South Nassau Communities Hospital

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South Nassau in the Community

10/18/2010

Award-winning Research on Cancer will Lead to Improved Patient Outcomes


A study by a team of leading lung cancer specialists postulated that if oncologists are able to determine if multiple tumors are metastatic or occurred simultaneously, staging of the cancer and treatment plan would be improved with the potential to improve outcomes and quality of care.

The study, Allelotyping for Loss of Heterozygosity (LOH) – Multifocal Primary Versus Metastatic Cancers, was recently awarded the prestigious Murray Friedman Resident Competition Award by the Brooklyn and Long Island Chapter of the American College of Surgeons. It was presented by surgical resident Svetlana Danovich, DO, PhD, on assignment with the department of thoracic oncology, South Nassau Communities Hospital, and co-authored by Shahriyour Andaz, MD, FACS, FRCS, director of thoracic oncology; Susan Wu, MD, chair of pathology and clinical laboratories; Stewart Fox, MD, director of cardiothoracic surgery, and Roxanne Rosario, clinical research coordinator, all from South Nassau Communities Hospital; and Carl Ruoff, a fourth year medical student from the School of Medicine on elective with the thoracic surgical service at South Nassau. All allelotyping tests performed during the study were carried out by Redpath, a genomics-based cancer diagnostic company in Pittsburgh, PA.

The goal of the study was to determine if allelotyping could be used to assess for LOH. The researchers achieved their goal by performing CT-guided needle biopsy, fine needle aspirates or surgery to remove specimens which included tumor cells as part of routine care. These specimens were micro-dissected for allelotyping. Allelotyping involved both DNA sequencing for specific cancerous gene mutation detection and LOH of cancer associated markers. The proportion of mutated cells within an individual sample was also assessed and a determination of metastatic cancer required demonstration of conforming LOH. The researchers based normal ranges for variation for each allele pair on a significant and representative sample of normal specimens from patients who had no evidence of ongoing neoplastic disease.

“The study revealed that when the loss of heterozygosity was identical (concordant) in the tumors they were metastatic. New multifocal primary cancers had discordant LOH, meaning their LOH was not identical,” said Dr. Andaz, a 2010 recipient of the American College of Surgeons Commission on Cancer’s prestigious Outstanding Performance Award. “Allelotyping for LOH increases the accuracy of diagnosis and improves the outcome of the treatment plan. This makes a tremendous difference in treating cancer as guidelines would suggest palliative therapy for metastatic cancers versus using a more aggressive approach for primary multifocal disease.”

This is the fourth consecutive year in which a study including Dr. Andaz has earned the prestigious award. Dr. Andaz specializes in complex chest cancer procedures and minimally invasive thorascopic surgery. His expertise includes resection and reconstruction of chest wall sarcomas, mesothelioma, tracheal resections and reconstructions, endobronchial surgery, esophageal resection and lung volume reduction surgery. Eliminating the need for large incisions and painful rib resections, the minimally invasive approach offers faster healing and shortened recovery time. For more information or to schedule an appointment with Dr. Andaz, call 1-877-SouthNassau, or visit southnassau.org.



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