Omar Picado Roque

University of Miami | UM · Department of Surgery

Purpose Genomic profiling in early-stage breast cancer provides prognostic and predictive information. Genomic profiling assays have not been validated in locally advanced breast cancer (LABC). We examined a large cancer registry to evaluate genomic profiling in LABC and its effect on treatment decisions and survival. Methods Females with ER+/HER2...

Background Papillary thyroid cancer (PTC) is three times more common in women than men. However, PTC in men appears to be associated with poorer outcomes than in women. This study compares the clinical presentation and pathologic features of men and women with PTC. Materials and methods A retrospective review of prospectively collected data for pa...

Background The Bethesda System for Reporting Thyroid Cytopathology has 6 diagnostic categories, each with an implied cancer risk of malignancy (ROM). Bethesda III, defined as atypia or follicular lesions of undetermined significance (AUS/FLUS) on fine needle aspiration (FNA), has an indeterminate ROM. This study investigates the utility of Afirma G...

BACKGROUND The rising incidence of thyroid cancer has been attributed to increased detection of papillary thyroid microcarcinoma (PTMC). Although some PTMCs are thought to harbor aggressive pathologic features, the clinical significance of these features remains unclear. This study examines factors associated with survival in this patient populatio...

Background Fine-needle aspiration combined with the Bethesda System for Reporting Thyroid Cytopathology is indispensable in the diagnostic evaluation of thyroid nodules. Their increased detection over the last few decades mandates the determination of which thyroid nodules require surgical management for malignancy. This study examines the correlat...

Objectives: Colloid carcinoma (CC) of the pancreas is associated with an improved prognosis compared with pancreatic ductal adenocarcinoma (PDAC), yet studies on the optimal management of these rare lesions are lacking. Methods: Patients with CC or PDAC treated from 2004 to 2014 were identified in the National Cancer Database. Clinicopathologic...

Background Papillary thyroid carcinoma (PTC) comprises the majority of thyroid malignancy, but it is associated with excellent long-term survival. Highly prevalent with increasing incidence, the optimal surgical management for patients with 1 to 4 cm PTC remains unclear. This study determines factors that affect clinical outcomes, including surviva...

Background: The corona virus disease of 2019 (COVID-19) imposed new public health constraints that deterred people from coming to the hospital. The outcome of patients who developed appendicitis during mandated COVID-19 quarantine has yet to be examined. The main objective was to establish whether there was an increased rate of perforated appendici...

Background The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) standardizes thyroid cytopathology reporting in six tier diagnostic categories. In recent years, noninvasive encapsulated follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP...

Background: Primary aldosteronism is a common cause of secondary hypertension. Resolution of hypertension and hypokalemia after adrenalectomy for primary aldosteronism is variable. This study examines preoperative factors for persistent hypertension and long-term outcome after laparoscopic adrenalectomy in patients with primary aldosteronism. Met...

Background: Sentinel lymph node biopsy provides prognostic information in patients with thick melanoma but is often underutilized. We examine regional lymph node evaluation (RLNE) in patients with thick melanoma and the effect on treatment and overall survival (OS). Methods: Patients with clinical T4N0M0 melanoma were selected from the National...

Background: Recent economic and social changes in low- and middle-income countries in Latin American have influenced the raise of noncommunicable diseases, including cancer. Data from cancer registries are critical for surveilling disease trends during periods of epidemiologic transition. The aim of this study is to generate population estimates of...

PurposePancreatic tumors are rare in children and limited data are available regarding incidence, treatment, and outcomes. We aim to describe patient and tumor characteristics and to report on survival of these diseases.Methods Children with pancreatic tumors were queried from the National Cancer Database (2004–2014). The association between treatm...

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality following distal pancreatectomy (DP). However, the influence of operative technique on VTE risk after DP is unknown. Objective The purpose of this study was to examine the association between the MIS technique versus the open technique and the development of postop...

Background: The significance of lymph node sampling (LNS) on disease-specific survival (DSS) of extremity soft tissue sarcomas (STS) is unknown. We investigated the effect of LNS on DSS in child and adolescent extremity STS. Materials and methods: The Surveillance, Epidemiology, and End Results registry was queried for patients aged <20 y with e...

Cardiac rehabilitation program (CRP) is a recognized non-pharmacological modality to decrease mortality after acute myocardial infarction (AMI) events. We aimed to evaluate the effect of CRP on the cardiac physiology in patients post myocardial infarction (MI). Online database search of PubMed, MEDLINE, EMBASE, SCOPUS, COCHRANE, and GOOGLE SCHOLAR...

Background: Obesity and thyroid cancer has increased in recent decades. Thyroid malignancy is linked with elevated thyroid-stimulating hormone (TSH) levels, which may have a positive association with body mass index (BMI). This study examines obesity and TSH level effect on papillary thyroid cancer (PTC) risk in a surgical population. Methods: A...

Objectives: The objective of this study was to evaluate the role of lymph node (LN) dissection and staging in outcomes of patients with pancreatic adenocarcinoma (PDAC) who underwent neoadjuvant chemotherapy (NAC). Methods: National Cancer Database was queried for patients with stages I to III PDAC diagnosed between 2004 and 2014. Overall surviv...

Background: This is the first meta-analysis to study optimal radiation dose in the setting of concurrent neoadjuvant chemoradiotherapy (cnCRT) for esophageal cancer (EC). We sought to compare outcomes between high dose radiotherapy (HDRT) [>48.85 Gy biologically effective dose (BED)] group and low dose radiotherapy (LDRT) (≤48.85 Gy BED) for patie...

Background: Parathyroidectomy guided by intraoperative parathormone (ioPTH) monitoring for primary hyperparathyroidism (pHPT) confirms removal of all hyperfunctioning parathyroid glands. This study evaluates the utility of an additional 20-min ioPTH measurement in patients who fail to meet the >50% ioPTH drop criterion. Methods: A retrospective...

79 Background: There are conflicting reports on the value of the extent of post neoadjuvant chemoradiation (NCRT) lymphadenectomy (LND) in locally advanced esophageal adenocarcinoma (E-ADC) and squamous cell carcinoma (E-SCC). We sought to study the impact of LND variables [positive and total lymph node (LN) number and LN ratio (LNR)] on oncologica...

78 Background: There is little consensus on the use of neoadjuvant chemoradiation (NCRT) versus neoadjuvant chemotherapy (NCT) in gastric carcinoma (GC) patients. We sought to compare the outcomes of these two approaches in a large national data base. Methods: National Cancer Data Base PUF (2004-2014) of GC patients who underwent NCRT/NCT followed...

453 Background: Pancreatic adenocarcinoma (PDAC) carries a dismal prognosis. Neoadjuvant chemoradiation therapy (NACR) has been introduced to enhance the outcomes of patients with borderline resectable and locally advanced PDAC, however the role of radiation therapy remains largely unknown. Methods: The National Cancer Database (NCDB) was queried f...

Hepatocellular carcinoma (HCC) has a recurrence rate of up to 70% in 5 years after resection, detrimentally lowering survival. The role of adjuvant therapy remains controversial; therefore, the aim of this study was to evaluate the disease‐free and overall survival of patients with HCC, not candidates for transplantation, undergoing resection and a...

Background With improved responses to chemotherapy and targeted treatments, the role of surgery in metastatic gastric cancer (MGC) to the liver needs to be revisited. We sought to examine whether surgical resection is associated with improvement of long-term survival. Methods The National Cancer Database was queried for MGC to the liver (2010-2014...

Background: Esophageal gastrointestinal stromal tumors (E-GIST) and leiomyosarcoma (E-LMS) are rare tumors. Previous studies are limited to small number of patients. We sought to study these two tumors using a large national database. Methods: The National Cancer Data Base 2004-2014 was queried for patients with E-GIST and E-LMS. The primary out...

Background The impact of the neoadjuvant chemoradiation-to-surgery (CRT-S) interval in patients with esophageal cancer is not clear. We aimed to determine the relationship between CRT-S interval and pathological complete response rate (pCR) and overall survival (OS). Methods National Cancer Data Base patients with CRT followed by surgery were stud...

Background: The reclassification of noninvasive encapsulated follicular variant papillary thyroid carcinoma (FVPTC) to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) may have significant implications by changing overall malignancy rates and minimizing the extent of surgical treatment. Methods: A retrospectiv...

PurposeManagement of the axilla in patients with early-stage breast cancer (ESBC) has evolved. Recent trials support less extensive axillary surgery in patients undergoing mastectomy. We examine factors affecting regional lymph node (RLN) surgery and outcomes in patients with ESBC undergoing mastectomy. Methods Women with clinical T1/2 N0 M0 invasi...

2 Background: The association of the interval between neoadjuvant chemo-radiation and surgery (CRT-S), and cancer outcomes in patients with esophageal cancer is not clear. We aimed to determine the relationship between CRT-S interval and pathological complete response rate (pCR), short and long overall survival (OS). Methods: Patients listed on the...

Introduction: Adjuvant Gemcitabine have recently been shown to improve progression free survival in some types of leiomyosarcoma. Adequate cellular uptake of the drug remains a challenge. We aimed to evaluate the role of nucleoside transporter activator (I3C) in increasing the in vitro efficacy of gemcitabine in the treatment of leimyosarcoma. Meth...

Background Outcomes of patients with pancreatic neuroendocrine tumors (panNETs) undergoing surgical or nonsurgical management and outcomes of enucleation versus standard resection were compared. MethodsMEDLINE, EMBASE, PubMed, Scopus, and Cochrane were queried (2000 to present). All studies comparing patients undergoing surgical versus nonsurgical...

Background: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). Methods: Online database search was performed...

357Background: HCC have a recurrence rate of up to 70% in 5 years after resection detrimentally lowering survival. The role of adjuvant HAIC in management of HCC in patients who are not candidates for transplantation is controversial. We aimed to evaluate overall and disease free survival in these patients. Methods: A comprehensive online search of...

Background: Transarterial radioembolization (TARE) has emerged as a newer regional therapy to transarterial chemoembolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). The aim of this study is to compare clinical outcomes of both the techniques. Methods: Online search for studies comparing TARE to TACE from 2005 to pre...

Objective: Despite the extensive use of screening studies, more than two thirds of HCC are detected at an advanced stage. Transarterial Chemoembolization (TACE) has been a widely used to treat unresectable HCC. Drug-eluting beads or DEBTACE has shown improved tolerability over conventional TACE (cTACE). This study aims to compare the overall surviv...

BACKGROUND: CRS+HIPEC to treat peritoneal surface malignancies (PSM) is commonly associated with significant post-operative complications. The aim of this study was to determine predictors of survival and factors associated with post-operative complications in these patients. METHODS: Records of all patients with PSM were retrospectively reviewed (...

BACKGROUND: The value of spleen preservation with distal pancre- atectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen pres- ervation (SPDP). METHODS: Online database search of PubMed, ME...

BACKGROUND: The optimal management of PNETs remains contro- versial. This study aims to compare survival of patients with PNETs under- going either surgical resection or non-surgical management. METHODS: A comprehensive search of MEDLINE, EMBASE, PubMed, SCOPUS and the Cochrane database was conducted (2006-present). All studies for patients with PN...

BACKGROUND: Pancreatic endocrine and exocrine dysfunction as well as POPF remain unresolved complications of pancreatic surgery. Central pan- createctomy (CP) has been an alternative technique to distal pancreatectomy (DP) to preserve pancreatic parenchyma. The aim of this update meta-analysis was to reevaluate the short term postoperative clinical...

323 Background: Transarterial Radio-embolization (TARE) has emerged as a newer regional technique to Transarterial Chemo-embolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). The aim of this study is to evaluate clinical outcomes of both techniques. Methods: Online search for studies comparing TARE to TACE from 2005 to p...