2022
A randomized, phase II trial of oral azacitidine (CC-486) in patients with resected pancreatic adenocarcinoma at high risk for recurrence
Heumann T, Baretti M, Sugar E, Durham J, Linden S, Lopez-Vidal T, Leatherman J, Cope L, Sharma A, Weekes C, O’Dwyer P, Reiss K, Monga D, Ahuja N, Azad N. A randomized, phase II trial of oral azacitidine (CC-486) in patients with resected pancreatic adenocarcinoma at high risk for recurrence. Clinical Epigenetics 2022, 14: 166. PMID: 36463226, PMCID: PMC9719150, DOI: 10.1186/s13148-022-01367-8.Peer-Reviewed Original ResearchConceptsResectable pancreatic ductal adenocarcinomaCC-486OBS patientsMetastatic settingAdjuvant therapyTreatment-related grade 3Randomized phase II studyMedian age 66Next-line therapyResultsForty-nine patientsMedian treatment durationPhase II studyEvidence of diseaseHigh-risk featuresPhase II trialProgression-free survivalStandard adjuvant therapyPancreatic ductal adenocarcinomaCancer recursEvaluable patientsMedian OSMedian PFSOral azacitidineR1 resectionSubsequent chemotherapy
2019
A phase 1 trial of the oral DNA methyltransferase inhibitor CC‐486 and the histone deacetylase inhibitor romidepsin in advanced solid tumors
Gaillard SL, Zahurak M, Sharma A, Durham J, Reiss K, Sartorius‐Mergenthaler S, Downs M, Anders N, Ahuja N, Rudek M, Azad N. A phase 1 trial of the oral DNA methyltransferase inhibitor CC‐486 and the histone deacetylase inhibitor romidepsin in advanced solid tumors. Cancer 2019, 125: 2837-2845. PMID: 31012962, PMCID: PMC6663621, DOI: 10.1002/cncr.32138.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAdultAgedAged, 80 and overAnorexiaAntineoplastic Combined Chemotherapy ProtocolsAzacitidineDepsipeptidesDNA Modification MethylasesDrug Administration ScheduleFemaleHistone Deacetylase InhibitorsHumansLong Interspersed Nucleotide ElementsMaleMaximum Tolerated DoseMethyltransferasesMiddle AgedNauseaNeoplasmsConceptsHistone deacetylase inhibitor romidepsinDisease control rateAdvanced solid tumorsPhase 1 studyCC-486Solid tumorsDose-escalation portionPhase 2 doseDose-limiting toxicityPossible clinical benefitPhase 1 trialDose-escalation designElement-1 methylationLINE-1 methylationStable diseaseCommon toxicitiesDose expansionExpansion cohortPrimary outcomeClinical benefitControl rateDrug exposureBlood samplesDay 1Dose levelsOperative Mortality Prediction for Primary Rectal Cancer: Age Matters
Li Z, Coleman J, D'Adamo CR, Wolf J, Katlic M, Ahuja N, Blumberg D, Ahuja V. Operative Mortality Prediction for Primary Rectal Cancer: Age Matters. Journal Of The American College Of Surgeons 2019, 228: 627-633. PMID: 30630082, DOI: 10.1016/j.jamcollsurg.2018.12.014.Peer-Reviewed Original ResearchConceptsPrimary rectal cancerRectal cancerLogistic regression modelsActual mortalityOlder patientsRisk calculatorAmerican CollegeCovariate-adjusted logistic regression modelsCurrent risk calculatorsICD-9/10 codesColorectal cancer increasesSurgeons NSQIP databaseYears age groupAge categoriesMortality risk estimatesOperative mortalityNSQIP databaseRegression modelsPrognostic valueFunctional statusCancer increasesCare discussionsMortality predictionCPT codesAge groups
2018
Low Frequency of Lymph Node Metastases in Patients in the United States With Early-stage Gastric Cancers That Fulfill Japanese Endoscopic Resection Criteria
Hanada Y, Choi AY, Hwang JH, Draganov PV, Khanna L, Sethi A, Bartel MJ, Goel N, Abe S, De Latour RA, Park K, Melis M, Newman E, Hatzaras I, Reddy SS, Farma JM, Liu X, Schlachterman A, Kresak J, Trapp G, Ansari N, Schrope B, Lee JY, Dhall D, Lo S, Jamil LH, Burch M, Gaddam S, Gong Y, Del Portillo A, Tomizawa Y, Truong CD, Brewer Gutierrez OI, Montgomery E, Johnston FM, Duncan M, Canto M, Ahuja N, Lennon AM, Ngamruengphong S. Low Frequency of Lymph Node Metastases in Patients in the United States With Early-stage Gastric Cancers That Fulfill Japanese Endoscopic Resection Criteria. Clinical Gastroenterology And Hepatology 2018, 17: 1763-1769. PMID: 30471457, DOI: 10.1016/j.cgh.2018.11.031.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAgedAged, 80 and overCarcinoma, Signet Ring CellEndoscopic Mucosal ResectionFemaleGastrectomyHumansJapanLymph NodesLymphatic MetastasisMaleMiddle AgedNeoplasm GradingNeoplasm InvasivenessNeoplasm StagingPractice Guidelines as TopicRetrospective StudiesStomach NeoplasmsTumor BurdenUnited StatesConceptsFrequency of lymphEarly gastric cancerEndoscopic resectionLymph node metastasisLymph nodesGastric cancerLymphovascular invasionNode metastasisGastric adenocarcinomaEarly gastric cancer lesionsEarly-stage gastric cancerEndoscopic resection criteriaLymph node dissectionTertiary care centerRisk of lymphRisk of metastasisGastric cancer lesionsDefinitive therapyNode dissectionResection criteriaSurgical resectionAsian patientsRetrospective studySubmucosal invasionRisk factorsTrends in Outcomes After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy
Gani F, Conca-Cheng AM, Nettles B, Ahuja N, Johnston FM. Trends in Outcomes After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Journal Of Surgical Research 2018, 234: 240-248. PMID: 30527480, DOI: 10.1016/j.jss.2018.09.032.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCarcinomaChemotherapy, Cancer, Regional PerfusionCombined Modality TherapyCytoreduction Surgical ProceduresDatabases, FactualFemaleHumansHyperthermia, InducedLogistic ModelsMaleMiddle AgedPatient SelectionPeritoneal NeoplasmsPostoperative ComplicationsRisk FactorsTreatment OutcomeConceptsCRS/HIPECHyperthermic intraperitoneal chemotherapyMedian operative timeLength of stayPostoperative morbidityCytoreductive surgeryOperative timeIntraperitoneal chemotherapySelect patientsClinical outcomesSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseCommon primary tumor siteQuality Improvement Program databaseMultivariable logistic regression analysisLow preoperative hematocritImprovement Program databasePreoperative serum albuminCareful patient selectionPrimary tumor siteLogistic regression analysisPostoperative complicationsPostoperative deathsPreoperative hematocritPeritoneal carcinomatosisAutomated diagnosis of colon cancer using hyperspectral sensing
Beaulieu RJ, Goldstein SD, Singh J, Safar B, Banerjee A, Ahuja N. Automated diagnosis of colon cancer using hyperspectral sensing. International Journal Of Medical Robotics And Computer Assisted Surgery 2018, 14: e1897. PMID: 29479794, DOI: 10.1002/rcs.1897.Peer-Reviewed Original ResearchConceptsColorectal cancerPossible metastatic diseaseColorectal cancer detectionColorectal cancer reliesMultiple tumor typesMetastatic diseaseOperative resectionSurgical resectionPathologic evaluationSurgical managementCancer reliesTumor specimensColon specimensColon cancerTumor typesPatient specimensCancerResectionPatientsDiagnostic methodsTumorsCancer detectionDiagnostic technologiesContrast agents
2017
The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction
Leeds IL, Canner JK, Efron JE, Ahuja N, Haut ER, Wick EC, Johnston FM. The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction. Journal Of Surgical Research 2017, 220: 402-409.e6. PMID: 28923559, PMCID: PMC5712450, DOI: 10.1016/j.jss.2017.08.039.Peer-Reviewed Original ResearchConceptsCancer patientsDiagnosis of cancerBenign diseaseCancer populationNational Surgical Quality Improvement Program 2005Chronic obstructive pulmonary diseaseSurgical risk modelsSurgical risk predictionObstructive pulmonary diseaseWorse surgical outcomesMalignant gastrointestinal diseasesOdds of deathHigh complication rateMultivariable logistic regressionParticipant Use FileRisk of deathPrimary procedure codeHigh mortality rateComplication rateSurgical complicationsIndependent predictorsMultiple complicationsPulmonary diseaseElective surgeryNoncancer patientsCirculating Epithelial Cells in Intraductal Papillary Mucinous Neoplasms and Cystic Pancreatic Lesions
Poruk KE, Valero V, He J, Ahuja N, Cameron JL, Weiss MJ, Lennon AM, Goggins M, Wood LD, Wolfgang CL. Circulating Epithelial Cells in Intraductal Papillary Mucinous Neoplasms and Cystic Pancreatic Lesions. Pancreas 2017, 46: 943-947. PMID: 28697136, DOI: 10.1097/mpa.0000000000000869.Peer-Reviewed Original ResearchConceptsIntraductal papillary mucinous neoplasmHigh-grade dysplasiaPapillary mucinous neoplasmBlood of patientsEpithelial cellsMucinous neoplasmsPancreatic lesionsAbsence of malignancyBenign pancreatic lesionsCystic pancreatic lesionsNineteen patientsPancreatic resectionPeripheral bloodPancreatic cystsISET methodPatientsPancreas-specific markersResectionMalignancyDysplasiaBloodNeoplasmsPancreatic sourceLow gradeLesionsLong‐term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer
Shrestha B, Sun Y, Faisal F, Kim V, Soares K, Blair A, Herman JM, Narang A, Dholakia AS, Rosati L, Hacker‐Prietz A, Chen L, Laheru DA, De Jesus‐Acosta A, Le DT, Donehower R, Azad N, Diaz LA, Murphy A, Lee V, Fishman EK, Hruban RH, Liang T, Cameron JL, Makary M, Weiss MJ, Ahuja N, He J, Wolfgang CL, Huang C, Zheng L. Long‐term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer. Cancer Medicine 2017, 6: 1552-1562. PMID: 28639410, PMCID: PMC5504321, DOI: 10.1002/cam4.1104.Peer-Reviewed Original ResearchConceptsMedian overall survivalUpfront chemotherapyNeoadjuvant chemotherapyNeoadjuvant therapySurgical resectionOverall survivalUpfront chemoradiationBorderline resectable pancreatic adenocarcinomaLong-term survival benefitBorderline resectable pancreatic cancerCurative surgical resectionResectable pancreatic cancerUpfront neoadjuvant chemotherapyResectable pancreatic adenocarcinomaSubpopulation of patientsJohns Hopkins HospitalLong-term survivalCurative intentNeoadjuvant chemoradiationConsecutive patientsSurvival benefitPancreatic cancerPancreatic adenocarcinomaRetrospective analysisChemoradiation
2016
Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection
Laurence G, Ahuja V, Bell T, Grim R, Ahuja N. Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection. The American Journal Of Surgery 2016, 214: 432-436. PMID: 28082009, DOI: 10.1016/j.amjsurg.2016.12.018.Peer-Reviewed Original ResearchConceptsMultivisceral resectionAdvanced colorectal cancerColorectal cancerCancer patientsYear survivalNon-metastatic colorectal cancerRadiation treatmentRecto-sigmoid cancerFive-year survivalSignificant associated morbidityKaplan-Meier analysisExtensive surgical proceduresGreatest survival advantageEligible patientsAssociated morbiditySelect patientsMeier analysisStandard surgeryRadical operationSEER dataAdjacent organsSurgical proceduresSurvival advantagePatientsSurgical specialistsCirculating Tumor Cell Phenotype Predicts Recurrence and Survival in Pancreatic Adenocarcinoma
Poruk KE, Valero V, Saunders T, Blackford AL, Griffin JF, Poling J, Hruban RH, Anders RA, Herman J, Zheng L, Rasheed ZA, Laheru DA, Ahuja N, Weiss MJ, Cameron JL, Goggins M, Iacobuzio-Donahue CA, Wood LD, Wolfgang CL. Circulating Tumor Cell Phenotype Predicts Recurrence and Survival in Pancreatic Adenocarcinoma. Annals Of Surgery 2016, 264: 1073-1081. PMID: 26756760, PMCID: PMC4936958, DOI: 10.1097/sla.0000000000001600.Peer-Reviewed Original ResearchConceptsCytokeratin-positive CTCsPancreatic adenocarcinomaMesenchymal markersVimentin-positive CTCsEpithelial tumor cells (ISET) methodFourth leading causeBetter treatment stratificationPortal blood samplesSignificant independent predictorsPotential prognostic biomarkerBiology of metastasisDetection of CTCsSurgical resectionIndependent predictorsPrognostic factorsMedian timeMultivariable analysisPDAC patientsPrognostic utilityCancer deathPatient prognosisLeading causeTreatment stratificationCancer recurrencePoor survivalA Contemporary Evaluation of the Cause of Death and Long‐Term Quality of Life After Total Pancreatectomy
Wu W, Dodson R, Makary MA, Weiss MJ, Hirose K, Cameron JL, Ahuja N, Pawlik TM, Wolfgang CL, He J. A Contemporary Evaluation of the Cause of Death and Long‐Term Quality of Life After Total Pancreatectomy. World Journal Of Surgery 2016, 40: 2513-2518. PMID: 27177647, DOI: 10.1007/s00268-016-3552-8.Peer-Reviewed Original ResearchConceptsCause of deathTotal pancreatectomyInsulin-dependent diabetesDiabetes-dependent QoLSF-36 surveyShort Form-36Majority of deathsLong-term qualityTotal hospitalizationsForm-36Preoperative stateDiabetes complicationsPreoperative assessmentWorse QoLDiabetic complicationsQOL surveyDiffuse diseasePatientsPancreatic enzymesQoLEuropean OrganizationHealth changesLife implicationsDeathPancreatectomyLong‐term outcomes in treatment of retroperitoneal sarcomas: A 15 year single‐institution evaluation of prognostic features
Abdelfatah E, Guzzetta AA, Nagarajan N, Wolfgang CL, Pawlik TM, Choti MA, Schulick R, Montgomery EA, Meyer C, Thornton K, Herman J, Terezakis S, Frassica D, Ahuja N. Long‐term outcomes in treatment of retroperitoneal sarcomas: A 15 year single‐institution evaluation of prognostic features. Journal Of Surgical Oncology 2016, 114: 56-64. PMID: 27076350, PMCID: PMC4917421, DOI: 10.1002/jso.24256.Peer-Reviewed Original ResearchConceptsCompartmental resectionRPS patientsSurgical resectionPrognostic factorsR0/R1 marginsR0/R1 resectionEn bloc surgical resectionBloc surgical resectionCornerstone of therapyMainstay of treatmentFive-year survivalRetrospective chart reviewPresence of metastasesEn bloc resectionExtent of resectionConnective tissue tumorsJohns Hopkins HospitalWarrants further investigationR1 resectionRetroperitoneal sarcomaChart reviewMedian survivalR1 marginsDistal recurrenceLocal recurrenceIGFBP-3 Gene Methylation in Primary Tumor Predicts Recurrence of Stage II Colorectal Cancers
Fu T, Pappou EP, Guzzetta AA, de Freitas Calmon M, Sun L, Herrera A, Li F, Wolfgang CL, Baylin SB, Iacobuzio-Donahue CA, Tong W, Ahuja N. IGFBP-3 Gene Methylation in Primary Tumor Predicts Recurrence of Stage II Colorectal Cancers. Annals Of Surgery 2016, 263: 337-344. PMID: 25822686, PMCID: PMC4648704, DOI: 10.1097/sla.0000000000001204.Peer-Reviewed Original ResearchConceptsStage II colorectal cancerRisk of recurrenceIGFBP-3 methylationLymph nodesColorectal cancerHazard ratioPrimary tumorHigh riskIndependent cohortFive-year recurrence-free survival ratesRecurrence-free survival ratesHigh-risk patientsSignificant prognostic factorsIdentification of patientsProportional hazards modelIGFBP-3Prognostic factorsTumor characteristicsPredicts RecurrenceHazards modelPatientsRecurrenceSurvival rateMultivariate analysisSurgeryPatterns of PD-L1 expression and CD8 T cell infiltration in gastric adenocarcinomas and associated immune stroma
Thompson ED, Zahurak M, Murphy A, Cornish T, Cuka N, Abdelfatah E, Yang S, Duncan M, Ahuja N, Taube JM, Anders RA, Kelly RJ. Patterns of PD-L1 expression and CD8 T cell infiltration in gastric adenocarcinomas and associated immune stroma. Gut 2016, 66: 794. PMID: 26801886, PMCID: PMC4958028, DOI: 10.1136/gutjnl-2015-310839.Peer-Reviewed Original ResearchConceptsPD-L1 expressionProgression-free survivalEpstein-Barr virusT-cell densityImmune stromaOverall survivalPD-L1T cellsAdaptive immune resistance mechanismHigh PD-L1 expressionMembranous PD-L1 expressionStromal PD-L1 expressionCD8 T cell infiltrationWorse progression-free survivalImmune resistance mechanismsImmune checkpoint inhibitorsPD-L1 positivityPD-L1 statusGastro-oesophageal junctionImmune-based therapiesT cell infiltrationPercentage of tumorsTumor-stromal interfaceCD8 densityCD8 infiltration
2015
Survival Following Lung Metastasectomy in Soft Tissue Sarcomas
Giuliano K, Sachs T, Montgomery E, Guzzetta A, Brock M, Pawlik TM, Yang SC, Ahuja N. Survival Following Lung Metastasectomy in Soft Tissue Sarcomas. The Thoracic And Cardiovascular Surgeon 2015, 64: 150-158. PMID: 26339728, DOI: 10.1055/s-0035-1563538.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAgedAged, 80 and overChildChild, PreschoolDisease-Free SurvivalFemaleHumansInfantKaplan-Meier EstimateLung NeoplasmsMaleMetastasectomyMiddle AgedNeoplasm GradingPneumonectomyRetrospective StudiesRisk FactorsSarcomaSoft Tissue NeoplasmsThoracoscopyTime FactorsTreatment OutcomeYoung AdultConceptsDisease-free intervalSoft tissue sarcomasLung metastasectomyTissue sarcomasLonger disease-free intervalLower pathologic gradeMedian overall survivalKaplan-Meier estimatesLog-rank testLow-grade tumorsGreatest survival advantageOverall survivalPostoperative factorsImproved survivalPatient selectionTumor characteristicsPathologic gradeMetastasis diagnosisCommon siteSurvival advantageSurvival analysisYounger ageMetastasectomyPatientsSurvival
2014
Role of a Multidisciplinary Clinic in the Management of Patients with Pancreatic Cysts: A Single-Center Cohort Study
Lennon AM, Manos LL, Hruban RH, Ali SZ, Fishman EK, Kamel IR, Raman SP, Zaheer A, Hutfless S, Salamone A, Kiswani V, Ahuja N, Makary MA, Weiss MJ, Hirose K, Goggins M, Wolfgang CL. Role of a Multidisciplinary Clinic in the Management of Patients with Pancreatic Cysts: A Single-Center Cohort Study. Annals Of Surgical Oncology 2014, 21: 3668-3674. PMID: 24806116, PMCID: PMC4332823, DOI: 10.1245/s10434-014-3739-x.Peer-Reviewed Original ResearchConceptsManagement of patientsPancreatic cystsSurgical resectionBranch-duct intraductal papillary mucinous neoplasmsSingle-center cohort studyIntraductal papillary mucinous neoplasmRisk categoriesPapillary mucinous neoplasmTypes of cancerCohort studyMultidisciplinary careCommon diagnosisMultidisciplinary clinicMucinous neoplasmsMalignant cystsHigh riskPatientsPatient careFurther evaluationCystsDiagnosisResectionClinicDifferent risksInstitution's recordsThe Impact of Postoperative Complications on the Administration of Adjuvant Therapy Following Pancreaticoduodenectomy for Adenocarcinoma
Wu W, He J, Cameron JL, Makary M, Soares K, Ahuja N, Rezaee N, Herman J, Zheng L, Laheru D, Choti MA, Hruban RH, Pawlik TM, Wolfgang CL, Weiss MJ. The Impact of Postoperative Complications on the Administration of Adjuvant Therapy Following Pancreaticoduodenectomy for Adenocarcinoma. Annals Of Surgical Oncology 2014, 21: 2873-2881. PMID: 24770680, PMCID: PMC4454347, DOI: 10.1245/s10434-014-3722-6.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsPrognosisRadiotherapy, AdjuvantRetrospective StudiesSurvival RateConceptsAdjuvant therapyPostoperative complicationsMedian survivalMultivariate analysisClavien-Dindo complication gradeTherapy warrants further investigationMultimodality adjuvant therapyOverall complication rateMethodsA retrospective reviewGrade of complicationsLonger median survivalLength of stayWarrants further investigationAdjuvant chemotherapyMedian TTANeoadjuvant approachComplication gradeComplication rateSevere complicationsRetrospective reviewClinicopathological dataResultsA totalPancreaticoduodenectomyRadiation therapyComplications
2013
Trends and Risk Factors for Transfusion in Hepatopancreatobiliary Surgery
Lucas DJ, Schexneider KI, Weiss M, Wolfgang CL, Frank SM, Hirose K, Ahuja N, Makary M, Cameron JL, Pawlik TM. Trends and Risk Factors for Transfusion in Hepatopancreatobiliary Surgery. Journal Of Gastrointestinal Surgery 2013, 18: 719-728. PMID: 24323432, DOI: 10.1007/s11605-013-2417-9.Peer-Reviewed Original ResearchConceptsRisk of transfusionRisk factorsPerioperative transfusionPreoperative hematocritBlood transfusionHPB proceduresPublic Use FilePatient-level risk factorsAnesthesiologists class IVIncidence of transfusionPerioperative blood transfusionPatient-level factorsHigh-risk factorsPatient-specific factorsHepatopancreatobiliary proceduresTransfusion utilizationPreoperative albuminTransfusion rateASA classificationPancreatic resectionHPB surgeryHepatopancreatobiliary surgeryProcedure typeInclusion criteriaTransfusionIncidence and prognostic impact of KRAS and BRAF mutation in patients undergoing liver surgery for colorectal metastases
Karagkounis G, Torbenson MS, Daniel HD, Azad NS, Diaz LA, Donehower RC, Hirose K, Ahuja N, Pawlik TM, Choti MA. Incidence and prognostic impact of KRAS and BRAF mutation in patients undergoing liver surgery for colorectal metastases. Cancer 2013, 119: 4137-4144. PMID: 24104864, PMCID: PMC3967132, DOI: 10.1002/cncr.28347.Peer-Reviewed Original ResearchConceptsColorectal liver metastasesSurgical therapyBRAF mutationsLiver metastasesKRAS statusPrognostic impactKRAS mutationsMolecular biomarkersThird of patientsRecurrence-free survivalKRAS gene mutationsPrognostic determinantsColorectal metastasesSurgical cohortWorse survivalClinicopathologic factorsIndependent predictorsCancer surgeryClinicopathologic featuresTumor numberPrognostic significanceBRAF analysisColorectal cancerLiver surgeryLower incidence