1 The 34 th Annual Assembly of General Surgeons An Annual Celebration of General Surgery Training and Research May 26, 2011 The Sutton Place Hotel 955 Bay Street Toronto, Ontario 2011 E. Bruce Tovee Invited Lecturer Michael J. Solomon MB BCh (Hons) BAO LRCPI LRCSI MSc (Tor) FRACS
2 E.B. TOVEE LECTURERS 2011 Michael Solomon 2010 Murray F. Brennan 2009 Mary L. Brandt 2008 Norman Kneteman 2007 Larry Gentilello 2006 Monica Bertagnolli 2005 Barbara L. Bass 2004 David E. Wesson 2003 John Birkmeyer 2002 Michael Sarr 2001 H. Paul Redmond 2000 Steven Strasberg 1999 Timothy Billiar 1998 B. Mark Evers 1997 Keith Kelly 1996 Ronald Maier 1995 Hartley Stern 1994 William Silen 1993 Charles Balch 1992 John Daly 1991 Douglas W. Wilmore 1990 Jonathan L. Meakins 1989 James Carrico 1988 James C. Thompson 1987 Haile Debas 1986 Hiram C. Polk, Jr Lawrence W. Way 1984 Seymour I. Schwartz 1983 John Duff 1982 David E. Sabiston
3 The 34 th Annual Assembly of General Surgeons An Annual Celebration of General Surgery Training and Research Featuring: Research Presentations and Posters The E. Bruce Tovee Invited Lecturer - Professor Michael Solomon The State of the Union Address Presentation of the Robert Mustard Mentorship Award Annual Assembly Research Awards Introduction of the 2011 Graduates of General Surgery The Valedictory Address
4 London Suite 2 nd Floor 7:00 8:00 CLOSED SESSION BY INVITATION ONLY PGY 4-5, Fellows General Surgery Fellows Symposium With Professor Michael J. Solomon Chair: Dr. Amy Gillis - Chief Administrative Fellow Queen Victoria Foyer (2 nd Floor) 7:30 General Registration With Continental Breakfast Queen Victoria Ballroom (2 nd Floor) 8:15 Welcome Dr. Andrew J. Smith The Bernard & Ryna Langer Chair Division of General Surgery Dr. Jim Rutka R.S. McLaughlin Professor and Chair Department of Surgery 8:30 Paper Session 1 Chair: Dr. Sean Cleary Queen Victoria Foyer (2 nd Floor) 9:15 Poster Session 1 and Break Dr. Shiva Jayaraman Queen Victoria Ballroom (2 nd Floor) 9:45 Paper Session 2 Chair: Dr. Carol- anne Moulton Queen Victoria Foyer (2 nd Floor) 10:45 Poster Session 2 and Break Dr. Tim Jackson Queen Victoria Ballroom (2 nd Floor) Introduction of the Bruce Tovee Lecturer Dr. Robin McLeod PROGRAM 11:15 Training Academic Surgeons in Australia Professor Michael J. Solomon Clinical Professor of Surgery, University of Sydney Head, SOuRCe (Surgical Outcomes Research Centre), University of Sydney Chairman, Post fellowship Training Board in Colorectal Surgery RACS & Colorectal Surgical Society of Australasia Academic Head, Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
5 Lunch Stop rd Floor 12:30 PROGRAM Queen Victoria Ballroom (2 nd Floor) Educational Symposium on Fellowship Panelists: Drs. Michael Solomon, Paul Grieg, Jon Caulfeild, Frances Wright & Zane Cohen 1:30 Paper Session 3 Chair: Dr. J.F. Boileau 2:30 State of the Union Address Dr. Andrew J. Smith Bernard & Ryna Langer Chair Division of General Surgery University of Toronto 3:30 Concurrent sessions will be held at Stop 33 (33 rd Floor) Laparoscopic Skills Competition for CAGS Finalists Chair: Dr. Peter Stotland Cocktail Reception 4:15 4:15 Concurrent Sessions Evening Program and Graduation Dinner Master of Ceremony: Dr. Andrew J. Smith Stop 33 (33 rd Floor) Presentation of the Robert Mustard Mentorship Award ScientiFic Awards: Dr. Michael J. Solomon 5:30 Graduation Ceremony: Dr. Najma Ahmed Valedictory address: Dr. Varun Kapila Closing comments
6 1 Paper Session Chair: Dr. Sean Cleary SURGICAL ONCOLOGY FELLOWS 2011
7 Developing Oncolytic Virotherapy for Malignant Peritoneal Mesothelioma Sergio A. Acuna, Besmira Cako, Kathryn Ottolino-Perry, Nan Tang, Fernando A. Angarita, and J. Andrea McCart Introduction/Objectives: Malignant peritoneal mesothelioma (MPM) has a dismal prognosis. With current therapies survival is limited. Oncolytic viruses are a promising new therapy for cancer because of their ability to kill tumour cells with minimal toxicity to normal tissues. Our objective was to evaluate the potential of vaccinia virus (VV) to treat MPM when administered alone or as an adjuvant treatment to surgery. Methods: AC29, AB12 (murine mesothelioma) and NIH/ 3T3 cells (murine fibroblasts) were used to study the cytotoxicity of VV using MTS and crystal-violet assays. Immunocompetent CBA/J and BALB/c mice were injected intraperitoneally (i.p.) with murine MPM cells, and administered i.p. VV alone or following surgical debulking. PAPER SESSION 1 Chair: Dr. Sean Cleary Results: The cytopathic effect of VV on MPM cell lines was significantly increased (viability: 10.5% [AC29], 26.1% [AB12], 73.3% [3T3]) compared to the control. In an orthotopic model, VV induced tumour regression and prolonged median (+9 days [AB12]) and long term survival (33.3% [AC29]). Adjuvant treatment after debulking was not superior to VV alone. Conclusions: VV selectively kills MPM cells in vitro and leads to improved survival in immunocompetent murine models. Adjuvant treatment to debulking surgery does not increase survival compared to VV alone. These results justify further studies of VV as a novel treatment for MPM.
8 Metastasis signature protein Polo-like Kinase 4 (Plk4) predicts death and affects cell migration and invasion Francis SW. Zih, Carla O. Rosario, Carol J. Swallow Introduction: Targeted molecular therapy has become increasingly important in the personalized treatment of metastatic cancer. Recent studies have identified a group of signature genes in cancer metastases that predicts treatment failure. One of these genetic markers is Pololike Kinase 4 (Plk4), a cell cycle regulator that upregulates RhoGTPase activity. We hypothesize that Plk4 acts as an oncoprotein by increasing cancer cell motility and invasion. Objective: To determine the effect of decreased level of Plk4 on cell migration rate. Methods: Real-time migration rates were compared between non-treated Plk4+/+ and Plk4+/- murine embryonic fibroblasts (MEFs). Early passage Plk4+/+ MEFs were transfected with Plk4 SiRNA and real-time migration rates were compared to buffer-only and nontreated controls. Suppression of Plk4 expression by SiRNA was confirmed by real time RT-PCR. PAPER SESSION 1 Chair: Dr. Sean Cleary Results: In three independent experiments using different MEF lines of each genotype, Plk4+/- MEF migration was consistently reduced by approximately 40% as compared to Plk4+/+ MEFs. Plk4+/+ MEFs were successfully transfected with Plk4 SiRNA and the expression of Plk4 confirmed to be 60-70% lower than buffer-only controls. The migration rate was lower in the SiRNA treated cells in two consecutive experiments. Fluorescence microscopy demonstrated the specific localization of Plk4 to the protrusions of migrating MEFs, suggesting that it acts in focal microdomains to regulate actin remodelling at the cell perimeter. Conclusion: Suppression of Plk4 significantly impairs cell migration in MEFs. We are currently examining the effect of reducing Plk4 activity on colorectal cancer cell migration. Plk4 may represent an important molecular target in metastatic cancer therapy, and its inhibition may overcome resistance to other treatment modalities.
9 Physiologic Evaluation of Donor Lung Injury During Protective Ex Vivo Lung Perfusion in a Porcine Brain Death Model Jonathan Yeung, Terumoto Koike, Manyin Chen, Matthew Rubacha, Douglas J. Cook, Masaaki Sato, Yasushi Matsuda, Thomas K. Waddell, Arthur S. Slutsky, Mingyao Liu, Shaf Keshavjee Purpose Normothermic Ex vivo lung perfusion (EVLP) is a novel method of donor lung preservation for transplantation. Since cellular metabolism is preserved, further evaluation can occur during EVLP. We explored EVLP lung evaluation using a brain-death injury model. Methods Brain death was induced and maintained for 10h in 30-35kg pigs and then the lungs cold stored for 24h. EVLP was then performed for 12h in these lungs and in non-injured controls. PO2, lung compliance, airway pressures, and pulmonary vascular resistance (PVR) were measured during EVLP. The left lungs were subsequently transplanted. PAPER SESSION 1 Chair: Dr. Sean Cleary Results Control lungs had stable physiologic parameters. Injured lungs had decreased compliance and increased airway pressures over 12h EVLP. PVR started high in injured lungs then dropped to near control levels. PO2 was high in both groups during EVLP but the injured group had poor oxygenation post-transplant. Lack of PO2 change with injury during EVLP was due to the linear PO2-O2 content curve of an acellular solution. Fall in PVR was due to reduced vascular reactivity. Conclusion While PO2 is the de facto in vivo standard for lung function, the EVLP strategy alters this response. This data suggests that transplantation should be performed only when all physiological parameters are stable or improve over at least 4h of EVLP.
10 1 Poster Session Hosted by: Dr. Shiva Jayaraman Please refer to Poster Presentations section for all poster listings. M.I.S. FELLOWS 2011
11 2 Paper Session Chair: Dr. Carol- anne Moulton HPB & TRANSPLANT FELLOWS 2011
12 Clinical and Economic Comparison of Laparoscopic and Open Liver Resections Using a 2 to 1 Matched Pair Analysis: An Institutional Experience F. D. Bhojani, A. Fox, K. B. Pitzul, C. Moulton, A. Wei, A. Okrainec, and S. Cleary Introduction: Laparoscopic liver resection (LLR) is an option for patients requiring hepatectomy. The purpose of this study was to review our institutional experience, and perform a cost analysis, compared to Open Liver Resection (OLR). Methods: We evaluated all LLR matching each to 2 OLR for number of segments resected, demographics, and liver histology. Pathology, peri-operative, and cost outcomes were compared including and excluding converted cases. PAPER SESSION 2 Chair: Dr. Carol- anne Moulton Results: 57 patients underwent attempted LLR. Median blood loss was lower for LLR vs. OLR at 250mL and 500mL respectively (P<.001). Median OR time was lower for LLR at 240min vs. 270min for OLR (p=.141). Median length of stay (LOS) was lower for LLR at 5 days vs. 6 days for OLR (p<.001) with no difference in frequency of complications, ICU admission, or reoperation. Total cost for LLR was lower at $11,376 vs. $12,523 for OLR (p = 0.077). When cases converted to open were excluded, median OR time for LLR shortened to 229min (p=.007) and median LOS shortened to 4 days for LLR (p<.001). Total cost for LLR reduced to $10,857 (p =.003). Conclusion: Our experience highlights clinically and statistically significant reductions in OR time, blood loss, LOS, and overall costs favouring implementation of LLR when feasible.
13 Trauma Triage in Toronto: The Impact of Distance and Patient Characteristics on Triage to Trauma Centre Care in an Urban Trauma System Barbara Haas, Aristithes G. Doumouras, David Gomez, Charles de Mestral, Donald M. Boyes, Laurie Morrison, Alan M. Craig, and Avery B. Nathens Introduction/Objectives: Urban trauma systems are characterized by high population density, availability of trauma centres (TC) and short transport times. Small changes in triage practices might significantly impact lives saved. We evaluated triage practices in Toronto to identify opportunities for improving care delivery. Methods: This is a retrospective cohort study of adults meeting field trauma triage criteria in Toronto ( ). Travel distances between the site of injury, the closest non-trauma centre (NTC) and the closest TC were estimated using geographic information systems. For patients transported to NTCs, we estimated differential distance (DD): the additional travel distance required to transport directly to a TC. Logistic regression was used to analyze the effect of DD and other patient characteristics on triage. PAPER SESSION 2 Chair: Dr. Carol- anne Moulton Results: Inclusion criteria identified 898 patients; only 53% were transported to a TC. Falls, female gender and age >65 were associated with transport to NTC. Increased DD was associated with a significantly decreased likelihood of triage to a TC. Conclusions: Differential distance between the closest NTC and closest TC was associated with lower compliance with triage protocols, even in an urban setting where TCs can be accessed in an acceptable time. These findings suggest a need to explore EMS provider perspectives to understand how triage guidelines are interpreted in the field.
14 Technical Outcomes of Laparoscopic Gastrectomy with D2 Lymphadenectomy for Gastric Cancer Experience in a Community Based Practice Danielle A. Bischof, Peter K. Stotland, John A. Hagen, Carol J. Swallow, and Lazar V. Klein Introduction/Objectives For patients with curable gastric adenocarcinoma, gastrectomy with D2 lymphadenectomy is accepted as oncologically appropriate. Laparoscopic gastrectomy has been shown to reduce length of stay (LOS) compared to open surgery, but is also associated with decreased lymph node (LN) retrieval. The purpose of this study was to examine the safety and technical outcomes of laparoscopic gastrectomy with D2 lymphadenectomy in a community setting. Methods All cases of curative intent laparoscopic gastrectomy performed at two community hospitals from 07/08 to 02/11 were identified, and charts reviewed retrospectively. Patient demographics, LN retrieval, operative time, LOS, morbidity and mortality were examined. PAPER SESSION 2 Chair: Dr. Carol- anne Moulton Results Twenty-nine cases were identified; 69% of patients were male and the median age was 69 (Range=28-84). 65% of cases were subtotal gastrectomy and 35% were total gastrectomy. Median operative time was 230 minutes (Range= ). Median LOS was 4 days (Range=2-49). Median number of LNs retrieved was 32 (Range=15-62) and all patients had adequate lymph node assessment according to AJCC staging criteria; 69% of patients had nodal metastases. There were seven major complications including two post-operative deaths. Conclusions Laparoscopic gastrectomy with D2 lymphadenectomy can be performed in a community setting with LN retrieval and complication rates comparable to published open and laparoscopic literature. Morbidity was predominantly related to total gastrectomy and a learning curve was seen associated with the method of anastamosis.
15 Outcomes for Deep Melanoma (> 4 mm): An analysis of 1731 cases Moises Cukier, Calvin H.L. Law, Natalie G. Coburn, and Frances C. Wright Introduction/Objective: Outcomes and optimal surgical treatment for patients with deep melanoma (>4 mm) have not been well studied. The purpose of our study is to describe the clinicopathological features of this population and analyze predictive factors for survival. Methods: We performed an analysis of the Surveillance, Epidemiology, and End Results (SEER) database, selecting patients age 18-80, diagnosed , who had truncal or limb melanoma, with a Breslow depth of > 4.0 mm. Overall survival (OS) was calculated with Kaplan-Meier methodology and adjusted for prognostic factors using a Cox proportional hazards regression model. Results: We identified 1731 patients with deep melanoma, 63% were male and the median age was 61. At presentation, 90% had no evidence of metastatic (M0) disease and of these patients, only 11% had clinically positive lymph nodes (LN) and 22% had micrometastasis. The 3-year OS was 60.2%. Multivariate Cox analysis demonstrated that improved survival was associated with age < 60 years [HR 0.599, p < 0.001], no ulceration [HR 0.656; p ], clinically negative LN [HR 0.339; p < ], M0 disease [HR 0.335; p < ] and Breslow 4-8 mm (compared to > 8 mm) [HR 0.667; p ]. PAPER SESSION 2 Chair: Dr. Carol- anne Moulton Conclusions: Ulceration, nodal status, metastases, and melanoma depth negatively predict survival; however, thickness was the least influential. Overall, we found that patients with deep melanomas have encouraging outcomes. We advocate that in the absence of metastatic disease, these patients should be offered the same surgical treatment as those with intermediate thickness melanomas.
16 2 Poster Session Hosted by: Dr. Tim Jackson Please refer to Poster Presentations section for all poster listings.
17 The E. Bruce Tovee Lecture Training Academic Surgeons in Australia Professor Michael Solomon is a consultant surgeon and Academic Head of the Department of Colorectal Surgery at the Royal Prince Alfred in Sydney. He is a Clinical Professor of Surgery and Director of Colorectal Research, both for Royal Prince Alfred Hospital and the University of Sydney and is a past the President of the Colorectal Surgical Society of Australia & New Zealand (CSSANZ). He is the current Chairman of the Post- FRACS Training Board in Colorectal Surgery of RACS & CSSANZ. Professor Solomon has extensive experience in clinical surgical research and has published over 150 papers. He is the Founding Director and Head of the Surgical Outcomes Research Centre (SOuRCe) at the University of Sydney which was established as a multidisciplinary, academic research unit dedicated to the advancement of evidence- based surgical practice through the conduct of outcomes- orientated surgical research. He teaches clinical epidemiology and research methods to postgraduate students and surgical fellows and currently supervises three PhD students and 6 Masters students, all of whom are academic surgeons. He has obtained over 9 million dollars in peer- reviewed funding for colorectal research and is actively involved as principal investigator in 9 RCT s. Professor Solomon is a member of many national and international colorectal advisory committees. He chaired the Australian NHMRC guidelines for the prevention, early detection and treatment of colorectal cancer in Professor Solomon is on the Editorial Board for the Colorectal Disease, the International Journal of Colorectal Diseases and Diseases of the Colon & Rectum. Professor Solomon s surgical expertise is in multi- disciplined complex pelvic surgery for advanced and recurrent malignancy, in]lammatory bowel disease and pelvic ]loor disorders as well as laparoscopic colorectal surgery E. Bruce Tovee Invited Lecturer Michael J. Solomon MB BCh (Hons) BAO LRCPI LRCSI MSc (Tor) FRACS
18 3 Paper Session Chair: Dr. Jean Francois Boileau COLORECTAL FELLOWS 2011
19 Do MRI Reports Contain the Information Necessary to make Appropriate Decisions for Preoperative Chemoradiation (pre-crt) for Rectal Cancer? Eisar Al-Sukhni, David Messenger, Laurent Milot, Mark Fruitman, Selina Schmocker, Charles Victor, Robin McLeod, and Erin Kennedy Introduction/Objective Allocation of preoperative chemoradiation (precrt) for rectal cancer increasingly relies on MRI. This study aimed to determine whether MRI reports contain the information necessary for rectal cancer precrt treatment decision-making (TDM). Methods This population-based study was performed in two parts. Part 1 was a cross-sectional survey of clinician end users opinions on specific MRI criteria used in rectal cancer precrt TDM. Part 2 was an audit of a convenience sample of MRI reports to determine if criteria required by end users are routinely reported. PAPER SESSION 3 Chair: Dr. Jean Francois Boileau Results T-stage, nodes, and CRM were considered absolutely necessary for precrt TDM by 97%, 94%, and 77% of 243 survey respondents, respectively. The audit revealed that 57% (54/94) of reports explicitly stated T-stage and 43% commented on CRM. A third of descriptions were insufficient to estimate CRM. CRM reporting increased with advanced tumor stage (p=0.001), but not with tumor location or level above the anal verge. Although 96% of reports commented on lymph nodes, size was the only criterion used to describe nodes in 54% of cases. Conclusions There appears to be a gap between what end users require and what they receive on MRI reports for rectal cancer. Strategies to improve communication between radiologists and end users are warranted.
20 In the minds of surgeons: understanding their reactions to error Shelly Luu, Glenn Regehr, Lucas Murnaghan, Steven Gallinger, and Carol-anne Moulton Introduction/Objectives Adverse patient events are common yet many surgeons are unprepared for the resulting psychological reactions. This study explored surgeon s reactions to develop a framework for understanding these reactions. Methods Semi-structured 60-minute interviews were conducted with 18 surgeons across specialties, experience levels, and gender to explore recollections of their reactions to adverse events using a reflexive and constructivist grounded theory approach. 28 brief interviews were conducted exploring immediate experiences following adverse events. Saturation of major themes was achieved after purposive and theoretical sampling. PAPER SESSION 3 Chair: Dr. Jean Francois Boileau Results Surgeons perceived themselves to have unique reactions, yet a consistent pattern emerged. Initially, surgeons experience intense feelings of failure and self-doubt, followed with assessments of their contribution towards the event. Lastly, a recovery phase occurred, where coping strategies involving judgment biases and behavioural modification were used. Cumulative effects over several years on the surgeon were also noted. Conclusions Surgeons are more consistent in the depth and pattern of their reactions than they realize. Errors are experienced by the surgeon as a personal affront and might be considered best as a form of immediate performance feedback. Our framework also offers a language for surgeons to discuss and reflect on their role in adverse events, providing better teaching and learning opportunities.
21 Outcomes of surgical resection in locally recurrent rectal cancer: metastatic disease is a negative predictor of overall survival Emily Partridge, Carol Swallow, and Andy Smith. Introduction: The clinical benefit of resection for locally recurrent rectal cancer (LRRC) in the presence of distant metastatic (M1) disease is unproven. We evaluated the longterm survival of patients who underwent surgical resection for LRRC, comparing patients with and without M1 disease. Methods: A retrospective chart review of 55 consecutive patients who underwent resection of LRRC from March 1995 through January Patients were grouped based on M1 disease: MET group included patients who had distant mets at primary presentation, prior to or synchronous with their LR; NON-MET had no M1 disease prior to their resection for LRRC. The primary end-points were disease-free survival (DFS) and overall survival (OS). Results: Of the total cohort of 55 patients, 10 patients (18%) were in the MET group and 45 (82%) in the NON-MET. Gender and age were distributed evenly between the two groups. All 55 patients underwent multivisceral resection with microscopically-negative margins. In the MET group, 5-year DFS and OS rates were 10% and 10% respectively with a median survival time of 39 months from the time of LRRC resection. In the NON-MET group, 5-year DFS and OS were 17% and 25% (p < 0.05) with a median survival time of 53 months from the time of LRRC resection. TN stage at the time of primary, preoperative treatment, and interval from primary to recurrence did not predict survival. Of the 45 patients in the NON-MET group, 21 did go on to develop distant metastatic disease following resection for LRRC, with 5-year DFS and OS rates of 0% and 14% respectively. The remaining 24 patients in the NON-MET group had an overall 5-year DFS and OS of 33%. PAPER SESSION 3 Chair: Dr. Jean Francois Boileau Conclusions: In this series of patients who underwent resection of LRRC, presence of metastatic disease was a significant predictor of OS and DFS. Although not statistically significant, survival data does trend towards longer OS in patients whose metastases presented metachronously after the diagnosis of LRRC. Carefully selected patients with distant metastases may benefit from resection of LRRC and aggressive metastectomy in addition to conventional adjuvant therapies.
22 Association of HER2 Status and Ipsilateral Breast Tumour Recurrence after Breast Conservation Therapy for Invasive Breast Carcinoma Patrick O. Roberts, Robert Tasevski, Nicholas Hwang, Ellen Maki, and David R. McCready Background Ipsilateral breast tumor recurrence (IBTR) occurs in approximately 5-10% of patients with invasive breast cancer 5 years following breast conservation surgery (BCS) with radiotherapy (RT). The impact of HER2 status on the local control of breast cancer is unclear. The purpose of this study was to examine the association of HER2 status and IBTR. PAPER SESSION 3 Chair: Dr. Jean Francois Boileau Methods 287 BCS for invasive breast cancer from a prospective database were reviewed. All had negative margins, adjuvant breast radiotherapy and known HER2, estrogen receptor (ER) and progesterone receptor (PR) status. Patients with positive lymph nodes or high risk node negative disease were given third generation chemotherapy regimens. Standard endocrine therapy was given to patients with ER positive tumors. IBTR rates were calculated using the Kaplan-Meier method. Cox proportional hazards models were fit to explore associations of HER2 status and IBTR after adjustment for patient and pathological characteristics. Results Twenty-eight (9.7%) of the cancers were HER2 positive, 234 (81.5%) ER positive, and 161 (56.1%) PR positive. Seventeen (60.7%) HER2 positive patients received Trastuzumab. After a median follow-up of 3.6 years (range years), 10 (3.5%) patients had IBTR, five were HER2 positive. HER2 positive patients had a significantly higher 5-year IBTR rate compared to HER2 negative patients (19.1% versus 1.6%, respectively; p=0.0001). Three of the 5 HER2 positive patients with IBTR received trastuzumab. After adjusting for ER status, size of invasive tumor, grade, margin distance and age at surgery, HER2 receptor positive patients continued to have a higher risk of IBTR (hazard ratio [HR] 0.16; p= 0.013). Conclusion HER2 receptor positive breast cancer patients who undergo BCS with RT have a higher risk of IBTR compared to HER2 negative patients.
23 Poster Presentations in alphabetical order by \irst author PEDIATRIC SURGERY FELLOWS 2011
24 1.Diagnos4c accuracy of MRI for assessment of T- category, nodal metastases, and circumferen4al resec4on margin involvement in pa4ents with rectal cancer: a meta- analysis. Eisar Al- Sukhni, Laurent Milot, Mark Fruitman, Joseph Beyene, Charles Victor, Selina Schmocker, Robin McLeod, Erin Kennedy. 2.Iden4fying candidate genes for familial pancrea4c cancer by exome sequencing. Wigdan Al- Sukhni, Quang Trinh, Hyeja Kim, Spring Holter, Ayelet Borgida, John McPherson, Steven Gallinger. 3.Development of a rapid intra- opera4ve molecular assay of oncoly4c virotherapy for colorectal carcinomatosis. Fernando A. Angarita, Nan Tang, J. Andrea McCart 4.A Decision Model of Segmental Compared to Extended Resec4on for Young Individuals with Lynch Syndrome. Melyssa Aronson, Spring Holter, BharaO Bapat, Aaron PolleP, Steven Gallinger, Zane Cohen and Robert Gryfe. 5.Ileocolic resec4ons for Crohn s disease: Is there a difference according to the complexity of the disease? Felipe Bellolio, Helen MacRae, Zane Cohen, Brenda O Connor, Harden Huang, Robin S. McLeod. 6.Does earlier lobectomy result in bever long term pulmonary func4on in children with congenital lung anomalies? A prospec4ve study. Alana Beres MD, Yoko Naito MD, Eveline Lapidus- Krol RN,MSc, Felix Ratjen MD, PhD, Jacob C. Langer MD1. POSTER Presenta7ons 7.Evalua4on of a pa4ent held record for post- opera4ve surveillance of pa4ents with colorectal cancer. Danielle A. Bischof, Barbara- Ann Maier, Andy J Smith, Margaret Fitch, Frances C. Wright 8.The Effect of Plk4 on cell migra4on and invasion: A role for MMP expression. Olga Brashavitskaya, Carla O Rosario, James W Dennis, Carol J Swallow 9.Neoadjuvant chemoradiotherapy and mul4visceral resec4on for primary locally advanced adherent colon cancer. Moises Cukier, Hany Soliman, Andrew J. Smith, C. Shun Wong.
25 10. Incidence, management and mortality of blunt thoracic aor4c injury: an evolving story. Charles de Mestral, Barbara Haas, Andrew Dueck, David Gomez, Sunjay Sharma, Avery Nathens 11. Facilita4ng Bayesian Analyses of Clinical Trials of Novel Lipid Based Approaches to Paediatric Intes4nal Failure Associated Liver Disease - An Expert Belief Elicita4on Study. Ivan Diamond, Robert Grant, Brian Feldman, George Tomlinson, Paul Pencharz, Simon Ling, Aideen Moore, Paul Wales 12. Pa4ent experiences of having a rare cancer: a qualita4ve study. Yael Feinberg, Calvin H.L. Law, Simron Singh, Frances C. Wright. 13. Outcomes and costs of laparoscopic distal pancreatectomy. Comparison to open resec4on in a single centre. Adrian Fox, Kristen Pitzul, Faizal Bhojani, Max Kaplan, Carol- anne Moulton, Alice Wei, Ian McGilvray, Sean Cleary, Allan Okrainec 14. Mul4- modality therapy for pancrea4c adenocarcinoma with arterial involvement. ARCAP: Arterial Resec4on for Cancer of the Pancreas. Adrian Fox, Theodore W. Small, Peter Kim, Stefan Serra, John Kim, Monika Krzyzanowska, Daniel Renouf, George Zogopoulos, Steven Gallinger, Ian McGilvray 15. A Pa4ent Centred Approach toward Wait Times in the Surgical Management of Colon Cancer in the province of Ontario. Amy Gillis, Andy Smith, Calvin Law, Natalie Coburn POSTER Presenta7ons 16. Surgery for Suspected Rota4on Abnormality: Selec4on of Open vs Laparoscopic Surgery Using a Ra4onal Approach Marvin Hsiao, Jacob C. Langer 17. Gene4c Variants in Carcinogen Metabolizing Enzymes, CigareVe Smoking and Pancrea4c Cancer Risk. Ji- Hyun Jang, Michelle CoPerchio, Ayelet Borgida, Steven Gallinger, Sean P. Cleary 18. Sex- associated differences in access to trauma center care: a popula4on- based analysis. David Gomez, Barbara Haas, Charles de Mestral, Sunjay Sharma, Brandon Zagorski, Joel Ray, Gordon Rubenfeld, Avery B. Nathens
26 19. Dropping the Ball in the Surgical Juggling Act: Exploring the Unspoken at Quality Assurance Rounds. Shuk On Annie Leung, Glenn Regehr, Steven Gallinger, Carol- anne Moulton 20. The safe implementa4on of a mul4disciplinary bariatric surgery program in the absence of a formal accredita4on system at a ter4ary care center in Canada. Carmen Mueller, Chris Daigle, T. Swanson, Allan Okrainec, K. Pitzul, Todd Penner, David Urbach, Tim Jackson 21. A systema4c review of the anal fistula plug (AFP) for pa4ents with Crohn s and Non- Crohn s related fistula in ano. JM O Riordan, I DaPa, NN Baxter. 22. Long term outcome of colectomy and ileorectal anastomosis (IRA) for Crohn s Disease (CD). JM O Riordan, BI O Connor, H Huang, R Gryfe, HM MacRae, Z Cohen, RS McLeod 23. Timing of Vaccinia Virus Delivery Cri4cal for Tumour Response. Kathryn OPolino- Perry, Nan Tang, Renee Head, Calvin Ng, Ralph DaCosta, J.Andrea McCart 24. Individualized Deliberate Prac4ce on a Virtual Reality Simulator Improves Technical Performance of Surgical Novices in the Opera4ng Room: A Randomized Controlled Trial. Vanessa Palter, Teodor Grantcharov 25. Enhancing the Quality Improvement Outcomes of the CCO HPB Community of Prac4ce. Jennifer Peller, Carol- anne Moulton, Steven Gallinger, Simon KiPo POSTER Presenta7ons 26. Crisis in the General Surgery Work Force: A qualita4ve explora4on of career sa4sfiers and dissa4sfiers among General Surgeons. Adnan Qureshi, Najma Ahmed, Mary Chiu, Bochra Kurabi, Avery Nathens, Lesley Gotleib Conn, Anand Pandya, Simon KiPo 27. Sources of bias in non- randomized compara4ve studies of surgical procedures. Sandhu L, Tomlinson, G, Kennedy ED, Wei AC, Baxter NN, Urbach DR.
Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer Shannon Acker April 4, 2011 Rectal Cancer 40,870 new cases in the US in 2009 49,920 deaths from colorectal cancer Second leading cause
Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,
Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center I have no disclosures
Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group Lotte Holm Land MD, ph.d. Onkologisk Afd. R. OUH Kræft og komorbiditet - alle skal
Cancer of the Cardia/GE Junction: Surgical Options Michael A Smith, MD Associate Chief Thoracic Surgery Center for Thoracic Disease St Joseph s Hospital and Medical Center Phoenix, AZ Michael Smith, MD
Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma Marc de Perrot, Ronald Feld, Natasha B Leighl, Andrew Hope, Thomas K Waddell, Shaf Keshavjee,
GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); firstname.lastname@example.org Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT
National Bowel Cancer Audit Report 2008 Public and Executive Summary Prepared in association with: Healthcare Quality Improvement Partnership HQIP Association of Coloproctology of Great Britain and Ireland
Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable
7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined
HEALTH SERVICES RESEARCH Assessment the Impact of Real-time Tumor Tracking & Reduced Planning Target Volume Margins on Quality-of-Life in Prostate Cancer Patients Treatment with Intensity Modulated Radiotherapy
Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka Neoadiuvant and adiuvant therapy for advanced gastric cancer Franco Roviello, IT Neoadjuvant and adjuvant therapy for advanced
SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD Case Presentation 35 year old male referred from PMD with an asymptomatic palpable right neck mass PMH/PSH:
ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) 3 Integrated Trials Testing Targeted Therapy in Early Stage Lung Cancer Part of NCI s Precision Medicine Effort in
Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for
MERCY REGIONAL CANCER CENTER 2012 CANCER PROGRAM ANNUAL REPORT Using 2011 Data Mercy Regional Cancer Center When you have cancer, you might think first of treatments chemotherapy and radiation. You want
The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006 Overview Pancreatic ductal adenocarcinoma Pancreaticoduodenectomy
بسم هللا الرحمن الرحيم Updates in Mesothelioma By Samieh Amer, MD Professor of Cardiothoracic Surgery Faculty of Medicine, Cairo University History Wagner and his colleagues (1960) 33 cases of mesothelioma
Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy W. Fraser Symmans, M.D. Associate Professor of Pathology UT M.D. Anderson Cancer Center Pathologic Complete Response (pcr) Proof
Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,
Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History
The 2014 Cancer Program Annual Public Reporting of Outcomes/Annual Site Analysis Statistical Data from 2013 More than 70 percent of all newly diagnosed cancer patients are treated in the more than 1,500
NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER Definitions: NACT is recommended initial treatment for inflammatory breast cancer and inoperable
Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Lung cancer accounts for 13% of all cancer diagnoses and is the leading cause of cancer death in both males
Prognostic and Predictive Factors in Oncology Mustafa Benekli, M.D. NCI Definitions ESMO Course -Essentials of Medical Oncology -Istanbul 2 Prognostic factor: NCI Definition A situation or condition, or
Major Advances in Cancer Prevention, Diagnosis and Treatment~ Why Mesothelioma Leads the Way H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland
Travel Distance to Healthcare Centers is Associated with Advanced Colon Cancer at Presentation Yan Xing, MD, PhD, Ryaz B. Chagpar, MD, MS, Y Nancy You MD, MHSc, Yi Ju Chiang, MSPH, Barry W. Feig, MD, George
Updated June 2014 Derived and updated by consensus of members of the Providence Thoracic Oncology Program with the aid of evidence-based National Comprehensive Cancer Network (NCCN) national guidelines,
Moving forward, where are we with Clinical Trials? Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic AATS/STS General Thoracic Surgery Symposium Sunday, April 27 th 2014 2012 MFMER slide-1 Where
All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits
Hosts Anees Chagpar MD Associate Professor of Surgical Oncology Francine MD Professor of Medical Oncology New Methods for Treating Colorectal Cancer Guest Expert: Scott, MD Associate Professor in the Department
Breast Cancer & Treatment in ACT and Surrounding Regions QUALITY ASSURANCE PROJECT Five-year report Community Health Pathology Southern Area Health Service ACT Health General Practitioners Nurses Social
Early mortality rate (EMR) in Acute Myeloid Leukemia (AML) George Yaghmour, MD Hematology Oncology Fellow PGY5 UTHSC/West cancer Center, Memphis, TN May,1st,2015 Off-Label Use Disclosure(s) I do not intend
Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer PREAMBLE The following recommendations regarding the safe performance of laparoscopic resection for curable colon and rectal cancer
The Use of Kinase Inhibitors: Translational Lab Results Targeting Specific Cell Signaling Pathways for the Treatment of Malignant Peritoneal Mesothelioma Sheelu Varghese, Ph.D. H. Richard Alexander, M.D.
Soft Tissue Tumors Sybile Val, MD Department of Surgery SUNY Downstate Medical Center October 29, 2009 Case Presentation 52 YOM presented to ED on 7/22 with 52 YOM presented to ED on 7/22 with abdominal
Peritoneal Surface Malignancies Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA Cancer dissemination routes Hematogenous metastases Lymphatic metastases Implants on peritoneal surfaces Surgically
Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer J.-L. Zhang, Q. Yao, J.-H. Chen,Y. Wang, H. Wang, Q. Fan, R. Ling, J. Yi and L. Wang Xijing Hospital Vascular Endocrine
How to treat early gastric cancer Surgery Mark I. van Berge Henegouwen Department of Surgery, AMC, Amsterdam Director upper GI surgical unit Academic Medical Center Upper GI surgery at AMC 100 oesophagectomies
SECOND PRIMARY BREAST CANCERS FOLLOWING HAEMATOLOGIC MALIGNANCIES A CASE SERIES STUDY FARAH TANVEER PGY 3 DR.MEIR WETZLER DR. TRACEY O CONNOR RESEARCH QUESTON Patients with previously diagnosed hematologic
Chemotherapy in Luminal Breast Cancer: Choice of Regimen Andrew D. Seidman, MD Attending Physician Breast Cancer Medicine Service Memorial Sloan Kettering Cancer Center Professor of Medicine Weill Cornell
Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.
Breast Cancer Educational Program June 5-6, 2015 Adjuvant Systemic Therapy For Early Breast Cancer: Who, What and for How Long? Debjani Grenier MD, FRCPC Medical Oncologist Disclosures Advisory Board Member:
Mesothelioma 1. Introduction 1.1 General Information and Aetiology Mesotheliomas are tumours that arise from the mesothelial cells of the pleura, peritoneum, pericardium or tunica vaginalis . Most are
www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who
Table of Contents 2 3 6 8 9 Cancer Committee Chairman s Report Accountability and Quality Improvement Measures Cancer Registry Cancer Sites 1 2014 Cancer Committee Thomas Sunnenberg, MD, Medical Oncology,
Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines April 2008 (presented at 6/12/08 cancer committee meeting) By Shelly Smits, RHIT, CCS, CTR Conclusions by Dr. Ian Thompson, MD Dr. James
Changes in Breast Cancer Reports After Second Opinion Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Second Opinion in Breast Pathology Usually requested when a patient is referred
Many Hearts Many Minds One Goal Volume 2 Number 3 May 2005 Cancer Staging bt Maureen MacIntyre, Director, Surveillance and Epidemiology Unit, Cancer Care Nova Scotia and Dr. Eva Grunfeld, Clinician Scientist
July 2013 Edition Vol. 7, Issue 7 Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns By Julie Katz, MPH, MPhil Biomarkers played a prominent role in the research presented in
Special Report Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008 Matthew B. Schabath, PhD, Zachary J. Thompson, PhD,
GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER Author: Dr Susan O Reilly On behalf of the Breast CNG Written: December 2008 Agreed at CNG: June 2009 & June 2010 Review due: June 2011 Guidelines Adjuvant Systemic
Cancer research in the Midland Region the prostate and bowel cancer projects Ross Lawrenson Waikato Clinical School University of Auckland MoH/HRC Cancer Research agenda Lung cancer Palliative care Prostate
Columbia University Mesothelioma Center www.mesocenter.org Multimodal clinical trials, treatment (surgery, radiation, chemotherapy) Peritoneal mesothelioma program Immunotherapy translational, experimental
Summary. 111 Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical recurrence (BCR) is the first sign of recurrent
Primary Care Management of Colorectal Cancer Dr. Dan Renouf, Medical Oncologist, BC Cancer Agency Vancouver Centre November 1, 2014 www.fpon.ca Primary Care Management of Colorectal Cancer Survivors Daniel
Gene expression profiling and expanded immunohistochemistry tests for guiding adjuvant chemotherapy decisions in early breast cancer management: MammaPrint, Oncotype DX, IHC4 and Mammostrat Issued: September
TNM staging and prognosis Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania The Basics of TNM Staging Premises: Cancers of the same
Surgical Margins and follow up of Squamous Cell Carcinoma Steve Keohane Poor registration Well established projected increase in incidence for next 2 decades Significant morbidity but relatively low mortality
Post- survival in completely resected stage I non-small cell lung cancer with local J-J Hung, 1,2,3 W-H Hsu, 3 C-C Hsieh, 3 B-S Huang, 3 M-H Huang, 3 J-S Liu, 2 Y-C Wu 3 See Editorial, p 185 c A supplementary
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer AGO AGO e. e. V. V. Loco-regional Recurrence Loco-regional Recurrence Version 2002: Brunnert / Simon Versions 2003 2012: Audretsch
Lung Cancer in 2015: A Multidisciplinary Update Invited Guest Faculty: Toronto General Hospital Toronto, Canada Saturday April 18, 2015 7:00 am-4:30 pm Westin Pasadena 191 N. Los Robles Avenue Pasadena,
INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS Description of Treatment A major difficulty in treating
- Updated July 2011 Guideline Authors: Todd S. Crocenzi, M.D.; Mark Whiteford, M.D.; Matthew Solhjem, M.D.; Carlo Bifulco, M.D.; Melissa Li, M.D.; Christopher Cai, M.D.; and James Durham, M.D. Contents
1. What is cancer? 2. What causes cancer?. What causes cancer? 3. Can cancer be prevented? The Facts One out of every two men and one out of every three women will have some type of cancer at some point
1 page Overview 21 Oct Tuesday 1500 on REGISTRATION 1800 Welcome Reception & Cocktails at the Cape Town International Conference Centre (CTICC) 22 Oct Wednesday 0730 REGISTRATION 0830 OPENING 0900 PLENARY
A guide for women who are considering breast cancer treatment with chemotherapy and/or hormonal therapy before surgery Contents Introduction... 1 What type of breast cancer do I have?... 2 What treatments
The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives
October is Breast Cancer Awareness Month! A STUDY OF CHARACTERISTICS AND MANAGEMENT OF BREAST CANCER IN TAIWAN Eric Kam-Chuan Lau, OMS II a, Jim Yu, OMSII a, Christabel Moy, OMSII a, Jian Ming Chen, MD
Breast Cancer Care & Research Professor John FR Robertson University of Nottingham Nottingham City Hospital Breast Cancer (BC) 15,000 BC deaths in the UK each year 20% female cancer deaths 5% all female
How TARGIT Intra-operative Radiotherapy can help Older Patients with Breast cancer Jeffrey S Tobias, Jayant S Vaidya, Frederik Wenz and Michael Baum, University College Hospital, London, UK - on behalf
A RANDOMIZED TRIAL COMPARING RADICAL HYSTERECTOMY AND PELVIC NODE DISSECTION VS SIMPLE HYSTERECTOMY AND PELVIC NODE DISSECTION IN PATIENTS WITH LOW RISK EARLY STAGE CERVICAL CANCER A Gynecologic Cancer
Na#onal Asbestos Forum 2013: Advance in Medical Research on Asbestos- Related Diseases Professor Nico van Zandwijk Asbestos Diseases Research Ins#tute Content List of Asbestos- Related Diseases Epidemiology
Carcinoma of the Cervix Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Cervical Cancer Treatment Treatment Microinvasive (Stage IA1): Simple (extrafascial) hysterectomy/cone
RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which
Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Alberto Riccardi SMALL CELL LUNG CARCINOMA Summary of treatment approach * limited
Metastatic Breast Cancer 201 Carolyn B. Hendricks, MD October 29, 2011 Overview Is rebiopsy necessary at the time of recurrence or progression of disease? How dose a very aggressive treatment upfront compare
PET/CT in Lung Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria GLOBOCAN 2012 #1 #3 FDG-PET/CT
Thomas A. Kollmorgen, M.D. Oregon Urology Institute None 240,000 new diagnosis per year, and an estimated 28,100 deaths (2012) 2 nd leading cause of death from cancer in U.S.A. Approximately 1 in 6 men
Underwriting cancer In this issue of the Decision, we provide an overview of Canadian cancer statistics and the information we use to make an underwriting decision. The next few issues will deal with specific
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Adjuvant Therapy for Breast
Specific Standards of Accreditation for Residency Programs in Radiation Oncology 2015 VERSION 3.0 INTRODUCTION The purpose of this document is to provide program directors and surveyors with an interpretation
BIT's 4th World Cancer Congress 2011 People s Republic of China Dalian The Di Bella Method (DBM) improves Survival, Objective Response and Performance Status in treated with DBM therapy Retrospective observational