The atrial neoannulus technique for mitral valve replacement in patients with severe mitral annular calcification.

Objectives: Mitral valve replacement (MVR) in patients with severe mitral annular calcification (MAC) remains technically challenging because of the risk of annular disruption and associated complications. We report short-term outcomes of a novel surgical approach that creates an atrial neoannulus for prosthetic valve implantation in high-risk patients with severe mitral stenosis or mixed disease.

Methods: Between September 2021 and January 2025, 27 consecutive patients with severe MAC underwent MVR at a tertiary referral center.

Influences of age and obesity on heart transplant outcomes.

Objective: Obesity and older age have both been identified as risk factors for a worse long-term prognosis after heart transplantation. We sought to determine the 5-year outcomes for heart transplant patients with high-risk body mass index (BMI) >30 (HRB), high-risk age >70 years (HRA), or both (HRAB) as compared with recipients with normal risk (NR) in the modern era.

Methods: Records of isolated heart transplants in the United States from 2014 to 2023 were obtained for adults older than 18 years.

Extracavitary Cardiac Calcific Amorphous Tumors Compressing Biventricular Outflow Tracts.

Extracavitary cardiac calcific amorphous tumors/masses are extremely rare. We present a case report of a 62-year-old man with end-stage renal disease who presented with extracavitary cardiac calcific amorphous tumors/masses compressing the biventricular outflow tracts, resulting in hemodynamic compromise and progressive limitation of activities. The patient was successfully treated with surgery, with complete resolution of symptoms and markedly improved quality of life.

A Systematic Review of Conversion to Resectability in Unresectable Metastatic Colorectal Cancer Chemotherapy Trials.

Objectives: Metastasectomy in patients with metastatic colorectal cancer (mCRC) confers a significant survival benefit. We hypothesized that conversion to resectability (C2R) correlates with superior overall survival (OS) in patients with unresectable mCRC.

Methods: A prospectively registered systematic review (PROSPERO CRD42015024104) of randomized clinical trials published after 2003 was conducted.

Potential evidence of peritoneal recurrence in Stage-II colon cancer from the control arm of CALGB9581.

Background: Relapse of early-stage colon cancer (CC) after curative-intent resection occurs. We hypothesized that known risk factors for peritoneal metastases (PM) can define a high-risk state (HRS) that predicts recurrence and mortality.

Methods: CALGB9581 trial patients receiving no adjuvant treatment after stage-II CC resection were included.

A Study to Evaluate Depression and Perceived Stress Among Frontline Indian Doctors Combating the COVID-19 Pandemic.

Objective: Amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, health care workers of multiple disciplines have been designated as frontline doctors. This unforeseen situation has led to psychological problems among these health care workers. The objective of this study was to evaluate the mental health status of pan-Indian frontline doctors combating the COVID-19 pandemic.

Cost-effectiveness of Maintenance Capecitabine and Bevacizumab for Metastatic Colorectal Cancer.

Importance: Unregulated drug prices increase cancer therapy costs. After induction chemotherapy, patients with metastatic colon cancer can receive maintenance capecitabine and bevacizumab therapy based on improved progression-free survival, but whether this treatment's cost justifies its benefits has not been evaluated in the United States.

Objective: This study sought to determine the influence of capecitabine and bevacizumab drug prices on cost-effectiveness from a Medicare payer's perspective.

Surgery for benign prostatic hyperplasia: Profile of patients in a tertiary care institution.

Background: Medical therapy is widely used for managing benign prostatic hyperplasia (BPH) and has made an impact on the profile of patients who ultimately undergo surgery. This changing profile may impact outcomes of surgery and associated complications. To assess the impact of medical management, we evaluated the profile of patients who had surgery for BPH at our institution.

Surgical Strategy and Outcomes in Duodenal Gastrointestinal Stromal Tumor.

Background: The surgical management of duodenal gastrointestinal stromal tumors (DGIST) is poorly characterized. Limited resection may be technically feasible and oncologically safe, but anatomic considerations may compromise the resection margins due to the proximity of critical structures, thereby necessitating more extensive resections such as pancreaticoduodenectomy.

Methods: Patients undergoing surgery for DGIST at two institutions from 1994 to 2014 were identified.

Is long-term survival possible after margin-positive resection of retroperitoneal sarcoma (RPS)?

Background/objectives: For various reasons, some patients undergo a gross margin positive resection (R2) leading to a dilemma in care. We hypothesized that there is a subset of patients who have long-term survival (LTS, ≥5 years) after R2 resection for retroperitoneal sarcoma (RPS).

Methods: National Cancer Database data from 1998 to 2011 were reviewed to identify patients with RPS who had R2 resections.

Hepatic Perfusion Therapy.

Isolated hepatic perfusion uses the unique vascular supply of hepatic malignancies to deliver cytotoxic chemotherapy. The procedure involves vascular isolation of the liver and delivery of chemotherapy via the hepatic artery and extraction from retrohepatic vena cava. Benefits of hepatic perfusion have been observed in hepatic metastases of ocular melanoma and colorectal cancer and primary hepatocellular carcinoma.

Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Management of Peritoneal Carcinomatosis.

Background: Malignant peritoneal disease can lead to significant debility due to bowel obstructions, ascites, and cancer cachexia. Moreover, inadequate imaging techniques can lead to the suboptimal detection of disease, and the poor vascularity of tumors can lead to a poor response to systemic chemotherapy. However, combination cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising novel treatment for patients with this disease.

Neoadjuvant radiotherapy for retroperitoneal sarcoma: A systematic review.

Background And Objectives: The multi-modal treatment of retroperitoneal sarcoma has seen increased use of neoadjuvant radiation. However, its effect on local recurrence and survival remain controversial. We aimed to synthesize and evaluate the literature.

Impact of surgical volume of centers on post-operative outcomes from cytoreductive surgery and hyperthermic intra-peritoneal chemoperfusion.

Complex surgical operations performed at centers of high volume have improved outcomes due to improved surgical proficiency, and betters systems of care including avoidance of errors. Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemoperfusion (HIPEC), which has been shown to be an oncologically effective strategy for peritoneal carcinomatosis (PC), is one such procedure with significant morbidity and mortality. The learning curve to reach technical proficiency in CRS + HIPEC is about 140-220 cases for a center.

Cost Differential of Chemotherapy for Solid Tumors.

Purpose: A significant portion of national cancer expenditure is attributed to chemotherapy.Although the National Comprehensive Cancer Network has generated recommendations for the treatment of various solid tumors, the outlined chemotherapeutic strategies lack information about the cost differential for increasing effectiveness.

Methods: Chemotherapy regimens (curative [adjuvant/neoadjuvant] and metastatic therapy) and dosages outlined in the 2013 National Comprehensive Cancer Network guidelines were acquired for four common cancers: bladder, breast, colon, and lung.

Conditional Survival as a Patient Centered Metric for Patients with Appendiceal Adenocarcinoma.

Background: Prognosis of appendiceal adenocarcinoma patients is based on burden of disease, histology, and nature of therapy, which remains static despite time in follow-up. We hypothesized that conditional survival provides an informative metric that allows patients better understanding of their disease.

Methods: Using the Surveillance, Epidemiology and End Results database, patients with appendiceal adenocarcinoma from 1988 to 2012 were included.

Age-based disparities in treatment and outcomes of retroperitoneal rhabdomyosarcoma.

Background: Elderly patients (EPs) suffering from retroperitoneal rhabdomyosarcoma (RRMS) carry a considerably poorer prognosis compared to younger patients (YPs). We hypothesized that EPs received less aggressive and comprehensive treatment than YPs, resulting in poorer survival outcomes.

Materials And Methods: All patients diagnosed with RRMS since 1998 in the National Cancer Data Base (NCDB) were reviewed for patient demographics, tumor characteristics, treatment modalities and survival outcomes.

Comparative Effectiveness of Hepatic Artery Based Therapies for Unresectable Colorectal Liver Metastases: A Meta-Analysis.

Background: Patients with unresectable Colorectal Liver Metastases (CRLM) are increasingly being managed using Hepatic Artery Based Therapies (HAT), including Hepatic Arterial Infusion (HAI), Radioembolization (RE), and Transcatheter Arterial Chemoembolization (TACE). Limited data is available on the comparative effectiveness of these options. We hypothesized that outcomes in terms of survival and toxicity were equivalent across the three strategies.

Retroperitoneal solitary fibrous tumor: surgery as first line therapy.

Background: Solitary fibrous tumors (SFT) of the retroperitoneum are rare spindle cell neoplasms, with a paucity of data on treatment outcomes. We hypothesized that surgical excision offered acceptable outcomes in SFTs.

Methods: The National Cancer Database (NCDB) was used to identify patients with SFT from 2004 to 2011.