Richard A. Prinz, M.D.

Richard A. Prinz, M.D.

Richard A. Prinz, M.D.

Profile

Conditions & Procedures

Conditions

Adrenal Disorders, Endocrine Cancer, Hyperparathyroidism, Parathyroid

Procedures

Adrenal Surgery, Endocrine Surgery, Parathyroid Surgery, Thyroid & Parathyroid Surgery, Thyroid Surgery

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Academic Rank

Clinical Professor

Languages

English

Board Certified

Surgery

Clinical Service

Surgical Oncology

Education, Training & Fellowships

Medical School

Loyola University Medical School, 1972

Internship

Barnes-Jewish Hospital, 1973

Residency

Barnes-Jewish Hospital, 1974
Loyola University Stritch School of Medicine, 1977

Fellowship

Royal Postgraduate Medical School, 1980

Locations

A

NorthShore Medical Group

1000 Central St.
Suite 800
Evanston, IL 60201
847.570.1700 847.733.5296 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

1329 N. Wolf Rd.
Mt. Prospect, IL 60056
847.803.3040 847.733.5296 fax Get Directions This location is wheelchair accessible.
C

NorthShore Medical Group

757 Park Ave. West
Suite 2850
Highland Park, IL 60035
847.570.1700 847.733.5296 fax Get Directions This location is wheelchair accessible.

Insurance

Commercial Plans - Employer Sponsored
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Choice POS II
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Health Network Only
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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SPECIALTY CARE
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
PRIMARY CARE
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HOSPITALS
Aetna Sub- Cofinity
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Sub- First Health
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Traditional Choice-Indemnity Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Beechstreet PPO Network
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Advantage HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Choice Options
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO Plans (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Select PPO
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SPECIALTY CARE
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Blue Cross Blue Shield Blue Choice Select Value Choice
PRIMARY CARE
SPECIALTY CARE
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Blue Cross Blue Shield Blue Distinction Total Care Benefit Differentail
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SPECIALTY CARE
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Blue Cross Blue Shield Blue Options (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue PPO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
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Blue Cross Blue Shield Blue Precision HMO Plans (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
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Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
PRIMARY CARE
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Blue Cross Blue Shield BlueEdge HSA and BlueEdge HCA
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Blue Cross Blue Shield BluePrint
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Blue Cross Blue Shield Community Participating Option
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Blue Cross Blue Shield HMOI
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Blue Cross Blue Shield PPO
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Great West Healthcare (GWH) Cigna Network
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Cigna HMO
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Cigna HMO Open Access
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Cigna HMO Open Access POS
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Cigna HMO POS
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Cigna Medical PPO
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Cigna Medical Indemnity
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Cigna Medical LocalPlus
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Cigna Medical LocalPlus In-Network
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Cigna Medical Network
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Cigna Medical Network POS
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Cigna Medical Open Access Plus (OAP)
PRIMARY CARE
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Cigna Medical Open Access Plus (OAP) In-Network
PRIMARY CARE
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry HMO
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Coventry POS
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Coventry PPO
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Galaxy Health Network
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Health Alliance HMO, PPO, POS, POS-C
PRIMARY CARE
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HOSPITALS
 
 
 
Health Link HMO
If Unicare Affiliate logo present on card
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Health Link PPO
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Link-Open Access I, II, III
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Healthcare's Finest Network- FHN 10 & 20
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Healthcare's Finest Network- FHN Platinum
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Healthcare's Finest Network- HFN Community Health Connect
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Healthcare's Finest Network- HFN Community Health Connect Elite
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Healthcare's Finest Network- HFN Community Health Connect Premiere
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Healthcare's Finest Network- HFN-ID
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Humana Advocate Centered EPO
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Humana Advocate Centered HMO
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Humana Choice POS
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Humana Classic Plan (Traditional Indemnity Plan)
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Humana Coinsurance: NPOS
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Humana Coinsurance: PPO
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Humana Coinsurance:HMO
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Humana Condell Custom PPO
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Humana Copay: HMO
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Humana Copay: NPOS
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Humana Copay: PPO
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Humana COT National POS-Open Access
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Humana Edward- Elmhurst Value HMO
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Humana Edward-Elmhurst Advantage HSA/Choice PPO
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Humana High-deductible plans (HDHP) HMO
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Humana High-deductible plans (HDHP) National point of service (NPOS)
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Humana High-deductible plans (HDHP) PPO
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Humana Illinois Coordinated Care
Available In 2017
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Humana Level Funded Premium
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Humana NorthShore Complete Care
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Humana Self Funding: Administrative Services Only (ASO)
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Humana Self-Funding: Level Funded Premium (LFP)
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Humana Self-Funding: Minimum Premium (MP)
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Humana Self-Funding: Stop Loss Insurance
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
PRIMARY CARE
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Multiplan/ PHCS- Health EOS Network
PRIMARY CARE
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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SPECIALTY CARE
HOSPITALS
Multiplan/ PHCS- MultiPlan Practitioner Only
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Multiplan/ PHCS- MultiPlan Shared Savings
PRIMARY CARE
SPECIALTY CARE
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Multiplan/ PHCS- PHCS Healthy Directions
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Multiplan/ PHCS- PHCS Practitioner Only
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Multiplan/ PHCS- PHCS Savility
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Multiplan/ PHCS- ValuePoint by MultiPlan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
NorthShore Employee Network
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Preferred Network Access
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Preferred Plan- HealthSmart Get Better
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SPECIALTY CARE
HOSPITALS
Preferred Plan PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Stratose- National Preferred Provider Network
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SPECIALTY CARE
HOSPITALS
 
 
Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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SPECIALTY CARE
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Unicare PPO
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SPECIALTY CARE
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UniCare Travel Access
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United Healthcare Catalyst
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United Healthcare Choice
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United Healthcare Choice Plus
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United Healthcare Core
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Exchange Plans
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SPECIALTY CARE
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Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balance Care 10+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Basic 103 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Premier 101 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Solution 102 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry $15 Copay; Silver & Gold
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze $ 20 Copay
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze $10 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze $15 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health - an Affiliate of United Healthcare
Verify physician participation and out of pocket expenses with Harken
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Alliance HMO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Alliance POS (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Alliance PPO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Humana Chicago HMOx (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Land of Lincoln Health Traditional PPO
Plan Ending 9/30/16
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare Compass (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Medicaid
PRIMARY CARE
SPECIALTY CARE
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Aetna Better Health FHP
PRIMARY CARE
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
PRIMARY CARE
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Cigna HealthSpring ICP
PRIMARY CARE
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Community Care Alliance- ICP
PRIMARY CARE
SPECIALTY CARE
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Family Health Network- FHP
PRIMARY CARE
SPECIALTY CARE
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Harmony/WellCare FHP Plan
PRIMARY CARE
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HOSPITALS
 
 
Humana ICP
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare Family Health Plan (FHP/ACA)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare ICP
Primary Care- Current Patients Only
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Illinois Department of Public Aid (IDPA)
PRIMARY CARE
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Meridian FHP/ACA Expansion
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Meridian ICP
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Molina ICP
PRIMARY CARE
SPECIALTY CARE
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Next Level ACA/FHP
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Medicare Advantage Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare (SM) Plan (HMO)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare (SM) Plan (PPO)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Advantage Group Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Value Plan (HMO)/HMO Value
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Value Plan (PPO)/PPO Value Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Traditional Choice Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Medicare Advantage Basic HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Advantage HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Premier HMO-POS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Primary HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring TotalCare HMO-SNP
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Community Care Alliance Complete HMO-D-SNP
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Community Care Alliance HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Access (HMO-SNP)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Choice (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Health Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare RX (HMO)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Value (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare HMO Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare Special Needs Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Humana Choice PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Community HMO Diabetes and Heart (SNP Program)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Gold Plus HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Gold Plus PFFS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Molina Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare - AARP Medicare Complete
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare AARP Medicare Complete Access
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- AARP Medicare Complete Plus (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare Medicare Advantage Focus
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- Medicare Solutions/Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Medicare Medicaid Alignment Initiative (MMAI) Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Better Health MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Illinicare MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Molina MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Commercial - Individual Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Premier 101 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Shield Basic 103 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Precision Platinum HMO 104
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Solution 102 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry $15 Copay: Silver & Gold
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
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Publications

  • External radiation is associated with limited improvement in overall survival in resected margin-negative stage IIB pancreatic adenocarcinoma.

    Surgery 2016 Sep 7

    Authors: Kantor O, Talamonti MS, Lutfi W, Wang CH, Winchester DJ, Marsh R, Prinz RA, Baker MS
    Abstract
    The absolute benefit of adjuvant external beam radiation therapy after a margin-negative resection in early stage pancreatic cancer has not been determined.
    We queried the National Cancer Data Base for patients with pathologic stage I-II pancreatic adenocarcinoma who underwent operative resection between 2004 and 2012. Multivariate Cox regression adjusted for age, race, comorbidities, facility type, location and volume, type of pancreatectomy, and tumor grade was used to estimate stage-specific survival.
    A total of 15,966 patients with stage I-II pancreatic adenocarcinoma underwent upfront operative therapy (no neoadjuvant treatment) and had a margin-negative resection during the study period. A total of 835 (5.2%) patients were pathologic stage IA, 1,539 (9.5%) were stage IB, 3,378 (20.9%) were stage IIA, and 10,214 (63.1%) were stage IIB. Chemoradiation utilization increased with increasing stage (22.8% in stage IA vs 39.6% in stage IIB, P < .01). Chemoradiation was more common at low-volume centers (39.0% vs 31.7% at high-volume centers, P < .01) and with younger age (43.3% of patients <70 years old compared to 25.0% ≥70 years old, P < .01). Treatment at a high-volume center was associated with decreased mortality (hazard ratio 0.80-0.89) across all stages. Age ≥70 years old (hazard ratio 1.18-1.29, P < .01) and higher grade (hazard ratio 1.68-2.69, P < .01) were associated with higher risk of mortality at all stages. Chemoradiation was associated with a benefit in median overall survival over chemotherapy alone for stage IIB disease (21.8 months vs 19.5 months, P < .01). Chemoradiation was not associated with a significant benefit in median overall survival for stage IA, IB, or IIA disease (P > .30).
    Addition of radiation to adjuvant chemotherapy after margin-negative resection of pancreatic adenocarcinoma is associated with a limited survival benefit in patients with pathologic stage IIB disease and should be weighed against its associated risks in these patient groups.
    PMID: 27614417 [PubMed - as supplied by publisher]
  • Perioperative chemotherapy is associated with a survival advantage in early stage adenocarcinoma of the pancreatic head.

    Surgery 2016 Sep

    Authors: Lutfi W, Talamonti MS, Kantor O, Wang CH, Liederbach E, Stocker SJ, Bentrem DJ, Roggin KK, Winchester DJ, Marsh R, Prinz RA, Baker MS
    Abstract
    The value of neoadjuvant chemotherapy in the treatment of early stage pancreatic cancer is not yet clear.
    We evaluated patients from the National Cancer Data Base who underwent pancreaticoduodenectomy for clinical stage I and II pancreatic adenocarcinoma between 2006 and 2012.
    In total, 7,881 patients were identified. Of these, 27.5% received no chemotherapy, 57.4% received adjuvant chemotherapy, 10.2% received neoadjuvant chemotherapy alone, and 4.9% received perioperative chemotherapy, both preoperative and postoperative chemotherapy. Neoadjuvant chemotherapy use (neoadjuvant chemotherapy alone and perioperative chemotherapy) increased from 12.0% in 2006 to 20.2% in 2012. Patients who received chemotherapy prior to the operation (neoadjuvant chemotherapy alone and perioperative chemotherapy) had greater rates of margin negative (80.2% vs 73.0%, P < .001) and node negative (58.2% vs 28.7%, P < .001) resections and shorter mean durations of stay (12.0 vs 11.1 days, P = .012) than those receiving either adjuvant chemotherapy or no chemotherapy at all. There were no differences in 30-day unplanned readmissions (P = .074) and 90-day mortality (P = .227). On Cox survival analysis, adjusted for clinical variables including age and comorbid disease, patients undergoing perioperative chemotherapy, adjuvant chemotherapy, and neoadjuvant chemotherapy alone demonstrated significantly improved overall survival relative to that of patients undergoing resection alone (all P < .001). Patients receiving perioperative chemotherapy demonstrated a significant overall survival advantage compared with those receiving adjuvant chemotherapy (hazard ratio 0.75; 95% confidence interval, 0.65-0.85). Neoadjuvant chemotherapy alone had a marginal overall survival benefit compared with adjuvant chemotherapy (hazard ratio 0.89; 95% confidence interval, 0.81-0.98).
    Early stage pancreatic cancer patients who receive perioperative chemotherapy have better overall survival than those receiving no chemotherapy, adjuvant chemotherapy, or neoadjuvant chemotherapy alone. Patterns of postoperative morbidity are similar regardless of the sequence of therapy. Neoadjuvant chemotherapy should be considered for patients presenting with early stage pancreatic cancer.
    PMID: 27422328 [PubMed - as supplied by publisher]
  • Response to commentary on: Risk factors for central lymph node metastasis in papillary thyroid carcinoma: A National Cancer Data Base (NCDB) study.

    Surgery 2016 May 26

    Authors: Suman P, Wang CH, Abadin SS, Block R, Raghavan V, Moo-Young TA, Prinz RA, Winchester DJ
    Abstract
    Postthyroidectomy radioiodine (RAI) therapy is indicated for papillary thyroid carcinoma (PTC) with high-risk features. There is 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 to 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 and 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 9,706 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 (hazard ratio [HR] 1.26, 95% confidence interval [CI] 0.98-1.62, P = .07) on adjusted Cox multivariable analysis. Timing of RAI therapy failed to affect OS in propensity-matched high-risk patients (HR 1.09, 95% CI 0.75-1.58, P = .662).
    The timing of postthyroidectomy initial RAI therapy does not affect OS in patients with high-risk PTC.
    CI = confidence interval CLNM = cervical lymph node metastasis FVPTC = follicular variant papillary thyroid carcinoma HR = hazard ratio KM = Kaplan-Meier NCDB = National Cancer Data Base OS = overall survival PTC = papillary thyroid carcinoma RAI = radioactive iodine.
    PMID: 27238355 [PubMed - as supplied by publisher]
  • The sonic hedgehog signaling pathway stimulates anaplastic thyroid cancer cell motility and invasiveness by activating Akt and c-Met.

    Oncotarget 2016 Mar 1

    Authors: Williamson AJ, Doscas ME, Ye J, Heiden KB, Xing M, Li Y, Prinz RA, Xu X
    Abstract
    The sonic hedgehog (Shh) pathway is highly activated in thyroid neoplasms and promotes thyroid cancer stem-like cell phenotype, but whether the Shh pathway regulates thyroid tumor cell motility and invasiveness remains unknown. Here, we report that the motility and invasiveness of two anaplastic thyroid tumor cell lines, KAT-18 and SW1736, were inhibited by two inhibitors of the Shh pathway (cyclopamine and GANT61). Consistently, the cell motility and invasiveness was decreased by Shh and Gli1 knockdown, and was increased by Gli1 overexpression in KAT-18 cells. Mechanistic studies revealed that Akt and c-Met phosphorylation was decreased by a Gli1 inhibitor and by Shh and Gli1 knockdown, but was increased by Gli1 overexpression. LY294002, a PI-3 kinase inhibitor, and a c-Met inhibitor inhibited the motility and invasiveness of Gli1-transfected KAT-18 cells more effectively than the vector-transfected cells. Knockdown of Snail, a transcription factor regulated by the Shh pathway, led to decreased cell motility and invasiveness in KAT-18 and SW1736 cells. However, key epithelial-to-mesenchymal transition (EMT) markers including E-cadherin and vimentin as well as Slug were not affected by cyclopamine and GANT61 in either SW1736 or WRO82, a well differentiated follicular thyroid carcinoma cell line. Our data suggest that the Shh pathway-stimulated thyroid tumor cell motility and invasiveness is largely mediated by AKT and c-Met activation with little involvement of EMT.
    PMID: 26859575 [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
    Abstract
    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
    Abstract
    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]
  • 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
    Abstract
    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]
  • The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes.

    American journal of surgery 2015 Mar

    Authors: Sharpe SM, Talamonti MS, Wang E, Bentrem DJ, Roggin KK, Prinz RA, Marsh RD, Stocker SJ, Winchester DJ, Baker MS
    Abstract
    The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established.
    The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011.
    One hundred forty-five patients underwent LDP; 625 underwent ODP. Compared with ODP, patients undergoing LDP were older (68 ± 10.1 vs 66 ± 10.5 years, P = .027), more likely treated in academic centers (70% vs 59%, P = .01), and had shorter hospital stays (6.8 ± 4.6 vs 8.9 ± 7.5 days, P < .001). Demographic data, lymph node count, 30-day unplanned readmission, and 30-day mortality were identical between groups. Multivariable regression identified a lower probability of prolonged length of stay with LDP (odds ratio .51, 95% confidence interval .327 to .785, P = .0023). There was no association between surgical approach and node count, readmission, or mortality.
    LDP for DAC provides shorter postoperative lengths of stay and rates of readmission and 30-day mortality similar to OPD without compromising perioperative oncologic outcomes.
    PMID: 25596756 [PubMed - as supplied by publisher]
  • Comparison of tumor markers for predicting outcomes after resection of nonfunctioning pancreatic neuroendocrine tumors.

    Surgery 2014 Dec

    Authors: Cherenfant J, Talamonti MS, Hall CR, Thurow TA, Gage MK, Stocker SJ, Lapin B, Wang E, Silverstein JC, Mangold K, Odeleye M, Kaul KL, Lamzabi I, Gattuso P, Winchester DJ, Marsh RW, Roggin KK, Bentrem DJ, Baker MS, Prinz RA
    Abstract
    This study compares the predictability of 5 tumor markers for distant metastasis and mortality in pancreatic neuroendocrine tumors (PNETs).
    A total of 128 patients who underwent pancreatectomy for nonfunctioning PNETs between 1998 and 2011 were evaluated. Tumor specimens were stained via immunochemistry for cytoplasmic and nuclear survivin, cytokeratin 19 (CK19), c-KIT, and Ki67. Univariate and multivariate regression analyses and receiver operating characteristics curve were used to evaluate the predictive value of these markers.
    A total of 116 tumors (91%) were positive for cytoplasmic survivin, 95 (74%) for nuclear survivin, 85 (66.4%) for CK19, 3 for c-KIT, and 41 (32%) for Ki67 >3%. Twelve (9%) tumors expressed none of the markers. Survivin, CK19, and c-KIT had no substantial effect on distant metastasis or mortality. Age >55 years, grade 3 histology, distant metastasis, and Ki67 >3% were associated with mortality (P < .05). A cut-off of Ki67 >3% was the best predictor (83%) of mortality with an area under the curve of 0.85. Ki67 >3% also predicted occurrence of distant metastases with odds ratio of 9.22 and 95% confidence interval of 1.55-54.55 (P < .015).
    Of the 5 markers studied, only Ki67 >3% was greatly associated with distant metastasis and death. Survivin, CK19, and c-KIT had no prognostic value in nonfunctioning PNETs.
    PMID: 25456943 [PubMed - as supplied by publisher]