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.

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. Masha 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.

In this inaugural episode of the Surgical Oncology Insight series of SurgOnc Today®, Dr. Shishir Maithel, Editor of Surgical Oncology Insight, SSO's open-access journal, discusses with Dr. Brett Ecker the results of a systematic review and meta-analysis characterizing the incidence of cfDNA-positivity after resection of colorectal cancer liver metastases  with quantification of its sensitivity and specificity for postoperative recurrence, as reported in his article, "The Prognostic Role of Post-operative cfDNA after Resection of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis."

The surgical management of superficial soft tissue sarcoma require a multidisciplinary surgical team given the defect and reconstruction required from an extended resection to achieve negative margins. This team most often includes the primary surgeon (surgical oncology or orthopedic oncology) and a plastic surgeon.  A critical decision in the treatment plan is whether or not to reconstruct immediately at the index operation or delay final reconstruction pending pathologic assessment of margins.  In this podcast, we will focus on the multidisciplinary surgical approach for superficial sarcoma. We will highlight the role of delayed reconstruction and key clinical considerations in this approach. 

Please listen in as Drs. Piltin, van Akkooi, and Hyngstrom discuss relevant clinical trial presentations from ASCO 2024 annual meeting and their impressions on the implications for surgical oncologists. Abstracts results discussed include the neoadjuvant NADINA and PIVOTAL trials as well as an initial report on upfront TIL therapy for stage IV patients.

In this episode of SurgOnc Today®, Dr. Patrick Sullivan is joined by Dr. Nicole Lopez and Dr. César Reátegui to discuss diverting ostomy. Current practice guidelines suggest that diverting ostomy is the standard of care in surgical management of rectal cancer after neoadjuvant therapy to minimize the risk of clinically significant leak which can then result in permanent colostomy. However, the risk of anastomotic leak after neoadjuvant chemoradiation ranges from 4-12% suggesting that most patients have unnecessary ostomy and additional surgery. With improvement of surgical techniques, utilization of robotic surgery and recent adoption of more TNT approaches, selective use of diverting ostomy will lead to improvement in QOL and decrease in health care costs with minimal impact on incidence of permanent colostomy.

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.