Chemotherapy or surgery first? What is the contemporary management for patients with locally advanced, resectable gastric cancer, and what does the data show? In this episode from the Surgical Oncology team at Behind the Knife, join the discussion on perioperative treatment of locally advanced gastric cancer and future advances that will benefit surgical patients.  Learning Objectives:  In this episode, we review perioperative chemotherapy regimens for locally advanced, resectable Gastric cancer, standard of care, and the future role for immunotherapy.  Hosts:  Adam Yopp, MD, FACS (@AdamYopp) is an Assistant Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a 2nd Year Complex General Surgical Oncology Fellow at the MD Anderson Cancer Center. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-3 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Papers Referenced in this Episode: Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial Al Batran et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/fulltext Efficacy and Safety of Pembrolizumab or Pembrolizumab Plus Chemotherapy vs Chemotherapy Alone for Patients With First-line, Advanced Gastric Cancer. The KEYNOTE-062 Phase 3 Randomized Clinical Trial Shitara et al https://jamanetwork.com/journals/jamaoncology/fullarticle/2769922 First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial Janjigian et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00797-2/fulltext Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss neuroblastoma management in pediatric surgery. Journal Article links:  Croteau N, Nuchtern J, LaQuaglia MP. Management of Neuroblastoma in Pediatric Patients. Surg Oncol Clin N Am 2021;30(2):291-304. https://pubmed.ncbi.nlm.nih.gov/33706901/ Madonna MB, Newman E. Handbook for Children with Neuroblastoma. Updated Spring 2018. Cancer Committee American Pediatric Surgical Association. 2018. https://www.pedsurglibrary.com/apsa/ub?cmd=repview&type=682-76&name=4_1884004_PDF https://www.pedsurglibrary.com/apsa/ub?cmd=repview&type=682-76&name=4_1884004_PDF Newman EA, Abdessalam S, Aldrink JH, Austin M, Heaton TE, Bruny J, et al. Update on neuroblastoma. J Pediatr Surg 2019;54(3):383-9. https://pubmed.ncbi.nlm.nih.gov/30305231/ Nuchtern JG, London WB, Barnewolt CE, Naranjo A, McGrady PW, Geiger JD, et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children's Oncology Group study. Ann Surg 2012;256(4):573-80. https://pubmed.ncbi.nlm.nih.gov/22964741/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

You are faced with a young patient with low rectal cancer who is a complete responder to neoadjuvant chemoradiotherapy. He asks if he should undergo surgical resection despite the absence of visible tumour. How do you approach such a question?  Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about the Watch and Wait strategy for rectal cancer, also known as the Organ Preservation strategy.  Learning objectives  -       To understand the rationale for Watch and Wait Strategy and the proportion of patients who become complete clinical responders.  -       To explain how patients under the Watch and Wait Strategy protocol should be followed up and when to consider a patient a clinical nonresponder. -       To understand the inclusion criteria for patients in the Watch and Wait Strategy References In order throughout the episode [1–3]: 1. Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U, Sousa AHS e, et al. Operative Versus Nonoperative Treatment for Stage 0 Distal Rectal Cancer Following Chemoradiation Therapy. Transactions Meet Am Surg Assoc. 2004;122(NA;):309–16. 2. Valk MJM van der, Hilling DE, Bastiaannet E, Kranenbarg EM-K, Beets GL, Figueiredo NL, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet. 2018;391(10139):2537–45. 3. Fernandez LM, Julião GPS, Figueiredo NL, Beets GL, Valk MJM van der, Bahadoer RR, et al. Conditional recurrence-free survival of clinical complete responders managed by watch and wait after neoadjuvant chemoradiotherapy for rectal cancer in the International Watch & Wait Database: a retrospective, international, multicentre registry study. Lancet Oncol. 2021;22(1):43–50. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Marginal ulcers are a common cause of abdominal pain following Roux-en-Y gastric bypass. Ever wonder how bariatric surgeons triage abdominal pain in post-bariatric surgery patients? A simplified approach to the work-up of these patients as well as the long-term management of marginal ulcers is included in this episode from your bariatric surgery team at UNMC! Journal Articles discussed: 1.     Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared with Intact Capsules for Marginal Ulceration following Roux-en-Y Gastric Bypass: https://pubmed.ncbi.nlm.nih.gov/27773764/ 2.     Thoracoscopic Truncal Vagotomy versus Surgical Revision of the Gastrojejunal Anastomosis for Recalcitrant Marginal Ulcers: https://pubmed.ncbi.nlm.nih.gov/30132208/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.