Publications by authors named "Lawrence Walter"

26 Publications

  • Page 1 of 1

Comment on "Pouch Versus No Pouch Following Total Gastrectomy: Meta-analysis of Randomized and Nonrandomized Studies".

Authors:
Walter Lawrence

Ann Surg 2020 04;271(4):e106

Professor of Surgery (Emeritus) and Director Emeritus, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA.

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http://dx.doi.org/10.1097/SLA.0000000000003420DOI Listing
April 2020

The Changing Face of Surgical Oncology.

Authors:
Walter Lawrence

Ann Surg Oncol 2017 12 25;24(Suppl 3):546-548. Epub 2017 Oct 25.

Division of Surgical Oncology and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.

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http://dx.doi.org/10.1245/s10434-017-6138-2DOI Listing
December 2017

Changes in and Impact of the Death Review Process in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

Rev Recent Clin Trials 2015 ;10(3):206-11

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada.

Death review was conducted for the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial to avoid the biases associated with causes of death entered on death certificates. An algorithm selected deaths for review. Records on diagnosis and terminal illness were perused in the coordinating center and by the chair of the death review committee (DRC). Identifying information and randomization arm was removed. Three reviewers independently determined the cause of death. Disagreement was resolved at a meeting of the DRC. This process was subsequently simplified. The cause of death was determined by one DRC member and compared to the death certificate. With agreement the case was finalized. When discordant, the records were sent to a second DRC member. If the reviewers agreed, the case was finalized. If not, a third member reviewed. If two of the three reviewers agreed, the case was sent back to the discordant reviewer. If the reviewer remained discordant the case was resolved by a conference call. Of the 4728 death reviews that were completed, the DRC confirmed the death certificate underlying cause for over 90%. Between 5% and 13% of the certified deaths were regarded as indirect causes of death, associated with the treatment of the ascertained cancer; differential for prostate cancer, 11% in the intervention arm and 6% in the control. Without review, between 1% and 6% of the deaths that occurred would not have been assigned to the relevant PLCO cancer. The DRC completed 76% of those requiring review before the process ceased.
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http://dx.doi.org/10.2174/1574887110666150730120752DOI Listing
July 2016

Genotyping Informatics and Quality Control for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort.

Genetics 2015 Aug 19;200(4):1051-60. Epub 2015 Jun 19.

Kaiser Permanente Northern California Division of Research, Oakland, California 94612.

The Kaiser Permanente (KP) Research Program on Genes, Environment and Health (RPGEH), in collaboration with the University of California-San Francisco, undertook genome-wide genotyping of >100,000 subjects that constitute the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. The project, which generated >70 billion genotypes, represents the first large-scale use of the Affymetrix Axiom Genotyping Solution. Because genotyping took place over a short 14-month period, creating a near-real-time analysis pipeline for experimental assay quality control and final optimized analyses was critical. Because of the multi-ethnic nature of the cohort, four different ethnic-specific arrays were employed to enhance genome-wide coverage. All assays were performed on DNA extracted from saliva samples. To improve sample call rates and significantly increase genotype concordance, we partitioned the cohort into disjoint packages of plates with similar assay contexts. Using strict QC criteria, the overall genotyping success rate was 103,067 of 109,837 samples assayed (93.8%), with a range of 92.1-95.4% for the four different arrays. Similarly, the SNP genotyping success rate ranged from 98.1 to 99.4% across the four arrays, the variation depending mostly on how many SNPs were included as single copy vs. double copy on a particular array. The high quality and large scale of genotype data created on this cohort, in conjunction with comprehensive longitudinal data from the KP electronic health records of participants, will enable a broad range of highly powered genome-wide association studies on a diversity of traits and conditions.
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http://dx.doi.org/10.1534/genetics.115.178905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574249PMC
August 2015

Automated Assay of Telomere Length Measurement and Informatics for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort.

Genetics 2015 Aug 19;200(4):1061-72. Epub 2015 Jun 19.

Department of Biochemistry and Biophysics, University of California, San Francisco, California 94158-2517

The Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH) Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort includes DNA specimens extracted from saliva samples of 110,266 individuals. Because of its relationship to aging, telomere length measurement was considered an important biomarker to develop on these subjects. To assay relative telomere length (TL) on this large cohort over a short time period, we created a novel high throughput robotic system for TL analysis and informatics. Samples were run in triplicate, along with control samples, in a randomized design. As part of quality control, we determined the within-sample variability and employed thresholds for the elimination of outlying measurements. Of 106,902 samples assayed, 105,539 (98.7%) passed all quality control (QC) measures. As expected, TL in general showed a decline with age and a sex difference. While telomeres showed a negative correlation with age up to 75 years, in those older than 75 years, age positively correlated with longer telomeres, indicative of an association of longer telomeres with more years of survival in those older than 75. Furthermore, while females in general had longer telomeres than males, this difference was significant only for those older than age 50. An additional novel finding was that the variance of TL between individuals increased with age. This study establishes reliable assay and analysis methodologies for measurement of TL in large, population-based human studies. The GERA cohort represents the largest currently available such resource, linked to comprehensive electronic health and genotype data for analysis.
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http://dx.doi.org/10.1534/genetics.115.178624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574243PMC
August 2015

Characterizing Race/Ethnicity and Genetic Ancestry for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort.

Genetics 2015 Aug 19;200(4):1285-95. Epub 2015 Jun 19.

Institute for Human Genetics, University of California, San Francisco, California 94143-0794 Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94158-2549 Kaiser Permanente Northern California Division of Research, Oakland, California 94612-2304

Using genome-wide genotypes, we characterized the genetic structure of 103,006 participants in the Kaiser Permanente Northern California multi-ethnic Genetic Epidemiology Research on Adult Health and Aging Cohort and analyzed the relationship to self-reported race/ethnicity. Participants endorsed any of 23 race/ethnicity/nationality categories, which were collapsed into seven major race/ethnicity groups. By self-report the cohort is 80.8% white and 19.2% minority; 93.8% endorsed a single race/ethnicity group, while 6.2% endorsed two or more. Principal component (PC) and admixture analyses were generally consistent with prior studies. Approximately 17% of subjects had genetic ancestry from more than one continent, and 12% were genetically admixed, considering only nonadjacent geographical origins. Self-reported whites were spread on a continuum along the first two PCs, indicating extensive mixing among European nationalities. Self-identified East Asian nationalities correlated with genetic clustering, consistent with extensive endogamy. Individuals of mixed East Asian-European genetic ancestry were easily identified; we also observed a modest amount of European genetic ancestry in individuals self-identified as Filipinos. Self-reported African Americans and Latinos showed extensive European and African genetic ancestry, and Native American genetic ancestry for the latter. Among 3741 genetically identified parent-child pairs, 93% were concordant for self-reported race/ethnicity; among 2018 genetically identified full-sib pairs, 96% were concordant; the lower rate for parent-child pairs was largely due to intermarriage. The parent-child pairs revealed a trend toward increasing exogamy over time; the presence in the cohort of individuals endorsing multiple race/ethnicity categories creates interesting challenges and future opportunities for genetic epidemiologic studies.
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http://dx.doi.org/10.1534/genetics.115.178616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574246PMC
August 2015

Dr. Jordan inspires.

Authors:
Walter Lawrence

Bull Am Coll Surg 2013 Jun;98(6):71

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June 2013

Technologic innovations in surgery: a philosophic reflection on their impact on operations for cancer.

Authors:
Walter Lawrence

J Surg Oncol 2009 Aug;100(2):163-8

Department of Surgery, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia 23298-0011, USA.

Technologic advances this past half-century have clearly had a positive effect on our ability to both diagnose and treat human cancer as well as on the operative treatment of other diseases. However, the impact of these innovations on the surgical treatment of cancer is not as clear as it is for many other problems that are managed surgically. This review is an "opinion piece" that attempts to assess the successes and failures of technologic innovations that have been introduced for the purpose of improving the operative treatment of cancer.
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http://dx.doi.org/10.1002/jso.21333DOI Listing
August 2009

Is our level of professionalism where it should be?

Authors:
Walter Lawrence

Bull Am Coll Surg 2004 Jun;89(6):21-5

Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.

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June 2004

On quality of life in the long-term survivors after total gastrectomy for gastric carcinoma.

Authors:
Walter Lawrence

J Surg Oncol 2008 Feb;97(2):131

Medical College of Virginia, (Virginia Commonwealth University) Richmond, VA 23298, USA.

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http://dx.doi.org/10.1002/jso.20924DOI Listing
February 2008

Clinical results of various reconstructions employed after total gastrectomy.

J Surg Oncol 2008 Feb;97(2):186-92

Division of Surgical Oncology and the Massey Cancer Center, Virginia Commonwealth University and the VCU Health System, Richmond, VA, USA.

Methods of restoring continuity after total gastrectomy, particularly those creating a "reservoir," have led to many publications over the last 20 years. These publications are herein reviewed in an attempt to answer questions regarding the clinical value of a jejunal "reservoir". The conclusion we reached from this review was that such a reconstruction does reduce unpleasant symptoms, aids weight maintenance, and is a valuable operative approach.
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http://dx.doi.org/10.1002/jso.20928DOI Listing
February 2008

Creating a model program for influenza surveillance in California: results from the 2005-2006 influenza season.

Am J Prev Med 2007 Oct;33(4):353-7

Department of Health Services, Viral and Ricksettial Disease Laboratory, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA.

Background: Influenza surveillance is valuable for monitoring trends in influenza-related morbidity and mortality. Using the 2005-2006 influenza season as an example, this paper describes a comprehensive influenza surveillance program used by the California Department of Public Health (CDPH).

Methods: Data collected from patients evaluated for acute respiratory illness in a given week were reported and summarized the following week, including (1) electronic hospital pneumonia and influenza admission and antiviral usage records from Kaiser Permanente, (2) sentinel provider influenza-like illness (ILI) reports, (3) severe pediatric influenza case reports (e.g., children either hospitalized in intensive care or expired), (4) school clinic ILI evaluations, and (5) positive influenza test results from a network of academic, hospital, commercial, and public health laboratories and the state CDPH Viral and Rickettsial Disease Laboratory.

Results: Influenza activity in California in the 2005-2006 season was moderate in severity; all clinical and laboratory markers rose and fell consistently. Extensive laboratory characterization identified the predominant circulating virus strain as A/California/7/2004(H3N2), which was a component of the 2005-2006 influenza vaccine; 96% of samples tested showed adamantane resistance.

Conclusions: By using multiple, complementary surveillance methods coupled with a strong laboratory component, the CDPH has developed a simple, flexible, stable, and widely accepted influenza surveillance system that can monitor trends in statewide influenza activity, ascertain the correlation between circulating strains with vaccine strains, and assist with detection of new strain variants. The methods described can serve as a model for influenza surveillance in other states.
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http://dx.doi.org/10.1016/j.amepre.2007.05.008DOI Listing
October 2007

Surgeon, scientist, and sailor--a tribute to Blake Cady, MD.

Authors:
Walter Lawrence

J Surg Oncol 2006 Dec;94(8):643-5

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http://dx.doi.org/10.1002/jso.20703DOI Listing
December 2006

Challenges in academic surgery.

Authors:
Walter Lawrence

J Am Coll Surg 2005 Sep;201(3):489-90; author reply 490

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http://dx.doi.org/10.1016/j.jamcollsurg.2005.05.018DOI Listing
September 2005

Assessment of the quality of oncology patient care.

Authors:
Walter Lawrence

J Surg Oncol 2005 Sep;91(3):151-2

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http://dx.doi.org/10.1002/jso.20298DOI Listing
September 2005

Medicaid chemical dependency patients in a commercial health plan: do high medical costs come down over time?

J Behav Health Serv Res 2005 Jul-Sep;32(3):253-63

Division of Research, Oakland, CA 94602, USA.

A cohort of 197 Medicaid-insured patients presenting for treatment in Kaiser Permanente's outpatient chemical dependency treatment program were observed the year prior to their program intake visit and followed for 3 years afterwards, to compare their medical costs and utilization to demographically matched commercially insured patients entering the same programs. The Medicaid-insured patients on average incurred medical costs 60% higher than non-Medicaid patients during the 12-month preintake period ($5402 vs $3377). [corrected] During the 3 years subsequently, however, both groups of chemical dependency patients displayed significant declines in medical costs, averaging 30% from the baseline period to the third year of follow-up. Cost trends reflected declines in use of hospital days, emergency department visits, and nonemergent outpatient visits. These results may help address concerns among Medicaid managed care providers and payers by giving a more realistic account of the long-term costs of this group of high-utilizing enrollees.
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http://dx.doi.org/10.1007/BF02291826DOI Listing
August 2005

Radical surgery for cancer: a historical perspective.

Surg Oncol Clin N Am 2005 Jul;14(3):441-6, v

Medical College of Virginia, Richmond, VA 23298, USA.

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http://dx.doi.org/10.1016/j.soc.2005.05.003DOI Listing
July 2005

Gastric Adenocarcinoma.

Authors:
Walter Lawrence

Curr Treat Options Gastroenterol 2004 Apr;7(2):149-157

Department of Surgery, Virginia Commonwealth University, Box 98011, 1200 East Broad Street, Richmond, VA 23298, USA.

Adenocarcinoma of the stomach is advanced enough in some patients to preclude curative treatment, but many gastric cancer patients have what appears to be localized disease that is amenable to surgical resection, which is the only truly effective treatment. Long-term results of what appear to be "curative resections" are relatively poor, however, and new management tools such as sentinel lymph node biopsy, recently promising adjunctive therapies (such as radiochemotherapy), and the organization of the order of treatment combinations do require further study with an eye to improving outcomes. However, there appears to be little hope for a dramatic improvement in treatment results from these innovations for patients with established gastric cancer. Fortunately, gastric cancer in the United States has gone from being the number one cause of cancer death in our population 50 years ago to that of being the number eight cause of cancer death at this time. This intriguing major decrease in the incidence of this disease must be considered secondary to one or more changes in our own environment that we hope will be exploitable in the future. As with cancers of all types and in all sites, a prevention strategy may prove more effective than the treatment strategies that are outlined here. The management strategies outlined are hopefully only temporary ones until we are able to develop a better handle on primary prevention.
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http://dx.doi.org/10.1007/s11938-004-0036-yDOI Listing
April 2004

The Depression-Arkansas scale: A validation study of a new brief depression scale in an HMO.

J Clin Psychol 2003 Apr;59(4):465-81

Division of Research, Northern California Region, Kaiser Permanente Medical Care Program, Oakland, 94216-2304, USA.

Recent trends in mental-health care have increased the need for practical depression instruments. The Depression-Arkansas (D-ARK), a brief, economical, multipurpose instrument, has been validated for assessing major depressive disorder (MDD) and depressive-symptom severity. Psychometric properties of the D-ARK were compared with standard depression scales (Beck Depression Inventory and Geriatric Depression Scale) among 294 adult and 193 senior primary-care patients, respectively, and 163 patients enrolled in cognitive-behavioral depression classes. The severity scale displayed adequate internal reliability (coefficient alpha =.81-.86), high correlation with the BDI-2 (r =.78-.83) and GDS (r =.75), and similar factor structure to the BDI-2. The D-ARK was calibrated against the BDI-2 and GDS, providing familiar severity category cutpoints with the new instrument. This study yields further data supporting the reliability, validity, and practical utility of the D-ARK.
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http://dx.doi.org/10.1002/jclp.10137DOI Listing
April 2003

Editorial commentary: Screening mammography.

Authors:
Walter Lawrence

J Surg Oncol 2002 Dec;81(4):159

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http://dx.doi.org/10.1002/jso.10194DOI Listing
December 2002

Diagnosis and management of patients with thyroid nodules.

J Surg Oncol 2002 Jul;80(3):157-70

Division of Surgical Oncology, Medical College of Virginia, Richmond, Virginia 23298, USA.

Fewer than 5% of all adults will have a palpable thyroid nodule, but this is still a large number of individuals who require evaluation. Although most thyroid nodules are a result of a benign disease process (more than 95%), the possibility of thyroid cancer is always a consideration. Important aspects of history taking with a patient in whom a thyroid nodule has been noted include age, gender, family history of thyroid or endocrine disease, prior low dosage head and neck radiation, recent hoarseness, dysphagia, and symptoms of hypermetabolism. Key features of evaluation by physical examination are the size and location of the thyroid abnormality, the degree of firmness of the nodule, the presence of other nodules in the thyroid, palpable cervical lymph nodes, vocal cord paresis or paralysis, and tachycardia and/or tremor. The major categories of thyroid abnormality in such patients include cysts, adenomas, thyroiditis, and cancer. Although radionuclide scans, ultrasound examination and computer tomography have all been employed in the assessment of thyroid nodules, and thyroid stimulating hormone assay is useful for confirming a euthyroid state, fine needle aspiration biopsy (FNAB) has proved to be the most efficient diagnostic tool. The findings from FNAB allow avoidance of operative treatment for a large portion of these patients with palpable thyroid nodules, but a diagnosis of "follicular neoplasm" on FNAB usually requires operation, despite the fact that many such patients do ultimately prove to have a benign lesion. The extent of operation in patients undergoing surgery will depend on the diagnostic findings before operation, but unilateral thyroid lobectomy is the minimum procedure when surgery is required.
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http://dx.doi.org/10.1002/jso.10115DOI Listing
July 2002

Medicaid patients in a private health maintenance organization: patterns of chemical dependency treatment.

J Behav Health Serv Res 2002 Feb;29(1):1-14

Kaiser Permanente Medical Program, Northern California Region, Division of Research, Oakland, CA 94611, USA.

Although many Medicaid beneficiaries receive health care through commercial health maintenance organizations (HMOs), the impact of private managed care on low-income individuals seeking treatment for substance abuse has rarely been studied. This study examined treatment patterns of 234 Medicaid recipients who presented for care at an HMO between 1995 and 1997. After adjustment for demographic factors and duration of health plan membership, the Medicaid patients returned to start treatment after intake less often (odds ratio = 0.60) and dropped out of treatment sooner (median = 14 versus 28 days) than non-Medicaid patients. While many Medicaid patients received significant amounts of substance abuse treatment, further research is needed to explain the observed treatment gap and to identify areas where HMOs can improve services for some of their most vulnerable members.
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http://dx.doi.org/10.1007/BF02287828DOI Listing
February 2002
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