Evaluating Variation in Lymph Node Sampling During Sentinel Lymph Node Biopsy for Melanoma.

Background: The operative standard for melanoma, implemented by the Commission on Cancer (CoC), addresses margin width and excision depth, but does not collect information on sentinel lymph node biopsy (SLNB). However, SLNB, an implemented technical standard in breast cancer, is also critical in the management of melanoma through its impact on nodal staging. This study aimed to characterize the current facility-level variation in nodal yield and nodal positivity to determine if there is an opportunity for improvement through standardization.

Beyond TNM staging: Machine learning of individualized colon cancer outcomes.

Background: Anatomic TNM staging lacks patient information that can influence cancer survival. Using machine learning, specifically extreme gradient boosting with survival embeddings, a model can be developed to improve predictive accuracy of patient survival by including additional clinical information.

Methods: A retrospective study of 382,531 colon cancer cases diagnosed between 2018 and 2021 using the National Cancer Database.

Site Reviewer Perspectives on the Implementation of the Commission on Cancer Operative Standards.

Background: To reduce technical variation in cancer surgery, the Commission on Cancer (CoC) recently implemented six operative standards as part of its national cancer center accreditation process. CoC sites are evaluated for compliance with these standards through scheduled visits conducted by trained site reviewers. We characterized site reviewers' perspectives on the implementation of the operative standards.

First National Effort to Optimize the Performance of Cancer Surgery by the American College of Surgeons Commission on Cancer and Cancer Surgery Standards Program: Early Results After Implementation of the Operative Standards.

Objective: To evaluate the first 3 years of compliance with the American College of Surgeons Commission on Cancer (CoC) Operative Standards.

Background: CoC implemented evidence-based standards to improve the quality of sentinel lymph node biopsy and axillary lymph node dissection for breast cancer (operative standards 5.3 and 5.

Early compliance with lung cancer lymph node standard 5.8: An analysis of 2022 and 2023 Commission on Cancer site reviews.

Objective: To address variability in nodal staging during curative-intent lung cancer resections, the Commission on Cancer implemented Standard 5.8 in 2021, requiring lymph nodes be sampled from ≥3 mediastinal stations and ≥1 hilar station and documented in a synoptic pathology report. We assessed compliance data from recent site reviews to evaluate the early implementation of Standard 5.

Sumoylated Etv1 establishes mouse mammary cancer stem cells that support tumorigenesis by non-stem cancer cells.

The small ubiquitin-like modifier (SUMO) pathway is required for maintenance of cancer stem cells/tumor-initiating cells (CSCs/TICs), which drive tumorigenesis when transplanted into immunocompromised mice. We found that inhibition of the SUMO pathway blocked Neu-mediated mammary oncogenesis and inhibited the function of CSCs/TICs without effects on normal mammary stem cells. Transcriptomic analysis implicated SUMO-conjugated Etv1 as being critical for oncogenesis.

Risk of Recurrence and Cancer Stem Cell Marker CD133 Expression Vary in Males Versus Females with Papillary Thyroid Cancer.

Background: Molecular profiling has refined the identification of pathologic subtypes in other cancers, but is not currently used for prognostication in papillary thyroid cancer (PTC). The cancer stem cell marker, CD133, is a glycoprotein associated with tumor initiation and radioresistance in PTC, but its role in prognostication continues to be defined. This study sought to define the association between CD133 expression in PTC and recurrence-free survival (RFS).

Antagonistic roles for MITF and TFE3 in melanoma plasticity.

Melanoma cells can switch from a melanocytic and proliferative state to a mesenchymal and invasive state and back again. This plasticity drives intratumoral heterogeneity, progression, and therapeutic resistance. Microphthalmia-associated transcription factor (MITF) promotes the melanocytic/proliferative phenotype, but factors that drive the mesenchymal/invasive phenotype and the mechanisms that effect the switch between cell states are unclear.

Quality of Cancer Recurrence Data in the National Cancer Database: A Reappraisal of Reporting Readiness.

Background: This study evaluated the quality of cancer recurrence data in the National Cancer Database (NCDB) to determine if missingness and reporting consistency have improved enough to support national research.

Methods: This multi-methods study included NCDB analyses and a cancer registry staff survey. Trends in recurrence data missingness from 2004 to 2021 and multivariable analyses of factors associated with missingness from 2017 to 2021 were evaluated for 4,568,927 patients with non-metastatic cancer.

Trends in Specialty Training and National Institutes of Health Funding Among Surgeon-Scientists.

Purpose: To determine if dual-degree training [ie, completion of a National Institutes of Health (NIH)-funded MD/PhD program], among other professional development and demographic variables, predicted academic productivity (eg, K-to-R conversion, number of publications, etc.) among early-career surgeon-scientists.

Methods: We analyzed publicly available data from the National MD/PhD Program Outcomes Study and the Association of American Medical Colleges Graduate Medical Education Track database to identify trends in the number and proportion of MD/PhD graduates pursuing surgical specialties.

American College of Surgeons Cancer Program Annual Report from 2021 Participant User File.

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers.

American College of Surgeons survival calculator for biliary tract cancers: using machine learning to individualize predictions.

Background: Although cancer prognosis is most commonly estimated by tumor stage, survival is multifactorial. Our objective was to develop an American College of Surgeons "Biliary Tract Cancer Survival Calculator" prototype using machine learning to generate personalized survival estimates based on patient, tumor, and treatment factors.

Methods: The National Cancer Database was used to identify all patients with biliary tract malignancies between 2010 and 2017 including intrahepatic bile duct, extrahepatic bile duct, and gallbladder cancers.

Association of commission on cancer accreditation with receipt of guideline-concordant care and survival among patients with colon cancer.

Background: Guideline-concordant care (GCC) is associated with improved survival for patients with cancer; however, variations in receipt of GCC remain a concern. The objective of this study was to evaluate the association of Commission on Cancer (CoC) hospital accreditation status with receipt of GCC and survival among patients with colon cancer.

Methods: This retrospective observational study identified patients diagnosed with stage I-IV colon cancer from 2018 to 2020 from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program Database.

Social Vulnerability and Receipt of Guideline-Concordant Care among Patients with Colorectal Cancer.

Background: Cancer outcome disparities have been reported in highly vulnerable communities. The objective of this study was to evaluate the association of social vulnerability with receipt of guideline-concordant care (GCC) and mortality risk for patients with colorectal cancer.

Study Design: This retrospective observational study identified patients with stage I to III colon or stage II to III rectal cancer between 2018 and 2020 from the National Program of Cancer Registries Database.

Hospital Accreditation Status and Treatment Differences Among Black Patients With Colon Cancer.

Importance: Hospital-level factors, such as hospital type or volume, have been demonstrated to play a role in treatment disparities for Black patients with cancer. However, data evaluating the association of hospital accreditation status with differences in treatment among Black patients with cancer are lacking.

Objective: To evaluate the association of Commission on Cancer (CoC) hospital accreditation status with receipt of guideline-concordant care and mortality among non-Hispanic Black patients with colon cancer.

Antagonistic Roles for MITF and TFE3 in Melanoma Plasticity.

Melanoma cells have the ability to switch from a melanocytic and proliferative state to a mesenchymal and invasive state and back again. This plasticity drives intra-tumoral heterogeneity, progression, and therapeutic resistance. Microphthalmia-associated Transcription Factor (MITF) promotes the melanocytic/proliferative phenotype, but factors that drive the mesenchymal/invasive phenotype and the mechanisms that effect the switch between cell states are unclear.

For the Love of the Game: Calculating the Premium Associated With Academic Surgical Practice.

Objective: We sought to determine the premium associated with a career in academic surgery, as measured by compensation normalized to the work relative value unit (wRVU).

Background: An academic surgical career embodying innovation and mentorship offers intrinsic rewards but is not well monetized. We know compensation for academic surgeons is less than their nonacademic counterparts, but the value of clinical effort, as normalized to the wRVU, between academic and nonacademic surgeons has not been well characterized.

Active Gα Mutants Accelerate Breast Tumor Metastasis via the c-Src Pathway.

Constitutively active mutations in the Gα and Gα subunits of heterotrimeric G proteins have been found in various human cancers, including breast cancer, but their precise roles in tumor formation, progression, and metastasis remain poorly understood. This study focused on GαR243H and GαR179C mutants in breast cancer. These mutants alone were insufficient to initiate mammary tumor formation in mice.

ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence.

Background: Rising incidence of papillary thyroid microcarcinomas (PTMC) has raised concerns for overdiagnosis. Utility of the American Thyroid Association Risk Stratification System (ATA-RSS) 2015 in predicting risk of disease recurrence in patients with PTMC was assessed.

Methods: Electronic health records of patients who underwent total thyroidectomy were queried.

Epidemiology and survival outcomes of colorectal mixed neuroendocrine-non-neuroendocrine neoplasms and neuroendocrine carcinoma.

Background: Mixed neuroendocrine-non-neuroendocrine neoplasms are a rare subtype of neuroendocrine neoplasm consisting of ≥30% each of neuroendocrine and non-neuroendocrine differentiation. Neuroendocrine carcinomas are poorly differentiated neuroendocrine tumors. The epidemiology and prognosis of colorectal mixed neuroendocrine-non-neuroendocrine neoplasms and neuroendocrine carcinomas are not clearly defined in the literature.

The distinct roles of MSH2 and MLH1 in basal-like breast cancer and immune modulation.

The mismatch repair (MMR) pathway is known as a tumor suppressive pathway and genes involved in MMR are commonly mutated in hereditary colorectal or other cancer types. However, the function of MMR genes/proteins in breast cancer progression and metastasis are largely undefined. We found that MSH2, but not MLH1, is highly enriched in basal-like breast cancer (BLBC) and that its protein expression is inversely correlated with overall survival time (OS).