A. James Moser, MD
A. James Moser, MD
Associate Professor of Surgery
Co-Director, BIDMC Pancreas and Liver Institute
Our group is evaluating the role of minimally invasive surgery for pancreatic cancer in a prospective study of comparative effectiveness to traditional open surgery. Our objective reflects a multicenter, collaborative effort including the University of Pittsburgh Medical Center, the University of Pisa (Italy), and Maastricht University (Netherlands).
Currently, more than 70% of patients with potentially resectable pancreatic cancer do not undergo potentially curative surgery. Although possible causes for this phenomenon are numerous, fear of traditional open surgery, perceived prolonged impairment of quality of life and nutrition afterward, as well as minimal proven survival benefits are all factors that can be studied in properly designed clinical trials.
Our published data to date demonstrates no apparent inferiority of cancer outcomes after minimally invasive resection, and mounting evidence suggests improved short-term postoperative outcomes and possibly better completion rates of adjuvant chemotherapy after minimal access surgery. Whether short-term benefits will translate into improved long-term outcomes and better nutrition are the subject of maturing multicenter studies. Methods to accelerate the training and adoption of new technologies are underway through evaluation of the learning curve for advanced minimally invasive surgery.
Jamal MH, Doi SA, Moser AJ, Dumitra S, Abou Khalil J, Simoneau E, Chaudhury P, Onitilo AA, Metrakos P, Barkun JS. McGill Brisbane Symptom Score for patients with resectable pancreatic head adenocarcinoma. World J Gastroenterol 2014;20(34):12226-32.
Boone BA, Sabbaghian S, Zenati M, Marsh JW, Moser AJ, Zureikat AH, Singhi AD, Zeh HJ 3rd, Krasinskas AM. Loss of SMAD4 staining in pre-operative cell blocks is associated with distant metastases following pancreaticoduodenectomy with venous resection for pancreatic cancer. J Surg Oncol 2014;110(2):171-5.
Rajagopalan MS, Heron DE, Wegner RE, Zeh HJ, Bahary N, Krasinskas AM, Lembersky B, Brand R, Moser AJ, Quinn AE, Burton SA. Pathologic response with neoadjuvant chemotherapy and stereotactic body radiotherapy for borderline resectable and locally advanced pancreatic cancer. Radiat Oncol 2013;8:254.
Kim CH, Ling DC, Wegner RE, Flickinger JC, Heron DE, Zeh H, Moser AJ, Burton SA. Stereotactic body radiotherapy in the treatment of pancreatic adenocarcinoma in elderly patients. Radiat Oncol 2013;8:240.
Nath BD, Freedman SD, Moser AJ. The Frey procedure is a treatment for chronic pancreatitis, not pancreas divisum. JAMA Surg 2013;148(11):1062.
Zureikat AH*, Moser AJ*, Boone BA, Bartlett DL, Zenati M, Zeh HJ 3rd. 250 robotic pancreatic resections: Safety and feasibility. Ann Surg 2013;258(4):554-9;discussion 559-62. *equal credit in authorship