Julia Visgauss

Positions:

Assistant Professor of Orthopaedic Surgery

Orthopaedics
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2012

Johns Hopkins University School of Medicine

Resident, Orthopaedic Surgery

Duke University School of Medicine

Grants:

Genetic Profiling of Chondrosarcoma: A Clinical and Histologic Correlative Study

Administered By
Orthopaedics
Awarded By
Piedmont Orthopedic Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

Treatment of Chondroblastoma with Denosumab

Authors
Visgauss, JD; Lazarides, A; Dickson, B; Cardona, D; Sheth, M; DeWitt, SB; Somarelli, JA; Eward, WC
MLA Citation
Visgauss, Julia D., et al. “Treatment of Chondroblastoma with Denosumab.” Jbjs Case Connector, vol. 11, no. 2, Ovid Technologies (Wolters Kluwer Health). Crossref, doi:10.2106/jbjs.cc.20.00178.
URI
https://scholars.duke.edu/individual/pub1482459
Source
crossref
Published In
Jbjs Case Connector
Volume
11
DOI
10.2106/jbjs.cc.20.00178

Staging and Surveillance of Myxoid Liposarcoma: Follow-up Assessment and the Metastatic Pattern of 169 Patients Suggests Inadequacy of Current Practice Standards.

BACKGROUND: Unlike other sarcoma subtypes, myxoid liposarcoma (MLS) has a propensity for extra-pulmonary metastases. Computed tomography (CT) scan of the chest, abdomen, and pelvis has become an accepted practice for surveillance. However, recent literature suggests that this may be inadequate. This study aimed to assess the ability of current imaging methods to detect metastases adequately in this population. METHODS: The study identified 169 patients with MLS diagnosed between 2000 and 2016. The timing and location of metastases, the reasons leading to the MLS diagnosis, and the imaging methods were recorded. The locations of metastases were classified into the following categories: pulmonary, soft tissue, bone, retroperitoneal, intraperitoneal, solid organ, and lymph node. RESULTS: An initial diagnosis of metastasis was made at presentation with staging CT scan for 3 (10 %) of 31 patients, with a follow-up surveillance CT scan for 15 (48 %) of the patients or with subsequent imaging obtained in response to patient-reported symptoms for 13 (42 %) of the patients. The proportions of patients who had metastases in each location were as follows: soft tissue (84 %), pulmonary (68 %), intraabdominal (48 %), solid organ (48 %), bone (45 %), lymph node (32 %), and retroperitoneal (29 %). Although 14 patients had bone metastases, only 1 patient had a sclerotic/blastic presentation visualized on CT scan, and the diagnosis for the remaining 13 patients was determined by magnetic resonance imaging (MRI). CONCLUSION: Due to metastatic disease identified outside surveillance imaging for 58 % of the patients, the diversity of locations, and the significant failure of CT and bone scan to identify bone metastases, this study questioned the adequacy of CT scan for surveillance of MLS. Consideration should be given to the use of whole-body MRI for detection of metastasis in MLS.
Authors
Visgauss, JD; Wilson, DA; Perrin, DL; Colglazier, R; French, R; Mattei, J-C; Griffin, AM; Wunder, JS; Ferguson, PC
MLA Citation
URI
https://scholars.duke.edu/individual/pub1482267
PMID
33961173
Source
pubmed
Published In
Annals of Surgical Oncology
Published Date
DOI
10.1245/s10434-021-10091-1

Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study

<jats:sec><jats:title>PURPOSE</jats:title><jats:p> As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. </jats:p></jats:sec><jats:sec><jats:title>PATIENTS AND METHODS</jats:title><jats:p> This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). </jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p> Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). </jats:p></jats:sec><jats:sec><jats:title>CONCLUSION</jats:title><jats:p> Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks. </jats:p></jats:sec>
Authors
Glasbey, JC; Nepogodiev, D; Simoes, JFF; Omar, O; Li, E; Venn, ML; PGDME,; Abou Chaar, MK; Capizzi, V; Chaudhry, D; Desai, A; Edwards, JG; Evans, JP; Fiore, M; Videria, JF; Ford, SJ; Ganly, I; Griffiths, EA; Gujjuri, RR; Kolias, AG; Kaafarani, HMA; Minaya-Bravo, A; McKay, SC; Mohan, HM; Roberts, KJ; San Miguel-Méndez, C; Pockney, P; Shaw, R; Smart, NJ; Stewart, GD; Sundar, MRCOG, S; Vidya, R; Bhangu, AA; Chaar, MA; Ganyli, I; Roberts, K; Sundar, S; Siaw-Acheampong, K; Benson, RA; Bywater, E; Dawson, BE; Heritage, E; Jones, CS; Kamarajah, SK; Khatri, C; Khaw, RA; Keatley, JM; Knight, A; Lawday, S; Mann, HS; Marson, EJ; McLean, KA; Mills, EC; Pellino, G; Picciochi, M; Taylor, EH; Tiwari, A; Trout, IM; Wilkin, RJW; Gallo, G; Moug, S; Pata, F; Di Saverio, S; Vallance, A; Vimalchandran, D; Evans, RPT; Townend, P; McKay, S; Isaac, J; Satoi, S; Edwards, J; Coonar, AS; Marchbank, A; Caruana, EJ; Layton, GR; Patel, A; Brunelli, A; Ford, S; Gronchi, A; Almond, M; Tirotta, F; Dumitra, S; Kolias, A; Price, SJ; Fountain, DM; Jenkinson, MD; Hutchinson, P; Marcus, HJ; Piper, RJ; Lippa, L; Servadei, F; Esene, I; Freyschlag, C; Neville, I; Rosseau, G; Schaller, K; Demetriades, AK; Robertson, F; Alamri, A; Schache, AG; Winter, SC; Ho, M; Nankivell, P; Biel, JR; Batstone, M; Wilkins, A; Singh, JK; Thekinkattil, D; Fotopoulou, C; Leung, E; Khan, T; Chiva, L; Sehouli, J; Fagotti, A; Cohen, P; Gutelkin, M; Ghebre, R; Konney, T; Pareja, R; Bristow, R; Dowdy, S; Shylasree, TS; Seenivasagam, RK; Ng, J; Fujiwara, K; Lamb, B; Narahari, K; McNeill, A; Colquhoun, A; McGrath, J; Bromage, S; Barod, R; Kasivisvanathan, V; Klatte, T; Abbott, TEF; Abukhalaf, S; Adamina, M; Ademuyiwa, AO; Agarwal, A; Akkulak, M; Alameer, E; Alderson, D; Alakaloko, F; Albertsmeiers, M; Alser, O; Alshaar, M; Alshryda, S; Arnaud, AP; Augestad, KM; Ayasra, F; Azevedo, J; Bankhead-Kendall, BK; Barlow, E; Beard, D; Blanco-Colino, R; Brar, A; Breen, KA; Bretherton, C; Buarque, IL; Burke, J; Chaar, M; Chakrabortee, S; Christensen, P; Cox, D; Cukier, M; Cunha, MF; Davidson, GH; Drake, TM; Edwards, JG; Elhadi, M; Emile, S; Farik, S; Fitzgerald, JE; Garmanova, T; Ghosh, D; Ataíde Gomes, GM; Grecinos, G; Gründl, M; Halkias, C; Harrison, EM; Hisham, I; Hutchinson, PJ; Hwang, S; Isik, A; Jonker, P; Keller, D; Kruijff, S; Lawani, I; Lederhuber, H; Leventoglu, S; Litvin, A; Loehrer, A; Löffler, MW; Lorena, MA; Modolo, MM; Major, P; Martin, J; Mashbari, HN; Mazingi, D; Metallidis, S; Moore, R; Moszkowicz, D; Ng-Kamstra, JS; Maimbo, M; Negoi, I; Niquen, M; Ntirenganya, F; Olivos, M; Oussama, K; Outani, O; Parreno-Sacdalanm, MD; Perez Rivera, CJ; Pinkney, TD; van der Plas, W; Qureshi, A; Radenkovic, D; Ramos-De la Medina, A; Roslani, AC; Rutegård, M; Segura-Sampedro, JJ; Santos, I; Sayyed, R; Schache, A; Schnitzbauer, AA; Seyi-Olajide, JO; Sharma, N; Shu, S; Soreide, K; Spinelli, A; Sund, M; Tabiri, S; Tsoulfas, G; van Ramshorst, GH; Vimalachandran, D; Warren, OJ; Wedderburn, D; Wright, N; Allemand, C; Boccalatte, L; Figari, M; Lamm, M; Larrañaga, J; Marchitelli, C; Noll, F; Odetto, D; Perrotta, M; Saadi, J; Zamora, L; Alurralde, C; Caram, EL; Eskinazi, D; Mendoza, JP; Usandivaras, M; Badra, R; Esteban, A; García, JS; García, PM; Gerchunoff, JI; Lucchini, SM; NIgra, MA; Vargas, L; Hovhannisyan, T; Stepanyan, A; Gould, T; Gourlay, R; Griffiths, B; Gananadha, S; McLaren, M; Cecire, J; Joshi, N; Salindera, S; Sutherland, A; Ahn, JH; Charlton, G; Chen, S; Gauri, N; Hayhurst, R; Jang, S; Jia, F; Mulligan, C; Yang, W; Ye, G; Zhang, H; Ballal, M; Gibson, D; Hayne, D; Moss, J; Richards, T; Viswambaram, P; Vo, UG; Bennetts, J; Bright, T; Brooke-Smith, M; Fong, R; Gricks, B; Lam, YH; Ong, BS; Szpytma, M; Watson, D; Bagraith, K; Caird, S; Chan, E; Dawson, C; Ho, D; Jeyarajan, E; Jordan, S; Lim, A; Nolan, GJ; Oar, A; Parker, D; Puhalla, H; Quennell, A; Rutherford, L; Townend, P; Von Papen, M; Wullschleger, M; Blatt, A; Cope, D; Egoroff, N; Fenton, M; Gani, J; Lott, N; Pockney, P; Shugg, N; Elliott, M; Phung, D; Phan, D; Townend, D; Bong, C; Gundara, J; Frankel, A; Bowman, S; Guerra, GR; Bolt, J; Buddingh, K; Dudi-Venkata, NN; Jog, S; Kroon, HM; Sammour, T; Smith, R; Stranz, C; Batstone, M; Lah, K; McGahan, W; Mitchell, D; Morton, A; Pearce, A; Roberts, M; Sheahan, G; Swinson, B; Alam, N; Banting, S; Chong, L; Choong, P; Clatworthy, S; Foley, D; Fox, A; Hii, MW; Knowles, B; Mack, J; Read, M; Rowcroft, A; Ward, S; Wright, G; Lanner, M; Königsrainer, I; Bauer, M; Freyschlag, C; Kafka, M; Messner, F; Öfner, D; Tsibulak, I; Emmanuel, K; Grechenig, M; Gruber, R; Harald, M; Öhlberger, L; Presl, J; Wimmer, A; Namazov, İ; Samadov, E; Barker, D; Boyce, R; Corbin, S; Doyle, A; Eastmond, A; Gill, R; Haynes, A; Millar, S; O’Shea, M; Padmore, G; Paquette, N; Phillips, E; St. John, S; Walkes, K; Flamey, N; Pattyn, P; Oosterlinck, W; Van den Eynde, J; Van den Eynde, R; Gatti, A; Nardi, C; Oliva, R; De Cicco, R; Cecconello, I; Gregorio, P; Pontual Lima, L; Ribeiro Junior, U; Takeda, F; Terra, RM; Sokolov, M; Kidane, B; Srinathan, S; Boutros, M; Caminsky, N; Ghitulescu, G; Jamjoum, G; Moon, J; Pelletier, J; Vanounou, T; Wong, S; Dumitra, S; Kouyoumdjian, A; Johnston, B; Russell, C; Demyttenaere, S; Garfinkle, R; Abou-Khalil, J; Nessim, C; Stevenson, J; Heredia, F; Almeciga, A; Fletcher, A; Merchan, A; Puentes, LO; Mendoza Quevedo, J; Bačić, G; Karlović, D; Kršul, D; Zelić, M; Luksic, I; Mamic, M; Bakmaz, B; Ćoza, I; Dijan, E; Katusic, Z; Mihanovic, J; Rakvin, I; Frantzeskou, K; Gouvas, N; Kokkinos, G; Papatheodorou, P; Pozotou, I; Stavrinidou, O; Yiallourou, A; Martinek, L; Skrovina, M; Szubota, I; Žatecký, J; Javurkova, V; Klat, J; Avlund, T; Christensen, P; Harbjerg, JL; Iversen, LH; Kjaer, DW; Kristensen, H; Mekhael, M; Ebbehøj, AL; Krarup, P; Schlesinger, N; Smith, H; Abdelsamed, A; Azzam, AY; Salem, H; Seleim, A; Abdelmajeed, A; Abdou, M; Abosamak, NE; AL Sayed, M; Ashoush, F; Atta, R; Elazzazy, E; Elhoseiny, M; Elnemr, M; Elqasabi, MS; Elsayed Hewalla, ME; Elsherbini, I; Essam, E; Eweda, M; Ghallab, I; Hassan, E; Ibrahim, M; Metwalli, M; Mourad, M; Qatora, MS; Ragab, M; Sabry, A; Saifeldin, H; Saleh Mesbah Mohamed Elkaffas, M et al.
MLA Citation
Glasbey, James C., et al. “Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.” Journal of Clinical Oncology, vol. 39, no. 1, American Society of Clinical Oncology (ASCO), Jan. 2021, pp. 66–78. Crossref, doi:10.1200/jco.20.01933.
URI
https://scholars.duke.edu/individual/pub1482458
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
39
Published Date
Start Page
66
End Page
78
DOI
10.1200/jco.20.01933

The role of Denosumab in joint preservation for patients with giant cell tumour of bone.

AIMS: Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with high-risk GCTB treated with neoadjuvant Denosumab. The aim of this study was to determine if this initial favourable outcome following the use of Denosumab was maintained with longer follow-up. METHODS: Patients with GCTB of the limb considered high-risk for unsuccessful joint salvage, due to minimal periarticular and subchondral bone, large soft tissue mass, or pathological fracture, were treated with Denosumab followed by extended intralesional curettage with the goal of preserving the joint surface. Patients were followed for local recurrence, metastasis, and secondary sarcoma. RESULTS: A total of 25 patients with a mean age of 33.8 years (18 to 67) with high-risk GCTB received median six cycles of Denosumab before surgery. Tumours occurred most commonly around the knee (17/25, 68%). The median follow-up was 57 months (interquartile range (IQR) 13 to 88). The joint was salvaged in 23 patients (92%). Two required knee arthroplasty due to intra-articular fracture and arthritis. Local recurrence developed in 11 patients (44%) at a mean of 32.5 months (3 to 75) following surgery, of whom four underwent repeat curettage and joint salvage. One patient developed secondary osteosarcoma and another benign GCT lung metastases. CONCLUSION: The use of Denosumab for joint salvage was associated with a higher than expected rate of local recurrence at 44%. Neoadjuvant Denosumab for joint-sparing procedures should be considered with caution in light of these results. Cite this article: Bone Joint J 2021;103-B(1):184-191.
Authors
Perrin, DL; Visgauss, JD; Wilson, DA; Griffin, AM; Abdul Razak, AR; Ferguson, PC; Wunder, JS
MLA Citation
Perrin, David Louis, et al. “The role of Denosumab in joint preservation for patients with giant cell tumour of bone.Bone Joint J, vol. 103-B, no. 1, Jan. 2021, pp. 184–91. Pubmed, doi:10.1302/0301-620X.103B1.BJJ-2020-0274.R1.
URI
https://scholars.duke.edu/individual/pub1472989
PMID
33380180
Source
pubmed
Published In
Bone and Joint Journal
Volume
103-B
Published Date
Start Page
184
End Page
191
DOI
10.1302/0301-620X.103B1.BJJ-2020-0274.R1

Sarcoma treatment in the era of molecular medicine.

Sarcomas are heterogeneous and clinically challenging soft tissue and bone cancers. Although constituting only 1% of all human malignancies, sarcomas represent the second most common type of solid tumors in children and adolescents and comprise an important group of secondary malignancies. More than 100 histological subtypes have been characterized to date, and many more are being discovered due to molecular profiling. Owing to their mostly aggressive biological behavior, relative rarity, and occurrence at virtually every anatomical site, many sarcoma subtypes are in particular difficult-to-treat categories. Current multimodal treatment concepts combine surgery, polychemotherapy (with/without local hyperthermia), irradiation, immunotherapy, and/or targeted therapeutics. Recent scientific advancements have enabled a more precise molecular characterization of sarcoma subtypes and revealed novel therapeutic targets and prognostic/predictive biomarkers. This review aims at providing a comprehensive overview of the latest advances in the molecular biology of sarcomas and their effects on clinical oncology; it is meant for a broad readership ranging from novices to experts in the field of sarcoma.
Authors
Grünewald, TG; Alonso, M; Avnet, S; Banito, A; Burdach, S; Cidre-Aranaz, F; Di Pompo, G; Distel, M; Dorado-Garcia, H; Garcia-Castro, J; González-González, L; Grigoriadis, AE; Kasan, M; Koelsche, C; Krumbholz, M; Lecanda, F; Lemma, S; Longo, DL; Madrigal-Esquivel, C; Morales-Molina, Á; Musa, J; Ohmura, S; Ory, B; Pereira-Silva, M; Perut, F; Rodriguez, R; Seeling, C; Al Shaaili, N; Shaabani, S; Shiavone, K; Sinha, S; Tomazou, EM; Trautmann, M; Vela, M; Versleijen-Jonkers, YM; Visgauss, J; Zalacain, M; Schober, SJ; Lissat, A; English, WR; Baldini, N; Heymann, D
MLA Citation
Grünewald, Thomas Gp, et al. “Sarcoma treatment in the era of molecular medicine.Embo Mol Med, vol. 12, no. 11, Nov. 2020, p. e11131. Pubmed, doi:10.15252/emmm.201911131.
URI
https://scholars.duke.edu/individual/pub1462265
PMID
33047515
Source
pubmed
Published In
Embo Mol Med
Volume
12
Published Date
Start Page
e11131
DOI
10.15252/emmm.201911131