Annual Cancer Symposium - 2010 Scientific Program - Thursday Sessions

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Breast Cancer Controversies –
More vs. Less

8:00 – 10:00 am Thursday

Room 222-227 • America’s Center

Moderator: David J. Winchester, MD
          Disclosure: None

8:00 am Trends in Local Treatment of Breast Cancer: Should We Be Worried?
Todd M. Tuttle, MD
Associate Professor Chief, Division of Surgical Oncology University of Minnesota Minneapolis, MN
Disclosure: Speaker: Genomic Health

8:20 am Nipple-Sparing Mastectomy – Taboo or Breakthrough?
V. Suzanne Klimberg, MD
Professor of Surgery Director of Breast Surgical Oncology University of Arkansas for Medical Sciences Little Rock, AR
Disclosure: Stocks: AngioDynamics

8:40 am Managing the Positive Sentinel Node
David J. Winchester, MD
Clinical Professor of Surgery University of Chicago Pritzker School of Medicine Chief, Division of Surgical Oncology NorthShore University HealthSystem Evanston, IL
Disclosure: None

9:00 am Pathological Staging and Biomarker Analysis in Breast Cancer – A Medical Oncologist’s Perspective
Matthew J. C. Ellis, MB, PhD
Professor of Medicine Division of Medical Oncology Washington University School of Medicine St. Louis, MO
Disclosure: Consultant: Novartis, Astrazeneca, Pfizer, Merck, GSK, Monogram Biosciences, Genentech, Qiagen BmgH; Commercial Interest: Novartis, AZ, Pfizer, GSK, Genentech; Speaker: Novartis, AZ, Taiho, GSK; Research Grant: University Genomics Patent

9:20 am Radiation Therapy in the Current Era
Jay R. Harris, MD
Professor of Radiation Oncology Harvard Medical School Chair, Department of Radiation Oncology DanaFarber Cancer Institute Boston, MA
Disclosure: None

9:40 am Panel Discussion/Questions
Objectives: At the conclusion of this session, participants should be able to: a) present data on reasons for increasing mastectomy rates as well as current indications or considerations in offering this surgical option; b) detail indications and techniques for nipplesparing mastectomy; c) present data on the morbidity and longterm outcome of limited axillary surgery for the positive sentinel node; d) detail the impact of expanding roles of mastectomy, nipplepreservation, and lymph node preservation on systemic therapy; and e) discuss radiation therapy options.

10:00 – 10:30 am Refreshment Break in Foyer

Update on the Management of Gastric Cancer for the Surgeon

8:00 – 10:00 am Thursday

Room 220-221 • America’s Center

Moderator: Sam S. Yoon, MD
Disclosure: None

8:00 am Outcomes of Gastric Cancer Surgery in the US
Jennifer F. Tseng, MD, MPH
Associate Professor of Surgery and Cancer Biology Division of Surgical Oncology and Endocrine Surgery University of Massachusetts Medical Center Worcester, MA
Disclosure: None

8:20 am D1, D1+, or D2 Lymphadenectomy: Which is Best? Masaki Mori, MD, PhD Chairman Professor of Surgery Graduate School of Medicine Osaka University Suita, Japan
Disclosure: None (OffLabel Use of Treatments)

8:40 am Training Italian Surgeons to Perform D1 and D2 Lymphadenectomies Maurizio Degiuli, MD Coordinator, Italian Gastric Cancer Study Group Pino Torinese, Italy
Disclosure: None

9:00 am Laparoscopic Surgery for Gastric Cancer
Vivian E. Strong, MD
Assistant Professor of Surgery Gastric and Mixed Tumor Service Memorial SloanKettering Cancer Center New York, NY
Disclosure: None

9:20 am Adjuvant Therapy for Gastric Cancer
Manish A. Shah, MD
Attending Physician Memorial SloanKettering Cancer Center New York, NY
Disclosure: None

9:40 am Panel Discussion/Questions

Objectives: At the conclusion of this session, participants should be able to: a) discuss the outcomes of patients following gastric cancer surgery in the United States; b) state which lymph node stations should be dissected for D1, D1+, and D2 lymphadenectomies; c) discuss the pros and cons of D1, D1+, and D2 lymphadenectomies; d) discuss the training of surgeons in the Italian Gastric Cancer Study Group in the performance of D1 and D2 lymphadenectomies; e) discuss laparoscopic techniques for gastric cancer; f) discuss the evidence for specific adjuvant therapies for gastric cancer; and g) discuss the current ongoing major adjuvant therapy for gastric cancer.

10:00 – 10:30 am Refreshment Break in Foyer

Comparative Effectiveness: Implications and Opportunities for the Surgical Oncologist

10:30 am – Noon Thursday

Room 222-227 • America’s Center

Moderators: James C. Cusack, Jr., MD* and Ezekiel Emanuel, MD, PhD (invited)**
*Disclosure: None **Disclosure: None

10:30 am Introduction
James C. Cusack, Jr., MD
Associate Professor of Surgery Harvard Medical School Division of Surgical Oncology Massachusetts General Hospital Boston, MA
Disclosure: None

10:35 am Comparative Effectiveness: What It Is and What Does It Mean for Oncology Practice? Caprice C. Greenberg, MD, MPH Associate Professor of Surgery Harvard Medical School Center for Outcomes and Policy Research, DanaFarber Cancer Institute Center for Surgery and Publich Health, Brigham and Women’s Hospital Boston, MA
Disclosure: None

11:00 am The European Model: Evidence-Based Reimbursement Affords Patient Access to Novel Therapeutics and Promotes Participation in Clinical Trials Alexander M. M. Eggermont, MD, PhD Professor and Head Surgical Oncology Erasmus University Medical Center Daniel den Hoed Cancer Center Rotterdam, The Netherlands
Disclosure: Consultant, Advisory Board, Speaker, Honorarium, Research Grant: Schering Plough; Advisory Board: BMS, EISAI, Pfizer, Roche; Consultant: EISAI

11:25 am Clinical Trials of the 21st Century: Research
Opportunities for the Academic and Community Surgical Oncologist in Defining Practice Standards
John E. Niederhuber, MD
Director, National Cancer Institute Bethesda, MD
Disclosure: None

11:50 am Panel Discussion/Questions

Objectives: At the conclusion of this session, participants should be able to: a) define comparative effectiveness; b) describe the federal policy changes that are shaping the care provided to surgical patients; c) analyze an individual practice in the context of quality metrics and costeffective standards; and d) identify opportunities to shape practice standards through development and participation in clinical trials that assess clinical outcome and the costs associated with treatment.

Noon – 1:00 pm Lunch (on own)

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New Concepts in Image-Guided Cancer Therapy

10:30 am – Noon Thursday

Room 220-221 • America’s Center

Moderator: Stephen R. Grobmyer, MD
Disclosure: None

10:30 am Image-Guided Cancer Surgery Using Invisible Near-Infrared Fluorescent Light
John Frangioni, MD, PhD
Associate Professor of Medicine Harvard Medical School Associate Professor of Radiology Harvard Medical School Attending Physician, Division of Hematology/Oncology Beth Israel Deaconess Medical Center Boston, MA
Disclosure: Research Grant: Sponsored Research GE Global Research Employee: Beth Israel Deaconess Med Ctr Potential Future Royalties (OffLabel Use of Treatments)

10:50 am Intra-Operative Image-Guided Liver Surgery
William R. Jarnagin, MD
Chief, HPB Service Vice Chairman, Department of Surgery Memorial SloanKettering Cancer Center Professor of Surgery Weill Cornell Medical College New York, NY
Disclosure: Research Grant: Pathfinder Therapeutics

11:10 am Non-Invasive Radiofrequency Treatment of Cancer
Steven A. Curley, MD
Professor of Surgical Oncology Charles B. Barker Chair in Surgery Chief, Gastrointestinal Tumor Surgery University of Texas MD Anderson Cancer Center Houston, TX
Disclosure: None

11:30 am Image-Guided Cancer Therapy at the NIH
Center for Interventional Oncology
Bradford J. Wood, MD
Director, Center for Interventional Oncology Chief, Interventional Radiology National Institutes of Health Clinical Center Bethesda, MD
Disclosure: Research Grant: Philips Healthcare, Traxtal Inc, Biocompatibles LLC, NIH Intramural Research Program, Celsion Corp, Center for Interventional Oncology NCI (OffLabel Use of Treatments)

11:50 am Panel Discussion/Questions

Objectives: At the conclusion of this session, participants should be able to: a) discuss the growing importance of intraoperative imaging in cancer surgery; b) discuss the growing importance of imaging in noninvasive cancer therapy; c) describe Kanzius technology; d) identify current barriers to implementation of image guided cancer therapy; e) examine ongoing clinical trials in image guided cancer therapy; and f) determine future strategies for image guided cancer therapy.

Noon – 1:00 pm Lunch (on own)

Great Debates in Surgical Oncology

1:00 – 3:00 pm Thursday

Room 222-227 • America’s Center

Moderator: Daniel G. Coit, MD
          Disclosure: None

1:00 pm Sentinel Lymph Node Biopsy Should be Performed Prior to Neoadjuvant Chemotherapy in Breast Cancer
PRO: Armando E. Giuliano, MD
Chief of Science and Medicine John Wayne Cancer Institute Santa Monica, CA
Disclosure: None
CON: Hiram S. Cody, III, MD
Attending Surgeon Breast Service, Department of Surgery Memorial SloanKettering Cancer Center Professor of Clinical Surgery Weill Cornell Medical College New York, NY
Disclosure: None

1:30 pm Interferon Should be the Control Arm in Adjuvant Therapies for Melanoma
PRO: John M. Kirkwood, MD
Professor of Medicine and Dermatology University of Pittsburgh Director, Melanoma and Skin Cancer Program University of Pittsburgh Cancer Institute Pittsburgh, PA
Disclosure: Speaker, Honorarium: Schering
CON: Alexander M. M. Eggermont, MD, PhD
Professor and Head Surgical Oncology Erasmus University Medical Center Daniel den Hoed Cancer Center Rotterdam, The Netherlands
Disclosure: Consultant, Advisory Board, Speaker, Honorarium, Research Grant: Schering Plough; Advisory Board: BMS, EISAI, Pfizer, Roche; Consultant: EISAI

2:00 pm Neoadjuvant Chemotherapy Should be Given Prior to Resection of Colorectal Metastases to the Liver
PRO: JeanNicolas Vauthey, MD
Professor of Surgery Chief, Liver Service Department of Surgical Oncology University of Texas MD Anderson Cancer Center Houston, TX
Disclosure: Speaker, Honorarium: SanofiAventis; Research Grant: Genentech
CON: Michael A. Choti, MD, MBA
Jacob C. Handelsman Professor of Surgery Johns Hopkins Sidney Kimmel Cancer Center Baltimore, MD
Disclosure: Advisory Board: Genentech, Sanofiaventis, BristolMyers Squibb (OffLabel Use of Treatments)
Objectives: Upon completion of this session, participants should be able to: a) describe the potential advantages and disadvantages surrounding the timing of SLN biopsy in patients undergoing neoadjuvant chemotherapy; b) assess the data supporting the use of adjuvant interferon for patients with highrisk melanoma; and c) describe the rationale and limitations of delivering chemotherapy prior to the resection of colorectal metastases to the liver.

3:00 – 3:30 pm Refreshment Break in Foyer

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Practice-Changing Clinical Trials

3:30 – 5:00 pm Thursday

Room 222-227 • America’s Center

Partially supported by an educational grant from Amgen

Moderators: Martin D. McCarter, MD* and Ronald P. DeMatteo, MD**
*Disclosure: Consultant: Covidien; Speaker: Institute for Medical Education and Research **Disclosure: Consultant, Advisory Board, Speaker, Honorarium: Novartis

3:30 pm Highlights from Recent Major Clinical Trials Worldwide
BREAST:
Arnold Hill, MD
Professor and Chairman of Surgery Royal College of Surgeons in Ireland Beaumont Hospital Dublin, Ireland
Disclosure: None
MELANOMA:
Michael S. Sabel, MD
Associate Professor of Surgery Division of Surgical Oncology University of Michigan Ann Arbor, MI
Disclosure: Speaker, Honorarium, Research Grant: Schering
GI, SARCOMA:
Douglas S. Tyler, MD
Associate Medical Director, Oncology Services Duke University Medical Center Chief, Surgical Services, Durham VA Medical Center Vice Chairman, Department of Surgery Durham, NC
Disclosure: Research Grant: Adherex Technologies Inc; Speaker: Novartis Oncology (Off-Label Use of Treatments)

4:00 pm The Role of Surgeons in Changing Clinical Practice
Heidi Nelson, MD
Fred C. Andersen Professor of Surgery Mayo Clinic College of Medicine Rochester, MN
Disclosure: None

4:10 pm ACOSOG Trials in Progress:
Update on Current ACOSOG Clinical Trials in Breast Cancer
Kelly K. Hunt, MD
Professor, Surgical Oncology University of Texas MD Anderson Cancer Center Houston, TX
Disclosure: Speaker: Novartis
Update on Current ACOSOG Clinical Trials in GI, Thoracic, and Sarcoma
Mitchell C. Posner, MD
Thomas D. Jones Professor of Surgery Chief, Section of General Surgery Chief, Surgical Oncology University of Chicago Medical Center Chicago, IL
Disclosure: None

Objectives: At the conclusion of this session, participants should be able to: a) describe findings from major national and international cancer clinical trials; b) discuss how to incorporate new trail findings into contemporary practice; c) identify currently enrolling clinical trials pertinent to surgical oncologists; and d) identify ways to participate in cooperative group trials.

Minimally Invasive Hepato-Pancreato-Biliary Oncological Surgery: Interim Assessment of a Maturing Field

3:30 – 5:15 pm Thursday

Room 220-221 • America’s Center

Partially supported by an educational grant from AngioDynamics

Moderator: Clifford S. Cho, MD
Disclosure: None

3:35 pm Staging Laparoscopy for HPB Neoplasms: Is There Still a Role?
Peter J. Allen, MD
Associate Attending Surgeon Memorial SloanKettering Cancer Center New York, NY
Disclosure: None

3:55 pm Minimally Invasive Partial Hepatectomy: When, Why, and for Whom?
David A. Geller, MD
Richard L. Simmons Professor of Surgery University of Pittsburgh Medical Center Pittsburgh, PA
Disclosure: Consultant: Covidien, Applied Medical and Aloka

4:15 pm Minimally Invasive Left Pancreatectomy: Is This the New Standard?
Sharon M. Weber, MD
Associate Professor University of Wisconsin School of Medicine and Public Health Madison, WI
Disclosure: None

4:35 pm Future Evolution of Minimally Invasive HPB
Surgical Oncology: What Comes Next?
Yuman Fong, MD
Murray F. Brennan Chair in Surgery Memorial SloanKettering Cancer Center New York, NY
Disclosure: Consultant: Covidien, Ethicon, Genelux, Cynvec

4:55 pm Panel Discussion/Questions

Objectives: At the conclusion of this symposium, participants should be able to: a) explain the current indications and limitations of staging laparoscopy for hepatopancreatobiliary cancers; b) compare postoperative outcomes associated with minimally invasive versus traditional open partial hepatectomy and left pancreatectomy, including length of hospitalization, rate of complications, and oncological results; c) detail the current limitations of minimally invasive partial hepatectomy and left pancreatectomy; d) use the differential outcomes between minimally invasive and open hepatectomy and pancreatectomy to determine which patients should not undergo a minimally invasive resection; and e) describe the future direction of emerging technologies relevant to minimally invasive hepatectomy and pancreatectomy.

BurnOut Among Surgeons: What Is It? Who Is At Risk? How to Respond?

5:30 – 7:00 pm Thursday

Room 220-221 • America’s Center

Moderator: Bridget N. Fahy, MD
Disclosure: Research Grant: Golfers Against Cancer

5:30 pm Results of the ACS and SSO Surveys on Stress and Burn-out
Tait D. Shanafelt, MD
Associate Professor of Medicine Mayo Clinic Rochester, MN
Disclosure: Research Grant: Celgene, Genentech, Hospira, Cephalon, Polyphenon E International
Henry M. Kuerer, MD, PhD
Professor and Director, Breast Surgical Oncology Training Program University of Texas MD Anderson Cancer Center Houston, TX
Disclosure: None

5:55 pm Personal and Professional Consequences
Charles M. Balch, MD
Professor of Surgery, Oncology, and Dermatology Johns Hopkins Department of Surgery Deputy Director for Clinical Trials and Outcomes Research Johns Hopkins Institute for Clinical and Translational Research Director, Johns Hopkins Clinical Research Network Baltimore, MD
Disclosure: Consultant, Honorarium: Schering Plough

6:15 pm Burn-out Among Women in Surgery
Bridget N. Fahy, MD
Department of Surgery The Methodist Hospital Houston, TX
Disclosure: Research Grant: Golfers Against Cancer

6:30 pm Professional Interventions and Rehabilitation
Gerald Bechamps, MD
Medical Director and Chief Executive Officer Washington Physicians Health Program Chair, American College of Surgeons Committee on Physician Health and Competency Winchester Medical Center Winchester, VA
Disclosure: None

Objectives: At the conclusion of this session, participants should be able to: a) identify those surgeons at greatest risk for burnout and professional factors that contribute to or reduce this risk; b) recognize the symptoms of professional burnout and its associated psychological consequences; c) discuss the impact that surgeon burnout can have on patient outcomes; and d) examine the interventions needed to prevent or ameliorate the adverse personal and professional effects of burnout.

Welcome Reception
7:30 – 9:00 pm Thursday
Renaissance Grand Hotel Majestic Ballroom
All Registrants Invited
Join us for hors d’oeuvres and refreshments.

Outcomes Research Committee Presents
Quality Measurement in Cancer Care Delivery

5:30 – 7:00 pm Thursday

Room 222-227 • America’s Center

Moderators: Sandra L. Wong, MD, MS* and Janice N. Cormier, MD, MPH**
*Disclosure: None **Disclosure: Speaker: Novartis Pharmaceutical

5:30 pm Introduction
Stanley P. L. Leong, MD
Professor of Surgery University of California San Francisco, CA
Disclosure: None

5:35 pm Defining Quality in Cancer Surgery
Clifford Y. Ko, MD
Professor of Surgery and Health Services UCLA Schools of Medicine and Public Health Director, Division of Research and Optimal Patient Care American College of Surgeons Los Angeles, CA
Disclosure: None

5:55 pm Cancer Care Quality in Upper GI Cancers
Laurence E. McCahill, MD
Director, Surgical Oncology Assistant Director, Lack Cancer Center St. Mary's Health Care Grand Rapids, MI
Disclosure: None

6:15 pm Quality Evaluation and Improvement in Cancer Care: Programs of the Commission on Cancer
Stephen B. Edge, MD
Chair, Breast and Soft Tissue Surgery Professor of Surgery and Oncology Roswell Park Cancer Institute University at Buffalo Buffalo, NY
Disclosure: None

6:35 pm Panel Discussion/Questions

Objectives: At the conclusion of this session, participants should be able to: a) provide surgeons with a clear understanding of the means of defining and measuring quality in cancer care; b) describe a concrete method to implement a quality management program for GI surgery; and c) explain how to use the current tools and systems that have been put in place by the Commission on Cancer using the National Cancer Data Base and local cancer registry data.

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