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®'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."

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. 

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. 

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

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®, 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®, 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.

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 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®, 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.

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, 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.

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, 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®, 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 ®, 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®, 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.

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®, 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.

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.

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.”

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.

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®, 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®, 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.

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®, 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.

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, 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.

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.

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®, 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.

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 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®, 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®, 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. 

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®, 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.

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.

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 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.

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.

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.

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. 

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.

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.

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.