Alexandra Lopez-Aguiar and Mohammad Zaidi Receive 2018 ASCO Merit Awards

November 2017

Emory general surgery resident Alexandra Lopez-Aguiar, MD, and post-doctoral research fellow Mohammad Zaidi, MD, have been selected to receive 2018 Conquer Cancer Foundation Merit Awards of the American Society of Clinical Oncology (ASCO). Dr. Lopez-Aguiar and Dr. Zaidi are engaged in research fellowships in the lab of Emory surgical oncologist-scientist Shishir Maithel, MD.

This is the fourth year in a row that fellows from Dr. Maithel's lab have received Merit Awards, and the second year for Dr. Lopez-Aguiar.

ASCO established Merit Awards to honor early career oncologists' research activities. The awards are distributed to residents and fellows whose research is addressed in high-quality abstracts submitted to an ASCO meeting, and will assist with funding Dr. Lopez-Aguiar and Dr. Zaidi's attendance of the 2018 Gastrointestinal Cancers Symposium in San Francisco, January 18-20, 2018, where they will present their abstracts.

Dr. Lopez-Aguiar's abstract described an eight institution study that recommended that regional lymphadenectomy be routinely considered during pancreatic neuroendocrine tumors (PanNETs) resection. The study team focused on 695 patients who underwent PanNETs resection at their institutions from 2000 to 2016, and found that twenty six percent had lymph node positive disease. They also discovered that the preoperative factors that predicted lymph node metastases included tumor size greater than two centimeters, proximal tumor location, moderate differentiation, and detection of Ki-67 (a protein that is a cellular marker for proliferation) greater than three percent.

The investigators concluded that these observations, coupled with the nine-to-23 percent incidence of lymph node metastases in patients without such risk factors, merited the considered inclusion of lymphadenectomy during resection of PanNETs. While pancreatoduodenectomy inherently includes sufficient lymph node retrieval, the study team advised that distal pancreatectomy should remove seven or more lymph nodes for accurate staging.

Dr. Zaidi's abstract reported the results of an eight-institution study from the U.S. Neuroendocrine Tumor Study Group that aimed to define the number of lymph nodes needed to accurately stage small bowel neuroendocrine tumors. The investigators evaluated 203 patients who underwent curative-intent resection for small bowel neuroendocrine tumors (SB-NETs) at their institutions from 2000 to 2016, and found that precise lymph node staging required a minimum of eight lymph nodes for examination.

A finding of three or more positive lymph nodes was associated with decreased three-year recurrence-free survival, compared to one, two, or no positive lymph nodes. The team determined that thorough regional lymphadenectomy was critical for accurate staging and management of patients with SB-NETs.

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