Geospatial heterogeneity of hotspots for incidence and late-stage diagnosis of breast, colorectal, and lung cancer.

Purpose: Cancer control relies on the identification of populations at risk (hotspots) of new or late-stage cancer diagnoses. However, the extent to which hotspots differ between cancer sites or between outcome measures has been poorly characterized. We sought to determine the geospatial heterogeneity of hotspots of breast, colorectal, and lung cancer incidence and late-stage diagnoses.

Leadership in Action: Tales From the Trenches.

Surgeons are natural leaders, but leadership within academic surgery at various levels presents unique challenges. During the 2025 Academic Surgical Congress Hot Topics session on Leadership in Action, we discussed the real challenges faced by leaders in academic surgery across different levels. We review common themes and strategies employed when confronting these difficult situations, focusing on perseverance and creative problem solving.

Implementation of an Early Feeding Pathway in Patients Undergoing Esophagectomy.

Introduction: Recent literature indicates that early oral feeding after esophagectomy is feasible and safe, though there is no standardized consensus for this nutritional advancement. The purpose of this study was to evaluate a standardized early feeding (EF) pathway implemented at a single quaternary institution.

Materials And Methods: All patients who underwent esophagectomy from January 2016 to September 2021 were evaluated.

Minimally invasive resection of non-small cell lung cancer after chemoimmunotherapy: A multicenter study in academic hospitals.

Objective: We sought to analyze the outcomes of minimally invasive surgery and open resection of non-small cell lung cancer after neoadjuvant chemoimmunotherapy relative to treatment response.

Methods: Data from 5 centers in the United States and Germany were combined for all patients undergoing resection for non-small cell lung cancer after neoadjuvant chemoimmunotherapy between 2019 and 2024. Clinical and pathologic factors associated with minimally invasive surgery were analyzed.

The implementation of an electronic symptom management system to monitor postoperative pain in thoracic surgery patients: A multicenter evaluation.

Objective: Few studies have evaluated postoperative recovery of patients after thoracic surgery using patient-reported outcome measures. This multi-institutional study analyzed postoperative pain and opioid use among patients undergoing thoracic surgery based on patient-reported outcome measures data collected through an electronic symptom management system.

Methods: The electronic symptom management system is a multi-symptom questionnaire based on a Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events that is integrated into the electronic health record and administered via the patient portal.

Impact of Living in a Food Desert on Complications After Fracture Surgery.

Background: Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food desert residency among orthopaedic trauma patients and to investigate the impact of food desert residency on the rate of unplanned reoperation with use of a large, high-quality, prospectively collected dataset with adjudicated outcomes. We hypothesized that orthopaedic trauma patients would reside in food deserts at a higher rate than the general U.

Depletion of conventional CD4 T cells is required for robust priming and dissemination of tumor antigen-specific CD8 T cells in the setting of anti-CD4 therapy.

Background: Overcoming immune suppression is a major barrier to eliciting potent CD8 T cell responses against cancer. Treatment with anti-CD4 monoclonal antibody is an effective means for eliminating CD4Foxp3 regulatory (Treg) cells in preclinical models and has also demonstrated efficacy in early clinical trials. However, the underlying basis for treatment efficacy, more specifically the implications of codepleting other CD4-expressing cell compartments in tumor-bearing hosts, is not well understood.

Association of Food Desert Residence and 5-Year Mortality in Lung Cancer Patients Undergoing Resection.

Introduction: Food desert (FD) residence has emerged as a risk factor for poor outcomes in breast, colon and esophageal cancers. The purpose of this retrospective study was to examine FD residence as an associated risk factor in nonsmall cell lung cancer (NSCLC) patients treated with anatomic lung resection (ALR).

Methods: All consecutive ALRs for stage I-III NSCLC from January 2015 to December 2017 at a single institution were reviewed.

Disparities in Access to Multidisciplinary Cancer Consultations and Treatment for Patients With Early-Stage Non-Small Cell Lung Cancer: A SEER-Medicare Analysis.

Purpose: Disparities in access to a multidisciplinary cancer consultation (MDCc) persist, and the role of physician relationships remains understudied. This study examined the extent to which multilevel factors, including patient characteristics and patient-sharing network measures reflecting the structure of physician relationships, are associated with an MDCc and receipt of stereotactic body radiation therapy versus surgery among patients with early-stage non-small cell lung cancer (NSCLC).

Methods And Materials: In this cross-sectional study, we analyzed Surveillance, Epidemiology, and End Results (SEER)-Medicare data for patients diagnosed with stage I-IIA NSCLC from 2016 to 2017.

The Effect of Lung Resection for NSCLC on Circulating Immune Cells: A Pilot Study.

This pilot study sought to evaluate the circulating levels of immune cells, particularly regulatory T-cell (Treg) subsets, before and after lung resection for non-small cell lung cancer. Twenty-five patients consented and had specimens collected. Initially, peripheral blood of 21 patients was collected for circulating immune cell studies.

Food Deserts Increase Readmission After Esophagectomy for Cancer: A Multi-institutional Study.

Background: Food deserts are low-income census tracts with poor access to supermarkets and are associated with worse outcomes in breast, colon, and a small number of esophageal cancer patients. This study investigated residency in food deserts on readmission rates in a multi-institutional cohort of esophageal cancer patients undergoing trimodality therapy.

Methods: A retrospective review of patients who underwent trimodality therapy at 6 high-volume institutions from January 2015 to July 2019 was performed.

Lessons learned by thoracic surgeons during the COVID-19 pandemic.

Background: The scale of the coronavirus disease 2019 (COVID-19) pandemic has necessitated healthcare systems to adapt and evolve, altering physician roles and expectations. Thoracic surgeons have seen practice changes from new COVID-19 consults to necessary delay and triage of elective care. The goal of this study was to understand the impact of COVID-19 on thoracic surgeon experiences in order to anticipate roles and changes in practice in future such circumstances.

Reasons for Long-term Opioid Prescriptions After Guideline-directed Opioid Prescribing and Excess Opioid Pill Disposal.

Objectives: The aim of this study was to determine the frequency and reasons for long-term opioid prescriptions (rxs) after surgery in the setting of guideline-directed prescribing and a high rate of excess opioid disposal.

Background: Although previous studies have demonstrated that 5% to 10% of opioid-naïve patients prescribed opioids after surgery will receive long-term (3-12 months after surgery) opioid rxs, little is known about the reasons why long-term opioids are prescribed.

Methods: We studied 221 opioid-naïve surgical patients enrolled in a previously reported prospective clinical trial which used a patient-centric guideline for discharge opioid prescribing and achieved a high rate of excess opioid disposal.

Reducing Unnecessary Type and Screens Prior to Thoracic Surgery: A Quality Improvement Initiative.

Introduction: Previous work identified that routine preoperative type and screen (T&S) testing before elective thoracic surgery is overutilized. We hypothesized that instituting a quality improvement (QI) initiative to change practice would significantly reduce this unnecessary testing, reduce costs, and improve healthcare efficiency.

Materials And Methods: A QI initiative was developed at a single, academic center to reduce empiric T&S ordering before elective anatomic lung resections.

Tumour, whole-blood, plasma and tissue concentrations of metformin in lung cancer patients.

Aim: Metformin is used for the management of type 2 diabetes mellitus (T2DM) and is being tested clinically as an anticancer agent. Metformin concentrations safely achievable in human solid tissues including tumours are unknown. This study was designed to determine metformin concentration in tissue compartments as a function of dose to inform rational dosing in preclinical models and interpretation of clinical results.

Structure and mechanics of the vitreoretinal interface.

Vitreoretinal mechanics plays an important role in retinal trauma and many sight-threatening diseases. In age-related pathologies, such as posterior vitreous detachment and vitreomacular traction, lingering vitreoretinal adhesions can lead to macular holes, epiretinal membranes, retinal tears and detachment. In age-related macular degeneration, vitreoretinal traction has been implicated in the acceleration of the disease due to the stimulation of vascular growth factors.

Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer.

Background: Nutritional status is related to treatment outcomes for esophageal cancer. Residing in a food desert (FD) has been associated with worse outcomes in breast and colon cancer. We assessed the association of residing in a FD on 30-day outcomes of esophageal cancer patients who received tri-modality therapy.

Resident memory CD8 T cells in regional lymph nodes mediate immunity to metastatic melanoma.

The nature of the anti-tumor immune response changes as primary tumors progress and metastasize. We investigated the role of resident memory (Trm) and circulating memory (Tcirm) cells in anti-tumor responses at metastatic locations using a mouse model of melanoma-associated vitiligo. We found that the transcriptional characteristics of tumor-specific CD8 T cells were defined by the tissue of occupancy.