Nicholas Rydzewski, 2018

Nicholas Rydzewski, MD

Radiation Oncology Resident

Department of Human Oncology


Intern, Presence Saint Joseph Hospital, (2018)

MD, Northwestern University, Medicine (2017)

BS, University of Michigan, Neuroscience (2013)

Selected Honors and Awards

Phi Beta Kappa (2013)

Underwood-Alger Scholarship, University of Michigan (2012)

  • Clinical Implications of Scleroderma in the Decision for Radiotherapy-Based Larynx Preservation. JAMA Otolaryngol Head Neck Surg
    Rydzewski NR, Harari PM, Hartig GK, Francis D, Witek ME
    2019 Dec 12; :
  • Mortality After Stereotactic Radiosurgery for Brain Metastases and Implications for Optimal Utilization: A National Cancer Database Study. Am J Clin Oncol
    Rydzewski NR, Khan AJ, Strauss JB, Chmura SJ
    2018 Apr 10; :
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      OBJECTIVES: Brain metastases are associated with cancer progression and poor outcomes. The use of stereotactic radiosurgery (SRS) to treat brain metastases has been increasing due to its potential to quickly treat metastatic disease while avoiding the morbidity associated with surgery or whole brain radiation therapy (WBRT). This study seeks to analyze practice patterns of the use of SRS for brain metastases, focusing on the endpoint of short-term mortality.

      MATERIALS AND METHODS: This study used the National Cancer Database to observe cancer patients diagnosed with a non-Central Nervous System primary from 2010 to 2012 who presented at diagnosis with metastatic disease to the brain and received either WBRT or SRS. The primary endpoint was time to mortality determined by the Kaplan-Meier product-limit estimate of the failure function.

      RESULTS: A total of 18,604 patients were included in the analysis from first day of treatment (16,219 patients received WBRT and 2385 received SRS). At 90 days, mortality was 39.3% for those who received WBRT and 20.0% for those who received SRS. For patients 70 and older who received SRS, mortality was 30.2% at 90 days.

      CONCLUSIONS: Analysis of short-term mortality after treatment for brain metastases by using the National Cancer Database provides a window into national treatment patterns and associated outcomes. Roughly 1 in 5 patients who receive SRS and roughly 1 in 3 patients 70 and older who receive SRS die within 90 days of treatment. These data suggest some degree of overutilization of SRS in some patient populations, most notably those patients over the age of 70.

      View details for PubMedID 29642077
  • Role of adjuvant external beam radiotherapy and chemotherapy in one versus two or more node-positive vulvar cancer: A National Cancer Database study. Radiother Oncol
    Rydzewski NR, Kanis MJ, Donnelly ED, Lurain JR, Strauss JB
    2018 12; 129 (3): 534-539
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      BACKGROUND AND PURPOSE: Inguinal lymph node involvement is considered the most important prognostic risk factor for survival in vulvar cancer. However, controversy exists concerning the optimal adjuvant therapy for node-positive disease. This study sought to identify the optimal adjuvant therapy for each subset of women with node-positive disease.

      MATERIAL AND METHODS: The National Cancer Database (NCDB) was queried to identify women with inguinal node positive vulvar cancer. Survival analysis was performed using log-rank test, the Kaplan-Meier estimates, and Cox proportional hazards to both clarify prognosis and identify the benefit of each treatment modality in individual subsets of women.

      RESULTS: A total of 2779 women with inguinal node positive vulvar cancer were identified. On multivariate Cox model hazard ratio, radiotherapy yielded a survival advantage for women with one positive node (HR 0.81, p = 0.027) and two or more positive nodes (HR = 0.59, p < 0.001). The addition of chemotherapy to radiotherapy yielded an incremental improvement in survival for women with 2 or more positive nodes (HR = 0.79, p = 0.022) but not women with 1 positive node (HR = 0.93, p = 0.605).

      CONCLUSIONS: All patients with node positive disease benefited from radiotherapy. By contrast, only those with 2 or more positive nodes benefited from the addition of chemotherapy to radiotherapy.

      View details for PubMedID 29631932
  • Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma. Cancer
    Rydzewski NR, Lesniak MS, Chandler JP, Kalapurakal JA, Pollom E, Tate MC, Bloch O, Kruser T, Dalal P, Sachdev S
    2018 02 15; 124 (4): 734-742
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      BACKGROUND: Atypical and malignant meningiomas are far less common than benign meningiomas. As aggressive lesions, they are prone to local recurrence and may lead to decreased survival. Although malignant meningiomas typically are treated with maximal surgical resection and adjuvant radiotherapy (RT), to the authors' knowledge the optimal treatment for atypical lesions remains to be defined. There are limited prospective data in this setting.

      METHODS: The National Cancer Data Base was queried to investigate cases of histologically confirmed meningiomas diagnosed from 2004 to 2014. This included 7811 patients with atypical meningiomas (World Health Organization grade 2) and 1936 patients with malignant meningiomas (World Health Organization grade 3); during the same period, a total of 60,345 patients were diagnosed with benign meningiomas (World Health Organization grade 1). Data collected included patient and tumor characteristics, extent of surgical resection, and use of RT. Survival analysis was performed using Kaplan-Meier estimates with the log-rank test of significance and Cox univariate and multivariate regression. Logistic regression was used to determine factors associated with use of RT.

      RESULTS: The 5-year overall survival rate was 85.5% in patients with benign meningiomas, 75.9% in patients with atypical meningiomas, and 55.4% in patients with malignant meningiomas (P<.0001). In patients with atypical meningiomas, gross (macroscopic) total resection (GTR) and adjuvant RT were found to be associated with significantly improved survival, independently and especially in unison (GTR plus RT: hazard ratio, 0.47; P = .002). On multivariate analysis, the combination of GTR plus RT was found to be the most important factor for improved survival. However, GTR was associated with significantly lower rates of RT use.

      CONCLUSIONS: GTR and adjuvant RT appear to be highly associated with improved survival, independent of other factors, in patients with atypical meningiomas. Cancer 2018;124:734-42. © 2017 American Cancer Society.

      View details for PubMedID 29131312
  • Receipt of vaginal brachytherapy is associated with improved survival in women with stage I endometrioid adenocarcinoma of the uterus: A National Cancer Data Base study. Cancer
    Rydzewski NR, Strohl AE, Donnelly ED, Kanis MJ, Lurain JR, Nieves-Neira W, Strauss JB
    2016 Dec 01; 122 (23): 3724-3731
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      BACKGROUND: Randomized controlled trials have consistently shown that the use of postoperative radiotherapy (RT) for stage I endometrial cancer leads to a reduction in the incidence of pelvic recurrences without a corresponding reduction in overall mortality. It was hypothesized that a reduction in mortality associated with the receipt of RT could be identified in a large data set with greater statistical power.

      METHODS: Women with surgically staged IA or IB endometrial adenocarcinoma who were treated with total hysterectomy between 2003 and 2011 were identified in the National Cancer Data Base. Chi-square tests and multivariate logistic regression were performed to analyze factors associated with the treatment type. A survival analysis was performed with log-rank testing, Cox proportional hazards regression, and Kaplan-Meier estimates.

      RESULTS: A total of 44,309 eligible women were identified (33,380 at stage IA and 10,929 at stage IB): 88.4% of the women with stage IA tumors and 51.6% of the women with stage IB tumors received no RT. Older age, comorbid disease, a higher histologic grade, and a larger tumor size were independently associated with an increase in mortality. The receipt of vaginal brachytherapy (VB) was independently associated with a reduction in mortality for both stage IA disease (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.67-0.97) and stage IB disease (HR, 0.62; 95% CI, 0.51-0.74).

      CONCLUSIONS: Analyses of this large database support the utility of postoperative VB for many women with stage I endometrial cancer. Unfortunately, RT appears to be underused in this population. Greater adherence to consensus guidelines may lead to improved outcomes. Cancer 2016;122:3724-31. © 2016 American Cancer Society.

      View details for PubMedID 27509082
  • National Evaluation of the New Commission on Cancer Quality Measure for Postmastectomy Radiation Treatment for Breast Cancer. Ann Surg Oncol
    Minami CA, Bilimoria KY, Hansen NM, Strauss JB, Hayes JP, Feinglass JM, Bethke KP, Rydzewski NR, Winchester DP, Palis BE, Yang AD
    2016 Aug; 23 (8): 2446-55
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      BACKGROUND: Current guidelines recommend postmastectomy radiotherapy (PMRT) for patients with ≥4 positive lymph nodes and suggest strong consideration of PMRT in those with 1-3 positive nodes. These recommendations were incorporated into a Commission on Cancer quality measure in 2014. However, national adherence with these recommendations is unknown. Our objectives were to describe PMRT use in the United States in patients with stage I to III invasive breast cancer and to examine possible factors associated with the omission of PMRT.

      METHODS: From the National Cancer Data Base, 753,536 mastectomies at 1123 hospitals were identified from 1998 to 2011. PMRT use over time was examined using random effects logistic regression analyses, adjusting for patient, tumor, and hospital characteristics. Analyses were stratified by nodal status (≥4 nodes positive, 1-3 nodes positive, node negative).

      RESULTS: The proportion of patients receiving PMRT increased from 1998 to 2011 (>4 positive nodes: 56.2 to 66.6 %; 1-3 positive nodes: 28.0 to 39.1 %; node-negative: 8.3 to 10.0 %, p < 0.001 for all). In adjusted analyses, patients with ≥4 positive nodes were more likely to have PMRT omitted if they had smaller tumors. Patients with 1-3 positive nodes were more likely to have PMRT omitted if they had lower grade or smaller tumors. Irrespective of patients' nodal status, PMRT utilization rates decreased as age increased.

      CONCLUSIONS: Though PMRT rates increased over time in patients with ≥4 and 1-3 positive nodes, PMRT in patients with ≥4 positive nodes remains underutilized. Feedback to hospitals using the new Commission on Cancer PMRT measure may help to improve adherence rates.

      View details for PubMedID 27169774
  • A molecular mechanism to regulate lysosome motility for lysosome positioning and tubulation. Nat Cell Biol
    Li X, Rydzewski N, Hider A, Zhang X, Yang J, Wang W, Gao Q, Cheng X, Xu H
    2016 Apr; 18 (4): 404-17
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      To mediate the degradation of biomacromolecules, lysosomes must traffic towards cargo-carrying vesicles for subsequent membrane fusion or fission. Mutations of the lysosomal Ca(2+) channel TRPML1 cause lysosomal storage disease (LSD) characterized by disordered lysosomal membrane trafficking in cells. Here we show that TRPML1 activity is required to promote Ca(2+)-dependent centripetal movement of lysosomes towards the perinuclear region (where autophagosomes accumulate) following autophagy induction. ALG-2, an EF-hand-containing protein, serves as a lysosomal Ca(2+) sensor that associates physically with the minus-end-directed dynactin-dynein motor, while PtdIns(3,5)P(2), a lysosome-localized phosphoinositide, acts upstream of TRPML1. Furthermore, the PtdIns(3,5)P(2)-TRPML1-ALG-2-dynein signalling is necessary for lysosome tubulation and reformation. In contrast, the TRPML1 pathway is not required for the perinuclear accumulation of lysosomes observed in many LSDs, which is instead likely to be caused by secondary cholesterol accumulation that constitutively activates Rab7-RILP-dependent retrograde transport. Ca(2+) release from lysosomes thus provides an on-demand mechanism regulating lysosome motility, positioning and tubulation.

      View details for PubMedID 26950892
  • The socioeconomic gradient in all-cause mortality for women with breast cancer: findings from the 1998 to 2006 National Cancer Data Base with follow-up through 2011. Ann Epidemiol
    Feinglass J, Rydzewski N, Yang A
    2015 Aug; 25 (8): 549-55
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      PURPOSE: To analyze the association between socioeconomic status (SES) and all-cause mortality among women diagnosed with breast cancer before and after controlling for insurance status, race and ethnicity, stage, treatment modalities, and other demographic and hospital characteristics.

      METHODS: Data analyzed included follow-up through 2011 for 582,396 patients diagnosed between 1998 and 2006 with ductal carcinoma in situ or invasive (stage I-IV) breast cancer from the National Cancer Data Base. SES was measured by grouping patients into six income and education-level ZIP code categories. Hierarchical Cox regression models were used to analyze SES survival differences.

      RESULTS: Five- and 10-year survival probabilities for the highest SES group were 87.8% and 71.5%, versus 79.5% and 61.5% for the lowest SES group. Controlling for all covariates reduced the highest-to-lowest SES hazard ratio from 1.69 (95% confidence interval: 1.64-1.74) to 1.27 (95% confidence interval: 1.24-1.31). Results were virtually identical in models that included comorbidity and invasive cancer patients only.

      CONCLUSIONS: Differences in insurance status, race, and stage at diagnosis are important components of SES disparities and explain about two-thirds of the initial SES survival disparity. The residual SES effect likely mirrors underlying social determinants of health for all American women.

      View details for PubMedID 25795226

Contact Information

Nicholas R. Rydzewski, MD

600 Highland Avenue,
Madison, WI 53792