Herb Chen

University of Alabama at Birmingham

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Rebecca S. Sippel

University of Wisconsin–Madison

Mark Sywak

Royal North Shore Hospital

Courtney J. Balentine

University of Wisconsin–Madison

Leigh Delbridge

University of Sydney

James C. Lee

Kaiser Permanente

Sara J. Knight

University of Utah

Janet M. Turan

Koç University

Stanley Sidhu

Royal North Shore Hospital

Glen Leverson

University of Wisconsin–Madison

Smita Bhatia

University of Alabama at Birmingham

Cooperative Institutions

University of Alabama at Birmingham

University of Wisconsin–Madison

Northwestern University

American College of Surgeons

University of Southern California

University of KwaZulu-Natal

University of Wisconsin Carbone Cancer Center

University of Utah

Universitat Autònoma de Barcelona

University of Alabama

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Disease outcomes and nodal recurrence in patients with papillary thyroid cancer and lateral neck nodal metastases

ANZ Journal of Surgery (2013)

Christine J. O’Neill Nicholas Coorough James C. Lee Joshua Michael Clements Leigh Delbridge

Abstract Background The prognostic influence of lateral neck nodal metastases present at the time of diagnosis of papillary thyroid cancer ( PTC ) remains controversial. This study aims to document disease outcomes and nodal recurrence rates in such patients. Methods Patients with PTC and lateral neck nodal metastases who underwent concurrent total thyroidectomy, central and lateral compartment neck dissection between 2000 and 2010 were identified from the prospectively maintained surgical databases of The U niversity of S ydney and U niversity of W isconsin E ndocrine S urgical U nits. Disease outcomes and nodal recurrence rates were compared at 12 months post‐operatively and in longer‐term follow‐up. Results During this 11‐year period, 121 patients were identified. Mean age was 45 years; 58% were female and 98% underwent post‐operative radioactive iodine ablation. At a median follow‐up of 31 months (range 12–140), there were no disease‐specific deaths and disease‐free survival (defined by stimulated serum thyroglobulin ( T g) < 2.0 μg/L, negative clinical and radiological examination) was 66%. Of the 50 patients with persistently elevated T g measured 12 months post‐operatively, 15 developed clinical lateral neck nodal recurrence. All have undergone re‐operative surgery. Elevated stimulated T g at 12 months post‐operatively and a nodal ratio of >30% were significantly associated with an increased risk of lateral neck nodal recurrence. Conclusion With total thyroidectomy, formal compartmental neck dissection and radioactive iodine treatment, disease‐free survival can be achieved in the majority of patients with PTC and synchronous lateral neck nodal metastases. A persistently elevated T g post‐operatively and a high ratio of metastatic nodes identify patients at increased risk of locoregional recurrence.

Neck dissection

10.1111/ans.12045

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Citations (19)

A Structured Compensation Plan Improves But Does Not Erase the Sex Pay Gap in Surgery

Annals of Surgery (2018)

Melanie S. Morris Herb Chen Martin J. Heslin Helen Krontiras

Objective: The aim of this study is to examine the relationship between the sex pay gap in a large academic department of surgery and a recently instituted structured compensation plan. Summary of Background Data: A recent large study found that after controlling for measures of academic and clinical productivity, male physicians earned nearly $20,000 more annually than female physicians. Increased salary transparency has been proposed as a method to reduce this disparity. Methods: A new structured compensation plan was developed to improve transparency of compensation and financial viability of each division. The total compensations of each faculty member before and after the new compensation plan were calculated. Salaries were compared with the Association of Academic Medical Colleges (AAMC) median value based on specialty, region, academic rank, stratified by sex and compared. Work relative value units (wRVUs) were calculated for each faculty member during the entire study period, stratified by sex and compared. Results: Among 44 eligible surgeons (33 men and 11 women), a sex pay gap existed with male surgeon salaries significantly higher than female surgeon salaries [56% (8 to 213) vs 26% (1 to 64); P < 0.00001] despite similar RVU production (men 8725 ± 831 vs women 7818 ± 911, P = 0.454). The new compensation plan did not significantly change male surgeon salaries [56% (8 to 213) vs 58% (26 to 159); P = 0.552] but did significantly increase the salaries of female surgeons [26% (1 to 64) vs 42% (10 to 80); P = 0.026]. Conclusion: A structured compensation plan can improve the sex pay gap in a short period of time. More transparency in surgical compensation plans is essential to understand the most equitable way to compensate all surgeons.

Salary

Specialty

Gender Pay Gap

10.1097/sla.0000000000002928

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Citations (55)

Role of Notch1 in NIKS cellular differentiation

Journal of the American College of Surgeons (2011)

Madhuchhanda Roy Sandy J. Schlosser Lynn B. Allen-Hoffman Herb Chen Timothy W. King

Roy, Madhuchhanda MD, PhD; Schlosser, Sandy J. BSc; Allen-Hoffman, Lynn B. PhD; Chen, Herb MD, FACS; King, Timothy W. MD, PhD Author Information

10.1016/j.jamcollsurg.2011.06.226

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Citations (1)

Use of the Gamma Probe to Identify Multigland Disease in Primary Hyperparathyroidism

International Journal of Endocrine Oncology (2016)

Kirby Tobin Rachel R Ayers Mohammad H. Rajaei Rebecca S. Sippel Courtney J. Balentine

Aim: The purpose of this study was to determine threshold gamma probe counts to distinguish single adenoma (SA) from multigland disease (MGD) during radioguided parathyroidectomy. Methods: A retrospective analysis of 1656 patients was performed. Ex vivo counts of the first excised gland were taken and recorded as a percentage of background counts. Results: 69.4% of MGD patients had counts below the 50% threshold. The 50% threshold correctly grouped 72.8% of our cohort. Counts of more than 100% were accurate for grouping SA, with only 6.8% of patients with counts more than 100% having MGD. Conclusions: The gamma probe can aid surgeons in deciding to continue neck exploration if MGD is suspected or wait for labs to confirm cure if SA is suspected.

10.2217/ije.15.27

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Citations (11)

A Phase II Trial of a Histone Deacetylase Inhibitor Panobinostat in Patients With Low-Grade Neuroendocrine Tumors

The Oncologist (2016)

Ning Jin Sam Joseph Lubner Daniel Mulkerin Saurabh Rajguru Lakeesha Carmichael

Abstract Lessons Learned Pancreatic neuroendocrine tumors versus carcinoid tumors should be examined separately in clinical trials. Progression-free survival is more clinically relevant as the primary endpoint (rather than response rate) in phase II trials for low-grade neuroendocrine tumors. Background. The most common subtypes of neuroendocrine tumors (NETs) are pancreatic islet cell tumors and carcinoids, which represent only 2% of all gastrointestinal malignancies. Histone deacetylase (HDAC) inhibitors have already been shown to suppress tumor growth and induce apoptosis in various malignancies. In NET cells, HDAC inhibitors have resulted in increased Notch1 expression and subsequent inhibition of growth. We present here a phase II study of the novel HDAC inhibitor panobinostat in patients with low-grade NET. Methods. Adult patients with histologically confirmed, metastatic, low-grade NETs and an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2 were treated with oral panobinostat 20 mg once daily three times per week. Treatment was continued until patients experienced unacceptable toxicities or disease progression. The study was stopped at planned interim analysis based on a Simon two-stage design. Results. Fifteen patients were accrued, and 13 were evaluable for response. No responses were seen, but the stable disease rate was 100%. The median progression-free survival (PFS) was 9.9 months, and the median overall survival was 47.3 months. Fatigue (27%), thrombocytopenia (20%), diarrhea (13%), and nausea (13%) were the most common related grade 3 toxicities. There was one grade 4 thrombocytopenia (7%). These results did not meet the prespecified criteria to open the study to full accrual. Conclusion. The HDAC inhibitor panobinostat has a high stable disease rate and reasonable PFS in low-grade NET, but has a low response rate.

Panobinostat

Clinical endpoint

Progression-free survival

10.1634/theoncologist.2016-0060

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Citations (41)

Table of Contents (3 pgs)

The American Journal of Surgery (2018)

Jane Carter Hiram C. Polk Norman Galbraith Kelly M. McMasters William G. Cheadle

Table (database)

10.1016/s0002-9610(18)30937-1

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Persistently elevated serum thyroglobulin levels predict lateral recurrence in patients with papillary thyroid cancer and lateral neck nodal metastases

James C. Lee Christine J. O’Neill Nicholas Coorough Leigh Delbridge Rebecca S. Sippel

Thyroglobulin

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The University of Alabama at Birmingham Surgery Community Network: Tackling the Challenges of Rural Surgery

The American Surgeon (2022)

Abigayle Kraus Drew J. Gunnells Daniel I. Chu Alexis E. Kennedy Tyler G. Hughes

Over the past 5 years, The University of Alabama at Birmingham (UAB) Department of Surgery has taken a keen interest in the practice of surgery in rural Alabama and has established the UAB surgery community network. Our goal is to improve the delivery of surgical care in rural areas through active recruitment of rural surgeons, the development of research around rural surgery practice, and the expansion of a surgery network throughout the state. Here, we will present the challenges faced by rural surgery, our early work to address these challenges, and offer a plan for moving forward.

Rural community

Rural Health

10.1177/00031348221109471

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Citations (1)

Joining and Becoming Involved in Surgical Societies

Success in academic surgery (2020)

Jess Fazendin Lillian S. Kao Herb Chen

Professional association

Professional Standards

Patient Care

10.1007/978-3-030-29271-3_12