David J. Winchester, M.D.

David J. Winchester, M.D.

David J. Winchester, M.D.

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Conditions & Procedures


Abscess, Appendix, Breast Cancer, Cyst, Gallbladder, Gallbladder Disease, Hernia, Lipoma, Melanoma, Parathyroid, Sarcoma, Skin Lesion


Abdominal Hernia Repair, Endocrine Surgery, General Surgery, Inguinal Hernia Repair, Minimally Invasive Hernia Surgery, Parathyroid Surgery, Peritoneal Dialysis (PD) Catheter, Port-a-cath, Surgical Oncology, Surgical Oncology in Breast, Temporal Artery Biopsy, Thyroid & Parathyroid Surgery, Thyroid Surgery

General Information




NorthShore Medical Group


General Surgery, Surgical Oncology

Academic Rank

Clinical Professor


English, Spanish

Board Certified


Clinical Service

Surgical Oncology

Education, Training & Fellowships

Medical School

Northwestern Feinberg School of Medicine, 1986


Northwestern Feinberg School of Medicine


Northwestern Feinberg School of Medicine


University of Texas MD Anderson Cancer Center



NorthShore Medical Group

2050 Pfingsten Rd.
Suite 128
Glenview, IL 60026
847.570.1700 847.503.4353 fax Get Directions This location is wheelchair accessible.

NorthShore Medical Group

1000 Central St.
Suite 800
Evanston, IL 60201
847.570.1700 847.503.4353 fax Get Directions This location is wheelchair accessible.

NorthShore Medical Group

2050 Pfingsten Rd.
Suite 130
Glenview, IL 60026
847.570.1700 847.503.4353 fax Get Directions This location is wheelchair accessible.

NorthShore Medical Group

2650 Ridge Ave.
Suite 1155
Evanston, IL 60201
847.570.1700 847.503.4353 fax Get Directions This location is wheelchair accessible.


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    Verify physician participation and out of pocket expenses with Harken
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    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2016 Mar 28

    Authors: Suman P, Wang CH, Abadin SS, Block R, Raghavan V, Moo-Young TA, Prinz RA, Winchester DJ
    Post-thyroidectomy radioiodine (RAI) therapy is indicated for papillary thyroid carcinoma (PTC) with high-risk features. There is a variability in the timing of RAI therapy with no consensus. We analyzed the impact of the timing of initial RAI therapy on overall survival (OS) in PTC.
    The National Cancer Data Base (NCDB) was queried from 2003-2006 for patients with PTC undergoing near/subtotal or total thyroidectomy, and RAI therapy. High-risk patients had tumors > 4 cm in size, lymph node involvement or grossly positive margins. Early RAI was ≤3 months whereas delayed was between 3-12 months after thyroidectomy. Kaplan-Meier (KM) and Cox survival analyses were performed after adjusting for patient and tumor-related variables. A propensity matched set of high-risk patients after eliminating bias in RAI timing was also analyzed.
    There were 9706 patients in the high-risk group. The median survival was 74.7 months. KM analysis showed a survival benefit for early RAI in high-risk patients (P .025). However, this difference disappeared (HR 1.26, 95% CI .98-1.62, P .07) on adjusted Cox multivariable analysis. Timing of RAI therapy failed to affect OS in propensity matched high-risk (HR 1.09, 95% CI .75-1.58, P .662) patients.
    The timing of post-thyroidectomy initial RAI therapy does not affect OS in patients with high-risk PTC.
    PMID: 27018620 [PubMed - as supplied by publisher]
  • The Learning Curve Is Surmountable: In Reply to Fong and colleagues.

    Journal of the American College of Surgeons 2016 Feb

    Authors: Kantor O, Pesce C, Liederbach E, Wang CH, Winchester DJ, Yao K
    There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer.
    Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy.
    From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management.
    There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.
    PMID: 26809388 [PubMed - as supplied by publisher]
  • A Graded Evaluation of Outcomes Following Pancreaticoduodenectomy with Major Vascular Resection in Pancreatic Cancer.

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2016 Feb

    Authors: Kantor O, Talamonti MS, Stocker SJ, Wang CH, Winchester DJ, Bentrem DJ, Prinz RA, Baker MS
    Previous studies examining short- and long-term outcomes of pancreaticoduodenectomy with vascular resection for pancreatic adenocarcinoma have not graded perioperative complication severity. These studies may provide incomplete assessments of the efficacy of vascular resection. In the current study, we evaluated 36 patients who had pancreaticoduodenectomy with major vascular resection. These were matched 1:3 by tumor stage and age to patients who had pancreaticoduodenectomy without vascular resection. Charts were reviewed to identify all complications and 90-day readmissions. Complications were graded as either severe or minor adverse postoperative outcomes, taking into account the total length of stay. There were no statistical differences in patient demographics, comorbidities, or symptoms between the groups. Patients who had vascular resection had significantly increased rates of severe adverse postoperative outcomes, readmissions, lengths of hospital stay, as well as higher hospital costs. Hypoalbuminemia and major vascular resection were independent predictors of severe adverse postoperative outcomes. On multivariate Cox-regression survival analysis, patients who had vascular resection had decreased recurrence-free (12 vs. 17 months) and overall (17 vs. 29 months) survival. Major vascular resection was a predictor of mortality, may be an independent prognostic factor for survival, and may warrant incorporation into future staging systems.
    PMID: 26493974 [PubMed - as supplied by publisher]
  • Risk factors for central lymph node metastasis in papillary thyroid carcinoma: A National Cancer Data Base (NCDB) study.

    Surgery 2016 Jan

    Authors: Suman P, Wang CH, Abadin SS, Moo-Young TA, Prinz RA, Winchester DJ
    There is no consensus regarding prophylactic central lymph node dissection (pCLND) in patients with papillary thyroid carcinoma (PTC). Identification of risk factors for central lymph node metastasis (CLNM) in patients with PTC could assist surgeons in determining whether to perform selective pCLND.
    The National Cancer database was queried from 1998 to 2011 for patients with clinical staging T1-4cN0M0 PTC. All patients underwent near, sub-, or total thyroidectomy with or without pCLND. Univariate and multivariable logistic regressions were performed on the following clinical variables: age, sex, race and tumor size as risk factors for pathologic CLNM (pN1a).
    In 39,562 patients with T1-4cN0M0 PTC, 61% underwent pCLND. Patients with age >45 years, African American race, tumor size ≤ 1 cm, unifocal tumors, follicular variant PTC, no insurance, and treatment at community cancer facilities were less likely to have pCLND (P < .001). In the pCLND group, 15.6% of patients had CLNM. On adjusted multivariable logistic regression, age ≤ 45 years, Asian race, male sex, and larger tumors were statistically significantly associated with CLNM.
    Age ≤ 45 years, Asian race, male sex, and larger tumors are associated with the presence of CLNM, which allows for selective pCLND in PTC.
    PMID: 26435436 [PubMed - as supplied by publisher]
  • Survival Outcomes and Pathologic Features Among Breast Cancer Patients Who Have Developed a Contralateral Breast Cancer.

    Annals of surgical oncology 2015 Dec

    Authors: Liederbach E, Wang CH, Lutfi W, Kantor O, Pesce C
    Studies have shown that contralateral breast cancer (CBC) portends worse survival compared to unilateral breast cancer (UBC), but few studies have been conducted in the United States, and survival is usually examined from the time of CBC development.
    Utilizing the Surveillance, Epidemiology, and End Results database, we selected 83,001 newly diagnosed breast cancer patients from 1998 to 2005. The time interval between the initial cancer and CBC was used as a time-dependent variable in a Cox regression analysis to examine overall survival (OS) and disease-specific survival (DSS) between UBC and CBC.
    Overall, 2130 patients (2.6 %) developed a CBC, 47.2 % within 5 years and 52.8 % ≥ 5 years. Most stage I patients (61.9 %) developed a stage I CBC, and a majority of stage II patients (51.6 %) developed a stage I CBC (p < 0.001). There was a median follow-up of 8.7 years. After adjustment, patients who developed a CBC 4 years after their initial breast cancer had worse DSS compared to patients with UBC (hazard ratio 1.36, 95 % confidence interval 1.03-1.79). Those patients who developed their CBC 8 years after their initial breast cancer had improved DSS (hazard ratio 0.37, 95 % confidence interval 0.20-0.67). Similar trends were observed for OS. Similar trends for OS and DSS were observed for estrogen receptor-negative women and women <50 years old.
    Development of a CBC early is associated with worse survival, but CBC development later on is associated with improved survival. Future studies are needed that can assist physicians with how to predict whether a patient will develop a CBC early on.
    PMID: 26334294 [PubMed - as supplied by publisher]
  • Early National Experience with Laparoscopic Pancreaticoduodenectomy for Ductal Adenocarcinoma: A Comparison of Laparoscopic Pancreaticoduodenectomy and Open Pancreaticoduodenectomy from the National Cancer Data Base.

    Journal of the American College of Surgeons 2015 Jul

    Authors: Sharpe SM, Talamonti MS, Wang CE, Prinz RA, Roggin KK, Bentrem DJ, Winchester DJ, Marsh RD, Stocker SJ, Baker MS
    There is considerable debate about the safety and clinical equivalence of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDCA).
    We queried the National Cancer Data Base to identify patients undergoing LPD and OPD for PDCA between 2010 and 2011. Chi-square and Student's t-tests were used to evaluate differences between the 2 approaches. Multivariable logistic regression modeling was performed to identify patient, tumor, or facility factors associated with perioperative mortality.
    Four thousand and thirty-seven (91%) patients underwent OPD. Three hundred and eighty-four (9%) patients underwent LPD. There were no statistical differences between the 2 surgical cohorts with regard to age, race, Charlson score, tumor size, grade, stage, or treatment with neoadjuvant chemoradiotherapy. Laparoscopic pancreaticoduodenectomy demonstrated a shorter length of stay (10 ± 8 days vs 12 ± 9.7 days; p < 0.0001) and lower rates of unplanned readmission (5% vs 9%; p = 0.027) than OPD. In an unadjusted comparison, there was no difference in 30-day mortality between the LPD and OPD cohorts (5.2% vs 3.7%; p = 0.163). Multivariable logistic regression modeling predicting perioperative mortality controlling for age, Charlson score, tumor size, nodal positivity, stage, facility type, and pancreaticoduodenectomy volume identified age (odds ratio [OR] = 1.05; p < 0.0001), positive margins (OR = 1.45; p = 0.030), and LPD (OR = 1.89; p = 0.009) as associated with an increased probability of 30-day mortality; higher hospital volume was associated with a lower risk of 30-day mortality (OR = 0.98; p < 0.0001). In institutions that performed ≥10 LPDs, the 30-day mortality rate of the laparoscopic approach was equal to that for the open approach (0.0% vs 0.7%; p = 1.00).
    Laparoscopic pancreaticoduodenectomy is equivalent to OPD in length of stay, margin-positive resection, lymph node count, and readmission rate. There is a higher 30-day mortality rate with LPD, but this appears driven by a surmountable learning curve for the procedure.
    PMID: 26095569 [PubMed - as supplied by publisher]
  • Parathyroid Carcinoma: An Update on Treatment Outcomes and Prognostic Factors from the National Cancer Data Base (NCDB).

    Annals of surgical oncology 2015 Nov

    Authors: Asare EA
    Parathyroid carcinoma is a rare disease. Conflicting results on prognostic factors and extent of surgical resection for patients with parathyroid carcinoma have been made based on small sample sizes. A large, robust dataset is needed to help address some of the controversies.
    A retrospective review of patients with parathyroid carcinoma in the National Cancer Data Base from 1985 to 2006 was performed. Characteristics of the cohort and type of treatment were evaluated. Prognostic factors were assessed with Cox proportional hazards regression models and 5- and 10-year OS rates were determined.
    There were 733 evaluable patients with a mean age of 56.1 ± 15.3 years (median 57, range 15-89) and mean tumor size of 29.6 ± 18.4 mm (median 25.0 mm, range 10.0-150.0). Tumor size, age at diagnosis, male sex, positive nodal status, and complete tumor resection had hazard ratios for death of 1.02 (1.01-1.02, p < 0.0001), 1.06 (1.05-1.07, p < 0.0001), 1.67 (1.24-2.25, p = 0.0008), 1.25 (0.57-2.76, p = 0.6), and 0.42 (0.22-0.81, p = 0.01), respectively, on multivariable analysis. Patients who had removal of the parathyroid tumor with concomitant resection of adjacent organs had HR for death of 0.70 (0.35-1.41, p = 0.3). The 5- and 10-year OS rates were 82.3 and 66 % respectively.
    Patient age, tumor size, and sex have modest effects on survival in patients with parathyroid carcinoma. A staging system with prognostic value for parathyroid carcinoma should include at least these pertinent prognostic factors.
    PMID: 26077914 [PubMed - as supplied by publisher]
  • Impact of the American College of Surgeons Oncology Group Z0011 Randomized Trial on the Number of Axillary Nodes Removed for Patients with Early-Stage Breast Cancer.

    Journal of the American College of Surgeons 2015 Jul

    Authors: Yao K, Liederbach E, Pesce C, Wang CH, Winchester DJ
    The Z0011 trial showed similar outcomes between sentinel node biopsy (SNB) alone and axillary node dissection (ALND) for early-stage breast cancer, but few studies have examined Z0011's impact on practice patterns.
    Using the National Cancer Data Base, we examined use of SNB alone in patients who did and did not fulfill Z0011 eligibility criteria from 1998 to 2011. Because the National Cancer Data Base does not specifically identify SNB vs ALND, we categorized removal of ≤4 nodes as SNB only and ≥10 nodes as ALND.
    Of 74,309 lumpectomy patients who fulfilled Z0011 criteria; 17,630 (23.7%) had a ≤4 nodes removed, 15,619 (21.0%) had 5 to 9 nodes removed, and 41,060 (55.3%) had ≥10 nodes removed. The proportion of lumpectomy patients receiving SNB increased from 6.1% in 1998 to 23.0% in 2009 to 56.0% in 2011 (p < 0.001). Independent predictors of ALND in lumpectomy patients were triple-negative tumors, younger than 50 years old, African-American race, size ≥3.0 cm, ≥2 positive nodes, invasive lobular carcinoma, grade III disease, and lymph node macrometastases. Patients outside of Z0011 criteria also underwent SNB alone: 54% of patients with tumors >5 cm, 52.5% who received no radiation therapy or accelerated partial breast irradiation, 35.9% with clinically positive nodes, 22.3% who underwent mastectomy, and 12.9% who had >3 tumor-positive nodes.
    The use of SNB alone for patients fulfilling Z0011 criteria has increased substantially from 2009 to 2011. A considerable proportion of patients falling outside of Z0011 eligibility criteria were also treated with SNB alone.
    PMID: 25899731 [PubMed - as supplied by publisher]
  • Use of Postmastectomy Radiotherapy and Survival Rates for Breast Cancer Patients with T1-T2 and One to Three Positive Lymph Nodes.

    Annals of surgical oncology 2015 Dec

    Authors: Huo D, Hou N, Jaskowiak N, Winchester DJ, Winchester DP, Yao K
    The effectiveness of postmastectomy radiotherapy (PMRT) in terms of survival for breast cancer patients with American Joint Committee on Cancer (AJCC) pT1-2 and one to three tumor positive lymph nodes is controversial, especially in this era of more effective systemic treatment.
    Using data from the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) program between 1998 and 2008, this study respectively identified 93,793 and 36,299 women with AJCC pT1-2pN1 breast cancer who underwent mastectomy. The association of PMRT use with overall and cause-specific survival was examined using multivariable Cox models in subgroups defined by tumor stage.
    In the NCDB cohort, 21.5 % of the patients (n = 20,236) received PMRT, and a very similar percentage (21.9 %, n = 7939) received PMRT in the SEER cohort. In the NCDB cohort, PMRT was associated with a 14 % relative risk reduction in all-cause mortality among the patients with two positive lymph nodes and tumors 2-5 cm in size or three positive nodes [hazard ratio (HR), 0.86; 95 % confidence interval (CI), 0.81-0.91; p < 0.0001], but PMRT had no beneficial effect for the patients with one positive node or two positive nodes and tumors 2 cm in size or smaller. Analysis of the SEER cohort confirmed this heterogeneous effect, showing PMRT to be associated with a 14 % relative risk reduction in breast cancer cause-specific mortality among the patients with two positive nodes and tumors 2-5 cm in size or three positive nodes (HR 0.86; 95 % CI 0.77-0.96; p = 0.007) but not in the other subgroup.
    The effectiveness of radiotherapy depends on the combination comprising the number of positive lymph nodes and tumor size, which may enable more precise patient selection for PMRT.
    PMID: 25820998 [PubMed - as supplied by publisher]

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Dr. Winchester discusses the latest findings from the study published in the British Journal of Medicine.

Dr. Winchester discusses the latest findings from the study published in the British Journal of Medicine.