Latest Publications

Our faculty’s research is frequently accepted for inclusion in the most prestigious peer-reviewed scientific journals, with over 330 articles published in 2015 alone. Below you will find the most recent publications.

The abstracts below are updated daily. For a more complete list, please visit this PubMed link.

Hospital Quality Metrics for Radical Cystectomy: Disease-Specific and Correlated to Mortality Outcomes.

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Hospital Quality Metrics for Radical Cystectomy: Disease-Specific and Correlated to Mortality Outcomes.

J Urol. 2019 Apr 22;:101097JU0000000000000282

Authors: Khanna A, Saarela O, Lawson K, Finelli A, Haber GP, Lee B, Abouassaly R

BACKGROUND: Measuring quality is a high priority for healthcare systems globally. Despite high perioperative morbidity, mortality, expenditures, and performance variation for radical cystectomy (RC), there is a paucity of validated bladder cancer quality metrics. We aimed to create a hospital quality scoring system for RC that is disease-specific and associated with patient-centered outcomes.
METHODS: The National Cancer Database was used to identify hospitals performing RC from 2004-2014. Mixed effects models were used to assess variation in hospital performance across seven quality indicators (QIs). Indirect standardization was used to case-mix adjust hospital performance. Associations between QIs, as well as a novel composite hospital quality metric, the Bladder Cancer Quality Score (BC-QS), and 30-day, 90-day, and overall mortality were assessed using logistic and Cox regression, respectively.
RESULTS: From 2004-2014, 1200 facilities performed RC in 48,341 patients. Mixed effects models demonstrated significant between-hospital variation across all QIs after case-mix adjustment. The composite BC-QS metric was composed of hospital positive margin rate, lymph node dissection rate, and neoadjuvant chemotherapy rate. Better BC-QS performance was associated with lower 30-day, 90-day, and overall mortality (adjusted odds ratio [OR] 0.78 [0.64-0.96], OR 0.84 [0.72-0.97], hazard ratio 0.86 [0.81-0.92]). Higher BC-QS hospitals had higher volume and more academic affiliation than lower BC-QS hospitals (p<0.0001).
CONCLUSIONS: The BC-QS captures variations in hospital performance for RC and associates higher quality with lower patient mortality. Our validation of this quality metric provides support for its potential use by both policymakers and payers in efforts to measure hospital quality for high-cost surgeries.

PMID: 31009290 [PubMed - as supplied by publisher]

An Observational Study of Concomitant Use of Emerging Therapies and Denosumab or Zoledronic Acid in Prostate Cancer.

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An Observational Study of Concomitant Use of Emerging Therapies and Denosumab or Zoledronic Acid in Prostate Cancer.

Clin Ther. 2018 04;40(4):536-549.e3

Authors: Liede A, Wade S, Lethen J, Hernandez RK, Warner D, Abernethy AP, Finelli A

PURPOSE: This observational study of oncologic clinical practices was designed to describe real-world patterns of use of emerging therapies (abiraterone acetate, cabazitaxel, enzalutamide, radium-223, sipuleucel-T) in patients with castration-resistant prostate cancer and to characterize their concomitant use with denosumab or zoledronic acid.
METHODS: A retrospective cohort study was conducted using a database of electronic health records from oncology practices across the United States. Eligible patients had a diagnosis of prostate cancer (International Classification of Diseases, Ninth Revision [ICD-9] code 185/International Classification of Diseases, Tenth Revision [ICD-10] code C61) before or concurrent with a visit between January 1, 2013, and December 31, 2015; follow-up was performed through June 30, 2016. From this population, we identified those who received an emerging therapy and a subset who also received denosumab or zoledronic acid.
FINDINGS: A total of 71,606 men met the eligibility criteria, and 5131 (7%) received emerging therapy. In the emerging therapy cohort (at the time of the first use), median age was 75 years, median prostate-specific antigen value was 22.7 ng/mL, 56% had bone metastases, and 80% were docetaxel naive. Abiraterone and enzalutamide were the most commonly used first emerging therapies (52% and 31%, respectively), followed by sipuleucel-T (9%), cabazitaxel (5%), and radium-223 (1.5%). Of the emerging therapy cohort, 3121 patients (61%) received concomitant denosumab (70%) or zoledronic acid (35%); 5% received both.
IMPLICATIONS: Among patients with prostate cancer treated in the United States, most of those treated with an emerging therapy between 2013 and 2015 also received denosumab or zoledronic acid, suggesting that the concomitant use of these therapy types is currently a common practice. Use of denosumab or zoledronic acid was higher in patients with verified bone metastases.

PMID: 29395290 [PubMed - indexed for MEDLINE]