Sotsky Award Will Fund Alexandra Lopez-Aguiar's Presentation of Study

February 2018

Alexandra Lopez-Aguiar, MD, has been awarded the Steve Sotsky Pancreatic Cancer Research Gift for her outstanding work in the pancreatic research field. The award will fund her attendance of the 2018 Annual Meeting of Americas Hepato-Pancreato-Biliary Association (AHPBA), March 7-11 in Miami Beach, where she will present her abstract, "The Conundrum of <2 cm Pancreatic Neuroendocrine Tumors: A Preoperative Risk Score to Predict Lymph Node Metastases and Guide Surgical Management."

Dr. Lopez-Aguiar is a general surgery resident on research sabbatical in the lab of Emory surgical oncologist-scientist Shishir Maithel, MD. Her coauthors were members of the multi-center U.S. Neuroendocrine Tumor Study Group, and included Dr. Maithel as senior author, Emory surgical oncologist Kenneth Cardona, MD, and current PGY-3 resident Cecilia Ethun, who completed her research sabbatical in Dr. Maithel's lab in late 2017.

The study worked towards resolving the controversy over the choice between resection or survelliance of <2cm pancreatic neuroendocrine tumors (PanNETs), which are often very slow-growing, but also contain individual cells that display heterogeneity in terms of proliferation, metastatic potential, and other qualities. Dr. Lopez-Aguiar and her team aimed to design and test a Lymph Node Risk Score (LNRS) that could accurately predict LN metastases for <2cm PanNETS using readily available preoperative data.

The team analyzed 309 patients who underwent curative-intent resection of primary non-functional <2cm PanNETs at eight institutions of the U.S. Neuroendocrine Tumor Study Group from 2000-2016. They found that the readily available preoperative factors of tumor location and percentage of Ki-67—a protein and marker of cellular proliferation—was associated with LN metastases. They then developed an LNRS by assigning values to these preoperative factors based on their odds ratio, and created seven predictive scores from combinations of different tumor locations and Ki-67 expression.

Dr. Lopez-Aguiar and her colleagues discovered that the incidence of LN metastases did indeed progressively increase based on risk group, and concluded that their simple and novel LN risk score appeared to accurately stratify risk of LN metastases for <2cm PanNETs, that it should be tested further, and that it could help guide management strategy.

This is the third major award Dr. Lopez-Aguiar has received while working in Dr. Maithel's lab, with the other two being the 2017 and 2018 Merit Awards of the American Society of Clinical Oncology.

The Steve Sotsky Pancreatic Cancer Research Gift was established by AHBPA member Tara Kent, MD, associate professor of surgery at Beth Israel Deaconess Medical Center, in memory of her father Mr. Steve Sotsky, who died of pancreatic cancer in September 2013. Mr. Sotsky recognized that ongoing research and communication of its results was essential to discovering innovative treatment options for patients with pancreatic disease, and that educational meetings were important to advancing ideas and giving them momentum, especially for young surgeons and residents.

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