About

Dr. Ravi J. Chokshi is an expert in cancer disease and treatment, with a focus on surgical oncology, HPB (hepato-pancreato-biliary), liver, pancreas, esophageal, gastric, peritoneal, colorectal malignancies, endocrine tumors, sarcoma, melanoma, and skin carcinomas. He completed his General Surgery training at Seton Hall in 2008, followed by fellowships in Minimally Invasive Surgical Oncology at Geisinger in 2009 and Surgical Oncology at the James Cancer Hospital at The Ohio State University in 2011. Since joining the faculty at Rutgers New Jersey Medical School in 2011, Dr. Chokshi has been promoted to Section Chief of Surgical Oncology and later to Associate Professor. He has successfully led programs to accreditation twice by the American College of Surgeons - Commission on Cancer and has been recognized as a NJ Top Doctor annually since 2014. His research includes basic science investigations, such as the sensitivity of immunohistochemistry biomarkers for hepaticopancreaticobiliary cancer diagnosis and deciphering the code for senescence escape during cancer progression, supported by NIH and foundation grants. As an educator, he has mentored numerous students, residents, and faculty, and has received multiple awards for teaching excellence. Dr. Chokshi is actively involved in global surgery initiatives and aims to integrate public health perspectives into his work, with an expected MPH degree completion in 2018.

Research topics

• Internal medicine
• Environmental health
• Virology
• Surgery
• Medicine

Selected publications

• Safety and effectiveness of ETHIZIA versus TachoSil for hemostasis during open liver surgery: a randomized controlled multicenter trial

  HPB · 2026-05-01

  articleOpen access

  BACKGROUND: Liver surgery carries a significant risk of perioperative bleeding. This randomized clinical trial compared the safety and efficacy of ETHIZIA, a novel, highly adaptable hemostatic patch, to the current standard of care during open liver surgery. METHODS: Adult subjects (N = 132) were randomized 2:1 to ETHIZIA or TachoSil to treat one or more target bleeding sites (TBS) on the liver transection plane. The objective was to demonstrate non-inferiority (margin 10%) and subsequently, superiority, of ETHIZIA to TachoSil in hemostatic success at 3 min post-application. RESULTS: For the first-treated TBS (Per protocol set, ETHIZIA N = 87, TachoSil N = 43), 3-min hemostatic success was both non-inferior (p < 0.0001) and superior (p = 0.0038) for ETHIZIA (93.1%) compared to TachoSil (76.7%); the median time to hemostasis was significantly shorter (0.5 versus 3.0 min, respectively (p < 0.0001)). Failure and rescue rates were lower for ETHIZIA (1.1% and 3.4%) than for TachoSil (7.0% and 11.6%). Efficacy results including additionally treated TBS were similar (ETHIZIA N = 139 TBS, TachoSil N = 59 TBS). Bile/non-bile fluid collections were more frequent in ETHIZIA-treated subjects, but multivariable regression indicated a multifactorial surgical basis and no association with hemostatic device. CONCLUSION: Fast and robust hemostasis supports ETHIZIA as a valuable and safe new hemostatic agent during open liver surgery. CLINICAL TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov as NCT05385952.

  PublisherDOI

• Impact of insurance coverage on diagnosis and surgical treatment of gastric malignancies in urban populations.

  Journal of Clinical Oncology · 2025-05-28

  articleSenior author

  e13783 Background: This study aims to investigate the influence of insurance coverage on the diagnosis and surgical management of gastric malignancies in urban populations.The study focuses on two groups: patients with Medicare, Medicaid, or charity care (public/uninsured group) versus those with private insurance. Staging and subsequent surgical intervention may be influenced by insurance type, which has implications for treatment outcomes in gastric cancer patients. Methods: Data was collected from a cohort of 109 patients diagnosed with gastric malignancies. Insurance coverage was categorized as either Medicare, Medicaid, charity care, or private insurance. Patients were also grouped based on the availability of pathological staging data. A total of 103 patients had some form of insurance information, with 84 covered by Medicare, Medicaid, or charity care and 19 having private insurance. Staging information was available for 58 patients, while 51 patients lacked documented pathology staging. It is notable that some patients that lacked pathological data had clinical evidence of metastatic or stage IV disease based on chart review. Results: From the 58 patients, 55 patients had both staging and insurance data. 46 were covered by Medicare, Medicaid, or charity care, and 9 had private insurance. Pathological stage (pTx) distribution in the Medicare/Medicaid/charity care group included pT0 (n = 1), pT1 (n = 7), pT2 (n = 11), pT3 (n = 21), and pT4 (n = 6). In the private insurance group, stage distribution was pT1 (n = 2), pT2 (n = 2), pT3 (n = 3), and pT4 (n = 2). Additionally, ethnic distribution revealed that among public/underinsured with staging patients, 22 were Hispanic, 13 Black/African American, 3 non-Hispanic White, 2 Asian American, and 6 from other ethnic groups. Among privately insured patients with staging, 4 were Hispanic, 2 Black/African American, and 3 non-Hispanic White. Conclusions: Insurance coverage affects both the diagnostic staging and treatment of gastric malignancies in urban populations. Patients with Medicare, Medicaid, or charity care tend to be diagnosed at later stages compared to those with private insurance. Furthermore, disparities in diagnosis and treatment are evident across different ethnic groups, with uninsured patients predominantly comprising Hispanic and Black populations. The findings underscore the need for policy interventions aimed at reducing healthcare disparities and improving access to timely and appropriate care for gastric cancer patients in underserved communities.

  PublisherDOI

• Endoscopic liquid biopsies of gastric fluid in a large human patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  eLife · 2025-12-16

  articleOpen access

  Gastric cancer remains a diagnostic and therapeutic challenge worldwide. Improved prognostic biomarkers could aid treatment planning across surgical, neoadjuvant, and adjuvant settings. We evaluated a novel liquid-biopsy approach integrated with esophagogastroduodenoscopy (EGD) by analyzing gastric fluid DNA (gfDNA) from a large cohort (n=1056) to assess its diagnostic utility and prognostic value in gastric cancer. In this exploratory study, gfDNA concentration was measured in patients with normal gastric mucosa, peptic diseases, preneoplastic conditions, or cancer. Variables included sex, gastric fluid pH, proton-pump inhibitor use, tumor subtype, stage, and outcomes. gfDNA levels were significantly higher in gastric cancer than in all comparison groups (mean 26.86 ng/µL; 95% CI 20.05–33.79; p=3.61 × 10e -12 ) and as compared to non-malignant controls (mean 10.77 ng/µL; 95% CI 9.23–12.33; p=9.55 × 10e -13 ) and preneoplastic states (mean 10.10 ng/µL; 95% CI 7.59–12.60; p=1.10 × 10e -5 ). Advanced tumors (T3) exhibited higher gfDNA than earlier stages (T2 or below; mean 25.66 vs 15.12 ng/µL; p=5.97 × 10e -4 ). In a subset of gastric cancer patients, gfDNA &gt;1.28 ng/µL associated with longer progression-free survival (p=0.009) and correlated with increased tumor-infiltrating immune cells (p=0.001); this association remained after adjusting for stage (p=0.014). Elevated gfDNA supports gastric cancer presence in the general human population and may inform disease management when combined with tissue biopsies. Importantly, gfDNA shows prognostic potential in established gastric cancer, where higher gfDNA content may paradoxically relate to better outcomes, potentially linked to immune-cell infiltration. These findings warrant further validation and integration with complementary diagnostic modalities to enhance accuracy and clinical utility.

  PublisherDOI

• Endoscopic liquid biopsies of gastric fluid in a large patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  eLife · 2025-11-28

  preprintOpen access

  Background Human gastric cancer remains a diagnostic and therapeutic challenge worldwide. Improved prognostic biomarkers may support treatment planning, including surgery, neoadjuvant and adjuvant therapies. We offer a new liquid biopsy approach, integrated with esophagogastroduodenoscopy (EGD) to evaluate gastric fluid recovered from a large patient cohort (n=1,056 patients), demonstrating the value of a simple DNA concentration analysis to provide diagnostic support and prognosis in gastric cancer. Methods We performed an exploratory study to evaluate gastric fluid DNA (gfDNA) concentration in patients with normal gastric mucosa or diagnosed with peptic diseases, preneoplastic conditions, or cancer. Key variables including sex, gastric fluid pH, use of proton-pump inhibitors, tumor subtype, clinical stage, and disease outcomes were considered. Results gfDNA concentrations were significantly increased in gastric cancer versus all groups (mean 26.86 ng/µL; 95% CI: 20.05 to 33.79; p=3.61e-12) and as compared to non-malignant controls (normal mucosa and peptic diseases; mean 10.77 ng/µL; 95% CI: 9.23 to 12.33; p=9.55e-13), and preneoplastic conditions (mean 10.10 ng/µL; 95% CI: 7.59 to 12.60; p=1.10e-5). gfDNA concentrations were higher in advanced tumors (T3; mean 25.66 ng/µL; 95% CI: 19.46 to 31.85) compared to early-stage disease (T2 and below; mean 15.12 ng/µL; 95% CI: 9.73 to 20.50; p=5.97e-4). Our findings also suggest gfDNA prognostic value for gastric cancer diagnosed subjects. In this subset, patients with gfDNA concentrations &gt;1.28 ng/µL showed longer progression-free survival (p=0.009), which correlated with increased tumor-infiltrating immune cells (p=0.001), remaining significant after adjusting for tumor stage (p=0.014). Conclusions While high gfDNA indicates gastric cancer in a general population and may contribute to disease management, its diagnostic clues should be integrated with further work up such as tissue biopsies, to ensure comprehensive and accurate clinical assessment. However, in patients with established gastric cancer, gfDNA is a potential prognostic marker, and subjects with high gfDNA content might paradoxically have better outcomes. The elevated presence of immune cell infiltrates—compared to those observed in peptic diseases and pre-neoplastic lesions (including their associated gastric cavity DNA shedding)—may serve as a critical missing link to resolve this empirical paradox.

  PublisherDOI

• Redefining the Role of Hemicorporectomy in the Modern Era and Shifting Trends Toward Non-Malignant Indications

  The American Surgeon · 2025-05-23 · 2 citations

  reviewSenior author

  Hemicorporectomy, or translumbar amputation, is a radical surgical procedure in which the lower half of the body is removed. To date, 79 cases have been reported in the literature. We conducted a systematic review of the literature of articles published in peer-reviewed journals after 1990 on independent cases of hemicorporectomies. Individual case reports published before 1990 were excluded; however, a review paper from 1990 was included as a retrospective cohort and a source of comparison. Twenty-seven studies with an average follow-up period of 5.2 years reported on 40 patients who underwent hemicorporectomy from 1990 to 2021. Average age at surgery was 36.8 years, and 82.5% were male. The most common indications for the procedure were osteomyelitis of the pelvis (35%), squamous cell carcinoma (22.5%), and trauma (12.5%). Trauma had the lowest mortality rate (20%), while osteomyelitis had the highest (39%). This systematic review of 40 hemicorporectomy cases between 1990 and 2022 shows promising results, with many patients achieving significant recovery milestones, such as mobility and employment. These findings suggest that, despite its radical nature, the procedure can be a safe option for critical patients with no other feasible alternatives.

  PublisherDOI

• Author response: Endoscopic liquid biopsies of gastric fluid in a large patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  2025-11-28

  peer-reviewOpen access

  Human gastric cancer remains a diagnostic and therapeutic challenge worldwide. Improved prognostic biomarkers may support treatment planning, including surgery, neoadjuvant and adjuvant therapies. We offer a new liquid biopsy approach, integrated with esophagogastroduodenoscopy (EGD) to evaluate gastric fluid recovered from a large patient cohort (n=1,056 patients), demonstrating the value of a simple DNA concentration analysis to provide diagnostic support and prognosis in gastric cancer.We performed an exploratory study to evaluate gastric fluid DNA (gfDNA) concentration in patients with normal gastric mucosa or diagnosed with peptic diseases, preneoplastic conditions, or cancer. Key variables including sex, gastric fluid pH, use of proton-pump inhibitors, tumor subtype, clinical stage, and disease outcomes were considered.gfDNA concentrations were significantly increased in gastric cancer versus all groups (mean 26.86 ng/µL; 95% CI: 20.05 to 33.79; p=3.61e-12) and as compared to non-malignant controls (normal mucosa and peptic diseases; mean 10.77 ng/µL; 95% CI: 9.23 to 12.33; p=9.55e-13), and preneoplastic conditions (mean 10.10 ng/µL; 95% CI: 7.59 to 12.60; p=1.10e-5). gfDNA concentrations were higher in advanced tumors (T3; mean 25.66 ng/µL; 95% CI: 19.46 to 31.85) compared to early-stage disease (T2 and below; mean 15.12 ng/µL; 95% CI: 9.73 to 20.50; p=5.97e-4). Our findings also suggest gfDNA prognostic value for gastric cancer diagnosed subjects. In this subset, patients with gfDNA concentrations >1.28 ng/µL showed longer progression-free survival (p=0.009), which correlated with increased tumor-infiltrating immune cells (p=0.001), remaining significant after adjusting for tumor stage (p=0.014).While high gfDNA indicates gastric cancer in a general population and may contribute to disease management, its diagnostic clues should be integrated with further work up such as tissue biopsies, to ensure comprehensive and accurate clinical assessment. However, in patients with established gastric cancer, gfDNA is a potential prognostic marker, and subjects with high gfDNA content might paradoxically have better outcomes. The elevated presence of immune cell infiltrates—compared to those observed in peptic diseases and pre-neoplastic lesions (including their associated gastric cavity DNA shedding)—may serve as a critical missing link to resolve this empirical paradox.

  PublisherDOI

• Endoscopic liquid biopsies of gastric fluid in a large human patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  eLife · 2025-08-26

  articleOpen access

  Gastric cancer remains a diagnostic and therapeutic challenge worldwide. Improved prognostic biomarkers could aid treatment planning across surgical, neoadjuvant, and adjuvant settings. We evaluated a novel liquid-biopsy approach integrated with esophagogastroduodenoscopy (EGD) by analyzing gastric fluid DNA (gfDNA) from a large cohort (n=1056) to assess its diagnostic utility and prognostic value in gastric cancer. In this exploratory study, gfDNA concentration was measured in patients with normal gastric mucosa, peptic diseases, preneoplastic conditions, or cancer. Variables included sex, gastric fluid pH, proton-pump inhibitor use, tumor subtype, stage, and outcomes. gfDNA levels were significantly higher in gastric cancer than in all comparison groups (mean 26.86 ng/µL; 95% CI 20.05–33.79; p=3.61 × 10e -12 ) and as compared to non-malignant controls (mean 10.77 ng/µL; 95% CI 9.23–12.33; p=9.55 × 10e -13 ) and preneoplastic states (mean 10.10 ng/µL; 95% CI 7.59–12.60; p=1.10 × 10e -5 ). Advanced tumors (T3) exhibited higher gfDNA than earlier stages (T2 or below; mean 25.66 vs 15.12 ng/µL; p=5.97 × 10e -4 ). In a subset of gastric cancer patients, gfDNA &gt;1.28 ng/µL associated with longer progression-free survival (p=0.009) and correlated with increased tumor-infiltrating immune cells (p=0.001); this association remained after adjusting for stage (p=0.014). Elevated gfDNA supports gastric cancer presence in the general human population and may inform disease management when combined with tissue biopsies. Importantly, gfDNA shows prognostic potential in established gastric cancer, where higher gfDNA content may paradoxically relate to better outcomes, potentially linked to immune-cell infiltration. These findings warrant further validation and integration with complementary diagnostic modalities to enhance accuracy and clinical utility.

  PublisherDOI

• Author response: Endoscopic liquid biopsies of gastric fluid in a large human patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  2025-12-16

  peer-reviewOpen access

  Elevated gfDNA supports gastric cancer diagnosis and may guide management when combined with tissue biopsies, and in established cancer, higher gfDNA may predict better outcomes, potentially indicating immune-cell infiltration.

  PublisherDOI

• Disparities in chemotherapy utilization among urban upper GI malignancy cancer patients at a safety-net hospital.

  Journal of Clinical Oncology · 2025-05-28

  articleSenior author

  e23170 Background: Urban underserved populations face barriers to cancer treatment. Safety-net hospitals, serving vulnerable groups, often reveal disparities in care. This study examines chemotherapy utilization, cancer staging, demographics, and insurance status among upper gastrointestinal (GI) malignancy patients at a safety-net hospital in Newark, NJ. Methods: Data from 109 patients treated at University Hospital, Newark, NJ, from 2014–2024 were analyzed. Patients had upper GI malignancies, including gastric adenocarcinoma, esophageal cancer, cholangiocarcinoma, gallbladder cancer, and metastatic adenocarcinoma of gastric origin. Variables included cancer staging, chemotherapy status, language, ethnicity, race, age, sex, and insurance type. Patients were categorized by chemotherapy receipt: “Yes” for treatment or “No” for non-treatment. Of the cohort, 61 patients did not receive chemotherapy. Descriptive and subgroup analyses identified treatment disparities. Results: Of the 61 patients who did not receive chemotherapy, 46 had upper GI malignancies: gastric adenocarcinoma (n=28), esophageal cancer (n=5), cholangiocarcinoma (n=3), gallbladder cancer (n=1), and metastatic adenocarcinoma (n=8). Non-treatment patients were predominantly Hispanic/Latino (n=20) and Black/African American (n=13), with smaller numbers identifying as non-Hispanic White (n=1), Asian American (n=4), or other ethnicities (n=7). Uninsured or underinsured patients, including those on Medicaid, Medicare, or charity care, accounted for 76% (n=35) of this group. Among chemotherapy recipients (n=32), most had Medicaid/Medicare (n=21), charity care (n=7), or private insurance (n=4). Advanced-stage disease was more common among non-treatment patients, reflecting delayed diagnoses and systemic barriers. Language barriers disproportionately impacted non-English speakers, reducing chemotherapy initiation. Conclusions: This study reveals significant disparities in chemotherapy utilization among urban cancer patients at a safety-net hospital. Hispanic/Latino and Black/African American patients were disproportionately affected, with gaps in insurance and language services compounding inequities. Advanced-stage disease at diagnosis further reduced treatment options. Efforts to address disparities should prioritize expanding insurance coverage, improving language services, and enhancing outreach to promote earlier diagnosis. Structural reforms in safety-net hospitals are critical to improving equity and outcomes for underserved urban populations with upper GI malignancies.

  PublisherDOI

• None: Endoscopic liquid biopsies of gastric fluid in a large patient cohort reveal DNA content as a candidate tumor biomarker in gastric cancer

  2025-08-26

  peer-reviewOpen access

  Human gastric cancer remains a diagnostic and therapeutic challenge worldwide. Improved prognostic biomarkers may support treatment planning, including surgery, neoadjuvant and adjuvant therapies. We offer a new liquid biopsy approach, integrated with esophagogastroduodenoscopy (EGD) to evaluate gastric fluid recovered from a large patient cohort (n=1,056 patients), demonstrating the value of a simple DNA concentration analysis to provide diagnostic support and prognosis in gastric cancer.We performed an exploratory study to evaluate gastric fluid DNA (gfDNA) concentration in patients with normal gastric mucosa or diagnosed with peptic diseases, preneoplastic conditions, or cancer. Key variables including sex, gastric fluid pH, use of proton-pump inhibitors, tumor subtype, clinical stage, and disease outcomes were considered.gfDNA concentrations were significantly increased in gastric cancer versus all groups (mean 26.86 ng/µL; 95% CI: 20.05 to 33.79; p=3.61e-12) and as compared to non-malignant controls (normal mucosa and peptic diseases; mean 10.77 ng/µL; 95% CI: 9.23 to 12.33; p=9.55e-13), and preneoplastic conditions (mean 10.10 ng/µL; 95% CI: 7.59 to 12.60; p=1.10e-5). gfDNA concentrations were higher in advanced tumors (T3; mean 25.66 ng/µL; 95% CI: 19.46 to 31.85) compared to early-stage disease (T2 and below; mean 15.12 ng/µL; 95% CI: 9.73 to 20.50; p=5.97e-4). Our findings also suggest gfDNA prognostic value for gastric cancer diagnosed subjects. In this subset, patients with gfDNA concentrations >1.28 ng/µL showed longer progression-free survival (p=0.009), which correlated with increased tumor-infiltrating immune cells (p=0.001), remaining significant after adjusting for tumor stage (p=0.014).While high gfDNA indicates gastric cancer in a general population and may contribute to disease management, its diagnostic clues should be integrated with further work up such as tissue biopsies, to ensure comprehensive and accurate clinical assessment. However, in patients with established gastric cancer, gfDNA is a potential prognostic marker, and subjects with high gfDNA content might paradoxically have better outcomes. The elevated presence of immune cell infiltrates—compared to those observed in peptic diseases and pre-neoplastic lesions (including their associated gastric cavity DNA shedding)—may serve as a critical missing link to resolve this empirical paradox.

  PublisherDOI

Frequent coauthors

• Simrandeep Singh

  Guru Gobind Singh Medical College and Hospital

  104 shared

• Patrick L. Quinn

  The Ohio State University

  83 shared

• Vishnu Prasath

  Rutgers, The State University of New Jersey

  80 shared

• Lorenzo Conti

  University of Pisa

  78 shared

• Marylise Boutros

  Cleveland Clinic Florida

  78 shared

• Giles J. Toogood

  Leeds Teaching Hospitals NHS Trust

  75 shared

• H Salem

  75 shared

• Sana Ali

  Allama Iqbal Open University

  75 shared

Education

• M.D.

  Ross University School of Medicine, West Indies

  2003

• M.A.

  Rutgers University

  2019

Awards & honors

• Excellence in Teaching award by the General Surgical Chief R…