SurgOnc Today® (Society of Surgical Oncology)

In this episode of SurgOnc Today®,  Judy Boughey, MD, from the Mayo Clinic in Rochester, MN, and Vice Chair of the SSO Breast Disease Site Work Group, discusses with her colleagues how they manage a missing clipped axillary lymph node. She is joined by Puneet Singh, MD, from MD Anderson Cancer Center and Firas Eladoumikdachi, MD, from Rutgers Cancer Institute of New Jersey. Their discussion is focused on patients with node positive breast cancer who were treated with neoadjuvant chemotherapy.

On SurgOnc Today®, J. Joshua Smith, MD, PhD, Glen Balch, MD, and Christina Bailey, MD, discuss modern rectal cancer trials and their relevance to clinical practice.

In this episode of SurgOnc Today®, Akhil Chawla, MD, from Northwestern University, and a member of the SSO HPB disease site working group, is joined by Bas Groot Koerkamp, MD, PhD, from Erasmus Medical Centre and Knut Jørgen Labori, MD, PhD, from Oslo University Hospital. They discuss the details, similarities, and differences of their respective clinical trials for neoadjuvant therapy for pancreatic adenocarcinoma, NORPACT-1 and PREOPANC2.

References/Resources:
NORPACT-1 results: https://www.sciencedirect.com/science/article/abs/pii/S2468125323004053?via%3Dihub
NORPACT-1 editorial: https://pubmed.ncbi.nlm.nih.gov/38604195/
PREOPANC-2 protocol: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08031-z
PREOPANC-2 results : https://www.annalsofoncology.org/article/S0923-7534(23)04228-X/fulltext

In this episode of SurgOnc Today®, Evan Glazer, MD, PhD, FACS, Chair of the SSO Gastrointestinal Disease Site Work Group, is joined by panelists to provide an International Perspective on GI Malignancies.  Their discussion focuses on the challenges and opportunities for professional collaboration and patient care as it relates to esophageal and gastric malignancies.

Panelists include: 

• Eduardo A. Guzmán Huerta, MD, Professor in Surgery, Tecnológico de Monterrey, Nuevo león, Mexico
• Nia Zalamea, MD, FACS, Assistant Professor General Surgery, Director UTHSC Global Surgery Institute, The University of Tennessee Health Science Center, Memphis, TN 
• Alejandro Rodriguez, MD – Assistant Professor, Tecnológico de Monterrey, Nuevo león, Mexico 

In this episode of SurgOnc Today®, Yinin Hu, MD, and Sarah Fisher, MD, are joined by Neal Saunders, MD, and Heather Wachtel, MD, for a discussion of molecular testing for thyroid nodules and how to incorporate this adjunct into clinical practice.

In this episode of SurgOnc Today, Associate Professor Gabrielle van Ramshorst MD, PhD, and Dr. Patrick Sullivan, MD, moderate a discussion with two top experts in the field of pelvic exenteration surgery, Dr. Brian Bednardski, MD, and Professor Michael Solomon, MD, PhD, on their experience in this complex type of surgery. The discussion covers the definition of pelvic exenteration, the organization of care, training in pelvic exenteration surgery, and recent developments in this field.

On SurgOnc Today®, Jeffrey J. Pelton, MD, and Randall P. Scheri, MD, discuss the use and efficiency of four-dimensional CT scanning in preoperatively localizing adenomas in patients with primary hyperparathyroidism prior to cervical exploration.

The discussion includes:

• The anatomic body planes and the “fourth dimension” of CT scanning.
• How the 4D CT scan is performed and how this achieves localization of abnormal parathyroid glands.
• The role 4D CT scanning plays in the pre-operative work-up for primary hyperparathyroidism.
• What the surgeon wants to know from the radiologist on a 4D CT report.
• Potential risks and pitfalls in interpreting a 4D CT scan prior to proceeding with surgical exploration.

Dr. Pelton and Dr. Scheri also discuss what the literature has reported on this subject, how they approach surgical exploration using the information and their own experiences with this test.

The 2020 Commission on Cancer (CoC) accreditation standards introduced six new operative standards pertaining to the technical aspects of cancer surgery. In this episode, SSO Colorectal Disease Site Work Group Chair, David Shibata, MD, James Fleshman, MD, and David Dietz, MD, describe Standard 5.7, Total Mesorectal Excision (TME) for Rectal Cancer and will cover the details of the standard, the key steps of TME, and its’ supporting evidence.

In patients with invasive breast cancer presenting with node positive disease, neoadjuvant chemotherapy is often recommended and can result in surgical downstaging in a significant proportion of cases. Management of the axilla in this setting has evolved. For those found to have a nodal pathologic complete response (ypN0), an axillary lymph node dissection (ALND) can potentially be avoided. Astrid Botty van den Bruele, MD, FACS, and Giacomo Montagna, MD, MPH, discuss the newly presented OPBC-04/EUBREAST-06 study, which supports omission of ALND in this population. The axillary staging techniques (SLNB vs TAD) are also addressed.

In this episode of SurgOnc Today®, Dr. Melanie Ongchin from the University of Pittsburgh, Dr. Trang Nguyen from Washington University, and Dr. Molly Kledzik from WVU are joined by Ms. Lindsay Barad, a patient and advocate for PMP Pals. Diagnosed with LAMN with PMP, Lindsay shares her unique perspective on the patient experience following CRS/HIPEC, emphasizing the challenges and considerations of young female patients regarding fertility.

In this episode of SurgOnc Today®, Mio Kitano, MD, MS, FACS, FSSO, Surgical Oncologist at UT Health San Antonio, TX, is joined by Mashaal Dhir, MD, FACS, FSSO, Surgical Oncologist and Section Chief of HPB Surgery at The SUNY Upstate Medical University in Syracuse, NY, and Nathan Bahary, MD, PhD, Division Chief of Medical Oncology at the Allegheny Health Network Cancer Institute and Director of AHNCI Clinical Research in Pittsburgh, PA. They discuss the most up-to-date information on how to diagnose and manage small bowel NET.

Moderator: 
Mio Kitano, MD, MS, FACS, FSSO - UT Health San Antonio

Faculty:  
Mashaal Dhir, MD, FACS, FSSO - SUNY Upstate Medical University
Nathan Bahary, MD, PhD - Allegheny Health Network

Unplanned surgical excisions of soft tissue sarcomas (“whoops operations”) can complicate the subsequent multidisciplinary management of the primary tumor due to potential microscopic tumor seeding of prior surgical sites, violation of uninvolved anatomic compartments, and sometimes a lack of gross residual tumor on staging imaging. Valerie Grignol, MD and Kilian Salerno, MD join John M. Kane III, MD, Vice-Chair of the SSO Sarcoma Disease Site Work Group, to discuss how unplanned excisions might alter the surgical and radiation decision-making for the treatment of soft tissue sarcomas.

In this episode of SurgOnc Today®, Michail Mavros, MD, and Sonia T. Orcutt, MD from the University of Arkansas for Medical Sciences are joined by Jonathan R. Strosberg, MD, head of the Neuroendocrine Division in the Department of Gastrointestinal Oncology, Moffitt Cancer Center and Past President of the North American Neuroendocrine Tumor Society (NANETS), and Mary A. Maluccio, MD, MPH, chief of the Division of Surgical Oncology at LSU and medical director of the NET Louisiana program. Gastric NETs are often misunderstood neoplasms with recent updates in classification and management, and the panelists discuss the most up-to-date information on how to diagnose and manage gastric NETs.

In this episode of SurgOnc Today®,  Dr. Judy Boughey, from the Mayo Clinic, in Rochester, MN and Dr. Carlos Garcia-Etienne, from the Ospedale Santa Chiara in the Autonomous Province of Trento, Italy review three practice changing studies and how their findings are important to breast surgical oncologists. During the podcast, they will review:

• Effectiveness of Breast-Conserving Surgery and 3-Dimensional Conformal Partial Breast Reirradiation for Recurrence of Breast Cancer in the Ipsilateral Breast: The NRG Oncology/RTOG 1014 Phase 2 Clinical Trial (JAMA Oncol. 2020 Jan 1;6(1):75-82. doi: 10.1001/jamaoncol.2019.4320.)
• Pembrolizumab for Early Triple-Negative Breast Cancer (N Engl J Med 2020; 382:810-821 DOI: 10.1056/NEJMoa1910549.)
• Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer (N Engl J Med. 2021 Jun 24;384(25):2394-2405. doi: 10.1056/NEJMoa2105215.)

In this episode of SurgOnc Today®, Samantha Ruff, MD, Rupen Shah, MD, Mustafa Raoof, MD, and Danielle DePeralta, MD, discuss the role of pressurized intraperitoneal aerosolized chemotherapy (PIPAC) and its emerging role in the management of peritoneal surface malignancies. We review the existing literature for this treatment modality and the recently published multi-center phase I trial performed in the United States. 

During this episode of SurgOnc Today®, Kenneth Cardona, MD, Nicholas Tawa, MD, PhD, Elizabeth Davis, MD, and Marwan Moussa, MD, discuss the value and role of cryoablation in the management of patients with desmoid tumors and examine clinical scenarios in which this treatment modality should be offered. They also discuss the CRYODESMO-1 prospective trial which investigated the utility of cryoablation in desmoid tumors.

ALT/WDLPS are fatty tumors most commonly occurring in the extremity and retroperitoneum that have a relatively indolent behavior, but a strong predilection for local recurrence. In this episode of SurgOnc Today®, Episode 2 of this series on ALT/WDLPS, Brian Kadera, MD, John Mullinax, MD, Giorgos Karakousis, MD, and Steven Thorpe, MD, will focus on local management, surgical approaches, and the risks/benefits of radiation in the neoadjuvant/adjuvant setting. We will highlight differences in the natural history of this tumor when it occurs in the extremity versus the retroperitoneum, and touch briefly on the management of local well-differentiated recurrences.

In this episode of SurgOnc Today®, join us as the Women in Cancer Surgery working group shares their triumphs, challenges, and the impactful experiences that have shaped their journeys in cancer surgery. Moderated by Sarah McLaughlin, MD, FSSO, and featuring Margo Shoup, MD, MBA, FSSO, Nathalie Johnson, MD, and Julie Ann Sosa, MD, MA, FACS, FSSO, explore the unwavering commitment and inspiring stories behind these exceptional women.

In this SSO Education Series episode of SurgOnc Today®, Dr. Seth Concors, an Assistant Professor of Surgical Oncology at Emory University interviews Dr. Aatur Singhi, an Associate Professor in the Divisions of Anatomic Pathology and Molecular Genomic Pathology, Director and Coordinator of Anatomic Pathology Research and Director of the UPMC Developmental Laboratory, who reviews the fundamentals of appendiceal pathology – reviewing recent changes relevant for clinical management.

In this episode of SurgOnc Today®, Olga Kantor, MD, Brigham and Women's Hospital, Boston, MA, Emily Sturm, MD, Southern Illinois University School of Medicine, Springfield, IL, Ibrahim Nassour, MD, University of Florida Health, Gainesville, FL, and Kimberly Washington, MD, FACS, Oregon Health and Science University, Portland, OR, discuss tips and tricks for fellows navigating the process of finding a job. They discuss how to prepare while in fellowship, how to find jobs, and how to approach interviews and negotiations. References

• Guetter CR, McGuire KP, Oropallo AR, et al. Surgical job negotiations: How current literature and expert opinion can inform your strategies. Am J Surgery. 2020 June 25;220(2020):1201-7.
• The Graduating Surgeon: A Primer for Surgical Trainees. Young Fellows Association, American College of Surgeons, downloaded 18 Jan 2022. https://www.facs.org/-/media/files/member-services/yfa/yfa_graduating_surgeon_primer.ashx

In this episode, Ko Un “Clara” Park, MD, FACS, Member of the SSO Breast DSWG and Assistant Professor of Surgery at The Ohio State University Wexner Medical Center reviews wire-free alternatives for localization of non-palpable breast lesions for surgery. Panelists and alternatives reviewed include:

Dr. Michael Alvarado, Professor of Surgery and member of the breast care and melanoma programs at the UCSF Helen Diller Family Comprehensive Cancer Center, discusses the use of radioactive seed.

Dr. Susan Hoover, Professor of Surgery at the Moffitt Cancer Center in Tampa, Florida, reviews other ‘seed-like’ localizers such as Savi Scout, Magseed, and the Faxitron localizer.

Dr. Lee G. Wilke, the Hendricks endowed chair in Breast Cancer Research; a tenured Professor of Surgery and the Associate Director for Clinical Research for the University of Wisconsin Carbone Cancer Center as well as the Director of the UW Health Breast Center in Madison, WI, discusses an innovative intraoperative navigation platform for tumor identification, a Smart Clip technology which can be inserted at time of the biopsy.

In this episode, Peritoneal Surface Malignancy Disease Site Workgroup Member, Beth Helmink, MD, PhD, from Washington University in St. Louis, reviews recent data regarding the evolving role of HIPEC in Ovarian Cancer.  Joining her for this discussion are two renowned gynecologic oncologists specializing the treatment of ovarian cancer, Willemien van Driel, MD, Netherlands Cancer Institute, and Ernst Lengyel, MD, PhD, University of Chicago.

In this episode of SurgOnc Today, Julie Hallet, MD, MSc, Vice-Chair of the SSO HPB disease site working group, and Lavanya Yohanathan, MD, from the HPB disease site working group are joined by Melissa Hogg, MD, from Northshore University Hospital and Giovanni Marchegiani, MD, from the University of Padova. They will discuss two key clinical scenarios during surveillance of pancreatic cystic neoplasms: when to pull the trigger on resection and if or when to discontinue surveillance.

Show notes: 
- Next generation sequencing of pancreatic cyst fluid: https://pubmed.ncbi.nlm.nih.gov/36209796/
- Discontinuation of surveillance for selected IPMNs: https://pubmed.ncbi.nlm.nih.gov/37406887/
- iCyst app: https://apps.apple.com/us/app/icyst/id1479833485 

In this episode of SurgOnc Today®, Puneet Singh, MD, and Anna Weiss, MD, discuss the newly published SOUND and LUMINA clinical trials. Both trials explore local regional de-escalation, omitting sentinel lymph node biopsy and radiation, respectively. They discuss the treatment challenges that incorporating these trial results may pose with their special guest, Kimberly Corbin, MD.

In this episode of SurgOnc Today®, Gautam Malhotra, MD, interviews Jeremy L. Davis, MD, Mio Kitano, MD, and Sonia Orcutt, MD, live at SSO 20204 after their panel discussion on “Getting the Most out of ERAS Pathways for Patients Undergoing Gastric Cancer Surgery”. They review the current literature on the use of ERAS for gastric cancer surgery, the importance of multi-disciplinary approach, and the challenges in the implementation.

In this episode of Surg Onc Today, Kimberly Washington, MD, Hepato-Pancreato-Biliary Surgeon at Texas Health Surgical Specialist/Texas Christian University in Fort Worth, Texas is joined by Jennifer Tseng MD, Medical Director of Breast Surgery, City of Hope Orange County, Associate Clinical Professor, Department of Surgery and Brian Sparkman, MD, MS, FACS, Complex General Surgical Oncology Fellow at Virginia Commonwealth University Medical Center, Richmond, VA. The initial year of practice can be a challenging yet pivotal learning experience. The episode offers expert advice, insider insights, and personal anecdotes to help ease your transition. Tune in for practical guidance that can assist you during this critical time.

On SurgOnc Today®, Patrick S. Sullivan, MD, Maria Diab, MD, and Nader Hanna, MD, discuss the use of liquid biopsy or ctDNA to identify molecular disease prior to clinically detectable disease. Molecular detection of ctDNA can be used to detect minimal residual disease (MRD) which is residual cancer cells detected only by molecular techniques but not by conventional testing. Molecular testing of ctDNA can also be used to detect molecular relapse. This allows the molecular detection of occult disease during adjuvant therapy or during surveillance. This information can be prognostic and help determine patients with increased risk of recurrent disease who may benefit from adjuvant therapy and targeted chemotherapy. It can also be used for prediction for adjuvant chemotherapy. In addition it can be used for de-escalation of chemotherapy by identifying patients who would not gain the benefit of chemotherapy. There are 2 approaches for detecting MRD. One is tumor agnostic and the second is tumor informed. The tumor informed has higher sensitivity by identifying mutations in the tumor tissue and tracking these mutations in the plasma.

Anthony Yang, MD, MS, FACS, Chair of the SSO Endocrine Disease Site Work Group is joined by fellow Workgroup Members, Mark Cohen, MD, FACS, FSSO and Cord Sturgeon, MD, MS, FACS, along with Samuel Hyde, CGC.

This episode is the first of a two-part series.  The expert panel will discuss the incidence, prevalence, and epidemiology of primary hyperparathyroidism (PHPT).  They will review inherited syndromes associated with PHPT as well as when to send patients/families to genetic counseling for further evaluation and how to diagnose those syndromes.  Part two of our series will focus on the surgical management of hereditary forms of PHPT.

Dr. Cohen is Professor of Surgery, Pharmacology and Biomedical Engineering; Vice Chair in Surgery for Clinical Operations; Director of the Center for Surgical Innovation; Director of the Medical School Pathway of Excellence in Innovation and Entrepreneurship; and Director of Endocrine Surgery Research at the University of Michigan. Dr. Sturgeon is Professor of Surgery, Chief of Endocrine Surgery at the Robert H. Lurie Comprehensive Cancer Center and the Director of Surgery at Northwestern Memorial Hospital.  Samuel Hyde is an ABGC-certified genetic counselor who specializes in hereditary cancer and is an instructor at the Northwestern University Feinberg School of Medicine.

On this episode of SurgOnc Today®, in honor of Asian American Native Hawaiian Pacific Islander (AANHPI) month, we highlight the achievements and contributions of those with AANHPI background and their involvement in surgical oncology care. Today we speak with some of the AANHPI leaders in surgical oncology around the US, providing insight into how their upbringing/heritage affected their careers in medicine.

Moderators: Tammy Ju

Faculty: Vikas Dudeja, Anai Kothari

In this episode of SurgOnc Today ®, Alex Parikh, MD, MPH, FACS, FSSO, from the University of Texas – San Antonio and Julie Hallet, MD, M.Sc., FRCSC, FSSO from the University of Toronto are joined by Monica M. Dua, MD, from Stanford University and Ching-Wei Tzeng, , MD, FACS, FSSO, from the MD Anderson Cancer Center. They will be discussing two important aspects of the surgical management of perihilar cholangiocarcinoma: strategies for pre-operative optimization and biliary drainage, and management of the future liver remnant. This is part one of a two-part series.

In this episode of SurgOnc Today®,  Dr. Jennifer Plichta is joined by Dr. Ann Partridge and Dr. Kristin Rojas to discuss practical pearls for addressing women’s sexual health concerns during breast cancer treatment and prevention using case-based discussions to illustrate common scenarios that breast surgeons may encounter in their clinic. These may include managing sexual health concerns in the neoadjuvant and adjuvant setting, as well as how to approach symptom management for patients seen in a high-risk program.

Jennifer Plichta, MD, MS is an Associate Professor of Surgery at Duke University

Ann Partridge, MD, MPH is a Professor of Medicine at Harvard Medical School, and Vice Chair of Medical Oncology at Dana-Farber Cancer Institute

Kristin Rojas, MD is an Assistant Professor of Surgery at the University of Miami, Sylvester Comprehensive Cancer Center 

References:

1. ASCO Guideline: Carter J, Lacchetti C, Anderson B, et al. Interventions to Address Sexual Problems in People With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Adaptation of Cancer Care Ontario Guideline. Journal of Clinical Oncology 2018 36:5, 492-511https://ascopubs.org/doi/full/10.1200/JCO.2017.75.8995
2. ACOG Supports Use of Vaginal Estrogen in Breast Cancer Survivors: https://www.acog.org/news/news-releases/2016/02/acog-supports-the-use-of-estrogen-for-breast-cancer-survivors
   1. Dew JE, Wren BG, Eden JA. A cohort study of topical vaginal estrogen therapy in women previously treated for breast cancer. Climacteric. 2003 Mar;6(1):45-52. PMID: 12725664.
   2. Le Ray I, Dell'Aniello S, Bonnetain F, Azoulay L, Suissa S. Local estrogen therapy and risk of breast cancer recurrence among hormone-treated patients: a nested case-control study. Breast Cancer Res Treat. 2012 Sep;135(2):603-9. doi: 10.1007/s10549-012-2198-y. Epub 2012 Aug 19. PMID: 22903687.https://link.springer.com/article/10.1007%2Fs10549-012-2198-y
3. Studies on Risk of Recurrence With Vaginal Estrogen: 
4. American Association of Sexuality Educators, Counselors, and Therapists (AASECT): https://www.aasect.org/
5. PROSE Study: Rebbeck TR, Friebel T, Wagner T, et a. Effect of short-term hormone replacement therapy on breast cancer risk reduction after bilateral prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol. 2005 Nov 1;23(31):7804-10. doi:10.1200/JCO.2004.00.8151. Epub 2005 Oct 11. PMID: 16219936.

Timothy Mullett, MD, Stephen Swisher, MD, and Nirmal Veeramachaneni, MD discuss the Commission on Cancer (CoC) Standard 5.8 including a review of the requirements for nodal assessment during curative operation for lung cancer and best practices to accomplish the requirement.

In this episode of SurgOnc Today®, Brian E. Kadera, MD, Ben Hinrichs, MD, and Konstantinos Chouliaras, MD, focus on the diagnosis and work-up of fatty tumors in the extremity and the retroperitoneum. They highlight the imaging features, the utility of biopsy and specifically, MDM2 fluorescence in-situ hybridization. They also review the pitfalls of gross and microscopic margin assessment.

Dr. Rick Greene discusses with Dr. Heather Neuman and Dr. Alyssa Wiener the results of a randomized trial of topical pain approaches for radiotracer injections for breast cancer sentinel lymph node mapping, as reported in her article, "A Four-Arm Randomized Clinical Trial of Topical Pain Control for Sentinel Node Radiotracer Injections in Patients with Breast Cancer.”

This episode of SurgOnc Today®, recorded at SSO 2024, focuses on understanding the training and preparation needed prior to embarking on pelvic exenterative surgery and international collaboration to improve the outcomes of complex pelvic resections.

In this episode of SurgOnc Today, Tina Hieken, MD, from the Mayo Clinc, in Rochester, MN interviews Georgia Beasley, MD, MHS, from Duke University in Durham, NC and Christina Stevenson, MD, MS, from the University of Connecticut in Farmington, CT. They review the following studies and how their findings are important to surgical oncologists specializing in melanoma.

Safety and Efficacy of Pembrolizumab Compared to Placebo in Resected High-risk Stage II Melanoma (MK-3475-716/KEYNOTE-716)

LBA3_PR - Pembrolizumab versus placebo after complete resection of high-risk stage II melanoma: Efficacy and safety results from the KEYNOTE-716 double-blind phase III trial

Neoadjuvant PD-1 Blockade in Patients With Stage IIB/C Melanoma

The surgical management of superficial soft tissue sarcoma require a multidisciplinary surgical team given the defect and reconstruction required from an extended resection to achieve negative margins. This team most often includes the primary surgeon (surgical oncology or orthopedic oncology) and a plastic surgeon.  A critical decision in the treatment plan is whether or not to reconstruct immediately at the index operation or delay final reconstruction pending pathologic assessment of margins.  In this podcast, we will focus on the multidisciplinary surgical approach for superficial sarcoma. We will highlight the role of delayed reconstruction and key clinical considerations in this approach. 

In this episode of SurgOnc Today, Alexander Parikh, MD, MPH, from the University of Texas – San Antonio and Chair of the SSO HPB disease site working group, and Laleh G. Melstrom, MD, MSCI, from City of Hope National Medical Center, are joined by Timothy Newhook, MD, from the University of Texas MD Anderson Cancer Center and Andreas Kaiser, MD, from the City of Hope. We will be discussing the management of synchronous rectal cancer with liver metastases.

During this episode of SurgOnc Today®, Valerie P. Grignol, MD, Vice Chair of the SSO Sarcoma Disease Site Work Group, Timur Mitin, MD, PhD, Arun Singh, MD, and Neha Goel, MD, discuss the evaluation, treatment and management of primary and radiation induced angiosarcoma of the breast through a case based discussion.

This episode of SurgOnc Today is episode 3 of our Management of ALT/WDLPS series. Dr. Brian Kadera, Dr. Jessica Cintolo-Gonzalez and Dr. John Miura will discuss surveillance and treatment approaches for recurrent well-differentiated liposarcoma (WDLPS) in the retroperitoneum, which has a very high rate of recurrence. Even after radical resections by experienced surgeons, these tumors can recur a decade later. They will review the natural history of late-stage WDLPS, the actual risk of transformation from well-differentiated to dedifferentiated liposarcoma (WD to DD), and a multidisciplinary treatment approach to unresectable recurrences.

In part two of the series on the role of transplant for liver tumors, Alexander Parikh, MD, MPH, Chair of the SSO HPB Disease Site Work Group, is again joined by Ana Luiza Gleisner, MD, PhD, from the University of Colorado Anschutz Medical Campus in Aurora, CO and Shimul A. Shah, MD, MHCM, from the University of Cincinnati College of Medicine in Cincinnati, OH. They review the role of liver transplantation for malignancies of and to the liver. The discussion also covers the role of liver transplantation in the treatment of colorectal liver metastases including the impact of liver-directed therapies on the role of liver transplant.

In this episode of SurgOnc Today®, Dr. Julie Hallet from the University of Toronto, and Vice-Chair of the SSO HPB disease site working group, is joinded by Dr. James R. Howe from the University of Iowa and Dr. Nadine Mallak from the Oregon Health and Science University. They discuss how somatostatin receptor PET imaging, such as DOTATE-PET, can be used to guide and support the surgical management of pancreatic neuroendocrine tumors.

Moderator:

Julie Hallet MD, Msc;

Associate Professor of Surgery. University of Toronto, Toronto, Canada;

Surgical Oncologist, Susan Leslie Clinic for Neuroendocrine Tumors – Sunnybrook Health Sciences Centre, Toronto, Canada

Vice-Chair, HPB DSWG, SSO

Faculty: 

James R. Howe, MD

Professor of Surgery and Director of Surgical Oncology and Endocrine Surgery, Roy J. and Lucille A. Carver University of Iowa College of Medicine, Iowa City, Iowa

Nadine Mallak, MD

Associate Professor, Department of Diagnostic Radiology, Nuclear Medicine and Body Imaging sections

Director, PET/MRI, Clinical, Oregon Health and Science University, Portland, OR

References

NANETS guidelines for the surgical management of pancreatic neuroendocrine tumors

https://nanets.net/images/guidelines/2020_NANETS_Consensus_Paper_on_the_Surgical_Management_of_Pancreatic_Neuroendocrine_Tumors.pdf

SNMMI appropriate use criteria for somatostatin receptor PET imaging in neuroendocrine tumors

https://s3.amazonaws.com/rdcms-snmmi/files/production/public/Quality/jnm202275_New%20-%20revised.pdf

Desmoids are a unique subset of soft tissue tumors. While they can cause symptoms related to local progression, they do not metastasize and a subset have indolent behavior, in some cases regressing spontaneously. Because surgery for desmoids can be morbid and recurrence rates are high, non-operative treatment has become the preferred treatment strategy for desmoid patients. Active observation, regional therapies for anatomically appropriate cases and medical therapies can all be employed in patients with desmoid-type fibromatosis. Aimee M. Crago, MD, PhD, and Brian E. Kadera, MD, discuss cases requiring non-operative management to assist listeners in integrating recently published data into their practices.

In this episode of SurgOnc Today™, Evan Glazer, MD, PhD, FACS, FSSO, Vice Chair of the SSO Gastrointestinal Disease Site Workgroup, is joined by Julie Hallet MD, MSc, FRCSC, Natalie Coburn MD, MPH and Jesse Zuckerman, MDCM, all from the University of Toronto. Focusing on 2020 Practice Changing Studies in Gastrointestinal Surgical Oncology, they review the Declining Use of Red Blood Cell Transfusions for Gastrointestinal Cancer Surgery: A Population-Based Analysis. Ann Surg Oncol 28, 29–38 (2021). https://doi.org/10.1245/s10434-020-09291-y

During this episode of SurgOnc Today®, Austin D. Williams, MD, Fox Chase Cancer Center, Zachary J. Brown, DO, New York University - Long Island School of Medicine, and Allison Martin, MD, University of Texas MD Anderson Cancer Center, discuss the various career options within surgical oncology, including breast, hepatobiliary and colorectal. The discussion covers information specific to each of these surgical oncology subspecialties and provides information important for any trainee who is contemplating a career as a surgical oncologist.

In this episode of SurgOnc Today, Alexander Parikh MD, MPH, FACS, FSSO, will continue the discussion on the nuts and bolts of neoadjuvant therapy for pancreas cancer with Syed Ahmad, MD, and Susan Tsai, MD, MHS. In part 2, they specifically discuss two important aspects of delivering neoadjuvant therapy for pancreatic adenocarcinoma. Specifically, how to choose which specific regimens to use and the role of chemoradiation. 

In this episode, Sandra L. Wong, MD, MS, FSSO, speaks with Ryan Fields, MD, recipient of the 2014 SSO Clinical Investigator Award, about the impact the award had in helping him to achieve his future career goals. 

In this episode Carmen Solorzano, MD, Chair of the SSO Endocrine Disease Site Work Group, Electron Kebebew, MD, and Geoffrey Young, MD, PhD, discuss two practice changing studies regarding the management of Medullary and Anaplastic Thyroid Cancer.

Carmen Solorzano, MD, Professor of Surgery, Chair, Department of Surgery, and Director, Vanderbilt Endocrine Surgery

Geoffrey Young, MD, PhD, Chief, Head and Neck Surgery; Miami Cancer Institute

Electron Kebebew, MD, Professor and Chief, Stanford University School of Medicine

References/Resources

1-Efficacy of Selpercatinib in RET-Altered Thyroid Cancers.

Wirth LJ et al. N Engl J Med. 2020 Aug 27;383(9):825-835. doi: 10.1056/NEJMoa2005651.PMID: 32846061

2- 2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer- American Thyroid Association Anaplastic Thyroid Cancer Guidelines Task Force. KC Bible, E Kebebew et al. Thyroid Published Online:12 March 2021https://doi.org/10.1089/thy.2020.0944

3-Nihilism no more: The 2021 ATA Anaplastic Thyroid Cancer Guidelines. JD Pasternak, TE Angell, J Lorch. Clinical Thyroidology Vol. 33, No.5. Published Online:7 May 2021https://doi.org/10.1089/ct.2021;33.229-234

In this episode of SurgOnc Today, Genevieve Boland, MD, PhD, FSSO, of Massachusetts General Hospital – Vice Chair of the SSO Melanoma Disease Site Working Group is joined by fellow committee members, Rogerio Neves, MD, PhD, FACS, FSSO, from Moffitt Cancer Center and Amanda Kirane, MD, FACS, FSSO, from Stanford University. They discuss the current clinical application of tumor infiltrating lymphocytes (TILs) in melanoma, recent clinical trial results, advances in TILs production that have allowed for expanded patient access, and insight on appropriate patient or tumor selection for therapy.

Historically, mastectomy was recommended for women with multiple ipsilateral breast cancer due to perceptions regarding high rates of local recurrence with breast conservation. A recent prospective clinical trial demonstrated that breast conservation therapy may be appropriate to consider for women with multiple ipsilateral breast cancer. This episode of SurgOnc Today® features Ashley Woodfin, MD, discussing with Judy C. Boughey, MD, and Kari Rosenkranz, MD, the findings of the Alliance Z11102 clinical trial and how to implement these into practice.

In this episode of SurgOnc Today®, Dr. Cord Sturgeon and Dr. Mahsa Javid are joined by Dr. Eduardo Guzmán Huerta, Dr. Juan Pablo Pantoja, and Professor Brian Lang to discuss factors affecting management of thyroid cancer with this group of experts who have a wealth of experience in different parts of the globe. Considerations affecting decision making and treatment options, adjuvant testing, adjuncts to surgery, overall costs and the system factors that need to be taken into account in the treatment and follow up of patients with thyroid cancer are explored. The discussed contributes towards advancing our understanding of worldwide processes and challenges in the management of thyroid cancer.

In this episode of SurgOnc Today, Sarah McLaughlin, MD, interviews renowned surgical oncologists Lisa Newman, MD, MPH, and Monica Morrow, MD, to get their perspectives on how women’s experiences with medical school, surgical training, and professional career trajectories have evolved during their time in medicine.

The management of locally advanced extremity soft tissue sarcomas require a multidisciplinary approach. Surgery remains the standard of care for cure, however, other loco-regional treatments including radiation and isolated limb perfusion as well as systemic treatments have been utilized to reduce local and distant recurrence risk. In this podcast, we will focus on the multidisciplinary approach for locally advanced extremity sarcomas. We will highlight the role of limb-sparing resections versus amputations.

In this episode of SurgOnc Today®, Deepa Magge, MD, and Abhineet Uppal, MD, provide a recap of highlights from the SSO Advanced Cancer Therapies conference held in February 2024.

This session will review state of the art therapy for peritoneal mesothelioma. The discussion includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as well as systemic chemotherapy and immunotherapy.

Edward Levine, MD, moderates this podcast and is Professor of Surgery and Chief, Surgical Oncology at Wake Forest University. Trang Nguyen, MD, is an Assistant Professor of Surgery at Indiana University and Sinziana Dumitra, MD, MSc, FRCSC, FSSO, is an Assistant Professor of Surgery at McGill University. 

In this podcast, the relatively new ASCO guidelines for breast cancer genetic testing will be discussed. The differences between these and other guidelines, such as ASBrS and NCCN, will be discussed. In addition, the different testing options and implications of positive results will be reviewed. 

In this episode of SurgOnc Today, live from SSO 2024, Dr. Alex Parikh from the University of Texas – San Antonio and Chair of the SSO HPB disease site working group, and Dr. Julie Hallet from the University of Toronto, and Vice-Chair of the SSO HPB disease site working group, are joined by Dr. Ana Gleisner from the University of Colorado and Dr. Skye Mayo from the Oregon Health and Sciences University. They will be discussing two important aspects of the surgical management of perihilar cholangiocarcinoma: determining resectability as it relates to vascular involvement, and the role of neoadjuvant therapy.

In this episode of SurgOnc Today®, Dr. Julie Hallet, Chair of the SSO HPB Disease Site Working Group, reviews key updates and takeaways from the recent AHPBA Annual Meeting held in April 2024 in Miami. They are joined by Dr. Miral Grandhi, Dr. Amer Zureikat, Dr. Rebecca Snyder, and Dr. Katrina Duncan to review clinical trials on blood management for liver resection, biliary decompression for Klatskin tumors, and total venous deprivation to generate liver hypertrophy, as well as new data on genomics of pancreatic neuroendocrine tumors and bile liquid biopsy, and why evidence from clinical trials may not be adopted in HPB surgery.

In this episode, Karyn Stitzenberg, MD, MPH, Vice Chair of the SSO Colorectal Disease Site Work Group is joined by Patrick S. Sullivan, MD, FACS, FASCRS, Associate Professor of Surgery and Chief Quality Officer, Division of Colorectal Surgery at the Winship Cancer Institute of Emory University in Atlanta, Georgia. They review practice changing studies in colorectal surgical oncology from 2020.

In this inaugural episode of the Surgical Oncology Insight series of SurgOnc Today®, Dr. Shishir Maithel, Editor of Surgical Oncology Insight, SSO's open-access journal, discusses with Dr. Brett Ecker the results of a systematic review and meta-analysis characterizing the incidence of cfDNA-positivity after resection of colorectal cancer liver metastases  with quantification of its sensitivity and specificity for postoperative recurrence, as reported in his article, "The Prognostic Role of Post-operative cfDNA after Resection of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis."

Please listen in as Drs. Piltin, van Akkooi, and Hyngstrom discuss relevant clinical trial presentations from ASCO 2024 annual meeting and their impressions on the implications for surgical oncologists. Abstracts results discussed include the neoadjuvant NADINA and PIVOTAL trials as well as an initial report on upfront TIL therapy for stage IV patients.

In this episode of SurgOnc Today®, Chantal Reyna MD, Medical Director of Breast and Chief of Breast Surgery in the Upland, PA is joined by Jennifer Plichta MD, Associate Professor of Surgery at Duke University in Durham, NC and Chandler Cortina MD, Assistant Professor of Surgery and Chief of the Surgical Oncology Breast & Endocrine Service at the Medical College of Wisconsin at Medical College of Wisconsin in Milwaukee, WI. With the treatment of female breast cancer continuously evolving, the treatment of male breast cancer can be a challenge due to its rarity. This episode focuses on the current incidence, evaluation, and management of male breast cancer.

Recent trials in sarcoma sought to determine the impact of neoadjuvant therapies and histologic/genomically specific treatments. Valerie Grignol, MD, Gabriel R. Tinoco Suarez, MD, and Alessandro Gronchi, MD, FSSO, discuss the following recent trials will. The EORTC-62902:STRASS trial evaluated the impact of neoadjuvant radiotherapy for retroperitoneal sarcoma on abdominal recurrence-free survival. A study by the Italian, Spanish, French and Polish Sarcoma groups sought to determine if histology-tailored neoadjuvant chemotherapy was superior to standard anthracycline plus ifosfamide for high-risk extremity and trunk soft tissue sarcoma for disease-free and overall survival. The NAVIGATOR study evaluated the PDGFRA inhibitor avapritinib and its activity in D842V-mutant gastrointestinal stromal tumors. Lastly the INVICTUS study evaluated the impact of further line therapy ripretinib, a switch-control tyrosine kinase inhibitor, on progression-free survival in advanced gastrointestinal stromal tumors.

Valerie Grignol, MD - Member, SSO Sarcoma Disease Site Work Group, Assistant Professor of Surgery, The Ohio State University

Gabriel R. Tinoco Suarez, MD - Medical Oncologist and Clinical Assistant Professor - Division of Medical Oncology at The Ohio State University

Alessandro Gronchi, MD, FSSO - Chair Sarcoma Service - Department of Surgery; Fondazione IRCCS Istituto Nazionale dei Tumori (Milan, Italy)

During this episode of SurgOnc Today®, Heather Wachtel, MD, University of Pennsylvania, Mahsa Javid, MD, MA, PhD, Medical University of South Carolina, Colleen Kiernan, MD, MPH, FACS, Vanderbilt University, and Cord Sturgeon, MD, Northwestern University, discuss strategies for building an early surgical practice with an endocrine focus. Many of these strategies will be relevant to complex general surgical oncology and breast careers. The discussion covers components of practice building including clinical resources, establishing a referral basis, mentoring and support, and promotion.

References/Resources

Tips and Tricks for Finding a Job (SurgOnc Today 2022)

Surgical Oncologists in the Community Cancer Care Setting: Opportunities for Graduating Fellows (SurgOnc Today 2021)

In this episode of SurgOnc Today®, Antonio Picon, MD, Director of Surgical Oncology at Stamford Health and his guest Steven McClane, MD, from Cooper Health will discuss the National Accreditation Program for Rectal Cancer and how surgeons can apply, develop and maintain a rectal cancer center of excellence. Learn about the process to become accredited and take your rectal cancer program to a different level. https://www.facs.org/quality-programs/cancer/naprc

In this episode of SurgOnc Today®, Dr. Patrick Sullivan is joined by Dr. Nicole Lopez and Dr. César Reátegui to discuss diverting ostomy. Current practice guidelines suggest that diverting ostomy is the standard of care in surgical management of rectal cancer after neoadjuvant therapy to minimize the risk of clinically significant leak which can then result in permanent colostomy. However, the risk of anastomotic leak after neoadjuvant chemoradiation ranges from 4-12% suggesting that most patients have unnecessary ostomy and additional surgery. With improvement of surgical techniques, utilization of robotic surgery and recent adoption of more TNT approaches, selective use of diverting ostomy will lead to improvement in QOL and decrease in health care costs with minimal impact on incidence of permanent colostomy.

In this episode of SurgOnc Today®, we talk with Dawn Mussallem, DO, a certified lifestyle medicine physician. She helps us walk through the importance of staying healthy and provides thoughts and suggestions for healthy living. We discuss exercise, nutrition, health and happiness.

In this episode of SurgOnc Today®, Martin Goodman, MD, is joined by fellow members of the SSO Peritoneal Surface Malignancy Disease Site Workgroup, Ioannis Konstantinidis, MD, FACS, FSSO, and Trang Nguyen, MD.  They discuss various scenarios in which patients present with malignant bowel obstruction, reviewing the decision making process and treatment options to meet the individualized needs of each patient.  

In this episode of SurgOnc Today®, Genevieve Boland, MD, PhD, Amanda Kirane, MD, and G. Paul Wright, MD, discuss breaking news and updates from the Society of Immunotherapy of Cancer (SITC) and Society of Melanoma Research (SMR) meetings.

In this episode of SurgOnc Today®, Richard White, MD, Chair of the SSO Melanoma Disease Site Work Group, moderates as Melanoma DSWG members, Nasreen Vohra, MD reviews updates on local therapies and Michael Lowe, MD, MA, reviews updates on neoadjuvant trials in melanoma.

In this episode for SurgOnc Today, Jeffrey Farma, MD, from Fox Chase Cancer Center/Temple Health in Philadelphia, PA, interviews James Jakub, MD, from Mayo Clinic Jacksonville, FL and Luke Rothermel, MD, MPH, from University Hospitals-Cleveland Medical Center Cleveland, OH.  We will review the current updates on the evaluation, workup and treatment of patients with Merkel cell carcinoma.  This will include the surgical management, current trends on both neoadjuvant and adjuvant therapy, recurrence and surveillance strategies.

In this episode of SurgOnc Today®, Doreen Agnese, MD, and Sarah Blair, MD, discuss data presented at the 25th Annual Meeting of the American Society of Breast Surgeons, including updates on cryoablation, use of immediate lymphatic reconstruction, decision aids in management of DCIS, surgical complications in patients treated with immunotherapy for ER positive tumors, and quality of life in older patients treated with endocrine therapy.

In this episode of SurgOnc Today®, members of the SSO Fellows and Young Attendings Subcommittee, including Emily Sturm, MD, Zhi Ven Fong, MD, MPH, Allison Martin, MD, and Olga Kantor, MD, review common questions about preparing for and navigating the application process of surgical oncology fellowships.

To view the article referenced in the podcast, please click here.

Lymph node dissection is a crucial component of the surgical treatment of gastric cancer. The technical aspects of lymph node dissection, especially D2, require a significant degree of training and expertise. In this episode of SurgOnc Today®, Ahmed Dehal, MD, MPH, interviews Vivian Strong, MD, from Memorial Sloan Kettering Cancer Center and Yanghee Woo, MD, from City of Hope to discuss this topic.

In this episode of SurgOnc Today®'s Surgical Oncology Insight series, Dr. Shishir Maithel, Editor of Surgical Oncology Insight, discusses with Dr. Rita Mukhtar contemporary neoadjuvant therapy approaches to the treatment of breast cancer, with a focus on the interplay between imaging, systemic therapy, radiotherapy, and surgical management, as reported in her article, "The Neoadjuvant Approach to Treatment of Breast Cancer: Multidisciplinary Management to Improve Outcomes."

Anthony Yang, MD, MS, FACS, Chair of the SSO Endocrine Disease Site Work Group is joined by fellow Workgroup Members, Mark Cohen, MD, FACS, FSSO and Cord Sturgeon, MD, MS, FACS, along with Samuel Hyde, CGC.

This podcast is the second of a two-part series.  Whereas the first episode discussed an overview of primary hyperparathyroidism (PHPT) and the inherited syndromes associated with it, this episode will focus on the surgical management of hereditary forms of PHPT, specifically multiple endocrine neoplasia syndromes types 1 & 2 (MEN1 & MEN2).

Dr. Cohen is Professor of Surgery, Pharmacology and Biomedical Engineering; Vice Chair in Surgery for Clinical Operations; Director of the Center for Surgical Innovation; Director of the Medical School Pathway of Excellence in Innovation and Entrepreneurship; and Director of Endocrine Surgery Research at the University of Michigan. Dr. Sturgeon is Professor of Surgery, Chief of Endocrine Surgery at the Robert H. Lurie Comprehensive Cancer Center and the Director of Surgery at Northwestern Memorial Hospital.  Samuel Hyde is an ABGC-certified genetic counselor who specializes in hereditary cancer and is an instructor at the Northwestern University Feinberg School of Medicine.

In this episode, Edward Levine, MD Chair of the SSO Peritoneal Surface Malignancy DSWG, is joined by Brian Badgwell, MD of MD Anderson Cancer Center and Pieter Tanis, MD, PhD of the University of Amsterdam.  They discuss whether patients at high risk of peritoneal dissemination from gastric and colon cancers should undergo HIPEC as an adjuvant therapy. 

In this episode of SurgOnc Today®, David Bartlett, MD, Chair of the Allegheny Health Network Cancer Institute and SSO Past-President, is joined by Margo Shoup, MD, MBA, President of the Orlando Health Cancer Institute and Glenda Callender, MD, Medical Director of Endocrine Surgery at the Hartford HealthCare Cancer Institute. They discuss their experiences with mid-career transitions from academia to the community cancer care setting.

In this episode of SurgOnc Today®, Doreen Agnese, MD, from The Ohio State University Medical Center is joined by Toan Nguyen, MD, from Lakeland Regional Health and Mark Robson, MD, from Memorial Sloan Kettering Cancer Center. Realizing that genetic testing is being performed more frequently and by many different providers for patients both with and without breast cancer, they discuss the management of non-BRCA breast cancer susceptibility genes.

In this episode of SurgOnc Today®, Tina Hieken, MD, Jeffrey Farma, MD, and Danielle Bello, MD, discuss the evolving role of surgery in the contemporary management of patients with Stage IV melanoma. The discussion includes the changing role of surgery for patients with metastatic melanoma in the current landscape of efficacious systemic immunotherapies and targeted therapies, and the role of surgical oncologists in  clinical trials testing new and expanded approaches such as adoptive T cell therapy for patients with advanced melanoma.

The podcast will explore different barriers to implement international cancer quality standards in developing countries, approach to overcome these barriers and how the SSO can help and support access to world class cancer care in developing countries. This episode is led by Dr. Cherif Boutros, who is joined by Dr. Nader Hanna and Dr. Joseph Espat. 

This episode of SurgOnc Today® features Tina Hieken, MD, from Mayo Clinic, in Rochester, MN, and Chair of the SSO Melanoma Disease Site Work Group interviews John Hyngstrom, MD, from the University of Utah and Michael Lowe, MD, MA, from Emory University. They will review recently reported phase II melanoma neoadjuvant studies and how the findings from these trials are important to surgical oncologists specializing in melanoma.

In this episode of SurgOnc Today®, Sonia Orcutt, MD and Michail Mavros, MD, from the University of Arkansas for Medical Sciences are joined by Callisia N. Clarke, MD, MS, FACS, FSSO, Chief of the Division of Surgical Oncology at the Medical College of Wisconsin, and Alexandra Gangi, MD, FSSO, Director of the Gastrointestinal Tumor Program at Cedars Sinai Medical Center. The optimal treatment of high-grade well-differentiated neuroendocrine tumors has not been well-described, as they have only in recent years been identified as distinct from neuroendocrine carcinomas. The panelists discuss the most up-to-date information on diagnosis and management of gastroenteropancreatic high-grade well differentiated neuroendocrine tumors.

In this episode of SurgOnc Today®, Julie Hallet, MD, MSc, FRCSC, FSSO, from the University of Toronto and Vice-Chair of the SSO HPB disease site working group is joined by Stefano Partelli, MD, PhD, from Università Vita-Saluta San Raffaele and Els Nieveen van Dijkum, MD, PhD, from Amsterdam UMC. We will delve into the rationale behind the non-operative management of non-functional sporadic pancreatic neuroendocrine tumors (PNETs) as well as the design and results of two prospective studies, ASPEN and PANDORA.

Show Notes:

PANDORA: https://academic.oup.com/bjs/article/108/8/888/6202974

ASPEN (interim analysis): https://academic.oup.com/bjs/article/109/12/1186/6672718?login=false

In this episode of SurgOnc Today®, Mihir M. Shah, MD, Mashaal Dhir, MD, and June S. Peng, MD, discuss the workup and management of gastric adenocarcinoma. The discussion elaborates on several scenarios, including molecular testing, surgical approaches to advanced gastric cancers, treatment sequencing, tumor-related gastric obstruction management, diagnostic laparoscopy role, perioperative management, and low-volume carcinomatosis management.

In this episode of SurgOnc Today®, Laurence McCahill, MD, of Western Michigan University is joined by Julie Barone, DO, Medical Director of Vail Comprehensive Breast Care and John Abad, MD, of Northwestern Medicine Regional Medical Group.  They discuss their personal pathways that brought them into leadership roles within the community care practice setting, including their experiences with the accreditation of their programs, the establishment of their research programs and the use of their programs’ outcomes.  They also touch upon the characteristics that a physician seeking a career at a satellite program of an academic medical center should seek out and they address their recommendations for achieving balance between their administrative and surgery roles.

In part two of the HPB Incidentalomas episode, Alexander A. Parikh, MD, Vice Chair of the Hepato-Pancreato-Biliary Disease Site Work Group and disease site work group members Jin He, MD, PhD, and H.J. Kim, MD discuss the incidence, workup, treatment options, and controversies in the management of benign and indolent incidental lesions involving the duodenum and pancreas.

In this episode, Melissa Hogg, MD from Northshore University Health System, chair of the Hepato-Pancreato-Biliary Disease Site Workgroup, is joined by Jashodeep Datta, MD, from the University of Miami School of Medicine in Miami, FL and Dr. Carrie Luu, MD, from Saint Louis University Hospital in St. Louis, MO.  They review practice changing studies in Hepato-Pancreato-Biliary Surgical Oncology from 2020. They discuss the SWOG S1505 clinical trial manuscript and the Know Your Tumor Registry publication.

This episode of SurgOnc Today®, features guest faculty, Astrid Botty Van Den Bruele, MD, and Meghan Flanagan, MD, MPH. In a contemporary group of patients diagnosed with contralateral axillary metastases (CAM), those selected for treatment with presumed curative intent experienced improved OS when compared to stage IV (M1) patients. The current literature, as well as some forthcoming data, adds additional support for re-evaluating the stage IV designation, in favor of N3, and consideration of curative intent treatment in this disease entity.

In this episode of SurgOnc Today, Brian Sparkman, MD, is joined by Lily Lai, MD, Margo Shoup, MD, MBA, and Kristen Massimino, MD, to discuss how CGSO fellowships prepare surgeons for a career in community practice and how we might improve this in the future.

Show Notes:

Medical students are caught in the residency 'research arms race' - STAT - https://www.statnews.com/2024/04/29/research-arms-race-medical-students-residency-applications/

Behrens S, Ann Surg Oncol. 2024 Jan; 31(1):31-42. DOI: 10.1245/s10434-023-14524-x

Clarke CN. Surg Oncol Clin N Am. 2022 Jan; 31910: 21 – 27. DOI: 10.1016/j.soc.2021.07.004

Wach MW. Ann Surg Oncol. 2019 Sep; 26(9):2675-2681. DOI: 10.1245/s10434-019-07372-1

In this episode of SurgOnc Today®, Prakash Pandalai, MD, Georgios Karagkounis, MD, and Fadwa Ali, MD, review the evolution of the Watch and Wait strategies in the management of rectal cancer patients with an emphasis on challenges, current clinical trials, and future directions.

This podcast was recorded on September 30, which is the National Day for Truth and Reconciliation in Canada and features an interview with Dr. Nadine Caron, who was the first Indigenous female surgeon in Canada. Dr. Caron shares her experience and perspectives from her leadership roles in health equity for First Nations peoples in Northern British Columbia with Dr. Cord Sturgeon and Dr. Mahsa Javid. The conversation explores the inequities in cancer care and cancer outcomes among Indigenous Peoples. Cancer incidence and survival among Indigenous People, gaps in knowledge, drivers of inequity, and a path forward for developing trust are discussed.

During this episode of SurgOnc Today, Jan Franko, MD, PhD, Niraj J. Gusani, MD, MS, and Viet H. Le, MD, discuss malignant bowel obstruction (MBO). They define MBO broadly as any symptoms compatible with bowel obstruction in settings of rather large volume intraabdominal malignancy. Some 30% GI cancers, and some 50% ovarian cancers develop MBO – often a preterminal event. For clarity, they did not consider clinically more straightforward situations of malignant single-point obstructions treatable by resection, bypass or stent. They will forego localized gastric outlet, duodenal and rectosigmoid primary tumors. They explore what symptom burden could be potentially qualify as obstructive symptoms: frank MBO with total dependency on gastric decompression, or perhaps symptoms of progressive weight loss without over need for gastric decompression or parenteral nutrition.

Over past 20 years median overall survival those diagnosed with MBO is 3-4 months. If operated, perioperative 30-day mortality is commonly 6-15%, and perhaps as high as 40% among those with ascites. These outcomes are drive by difficult-to-treat disease and palliative nature of therapy. Depressing outcomes are difficult to explain to patients, families, and administrators. Care for those suffering.

Treatment options include non-operative (gastric decompression, antiemetics, somatostatin analogies, TPN/IVF support, and hospice care), non-operative interventional (GI stenting), and operative (resections, bypass, stoma, functional palliative cytoreduction, ascites control).

They discuss expectations from accrued SWOG S1316 trial: Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction.

In this episode of SurgOnc Today®, Tina Hieken, MD, from the Mayo Clinic, in Rochester, Minnesota, interviews Jay Lee, MD, MHSc, from Duke University in Durham, North Carolina, and Julia Terhune, MD, from the University of Maryland in Baltimore, Maryland. They will discuss the current and evolving indications for adjuvant therapy in patients with stage III melanoma including vaccine trials.

In this episode of SurgOnc Today, Alexander Parikh MD, MPH, FACS, FSSO, from the University of Texas, San Antonio and Chair of the SSO HPB Disease Site Work Group, and Julie Hallet, MD, M.Sc., FRCSC, from the University of Toronto, and Vice-Chair of the SSO HPB Disease Site Work Group, are joined by Flavio G. Rocha, MD, FACS, FSSO, from the Oregon Health and Science University and Susanne G. Warner, MD, from the Mayo Clinic Rochester. They discuss two important aspects of delivering neoadjuvant therapy for pancreatic adenocarcinoma: the use of staging laparoscopy and the assessment of response. 

In this episode of SurgOnc Today®, Emily Sturm MD, Malini D. Sur, MD, and James Nitzkorski, MD, discuss what graduating fellows will want to contemplate when considering becoming a community-based surgical oncologist. They also review the variety of practice settings, the types of available support you’ll want to examine, and some of the day-to-day opportunities and challenges to expect.

During this episode of SurgOnc Today, Richard White, MD, Chair of the SSO Melanoma Disease Site Work Group and Giorgos Karakousis, MD, explore the science behind gene expression profiling and its role in patients with early stage melanoma.

Richard White, MD, Chief, Division of Surgical Oncology, , endowed professor of surgery, co-director of the Barbara Levine Breast Center and co-director of the Cutaneous Malignancy Program at Atrium Health Levine Cancer Institute.

Giorgos Karakousis, MD - Associate Professor of Surgery at the Hospital of the University of Pennsylvania.

In this episode of SurgOnc Today®, Jennifer Plichta MD, Associate Professor of Surgery and Director of the Breast Risk Assessment Clinic at the Duke University Medical Center, is joined by Melissa Pilewskie, MD, Associate Professor of Surgery and Director of the Breast Care Center at the University of Michigan and Zahraa AlHilli, MD, MBA, Interim Director of the Breast Center and Co-Director of the Comprehensive Breast Program at Cleveland Clinic. Given the continuous advancements in breast imaging and risk assessment, it is important to be familiar with the latest imaging modalities, the risk assessment tools available, and how to incorporate them into routine clinical care. This episode focuses on the practical considerations for managing patients with an increased risk of breast cancer.