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Paul Joseph Mosca

Associate Professor of Surgery
Surgical Oncology
3966, 10 Bryan Searle Dr, 466G Seeley G Mudd, Durham, NC 27710
615 Douglas Street, Ste. 602, Durham, NC 27705

Selected Publications


The Sloop family: Addressing rural health disparities through service and education.

Journal Article J Med Biogr · February 2024 Dr Mary T. Martin Sloop and Dr Eustace Henry Sloop shaped the landscape of healthcare and education for the small town of Crossnore in the mountains of Western North Carolina throughout the early- to mid-twentieth century. The duo of general practitioners ... Full text Link to item Cite

Racial disparities in time to laparoscopic cholecystectomy for acute cholecystitis.

Journal Article Am J Surg · August 2023 BACKGROUND: Disparities in healthcare exist, yet few data are available on racial differences in time from admission to surgery. This study aimed to compare time from admission to laparoscopic cholecystectomy for acute cholecystitis between non-Hispanic Bl ... Full text Link to item Cite

Data from Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma

Other · March 31, 2023 <div>AbstractPurpose:<p>In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanom ... Full text Cite

Data from Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma

Other · March 31, 2023 <div>AbstractPurpose:<p>In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanom ... Full text Cite

A new look at an old well-being construct: evaluating the psychometric properties of 9, 5, and 1-item versions of emotional exhaustion metrics.

Journal Article Front Psychol · 2023 OBJECTIVE: To compare the relative strengths (psychometric and convergent validity) of four emotional exhaustion (EE) measures: 9- and 5-item scales and two 1-item metrics. PATIENTS AND METHODS: This was a national cross-sectional survey study of 1409 US p ... Full text Link to item Cite

Examining the role of wide excision margins in pediatric melanoma: A National Cancer Database analysis.

Journal Article Pediatr Blood Cancer · November 2022 BACKGROUND: Although adult guidelines are often applied to children, age-specific surgical margins have not been defined for pediatric melanoma. PROCEDURE: Patients <20 years of age with invasive, cutaneous melanoma were identified using the 2004-2016 N ... Full text Link to item Cite

Racial Disparities in Surgery for Malignant Bowel Obstruction.

Journal Article Ann Surg Oncol · May 2022 BACKGROUND: Operative management of patients with malignant bowel obstruction (MBO) may provide effective palliation, but is associated with substantial risks. This study aimed to analyze racial and ethnic differences in surgical outcomes for patients with ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Greater Compliance With Early Sepsis Management is Associated With Safer Care and Shorter Hospital Stay.

Journal Article J Healthc Qual · November 2021 This retrospective, cross-sectional study of U.S. hospitals in Medicare's Inpatient Quality Reporting Program aimed to determine whether variation in Sepsis/Septic Shock (Bundle SEP-1) compliance is linked to hospital size and measures of safety and operat ... Full text Link to item Cite

Characterization of Sentinel Lymph Node Immune Signatures and Implications for Risk Stratification for Adjuvant Therapy in Melanoma.

Journal Article Annals of surgical oncology · July 2021 BackgroundAlthough sentinel lymph node (SLN) biopsy is a standard procedure used to identify patients at risk for melanoma recurrence, it fails to risk-stratify certain patients accurately. Because processes in SLNs regulate anti-tumor immune resp ... Full text Cite

Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma.

Journal Article Clin Cancer Res · March 1, 2021 PURPOSE: In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanoma. PATIENTS AND METHODS: Twenty-fou ... Full text Link to item Cite

The Legacy of Joseph A. Moylan, M.D.: "It's About Everyone Else".

Journal Article Ann Surg Open · March 2021 The history of modern American surgery is marked by larger-than-life pioneers who have made transformative contributions to our field. These extraordinary individuals have been known primarily for their technical and clinical mastery, development of novel ... Full text Link to item Cite

Oncologic Outcomes After Isolated Limb Infusion for Advanced Melanoma: An International Comparison of the Procedure and Outcomes Between the United States and Australia.

Journal Article Ann Surg Oncol · December 2020 BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-dose chemotherapy to extremities affected by locally advanced or in-transit melanoma. This study compared the outcomes of melanoma patients treated with ILI in t ... Full text Link to item Cite

The utility of initial staging PET-CT as a baseline scan for surveillance imaging in stage II and III melanoma.

Journal Article Surg Oncol · December 2020 BACKGROUND: This study evaluates the utility of whole-body PET-CT for the initial staging and subsequent surveillance imaging of patients with completely resected stage II and stage III melanoma. METHODS: A single-center, retrospective review of patients w ... Full text Link to item Cite

The Sloop family: Addressing rural health disparities through service and education.

Journal Article J Med Biogr · February 2024 Dr Mary T. Martin Sloop and Dr Eustace Henry Sloop shaped the landscape of healthcare and education for the small town of Crossnore in the mountains of Western North Carolina throughout the early- to mid-twentieth century. The duo of general practitioners ... Full text Link to item Cite

Racial disparities in time to laparoscopic cholecystectomy for acute cholecystitis.

Journal Article Am J Surg · August 2023 BACKGROUND: Disparities in healthcare exist, yet few data are available on racial differences in time from admission to surgery. This study aimed to compare time from admission to laparoscopic cholecystectomy for acute cholecystitis between non-Hispanic Bl ... Full text Link to item Cite

Data from Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma

Other · March 31, 2023 <div>AbstractPurpose:<p>In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanom ... Full text Cite

Data from Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma

Other · March 31, 2023 <div>AbstractPurpose:<p>In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanom ... Full text Cite

A new look at an old well-being construct: evaluating the psychometric properties of 9, 5, and 1-item versions of emotional exhaustion metrics.

Journal Article Front Psychol · 2023 OBJECTIVE: To compare the relative strengths (psychometric and convergent validity) of four emotional exhaustion (EE) measures: 9- and 5-item scales and two 1-item metrics. PATIENTS AND METHODS: This was a national cross-sectional survey study of 1409 US p ... Full text Link to item Cite

Examining the role of wide excision margins in pediatric melanoma: A National Cancer Database analysis.

Journal Article Pediatr Blood Cancer · November 2022 BACKGROUND: Although adult guidelines are often applied to children, age-specific surgical margins have not been defined for pediatric melanoma. PROCEDURE: Patients <20 years of age with invasive, cutaneous melanoma were identified using the 2004-2016 N ... Full text Link to item Cite

Racial Disparities in Surgery for Malignant Bowel Obstruction.

Journal Article Ann Surg Oncol · May 2022 BACKGROUND: Operative management of patients with malignant bowel obstruction (MBO) may provide effective palliation, but is associated with substantial risks. This study aimed to analyze racial and ethnic differences in surgical outcomes for patients with ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Greater Compliance With Early Sepsis Management is Associated With Safer Care and Shorter Hospital Stay.

Journal Article J Healthc Qual · November 2021 This retrospective, cross-sectional study of U.S. hospitals in Medicare's Inpatient Quality Reporting Program aimed to determine whether variation in Sepsis/Septic Shock (Bundle SEP-1) compliance is linked to hospital size and measures of safety and operat ... Full text Link to item Cite

Characterization of Sentinel Lymph Node Immune Signatures and Implications for Risk Stratification for Adjuvant Therapy in Melanoma.

Journal Article Annals of surgical oncology · July 2021 BackgroundAlthough sentinel lymph node (SLN) biopsy is a standard procedure used to identify patients at risk for melanoma recurrence, it fails to risk-stratify certain patients accurately. Because processes in SLNs regulate anti-tumor immune resp ... Full text Cite

Ipilimumab and Radiation in Patients with High-risk Resected or Regionally Advanced Melanoma.

Journal Article Clin Cancer Res · March 1, 2021 PURPOSE: In this prospective trial, we sought to assess the feasibility of concurrent administration of ipilimumab and radiation as adjuvant, neoadjuvant, or definitive therapy in patients with regionally advanced melanoma. PATIENTS AND METHODS: Twenty-fou ... Full text Link to item Cite

The Legacy of Joseph A. Moylan, M.D.: "It's About Everyone Else".

Journal Article Ann Surg Open · March 2021 The history of modern American surgery is marked by larger-than-life pioneers who have made transformative contributions to our field. These extraordinary individuals have been known primarily for their technical and clinical mastery, development of novel ... Full text Link to item Cite

Oncologic Outcomes After Isolated Limb Infusion for Advanced Melanoma: An International Comparison of the Procedure and Outcomes Between the United States and Australia.

Journal Article Ann Surg Oncol · December 2020 BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-dose chemotherapy to extremities affected by locally advanced or in-transit melanoma. This study compared the outcomes of melanoma patients treated with ILI in t ... Full text Link to item Cite

The utility of initial staging PET-CT as a baseline scan for surveillance imaging in stage II and III melanoma.

Journal Article Surg Oncol · December 2020 BACKGROUND: This study evaluates the utility of whole-body PET-CT for the initial staging and subsequent surveillance imaging of patients with completely resected stage II and stage III melanoma. METHODS: A single-center, retrospective review of patients w ... Full text Link to item Cite

Relationship Between HCAHPS Scores and Survey Response Rate Is Linked to Hospital Size.

Journal Article J Patient Exp · December 2020 Patient experience is an important dimension of health care quality and is assessed using the standard Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for inpatients. The HCAHPS scores may vary based on survey response rate ... Full text Link to item Cite

Factors predicting toxicity and response following isolated limb infusion for melanoma: An international multi-centre study.

Conference Eur J Surg Oncol · November 2020 INTRODUCTION: Isolated limb infusion (ILI) is a minimally-invasive procedure for delivering high-dose regional chemotherapy to treat melanoma in-transit metastases confined to a limb. The aim of this international multi-centre study was to identify predict ... Full text Link to item Cite

Retreatment with talimogene laherparepvec for advanced melanoma.

Journal Article Immunotherapy · November 2020 Aim: Talimogene laherparepvec (T-VEC) is a genetically modified oncolytic herpesvirus approved for the treatment of unresectable, locoregionally advanced and recurrent melanoma. There is little relevant literature in the context of retreatment with T-VEC. ... Full text Link to item Cite

Higher BMI, But Not Sarcopenia, Is Associated With Pembrolizumab-related Toxicity in Patients With Advanced Melanoma.

Journal Article Anticancer Res · September 2020 BACKGROUND/AIM: To determine whether BMI and sarcopenia were related to treatment-limiting toxicity or efficacy of pembrolizumab treatment in melanoma patients. PATIENTS AND METHODS: Medical records for melanoma patients undergoing pembrolizumab treatment ... Full text Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers.

Journal Article J Med Internet Res · May 14, 2020 BACKGROUND: Emotional exhaustion (EE) in health care workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed. OBJECTIVE: This randomized single-exposure trial examined the efficacy of ... Full text Open Access Link to item Cite

International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients.

Journal Article Ann Surg Oncol · May 2020 BACKGROUND: Isolated limb infusion (ILI) is used to treat in-transit melanoma metastases confined to an extremity. However, little is known about its safety and efficacy in octogenarians and nonagenarians (ON). PATIENTS AND METHODS: ON patients (≥ 80 years ... Full text Link to item Cite

Type of Organ Transplanted Impacts the Risk and Presentation of Cutaneous Squamous Cell Carcinoma in Transplant Recipients.

Journal Article Exp Clin Transplant · February 2020 OBJECTIVES: Transplant immunosuppression increases the risk of cutaneous squamous cell carcinoma by 65- to 200-fold. Our objective was to investigate the impact of the type of organ transplanted on the risk and presentation of cutaneous squamous cell carci ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Efficacy of Talimogene Laherparepvec (T-VEC) Therapy in Patients with In-Transit Melanoma Metastasis Decreases with Increasing Lesion Size.

Conference Ann Surg Oncol · December 2019 BACKGROUND: Talimogene laherparepvec (T-VEC) is the first injectable oncolytic viral therapy approved for in-transit melanoma metastasis, with a reported overall response rate (ORR) of 25% and complete response rate (CRR) of 10%. To ascertain the role of p ... Full text Link to item Cite

Correction to: Sentinel Lymph Node Biopsy and Completion Lymph Node Dissection for Melanoma.

Journal Article Curr Treat Options Oncol · August 29, 2019 The original version of this article, which published in Current Treatment Options in Oncology, Volume 19, Issue 11, November 2018, contained an error within the Conflict of Interest statements. It was originally stated that "Norma E. Farrow received suppo ... Full text Link to item Cite

Long-Term Oncologic Outcomes After Isolated Limb Infusion for Locoregionally Metastatic Melanoma: An International Multicenter Analysis.

Conference Ann Surg Oncol · August 2019 BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive procedure for delivering high-dose regional chemotherapy to patients with locally advanced or in-transit melanoma located on a limb. The current international multicenter study evaluated the ... Full text Link to item Cite

Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers (Preprint)

Journal Article · July 19, 2019 BACKGROUNDEmotional exhaustion (EE) in health care workers is common and consequentially linked to lower quality of care. Effective interventions to address EE are urgently needed. ... Full text Open Access Cite

The impact of transplant rejection on cutaneous squamous cell carcinoma in renal transplant recipients.

Journal Article Clin Exp Dermatol · April 2019 BACKGROUND: The incidence of cutaneous squamous cell carcinoma (cSCC) is markedly increased in renal transplant recipients compared with that of the nontransplant population. AIM: To investigate whether there is a relationship between transplant rejection ... Full text Link to item Cite

Updates in adjuvant systemic therapy for melanoma.

Journal Article J Surg Oncol · January 2019 There has been a rapid increase in adjuvant therapies approved for treatment following surgical resection of stages III/IV melanoma. We review current indications for adjuvant therapy, which currently includes a heterogenous group of stages III and IV pati ... Full text Link to item Cite

The Improvement Readiness scale of the SCORE survey: a metric to assess capacity for quality improvement in healthcare.

Journal Article BMC Health Serv Res · December 17, 2018 BACKGROUND: Quality improvement efforts are inextricably linked to the readiness of healthcare workers to take them on. The current study aims to clarify the nature and measurement of Improvement Readiness (IR) by 1) examining the psychometric properties o ... Full text Open Access Link to item Cite

Outcomes of patients with a pretransplant history of early-stage melanoma.

Journal Article Melanoma Res · October 2018 A history of melanoma within the preceding 5 years is commonly considered a contraindication to solid organ transplantation. We investigated how a pretransplant history of melanoma impacts patient survival and melanoma recurrence. Institutional Review Boar ... Full text Link to item Cite

Sentinel Lymph Node Biopsy and Completion Lymph Node Dissection for Melanoma.

Journal Article Curr Treat Options Oncol · September 19, 2018 This review critically evaluates recent trials which have challenged the practice of completion lymph node dissection (CLND) for melanoma patients diagnosed with regional metastasis by positive sentinel lymph node biopsy (SLNB). Two trials in the last 2 ye ... Full text Link to item Cite

Examining the incidence and presentation of melanoma in thoracic transplant patients

Conference JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY · September 1, 2018 Link to item Cite

Does the number of sentinel lymph nodes removed affect the false negative rate for head and neck melanoma?

Journal Article J Surg Oncol · June 2018 BACKGROUND AND OBJECTIVES: Head and neck (HN) cutaneous melanoma is associated with worse disease-free survival compared to non-HN cutaneous melanoma, possibly due to inadequate staging. We aim to determine if a higher yield of sentinel lymph nodes (SLNs) ... Full text Link to item Cite

Timing and Number of Cutaneous Squamous Cell Carcinomas in Transplant Recipients.

Journal Article JAMA Dermatol · June 1, 2018 This cohort study of 3652 recipients of solid organ transplants examines the timing and number of cutaneous squamous cell carcinomas that developed after transplantation. ... Full text Link to item Cite

Examining the Incidence and Presentation of Melanoma in the Cardiothoracic Transplant Population.

Journal Article JAMA Dermatol · May 1, 2018 IMPORTANCE: The immunosuppression vital to maintaining transplanted organs comes with an increased incidence of cutaneous neoplasms. Understanding the genesis of malignant melanoma (MM) in transplant subpopulations is necessary for adequate disease surveil ... Full text Link to item Cite

Correction to: The changing landscape of dermatology practice: melanoma and pump-probe laser microscopy.

Journal Article Lasers Med Sci · December 2017 The published online version contains mistake. Warren S. Warren was not included in the author group section. Corrected author group section is shown above. ... Full text Link to item Cite

The changing landscape of dermatology practice: melanoma and pump-probe laser microscopy.

Journal Article Lasers Med Sci · November 2017 To present current melanoma diagnosis, staging, prognosis, and treatment algorithms and how recent advances in laser pump-probe microscopy will fill in the gaps in our clinical understanding. Expert opinion and significantly cited articles identified in SC ... Full text Link to item Cite

Management of a cutaneous squamous cell carcinoma overlying an AV fistula.

Journal Article BMJ Case Rep · May 6, 2017 Cutaneous squamous cell carcinoma (cSCC) currently affects over 700 000 patients per year in the USA alone, and its incidence continues to rise in recent years. A known risk factor for cSCC is chronic inflammation; a cSCC that develops at a site of chronic ... Full text Link to item Cite

Clinical Acuity Shorthand System: a standardized classification tool to facilitate handoffs.

Journal Article J Surg Res · May 1, 2017 BACKGROUND: The handoff of medical information from one provider to another can be inefficient and error prone, potentially undermining patient safety. Although several tools for structuring handoffs exist, none provide a brief, standardized framework for ... Full text Link to item Cite

Isolated Limb Infusion as a Limb Salvage Strategy for Locally Advanced Extremity Sarcoma.

Journal Article J Am Coll Surg · April 2017 BACKGROUND: Treatment-resistant, locally advanced soft tissue sarcomas often require amputation for complete tumor extirpation. Isolated limb infusion (ILI) selectively delivers high-dose chemotherapy to the extremity in an attempt to achieve limb salvage. ... Full text Link to item Cite

A multidisciplinary approach to toxicity management of modern immune checkpoint inhibitors in cancer therapy.

Journal Article Melanoma Res · October 2016 Immune-related Adverse Events (irAEs) are the most significant toxicities associated with the use of checkpoint inhibitors, and result from disinhibition of the host's immune homeostasis. The adverse effects experienced from immunotherapy are significantly ... Full text Link to item Cite

Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma.

Journal Article J Pediatr Surg · June 2016 Featured Publication BACKGROUND/PURPOSE: Sentinel lymph node biopsy (SLNB)-based management has been shown to improve disease-free survival in adult melanoma, but there is scant evidence regarding the utility of SLNB in pediatric melanoma. METHODS: The 2004-2011 Surveillance, ... Full text Link to item Cite

Computed Tomography-Based Limb Volume Measurements for Isolated Limb Infusion in Melanoma.

Journal Article Ann Surg Oncol · April 2016 Featured Publication BACKGROUND: Despite advances in cross-sectional imaging, chemotherapeutic dosing for isolated limb infusion (ILI) in melanoma is currently calculated through cumbersome and potentially imprecise manual measurements. The primary objective of this study was ... Full text Link to item Cite

A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer.

Journal Article Sci Transl Med · January 6, 2016 Featured Publication Local recurrence is a common cause of treatment failure for patients with solid tumors. Intraoperative detection of microscopic residual cancer in the tumor bed could be used to decrease the risk of a positive surgical margin, reduce rates of reexcision, a ... Full text Link to item Cite

Nanotechnology-based strategies for combating toxicity and resistance in melanoma therapy.

Journal Article Biotechnol Adv · 2016 Featured Publication Drug toxicity and resistance remain formidable challenges in cancer treatment and represent an area of increasing attention in the case of melanoma. Nanotechnology represents a paradigm-shifting field with the potential to mitigate drug resistance while im ... Full text Link to item Cite

Abstract SY36-03: Intraoperative molecular imaging with protease-activated fluorescent imaging agents

Conference Cancer Research · August 1, 2015 AbstractIntra-operative detection of residual cancer in the tumor bed can be used to decrease the risk of a positive surgical margin, reduce the rate of re-excision, and tailor adjuvant therapy. LUM015 is a ... Full text Cite

Sentinel lymph node biopsy following a rotational flap.

Journal Article BMJ Case Rep · July 14, 2015 Featured Publication Sentinel lymph node biopsy (SLNB) is a critical component of melanoma management. Extensive prior surgery at the site of a primary melanoma is considered a relative contraindication for SLNB. While evidence suggests that SLNB may be performed accurately ev ... Full text Link to item Cite

A multicenter phase I dose escalation trial to evaluate safety and tolerability of intra-arterial temozolomide for patients with advanced extremity melanoma using normothermic isolated limb infusion.

Conference Ann Surg Oncol · January 2015 Featured Publication BACKGROUND: L-phenylalanine mustard (LPAM) has been the standard for use in regional chemotherapy (RC) for unresectable in-transit melanoma. Preclinical data demonstrated that regional temozolomide (TMZ) may be more effective. METHODS: Patients with AJCC S ... Full text Link to item Cite

Rhabdomyosarcomatous Transformation of a Gastrointestinal Stromal Tumor following Treatment with Imatinib.

Journal Article Case Rep Oncol Med · 2015 Featured Publication Rhabdomyosarcomatous dedifferentiation of GIST following tyrosine kinase inhibitor (TKI) therapy is rare, with only a handful of cases previously reported in the literature. Herein we present a case of metastatic GIST initially treated with imatinib that d ... Full text Link to item Cite

Defining the learning curve for team-based laparoscopic pancreaticoduodenectomy.

Conference Ann Surg Oncol · November 2014 Featured Publication BACKGROUND: The purpose of this study was to define the learning curves for laparoscopic pancreaticoduodenectomy (LPD) with and without laparoscopic reconstruction, using paired surgical teams consisting of advanced laparoscopic-trained surgeons and advanc ... Full text Link to item Cite

Surgical interventions in cancer patients at the end of life: Experiences at an academic medical center.

Journal Article J Clin Oncol · October 20, 2014 281 Background: Surgical quality measures look to reduce variation and improve outcomes. Procedure goals can range from cure to symptom improvement. Knowledge of procedures used in this population can inform quality metrics, ensure palliation is included a ... Full text Link to item Cite

Immunotherapy Following Disease Progression after Regional Treatment of Melanoma

Journal Article Journal of Surgical Research · February 2014 Featured Publication Full text Cite

Melanoma immunotherapy using mature DCs expressing the constitutive proteasome.

Journal Article J Clin Invest · July 2013 Featured Publication BACKGROUND: Many cancers, including melanoma, exclusively express constitutive proteasomes (cPs) and are unable to express immunoproteasomes (iPs). In contrast, mature DCs used for immunotherapy exclusively express iPs. Since proteasomes generate peptides ... Full text Link to item Cite

Plasma cytokine analysis in patients with advanced extremity melanoma undergoing isolated limb infusion.

Journal Article Ann Surg Oncol · April 2013 Featured Publication BACKGROUND: Preprocedure clinical and pathologic factors have failed to consistently differentiate complete response (CR) from progressive disease (PD) in patients after isolated limb infusion (ILI) with melphalan for unresectable in-transit extremity mela ... Full text Link to item Cite

Integration of Palliative Surgery into the Palliative Care Delivery Team

Journal Article Journal of Palliative Care & Medicine · 2013 Featured Publication Full text Cite

A multi-institution experience comparing the clinical and physiologic differences between upper extremity and lower extremity melphalan-based isolated limb infusion.

Journal Article Cancer · December 15, 2012 Featured Publication BACKGROUND: Although studies of melphalan-based isolated limb infusion (ILI) combine data from upper extremity (UE) treatments with those from lower extremity (LE) treatments, differences between the 2 may be clinically important. METHODS: Candidates for U ... Full text Link to item Cite

Surgery and the D-Word: Approaching the Topic of Death and Dying with Surgical Patients

Journal Article Journal of Palliative Care & Medicine · March 1, 2012 Featured Publication Full text Cite

Overview of Palliative Surgery: Principles and Priorities

Journal Article Journal of Palliative Care & Medicine · 2012 Featured Publication Full text Cite

Circulating tumor cells in melanoma patients.

Journal Article PLoS One · 2012 Featured Publication Circulating tumor cells (CTCs) are of recognized importance for diagnosis and prognosis of cancer patients. With melanoma, most studies do not show any clear relationship between CTC levels and stage of disease. Here, CTCs were enriched (∼400X) from blood ... Full text Link to item Cite

The Akt signaling pathway: an emerging therapeutic target in malignant melanoma.

Journal Article Cancer Biol Ther · December 15, 2011 Featured Publication Studies using cultured melanoma cells and patient tumor biopsies have demonstrated deregulated PI3 kinase-Akt3 pathway activity in ~70% of melanomas. Furthermore, targeting Akt3 and downstream PRAS40 has been shown to inhibit melanoma tumor development in ... Full text Link to item Cite

When a chance to cut is not a chance to cure: a future for palliative surgery?

Other Ann Surg Oncol · November 2011 Featured Publication In the context of healthcare reform, Surgery stands at a critical juncture. Attempting to rein in healthcare spending, legislators and payers can be expected to closely examine the legitimacy and necessity of a variety of medical treatments, including surg ... Full text Link to item Cite

Steroid hormones drive cancer development.

Other Cancer Biol Ther · October 15, 2010 Full text Link to item Cite

Predictive factors of regional toxicity and serum creatine phosphokinase levels after isolated limb infusion for melanoma: a multi-institutional analysis.

Journal Article Ann Surg Oncol · September 2009 BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve ... Full text Link to item Cite

A multi-institutional experience of isolated limb infusion: defining response and toxicity in the US.

Journal Article J Am Coll Surg · May 2009 BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive approach for treating in-transit extremity melanoma, with only two US single-center studies reported. Establishing response and toxicity to ILI as compared with hyperthermic isolated limb per ... Full text Link to item Cite

Targeting Akt3 signaling in malignant melanoma using isoselenocyanates.

Journal Article Clin Cancer Res · March 1, 2009 PURPOSE: Melanoma is the most invasive and deadly form of skin cancer. Few agents are available for treating advanced disease to enable long-term patient survival, which is driving the search for new compounds inhibiting deregulated pathways causing melano ... Full text Link to item Cite

Pharmacokinetics & drug resistance of melphalan in regional chemotherapy: ILP versus ILI.

Journal Article Int J Hyperthermia · May 2008 Featured Publication Two forms of regional chemotherapy for the treatment of advanced melanoma or sarcoma of the extremity are isolated limb perfusion (ILP) and the more recently described isolated limb infusion (ILI). Melphalan is the most commonly employed agent in both ILP ... Full text Link to item Cite

Can surgeons improve survival in stage IV melanoma?

Journal Article J Surg Oncol · April 1, 2008 Featured Publication Successful systemic management of stage IV melanoma continues to be elusive because of the paucity of effective therapies. This has fueled the continued interest in surgical resection. Several single-institution studies and a current, large, multi-institut ... Full text Link to item Cite

Current immunotherapeutic strategies in malignant melanoma.

Journal Article Surg Oncol Clin N Am · October 2007 Featured Publication The basis of immunotherapy for melanoma is the existence of melanoma-associated antigens that can be targeted by the immune system. Identification of many of these antigens has enabled investigators to develop a wide array of immunotherapy strategies for t ... Full text Link to item Cite

Dendritic cell vaccines.

Journal Article Front Biosci · May 1, 2007 Featured Publication Dendritic cells are antigen-presenting cells that have been shown to stimulate tumor antigen-specific T cell responses in preclinical studies. Consequently, there has been intense interest in developing dendritic cell based cancer vaccines. A variety of me ... Full text Link to item Cite

Histopathologic characteristics, recurrence patterns, and survival of 129 patients with desmoplastic melanoma.

Journal Article Ann Surg Oncol · May 2006 BACKGROUND: Desmoplastic melanoma (DM) has been associated with higher local recurrence rates than other types of cutaneous melanoma. Current controversies regarding locoregional treatment strategies warrant further investigation. METHODS: Retrospective re ... Full text Link to item Cite

Intracellular Cytokine Assays

Chapter · December 1, 2005 This chapter provides an overview of intracellular cytokine assays. Intracellular cytokine assays are a relatively new method of identifying cytokine production by individual T cells and have the ability to correlate cytokine expression with cell surface p ... Full text Cite

Predictors of outcome after hyperthermic isolated limb perfusion: role of tumor response.

Journal Article Arch Surg · November 2005 HYPOTHESIS: Analysis of multiple clinical and pathological factors in patients undergoing therapeutic hyperthermic isolated limb perfusion for extremity melanoma can identify variables with prognostic significance. DESIGN: Retrospective review of a prospec ... Full text Link to item Cite

Melanoma arising in a skin graft.

Journal Article Ann Plast Surg · January 2005 Featured Publication Cutaneous melanoma remains an ongoing public health threat, and the cornerstone of management continues to be early diagnosis and treatment. Unfortunately, primary melanomas may have atypical presentations, making early diagnosis difficult and causing sign ... Full text Link to item Cite

Immune monitoring.

Journal Article Cancer Treat Res · 2005 A wide array of immunologic tests are available for immune monitoring in cancer vaccine trials, and the number of novel assays and technical modifications continues to burgeon. Because only a small fraction of all proposed vaccine trials tested in phase I- ... Full text Link to item Cite

Pneumatosis intestinalis after lung transplant.

Journal Article Abdom Imaging · 2005 Pneumatosis intestinalis may be idiopathic or associated with numerous conditions. Uncommonly, it has been associated with organ transplantation. We report one case of pneumatosis intestinalis after lung transplantation in an adult patient. To our knowledg ... Full text Link to item Cite

Intracellular Cytokine Assays

Chapter · December 30, 2004 This chapter provides an overview of intracellular cytokine assays. Intracellular cytokine assays are a relatively new method of identifying cytokine production by individual T cells and have the ability to correlate cytokine expression with cell surface p ... Full text Cite

Active immunotherapy with Flt3-ligand mobilized peripheral blood dendritic cells loaded with carcinoembryonic antigen peptide in patients with metastatic malignancies

Journal Article Journal of Applied Research · December 1, 2004 Background: Dendritic cells (DC) loaded with tumor antigens induce immune responses in some cancer patients. However, the most commonly used method for obtaining clinical grade DC requires in vitro generation over 7 days in media containing cytokine, incre ... Cite

Flt3-ligand as a vaccine adjuvant: Results in a study of Flt3-ligand plus tetanus toxoid immunization

Journal Article Journal of Applied Research · December 1, 2004 Dendritic cells (DC) efficiently process and present antigens to the effector arm of the immune system, thereby stimulating immunity against antigens of both foreign and self origin. Administration of Flt3-ligand (FL) has been reported to increase dendriti ... Cite

Immunotherapy of surgical malignancies.

Journal Article Curr Probl Surg · January 2004 Full text Link to item Cite

Immunotherapy with autologous, human dendritic cells transfected with carcinoembryonic antigen mRNA.

Journal Article Cancer Invest · June 2003 Immunizations with dendritic cells (DC) transfected with RNA encoding tumor antigens induce potent tumor antigen-specific immune responses in vitro and in murine models. We performed a phase I study of patients with advanced carcinoembryonic antigen (CEA)- ... Full text Link to item Cite

Proteomics for monitoring immune responses to cancer vaccines.

Journal Article Curr Opin Mol Ther · February 2003 Featured Publication Standardized biomarkers for the detection of clinically significant immunological responses would be extremely valuable in immunotherapy trials. Most available assays measure either the frequency or function of antigen-specific T-cells, or the titers of an ... Link to item Cite

Current status of dendritic cell immunotherapy of malignancies.

Journal Article Int Rev Immunol · 2003 Featured Publication Because dendritic cells (DC) are central to the induction of antigen-specific T cell responses, their use for the active immunotherapy of malignancies has been of considerable interest. Since clinical trials with DC-based vaccines have been initiated, a nu ... Full text Link to item Cite

Immunoregulatory T cells in cancer immunotherapy.

Journal Article Expert Opin Biol Ther · December 2002 Many of the tumour antigens targeted by active immunisation strategies are in fact self-antigens. Successful anticancer immunotherapy will therefore require not only potent methods of T cell activation, but also successful interference with mechanisms of i ... Full text Link to item Cite

Dendritic cell-based vaccines in cancer: Clinical experience to date

Journal Article American Journal of Cancer · December 1, 2002 Therapeutic vaccines that can activate the immune system to destroy malignancies hold the promise of a low-toxicity, precisely targeted anticancer treatment modality. Because dendritic cells (DCs) are central to the activation of antigen-specific immune re ... Full text Cite

Multiple signals are required for maturation of human dendritic cells mobilized in vivo with Flt3 ligand.

Journal Article J Leukoc Biol · September 2002 Featured Publication The ligand for the receptor tyrosine kinase fms-like tyrosine kinase 3 (Flt3L) is a growth factor for hematopoietic progenitors and induces expansion of the two distinct lineages of dendritic cells (DC) that have been described in humans. These two lineage ... Link to item Cite

Dendritic cell recovery following nonmyeloablative allogeneic stem cell transplants.

Journal Article J Hematother Stem Cell Res · August 2002 Nonmyeloablative allogeneic stem cell transplantation (NMSCT) may destroy some malignancies through a graft-versus-tumor (GVT) effect, but tumor relapse and viral reactivation remain challenges for which immunizations may be helpful. Dendritic cells (DC), ... Full text Link to item Cite

Dendritic cell maturation in active immunotherapy strategies.

Journal Article Expert Opin Biol Ther · January 2002 Dendritic cells (DCs) loaded with tumour antigen have become the centrepiece of clinical trials testing active immunotherapy strategies. Important variables include the source of DCs, the choice of antigens, the method of antigen loading and the route and ... Full text Link to item Cite

Assays for monitoring cellular immune responses to active immunotherapy of cancer.

Journal Article Clin Cancer Res · May 2001 Numerous cancer immunotherapy strategies are currently being tested in clinical trials. Although clinical efficacy will be the final test of these approaches, the long and complicated developmental pathway for these agents necessitates evaluating immunolog ... Link to item Cite

Surrogate markers of response to cancer immunotherapy.

Other Expert Opin Biol Ther · March 2001 Clinically effective cancer immunotherapy has been sought for more than 100 years and has been recently applied most successfully in strategies that passively deliver immune effectors such as monoclonal antibodies (anti-CD20 for lymphoma and anti-HER2/neu ... Full text Link to item Cite

Direct detection of cellular immune responses to cancer vaccines.

Journal Article Surgery · March 2001 Featured Publication The evaluation of cancer immunotherapy is predicated on the hypothesis that markers of tumor antigen-specific T-cell immunity will cone-late with clinical efficacy. Establishing which candidate vaccines should enter large-scale clinical trials will necessi ... Full text Link to item Cite

Monitoring cellular immune responses to cancer immunotherapy.

Journal Article Curr Opin Mol Ther · February 2001 Many clinical trials are testing the feasibility of stimulating the immune system to treat cancer. Although the efficacy of this approach will ultimately be determined by clinically relevant endpoints, detection of the magnitude and activity of the immune ... Link to item Cite

Quantitating therapeutically relevant T-cell responses to cancer vaccines.

Journal Article Crit Rev Immunol · 2001 Successful application of active immunotherapy to the treatment of cancer will require stimulation of potent antigen-specific T-cell responses. It is not known how numerous or how potent these T cells must be in order to abrogate tumors, but the levels of ... Link to item Cite

Preoperative mobilization of circulating dendritic cells by Flt3 ligand administration to patients with metastatic colon cancer.

Journal Article J Clin Oncol · December 1, 2000 PURPOSE: To evaluate preoperative dendritic cell (DC) mobilization and tumor infiltration after administration of Flt3 ligand (Flt3L) to patients with metastatic colon cancer. PATIENTS AND METHODS: Twelve patients with colon cancer metastatic to the liver ... Full text Link to item Cite

A subset of human monocyte-derived dendritic cells expresses high levels of interleukin-12 in response to combined CD40 ligand and interferon-gamma treatment.

Journal Article Blood · November 15, 2000 Featured Publication Dendritic cells (DCs) may arise from multiple lineages and progress through a series of intermediate stages until fully mature, at which time they are capable of optimal antigen presentation and T-cell activation. High cell surface expression of CD83 is pr ... Link to item Cite

Gene therapy for lung cancer.

Journal Article Clin Lung Cancer · February 2000 Featured Publication Gene therapy is emerging as a promising modality for the treatment of lung cancer. Diverse strategies employing gene therapy for lung cancer have been investigated in vitro and in animal models, and a number of these approaches have met with promising resu ... Full text Link to item Cite

Mimosine targets serine hydroxymethyltransferase.

Journal Article J Biol Chem · February 2, 1996 The plant amino acid, mimosine, is an extremely effective inhibitor of DNA replication in mammalian cells (Mosca, P. J., Dijkwel, P. A., and Hamlin, J. L. (1992) Mol. Cell. Biol. 12, 4375-4383). Mimosine appears to prevent the formation of replication fork ... Full text Link to item Cite

Mimosine, a novel inhibitor of DNA replication, binds to a 50 kDa protein in Chinese hamster cells.

Journal Article Nucleic Acids Res · January 25, 1995 We recently demonstrated that the plant amino acid, mimosine, is an extremely efficacious inhibitor of DNA replication in mammalian cells [P. A. Dijkwel and J. L. Hamlin (1992) Mol. Cell. Biol. 12, 3715-3722; P. J. Mosca et al. (1992) Mol. Cell. Biol. 12, ... Full text Link to item Cite

Defining origins of replication in mammalian cells.

Journal Article Biochim Biophys Acta · December 30, 1994 Full text Link to item Cite

Initiation of replication at a mammalian chromosomal origin.

Journal Article Cold Spring Harb Symp Quant Biol · 1993 Full text Link to item Cite

The plant amino acid mimosine may inhibit initiation at origins of replication in Chinese hamster cells.

Journal Article Mol Cell Biol · October 1992 An understanding of replication initiation in mammalian cells has been hampered by the lack of mutations and/or inhibitors that arrest cells just prior to entry into the S period. The plant amino acid mimosine has recently been suggested to inhibit cells a ... Full text Link to item Cite