In-depth hot topics presentations led by two expert panels will reveal new, and often divisive, current and next generation innovations in general surgery and surgical oncology.
In this morning’s “Hot Topics in Surgical Oncology” session, panelists will delve into five areas of cancer care—breast cancer, rectal cancer, pancreatic cancer, liver metastases, and desmoid tumors—that have experienced a period of rapid transformation in recent years.
“Most busy clinicians find it difficult to stay current in cancer surgery, especially considering that the latest advances may be presented at a medical meeting, published in one of many journals, or discussed in an online forum,” said Kenneth K. Tanabe, MD, FACS, a surgical oncologist and chief of the Division of Gastrointestinal and Oncologic Surgery at Massachusetts General Hospital in Boston, who is comoderating the session with Russell S. Berman, MD, FACS, a surgical oncologist from Weill Cornell Medicine in New York, New York. “It is simply not feasible to constantly scour all these reference sources. But our panel of expert surgeons have synthesized the latest published—and unpublished—information to provide evidence-based recommendations in specific areas that are ’hot’ and moving quickly.”
Due to the fact that neoadjuvant treatments are more commonly incorporated into cancer care management, this session will address new drug regimens that have changed surgical approaches to several different types of cancer, along with best practices for incorporating multimodality approaches into the care of these patients.
“Neoadjuvant therapies have been very effective—so effective that less surgery is required, which is termed as the “de-escalation of surgery,” said Dr. Tanabe. “When surgeons can perform less surgery, it is beneficial to patients, and it reduces the surgeon’s workload allowing them the opportunity to care for more patients. However, it is key for surgeons to understand appropriate patient selection for this approach,” he said, noting that the impact of neoadjuvant therapy on surgery for triple-negative breast cancer, pancreatic ductal adenocarcinoma, and rectal cancer will be discussed during this session. The resurgence of hepatic arterial infusion chemotherapy to treat liver tumors and the use of medications in lieu of surgery for desmoid tumors also will be addressed.
Later today, experts participating in the “Ten Hot Topics in General Surgery” session will deliver a series of concise, 6-minute presentations each offering novel perspectives on diagnostic, treatment, and management strategies.
Topics featured in this year’s session include managing difficult percutaneous endoscopic gastrostomy (PEG) tubes, endoscopy for acute cholecystitis, adjuvant immunotherapy in melanoma, stool tests for colon cancer detection, contraindications for resuscitative endovascular balloon occlusion of the aorta, and others.
“I think learning how to anticipate a difficult PEG and how to manage some of the complications related to PEG will be of great interest to a large number of general surgeons,” said Kenneth W. Sharp, MD, FACS, ACS Regent and Chair of the Program Committee, who will comoderate the session with Benjamin K. Poulose, MD, MPH, FACS, a general surgeon at The Ohio State University Wexner Medical Center in Columbus.
The de-escalation of surgery has emerged as a notable topic of consideration for Clinical Congress attendees in recent years, according to Dr. Sharp, and this year, a presentation will examine indications for eliminating surgery altogether for some breast cancer patients.
“Breast cancer treatment has gone from radical mastectomy to lumpectomies and chemotherapy,” Dr. Sharp said. “With certain types of breast cancer, we have molecular typing that tells us if a tumor will have a high response to chemotherapy. I think that, along with some of the things that have happened with ductal carcinoma in situ and with axillary lymph node testing, it will be a very interesting topic. And while this presentation and the one on stool tests for colon cancer detection are not really surgical—these are advancements that surgeons are going to want to learn more about in order to take better care of their patients.”
Each presentation in “Ten Hot Topics in General Surgery,” will be immediately followed by a 3-minute, audience-guided dialogue representing a diverse range of viewpoints and experiences for additional consideration.
