Betty Tong

Positions:

Associate Professor of Surgery

Surgery, Cardiovascular and Thoracic Surgery
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.S. 1995

Georgia Institute of Technology

M.D. 1999

Duke University

M.H.S. 2009

Johns Hopkins University

Grants:

Access to screening facilities for U.S. populations at risk for lung cancer: A geospatial analysis of access to CT facilities for individuals eligible for lung cancer screening

Administered By
Radiology, Cardiothoracic Imaging
Awarded By
Ge-Aur Radiology Research
Role
Mentor
Start Date
End Date

Publications:

Discussion.

Authors
MLA Citation
Tong, Betty C. “Discussion.J Thorac Cardiovasc Surg, vol. 162, no. 5, Nov. 2021, pp. 1383–85. Pubmed, doi:10.1016/j.jtcvs.2020.10.165.
URI
https://scholars.duke.edu/individual/pub1489127
PMID
33558119
Source
pubmed
Published In
The Journal of Thoracic and Cardiovascular Surgery
Volume
162
Published Date
Start Page
1383
End Page
1385
DOI
10.1016/j.jtcvs.2020.10.165

Definition and assessment of high risk in patients considered for lobectomy for stage I non–small cell lung cancer: The American Association for Thoracic Surgery expert panel consensus document

Objective: Lobectomy is a standard treatment for stage I non–small cell lung cancer, but a significant proportion of patients are considered at high risk for complications, including mortality, after lobectomy and might not be candidates. Identifying who is at risk is important and in evolution. The objective of The American Association for Thoracic Surgery Clinical Practice Standards Committee expert panel was to review important considerations and factors in assessing who is at high risk among patients considered for lobectomy. Methods: The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an expert panel that developed an expert consensus document after systematic review of the literature. The expert panel generated a priori a list of important risk factors in the determination of high risk for lobectomy. A survey was administered, and the expert panel was asked to grade the relative importance of each risk factor. Recommendations were developed using discussion and a modified Delphi method. Results: The expert panel survey identified the most important factors in the determination of high risk, which included the need for supplemental oxygen because of severe underlying lung disease, low diffusion capacity, the presence of frailty, and the overall assessment of daily activity and functional status. The panel determined that factors, such as age (as a sole factor), were less important in risk assessment. Conclusions: Defining who is at high risk for lobectomy for stage I non–small cell lung cancer is challenging, but remains critical. There was impressive strong consensus on identification of important factors and their hierarchical ranking of perceived risk. The panel identified several key factors that can be incorporated in risk assessment. The factors are evolving and as the population ages, factors such as neurocognitive function and frailty become more important. A minimally invasive approach becomes even more critical in this older population to mitigate risk. The determination of risk is a clinical decision and judgement, which should also take into consideration patient perspectives, values, preferences, and quality of life.
Authors
Pennathur, A; Brunelli, A; Criner, G; Keshavarz, H; Mazzone, P; Walsh, G; Luketich, J; Liptay, M; Wafford, E; Murthy, S; Marshall, MB; Tong, B; Lanuti, M; Wolf, A; Pettiford, B; Loo, B; Merritt, R; Rocco, G; Schuchert, M; Varghese, T; Swanson, SJ
MLA Citation
URI
https://scholars.duke.edu/individual/pub1500967
Source
scopus
Published In
The Journal of Thoracic and Cardiovascular Surgery
Published Date
DOI
10.1016/j.jtcvs.2021.07.030

Lung Cancer Screening Eligibility and Use: A Population Health Perspective of One Community.

<b>BACKGROUND</b> Low-dose chest CT (LDCT) is the only effective screening test for lung cancer. Annual lung cancer screening (LCS) is recommended by the US Preventive Services Task Force (USPSTF) for individuals at high risk for primary lung neoplasm.<b>METHODS</b> We retrospectively identified patients receiving LCS from January 2016 through March 2018 whose residential addresses were within our health center's county. We estimated driving distance from the patient's address to our health center and obtained sociodemographic characteristics from the electronic health record (EHR). The census-tract-level LCS-eligible population size was estimated, and their population characteristics determined via US Census Bureau, Centers for Disease Control and Prevention (CDC), and Behavioral Risk Factor Surveillance System (BRFSS) data. The Cochran-Mantel-Haenszel test was used to determine differences amongst the LCS-eligible and LCS-enrolled populations. Multivariable regression was used to determine the effects of sociodemographic characteristics on LCS eligibility.<b>RESULTS</b> There was modest correlation between census-tract-level LCS-eligible population size and LCS enrollment (<i>r</i> = 0.68, <i>P</i> < .001). 5.9% (364/6185) of the estimated LCS-eligible population in our county received LCS, with census-tract LCS rates ranging from 1.5% to 12.5%. Nonwhite race status (Hispanic and African American) was associated with decreased likelihood of LCS enrollment compared to White race (OR = 95% CI, 0.765 [0.61, 0.95] and 0.031 [0.008, 0.124], respectively). Older age, Medicaid, and uninsured statuses were positively correlated with LCS eligibility (<i>P</i> ≤ .01).<b>LIMITATIONS</b> This analysis comprises a single county. Other LCS facilities within our health system in neighboring counties, as well as individuals receiving LCS outside of our health system, are not captured.<b>CONCLUSIONS</b> The uptake of LCS remains low, with disproportionately lower screening rates amongst Hispanic and African American populations. Medicaid and uninsured patients in our community are also more likely to be LCS-eligible. These populations may be targets for interventions aimed at increasing LCS awareness and uptake.
Authors
Tailor, TD; Farrow, NE; Gao, J; Choudhury, KR; Tong, BC
MLA Citation
Tailor, Tina D., et al. “Lung Cancer Screening Eligibility and Use: A Population Health Perspective of One Community.North Carolina Medical Journal, vol. 82, no. 5, Sept. 2021, pp. 321–26. Epmc, doi:10.18043/ncm.82.5.321.
URI
https://scholars.duke.edu/individual/pub1497252
PMID
34544766
Source
epmc
Published In
North Carolina Medical Journal
Volume
82
Published Date
Start Page
321
End Page
326
DOI
10.18043/ncm.82.5.321

The Relationship Between Lymph Node Ratio and Survival Benefit With Adjuvant Chemotherapy in Node-positive Esophageal Adenocarcinoma.

BACKGROUND: We hypothesized that the ratio of positive lymph nodes to total assessed lymph nodes (LNR) is an indicator of cancer burden in esophageal adenocarcinoma and may identify patients who may most benefit from AC. OBJECTIVE: The aim of this study was to discern whether there is a threshold LNR above which AC is associated with a survival benefit in this population. METHODS: The 2004-2015 National Cancer Database was queried for patients who underwent upfront, complete resection of pT1-4N1-3M0 esophageal adenocarcinoma. The primary outcome, overall survival, was examined using multivariable Cox proportional hazards models employing an interaction term between LNR and AC. RESULTS: A total of 1733 patients were included: 811 (47%) did not receive AC whereas 922 (53%) did. The median LNR was 20% (interquartile range 9-40). In a multivariable Cox model, the interaction term between LNR and receipt of AC was significant (P = 0.01). A plot of the interaction demonstrated that AC was associated with improved survival beyond a LNR of about 10%-12%. In a sensitivity analysis, the receipt of AC was not associated with improved survival in patients with LNR <12% (hazard ratio 1.02; 95% confidence interval 0.72-1.44) but was associated with improved survival in those with LNR ≥12% (hazard ratio 0.65; 95% confidence interval 0.50-0.79). CONCLUSIONS: In this study of patients with upfront, complete resection of node-positive esophageal adenocarcinoma, AC was associated with improved survival for LNR ≥12%. LNR may be used as an adjunct in multidisciplinary decision-making about adjuvant therapies in this patient population.
Authors
Raman, V; Jawitz, OK; Farrow, NE; Voigt, SL; Rhodin, KE; Yang, C-FJ; Turner, MC; D'Amico, TA; Harpole, DH; Tong, BC
MLA Citation
Raman, Vignesh, et al. “The Relationship Between Lymph Node Ratio and Survival Benefit With Adjuvant Chemotherapy in Node-positive Esophageal Adenocarcinoma.Ann Surg, July 2020. Pubmed, doi:10.1097/SLA.0000000000004150.
URI
https://scholars.duke.edu/individual/pub1450943
PMID
32649467
Source
pubmed
Published In
Ann Surg
Published Date
DOI
10.1097/SLA.0000000000004150

Response.

Authors
Raman, V; Jawitz, OK; D'Amico, TA; Yang, C-FJ; Tong, BC
MLA Citation
Raman, Vignesh, et al. “Response.Chest, vol. 159, no. 1, Jan. 2021, pp. 445–46. Pubmed, doi:10.1016/j.chest.2020.08.2044.
URI
https://scholars.duke.edu/individual/pub1470173
PMID
33422217
Source
pubmed
Published In
Chest
Volume
159
Published Date
Start Page
445
End Page
446
DOI
10.1016/j.chest.2020.08.2044

Research Areas:

Esophagus--Cancer--Surgery
Lungs--Cancer--Patients
Lungs--Cancer--Surgery
Mesothelioma
Small cell lung cancer