ACS Surgery News

An estimated 886 bleeding control courses were offered in the days leading up to March 31, the official day of observance, and on the day of the event itself. These courses were led by approximately 3,460 instructors who are now filing reports with the American College of Surgeons (ACS) Stop the Bleed^® office on the number of attendees who completed the training.

Media coverage of the event was significant, with hundreds of local media reports released about the Stop the Bleed Day in their hometown newspapers, television stations, online blogs, and other media outlets across the nation. To date, Stop the Bleed Day has captured 798 media mentions and more than 736 million media impressions.

The ACS Bleedingcontrol.org website was a major source of information about the day. In fact, during the month of March the website experienced a high volume of traffic (174,253 page views). The ACS National Stop the Bleed Day web page (www.bleedingcontrol.org/march31) captured 5,487 page views, and an informational video (goo.gl/QLRnwC) explaining what the event was about captured more than 1,200 views on YouTube. Stop the Bleed training can now be found in all 50 states and in 65 countries.
 

An estimated 886 bleeding control courses were offered in the days leading up to March 31, the official day of observance, and on the day of the event itself. These courses were led by approximately 3,460 instructors who are now filing reports with the American College of Surgeons (ACS) Stop the Bleed^® office on the number of attendees who completed the training.

Media coverage of the event was significant, with hundreds of local media reports released about the Stop the Bleed Day in their hometown newspapers, television stations, online blogs, and other media outlets across the nation. To date, Stop the Bleed Day has captured 798 media mentions and more than 736 million media impressions.

The ACS Bleedingcontrol.org website was a major source of information about the day. In fact, during the month of March the website experienced a high volume of traffic (174,253 page views). The ACS National Stop the Bleed Day web page (www.bleedingcontrol.org/march31) captured 5,487 page views, and an informational video (goo.gl/QLRnwC) explaining what the event was about captured more than 1,200 views on YouTube. Stop the Bleed training can now be found in all 50 states and in 65 countries.
 

An estimated 886 bleeding control courses were offered in the days leading up to March 31, the official day of observance, and on the day of the event itself. These courses were led by approximately 3,460 instructors who are now filing reports with the American College of Surgeons (ACS) Stop the Bleed^® office on the number of attendees who completed the training.

Media coverage of the event was significant, with hundreds of local media reports released about the Stop the Bleed Day in their hometown newspapers, television stations, online blogs, and other media outlets across the nation. To date, Stop the Bleed Day has captured 798 media mentions and more than 736 million media impressions.

The ACS Bleedingcontrol.org website was a major source of information about the day. In fact, during the month of March the website experienced a high volume of traffic (174,253 page views). The ACS National Stop the Bleed Day web page (www.bleedingcontrol.org/march31) captured 5,487 page views, and an informational video (goo.gl/QLRnwC) explaining what the event was about captured more than 1,200 views on YouTube. Stop the Bleed training can now be found in all 50 states and in 65 countries.
 

The American College of Surgeons (ACS) has posted the results of the 2017 Member Survey conducted last summer, to which more than 4,400 ACS Fellows and Associate Fellows responded. An infographic (available at www.facs.org/member-services/2017-survey provides an overview of member response rates, along with information on member work settings, overall satisfaction, the value of membership, the likelihood of recommending membership to others, top member benefits by importance and satisfaction, and member experiences with ACS Chapters. The ACS also has posted more detailed survey findings, available at www.facs.org/member-services/2017-survey/findings along with descriptions of the actions being taken in response to the results.

The survey results were presented to the Board of Regents at its October 2017 meeting. In addition, the results were discussed with the ACS Executive Leadership Team and have been used to develop the 2018 ACS strategic plan.

We value your membership and appreciate you providing this useful feedback. Questions or comments should be directed to the Division of Member Services at [email protected].

The American College of Surgeons (ACS) has posted the results of the 2017 Member Survey conducted last summer, to which more than 4,400 ACS Fellows and Associate Fellows responded. An infographic (available at www.facs.org/member-services/2017-survey provides an overview of member response rates, along with information on member work settings, overall satisfaction, the value of membership, the likelihood of recommending membership to others, top member benefits by importance and satisfaction, and member experiences with ACS Chapters. The ACS also has posted more detailed survey findings, available at www.facs.org/member-services/2017-survey/findings along with descriptions of the actions being taken in response to the results.

The survey results were presented to the Board of Regents at its October 2017 meeting. In addition, the results were discussed with the ACS Executive Leadership Team and have been used to develop the 2018 ACS strategic plan.

We value your membership and appreciate you providing this useful feedback. Questions or comments should be directed to the Division of Member Services at [email protected].

The American College of Surgeons (ACS) has posted the results of the 2017 Member Survey conducted last summer, to which more than 4,400 ACS Fellows and Associate Fellows responded. An infographic (available at www.facs.org/member-services/2017-survey provides an overview of member response rates, along with information on member work settings, overall satisfaction, the value of membership, the likelihood of recommending membership to others, top member benefits by importance and satisfaction, and member experiences with ACS Chapters. The ACS also has posted more detailed survey findings, available at www.facs.org/member-services/2017-survey/findings along with descriptions of the actions being taken in response to the results.

The survey results were presented to the Board of Regents at its October 2017 meeting. In addition, the results were discussed with the ACS Executive Leadership Team and have been used to develop the 2018 ACS strategic plan.

We value your membership and appreciate you providing this useful feedback. Questions or comments should be directed to the Division of Member Services at [email protected].

The American College of Surgeons (ACS) Women in Surgery Committee (WiSC) is accepting nominations for the annual Dr. Mary Edwards Walker Inspiring Women in Surgery Award through May 31. The award will be presented at Clinical Congress 2018 in Boston, MA, in recognition of an individual’s significant contributions to the advancement of women in the field of surgery.

The award is named in honor of Mary Edwards Walker, MD, for her role as the first woman surgeon employed by the U.S. Army and the only woman to receive the Congressional Medal of Honor, the highest U.S. Armed Forces decoration for bravery. Dr. Walker’s example paved the way for women surgeons of today.

Nominees must have demonstrated a commitment to the advancement and inspiration of women in surgery and be members of the ACS, either in active practice or retired. WiSC members are ineligible for this award. The awardee is expected to attend Clinical Congress 2018 to accept the honor in person.

All nominations must be accompanied by the following documents:

• A letter of nomination outlining how the nominee has contributed to the advancement of women in the field of surgery

• An up-to-date curriculum vitae (CV) of the nominee

• Self-nominations are acceptable and should include a letter of reference

The letter of nomination and CV should be sent to Connie Bura at [email protected].

Read more about Dr. Walker, complete award eligibility requirements, and the selection process on the ACS website at www.facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/edwards-walker. Questions can be submitted to [email protected].

The American College of Surgeons (ACS) Women in Surgery Committee (WiSC) is accepting nominations for the annual Dr. Mary Edwards Walker Inspiring Women in Surgery Award through May 31. The award will be presented at Clinical Congress 2018 in Boston, MA, in recognition of an individual’s significant contributions to the advancement of women in the field of surgery.

The award is named in honor of Mary Edwards Walker, MD, for her role as the first woman surgeon employed by the U.S. Army and the only woman to receive the Congressional Medal of Honor, the highest U.S. Armed Forces decoration for bravery. Dr. Walker’s example paved the way for women surgeons of today.

Nominees must have demonstrated a commitment to the advancement and inspiration of women in surgery and be members of the ACS, either in active practice or retired. WiSC members are ineligible for this award. The awardee is expected to attend Clinical Congress 2018 to accept the honor in person.

All nominations must be accompanied by the following documents:

• A letter of nomination outlining how the nominee has contributed to the advancement of women in the field of surgery

• An up-to-date curriculum vitae (CV) of the nominee

• Self-nominations are acceptable and should include a letter of reference

The letter of nomination and CV should be sent to Connie Bura at [email protected].

Read more about Dr. Walker, complete award eligibility requirements, and the selection process on the ACS website at www.facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/edwards-walker. Questions can be submitted to [email protected].

The American College of Surgeons (ACS) Women in Surgery Committee (WiSC) is accepting nominations for the annual Dr. Mary Edwards Walker Inspiring Women in Surgery Award through May 31. The award will be presented at Clinical Congress 2018 in Boston, MA, in recognition of an individual’s significant contributions to the advancement of women in the field of surgery.

The award is named in honor of Mary Edwards Walker, MD, for her role as the first woman surgeon employed by the U.S. Army and the only woman to receive the Congressional Medal of Honor, the highest U.S. Armed Forces decoration for bravery. Dr. Walker’s example paved the way for women surgeons of today.

Nominees must have demonstrated a commitment to the advancement and inspiration of women in surgery and be members of the ACS, either in active practice or retired. WiSC members are ineligible for this award. The awardee is expected to attend Clinical Congress 2018 to accept the honor in person.

All nominations must be accompanied by the following documents:

• A letter of nomination outlining how the nominee has contributed to the advancement of women in the field of surgery

• An up-to-date curriculum vitae (CV) of the nominee

• Self-nominations are acceptable and should include a letter of reference

The letter of nomination and CV should be sent to Connie Bura at [email protected].

Read more about Dr. Walker, complete award eligibility requirements, and the selection process on the ACS website at www.facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/edwards-walker. Questions can be submitted to [email protected].

The family and friends of the late Claude H. Organ, Jr., MD, FACS, Past-President of the American College of Surgeons (ACS), have established an endowment through the ACS Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association. The ACS is accepting applications for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship through June 1.

The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow younger than 45 years old who is a member of one of the previously mentioned societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.

Past awardees have used their fellowships to develop their careers in creative ways. The 2017 fellow, Kakra Hughes, MD, FACS, visited locations in Ethiopia and Ghana to begin to develop partnerships and a program for resident training in vascular surgery.

The full requirements for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship are posted on the ACS website at www.facs.org/member-services/scholarships/special/organ. A decision regarding this year’s awardee is scheduled to be announced in August 2018. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].

The family and friends of the late Claude H. Organ, Jr., MD, FACS, Past-President of the American College of Surgeons (ACS), have established an endowment through the ACS Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association. The ACS is accepting applications for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship through June 1.

The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow younger than 45 years old who is a member of one of the previously mentioned societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.

Past awardees have used their fellowships to develop their careers in creative ways. The 2017 fellow, Kakra Hughes, MD, FACS, visited locations in Ethiopia and Ghana to begin to develop partnerships and a program for resident training in vascular surgery.

The full requirements for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship are posted on the ACS website at www.facs.org/member-services/scholarships/special/organ. A decision regarding this year’s awardee is scheduled to be announced in August 2018. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].

The family and friends of the late Claude H. Organ, Jr., MD, FACS, Past-President of the American College of Surgeons (ACS), have established an endowment through the ACS Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association. The ACS is accepting applications for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship through June 1.

The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow younger than 45 years old who is a member of one of the previously mentioned societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.

Past awardees have used their fellowships to develop their careers in creative ways. The 2017 fellow, Kakra Hughes, MD, FACS, visited locations in Ethiopia and Ghana to begin to develop partnerships and a program for resident training in vascular surgery.

The full requirements for the Claude H. Organ, Jr., MD, FACS, Traveling Fellowship are posted on the ACS website at www.facs.org/member-services/scholarships/special/organ. A decision regarding this year’s awardee is scheduled to be announced in August 2018. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].

SAN FRANCISCO – Stress urinary incontinence (SUI) following removal of a mid-urethral sling (MUS) mesh is not necessarily associated with increased risk of postsurgical urinary incontinence, according to a retrospective study at a high-volume, tertiary medical center.

Follow-up procedures occurred more often in women with preoperative urodynamic SUI and less often in women who were stress continent.

Jim Kling/MDedge

Among women who were stress continent, obesity and postmenopausal status were linked to postsurgical SUI. There was no association between postsurgical SUI and the extent of mesh excision or prior revisions.

The study grew out of observations that SUI occurred less often than expected.

“There’s an increasing recognition of complications related to synthetic MUS,” said Janine Oliver, MD, who presented the study at the annual meeting of the American Urological Association. “As mesh removal procedures were being performed, we assumed that the majority of patients, if not all, would be incontinent afterward, since we were removing the sling that was put in to fix stress incontinence in most cases.”

In a patient who would benefit from a complete mesh removal, “the fear that it may lead to a higher risk of urinary incontinence is not a good justification to not do it,” Dr. Oliver said. She did note, however, that the procedures were done by specialists, so findings may not be applicable to general practitioners.

The study was performed while Dr. Oliver was a fellow at the University of California, Los Angeles. She is now with the division of urology at the University of Colorado, Anschutz, in Aurora.

SOURCE: Oliver J et al. AUA Annual Meeting. Abstract PD05-10.

SAN FRANCISCO – Stress urinary incontinence (SUI) following removal of a mid-urethral sling (MUS) mesh is not necessarily associated with increased risk of postsurgical urinary incontinence, according to a retrospective study at a high-volume, tertiary medical center.

Follow-up procedures occurred more often in women with preoperative urodynamic SUI and less often in women who were stress continent.

Jim Kling/MDedge

Among women who were stress continent, obesity and postmenopausal status were linked to postsurgical SUI. There was no association between postsurgical SUI and the extent of mesh excision or prior revisions.

The study grew out of observations that SUI occurred less often than expected.

“There’s an increasing recognition of complications related to synthetic MUS,” said Janine Oliver, MD, who presented the study at the annual meeting of the American Urological Association. “As mesh removal procedures were being performed, we assumed that the majority of patients, if not all, would be incontinent afterward, since we were removing the sling that was put in to fix stress incontinence in most cases.”

In a patient who would benefit from a complete mesh removal, “the fear that it may lead to a higher risk of urinary incontinence is not a good justification to not do it,” Dr. Oliver said. She did note, however, that the procedures were done by specialists, so findings may not be applicable to general practitioners.

The study was performed while Dr. Oliver was a fellow at the University of California, Los Angeles. She is now with the division of urology at the University of Colorado, Anschutz, in Aurora.

SOURCE: Oliver J et al. AUA Annual Meeting. Abstract PD05-10.

SAN FRANCISCO – Stress urinary incontinence (SUI) following removal of a mid-urethral sling (MUS) mesh is not necessarily associated with increased risk of postsurgical urinary incontinence, according to a retrospective study at a high-volume, tertiary medical center.

Follow-up procedures occurred more often in women with preoperative urodynamic SUI and less often in women who were stress continent.

Jim Kling/MDedge

Among women who were stress continent, obesity and postmenopausal status were linked to postsurgical SUI. There was no association between postsurgical SUI and the extent of mesh excision or prior revisions.

The study grew out of observations that SUI occurred less often than expected.

“There’s an increasing recognition of complications related to synthetic MUS,” said Janine Oliver, MD, who presented the study at the annual meeting of the American Urological Association. “As mesh removal procedures were being performed, we assumed that the majority of patients, if not all, would be incontinent afterward, since we were removing the sling that was put in to fix stress incontinence in most cases.”

In a patient who would benefit from a complete mesh removal, “the fear that it may lead to a higher risk of urinary incontinence is not a good justification to not do it,” Dr. Oliver said. She did note, however, that the procedures were done by specialists, so findings may not be applicable to general practitioners.

The study was performed while Dr. Oliver was a fellow at the University of California, Los Angeles. She is now with the division of urology at the University of Colorado, Anschutz, in Aurora.

SOURCE: Oliver J et al. AUA Annual Meeting. Abstract PD05-10.

SANDESTIN, FLA. – More than ever, clinicians need to rely on a multimodal approach to pain management, Katherine Galluzzi, DO, said at the annual Congress of Clinical Rheumatology.

In the era of opioid addiction – in which she said physicians have sometimes been unfairly vilified – pharmaceutical options are limited not only by the threat of abuse but also by governmental regulation, explained Dr. Galluzzi, chair of geriatrics at the Philadelphia College of Osteopathic Medicine.

The underpinning of pain management in the future will need to be cognitive-behavioral therapy, such as changing behavior and meditation; physical approaches, such as exercise and acupuncture; and interventional treatments, such as nerve blocks and trigger-point injections. Pharmacotherapy can’t do it all, nor should it, she said.

“This is what we have, this is what we need to do,” Dr. Galluzzi said. “This impacts the quality of life, and patients need to begin providing self-care. It’s not going to come in the form of a pill. It has to be a commitment between the patient and the physician.”

The Centers for Medicare & Medicaid Services are proposing a new limit on opioid prescriptions for Medicare recipients – a maximum of 90 morphine mg equivalents per day for no more than 7 days. That will affect older people, who are most likely to be in need of pain management, she said. Those on hospice care and experiencing certain cancer pain will be exempt, she noted in an interview.

Concerns about addiction to drugs such as gabapentin and benzodiazepines might make these therapies less of an option in coming years, Dr. Galluzzi added.

Risk evaluation and mitigation strategy training is an important tool for helping physicians weigh the benefits and the risks of opioid prescriptions. Dr. Galluzzi particularly suggests enrolling in a 3-4 hour, in-person program, saying that it’s well worth the time.

“If you haven’t done a risk assessment and mitigation strategies course and you’re an opioid prescriber,” she said, “I highly recommend that you do that.”

SANDESTIN, FLA. – More than ever, clinicians need to rely on a multimodal approach to pain management, Katherine Galluzzi, DO, said at the annual Congress of Clinical Rheumatology.

In the era of opioid addiction – in which she said physicians have sometimes been unfairly vilified – pharmaceutical options are limited not only by the threat of abuse but also by governmental regulation, explained Dr. Galluzzi, chair of geriatrics at the Philadelphia College of Osteopathic Medicine.

The underpinning of pain management in the future will need to be cognitive-behavioral therapy, such as changing behavior and meditation; physical approaches, such as exercise and acupuncture; and interventional treatments, such as nerve blocks and trigger-point injections. Pharmacotherapy can’t do it all, nor should it, she said.

“This is what we have, this is what we need to do,” Dr. Galluzzi said. “This impacts the quality of life, and patients need to begin providing self-care. It’s not going to come in the form of a pill. It has to be a commitment between the patient and the physician.”

The Centers for Medicare & Medicaid Services are proposing a new limit on opioid prescriptions for Medicare recipients – a maximum of 90 morphine mg equivalents per day for no more than 7 days. That will affect older people, who are most likely to be in need of pain management, she said. Those on hospice care and experiencing certain cancer pain will be exempt, she noted in an interview.

Concerns about addiction to drugs such as gabapentin and benzodiazepines might make these therapies less of an option in coming years, Dr. Galluzzi added.

Risk evaluation and mitigation strategy training is an important tool for helping physicians weigh the benefits and the risks of opioid prescriptions. Dr. Galluzzi particularly suggests enrolling in a 3-4 hour, in-person program, saying that it’s well worth the time.

“If you haven’t done a risk assessment and mitigation strategies course and you’re an opioid prescriber,” she said, “I highly recommend that you do that.”

SANDESTIN, FLA. – More than ever, clinicians need to rely on a multimodal approach to pain management, Katherine Galluzzi, DO, said at the annual Congress of Clinical Rheumatology.

In the era of opioid addiction – in which she said physicians have sometimes been unfairly vilified – pharmaceutical options are limited not only by the threat of abuse but also by governmental regulation, explained Dr. Galluzzi, chair of geriatrics at the Philadelphia College of Osteopathic Medicine.

The underpinning of pain management in the future will need to be cognitive-behavioral therapy, such as changing behavior and meditation; physical approaches, such as exercise and acupuncture; and interventional treatments, such as nerve blocks and trigger-point injections. Pharmacotherapy can’t do it all, nor should it, she said.

“This is what we have, this is what we need to do,” Dr. Galluzzi said. “This impacts the quality of life, and patients need to begin providing self-care. It’s not going to come in the form of a pill. It has to be a commitment between the patient and the physician.”

The Centers for Medicare & Medicaid Services are proposing a new limit on opioid prescriptions for Medicare recipients – a maximum of 90 morphine mg equivalents per day for no more than 7 days. That will affect older people, who are most likely to be in need of pain management, she said. Those on hospice care and experiencing certain cancer pain will be exempt, she noted in an interview.

Concerns about addiction to drugs such as gabapentin and benzodiazepines might make these therapies less of an option in coming years, Dr. Galluzzi added.

Risk evaluation and mitigation strategy training is an important tool for helping physicians weigh the benefits and the risks of opioid prescriptions. Dr. Galluzzi particularly suggests enrolling in a 3-4 hour, in-person program, saying that it’s well worth the time.

“If you haven’t done a risk assessment and mitigation strategies course and you’re an opioid prescriber,” she said, “I highly recommend that you do that.”

SAN DIEGO – National guidelines for the treatment of malignant pleural mesothelioma often are not followed, a new study showed, with fewer than one-third of patients receiving cancer-directed surgery.

Another 32% received no treatment, although that didn’t seem to have an impact on median months of survival.

Still, “there can be a wide variation in median survival time, depending on clinical factors and tumor characteristics,” said study coauthor Harmik Soukiasian, MD, of Cedars-Sinai Medical Center, Los Angeles. “Given the variation in prognosis, it is quite astonishing that over 30% of MPM patients are not receiving any form of treatment. As clinicians armed with these data, we need to investigate why that is.”

Dr. Soukiasian presented the study findings at the annual meeting of the American Association for Thoracic Surgery.

MPM, a rare cancer, is mainly linked to asbestos exposure. “MPM is almost always a fatal disease, and the prognosis can only be modestly influenced by oncological treatments,” according to the authors of guidelines released in 2013. “The diagnostic process can be complex, with highly specialized advice frequently required to arrive at a definite diagnosis. Treatment varies from therapeutic nihilism to radical combined-modality treatment approaches” (J Thorac Dis. 2013 Dec;5[6]:E254-E307).

Surgical resection is a controversial treatment for MPM, Dr. Soukiasian said. It is “based on the principle of macroscopic resection of solid tumor with adjuvant therapy to treat micrometastatic disease,” he explained. “Cancer-directed surgery for MPM is usually reserved for localized epithelial type histology and is associated with a 5-year survival rate of 15%.”

For the new study, the investigators tracked 3,834 patients in the National Cancer Database (2004-2014) diagnosed with MPM clinical stages I-III. Most had epithelioid MPM (69%), with sarcomatoid (17%) and mixed subtype (15%) making up the rest. They examined whether patient treatment complied with the National Comprehensive Cancer Network (NCCN) guidelines, which recommend surgery in resectable epithelioid MPM.

SOURCE: Espinoza-Mercado F et al. General Thoracic Surgery Simultaneous Scientific Session. Abstract 18.

SAN DIEGO – National guidelines for the treatment of malignant pleural mesothelioma often are not followed, a new study showed, with fewer than one-third of patients receiving cancer-directed surgery.

Another 32% received no treatment, although that didn’t seem to have an impact on median months of survival.

Still, “there can be a wide variation in median survival time, depending on clinical factors and tumor characteristics,” said study coauthor Harmik Soukiasian, MD, of Cedars-Sinai Medical Center, Los Angeles. “Given the variation in prognosis, it is quite astonishing that over 30% of MPM patients are not receiving any form of treatment. As clinicians armed with these data, we need to investigate why that is.”

Dr. Soukiasian presented the study findings at the annual meeting of the American Association for Thoracic Surgery.

MPM, a rare cancer, is mainly linked to asbestos exposure. “MPM is almost always a fatal disease, and the prognosis can only be modestly influenced by oncological treatments,” according to the authors of guidelines released in 2013. “The diagnostic process can be complex, with highly specialized advice frequently required to arrive at a definite diagnosis. Treatment varies from therapeutic nihilism to radical combined-modality treatment approaches” (J Thorac Dis. 2013 Dec;5[6]:E254-E307).

Surgical resection is a controversial treatment for MPM, Dr. Soukiasian said. It is “based on the principle of macroscopic resection of solid tumor with adjuvant therapy to treat micrometastatic disease,” he explained. “Cancer-directed surgery for MPM is usually reserved for localized epithelial type histology and is associated with a 5-year survival rate of 15%.”

For the new study, the investigators tracked 3,834 patients in the National Cancer Database (2004-2014) diagnosed with MPM clinical stages I-III. Most had epithelioid MPM (69%), with sarcomatoid (17%) and mixed subtype (15%) making up the rest. They examined whether patient treatment complied with the National Comprehensive Cancer Network (NCCN) guidelines, which recommend surgery in resectable epithelioid MPM.

SOURCE: Espinoza-Mercado F et al. General Thoracic Surgery Simultaneous Scientific Session. Abstract 18.

SAN DIEGO – National guidelines for the treatment of malignant pleural mesothelioma often are not followed, a new study showed, with fewer than one-third of patients receiving cancer-directed surgery.

Another 32% received no treatment, although that didn’t seem to have an impact on median months of survival.

Still, “there can be a wide variation in median survival time, depending on clinical factors and tumor characteristics,” said study coauthor Harmik Soukiasian, MD, of Cedars-Sinai Medical Center, Los Angeles. “Given the variation in prognosis, it is quite astonishing that over 30% of MPM patients are not receiving any form of treatment. As clinicians armed with these data, we need to investigate why that is.”

Dr. Soukiasian presented the study findings at the annual meeting of the American Association for Thoracic Surgery.

MPM, a rare cancer, is mainly linked to asbestos exposure. “MPM is almost always a fatal disease, and the prognosis can only be modestly influenced by oncological treatments,” according to the authors of guidelines released in 2013. “The diagnostic process can be complex, with highly specialized advice frequently required to arrive at a definite diagnosis. Treatment varies from therapeutic nihilism to radical combined-modality treatment approaches” (J Thorac Dis. 2013 Dec;5[6]:E254-E307).

Surgical resection is a controversial treatment for MPM, Dr. Soukiasian said. It is “based on the principle of macroscopic resection of solid tumor with adjuvant therapy to treat micrometastatic disease,” he explained. “Cancer-directed surgery for MPM is usually reserved for localized epithelial type histology and is associated with a 5-year survival rate of 15%.”

For the new study, the investigators tracked 3,834 patients in the National Cancer Database (2004-2014) diagnosed with MPM clinical stages I-III. Most had epithelioid MPM (69%), with sarcomatoid (17%) and mixed subtype (15%) making up the rest. They examined whether patient treatment complied with the National Comprehensive Cancer Network (NCCN) guidelines, which recommend surgery in resectable epithelioid MPM.

SOURCE: Espinoza-Mercado F et al. General Thoracic Surgery Simultaneous Scientific Session. Abstract 18.

BOSTON – Low postoperative calcium serum and parathyroid hormone (PTH) levels may be strong predictors of permanent hypoparathyroidism in total thyroidectomy patients, according to results of a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

With incidence of transient hypoparathyroidism at 20-30%, being able to predict at-risk patients can significantly help clinicians with postoperative management, according to Steven Brown, DO, of the University of Arizona, Phoenix.

“It’s very important to draw the preoperative lab and postoperative lab in order to help those patients who are at risk,” said Dr. Brown in an oral abstract session.

To test the predictive accuracy of PTH and calcium levels, investigators conducted a single-center, retrospective study of 176 total thyroidectomy patients recorded during 1999-2013.

Patients with hypoparathyroidism had an average age of about 47 years, was almost entirely composed of females, was majority hispanic, and had mean postop calcium and PTH levels of 7.6 mg/dL and 8.0 pg/mL, respectively.

Those without hypoparathyroidism averaged about 51 years old, were equally hispanic and white, and had postop calcium and PTH levels of 8.08 mg/dL and 30.8 pg/dL, respectively.

Patients were split into four groups: Group 1 had low calcium and PTH levels (66), group 2 had low calcium and normal PTH levels (30), group 3 had normal calcium and low PTH levels (31), and group 4 had normal levels of both (49).

Over the study period, hypoparathyroidism developed in 30% of patients in group 1, 10% in group 2, 15% in group 3, and 2% in group 4.

[email protected]

SOURCE: Brown S et al. AACE 2018, Abstract 720.

BOSTON – Low postoperative calcium serum and parathyroid hormone (PTH) levels may be strong predictors of permanent hypoparathyroidism in total thyroidectomy patients, according to results of a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

With incidence of transient hypoparathyroidism at 20-30%, being able to predict at-risk patients can significantly help clinicians with postoperative management, according to Steven Brown, DO, of the University of Arizona, Phoenix.

“It’s very important to draw the preoperative lab and postoperative lab in order to help those patients who are at risk,” said Dr. Brown in an oral abstract session.

To test the predictive accuracy of PTH and calcium levels, investigators conducted a single-center, retrospective study of 176 total thyroidectomy patients recorded during 1999-2013.

Patients with hypoparathyroidism had an average age of about 47 years, was almost entirely composed of females, was majority hispanic, and had mean postop calcium and PTH levels of 7.6 mg/dL and 8.0 pg/mL, respectively.

Those without hypoparathyroidism averaged about 51 years old, were equally hispanic and white, and had postop calcium and PTH levels of 8.08 mg/dL and 30.8 pg/dL, respectively.

Patients were split into four groups: Group 1 had low calcium and PTH levels (66), group 2 had low calcium and normal PTH levels (30), group 3 had normal calcium and low PTH levels (31), and group 4 had normal levels of both (49).

Over the study period, hypoparathyroidism developed in 30% of patients in group 1, 10% in group 2, 15% in group 3, and 2% in group 4.

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SOURCE: Brown S et al. AACE 2018, Abstract 720.

BOSTON – Low postoperative calcium serum and parathyroid hormone (PTH) levels may be strong predictors of permanent hypoparathyroidism in total thyroidectomy patients, according to results of a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

With incidence of transient hypoparathyroidism at 20-30%, being able to predict at-risk patients can significantly help clinicians with postoperative management, according to Steven Brown, DO, of the University of Arizona, Phoenix.

“It’s very important to draw the preoperative lab and postoperative lab in order to help those patients who are at risk,” said Dr. Brown in an oral abstract session.

To test the predictive accuracy of PTH and calcium levels, investigators conducted a single-center, retrospective study of 176 total thyroidectomy patients recorded during 1999-2013.

Patients with hypoparathyroidism had an average age of about 47 years, was almost entirely composed of females, was majority hispanic, and had mean postop calcium and PTH levels of 7.6 mg/dL and 8.0 pg/mL, respectively.

Those without hypoparathyroidism averaged about 51 years old, were equally hispanic and white, and had postop calcium and PTH levels of 8.08 mg/dL and 30.8 pg/dL, respectively.

Patients were split into four groups: Group 1 had low calcium and PTH levels (66), group 2 had low calcium and normal PTH levels (30), group 3 had normal calcium and low PTH levels (31), and group 4 had normal levels of both (49).

Over the study period, hypoparathyroidism developed in 30% of patients in group 1, 10% in group 2, 15% in group 3, and 2% in group 4.

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SOURCE: Brown S et al. AACE 2018, Abstract 720.

Veterans with advanced-stage lung cancer who received palliative care were less likely to commit suicide, according to new research that will be presented at an international conference of the American Thoracic Society.

“Suicide is a significant national public health problem, especially among lung cancer patients and among veterans,” said lead author, Donald R. Sullivan, MD, of the division of pulmonary and critical care medicine at Oregon Health & Science University and a member of the OHSU Knight Cancer Institute, in a statement.

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Veterans with advanced-stage lung cancer who received palliative care were less likely to commit suicide, according to new research that will be presented at an international conference of the American Thoracic Society.

“Suicide is a significant national public health problem, especially among lung cancer patients and among veterans,” said lead author, Donald R. Sullivan, MD, of the division of pulmonary and critical care medicine at Oregon Health & Science University and a member of the OHSU Knight Cancer Institute, in a statement.

xrender/thinkstock.com

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Veterans with advanced-stage lung cancer who received palliative care were less likely to commit suicide, according to new research that will be presented at an international conference of the American Thoracic Society.

“Suicide is a significant national public health problem, especially among lung cancer patients and among veterans,” said lead author, Donald R. Sullivan, MD, of the division of pulmonary and critical care medicine at Oregon Health & Science University and a member of the OHSU Knight Cancer Institute, in a statement.

xrender/thinkstock.com

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BOSTON – Acute weight loss during the first year after bariatric surgery has a significant effect on hemoglobin A_1c level improvement at 5 years’ follow-up, according to a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

The data presented could help clinicians understand when and where to focus their efforts to help patients optimize weight loss in order to see the best long-term benefits of the procedure, according to presenter Keren Zhou, MD, an endocrinology fellow at the Cleveland Clinic.

“Clinicians need to really focus on that first year weight loss after bariatric surgery to try and optimize 5-year A_1c outcomes,” said Dr. Zhou. “It also answers another question people have been having, which is how much does weight regain after bariatric surgery really matter? What we’ve been able to show here is that weight regain didn’t look very correlated at all.”

Dr. Zhou and her colleagues developed the ancillary study using data from the STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently) trial, specifically looking at 96 patients: 49 who underwent bariatric surgery and 47 who had a sleeve gastrectomy.

Patients were majority female, on average 48 years old, with a mean body mass index of 36.5 and HbA_1c level of 9.4.

Overall, bariatric surgery patients lost an average of 27.2% in the first year, and regained around 8.2% from the first to fifth year, while sleeve gastrectomy lost and regained 25.1% and 9.4% respectively.

When comparing weight loss in the first year and HbA_1c levels, Dr. Zhou and her colleagues found a significant correlation for both bariatric surgery and sleeve gastrectomy patients (r +.34; P = .0006).

“It was interesting because when we graphically represented the weight changes in addition to the A_1c over time, we found that they actually correlated quite closely, but it was only when we did the statistical analysis on the numbers that we found that [in both groups] people who lost less weight had a higher A_1c at the 5-year mark,” said Dr. Zhou.

In the non–multivariable analysis, however, investigators found a more significant correlation between weight regain and HbA_1c levels in gastrectomy patients, however these findings changed when Dr. Zhou and her fellow investigators controlled for insulin use and baseline C-peptide.

In continuing studies, Dr. Zhou and her team will dive deeper into why these correlations exist, as right now they can only speculate.

Dr. Zhou reported no relevant financial disclosures.

[email protected]

SOURCE: Zhou K et al. AACE 18. Abstract 240-F.

BOSTON – Acute weight loss during the first year after bariatric surgery has a significant effect on hemoglobin A_1c level improvement at 5 years’ follow-up, according to a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

The data presented could help clinicians understand when and where to focus their efforts to help patients optimize weight loss in order to see the best long-term benefits of the procedure, according to presenter Keren Zhou, MD, an endocrinology fellow at the Cleveland Clinic.

“Clinicians need to really focus on that first year weight loss after bariatric surgery to try and optimize 5-year A_1c outcomes,” said Dr. Zhou. “It also answers another question people have been having, which is how much does weight regain after bariatric surgery really matter? What we’ve been able to show here is that weight regain didn’t look very correlated at all.”

Dr. Zhou and her colleagues developed the ancillary study using data from the STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently) trial, specifically looking at 96 patients: 49 who underwent bariatric surgery and 47 who had a sleeve gastrectomy.

Patients were majority female, on average 48 years old, with a mean body mass index of 36.5 and HbA_1c level of 9.4.

Overall, bariatric surgery patients lost an average of 27.2% in the first year, and regained around 8.2% from the first to fifth year, while sleeve gastrectomy lost and regained 25.1% and 9.4% respectively.

When comparing weight loss in the first year and HbA_1c levels, Dr. Zhou and her colleagues found a significant correlation for both bariatric surgery and sleeve gastrectomy patients (r +.34; P = .0006).

“It was interesting because when we graphically represented the weight changes in addition to the A_1c over time, we found that they actually correlated quite closely, but it was only when we did the statistical analysis on the numbers that we found that [in both groups] people who lost less weight had a higher A_1c at the 5-year mark,” said Dr. Zhou.

In the non–multivariable analysis, however, investigators found a more significant correlation between weight regain and HbA_1c levels in gastrectomy patients, however these findings changed when Dr. Zhou and her fellow investigators controlled for insulin use and baseline C-peptide.

In continuing studies, Dr. Zhou and her team will dive deeper into why these correlations exist, as right now they can only speculate.

Dr. Zhou reported no relevant financial disclosures.

[email protected]

SOURCE: Zhou K et al. AACE 18. Abstract 240-F.

BOSTON – Acute weight loss during the first year after bariatric surgery has a significant effect on hemoglobin A_1c level improvement at 5 years’ follow-up, according to a study presented at the annual meeting of the American Association of Clinical Endocrinologists.

The data presented could help clinicians understand when and where to focus their efforts to help patients optimize weight loss in order to see the best long-term benefits of the procedure, according to presenter Keren Zhou, MD, an endocrinology fellow at the Cleveland Clinic.

“Clinicians need to really focus on that first year weight loss after bariatric surgery to try and optimize 5-year A_1c outcomes,” said Dr. Zhou. “It also answers another question people have been having, which is how much does weight regain after bariatric surgery really matter? What we’ve been able to show here is that weight regain didn’t look very correlated at all.”

Dr. Zhou and her colleagues developed the ancillary study using data from the STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently) trial, specifically looking at 96 patients: 49 who underwent bariatric surgery and 47 who had a sleeve gastrectomy.

Patients were majority female, on average 48 years old, with a mean body mass index of 36.5 and HbA_1c level of 9.4.

Overall, bariatric surgery patients lost an average of 27.2% in the first year, and regained around 8.2% from the first to fifth year, while sleeve gastrectomy lost and regained 25.1% and 9.4% respectively.

When comparing weight loss in the first year and HbA_1c levels, Dr. Zhou and her colleagues found a significant correlation for both bariatric surgery and sleeve gastrectomy patients (r +.34; P = .0006).

“It was interesting because when we graphically represented the weight changes in addition to the A_1c over time, we found that they actually correlated quite closely, but it was only when we did the statistical analysis on the numbers that we found that [in both groups] people who lost less weight had a higher A_1c at the 5-year mark,” said Dr. Zhou.

In the non–multivariable analysis, however, investigators found a more significant correlation between weight regain and HbA_1c levels in gastrectomy patients, however these findings changed when Dr. Zhou and her fellow investigators controlled for insulin use and baseline C-peptide.

In continuing studies, Dr. Zhou and her team will dive deeper into why these correlations exist, as right now they can only speculate.

Dr. Zhou reported no relevant financial disclosures.

[email protected]

SOURCE: Zhou K et al. AACE 18. Abstract 240-F.