Research by Condition

Choi AH, Ji L, Babcock B, et al, including Senthil M. Peritoneal carcinomatosis in gastric cancer: Are Hispanics at higher risk? J Surg Oncol. 2020 Dec;122(8):1624-1629. PMID: 32901938

A review of California patients with gastric cancer during a 10-year period determined that Hispanic ethnicity independently predicts a more aggressive tumor phenotype and signet ring adenocarcinoma than non-Hispanic whites. In addition, peritoneal carcinomatosis is more likely in Hispanic people with stage IV gastric cancer compared to other races and ethnicities. These findings highlight the need to understand genomic differences in Hispanic gastric cancer to help modify surveillance and treatment strategies.

Bansal VV, Kim D, Reddy B, et al, including Eng OS. Early integrated palliative care within a surgical oncology clinic. JAMA Netw Open. 2023 Nov 1;6(11):e2341928. PMID: 37934497

This paper showed that integration of a palliative care team into an oncology surgical clinic was associated with increased designation of advanced directives in patients undergoing surgical procedures for locoregionally advanced abdominal and soft tissue tumors at an academic center.

Are C, Murthy SS, Sullivan R, et al, including Senthil M. Global cancer surgery: pragmatic solutions to improve cancer surgery outcomes worldwide. Lancet Oncol. 2023 Dec;24(12):e472-e518. [Published correction appears in Lancet Oncol. 2023 Dec;24(12):e459.] PMID: 37924819

The second iteration of the Lancet Oncology Commission on Global Cancer Surgery developed eight broad, pragmatic and affordable actions aimed at improving the global capacity for cancer surgery, regardless of patients’ socioeconomic status or geographic location.

Krouse RS, Anderson GL, Arnold KB, et al, including Senthil M. Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial. Lancet Gastroenterol Hepatol. 2023 Oct;8(10):908-918. [Published correction appears in Lancet Gastroenterol Hepatol. 2024 Feb;9(2):e2.] PMID: 37541263

This multinational trial across 30 cancer centers determined there was no significant difference in the number of “good days” between surgical and nonsurgical management of malignant small bowel obstruction.

Hanse EA, Wang T, Tifrea D, Senthil M, Kim AC, Kong M, Eng OS. A novel assessment of metabolic pathways in peritoneal metastases from low-grade appendiceal mucinous neoplasms. Ann Surg Oncol. 2023 Aug;30(8):5132-5141. PMID: 37149550

A comparison of the phenotypic differences found in peritoneal metastases derived from low-grade appendiceal mucinous neoplasms (LAMNs) versus adenocarcinoma showed differences in gene expression, dominated by the prevalence of metabolic pathways, particularly lipid metabolism. Researchers hope to apply this knowledge to the potential development of novel therapeutics for pseudomyxoma peritonei secondary to LAMN.

Dhiman A, Kothary V, Witmer HDD, et al, including Eng OS. Role of tumor-informed personalized circulating tumor DNA assay in informing recurrence in patients with peritoneal metastases from colorectal and high-grade appendix cancer undergoing curative-intent surgery. Ann Surg. 2023 Dec 1;278(6):925-931. PMID: 36994703

Investigators compared disease-free survival (DFS) in patients with peritoneal metastases from colorectal and high-grade appendix cancers after curative cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, based on whether serial circulating tumor DNA (ctDNA) assays rose or remained stable. Serial ctDNA assessments proved to be a strong prognostic biomarker of recurrence and DFS.

Sullivan BG, Lo A, Yu J, et al, including Senthil M. Circulating tumor DNA is unreliable to detect somatic gene alterations in peritoneal carcinomatosis. Ann Surg Oncol. 2023 Jan;30(1):278-284. PMID: 35980549

Researchers retrospectively compared circulating tumor DNA (ctDNA) levels in patients with GI cancers (colorectal, upper GI and pancreaticobiliary). They determined that those with peritoneal carcinomatosis (PC) exhibited lower levels compared with patients with other metastases and warned that ctDNA results from patients with PC should be interpreted with caution due to lower sensitivity of this test in that population.

Abi-Jaoudeh N, Sadeghi B, Javan H, et al, including Imagawa DK. Drug eluting embolic transarterial chemoembolization with tyrosine kinase inhibitors targeted therapies in a VX2 model. Cancers (Basel). 2023 Jun 18;15(12):3236. PMID: 37370846

In a rabbit model of hepatocellular carcinoma (HCC), researchers successfully loaded a patented liposomal formulation with sorafenib or regorafenib for drug-eluting embolic transarterial chemoembolization, showing the drugs eluted locally without release into systemic circulation.

Huynh KN, Rao S, Roth B, et al, including Imagawa DK. Targeting hypoxia-inducible factor-1α for the management of hepatocellular carcinoma. Cancers (Basel). 2023 May 12;15(10):2738. PMID: 37345074

A review of the current knowledge on the role and biochemical pathways of hypoxia in the progression of hepatocellular carcinoma (HCC), including potential therapeutic options for targeting hypoxia for the management of HCC.

Tran TB, Malhotra G, Razavi M, et al. Emotional distress and financial toxicity in younger adult patients undergoing oncologic surgery. Ann Surg. 2022 Oct 1;276(4):694-700. PMID: 35838403

The biopsychosocial distress caused by a diagnosis of cancer was compared in young adults (YAs, ≤45 years) and older adults (OAs, >45 years). Researchers found YAs exhibited higher emotional distress, including increased anxiety, greater fear of procedures and difficulty managing emotions, as well as the risk of financial toxicity, compared to OAs.

Marcus R, Christopher W, Keller J, et al, including Wolf R and Jutric Z. Systemic therapy is associated with improved oncologic outcomes in resectable stage II/III intrahepatic cholangiocarcinoma: an examination of the National Cancer Database over the past decade. Cancers (Basel). 2022 Sep 3;14(17):4320. PMID: 36077855

Investigators compared three treatment strategies for resectable intrahepatic cholangiocarcinoma (ICC) using a large cancer registry in terms of their use and oncologic outcomes, finding benefits of both neoadjuvant and adjuvant therapy for patients with high-risk resectable ICC.

Dayyani F, Senthil M. Spontaneous fluctuation of tumor-informed circulating tumor DNA at low levels. JCO Precis Oncol. 2022 Jul;6:e2200177. PMID: 35834756

Correspondence in response to a report about the use of circulating tumor DNA (ctDNA) to detect molecular residual disease (MRD). The authors reported three case histories of patients who had resections of gastrointestinal tumors and were followed with sequential ctDNA monitoring. In each case they had positive ctDNA tests, with subsequent spontaneous conversion to negative despite no further chemotherapy.

Lorenz J, Moghanaki D, Keshava H, et al. Sins of omission: a meta-research study evaluating the omission of operability in published retrospective comparisons of surgery with stereotactic body radiotherapy in patients with early-stage non-small cell lung cancer. Lung Cancer. 2023 Jan;175:57-59. PMID: 36455397

In a retrospective meta-review of comparisons on overall survival of stereotactic body radiotherapy (SBRT) versus surgical resection for early-stage non-small cell lung cancer, investigators discovered that almost two-thirds of the studies lacked information on patient operability status, and nearly 90% lacked a direct comparison between operable SBRT patients and those receiving surgery. This complicates retrospective comparisons of surgery with SBRT by introducing the potential for confounding by operability.

Sedighim S, Frank MI, Heutlinger O, Lee C, Hachey SJ, Keshava HB. A systematic review of short-term outcomes of minimally invasive thoracoscopic surgery for lung cancer after neoadjuvant systemic therapy. Cancers (Basel). 2023 Aug 1;15(15):3908. PMID: 37568725

This meta-analysis to review overall outcomes of patients undergoing minimally invasive surgical (MIS) resection of the lung for the management of non-small cell lung cancers determined that MIS resection can be safely performed following systemic treatment and that it offers other benefits compared to open surgery.

Zell JA, Taylor TH, Albers CG, Carmichael JC, McLaren CE, Wenzel L, Stamos MJ. Phase IIa clinical biomarker trial of dietary arginine restriction and aspirin in colorectal cancer patients. Cancers (Basel). 2023 Mar 31;15(7):2103. PMID: 37046763

A previous finding that reducing tissue polyamines may provide tertiary prevention in nonmetastatic colorectal cancer (CRC) patients led to this phase IIa study to try to lower reduced rectal tissue polyamine in optimally treated stage I-III CRC patients after intervention with daily oral aspirin combined with dietary arginine restriction. While this regimen did significantly reduce dietary arginine intake and plasma arginine levels, rectal tissue polyamines were unaffected.

Yu J, Ostowari A, Gonda A, Mashayekhi K, Dayyani F, Hughes CCW, Senthil M. Exosomes as a source of biomarkers for gastrointestinal cancers. Cancers (Basel). 2023 Feb 16;15(4):1263. PMID: 36831603

This is a comprehensive review of diagnostic, prognostic and predictive exosomal biomarkers in colorectal and gastric cancers, as well as the challenges and limitations of exosomes in clinical application and future prospects.

Delaplain PT, Tay-Lasso E, Biffl WL, et al, including Nahmias J. Excluding hollow viscus injury for abdominal seat belt sign using computed tomography. JAMA Surg. 2022 Sep 1;157(9):771-778. PMID: 35830194

This prospective multi-center study across nine trauma centers determined that operative hollow viscus injury is highly unlikely in patients with a positive seat belt sign (SBS) but a normal CT examination, suggesting that patients with SBS alone and negative CT findings should not require admission and observation.

Grigorian A, Kabutey NK, de Virgilio C, Lekawa M, Schubl S, Martin M, Nahmias J. Combined arterial and venous lower extremity injury. JAMA Surg. 2023 Dec 1;158(12):1346-1347. PMID: 37792342

An analysis of more than 5,000 patients with leg trauma, and either combined arterial and venous injury or isolated arterial or venous injury, determined that both groups had similar rates of delayed fasciotomy. Importantly, in the combined group, delayed fasciotomy was not associated with increased amputation.

Yeates EO, Nahmias J, Gabriel V, et al. A prospective multicenter comparison of trauma and injury severity score, American Society of Anesthesiologists physical status, and National Surgical Quality Improvement Program Calculator’s ability to predict operative trauma outcomes. Anesth Analg. 2024 Jun 1;138(6):1260-1266. PMID: 38091502

In a multi-center, prospective study led by UC Irvine faculty, researchers evaluated the Trauma and Injury Severity Score (TRISS), the American Society of Anesthesiologists physical status (ASA-PS) score and the National Surgical Quality Improvement Program Surgical Risk Calculator (NSQIP-SRC) for their predictive ability for mortality, hospital length of stay (LOS) and complications in trauma patients undergoing surgery within 24 hours. Overall, while the NSQIP-SRC more accurately predicted both LOS and complications compared to ASA-PS and TRISS, the latter predicted mortality better than the other tools, though it was not improved when combined with them.

Yeates E, Grigorian A, Chinn J, et al, including Nguyen N, Dolich M, Schubl S, Lekawa M, and Nahmias J. Night radiology coverage for trauma: residents, teleradiology, or both? J Am Coll Surg. 2022 Sep 1;235(3):500-509. PMID: 35972171

This study retrospectively compared the accuracy of on-call radiology residents (RRs) and a teleradiology service (TS) in the interpretation of overnight CT scans in trauma patients. RRs had a lower discrepancy rate and turnaround time. Discrepancy rate was further reduced when interpretations by RRs and TS were combined.

Santos J, Grigorian A, Kuza C, Emigh B, Jeng J, Qazi A, Nguyen NT, Nahmias J. Development and validation of a renal replacement after trauma scoring tool. J Am Coll Surg. 2023 Jul 1;237(1):79-86. PMID: 36847387

Researchers created multiple logistic regression models to determine the risk for renal replacement therapy (RRT) in trauma patients, then used the weighted average and relative impact of each independent predictor to derive a renal replacement after trauma (RAT) scoring tool. In total, eleven predictors of RRT were included in the RAT score, which ranged from 0-11. Patients with a RAT score of 10 had a rate of RRT of 20%, compared to a rate of 1% in those with a score of 6.

Eguchi N, Tantisattamo E, Chung D, Reddy UG, Ferrey A, Dafoe D, Ichii H. Outcomes among undocumented immigrant kidney transplant recipients in California. JAMA Netw Open. 2023 Feb 1;6(2):e2254660. PMID: 36780162

In a retrospective analysis of recipients of kidney transplant at UC Irvine over an eight-year period, undocumented immigrants proved not to have a worse outcome in terms of graft loss or mortality compared to U.S. citizens.

Yi M, Cruz Cisneros L, Cho EJ, et al, including Swentek L and Ichii H. Nrf2 pathway and oxidative stress as a common target for treatment of diabetes and its comorbidities. Int J Mol Sci. 2024 Jan 9;25(2):821. PMID: 38255895

This paper reviews the role of oxidative stress in diabetes and how antioxidative Nrf2 pathways can be targeted for future treatment options.

Eguchi N, Damyar K, Alexander M, Dafoe D, Lakey JRT, Ichii H. Anti-oxidative therapy in islet cell transplantation. Antioxidants. 2022 May 24;11(6):1038. PMID: 35739935

During islet transplantation, oxidative stress is an important factor that negatively affects both the viability and function of isolated islets. This review discusses the potential application of antioxidative therapy during each step of islet cell transplantation to improve overall outcomes.

Eguchi N, Toribio AJ, Alexander M, et al, including Ichii H. Dysregulation of β-cells proliferation in diabetes: possibilities of combination therapy in the development of a comprehensive treatment. Biomedicines. 2022 Feb 17;10(2):472. PMID: 35203680

The authors discuss pancreatic β-cell mass/proliferation pathways that are dysregulated in diabetes and current therapeutic agents studied to induce β-cell proliferation. They also review possible combination therapies of proliferation agents with immunosuppressants and antioxidative therapy to improve overall long-term outcomes of diabetes.

BEST-CLI Investigators (including Kabutey NK). Surgery or endovascular therapy for chronic limb-threatening ischemia. N Engl J Med. 2022 Dec 22;387(25):2305-2316. PMID: 36342173

In a multicenter, international trial, 1,830 patients with chronic limb-threatening ischemia (CLTI) and infrainguinal peripheral artery disease were assigned to two cohorts: those who had a single segment of great saphenous vein that could be used for surgery (cohort 1) and those who required an alternative bypass conduit (cohort 2). They were then randomized to receive either endovascular therapy or surgical revascularization with a primary outcome of a major adverse limb event (as amputation above the ankle or a major limb reintervention: for example, a new bypass graft or graft revision, thrombectomy or thrombolysis) or death from any cause. In cohort 1, there were significantly fewer adverse limb events or deaths in the surgical group than in the endovascular group, but in cohort 2, the outcomes were similar in both groups. The research suggests a surgical risk assessment and a determination of saphenous-vein availability should be part of preprocedural planning in patients with CLTI, as bypass with a vein provided better outcomes in those with an adequate saphenous vein who were suitable candidates for both surgical and endovascular revascularization. In contrast, patients without an adequate saphenous vein may prefer an endoscopic intervention over surgery.

Grigorian A, Shipley J, Nahmias J, Nguyen N, Schwed AC, Petrie BA, de Virgilio C. Implications of using chatbots for future surgical education. JAMA Surg. 2023 Nov 1;158(11):1220-1222. PMID: 37728910

Using questions from a popular medical student textbook, different large language model AI programs were compared for their accuracy, explanation of incorrect answers, assessment of question difficulty and ability to generate high-quality exam questions. Chat GPT-4 proved most accurate, could explain why wrong answers were incorrect and accurately rated question difficulty, highlighting its potential in surgical education.

Huynh A, Nguyen A, Beyer RS, et al, including Nahmias J. Fixing a broken clerkship assessment process: reflections on objectivity and equity following the USMLE Step 1 change to pass/fail. Acad Med. 2023 Jul 1;98(7):769-774. PMID: 36780667

The authors evaluate objectivity and fairness in clerkship grading, its reliability in predicting residency performance, and systemic discrepancies in assessment and allocation of honors. They argue that there should be standardization of grading systems and greater adherence to and enforcement of transparency in grade distributions in the Medical Student Performance Evaluation to promote a fairer and more equitable residency selection process.

Gadde KM, Yin X, Goldberg RB, et al, including the Diabetes Prevention Program Research Group. Coronary artery calcium and cognitive decline in the diabetes prevention program outcomes study. J Am Heart Assoc. 2023 Nov 7;12(21):e029671. PMID: 37929764

The nationwide Diabetes Prevention Program Research Group sought to investigate the association of coronary artery calcium (CAC) with cognitive function in adults with impaired glucose tolerance or type 2 diabetes. Fourteen years after enrollment in the Diabetes Prevention Program Outcomes Study, participants had CT scans to assess CAC scores and correlate them to cognitive decline. In women with prediabetes or diabetes, CAC >300, compared with no calcification, was independently associated with greater decline in verbal memory.

Hosseinian S, de Assis R, Khalil G, et al, including Schubl SD. Analysis and comparison of SARS-CoV-2 variant antibodies and neutralizing activity for 6 months after a booster mRNA vaccine in a healthcare worker population. Front Immunol. 2023 May 17;14:1166261. PMID: 37266444

Healthcare workers at UC Irvine Medical Center who had received a primary mRNA vaccine followed by a booster dose had their SARS-CoV-2 antibody profiles assessed over six months. Antibodies to specific variants were also measured and in a subset. SARS-CoV-2 neutralization capacity was determined to confirm correlation with antibody levels. Antibodies against SARS-CoV-2 declined over the study period but remained higher than pre-booster dose levels, and neutralization activity was maintained. Booster doses to the original strain were less effective against newer Omicron variants. The authors concluded that breakthrough infections were likely due to infection with novel variants with different antibody specificity, rather than to time since last vaccination and noted that variant-specific vaccinations are necessary to prevent future surges of SARS-CoV-2 infections.

Ruhi-Williams P, Wu B, Nahmias J, et al, including Sagebin F, Gadde KM, and Nguyen NT. Analysis of veno-venous extracorporeal membrane oxygenation for COVID-19 compared to non-COVID etiologies. Ann Surg. 2023 Sep 1;278(3):464-470. PMID: 37325899

This study showed that there was double the risk of in-hospital mortality after veno-venous extracorporeal membrane oxygenation (V-V ECMO) in patients with COVID-19 versus those who received V-V ECMO but did not have COVID-19.

Coulon P, Prakash S, Dhanushkodi NR, et al, including Schubl SD. High frequencies of alpha common cold coronavirus/SARS-CoV-2 cross-reactive functional CD4+ and CD8+ memory T cells are associated with protection from symptomatic and fatal SARS-CoV-2 infections in unvaccinated COVID-19 patients. Front Immunol. 2024 Mar 28;15:1343716. PMID: 38605956

This study compares the antigen specificity, frequency, phenotype and function of cross-reactive memory CD4+ and CD8+ T cells between common cold coronaviruses (CCCs) and SARS-CoV-2 and supports a crucial role of specific cross-reactive memory T cells in protecting against subsequent severe COVID-19. It also provides insights into the development of multi-antigen T-cell-based universal vaccines against all coronaviruses.

Ruhi-Williams P, Manasa M, Fazl Alizadeh R, et al. Impact of COVID-19 pandemic on management and outcomes of acute cholecystitis at US academic centers. J Am Coll Surg. 2023 Jul 1;237(1):87-93. PMID: 37318137

The authors examined if there were changes to the management of acute cholecystitis prior to and during the COVID-19 pandemic. During the pandemic, patients were more likely to have medical management or percutaneous cholecystostomy tube placement and were less likely to have laparoscopic cholecystectomy. In addition, patients in the pandemic group who underwent procedural intervention had a longer length of stay, higher in-hospital death rate and higher costs compared to the pre-pandemic group.