JAMA Surgery

Nassoiy, Sean; Christopher, Wade; Marcus, Rebecca; Keller, Jennifer; Weiss, Jessica; Chang, Shu-Ching; Foshag, Leland; Essner, Richard; Fischer, Trevan; Goldfarb, Melanie

doi: 10.1001/jamasurg.2022.4456pmid: 36169964

Key PointsQuestionIs the receipt of neoadjuvant chemoradiation therapy (NACRT) followed by surgery for locally advanced rectal cancer (LARC) associated with improvements in overall survival among older patients (80 years and older)? FindingsIn this cohort study including 3868 patients with LARC who underwent surgical resection, 2273 (58.8%) received NACRT followed by surgical resection. NACRT was independently associated with a 25% decreased risk of death compared with alternative treatment sequences. MeaningThis study highlights the importance of therapy sequencing on outcomes in the treatment of LARC in older adults, concluding that NACRT was associated with improved R0 resection rates and a significant survival benefit when compared with treatment with surgery with or without adjuvant therapy.

Guillem, José G.; Luo, William Y.; Agala, Chris B.

doi: 10.1001/jamasurg.2022.4457pmid: 36169944

Nazarian, Scarlet; Gkouzionis, Ioannis; Kawka, Michal; Jamroziak, Marta; Lloyd, Josephine; Darzi, Ara; Patel, Nisha; Elson, Daniel S.; Peters, Christopher J.

doi: 10.1001/jamasurg.2022.3899pmid: 36069888

Key PointsQuestionCan the development of a diffuse reflectance spectroscopy (DRS) probe aid cancer margin assessment in esophageal and gastric cancer surgery? FindingsIn this validation study including 37 patients, the development of a DRS probe and tracking system showed that machine learning can provide real-time discrimination of normal and cancer tissue with high diagnostic accuracy of 93.9% and 96.2% for gastric and esophageal specimens, respectively. MeaningThis study highlights the potential for the DRS system to be used intraoperatively to aid cancer margin assessment in real time.

doi: 10.1001/jamasurg.2021.5412pmid: 36350311

Pitt, Susan C.; Dossett, Lesly A.

doi: 10.1001/jamasurg.2022.2343pmid: 35921100

This Viewpoint discusses the deimplementation of low-value care in surgery.

Belliveau, Sébastien; Gold, Morgan S.

doi: 10.1001/jamasurg.2022.2346pmid: 35976644

This Viewpoint discusses the opportunities afforded by modern technological advances and infrastructure that enable health care facilities to develop and rethink approaches to recycling, reducing, and reusing personal protective equipment.

Massick, Susan; King, KMarie; Pawlik, Timothy M.

doi: 10.1001/jamasurg.2022.3119pmid: 36044228

This Viewpoint discusses a targeted and purposeful approach to help standardize the process to identify, recruit, and hire diverse talent.

Dehghan, Niloofar; Nauth, Aaron; Schemitsch, Emil; Vicente, Milena; Jenkinson, Richard; Kreder, Hans; McKee, Michael

doi: 10.1001/jamasurg.2022.4299pmid: 36129720

This randomized clinical trial investigates if the surgical treatment of unstable chest wall injuries improves ventilator-free days and outcomes compared with nonoperative treatment.

Raff, Lauren; Gallaher, Jared; Charles, Anthony G.

doi: 10.1001/jamasurg.2022.4300pmid: 36129692

Simons, Janine M.; van Nijnatten, Thiemo J. A.; van der Pol, Carmen C.; van Diest, Paul J.; Jager, Agnes; van Klaveren, David; Kam, Boen L. R.; Lobbes, Marc B. I.; de Boer, Maaike; Verhoef, Cees; Sars, Paul R. A.; Heijmans, Harald J.; van Haaren, Els R. M.;