Swapnil D. Kachare

Radiotherapy associated with improved survival for high-grade sarcoma of the extremity

The impact of radiotherapy on local control in limb‐preserving surgery for high‐risk sarcoma has been well studied. However, the impact of the use and timing of radiation therapy on survival is unclear.

Assessment of health care cost for complex surgical patients: review of cost, re-imbursement and revenue involved in pancreatic surgery at a high-volume academic medical centre

BACKGROUND Pancreatic surgery is complex with the potential for costly hospitalization. METHODS A retrospective review of patients undergoing a pancreatic resection was performed. RESULTS The median age of the study population was 64 years. Half of the cohort was female (51%), and the majority were white (62%). Most patients underwent a pancreaticoduodenectomy (PD) (69%). The pre-operative age-adjusted Charlson comorbidity index was zero for 36% (n = 50), 1 for 31% (n = 43) and ≥2 for 33% (n = 45). The Clavien-Dindo grading system for post-operative complication was grade I in 17% (n = 24), whereas 45% (n = 62) were higher grades. The medians direct fixed, direct variable, fixed indirect and total costs were

Quantifying the Twitter Influence of Third Party Commercial Entities versus Healthcare Providers in Thirteen Medical Conferences from 2011 – 2013

2476,

Impact of Primary Tumor Surgery in Stage IV Male Breast Cancer

15,397,

Primary tumor resection in metastatic breast cancer: A propensity‐matched analysis, 1988‐2011 SEER data base

13,207 and

Maggot Therapy for Elephantiasis Nostras Verrucosa Reveals New Applications and New Complications: A Case Report

31,631, respectively. There was a positive contribution margin of

Abstract P2-13-26: Trend in primary tumor resection and disease specific survival in patients with metastatic breast cancer: A SEER database analysis (1988-2011)

7108, whereas the net margin was a loss of

Abstract P6-15-01: A comparative analysis of primary tumor resection in men and women with stage IV breast cancer

6790. On univariate analyses, age, type of operation and complication grade were associated with total cost (P ≤ 0.05), whereas operation type and complication grade were associated with a net margin (P = 0.01). These findings remained significant on multivariate analysis (P < 0.05). CONCLUSIONS Increased cost, reimbursement and revenue were associated with type of operation and post-operative complications.

Abstract P2-01-12: Impact of the ASOCOG Z0011 trial on a multi-institutional mixed practice setting

Introduction Twitter channels are increasingly popular at medical conferences. Many groups, including healthcare providers and third party entities (e.g., pharmaceutical or medical device companies) use these channels to communicate with one another. These channels are unregulated and can allow third party commercial entities to exert an equal or greater amount of Twitter influence than healthcare providers. Third parties can use this influence to promote their products or services instead of sharing unbiased, evidence-based information. In this investigation we quantified the Twitter influence that third party commercial entities had in 13 major medical conferences. Methods We analyzed tweets contained in the official Twitter hashtags of thirteen medical conferences from 2011 to 2013. We placed tweet authors into one of four categories based on their account profile: healthcare provider, third party commercial entity, none of the above and unknown. We measured Twitter activity by the number of tweet authors per category and the tweet-to-author ratio by category. We measured Twitter influence by the PageRank of tweet authors by category. Results We analyzed 51159 tweets authored by 8778 Twitter account holders in 13 conferences that were sponsored by 5 medical societies. A quarter of all authors identified themselves as healthcare providers, while only 18% could be identified as third party commercial entities. Healthcare providers had a greater tweet-to-author ratio than their third party commercial entity counterparts (8.98 versus 6.93 tweets). Despite having less authors and composing less tweets, third party commercial entities had a statistically similar PageRank as healthcare providers (0.761 versus 0.797). Conclusion The Twitter influence of third party commercial entities (PageRank) is similar to that of healthcare providers. This finding is interesting because the number of tweets and third party commercial entity authors required to achieve this PageRank is far fewer than that needed by healthcare providers. Without safety mechanisms in place, the Twitter channels of medical conferences can devolve into a venue for the spread of biased information rather than evidence-based medical knowledge that is expected at live conferences. Continuing to measure the Twitter influence that third parties exert can help conference organizers develop reasonable guidelines for Twitter channel activity.

Abstract LB-321: Combination dendritic cell and conventional chemoradiation therapy improves survival for rectal cancer in a murine model.

Background: Primary tumor surgery (PTS) is not a standard treatment modality in stage IV breast cancer. Retrospective studies in female breast cancer show improved survival in women undergoing PTS; however, data regarding the impact of surgery in male breast cancer are lacking. The objective of this study was to analyze the impact of PTS on survival among men with metastatic breast cancer. Methods: A retrospective study was conducted of men diagnosed with metastatic breast cancer at diagnosis were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2011. Cox proportional hazards regression models were used to compare the differences in survival in men who did and did not undergo PTS. Results: A total of 439 men with stage IV breast cancer at diagnosis were identified, of which 222 (51%) underwent PTS, 171 (77%) mastectomy, and 51 (23%) partial mastectomy. The median age was 65 years; 74% of participants were white, 51% had tumors ≤ T2, 65% had estrogen receptor (ER)‐positive tumor, and 24% had unknown ER status. Univariate analysis between the surgery and no‐surgery arms showed that white race (P = .04), lower T stage and grade (P = .0003, P = .004), ER positivity (P = .0002), and later year of diagnosis (P < .0001) were associated with better survival. PTS was associated with improvement in median overall survival (29 vs. 11 months, P < .0001). On Cox regression analysis, ER negativity (hazard ratio = 2.08; 95% confidence interval, 1.41–3.01; P < .0003) and not undergoing PTS were associated with diminished survival (hazard ratio = 1.81; 95% confidence interval, 1.42–2.31; P < .0001). Conclusion: PTS among men with metastatic breast cancer was associated with improved survival in this retrospective analysis. Micro‐Abstract: A Surveillance, Epidemiology, and End Results (SEER) database study demonstrated improvement in survival after primary tumor surgery in stage IV male breast cancer.