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In This Issue of JAMA Surgery |

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JAMA Surg. 2015;150(8):693. doi:10.1001/jamasurg.2014.2518.
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Long-term survival from pancreatic adenocarcinoma, defined as surviving at least 10 years from initial diagnosis, is a rare event. Few studies ever described patient characteristics associated with long-term survival. In this population-based cohort study, Paniccia and colleagues use the National Cancer Database to identify 431 patients with favorable outcomes from pancreatic adenocarcinoma and to develop a nomogram that predicts the likelihood of long-term survival.

Colorectal surgery patients are at high risk for venous thromboembolic events; however, questions remain regarding risk factors for the development of venous thromboembolism (VTE) and the optimal timing and duration of VTE prophylaxis. In a prospective study, the Colorectal Writing Group for the SCOAP-CERTAIN Collaborative examined 16 120 patients undergoing colorectal surgery and found that VTE rates remain low and largely unchanged despite significant increases in perioperative, in-hospital, and postdischarge chemoprophylaxis use.

It remains unclear whether surgical treatment provides any survival benefit for ductal carcinoma in situ (DCIS). In a cohort study using the Surveillance, Epidemiology, and End Results database, Sagara et al examined 57 222 cases of DCIS to investigate the survival benefit of breast surgery. Surgical management at the time of diagnosis improved survival in intermediate- and high-grade DCIS, whereas no significant survival benefit was demonstrated for low-grade DCIS.

In a study of patients with colon cancer from the Surveillance, Epidemiology, and End Results database, Thirunavukarasu et al evaluated the effect of inclusion of C stage into the standard American Joint Committee on Cancer (AJCC) TNM staging and studied the implication on survival estimates. They found that inclusion of C stage yields important stage-specific prognostic data, which may have important implications in multimodality therapy.

The relative impact of common bariatric procedures on health care use and costs is largely unknown. In this interrupted time series with comparison series study of 9870 bariatric surgical patients, Lewis and colleagues found that adjustable gastric banding and Roux-en-Y gastric bypass (RYGB) procedures were both associated with flattened total health care cost trajectories after surgery. However, RYGB patients had lower total and prescription costs by year 3 postoperatively.





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