvant therapy - Abstract
Summary Trimodality therapy with neoadjuvant chemoradiation followed by surgery significantly improves the survival of locally advanced (clinical stage IIA–III) esophageal cancer patients compared to treatment with surgery alone. This has resulted in an increased use of neoadjuvant therapy in recent years, yet little is known regarding how this increase has impacted the utilization of surgery in the treatment of locally advanced disease. Although previous reports of experimental protocols suggest that 90–95% of patients complete trimodality therapy including a surgical resection, trimodality therapy completion among adenocarcinoma patients eligible for curative resection has not been evaluated in a nonprotocol setting. We sought to (i) assess the completion of trimodality therapy among locally advanced esophageal adenocarcinoma patients; (ii) characterize the reasons for avoiding surgery; and (iii) identify factors associated with failure to complete trimodality therapy. We identified 296 patients with locally advanced esophageal adenocarcinoma eligible for trimodality therapy at our institution. All patients were evaluated in a multidisciplinary setting and considered eligible for curative resection after initial staging and physiologic assessment. Multivariable logistic regression was used to identify factors associated with failure to complete trimodality therapy. Of 296 trimodality-eligible patients, 33% (97/296) did not complete trimodality therapy. Reasons for not undergoing surgery included patient choice (27.8%, 27/97), distant progression of disease during chemoradiation (23.7%, 23/97), and physician preference for surveillance (23.7%, 23/97). In addition, 17.5% (17/97) of patients had physical deterioration in performance status, and treatment-related deaths occurred in 7.2% (7/97) prior to surgery. In the total study population (n = 296), multivariable logistic regression identified older age (≥70 years: odds ratio [OR] = 6.611, 95% confidence interval [CI]: 2.900–15.071), pretreatment standard uptake value (6.8–10.1: OR = 2.393, 95% CI: 1.050–5.455; ≥15.8: OR = 3.623, 95% CI: 1.604–8.186), and a radiation dose of 50.4 Gy (OR = 5.312, 95% CI: 2.365–11.929) as being significantly associated with failure to complete trimodality therapy. Among the subgroup of patients that successfully completed chemoradiation (n = 266), older patients (≥70 years: OR = 9.606, 95% CI: 3.637–25.372), those with a comorbidity score of 2 or higher (OR = 4.059, 95% CI: 1.257–13.103), and those that received a radiation dose of 50.4 Gy (OR = 4.878, 95% CI: 1.974–12.054) were at a significantly higher risk of not completing trimodality therapy. Trimodality therapy completion among patients with locally advanced esophageal adenocarcinoma in a nonprotocol setting is considerably lower than what has previously been reported in clinical trials. Our findings suggest that a selective approach to surgery is commonly utilized in clinical practice. Trimodality-eligible patients that are older and have a higher comorbidity score are at risk for not completing trimodality therapy.
- Published
- 2013
46. Risk factors for local and regional recurrence in patients with resected N0-N1 non-small-cell lung cancer, with implications for patient selection for adjuvant radiation therapy
- Author
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A. Vaporciyan, Lawrence B. Levy, Y. Zhuang, David C. Rice, Z. Liao, R.U. Komaki, Daniel R. Gomez, James D. Cox, J. L. Lopez Guerra, S.H. Lin, J. Jaen, and S.G. Swisher
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Lung Neoplasms ,medicine.medical_treatment ,Disease ,Pneumonectomy ,Risk Factors ,Carcinoma, Non-Small-Cell Lung ,Carcinoma ,medicine ,Humans ,Stage (cooking) ,Lung cancer ,Pathological ,Aged ,Aged, 80 and over ,business.industry ,Patient Selection ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Oncology ,ROC Curve ,Cardiothoracic surgery ,Area Under Curve ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Background The purpose of this study was to evaluate the actuarial risk of local and regional failure in patients with completely resected non-small-cell lung cancer (NSCLC), and to assess surgical and pathological factors affecting this risk. Patients and methods Between January 1998 and December 2009, 1402 consecutive stage I–III (N0–N1) NSCLC patients underwent complete resection without adjuvant radiation therapy. The median follow-up was 42 months. Results Local–regional recurrence was identified in 9% of patients, with local failure alone in 3% of patients, regional failure alone in 4% of patients, and both local and regional failure simultaneously in 2% of patients. Patients who had local failure were found to be at increased risk of mortality. By multivariate analyses, three variables were shown to be independently significant risk factors for local [surgical procedure (single/multiple wedges + segmentectomy versus lobectomy + bilobectomy + pneumonectomy), tumor size >2.7 cm, and visceral pleural invasion] and regional (pathologic N1 stage, visceral pleural invasion, and lymphovascular space invasion, LVI) recurrence, respectively. Conclusion Patients with N0–N1 disease have low rates of locoregional recurrence after surgical resection. However, several prognostic factors can be identified that increase this risk and identify patients who may benefit from adjuvant treatment.
- Published
- 2012
47. Clinical parameters model for predicting pathologic complete response following preoperative chemoradiation in patients with esophageal cancer
- Author
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Takashi Taketa, Roxana Mehran, Dipen M. Maru, R.U. Komaki, J. H. Lee, A. Vaporciyan, David C. Rice, William A. Ross, Arlene M. Correa, Wayne L. Hofstetter, Manoop S. Bhutani, Homer A. Macapinlac, Mariela A. Blum, Jeremy J. Erasmus, Jaffer A. Ajani, James W. Welsh, Akihiro Suzuki, S.G. Swisher, and S.H. Lin
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Oncology ,medicine.medical_specialty ,Preoperative chemoradiotherapy ,medicine.diagnostic_test ,Esophageal Neoplasms ,business.industry ,Hematology ,Original Articles ,Nomogram ,Esophageal cancer ,medicine.disease ,Preoperative care ,Combined Modality Therapy ,Survival Analysis ,Positron emission tomography ,Internal medicine ,Biopsy ,Multivariate Analysis ,Medicine ,Humans ,Radiology ,business ,Survival analysis - Abstract
Approximately 25% of patients with esophageal cancer (EC) who undergo preoperative chemoradiation, achieve a pathologic complete response (pathCR). We hypothesized that a model based on clinical parameters could predict pathCR with a high (≥60%) probability.We analyzed 322 patients with EC who underwent preoperative chemoradiation. All the patients had baseline and postchemoradiation positron emission tomography (PET) and pre- and postchemoradiation endoscopic biopsy. Logistic regression models were used for analysis, and cross-validation via the bootstrap method was carried out to test the model.The 70 (21.7%) patients who achieved a pathCR lived longer (median overall survival [OS], 79.76 months) than the 252 patients who did not achieve a pathCR (median OS, 39.73 months; OS, P = 0.004; disease-free survival, P = 0.003). In a logistic regression analysis, the following parameters contributed to the prediction model: postchemoradiation PET, postchemoradiation biopsy, sex, histologic tumor grade, and baseline (EUS)T stage. The area under the receiver-operating characteristic curve was 0.72 (95% confidence interval [CI] 0.662-0.787); after the bootstrap validation with 200 repetitions, the bias-corrected AU-ROC was 0.70 (95% CI 0.643-0.728).Our data suggest that the logistic regression model can predict pathCR with a high probability. This clinical model could complement others (biomarkers) to predict pathCR.
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- 2012
48. The Influence of Pretreatment Body Mass Index on Long-Term Prognosis of Patients With Esophageal Carcinoma After Surgery
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Ara A. Vaporciyan, G. L. Walsh, Wayne L. Hofstetter, Arlene M. Correa, Yuki Hayashi, David C. Rice, R. Mehran, J. A. Ajani, and S.G. Swisher
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Oncology ,Cancer Research ,medicine.medical_specialty ,Gastroesophageal adenocarcinoma ,business.industry ,medicine.disease ,Obesity ,Term (time) ,Abstracts ,Internal medicine ,medicine ,Carcinoma ,Risk factor ,business ,Body mass index - Abstract
e14525 Background: Obesity, a serious health problem in the United States, is a risk factor for gastroesophageal adenocarcinoma. However, the influence of obesity on patient's survival has not been...
- Published
- 2010
49. Clinical Outcome and Toxicity in Central Located Stage I or Isolated Recurrent Non-Small Cell Lung Cancer Treated With Stereotactic Ablative Radiation Therapy
- Author
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Daniel R. Gomez, Peter A Balter, W. James, Q. Xu, S.G. Swisher, J.Y. Chang, R.U. Komaki, and Jack A. Roth
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Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.medical_treatment ,Radiation therapy ,Recurrent Non-Small Cell Lung Cancer ,Internal medicine ,Toxicity ,Ablative case ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2013
50. The Influence of Positron Emission Tomography Scanning on Delay in Treatment of Non-Small Cell Lung Cancer
- Author
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B.D. Smith, Kaiping Liao, Jeremy J. Erasmus, Sharon H. Giordano, Daniel R. Gomez, S.G. Swisher, George R. Blumenschein, and Thomas A. Buchholz
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Cancer Research ,medicine.medical_specialty ,Radiation ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Oncology ,Positron emission tomography ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Non small cell ,business ,Lung cancer ,Nuclear medicine - Published
- 2013
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