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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 and in the SSO Mobile app. Make sure you don’t miss an episode by subscribing on Apple Podcasts and Spotify.

Management of Locally Advanced Extremity Sarcoma

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.

Getting the Most Out of ERAS Pathways for Patients Undergoing Gastric Cancer Surgery

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.

Preparation and Training for Pelvic Exenterative Surgery

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.

SSO Women In Cancer Surgery – Women’s History Month

In this episode for 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.

Only Merkel Cells In The Building

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.

Pancreatic Watch: Is Observation of Non-Functional Sporadic Small PNETs Safe?

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

WICS HerSurgStory: Illuminating Journeys, Uniting Excellence

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.

Sarcoma: Management of Atypical Lipomatous Tumor / Well-Differentiated Liposarcoma, Episode 2

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.

Adjuvant Therapy for Stage III Melanoma 2023: Impact of Vaccines & Neoadjuvant Therapy

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.

Lymphadenectomy for Gastric Cancer

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.

Recent Developments in Pelvic Exenteration

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.

Management of ALT/WDLPS Episode 1: Diagnosis and Pathologic Assessment

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.

Pancreatic Cysts Puzzles – Triggers for Operations and Surveillance

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

HPB: Nut and Bolts of Neoadjuvant Therapy for Pancreas Cancer – Part 2

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.

Melanoma Updates from SITC & SMR 2023

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.

Breast Podcast Updates In Clinical Trials Part 2: The SOUND and LUMINA Trials

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.

Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC)- Role in Management of Peritoneal Surface Malignancies

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.

Considerations for Management of Gastric Adenocarcinomas

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.

Updates in Classification and Management of Gastric NETs

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.

Interdisciplinary Cancer Team Series Module 2: A Multi-Institutional Review of Contralateral Axillary Metastases: Time for Reclassification as a Local-Regional Event

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.

Can Women with Multiple Ipsilateral Breast Cancer Consider Breast Conservation?

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.

Use of TAD vs SLN in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy and Rates of Recurrence

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.

The Use and Efficiency of 4D CT Scanning in Localizing Adenomas in Patients with Primary Hyperparathyroidism

On this episode of 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.

Peritoneal Mesothelioma – Therapy in 2023 and Beyond

This episode of SurgOnc Today® 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.

Recently Reported Melanoma Neoadjuvant Trials

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.

The Not-So-General Surgical Oncologist

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.

Modern Rectal Cancer Trials in 2023

In this episode of 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.

Nuts and Bolts of Neoadjuvant Therapy for Pancreatic Adenocarcinoma

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.

Tumor Infiltrating Lymphocytes Therapy in Melanoma

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.

Managing the Uncommon: Male Breast Cancer

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.

The Current Management of Desmoids: So Much More Than Surgery

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.

Mastering the Move: A Surgeon’s Transition to Practice

In this episode of SurgOnc 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.

Medical and Surgical Management of Pathogenic Variants in non-BRCA Breast Cancer Genes

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.

Work-up and Management of Small Bowel NET

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

Is ctDNA Ready for Prime 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.

DOTATE-PET-Scan in the Management of Pancreatic NET

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

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.

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.

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 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®, 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.

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

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 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.

During this episode of SurgOnc Today®, Alexander Parikh, MD, MPH, Chair of the SSO HPB DSWG, is 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. In this first installment of the two-part series, they discuss the role of liver transplantation in the treatment of primary hepatobiliary malignancies including hepatocellular cancer and cholangiocarcinoma.

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 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, 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.

During this episode of SurgOnc Today, Dr. Alexander Parikh, Vice Chair of the SSO HPB DSWG, is joined by Dr. Flavio Rocha from the Oregon Health & Science University in Portland, OR and Dr. Sepideh Gholami from the UC Davis Medical Center in Sacramento, CA. They review the findings and status of non-therapeutic HPB trials including the use of perioperative steroids for liver resection and pancreatic cyst surveillance.

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.

Addressing Women’s Sexual Health During Breast Cancer Treatment and Prevention

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:

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, 492-511 https://ascopubs.org/doi/full/10.1200/JCO.2017.75.8995
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
Studies on Risk of Recurrence With Vaginal Estrogen:
American Association of Sexuality Educators, Counselors, and Therapists (AASECT): https://www.aasect.org/
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.

2020 Practice Changing Studies in Breast Surgical Oncology

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.)

Surgical Oncologists in the Community Cancer Care Setting: Opportunities for Graduating Fellows

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.

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

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).

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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