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SurgOnc Today®

SurgOnc Today® is an educational podcast for cancer surgeons from the Society of Surgical Oncology. Each episode features conversations with individuals who are experts within their respective fields and are members of SSO.

Listen to the most recent episodes below or find all of the SurgOnc Today® episodes, organized by disease site, on ExpertEd@SSO. Make sure you don’t miss an episode by subscribing on Apple Podcasts, Spotify and Stitcher

Malignant Bowel Obstruction

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.

Tips for Applying to a Surgical Oncology Fellowship

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.

National Accreditation Program for Rectal Cancer: How to get it done

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

Gene Expression Profiling Technologies in Patients with Early Stage Melanoma Surgery

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.

2020-21 Practice Changing Studies in Endocrine Surgery

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

2020 Practice Changing Trials in Sarcoma

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)

The Evolving Role of HIPEC in Ovarian Cancer

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.

Practice Changing Studies in Colorectal Surgical Oncology (2021)

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.

Practice Changing Studies in Gastrointestinal Surgical Oncology (2021)

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

Practice Changing Studies in Hepato-Pancreato-Biliary Surgical Oncology (2021)

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.

Use of Wire-Free Alternatives for Localization of Non-Palpable Breast Lesions for Surgery

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.

Genetic Evaluation and Management of the Patient with Primary Hyperparathyroidism Part 1

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.

Genetic Evaluation and Management of the Patient with Primary Hyperparathyroidism Part 2

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.

ACS Commission on Cancer Surgery Standards

 


In this episode, SSO Immediate Past President James Howe, MD, SSO Secretary Kelly Hunt, MD, and Matthew Katz, MD, discuss ACS Commission on Cancer accreditation standards 5.3 through 5.8, what these standards are, where they came from, and why they are so important to all surgeons and their patients.

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.

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 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, 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. 

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 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 of SurgOnc Today®, Sean Dineen, MD, Laura Lambert, MD, and Chukwuemeka Ihemelandu, MD, discuss the state of the art management of colorectal cancer metastatic to the peritoneum including natural history and treatment options. They also preview future directions for the field.

In this episode of SurgOnc Today®, Carla Fisher, MD, Amy Degnim, MD and Faina Naklis, MD, discuss the management of high risk breast lesions including radial scars, papillomas without atypia, atypical ductal hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ.

Carla Fisher, MD, is a member of the SSO Breast DSWG and Director of Breast Surgery at Indiana University, Amy Degnim, MD, is the Joe M. and Ruth Roberts Professor of Surgery and Co-Leader of the Women’s Cancer Program at the Mayo Clinic and Faina Naklis, MD, is a surgeon at Brigham and Women’s / Dana-Farber.

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