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4. Research

Author

Lamm, Ryan, Ratnasekera, Asanthi, editor, Neff, Marc, editor, Yoon-Flannery, Kahyun, editor, and Beekley, Alec, editor

Published
2023
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5. Implementation of an opioid reduction toolkit in pancreatectomy patients significantly increases patient awareness of safe practice and decreases amount prescribed and consumed

Author

Lamm, Ryan, Cannaday, Shawnna, Ponzini, Francesca, Moskal, David, Lundgren, Megan, Williamson, John E., Wummer, Brandon, Huang, Rachel, Sun, George, Song, Steven G., Im, Brian, Kowal, Luke L., Wu, Inga, Bowne, Wilbur B., Nevler, Avinoam, Cowan, Scott W., Yeo, Theresa, Yeo, Charles J., and Lavu, Harish

Published
2023
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16. Hemorrhage Sites and Mitigation Strategies After Pancreaticoduodenectomy

Author

Preston, William A., primary, Collins, Micaela L., additional, Gönen, Mithat, additional, Murtha, Timothy, additional, Rivera, Victor, additional, Lamm, Ryan, additional, Schafer, Michelle, additional, Yarmohammadi, Hooman, additional, Covey, Anne, additional, Brody, Lynn A., additional, Topper, Stephen, additional, Nevler, Avinoam, additional, Lavu, Harish, additional, Yeo, Charles J., additional, Balachandran, Vinod P., additional, Drebin, Jeffrey A., additional, Soares, Kevin C., additional, Wei, Alice C., additional, Kingham, T. Peter, additional, D’Angelica, Michael I., additional, and Jarnagin, William R., additional

Published
2024
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18. A Resident-Driven Quality Initiative for Reducing Opioid Prescribing in Patients Undergoing Elective General Surgery Procedures, With Long-Term Follow-Up

Author

Lamm, Ryan, primary, Lundgren, Megan, additional, Christopher, Adrienne, additional, Woodroof, Jacob, additional, Edwards, Lindsay, additional, Kustera, Christopher, additional, Yeo, Charles J., additional, Noonan, Kristin M., additional, Lavu, Harish, additional, Costanzo, Caitlyn, additional, and Cowan, Scott, additional

Published
2023
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24. Tumor Biology and Immune Infiltration Define Primary Liver Cancer Subsets Linked to Overall Survival After Immunotherapy

Author

Budhu, Anuradha, Pehrsson, Erica C, He, Aiwu, Goyal, Lipika, Kelley, Robin Kate, Dang, Hien, Xie, Changqing, Monge, Cecilia, Tandon, Mayank, Ma, Lichun, Revsine, Mahler, Kuhlman, Laura, Zhang, Karen, Baiev, Islam, Lamm, Ryan, Patel, Keyur, Kleiner, David E, Hewitt, Stephen M, Tran, Bao, Shetty, Jyoti, Wu, Xiaolin, Zhao, Yongmei, Shen, Tsai-Wei, Choudhari, Sulbha, Kriga, Yuliya, Ylaya, Kris, Warner, Andrew C, Edmondson, Elijah F, Forgues, Marshonna, Greten, Tim F, Wang, Xin Wei, Budhu, Anuradha, Pehrsson, Erica C, He, Aiwu, Goyal, Lipika, Kelley, Robin Kate, Dang, Hien, Xie, Changqing, Monge, Cecilia, Tandon, Mayank, Ma, Lichun, Revsine, Mahler, Kuhlman, Laura, Zhang, Karen, Baiev, Islam, Lamm, Ryan, Patel, Keyur, Kleiner, David E, Hewitt, Stephen M, Tran, Bao, Shetty, Jyoti, Wu, Xiaolin, Zhao, Yongmei, Shen, Tsai-Wei, Choudhari, Sulbha, Kriga, Yuliya, Ylaya, Kris, Warner, Andrew C, Edmondson, Elijah F, Forgues, Marshonna, Greten, Tim F, and Wang, Xin Wei

Abstract

Primary liver cancer is a rising cause of cancer deaths in the US. Although immunotherapy with immune checkpoint inhibitors induces a potent response in a subset of patients, response rates vary among individuals. Predicting which patients will respond to immune checkpoint inhibitors is of great interest in the field. In a retrospective arm of the National Cancer Institute Cancers of the Liver: Accelerating Research of Immunotherapy by a Transdisciplinary Network (NCI-CLARITY) study, we use archived formalin-fixed, paraffin-embedded samples to profile the transcriptome and genomic alterations among 86 hepatocellular carcinoma and cholangiocarcinoma patients prior to and following immune checkpoint inhibitor treatment. Using supervised and unsupervised approaches, we identify stable molecular subtypes linked to overall survival and distinguished by two axes of aggressive tumor biology and microenvironmental features. Moreover, molecular responses to immune checkpoint inhibitor treatment differ between subtypes. Thus, patients with heterogeneous liver cancer may be stratified by molecular status indicative of treatment response to immune checkpoint inhibitors.

Published
2023

26. Tumor biology and immune infiltration define primary liver cancer subsets linked to overall survival after immunotherapy

Author

Budhu, Anuradha, primary, Pehrsson, Erica C., additional, He, Aiwu, additional, Goyal, Lipika, additional, Kelley, Robin Kate, additional, Dang, Hien, additional, Xie, Changqing, additional, Monge, Cecilia, additional, Tandon, Mayank, additional, Ma, Lichun, additional, Revsine, Mahler, additional, Kuhlman, Laura, additional, Zhang, Karen, additional, Baiev, Islam, additional, Lamm, Ryan, additional, Patel, Keyur, additional, Kleiner, David E., additional, Hewitt, Stephen M., additional, Tran, Bao, additional, Shetty, Jyoti, additional, Wu, Xiaolin, additional, Zhao, Yongmei, additional, Shen, Tsai-Wei, additional, Choudhari, Sulbha, additional, Kriga, Yuliya, additional, Ylaya, Kris, additional, Warner, Andrew C., additional, Edmondson, Elijah F., additional, Forgues, Marshonna, additional, Greten, Tim F., additional, and Wang, Xin Wei, additional

Published
2023
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29. Postoperative Handheld Gastric Point-of-Care Ultrasound and Delayed Bowel Function

Author

Lamm, Ryan, primary, Collins, Micaela, additional, Bloom, Jamie, additional, Joel, Marisa, additional, Iosif, Leah, additional, Park, Doo, additional, Reny, Jacky, additional, Schultz, Samuel, additional, Yeo, Charles J, additional, Beausang, David, additional, Schwenk, Eric S, additional, Costanzo, Caitlyn, additional, and Phillips, Benjamin R, additional

Published
2023
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30. Bracketed Localization in Breast-Conserving Surgery: Indications and Success Rates From a Single, High Volume, Academic Breast Cancer Center.

Author

Lyons, Walker, Lamm, Ryan, Duffner, Emily R, Shames, Jason, Willis, Alliric I, and Lazar, Melissa

Subjects
*LUMPECTOMY, *CORE needle biopsy, *BREAST cancer, *LOBULAR carcinoma, *CARCINOMA in situ, *DUCTAL carcinoma
Abstract

Background: Bracketed localization is a technique used to help localize lesions for breast-conserving surgery (BCS). To date, there are no guidelines for when bracketed localization should be used in clinical practice. Based on our experience, we aim to provide criteria that should prompt surgeons to consider bracketing. Methods: A single-institution retrospective chart review was performed on patients who underwent bracketed localization for BCS between 2015 and 2021. Lesion characteristics were recorded including lesion span, number of lesions, histology type on core needle biopsy and surgical specimen, margin status, and need for additional surgery. Results: One hundred and thirteen cases were analyzed. Imaging showed an average lesion span of 5.0-cm. Multifocal lesions represented 45% of cases. Ductal carcinoma in situ (DCIS) was a histological component in 64% of core needle biopsies and 76% of surgical specimens. Negative margins were achieved in 82% of patients on the first excision. Additional surgery was performed in 17% of patients. Invasive lobular carcinoma had the highest additional surgery rate at 23%. Negative margins with BCS were achieved in 96% of cases, including those with successful re-excision. Discussion: This descriptive study shows that bracketed localization was most often employed for patients with large lesion spans, multifocality, and a DCIS or invasive lobular component. While these characteristics are typically associated with higher rates of positive margins, our cohort's rate of additional surgery was comparable to the national average for all BCS operations. These results argue that surgeon utilization of bracketed localization may be beneficial in these clinical scenarios. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Reduced Rates of Post-Transplant Recurrent Hepatocellular Carcinoma in Non-Alcoholic Steatohepatitis: A Propensity Score Matched Analysis

Author

Lamm, Ryan, primary, Altshuler, Peter J., additional, Patel, Keyur, additional, Shaheen, Osama, additional, Amante, Angel Paulo, additional, Civan, Jesse, additional, Maley, Warren, additional, Frank, Adam, additional, Ramirez, Carlo, additional, Glorioso, Jaime, additional, Shah, Ashesh, additional, Dang, Hien, additional, and Bodzin, Adam S., additional

Published
2022
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36. Reduced Rates of Post-Transplant Recurrent Hepatocellular Carcinoma in Non-Alcoholic Steatohepatitis: A Propensity Score Matched Analysis

Author

Lamm, Ryan, Altshuler, Peter J, Patel, Keyur, Shaheen, Osama, Amante, Angel Paulo, Civan, Jesse, Maley, Warren, Frank, Adam, Ramirez, Carlo, Glorioso, Jaime, Shah, Ashesh, Dang, Hien, Bodzin, Adam S, Lamm, Ryan, Altshuler, Peter J, Patel, Keyur, Shaheen, Osama, Amante, Angel Paulo, Civan, Jesse, Maley, Warren, Frank, Adam, Ramirez, Carlo, Glorioso, Jaime, Shah, Ashesh, Dang, Hien, and Bodzin, Adam S

Abstract

Non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) has become the second leading cause of HCC-related liver transplantation in the United States. This study investigated post-transplant recurrence and survival for patients transplanted for NASH-related HCC compared to non-NASH HCC etiologies. Retrospective review of the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN) database identified 7,461 patients with HCC—1,405 with underlying NASH and 6,086 with non-NASH underlying diseases. After propensity score matching (PSM) to account for patient- and tumor-related confounders 1,175 remained in each group. Primary outcomes assessed were recurrence rate and recurrence-free survival. Recurrent malignancy at 5 years post-transplant was lower in NASH compared to non-NASH patients (5.80 vs. 9.41%, p = 0.01). Recurrence-free survival, however, was similar at 5 years between groups. Patients with NASH-related HCC were less likely to have post-transplant recurrence than their non-NASH counterparts, although recurrence-free survival was similar at 5 years.

Published
2022

42. Rare Occurrence of Pseudomyxoma Peritonei (PMP) Syndrome Arising from a Malignant Transformed Ovarian Primary Mature Cystic Teratoma Treated by Cytoreductive Surgery and HIPEC: A Case Report

Author

Ponzini, Francesca M., primary, Kowal, Luke L., additional, Ghafoor, Mariam, additional, Goldberg, Allison, additional, Chan, Joanna, additional, Lamm, Ryan, additional, Cannaday, Shawnna M., additional, Richard, Scott D., additional, Nevler, Avinoam, additional, Lavu, Harish, additional, Bowne, Wilbur B., additional, and Rosenblum, Norman G., additional

Published
2022
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44. Hepatic Stellate Cells and Hepatocarcinogenesis

Author

Barry, Anna E., primary, Baldeosingh, Rajkumar, additional, Lamm, Ryan, additional, Patel, Keyur, additional, Zhang, Kai, additional, Dominguez, Dana A., additional, Kirton, Kayla J., additional, Shah, Ashesh P., additional, and Dang, Hien, additional

Published
2020
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45. Hepatocellular Carcinoma-The Influence of Immunoanatomy and the Role of Immunotherapy

Author

Patel, Keyur, Lamm, Ryan, Altshuler, Peter, Dang, Hien, Shah, MD, Ashesh P., Patel, Keyur, Lamm, Ryan, Altshuler, Peter, Dang, Hien, and Shah, MD, Ashesh P.

Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related morbidity and mortality worldwide. Most patients are diagnosed with advanced disease, limiting their options for treatment. While current treatments are adequate for lower staged disease, available systemic treatments are limited, with marginal benefit at best. Chimeric antigen receptor (CAR) T cell therapy, effective in treating liquid tumors such as B-cell lymphoma, presents a potentially promising treatment option for advanced HCC. However, new challenges specific to solid tumors, such as tumor immunoanatomy or the immune cell presence and position anatomically and the tumor microenvironment, need to be defined and overcome. Immunotherapy currently in use must be re-engineered and re-envisioned to treat HCC with the hopes of ushering in an answer to advanced stage solid tumor disease processes. Future therapy options must address the uniqueness of the tumors under the umbrella of HCC. This review strives to summarize HCC, its staging system, current therapy and immunotherapy medications currently being utilized or studied in the treatment of HCC with the hopes of highlighting what is being done and suggesting what needs to be done in the future to champion this therapy as an effective option.

Published
2020

46. Hepatic Stellate Cells and Hepatocarcinogenesis

Author

Barry, Anna E, Baldeosingh, Rajkumar, Lamm, Ryan, Patel, Keyur, Zhang, Kai, Dominguez, Dana A, Kirton, Kayla J, Shah, Ashesh P., Dang, Hien, Barry, Anna E, Baldeosingh, Rajkumar, Lamm, Ryan, Patel, Keyur, Zhang, Kai, Dominguez, Dana A, Kirton, Kayla J, Shah, Ashesh P., and Dang, Hien

Abstract

Hepatic stellate cells (HSCs) are a significant component of the hepatocellular carcinoma (HCC) tumor microenvironment (TME). Activated HSCs transform into myofibroblast-like cells to promote fibrosis in response to liver injury or chronic inflammation, leading to cirrhosis and HCC. The hepatic TME is comprised of cellular components, including activated HSCs, tumor-associated macrophages, endothelial cells, immune cells, and non-cellular components, such as growth factors, proteolytic enzymes and their inhibitors, and other extracellular matrix (ECM) proteins. Interactions between HCC cells and their microenvironment have become topics under active investigation. These interactions within the hepatic TME have the potential to drive carcinogenesis and create challenges in generating effective therapies. Current studies reveal potential mechanisms through which activated HSCs drive hepatocarcinogenesis utilizing matricellular proteins and paracrine crosstalk within the TME. Since activated HSCs are primary secretors of ECM proteins during liver injury and inflammation, they help promote fibrogenesis, infiltrate the HCC stroma, and contribute to HCC development. In this review, we examine several recent studies revealing the roles of HSCs and their clinical implications in the development of fibrosis and cirrhosis within the hepatic TME.

Published
2020

47. Astrocyte HIF-2α supports learning in a passive avoidance paradigm under hypoxic stress

Author

Leiton, Cindy, primary, Chen, Elyssa, additional, Cutrone, Alissa, additional, Conn, Kristy, additional, Mellanson, Kennelia, additional, Malik, Dania M, additional, Klingener, Michael, additional, Lamm, Ryan, additional, Cutrone, Michael, additional, Petrie IV, John, additional, Sheikh, Joher, additional, DiBua, Adriana, additional, Cohen, Betsy, additional, and Floyd, Thomas F, additional

Published
2018
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48. Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru

Author

Lamm, Ryan, primary, Rosales, Luis Angel, additional, Lescano, Andres G., additional, Smith, Edward, additional, Perez, Erika, additional, Alves, Clark, additional, Sanchez, Juan F., additional, Messina, Catherine, additional, Murphy, Meagan, additional, Valdivia, Hugo, additional, Ballard, Sarah-Blythe, additional, Perrotta, Grace, additional, and Fuhrer, Jack, additional

Published
2018
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49. Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru.

Author

Lamm, Ryan, Alves, Clark, Perrotta, Grace, Murphy, Meagan, Messina, Catherine, Sanchez, Juan F., Perez, Erika, Rosales, Luis Angel, Lescano, Andres G., Smith, Edward, Valdivia, Hugo, Fuhrer, Jack, Ballard, Sarah-Blythe, Lamm, Ryan, Alves, Clark, Perrotta, Grace, Murphy, Meagan, Messina, Catherine, Sanchez, Juan F., Perez, Erika, Rosales, Luis Angel, Lescano, Andres G., Smith, Edward, Valdivia, Hugo, Fuhrer, Jack, and Ballard, Sarah-Blythe

Published
2018

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