Brian Brigman

Positions:

Professor of Orthopaedic Surgery

Orthopaedics
School of Medicine

Professor in Pediatrics

Pediatrics
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1994

University of North Carolina - Chapel Hill

Intern, Surgery

University of Nebraska, Lincoln

Resident, Orthopaedic Surgery

University of Nebraska, Lincoln

Fellow, Orthopaedic Oncology

Boston University

Grants:

Fresh Tissue Lab Agreement

Administered By
Orthopaedics
Awarded By
DePuy Synthes Companies
Role
Principal Investigator
Start Date
End Date

Protocol Number: 14-03-PATHOLHUM-02

Administered By
Orthopaedics
Awarded By
IlluminOss Medical, Inc.
Role
Principal Investigator
Start Date
End Date

Publications:

ASO Author Reflections: Identifying Modifiable and Non-Modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma.

Authors
MLA Citation
Lazarides, Alexander L., et al. “ASO Author Reflections: Identifying Modifiable and Non-Modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma.Ann Surg Oncol, Oct. 2021. Pubmed, doi:10.1245/s10434-021-10904-3.
URI
https://scholars.duke.edu/individual/pub1499473
PMID
34635971
Source
pubmed
Published In
Annals of Surgical Oncology
Published Date
DOI
10.1245/s10434-021-10904-3

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma: A National Cancer Database Study.

BACKGROUND: Limited data are available to inform the risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following surgical resection of chondrosarcoma. METHODS: We retrospectively reviewed 6653 patients following surgical resection of primary chondrosarcoma in the National Cancer Database (2004-2017). Both demographic and clinicopathologic variables were assessed for correlation with readmission and short-term mortality utilizing univariate and multivariate logistic regression modeling. RESULTS: Of 220 readmissions (3.26%), risk factors independently associated with an increased risk of unplanned 30-day readmission included Charlson-Deyo Comorbidity Index (CDCC) (odds ratio [OR] 1.31; p = 0.027), increasing American Joint Committee on Cancer (AJCC) stage (OR 1.31; p = 0.004), undergoing major amputation (OR 2.38; p = 0.001), and axial skeletal location (OR 1.51; p = 0.028). A total of 137 patients died within 90 days of surgery (2.25%). Risk factors associated with increased mortality included the CDCC (OR 1.60; p = 0.001), increasing age (OR 1.06; p < 0.001), having Medicaid insurance status (OR 3.453; p = 0.005), living in a zip code with a higher educational attainment (OR 1.59; p = 0.003), increasing AJCC stage (OR 2.32; p < 0.001), longer postoperative length of stay (OR 1.015; p = 0.033), and positive surgical margins (OR 2.75; p = 0.001). Although a majority of the cohort did not receive radiation therapy (88.8%), receiving radiotherapy (OR 0.132; p = 0.010) was associated with a decreased risk of short-term mortality. CONCLUSIONS: Several tumor, treatment, and patient factors can help inform the risk of readmission and short-term mortality in patients with surgically treated chondrosarcoma.
Authors
Evans, DR; Lazarides, AL; Cullen, MM; Somarelli, JA; Blazer, DG; Visguass, JD; Brigman, BE; Eward, WC
MLA Citation
Evans, Daniel R., et al. “Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma: A National Cancer Database Study.Ann Surg Oncol, Sept. 2021. Pubmed, doi:10.1245/s10434-021-10802-8.
URI
https://scholars.duke.edu/individual/pub1497734
PMID
34570333
Source
pubmed
Published In
Annals of Surgical Oncology
Published Date
DOI
10.1245/s10434-021-10802-8

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled for noncardiac surgery under general anaesthesia in an observational cohort study, of whom 52 underwent neuroimaging. We measured cognition; Aβ, tau, p-tau levels in CSF; and resting-state intrinsic functional connectivity in six Alzheimer's disease-risk regions before and 6 weeks after surgery. RESULTS: There were no significant APOE4-related differences in cognition or CSF biomarkers, except APOE4 carriers had lower CSF Aβ levels than non-carriers (preoperative median CSF Aβ [median absolute deviation], APOE4 305 pg ml-1 [65] vs 378 pg ml-1 [38], respectively; P=0.001). Controlling for age, APOE4 carriers had significantly greater preoperative functional connectivity than non-carriers between several brain regions implicated in Alzheimer's disease, including between the left posterior cingulate cortex and left angular gyrus (β [95% confidence interval, CI], 0.218 [0.137-0.230]; PFWE=0.016). APOE4 carriers, but not non-carriers, experienced significant connectivity decreases from before to 6 weeks after surgery between several brain regions including between the left posterior cingulate cortex and left angular gyrus (β [95% CI], -0.196 [-0.256 to -0.136]; PFWE=0.001). Most preoperative and postoperative functional connectivity differences did not change after controlling for preoperative CSF Aβ levels. CONCLUSIONS: Postoperative change trajectories for cognition and CSF Aβ, tau or p-tau levels did not differ between community dwelling older APOE4 carriers and non-carriers. APOE4 carriers showed greater preoperative functional connectivity and greater postoperative decreases in functional connectivity in key Alzheimer's disease-risk regions, which occur via Aβ-independent mechanisms.
Authors
Browndyke, JN; Wright, MC; Yang, R; Syed, A; Park, J; Hall, A; Martucci, K; Devinney, MJ; Moretti, EW; Whitson, HE; Cohen, HJ; Mathew, JP; Berger, M; MADCO-PC Investigators,
MLA Citation
URI
https://scholars.duke.edu/individual/pub1496919
PMID
34535274
Source
pubmed
Published In
Bja: British Journal of Anaesthesia
Published Date
DOI
10.1016/j.bja.2021.08.012

The Utility of Chest Imaging for Surveillance of Atypical Lipomatous Tumors.

Unlike other soft tissue sarcomas, atypical lipomatous tumors (ALTs) are thought to have a low propensity for metastasis. Despite this, a standard of care for pulmonary metastasis (PM) surveillance has not been established. This study aimed to evaluate the utility of chest imaging for PM surveillance following ALT excision. This was a multi-institution, retrospective review of all patients with primary ALTs of the extremities or superficial torso who underwent excision between 2006 and 2018. Minimum follow-up was two years. Long-term survival was evaluated using the Kaplan-Meier method. 190 patients with ALT were included. Average age was 61.7 years and average follow-up was 58.6 months (24 to 180 months). MDM2 testing was positive in 88 patients (46.3%), and 102 (53.7%) did not receive MDM2 testing. 188 patients (98.9%) had marginal excision, and 127 (66.8%) had marginal or positive margins. Patients received an average of 0.9 CT scans and 1.3 chest radiographs over the surveillance period. 10-year metastasis-free survival was 100%, with no documented deaths from disease. This study suggests that chest imaging does not have a significant role in PM surveillance following ALT excision, but advanced local imaging and chest surveillance may be considered in cases of local recurrence or concern for dedifferentiation.
Authors
Lazarides, AL; Ferlauto, HR; Burke, ZDC; Griffin, AM; Leckey, BD; Bernthal, NM; Wunder, JS; Ferguson, PC; Visgauss, JD; Brigman, BE; Eward, WC
MLA Citation
Lazarides, Alexander L., et al. “The Utility of Chest Imaging for Surveillance of Atypical Lipomatous Tumors.Sarcoma, vol. 2021, Jan. 2021, p. 4740924. Epmc, doi:10.1155/2021/4740924.
URI
https://scholars.duke.edu/individual/pub1499621
PMID
34671190
Source
epmc
Published In
Sarcoma
Volume
2021
Published Date
Start Page
4740924
DOI
10.1155/2021/4740924

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Osteosarcoma: A National Cancer Database Study.

<h4>Background</h4>There are limited data to inform risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following surgical resection of osteosarcoma.<h4>Methods</h4>We retrospectively reviewed patients (n = 5293) following surgical resection of primary osteosarcoma in the National Cancer Database (2004-2015). Univariate and multivariate methods were used to correlate variables with readmission and short-term mortality.<h4>Results</h4>Of 210 readmissions (3.97%), risk factors independently associated with unplanned 30-day readmission included comorbidity burden (odds ratio [OR] 2.4, p = 0.042), Medicare insurance (OR 1.9, p = 0.021), and axial skeleton location (OR 1.5, p = 0.029). A total of 91 patients died within 90 days of their surgery (1.84%). Risk factors independently associated with mortality included age (hazard ratio 1.1, p < 0.001), increasing comorbidity burden (OR 6.6, p = 0.001), higher grade (OR 1.7, p = 0.007), increasing tumor size (OR 2.2, p = 0.03), metastatic disease at presentation (OR 8.5, p < 0.001), and amputation (OR 2.0, p = 0.04). Chemotherapy was associated with a decreased risk of short-term mortality (p < 0.001).<h4>Conclusions</h4>Several trends were clear: insurance status, tumor location and comorbidity burden were independently associated with readmission rates, while age, amputation, grade, tumor size, metastatic disease, and comorbidity burden were independently associated with short-term mortality.
Authors
Evans, DR; Lazarides, AL; Cullen, MM; Visgauss, JD; Somarelli, JA; Blazer, DG; Brigman, BE; Eward, WC
MLA Citation
Evans, Daniel R., et al. “Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Osteosarcoma: A National Cancer Database Study.Annals of Surgical Oncology, vol. 28, no. 12, Nov. 2021, pp. 7961–72. Epmc, doi:10.1245/s10434-021-10099-7.
URI
https://scholars.duke.edu/individual/pub1482798
PMID
34018083
Source
epmc
Published In
Annals of Surgical Oncology
Volume
28
Published Date
Start Page
7961
End Page
7972
DOI
10.1245/s10434-021-10099-7