PURPOSE Acute diverticulitis is a disease with wide clinical spectrum, ranging from phlegmon (stage Ia), to localized abscesses (stages Ib and II), free perforation purulent III) or feculent peritonitis IV). While there little debate about the best treatment for mild episodes and/or very severe episodes, uncertainty persists optimal management intermediate stages (Ib II). The aim of our study was therefore define role computed tomography (CT) analyze its impact on acute diverticulitis....

We sought to characterize the effect of postoperative complications on long-term survival after colorectal cancer (CRC) resection.The impact early morbidity curative-intent CRC surgery remains controversial.The Veterans Affairs Surgical Quality Improvement Program and Central Cancer Registry databases were linked acquire perioperative cancer-specific data for 12,075 patients undergoing resection nonmetastatic (1999-2009). Patients categorized by presence any complication within 30 days type...

Racial, ethnic, and socioeconomic disparities in the survival of patients with hepatocellular carcinoma (HCC) continue to exist. The authors this report hypothesized that these differences result from inequities access care response therapy.Patients HCC (n = 20,920) were identified Surveillance, Epidemiology, End Results (SEER) database, who underwent liver transplantation for 4735) United Network Organ Sharing (UNOS) database. Clinical pathologic factors compared after stratified by race...

Pancreatic cancers of the body and tail (BT) appear to have poorer survival compared with head (HD) lesions. We hypothesized that potential disparities in outcome may be related tumor location. Our objective was examine relationship between location survival.The Surveillance, Epidemiology, End Results registry identified 33,752 patients pancreatic adenocarcinoma 6443 who underwent cancer-directed surgery 1988 2004. Differences relationships clinical factors were assessed. Multivariate...

Neoadjuvant therapy has been used to improve survival in operable pancreatic cancer. The authors' objective was compare long-term outcomes patients receiving neoadjuvant versus adjuvant for resectable adenocarcinoma.The California Cancer Surveillance Program Los Angeles County retrospectively identified 458 with nonmetastatic adenocarcinoma who underwent definitive resection and received systemic chemotherapy between 1987 2006. cohort grouped by timing of therapy-neoadjuvant or adjuvant....

PURPOSE: The primary goal of the Surgical Care Improvement Project is to improve quality care by implementing evidence-based health practices that prevent surgical complications. This study was designed test hypothesis an increase in compliance with process measures decreases rate site infections patients undergoing colorectal surgeries. METHODS: A multidisciplinary task force implemented and monitored individual elective resections at a tertiary institution. Individual rates were collected...

Objectives: The role of lymph node (LN) dissection for pancreatic cancer remains uncertain, and guidelines a minimum LN number have not been established. We hypothesized that in node-negative (N0) influences survival. Methods: Surveillance, Epidemiology, End Results database was queried patients undergoing resection N0 adenocarcinoma between 1988 2003. Lymph categorized as 1-10, 11-20, >20. Results: In cohort 1915 patients, the median 7 (range 1-57); 1365 (71%) had <11 LN. Survival...

Tumor board (TB) conferences facilitate multidisciplinary cancer care and are associated with overall improved outcomes. Because of shortages the oncology workforce limited access to TB conferences, is not available at every institution. This pilot study assessed feasibility acceptance using telemedicine implement a virtual (VTB) program within regional healthcare network.The VTB was implemented through videoconference technology electronic medical records between Houston (TX) Veterans...

In Brief Objective: Because appropriate rectal cancer care and subsequent outcomes can be influenced by several variables, our objective was to investigate how race, ethnicity, socioeconomic status (SES) may impact outcomes. Background: The management of requires a multidisciplinary approach utilizing medical surgical subspecialties. Methods: We performed an investigation patients with adenocarcinoma from Los Angeles County 1988 2006 using the Cancer Surveillance Program. Clinical pathologic...

The application of orthotopic liver transplantation (OLT) for patients with hepatocellular cancer (HCC) necessitates highly selective criteria to maximize survival and optimize allocation a scarce resource. objective this study was compare the outcomes OLT HCC in transplanted under Milan UCSF criteria. United Network Organ Sharing (UNOS) database queried who had undergone from 2002 2007, 1,972 (Milan criteria, n = 1, 913; 59) were identified. Patients stratified by pretransplant versus...

We previously detected CXCR4 expression in pancreatic intraepithelial neoplasia (PanIN) tissues and demonstrated CXCR4-enhanced proliferation of PanIN cells. Our objective was to determine if the targets AKT ERK mediate CXCR4-dependent cancer proliferation.We exposed cultured murine-derived PanIN, invasive (5143PDA) liver metastasis (5143LM) cells, human PANC-1 cells CXCL12, specific ligand, measured phosphorylation ERK1/2. The roles ERK1/2 cell were assessed by PI/3K-AKT small molecular...

An elevated serum α-fetoprotein (AFP) level before orthotopic liver transplant (OLT) is predictive of mortality after OLT for hepatocellular carcinoma (HCC).Retrospective analysis a population-based cohort.United Network Organ Sharing registry (2003-2008).We identified 2253 patients who underwent HCC with available pre-OLT AFP values.Patients were stratified by levels into low (<20 ng/mL), medium (20-399 or high (≥400 ng/mL) groups. Clinical and pathological characteristics compared among...

In Brief Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age impact on overall survival (OS). Background: TCNs represent additional burden for patients are associated higher short-term mortality. They not well-characterized in CRC patients, particularly the context of a growing elderly population, effect long-term is unknown. Methods: A retrospective cohort study (N = 486) having curative at tertiary referral...