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Cancer

Detection of Circulating Tumor DNA in Plasma: A Potential Biomarker for Esophageal Adenocarcinoma

Egyud and colleagues evaluated plasma levels of circulating tumor (ct)DNA in patients with esophageal adenocarcinoma, ranging from stage I to stage IV. The quantity of ctDNA and likelihood of ctDNA detection was greater at later stages, suggesting that it may be challenging to use for early-stage diagnosis. However, changes in ctDNA levels were indicative of response to therapy and recurrence, and the authors conclude that they may serve as a dynamic biomarker to monitor a patient’s response to treatment.

Adjuvant Therapy for Node-Positive Esophageal Cancer After Induction and Surgery: A Multisite Study

In this multiinstitutional retrospective study, administration of adjuvant chemotherapy for patients with persistent nodal disease after induction therapy and esophagectomy was associated with improved survival.

BMI, BMI Change, and Overall Survival in Patients With Lung Cancer

This study of over 25,000 pts from the International Lung Cancer Consortium identified underweight and severly obese patients as having poorer survival than others, whereas a survival advantage was evident among patients who were overweight or mildly obese.  Decreased BMI (wt loss) was associated with poorer outcomes across all BMI categories.

Novel Machine Learning Approach to Identify Preoperative Risk Factors Associated With Super-Utilization of Medicare Expenditure Following Surgery

Using a machine learning algorithm, resource utilization among more than 1 million Medicare patients undergoing one of 6 operations including CABG and lung resection was analyzed.  Super users comprised 4.8% of the cohort but consumed 31.7% of the resources.  Risk factors for super use included paraplegia/hemiplegia, weight loss, and CHF combined with chronic kidney disease. 

Association of Discretionary Hospital Volume Standards for High-Risk Cancer Surgery With Patient Outcomes and Access, 2005-2016

Regionalization of care for complex problems remains an open question in most countries. This review demonstrated that, for high risk cancer operations in the US, the Leapfrog group's volume standards did not differentiate between surgical mortality outcomes for lung and esophageal cancer surgery. However, differences were evident comparing lowest and highest volume quintiles for operative mortality associated with these procedures.

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