Recent Publications by CFE Educators
Recent Published articles, books, and other scholarship by Academy members, CFE Education Scientists, and CFE Faculty.
On the Use and Value of Reporting Guidelines in Health Professions Education Research.
2020
Authors: O'Brien BC, West CP, Coverdale JH, Durning SJ, Roberts LW
Innovation Reports: Guidance From the Editors.
2020
Authors: Durning SJ, O'Brien BC, West CP, Coverdale J, DeVilbiss MB, Roberts LW
Evaluation of Adjuvant Chemotherapy in Patients With Resected Pancreatic Cancer After Neoadjuvant FOLFIRINOX Treatment.
2020
Authors: van Roessel S, van Veldhuisen E, Klompmaker S, Janssen QP, Abu Hilal M, Alseidi A, Balduzzi A, Balzano G, Bassi C, Berrevoet F, Bonds M, Busch OR, Butturini G, Del Chiaro M, Conlon KC, Falconi M, Frigerio I, Fusai GK, Gagnière J, Griffin O, Hackert T, Halimi A, Klaiber U, Labori KJ, Malleo G, Marino MV, Mortensen MB, Nikov A, Lesurtel M, Keck T, Kleeff J, Pandé R, Pfeiffer P, Pietrasz D, Roberts KJ, Sa Cunha A, Salvia R, Strobel O, Tarvainen T, Bossuyt PM, van Laarhoven HWM, Wilmink JW, Groot Koerkamp B, Besselink MG, European-African Hepato-Pancreato-Biliary Association
IMPORTANCE
The benefit of adjuvant chemotherapy after resection of pancreatic cancer following neoadjuvant combination treatment with folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) is unclear.
OBJECTIVE
To assess the association of adjuvant chemotherapy with overall survival (OS) in patients after pancreatic cancer resection and neoadjuvant FOLFIRINOX treatment.
DESIGN, SETTING, AND PARTICIPANTS
This international, multicenter, retrospective cohort study was conducted from January 1, 2012, to December 31, 2018. An existing cohort of patients undergoing resection of pancreatic cancer after FOLFIRINOX was updated and expanded for the purpose of this study. All consecutive patients who underwent pancreatic surgery after at least 2 cycles of neoadjuvant FOLFIRINOX chemotherapy for nonmetastatic pancreatic cancer were retrospectively identified from institutional databases. Patients with resectable pancreatic cancer, borderline resectable pancreatic cancer, and locally advanced pancreatic cancer were eligible for this study. Patients with in-hospital mortality or who died within 3 months after surgery were excluded.
EXPOSURES
The association of adjuvant chemotherapy with OS was evaluated in different subgroups including interaction terms for clinicopathological parameters with adjuvant treatment in a multivariable Cox model. Overall survival was defined as the time starting from surgery plus 3 months (moment eligible for adjuvant therapy), unless mentioned otherwise.
RESULTS
We included 520 patients (median [interquartile range] age, 61 [53-66] years; 279 [53.7%] men) from 31 centers in 19 countries. The median number of neoadjuvant cycles of FOLFIRINOX was 6 (interquartile range, 5-8). Overall, 343 patients (66.0%) received adjuvant chemotherapy, of whom 68 (19.8%) received FOLFIRINOX, 201 (58.6%) received gemcitabine-based chemotherapy, 14 (4.1%) received capecitabine, 45 (13.1%) received a combination or other agents, and 15 (4.4%) received an unknown type of adjuvant chemotherapy. Median OS was 38 months (95% CI, 36-46 months) after diagnosis and 31 months (95% CI, 29-37 months) after surgery. No survival difference was found for patients who received adjuvant chemotherapy vs those who did not (median OS, 29 vs 29 months, univariable hazard ratio [HR], 0.99; 95% CI, 0.77-1.28; P = .93). In multivariable analysis, only the interaction term for lymph node stage with adjuvant therapy was statistically significant: In patients with pathology-proven node-positive disease, adjuvant chemotherapy was associated with improved survival (median OS, 26 vs 13 months; multivariable HR, 0.41 [95% CI, 0.22-0.75]; P = .004). In patients with node-negative disease, adjuvant chemotherapy was not associated with improved survival (median OS, 38 vs 54 months; multivariable HR, 0.85; 95% CI, 0.35-2.10; P = .73).
CONCLUSIONS AND RELEVANCE
These results suggest that adjuvant chemotherapy after neoadjuvant FOLFIRINOX and resection of pancreatic cancer was associated with improved survival only in patients with pathology-proven node-positive disease. Future randomized studies should be conducted to confirm this finding.
View on PubMedOn Treatments and Tests Deferred: Preparing for Collateral Damage from COVID-19.
2020
Authors: Jain S, Santhosh L
Shared Mental Models Among Clinical Competency Committees in the Context of Time-Variable, Competency-Based Advancement to Residency.
2020
Authors: Schwartz A, Balmer DF, Borman-Shoap E, Chin A, Henry D, Herman BE, Hobday P, Lee JH, Multerer S, Myers RE, Ponitz K, Rosenberg A, Soep JB, West DC, Englander R
Portal venous gas and hepatic cyst infection with Clostridium perfringens.
2020
Authors: Joseph A. Lin, Cecilia J. Im, Zachary C. Dietch, Carter C. Lebares
Improving Pediatric Readiness in General Emergency Departments: A Prospective Interventional Study.
2020
Authors: Abulebda K, Whitfill T, Montgomery EE, Thomas A, Dudas RA, Leung JS, Scherzer DJ, Aebersold M, Van Ittersum WL, Kant S, Walls TA, Sessa AK, Janofsky S, Fenster DB, Kessler DO, Chatfield J, Okada P, Arteaga GM, Berg MD, Knight LJ, Keilman A, Makharashvili A, Good G, Bingham L, Mathias EJ, Nagy K, Hamilton MF, Vora S, Mathias K, Auerbach MA, Improving Pediatric Acute Care through Simulation (ImPACTS)
Response to Letter to Editor: "Development and Validation of a Male Anterior Urethral Stricture Classification System".
2020
Authors: Erickson BA, Flynn KJ, Hahn AE, Cotter K, Alsikafi NF, Breyer BN, Broghammer JA, Buckley JC, Elliott SP, Myers JB, Peterson AC, Rourke KF, Smith TG, Vanni AJ, Voelzke BB, Zhao LC, Trauma and Urologic Reconstruction Network of Surgeons (TURNS)
Clinical and Radiographic Factors Associated With Failed Renal Angioembolization: Results From the Multi-institutional Genitourinary Trauma Study (Mi-GUTS).
2020
Authors: Armas-Phan M, Keihani S, Agochukwu-Mmonu N, Cohen AJ, Rogers DM, Wang SS, Gross JA, Joyce RP, Hagedorn JC, Voelzke B, Moses RA, Sensenig RL, Selph JP, Gupta S, Baradaran N, Erickson BA, Schwartz I, Elliott SP, Mukherjee K, Smith BP, Santucci RA, Burks FN, Dodgion CM, Carrick MM, Askari R, Majercik S, Nirula R, Myers JB, Breyer BN
OBJECTIVE
To find clinical or radiographic factors that are associated with angioembolization failure after high-grade renal trauma.
MATERIAL AND METHODS
Patients were selected from the Multi-institutional Genito-Urinary Trauma Study. Included were patients who initially received renal angioembolization after high-grade renal trauma (AAST grades III-V). This cohort was dichotomized into successful or failed angioembolization. Angioembolization was considered a failure if angioembolization was followed by repeat angiography and/or an exploratory laparotomy.
RESULTS
A total of 67 patients underwent management initially with angioembolization, with failure in 18 (27%) patients. Those with failed angioembolization had a larger proportion ofgrade IV (72% vs 53%) and grade V (22% vs 12%) renal injuries. A total of 53 patients underwent renal angioembolization and had initial radiographic data for review, with failure in 13 cases. The failed renal angioembolization group had larger perirenal hematoma sizes on the initial trauma scan.
CONCLUSION
Angioembolization after high-grade renal trauma failed in 27% of patients. Failed angioembolization was associated with higher injury grade and a larger perirenal hematoma. Likely these characteristics are associated with high-grade renal trauma that may be less amenable to successful treatment after a single renal angioembolization.
View on PubMed