Research Spotlight

Ferdinands, J.M., Gaglani, M., Martin, E.T., Monto, A.S., Middleton, D., Silveira, F., Talbot, H.K., Zimmerman, R. and Patel, M. (2021). “Waning vaccine effectiveness against influenza-associated hospitalizations among adults, 2015-2016 to 2018-2019, US Hospitalized Adult Influenza Vaccine Effectiveness Network.” Clin Infect Dis Jan 19;ciab045. [Epub ahead of print].

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We observed decreased effectiveness of influenza vaccine with increasing time since vaccination for prevention of influenza A(H3N2), influenza A(H1N1)pdm09, and influenza B(Yamagata)-associated hospitalizations among adults. Maximum VE was observed shortly after vaccination, followed by an absolute decline in VE of about 8 to 9% per month post-vaccination.

Spinelli, D., Weaver, F.A., Azizzadeh, A., Magee, G.A., Piffaretti, G., Benedetto, F., Miller, C.C., Sandhu, H.K., Gable, D.R. and Trimarchi, S. (2021). “Endovascular treatment of complicated versus uncomplicated acute type B aortic dissection.” J Thorac Cardiovasc Surg Jan 21;S0022-5223(21)00123-9. [Epub ahead of print].

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OBJECTIVE: The study objective was to analyze the outcomes of thoracic endovascular aortic repair performed for complicated and uncomplicated acute type B aortic dissections. METHODS: Patients from WL Gore’s Global Registry for Endovascular Aortic Treatment who underwent thoracic endovascular aortic repair for acute type B aortic dissections were included, and data were retrospectively analyzed. RESULTS: Of 5014 patients enrolled in the Global Registry for Endovascular Aortic Treatment, 172 underwent thoracic endovascular aortic repair for acute type B aortic dissections. Of these repairs, 102 were for complicated acute type B aortic dissections and 70 were for uncomplicated acute type B aortic dissections. There were 46 (45.1%) procedures related to aortic branch vessels versus 15 (21.4%) in complicated type B aortic dissections and uncomplicated type B aortic dissections (P = .002). The mean length of stay was 14.3 ± 10.6 days (median, 11; range, 2-75) versus 9.8 ± 7.9 days (median, 8; range, 0-42) in those with complicated type B aortic dissections versus those with uncomplicated acute type B aortic dissections (P < .001). Thirty-day mortality was not different between groups (complicated type B aortic dissections 2.9% vs uncomplicated acute type B aortic dissections 1.4%, P = .647), as well as aortic complications (8.8% vs 5.7%, P = .449). Aortic event-free survival was 62.9% ± 37.1% versus 70.6% ± 29.3% at 3 years (P = .696). CONCLUSIONS: In the Global Registry for Endovascular Aortic Treatment, thoracic endovascular aortic repair results for complicated type B aortic dissections versus uncomplicated acute type B aortic dissections showed that 30-day mortality and perioperative complications were equally low for both. The midterm outcome was positive. These data confirm that thoracic endovascular aortic repair as the first-line strategy for treating complicated type B dissections is associated with a low risk of complications. Further studies with longer follow-up are necessary to define the role of thoracic endovascular aortic repair in uncomplicated acute type B dissections compared with medical therapy. However, in the absence of level A evidence from randomized trials, results of the uncomplicated acute type B aortic dissection patient cohort treated with thoracic endovascular aortic repair from registries are important to understand the related risk and benefit.

Roy, A., Gabani, P., Davis, E.J., Oppelt, P., Merfeld, E., Keedy, V.L., Zoberi, I., Chrisinger, J.S.A., Michalski, J.M., Van Tine, B. and Spraker, M.B. (2021). “Concurrent paclitaxel and radiation therapy for the treatment of cutaneous angiosarcoma.” Clin Transl Radiat Oncol 27: 114-120.

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INTRODUCTION: We compared clinical outcomes in patients with cutaneous angiosarcoma receiving concurrent paclitaxel-based chemoradiotherapy (CRT) vs. other modalities (Non-CRT). MATERIALS AND METHODS: Patients with non-metastatic cutaneous angiosarcoma diagnosed from 1998 to 2018 at two institutions were identified. In the CRT cohort, paclitaxel 80 mg/m(2) weekly was given for up to 12 weeks and patients received radiotherapy (RT) during the final 6 weeks of chemotherapy. The RT dose was 50-50.4 Gy delivered in 1.8-2 Gy per fraction with an optional post-operative boost of 10-16 Gy. Kaplan-Meier and log-rank statistics were used to compare the outcomes between the two groups. P < 0.05 was considered statistically significant. RESULTS: Fifty-seven patients were included: 22 CRT and 35 Non-CRT. The CRT cohort had more patients > 60 years (100% vs. 60%, p < 0.001) and tumors >5 cm (68.2% vs 54.3%, p = 0.023). The median follow-up was 25.8 (1.5-155.2) months. There was no significant difference in 2-year local control (LC), distant control (DC), or progression-free survival (PFS) between the two groups. The 2-year overall survival (OS) was significantly higher for the CRT cohort (94.1% vs. 71.6%, p = 0.033). Amongst the subset of patients in the CRT cohort who received trimodality therapy, the 2-year LC, DC, PFS, and OS was 68.6%, 100%, 68.6%, and 100%, respectively. CONCLUSION: The use of concurrent paclitaxel CRT demonstrates promising outcomes. Given these results, we are currently evaluating the safety and efficacy of this regimen in prospective, phase 2 trial (NCT03921008).

Turley, S.D., Horton, J.D., Andersen, J.M. and Fordtran, J.S. (2021). “In memoriam: John M. Dietschy Sr., MD (1932-2020).” J Lipid Res 62: 100015.

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Dr John M. Dietschy Sr., a Professor Emeritus of Internal Medicine at the University of Texas Southwestern Medical Center at Dallas (UTSW), died on July 18 after a short illness. He was 87 years old. Dr Dietschy worked at UTSW for more than 5 decades before retiring in 2012 and continued at the University as a Professor Emeritus until his death. [No abstract; excerpt from article].

Fleshman, J. (2021). “Birth of the Board of Colon and Rectal Surgery: Curtice Rosser, J.D., M.D. (January 3, 1891, to October 23, 1969) Remembered at Baylor University Medical Center, Dallas, Texas.” Dis Colon Rectum 64(2): 157-162.

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Great leaders carry a vision with them that shapes and defines their life and their career. They believe in what can be, and, in so doing, bring the vision into reality. They motivate others and, by their effort and enthusiasm, drive the betterment of the institution or group with which they find themselves associated. Curtice Rosser, J.D., M.D., was such a man. The world of colon and rectal surgery owes Dr Rosser a great deal of gratitude for his vision and his leadership. Baylor University Medical Center (BUMC), Baylor College of Medicine, and Southwestern Medical College (now University of Texas Southwestern Medical School) also benefitted greatly from his presence during the early part of their existence. The American Board of Colon and Rectal Surgery exists directly because Dr Rosser and his colleagues envisioned colorectal surgery as a self-governing and credentialing subspecialty, equivalent to other strong surgical subspecialties, and invested time, energy, and political capital to realize their dream. [No abstract; excerpt from article].