DOUGLAS LEON FRAKER, MD

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This study looked at how doctors can tell if a patient with primary aldosteronism has a single gland causing their condition, which is important because those patients can be cured with surgery. Out of 461 patients studied, 324 were found to have unilateral aldosterone secretion, and using a new clinical risk score can predict this accurately 86% of the time. This matters because it can help identify patients who may benefit from surgery, leading to better treatment outcomes. Who this helps: Doctors and patients with resistant hypertension.

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This study looked at how the surgery to remove parathyroid glands (parathyroidectomy) has been performed over the years, specifically focusing on whether patients stay overnight or go home the same day. From 2013 to 2019, researchers found that 67.3% of these surgeries were done as same-day procedures, and the overall number of same-day surgeries increased while overnight stays decreased, particularly for conditions like primary hyperparathyroidism. This is important because it shows that more patients can safely have this surgery without needing to stay in the hospital, which can lead to less recovery time and lower healthcare costs. Who this helps: Patients needing parathyroidectomy, especially those with primary hyperparathyroidism.

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This paper discusses how surgery is the best way to treat primary hyperparathyroidism (PHPT), a condition where the parathyroid glands produce too much hormone. The authors highlight recent advancements in surgery, such as improved imaging and testing techniques, that help doctors determine the best timing for surgery to prevent complications. They emphasize that these improvements lead to better outcomes for patients, particularly those who may not show symptoms yet. Who this helps: This benefits patients with primary hyperparathyroidism who need surgery to manage their condition.

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This study looked at how many patients had adrenal surgery done as outpatient procedures from 2016 to 2020. Researchers found that the percentage of these surgeries performed on an outpatient basis increased from 44.1% in 2016 to 59.2% in 2020, with similar costs and readmission rates regardless of whether patients stayed overnight or were discharged the same day. This is important because it shows that more patients can go home the same day without compromising their safety or increasing costs. Who this helps: This helps patients who may prefer to recover at home rather than in a hospital.

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Researchers studied whether a simple blood test during parathyroid surgery—measuring how much a hormone called PTH drops during the operation—could predict whether the surgery would successfully cure a specific type of parathyroid disease and avoid a dangerous drop in calcium levels afterward. They tested this prediction method in over 1,000 patients from multiple hospitals and confirmed that a 50-65% drop in PTH during surgery reliably indicates the operation will work and help doctors avoid dangerously low calcium levels after surgery. This matters because doctors can now use this quick, real-time measurement during surgery to know whether they've removed the right amount of diseased tissue, without having to wait for results afterward.

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This study looked at how the number of surgeries a surgeon performs each year affects the outcomes for patients undergoing adrenalectomy, which is surgery to remove the adrenal glands. Out of 476 surgeries from 2016 to 2021, high-volume surgeons (those who did 6 or more procedures a year) performed 394, and they were more likely to use minimally invasive techniques, resulting in lower costs and shorter hospital stays. Specifically, laparoscopic surgery led to patients spending about 3.4 fewer days in the hospital and saved around $72,000 in hospitalization costs. Who this helps: This information benefits patients needing adrenal surgery and their doctors in making better care decisions.

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Researchers studied trends in primary hyperparathyroidism (PHPT), a condition where the body produces too much parathyroid hormone, affecting calcium levels. They examined over 1,000 patients who had surgery to remove the parathyroid glands between 2002 and 2019 and found that patients were showing milder symptoms and lower hormone and calcium levels. Despite these milder cases, the surgery successfully cured 93.7% of patients, indicating that even those with less severe disease can benefit from surgical intervention. Who this helps: This helps patients with primary hyperparathyroidism and their doctors by expanding treatment options.

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This study examined the differences in certain microRNAs (miRNAs) between postmenopausal women with Primary Hyperparathyroidism (PHPT) and those without the condition. Researchers found that 9 specific miRNAs were present in different amounts in women with PHPT, and these levels were linked to parathyroid hormone and calcium in the blood. This is important because it helps identify a unique biochemical signature for PHPT, which could improve diagnosis and treatment options for patients with this condition. Who this helps: This helps patients with Primary Hyperparathyroidism.

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This study focused on a specific type of immune cell called iron-rich tumor-associated macrophages (iTAMs) that are found in tumor environments. Researchers discovered that these iTAMs, which contain a lot of iron, help tumors grow by promoting blood vessel formation and suppressing the immune response, and that reducing a specific receptor called Ednrb in these cells can slow down tumor growth. Results showed that when Ednrb was deleted in immune cells, tumor growth decreased significantly, suggesting that targeting this pathway could be a potential strategy in cancer treatment. Who this helps: This research benefits cancer patients and doctors by providing insights into new treatment options.

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This study looked at the use and costs of same-day surgery versus overnight stays for total thyroid removal between 2013 and 2019. Researchers found that 19.4% of patients had surgery and went home the same day, a trend that increased from 14.8% to 20.8% during the study. The same-day surgery was cheaper, saving about $974 on average compared to overnight stays, and it was more common in specialized hospitals. Who this helps: Patients who undergo thyroid surgery can benefit from same-day discharge, potentially saving money and experiencing more convenience.

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This study looked at how men and women, as well as different racial and ethnic groups, experience and are treated for medullary thyroid cancer (MTC). They found that out of 6,154 patients, 68% received recommended surgery. Men and Hispanic patients tended to have larger tumors, while Black and Hispanic patients often had more advanced cancer and waited longer for surgery; Black patients were also less likely to receive the recommended surgical treatment. Who this helps: This research benefits patients with medullary thyroid cancer, particularly those who are men or from non-White backgrounds, by highlighting disparities in treatment and outcomes.

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This study looked at young adults with primary hyperparathyroidism (PHPT) to see if they were more likely to have a condition called multigland disease (MGD), which affects multiple glands. Out of nearly 3,900 patients studied, only 9.1% were under 40, and having a family history of PHPT was the strongest indicator of MGD, increasing the risk by four times. The findings suggest that younger patients without a family history are less likely to need extensive surgery to check for MGD. Who this helps: This helps doctors by guiding them on when to recommend surgery for younger patients with PHPT.

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This study looked at different imaging techniques used before redoing surgery for patients with a recurring problem of high parathyroid hormone levels. The researchers found that CT scans were the most effective at pinpointing where the issue was, with a success rate of 70.8%, while other methods like ultrasound and sestamibi scans were less reliable. They also noted that Parathyroid Vein Sampling (PAVS) accurately identified the problem in 96% of the cases it was used. Who this helps: This benefits patients with persistent hyperparathyroidism who need repeat surgery.

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This study looked at the impact of neoadjuvant chemotherapy (NCT) on patients with retroperitoneal sarcoma, specifically those with high-grade leiomyosarcoma or dedifferentiated liposarcoma, using data from over 2,600 patients. It found that only 6% of patients received NCT, and there was no significant difference in 5-year survival rates between those who did and those who did not receive chemotherapy (57.3% vs. 52.8%). This research matters because it suggests that adding NCT before surgery might not improve long-term survival for these patients. Who this helps: Patients with retroperitoneal sarcoma and their healthcare providers.

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This study examined how changes in parathyroid hormone levels during surgery can predict outcomes for patients with a specific type of hyperparathyroidism, where hormone levels are normal but too high for the amount of calcium in the blood. It found that patients with this condition had lower hormone declines during surgery compared to those with classic hyperparathyroidism. Specifically, those with a decline of 70% or more were more likely to experience low calcium levels after surgery (10.4% vs. 3.3%). Who this helps: This research benefits patients with normohormonal primary hyperparathyroidism and their doctors by guiding decisions during surgery.

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This study examined whether traveling to high-volume hospitals for cancer surgeries leads to better patient outcomes compared to having surgery at local hospitals with lower surgical volumes. Researchers analyzed data from nearly 50,000 patients and found that those who had surgery at local low-volume hospitals faced a 30-day mortality risk that was significantly higher compared to those at high-volume hospitals. Specifically, local low-volume hospitals were linked to a 35% increased risk of death within five years after surgery. Who this helps: This research benefits patients undergoing esophageal, pancreatic, or rectal cancer surgeries by highlighting the importance of having these procedures done at high-volume hospitals.

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This study looked at older adults (people in their 80s) with localized stomach tumors called gastrointestinal stromal tumors (GISTs) to understand how surgery affects their chances of surviving. Out of 949 patients, those who had surgery lived longer—71% of them survived five years compared to 59.6% of those who did not have surgery. However, there was a notable risk of death shortly after surgery, with 5.7% of those who had surgery dying within 90 days compared to 11% of those who did not. Who this helps: This information helps doctors make better decisions about whether to recommend surgery for older patients with stomach tumors.

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In this study, researchers looked at patients who had surgery to remove parathyroid glands due to kidney-related issues. They found that about 21% of these patients developed "hungry bone syndrome," which requires a longer hospital stay—averaging 6 days compared to just 3 days for those without the syndrome. This information is important because it helps patients understand they might need a longer hospital recovery and could face a chance of being readmitted within 30 days. Who this helps: Patients undergoing parathyroid surgery.

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This study looked at the best number of lymph nodes that should be examined after surgery for gastric cancer in patients who received chemotherapy before surgery. It found that patients whose lymph nodes were examined and found to have at least 23 nodes had a better chance of surviving for five years after surgery, with a survival rate of 57.9% compared to 49% for those with fewer nodes. This is important because it highlights the need for thorough lymph node evaluation to help doctors predict patient outcomes more accurately. Who this helps: Patients with gastric cancer.

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This study looked at how often neoadjuvant radiation therapy (NRT) is used for patients with cutaneous and soft tissue angiosarcoma, a rare type of cancer. Out of nearly 600 patients, only 4.5% received this type of radiation before surgery. Although NRT significantly increased the chances of a complete tumor removal (100% for those who received NRT compared to only 17.9% for those who didn't), it did not appear to improve overall survival rates. Who this helps: This benefits patients with angiosarcoma, especially those with larger tumors or those located in the head and neck.

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This study looked at how the number of surgeries done at a hospital affects survival rates for Black and non-Black patients with rectal cancer. Out of over 59,000 patients, Black patients had a 5-year survival rate of 72%, compared to 74.4% for non-Black patients. When treated at high volume hospitals, the survival rates for both groups were closer, indicating that these hospitals may help reduce racial disparities in outcomes. Who this helps: This benefits patients, especially those with rectal cancer, by highlighting the importance of access to high volume healthcare facilities.

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This study looked at whether certain patients with high-risk stage II colon cancer benefit from additional treatment after their tumors are removed. Researchers analyzed data from over 15,000 patients and developed a risk-score model based on factors like age, sex, and tumor characteristics. They found that while most low-risk patients didn’t gain from extra treatment, moderate-risk patients improved their survival by 10% and high-risk patients by 20% with the treatment; however, only about 20% of high-risk patients were receiving it. Who this helps: This benefits patients with high-risk stage II colon cancer by identifying those who could greatly benefit from extra treatment.

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This study looked at patients with nonmucinous adenocarcinoma of the appendix to find out if some could safely undergo a less extensive surgery instead of the standard right hemicolectomy. Among 2,487 patients, 113 (4.5%) had tumors considered low risk for lymph node metastasis, with just a 1.8% chance of metastasis, compared to a 27.4% rate for those at higher risk. This is important because it shows that certain patients can be treated with simpler surgery without lowering their survival chances. Who this helps: This helps patients with low-risk appendix cancer by offering them a less invasive option for treatment.

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This study looked at patients with a specific type of tumor called non-functional gastroenteropancreatic neuroendocrine tumors (GEP NETs) to understand how many of them had cancer spread to their lymph nodes. Out of 12,228 patients analyzed, over half (6,902 or 56.4%) had lymph node metastases. The researchers created a risk-score model that classifies patients into risk groups: low (8.7% chance of lymph node spread), intermediate (48.6%), high (64.9%), and very high risk (92.8%), based on factors such as age, tumor size, and location, which can help doctors make better treatment decisions. Who this helps: Patients with GEP NETs and their doctors.

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This study looked at the impact of surgery to remove adrenal tumors in patients with lung cancer that has spread to the adrenal glands. Researchers followed 122 patients and found that those who had this surgery lived an average of 47 months after the procedure. Factors that were linked to better survival included having the lung tumor removed first and the metastases being on the same side as the primary lung cancer. Who this helps: Patients with non-small cell lung cancer that has only spread to the adrenal glands.

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This study looked at how Merkel cell carcinoma (MCC), a rare type of skin cancer, spreads in patients. Out of 133 patients, 59% developed either local or distant metastases, with 87% experiencing local spread first, often to nearby lymph nodes. The study found that patients with stage III disease had a much higher risk of their cancer spreading, while those with stage IV had a lower chance of long-term survival. Who this helps: This information helps doctors better monitor and treat patients with Merkel cell carcinoma.

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This study looked at the effects of giving blood transfusions to patients with moderate anemia (when red blood cell levels are low) before they have surgery for cancer. Researchers found that out of 6,222 patients, those who received preoperative transfusions were more likely to develop infections after surgery and stayed in the hospital longer, without showing any positive outcomes from the transfusion. Specifically, patients who received transfusions had a 67% higher chance of getting infections and stayed in the hospital about 6% longer than those who did not. Who this helps: This information helps doctors make better choices for cancer patients who are anemic before surgery.

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This study looked at patients with a type of stomach tumor called gastric gastrointestinal stromal tumors (GISTs) to see if how much tumor was left behind during surgery (microscopic margins) affected their survival. Researchers found that, among more than 2,000 patients, those who had some tumor left after surgery (known as R1 resection) did not have a significantly different 5-year survival rate compared to those who had all the tumor removed (R0 resection) — 82.5% versus 88.6%. This finding is important because it indicates that having small amounts of tumor remaining does not affect the overall survival for these patients. Who this helps: This helps patients with gastric GISTs and their doctors make informed decisions about surgery.

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This study looked at how race affects patients with primary hyperparathyroidism who need surgery. Researchers found that African-American patients tended to have more severe symptoms and less thorough pre-surgery testing compared to White patients, yet both groups had similar success rates after surgery, with about 98% of patients from both groups having successful outcomes. This matters because it highlights the health disparities that exist before surgery, which can affect treatment quality and patient care. Who this helps: This helps patients and doctors understand the importance of equitable care and thorough evaluations regardless of race.

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This study looked at changes in how appendiceal adenocarcinoma, a type of cancer affecting the appendix, was diagnosed and treated over ten years. Researchers found that from 2006 to 2015, more young patients (under 40) and those with more advanced tumors were diagnosed, but the overall three-year survival rates remained similar at about 81% for the later group compared to 79% for the earlier group. This is important because it shows that despite changes in the types of patients diagnosed, the survival outcomes haven’t improved over time. Who this helps: This information is useful for doctors and patients navigating treatment options for appendiceal adenocarcinoma.

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This study looked at different causes of primary hyperparathyroidism (PHPT), focusing on patients with a single adenoma, double adenoma, or four-gland hyperplasia who underwent surgery to remove the problematic glands. They found that patients with double adenoma had a higher risk of their condition coming back; about 5.3% of these patients had persistent or recurrent disease, compared to 2.9% for those with a single adenoma. This research matters because it helps doctors understand the risks associated with different types of parathyroid conditions, guiding better treatment decisions. Who this helps: This helps patients with hyperparathyroidism by informing their treatment and follow-up care.

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This study looked at the use of preoperative biopsy (PBx) in patients with retroperitoneal sarcoma (a type of cancer) before surgery. It found that only 42.4% of the 2,620 patients studied received a biopsy, but those who did were more likely to get additional treatments like radiation or chemotherapy, and had better surgical outcomes. However, the biopsy itself did not directly improve overall survival rates, with 5-year survival rates being nearly the same for those who had a biopsy (56.5%) and those who did not (58.4%). Who this helps: This research helps doctors make informed decisions about treatment options for patients with this specific type of cancer.

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This study looked at patients with a condition called primary aldosteronism, where adrenal glands produce too much aldosterone, leading to high blood pressure. Out of 762 patients, 20 had confusing results showing decreased hormone levels from both adrenal glands—this is called apparent bilateral adrenal suppression (ABAS). When these patients had a repeat test, 70% got clearer results indicating where the problem was, with 9 of them having successful surgery that improved their blood pressure. Who this helps: This benefits patients with primary aldosteronism who might be candidates for surgery.

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This study looked at the survival rates of patients who had their stomachs completely removed due to gastric cancer. The researchers found that 9.1% of patients died within 90 days of the surgery, which is significantly higher than the 4.7% who died within the first 30 days. The results show that many deaths happen after the initial month, highlighting the need for better care during recovery after surgery. Who this helps: This information benefits patients undergoing total gastrectomy for gastric cancer and their healthcare providers.

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This study gathered a diverse group of medical experts to create guidelines for how to monitor and treat two types of rare tumors called pheochromocytoma and paraganglioma that cannot be surgically removed or have spread to other parts of the body. Their work involved reviewing existing research and voting on the best practices, resulting in clear recommendations for patient care. This is important because having standardized guidelines can help doctors provide better treatment and improve outcomes for patients facing these challenging conditions. Who this helps: Patients with metastatic pheochromocytoma and paraganglioma, as well as their healthcare providers.

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This study looked at a new imaging technique that helps doctors find hard-to-see parathyroid glands during surgery. The researchers found that this method could identify these hidden glands effectively, which is important for successful surgery and preventing complications. This matters because properly locating these glands can lead to better outcomes for patients undergoing thyroid surgery. Who this helps: Patients undergoing thyroid surgery.

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This study looked at how well surgical and medical treatments work for primary aldosteronism (PA), a common cause of high blood pressure that often goes undetected. It found that surgery to remove the adrenal gland (adrenalectomy) leads to better health outcomes than taking medication, with patients who had surgery experiencing fewer serious heart problems and kidney disease. This is important because finding and treating PA quickly can prevent long-term health issues. Who this helps: This helps patients with primary aldosteronism, especially those who may need surgery for better health outcomes.

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This research looked at how certain substances called catecholamines in the blood relate to weight and blood sugar control in patients with pheochromocytomas and paragangliomas, which are types of tumors. The study involved 360 patients and found that higher levels of norepinephrine and normetanephrine were linked to lower body weight and higher blood sugar levels (HbA1c), meaning that as these substances increased, blood sugar control worsened. After surgery, patients showed a drop in normetanephrine levels, which was associated with better blood sugar control, even if their weight went up. Who this helps: This information is useful for doctors treating patients with these tumors, as it provides insight into managing their weight and blood sugar.

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This study focused on gastric neuroendocrine tumors (GNETs) to see how different types affect patient outcomes. Researchers analyzed 121 patients and found that the size and grade of the tumors, rather than their type, significantly impacted survival. Specifically, small, low-grade type III tumors had a 0% chance of spreading and a 100% survival rate after five years, compared to larger or higher-grade tumors, which showed worse outcomes. Who this helps: This information benefits doctors and patients with gastric neuroendocrine tumors, especially those with smaller, low-grade tumors.

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This study looked at how the COVID-19 pandemic affected the timing of endocrine surgeries by examining a group of 146 patients. It found that patients ranked as high priority for surgery waited an average of 35 days, compared to 61 days for those with moderate priority and 79 days for low priority. This is important because the way patients are prioritized for surgery can significantly impact how quickly they receive necessary treatment. Who this helps: This helps patients needing endocrine surgery by ensuring they are prioritized effectively for timely care.

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This study looked at patients who had surgery to remove cancer that spread to their adrenal glands, specifically to understand how long they survive after the procedure and who benefits most. Out of 269 patients, the average survival after surgery was about 53 months, with 43% alive after five years. Those with lung cancer tended to live longer after the surgery, while patients with more advanced cancer outside the adrenal glands or incomplete tumor removal had shorter survival times. Who this helps: This information benefits patients with adrenal metastases and their doctors, guiding decisions about surgery.

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This study looked at factors that predict whether patients with mucinous appendiceal adenocarcinoma (a type of cancer in the appendix) will have lymph node metastasis (spread of cancer to lymph nodes). Researchers found that out of 1,158 patients, 21.1% had this spread, and they were more likely to have aggressive cancer features. Patients with lymph node metastasis had a much lower three-year survival rate of 17.4%, compared to 82.6% for those without it, highlighting the importance of identifying high-risk patients early. Who this helps: This information is beneficial for doctors and patients facing this specific type of cancer, as it can guide treatment decisions.

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This study looked at how often ventral hernia repairs are done for patients with cancer that has spread inside the abdomen, specifically comparing emergency (nonelective) surgeries to planned (elective) ones. Researchers found that while the overall number of hernia repairs stayed the same from 2003 to 2015, emergency repairs for these patients increased by 2.7% each year, and those undergoing emergency repairs faced significantly higher risks for complications, longer hospital stays, and increased medical costs. This is important because it highlights the growing issue of emergency surgeries in these patients, suggesting that more planned surgeries could improve their outcomes and reduce hospital costs. Who this helps: This benefits patients with intra-abdominal metastases, their families, and healthcare providers.

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This study looked into whether patients with specific types of cancer who received treatment at multiple hospitals (multicenter care, or MCC) had different survival outcomes compared to those treated at a single hospital (single-center care, or SCC). The research found that patients receiving MCC had similar survival rates at one and three years as those who received SCC, despite MCC potentially offering more convenience. This matters because it shows that patients can access care from multiple facilities without harming their chances of survival. Who this helps: Patients with gastrointestinal cancers undergoing complex treatments.

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This study looked at a unique case where malignant melanoma, a type of skin cancer, spread to a patient's existing thyroid cancer. A 42-year-old man had melanoma in his leg that had already spread to lymph nodes, and doctors found a 6.6 cm tumor in his thyroid that turned out to also contain melanoma cells. This is significant because it shows that melanoma can spread to another type of cancer rather than just surrounding tissues, highlighting the complexity of cancer behavior. Who this helps: This information is valuable for doctors treating patients with melanoma and thyroid cancer, as well as patients dealing with these conditions.

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This study looked at two scoring systems, PASS and GAPP, to determine how well they predict the likelihood of metastasis (spread of cancer) in tumors called pheochromocytomas and paragangliomas. Researchers followed 143 patients and found that 24% developed metastases, with the GAPP score showing a stronger prediction of aggressive tumors; for instance, a higher GAPP score was linked to a 3.37 times higher chance of disease recurrence compared to a lower score. This is important because better predictions can help doctors decide on the best treatment options and improve patient outcomes. Who this helps: Patients with pheochromocytoma and paraganglioma, as well as their doctors, will benefit from more accurate risk assessments.

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This study looked at how patients' weights change after surgery to remove part of the pancreas (pancreatectomy). Researchers found that, on average, patients lost about 6.6% of their body weight one year after the surgery, with those undergoing proximal pancreatectomy losing more weight than those with distal pancreatectomy. Key factors influencing recovery included age, weight before surgery, and whether patients received nutritional support before the operation; for instance, younger patients and those who were not obese tended to regain weight better. Who this helps: This research benefits doctors and patients by providing insights into which patients may struggle with weight loss after surgery and need additional nutritional support.