The Rants and Tirades of a Maniacal Senior Surgery Resident. Sushanth Reddy, M.D. General Surgery Resident University of Kentucky

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "The Rants and Tirades of a Maniacal Senior Surgery Resident. Sushanth Reddy, M.D. General Surgery Resident University of Kentucky"

Transcription

1 The Rants and Tirades of a Maniacal Senior Surgery Resident Sushanth Reddy, M.D. General Surgery Resident University of Kentucky

2 Last year. XPA XPA XPA [Itraconazole] µm [Itraconazole] µm [Itraconazole] µm % of Total Sterol 4α-methyl-5α-cholest-8-en-3ß-ol p = 0.02 LN - LN + % of Total Sterol 4α-methyl-5α-cholest-7-en-3ß-ol p = 0.46 LN - LN +

3

4

5

6 All Right, No Basic Science. Pancreatic Cystic Lesions Pseudocysts 1:20,000 Serous Cystadenomas 1:3,500,000 Mucinous Cystic Neoplasms 1:50,000 IPMN 1:150,000 Reddy S, Wolfgang CL. Surg Clin North Am, 2007

7 What s an IPMN?!!

8 Intraductal Papillary Mucinous Neoplasms 1980: Japanese report 4 patients with pancreatic cancer All had dilated pancreatic duct, mucinous features, patulous ampulla All 4 survived at least 3 years Over next decade: mucinous ductal ectasia, mucinous pancreatic tumor, mucin producing carcinoma of the pancreas, intraductal papillary hyperplasia, intraductal papillary neoplasm, and intraductal mucin producing tumor

9 Intraductal Papillary Mucinous Neoplasms 1997: MGH suggested the term Intraductal Papillary Mucinous Neoplasms (IPMN) More Intervention More Observation MCN Pseudocysts IPMN Serous Cystic Neoplasms

10 125 Number of Published Papers Year PubMed Search Term intraductal papillary mucinous neoplasms pancreas accessed 1/6/10

11 Why Are IPMN Important? IPMN have malignant potential There are ABSITE questions about them They can degenerate into cancer WHO Classification Low Grade Dysplasia Moderate Grade Dysplasia High Grade Dysplasia Invasive Cancer All IPMN have dysplasia!!

12 IPMN with Cancer Pancreatic adenocarcinoma is associated with poor survival Margin negative, node negative 5 year survival 15-20% Lance Armstrong Foundation: We don t fund non-curable diseases

13 Poultsides GA, Reddy S, et al. Ann Surg in press

14 IPMN - Associated vs. Standard Pancreatic Adenocarcinoma Pathologic Characteristics Invasive Carcinoma Size (median, cm) T stage IPMN-associated Invasive Adenocarcinoma n = 132 Standard Pancreatic Adenocarcinoma n = T 1 27% 4% T 2 21% 10% T 3 48% 83% T 4 4% 3% P 0.15 < Nodal Metastasis 51% 78% < Poor Differentiation 26% 44% < Vascular Invasion 33% 54% < Perineural Invasion 63% 92% < Margin Involvement 14% 28% < Poultsides GA, Reddy S, et al. Ann Surg in press

15 IPMN - Associated Invasive Adenocarcinoma Histologic Subtypes Pancreatobiliary type IPMN (Aggressive Pathway) Tubular Adenocarcinoma Intestinal type IPMN (Indolent Pathway) Colloid Carcinoma Adsay NV, et al. Am J Surg Pathol Jul;28(7):839-48

16 IPMN - Associated Invasive Adenocarcinoma Pathologic Characteristics Tubular n = 92 Colloid n = 35 Anaplastic n = 5 Overall Size (median, cm) Invasive Component Size (median, cm) T stage T 1 23% 40% 20% T 2 20% 23% 20% T 3 53% 34% 60% T 4 4% 3% - P * Nodal Metastasis 59% 29% 80% Poor Differentiation 28% 11% 100% Vascular Invasion 42% 7% 33% Perineural Invasion 69% 48% 50% Margin Involvement 18% 0% 40% * comparison of tubular vs. colloid carcinoma Poultsides GA, Reddy S, et al. Ann Surg in press

17 Poultsides GA, Reddy S, et al. Ann Surg in press

18 IPMN Related Cancers Given the favorable prognosis associated with IPMN associated cancers, an aggressive approach toward resection should be advocated Is the favorable outcome due to an inherent biologic difference or from an earlier presentation from the same cancer?

19 Selection for Resection Which patients with IPMN should be resected? Lesions with cancer How do we know?? High Grade Dysplasia? YES Theoretically the last step until invasive cancer Moderate or Low Grade Dysplasia?

20 Progression to Cancer Sohn TA, Yeo CJ, et al. Ann Surg 2004

21 Progression to Cancer Large autopsy series show that PanINs are present in 18-29% of non-cancerous pancreata

22 Selection for Resection Should HGD, MGD, or LGD be removed? Pancreatic resection is associated with high morbidity and mortality Most authors report presence of invasive cancer or malignancy in IPMN Malignancy = invasive cancer + HGD

23 Selection for Resection Consensus guidelines for management of IPMN 11 th Congress of International Association of Pancreatology (IAP) Sendai Criteria Resection indicated for: all main duct and combined type IPMN branch duct IPMN if: size > 30 mm mural nodule Symptomatic Tanaka M et al. Pancreatology 2006

24 Selection for Resection International consensus guidelines based on retrospective review of 8 studies of resected IPMN 475 patients (median 52 patients/study) Cancer Malignancy MD-IPMN 23-57% 63-92% BD-IPMN 0-31% 6-46% Controversy over how to manage branch duct lesions Is it safe to follow small (< 3 cm), asymptomatic branch duct IPMN without a solid component?

25 Branch Duct Lesions Recommendations for branch duct IPMN based on 2 studies 16 patients with BD-IPMN: None had invasive cancer in lesions < 3 cm 32 patients with BD-IPMN: 12/17 BD-IPMN > 3 cm had invasive cancer The paper did not clarify if these lesions were asssociated with solid components or symptoms A multivariate analysis was performed and size was predictive (OR 31.15, p = 0.009)

26 Branch Duct Lesions Appear to behave differently than MD- or combined type IPMN Lower incidence of malignancy and invasive cancer Pancreatic resection associated with significant morbidity Management guided by two studies with 33 patients between them!!

27 Malignancy in IPMN of the Pancreas Main duct: diffuse or segmental dilatation of the main pancreatic duct (MPD) > 5 mm without associated cystic lesion Schmidt CM et al. Ann Surg 2007 Kawamoto S, Fishman EK et al. AJR 2006

28 Malignancy in IPMN of the Pancreas Branch duct: dominant cystic lesion without MPD dilatation Schmidt CM et al. Ann Surg 2007 Kawamoto S, Fishman EK et al. AJR 2006

29 Malignancy in IPMN of the Pancreas Combined: cystic lesion with MPD dilatation > 5 mm Schmidt CM et al. Ann Surg 2007 Kawamoto S, Fishman EK et al. AJR 2006

30 Malignancy in IPMN of the Pancreas Main duct n = 36 (12%) Combined type n = 123 (42%) Branch duct n = 137 (46%) Age (median, yrs) Male gender 44% 50% 55% Symptomatic 75% 74% 47% Type of Resection Whipple 28% 71% 73% Distal 33% 13% 22% Total 39% 15% 1% Central 0% 1% 4% Size (median, cm) High Grade Dysplasia 22% 21% 20% Invasive carcinoma 58% 56% 27%

31 Malignancy in IPMN of the Pancreas Low/moderate grade dysplasia (n = 73) Branch duct IPMN (n= 137) High grade dyplasia (n = 27) Invasive carcinoma (n = 37) p-value Age (median, yrs) Male Gender 49% 56% 65% 0.30 Location in head/uncinate 71% 85% 65% 0.19 Size (median, cm) < Size > 3 cm 35% 56% 87% < Solid component 26% 32% 100% < Any symptom 42% 52% 76% Weight loss 14% 19% 27% 0.24 Abdominal pain 38% 44% 54% 0.32 Jaundice 1% 7% 24% < Nausea/vomiting 6% 15% 3% 0.17

32 Malignancy in IPMN of the Pancreas Multivariate Analysis Preoperative Predictors of Invasive Cancer in Branch Duct IPMN OR 95 % Confidence Interval p-value Solid component Infinity < Symptoms Size > 3 cm Size (continuous) Male gender Location in head/uncinate Age (continuous)

33 Malignancy in IPMN of the Pancreas Solid Component and Branch Duct Lesions Solid Component (n = 62) No Solid Component (n = 68) p-value Age (median, yrs) Male Gender 62.9% 50.0% 0.16 Location (head/uncinate) 70.6% 69.4% 1.0 Size (median, cm) < Symptomatic 61.3% 45.6% 0.08 Abd Pain 48.4% 41.8% 0.48 Jaundice 14.5% 3.0% 0.03 Weight Loss 22.6% 14.9% 0.37 Nausea/Vomiting 8.1% 6.0% 0.74 Invasive Cancer 58.0% 0% < High Grade Dysplasia 12.9% 25.0% 0.53

34 Malignancy in IPMN of the Pancreas Branch-duct IPMN without solid component (n = 68): All without invasive carcinoma Incidence of high grade dysplasia (25%) did not correlate with: size > 3 cm (p = 0.15) presence of symptoms (p = 0.59)

35 Malignancy in IPMN of the Pancreas Author Year Main duct and Combined type Branch duct n Malignancy* Invasive Carcinoma n Malignancy* Invasive Carcinoma Choi % % - Kitagawa % 54% 26 35% 31% Sugiyama % 57% 32 40% 9% Sohn % Salvia % 42% Rodriguez % 11% Schmidt % 28% % 14% Schnelldorfer % % - Reddy % 57% % 27% * Including high grade dysplasia (in situ) and invasive carcinoma

36 Malignancy in IPMN of the Pancreas Prospective, single-arm, observational study 82 patients with branch duct IPMN no mural nodules asymptomatic median lesion size 2.0 cm (range, cm) 12% of patients with lesions > 3 cm Median follow-up 61 months 13 patients had radiologic progression 9 tumors enlarged 4 developed mural nodules 7 of 13 patients underwent surgical resection None had invasive cancer and one had high grade dysplasia Tanno S et al. Gut 2008

37 Summary Invasive cancers associated with IPMN have favorable survival compared to standard pancreatic adenocarcinomas Survival benefit may be due to earlier presentation of the same lesion or a biologically different entity Main duct and combined type IPMN are more likely to have an invasive cancer than branch duct IPMN Presence of a solid component strongly correlated with invasive cancer in branch duct lesions Branch duct IPMN without a solid component did not have invasive cancer but did have high grade dysplasia

38 Summary In accordance with the IAP guidelines, main duct and combined type IPMN or branch duct IPMN with solid component have a strong association with malignancy and warrant surgical resection. Branch duct IPMN without a solid component did not harbor invasive carcinoma regardless of size. Similarly, size did not predict the presence of high grade dysplasia. Size > 3cm alone should be re-evaluated as an absolute indication for resection of branch duct IPMN without a solid component. Presence of a solid component is the strongest predictor of invasive cancer in branch-duct IPMN.

CLINICAL MANAGEMENT OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS OF THE PANCREAS

CLINICAL MANAGEMENT OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS OF THE PANCREAS 1 CLINICAL MANAGEMENT OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS OF THE PANCREAS Carlos Fernández-del Castillo, M.D. Associate Professor of Surgery Massachusetts General Hospital Harvard Medical School,

More information

The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality. Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006

The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality. Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006 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

More information

Cystic Neoplasms of the Pancreas: A multidisciplinary approach to the prevention and early detection of invasive pancreatic cancer.

Cystic Neoplasms of the Pancreas: A multidisciplinary approach to the prevention and early detection of invasive pancreatic cancer. This lecture is drawn from the continuing medical education program Finding Hope: Prevention, Early Detection and Treatment of Pancreatic Cancer, Nov, 2011. Robert P. Jury, MD Cystic Neoplasms of the Pancreas:

More information

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh Pancreatic Cancer The Killer that must be discovered early 27 th June 2015 Dr Alfred Kow Wei Chieh Consultant Department of Surgery Division of HPB Surgery & Liver Transplantation & Assistant Dean (Education)

More information

Intraductal Papillary Mucinous Neoplasms. Predictors of Malignant and Invasive Pathology

Intraductal Papillary Mucinous Neoplasms. Predictors of Malignant and Invasive Pathology ORIGINAL ARTICLES Predictors of and Pathology C. Max Schmidt, MD, PhD, MBA, FACS, Patrick B. White, MD, Joshua A. Waters, MD, Constantin T. Yiannoutsos, PhD, Oscar W. Cummings, MD, Marshall Baker, MD,

More information

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD 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:

More information

Cancer of the Exocrine Pancreas, Ampulla of Vater and Distal Common Bile Duct Proforma

Cancer of the Exocrine Pancreas, Ampulla of Vater and Distal Common Bile Duct Proforma Cancer of the Exocrine, Ampulla of Vater and Distal Coon Bile Duct Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Sex Male Female Intersex/indeterminate

More information

Cancer of the Cardia/GE Junction: Surgical Options

Cancer of the Cardia/GE Junction: Surgical Options 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

More information

Management of Liver Cancer: In the Era of Liver Transplantation

Management of Liver Cancer: In the Era of Liver Transplantation Management of Liver Cancer: In the Era of Liver Transplantation Marwan S. Abouljoud, M.D., F.A.C.S. Benson Ford Chair Transplant and Hepatobiliary Surgery Director, Henry Ford Transplant Institute I have

More information

OBJECTIVES By the end of this segment, the community participant will be able to:

OBJECTIVES By the end of this segment, the community participant will be able to: Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway

More information

Sentinel Lymph Node Mapping for Endometrial Cancer. Locke Uppendahl, MD Grand Rounds

Sentinel Lymph Node Mapping for Endometrial Cancer. Locke Uppendahl, MD Grand Rounds Sentinel Lymph Node Mapping for Endometrial Cancer Locke Uppendahl, MD Grand Rounds Endometrial Cancer Most common gynecologic malignancy in US estimated 52,630 new cases in 2014 estimated 8,590 deaths

More information

Management of Bile Duct Problems Treatment Overview

Management of Bile Duct Problems Treatment Overview Management of Bile Duct Problems Treatment Overview Bile Duct Obstruction Bile duct (or biliary) obstruction occurs for numerous reasons. Causes can include cancerous and non-cancerous processes as well

More information

POSTMENOPAUSAL ASSESS AND WHAT TO DO

POSTMENOPAUSAL ASSESS AND WHAT TO DO POSTMENOPAUSAL OVARIAN CYSTS:HOW TO ASSESS AND WHAT TO DO Steven R. Goldstein, MD Professor of Obstetrics and Gynecology Director of Gynecologic Ultrasound Co-Director, Bone Densitometry New York University

More information

Sybile Val, MD Department of Surgery. October 29, 2009

Sybile Val, MD Department of Surgery. October 29, 2009 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

More information

EMR Can anyone do this?

EMR Can anyone do this? EMR Can anyone do this? Norio Fukami, MD University of Colorado Piecemeal resection? 1 Endoscopic mucosal resection (EMR) and Endoscopic submucosal dissection (ESD) Endoscopic removal of premalignant or

More information

THYROID CANCER. I. Introduction

THYROID CANCER. I. Introduction THYROID CANCER I. Introduction There are over 11,000 new cases of thyroid cancer each year in the US. Females are more likely to have thyroid cancer than men by a ratio of 3:1, and it is more common in

More information

LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA

LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA STAGING SYSTEM Provides standardized nomenclature for exchanging information Groups patients according to the biologic behavior of their

More information

Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients

Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients Purpose: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its

More information

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy 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

More information

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY Dr. Shailesh V. Shrikhande Associate Professor & Consultant Surgeon GI and HPB Surgical Oncology Tata Memorial Hospital, Mumbai INDIA HELICAL

More information

Cancer of the Pancreas

Cancer of the Pancreas Cancer of the Pancreas James H. North Jr., M.D., F.A.C.S. It is estimated that in 2007, 37,170 patients will be diagnosed with cancer of the pancreas and 33,370 patients will die of this disease. 1 The

More information

Outline. Workup for metastatic breast cancer. Metastatic breast cancer

Outline. Workup for metastatic breast cancer. Metastatic breast cancer Metastatic breast cancer Immunostain Update: Diagnosis of metastatic breast carcinoma, emphasizing distinction from GYN primary 1/3 of breast cancer patients will show metastasis 1 st presentation or 20-30

More information

Bradley W. Schenck, copyright ACHIEVING EXCELLENCE IN ABSTRACTING BREAST CANCER

Bradley W. Schenck, copyright ACHIEVING EXCELLENCE IN ABSTRACTING BREAST CANCER Bradley W. Schenck, copyright ACHIEVING EXCELLENCE IN ABSTRACTING BREAST CANCER ACHIEVING EXCELLENCE IN ABSTRACTING BREAST CANCER Recoding Audit Performed in 2009 260 cases audited 17 data items audited

More information

Liver Transplantation for Hepatocellular Carcinoma. John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco

Liver Transplantation for Hepatocellular Carcinoma. John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco Liver Transplantation for Hepatocellular Carcinoma John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco Hepatocellular Carcinoma HCC is the 5th most common

More information

Bridging Techniques. What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS

Bridging Techniques. What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS Bridging Techniques What s between EMR and Traditional Surgery? Elisabeth C. McLemore, MD, FACS, FASCRS Associate Professor of Surgery Assistant Program Director, General Surgery Residency Disclosures

More information

Pancreatic Pseudocysts. Eric Rellinger October 3, 2012 Vanderbilt General Surgery

Pancreatic Pseudocysts. Eric Rellinger October 3, 2012 Vanderbilt General Surgery Pancreatic Pseudocysts Eric Rellinger October 3, 2012 Vanderbilt General Surgery Overview - Pancreatitis (Acute, Necrotizing, Chronic) - Pancreatic Pseudocysts - Clinical Presentation - Diagnostic Evaluation

More information

Breast Ultrasound: Benign vs. Malignant Lesions

Breast Ultrasound: Benign vs. Malignant Lesions October 25-November 19, 2004 Breast Ultrasound: Benign vs. Malignant Lesions Jill Steinkeler,, Tufts University School of Medicine IV Breast Anatomy Case Presentation-Patient 1 62 year old woman with a

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

Surgical Management of Papillary Microcarcinoma 趙 子 傑 長 庚 紀 念 醫 院 林 口 總 院 一 般 外 科

Surgical Management of Papillary Microcarcinoma 趙 子 傑 長 庚 紀 念 醫 院 林 口 總 院 一 般 外 科 Surgical Management of Papillary Microcarcinoma 趙 子 傑 長 庚 紀 念 醫 院 林 口 總 院 一 般 外 科 Papillary microcarcinoma of thyroid Definition latent aberrant thyroid occult thyroid carcinoma latent papillary carcinoma)

More information

Renal Pathology Update. Sundus Hussein MD, FRCPC

Renal Pathology Update. Sundus Hussein MD, FRCPC Renal Pathology Update Sundus Hussein MD, FRCPC Case History A 45 year old male with incidentally discovered a 3.5 x 3.9 x 2.7 cm renal mass Handling partial nephrectomy Handling partial nephrectomy

More information

NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA)

NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA) NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA) Merat Esfahani, MD Medical Oncologist, Hematologist Cancer Liaison Physician SwedishAmerican Regional Cancer Center

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم 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

More information

Evolution of Barrett s esophagus

Evolution of Barrett s esophagus Endoscopic Treatment and Surveillance of Esophageal Cancer: GI Perspective Charles J. Lightdale, MD Columbia University New York, NY Evolution of Barrett s esophagus Squamous esophagus Chronic inflammation

More information

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group 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

More information

J Clin Oncol 24:2897-2902. 2006 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 24:2897-2902. 2006 by American Society of Clinical Oncology INTRODUCTION VOLUME 24 NUMBER 18 JUNE 20 2006 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Perioperative CA19-9 Levels Can Predict Stage and Survival in Patients With Resectable Pancreatic Adenocarcinoma

More information

4/9/2012. Understanding the definition of Tumor Deposits. Guidance for pathologists on documenting TD. Utilizing the new N1c category

4/9/2012. Understanding the definition of Tumor Deposits. Guidance for pathologists on documenting TD. Utilizing the new N1c category Contributors: Carolyn Compton, MD, PhD J. Milburn Jessup, MD Leslie H. Sobin, MD Mary Kay Washington, MD, PhD Christian Wittekind, MD AJCC Cancer Staging Manual Seventh Edition UICC TNM Classification

More information

Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD

Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD Department of Pathology University of Szeged, Hungary ISUP Vancouver Classification of Renal Neoplasia Am J Surg Pathol 37:14691489, 2013 13 histologic

More information

Something Old, Something New.

Something Old, Something New. Something Old, Something New. Michelle A. Fajardo, D.O. Loma Linda University Medical Center Clinical Presentation 6 year old boy, presented with hematuria Renal mass demonstrated by ultrasound & CT scan

More information

Adenocarcinoma: follow-up and interventional radiology

Adenocarcinoma: follow-up and interventional radiology ESGAR-Pancreas Workshop Adenocarcinoma: follow-up and interventional radiology Marc Zins Groupe Hospitalier Paris saint-joseph Dublin, May 15-16, 2014 Learning Objectives To learn Normal post operative

More information

Endoscopic Resection for Barrett s Esophagus and Early Cancer 2014 Masters of Minimally Invasive Surgery

Endoscopic Resection for Barrett s Esophagus and Early Cancer 2014 Masters of Minimally Invasive Surgery Endoscopic Resection for Barrett s Esophagus and Early Cancer 2014 Masters of Minimally Invasive Surgery Matthew Hartwig, M.D. Duke Cancer Institute Case Presentation: Patient ER 51 y/o man with schizophrenia

More information

The Royal Marsden. Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum

The Royal Marsden. Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum The Royal Marsden Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum Any surgeon can cure Surgeon - dependent No surgeon can cure EMR D2 GASTRECTOMY H N SN. WEDGE

More information

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain 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

More information

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011 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

More information

Update on Mesothelioma

Update on Mesothelioma November 8, 2012 Update on Mesothelioma Intro incidence and nomenclature Update on Classification Diagnostic specimens Morphologic features Epithelioid Histology Biphasic Histology Immunohistochemical

More information

Medullary Thyroid Cancer: It is a pain in the neck?

Medullary Thyroid Cancer: It is a pain in the neck? 200 Research Paper Medullary Thyroid Cancer: It is a pain in the neck? Journal of Cancer 2011; 2:200-205 Marlon A. Guerrero 1, Sheila Lindsay 2, Insoo Suh 2, Menno R. Vriens 2, Elham Khanafshar 3, Wen

More information

Pathology of the Endometrium. Thomas C. Wright Columbia University, New York, NY. Most common diseases:

Pathology of the Endometrium. Thomas C. Wright Columbia University, New York, NY. Most common diseases: Pathology of the Endometrium Thomas C. Wright Columbia University, New York, NY Endometrium Most common diseases: Abnormal uterine bleeding Inflammatory conditions Benign neoplasms Endometrial cancer Page

More information

Benign Breast Disorders

Benign Breast Disorders Benign Breast Disorders Valerie Swiatkowski, MD Medical Student Lecture Introduction 16% of women ages 40-69 will seek advice from their physician regarding breast complaints over 10 years. Failure to

More information

Mucinous Cystadenoma of the Ovary

Mucinous Cystadenoma of the Ovary Case Studies [1] September 24, 2012 By Harpreet Singh, MD [2] A 50-year-old female with a history of progressive abdominal distention and discomfort for six months. A 50-year-old female with a history

More information

Aimee Lucas Title: A Prospective Study of Outcome in Patients with Pancreatic Cancer with BRCA Mutations.

Aimee Lucas Title: A Prospective Study of Outcome in Patients with Pancreatic Cancer with BRCA Mutations. Aimee Lucas Title: A Prospective Study of Outcome in Patients with Pancreatic Cancer with BRCA Mutations. A. Study Purpose and Rationale In the United States, pancreatic cancer is the fourth leading cause

More information

Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy

Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy CASE REPORT Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy Raffaele Dalla Valle 1, Cristina Mancini 2, Pellegrino Crafa 2, Rodolfo Passalacqua 3 1 Department of

More information

Colon cancer in patients 40 years old or younger

Colon cancer in patients 40 years old or younger BUMC Proceedings 1998;11:175-178 Colon cancer in patients 40 years old or younger ROBERT E. FARNER, MD, TAMMY L. FISHER, RN, ROBERT M. JACOBSON, MD, PAITOON TULANON, MD, EDWARD R. FRANKO, MD, R. D. DIGNAN,

More information

Image. 3.11.3 SW Review the anatomy of the EAC and how this plays a role in the spread of tumors.

Image. 3.11.3 SW Review the anatomy of the EAC and how this plays a role in the spread of tumors. Neoplasms of the Ear and Lateral Skull Base Image 3.11.1 SW What are the three most common neoplasms of the auricle? 3.11.2 SW What are the four most common neoplasms of the external auditory canal (EAC)

More information

9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH

9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH 9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH Differentiated thyroid cancer expresses the TSH receptor on the cell membrane and responds to TSH stimulation by increasing

More information

Medullary Renal Cell Carcinoma Case Report

Medullary Renal Cell Carcinoma Case Report Bahrain Medical Bulletin, Vol. 27, No. 4, December 2005 Medullary Renal Cell Carcinoma Case Report Mohammed Abdulla Al-Tantawi MBBCH, CABS* Abdul Amir Issa MBBCH, CABS*** Mohammed Abdulla MBBCH, CABS**

More information

Endometrial Cancer Treatment

Endometrial Cancer Treatment Endometrial Cancer Treatment January 2006 By Shelly Smits, RHIT, CCS, CTR mary by Ian Thompson, MD Data Source: Cancer registry information on uterine cancer diagnosed 1/1/2000 to 12/31/2004. Reason for

More information

PROTOCOL OF THE RITA DATA QUALITY STUDY

PROTOCOL OF THE RITA DATA QUALITY STUDY PROTOCOL OF THE RITA DATA QUALITY STUDY INTRODUCTION The RITA project is aimed at estimating the burden of rare malignant tumours in Italy using the population based cancer registries (CRs) data. One of

More information

TNM staging and prognosis. Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania

TNM staging and prognosis. Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania 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

More information

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA Breast Imaging Made Brief and Simple Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA What women are referred for breast imaging? Two groups of women are referred for

More information

Update on thyroid cancer surveillance and management of recurrent disease. Minimally invasive thyroid surgery

Update on thyroid cancer surveillance and management of recurrent disease. Minimally invasive thyroid surgery Update on thyroid cancer surveillance and management of recurrent disease Minimally invasive thyroid surgery July 2006 Michael W. Yeh, MD Program Director, Endocrine Surgery Assistant Professor, David

More information

Interval or Late Debulking Surgery in Advanced Ovarian Cancer: Progression Free and Overall Survival Advantages

Interval or Late Debulking Surgery in Advanced Ovarian Cancer: Progression Free and Overall Survival Advantages Med. J. Cairo Univ., Vol. 83, No. 2, March: 63-68, 2015 www.medicaljournalofcairouniversity.net Interval or Late Debulking Surgery in Advanced Ovarian Cancer: Progression Free and Overall Survival Advantages

More information

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D.

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D. Lung Cancer: Practical Application of Imaging In Determining Resectability Jeremy J. Erasmus, M. D. 62 year old man with a superior sulcus tumor. Which of the following precludes surgical resection in

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

A Patient s Guide to. Pancreatic Cysts. University of Michigan Comprehensive Cancer Center

A Patient s Guide to. Pancreatic Cysts. University of Michigan Comprehensive Cancer Center A Patient s Guide to Pancreatic Cysts University of Michigan Comprehensive Cancer Center Staff of the Comprehensive Cancer Center s Multidisciplinary Pancreatic Cancer Program provided information for

More information

Hepatocellular Carcinoma: What the hepatologist wants to know

Hepatocellular Carcinoma: What the hepatologist wants to know Hepatocellular Carcinoma: What the hepatologist wants to know Hélène Castel, MD Liver Unit Hôpital St-Luc CHUM? CAR Annual Scientific Meeting Saturday, April 27 th 2013 Disclosure statement I do not have

More information

How to treat early gastric cancer. Surgery

How to treat early gastric cancer. Surgery 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

More information

Histologic Subtypes of Renal Cell Carcinoma

Histologic Subtypes of Renal Cell Carcinoma Histologic Subtypes of Renal Cell Carcinoma M. Scott Lucia, MD Associate Professor Chief of Genitourinary and Renal Pathology Director, Prostate Diagnostic Laboratory Dept. of Pathology University of Colorado

More information

BAISHIDENG PUBLISHING GROUP INC

BAISHIDENG PUBLISHING GROUP INC Reviewer s code: 01714224 Reviewer s country: Italy Date reviewed: 2015-01-30 20:36 [ Y] Grade A: Priority publishing [ ] Accept [ ] Grade C: Good [ Y] Grade D: Fair language [ Y] Major revision The article

More information

How to report Upper GI EMR/ESD specimens

How to report Upper GI EMR/ESD specimens Section of Pathology and Tumour Biology How to report Upper GI EMR/ESD specimens Dr.H.Grabsch Warning. Most of the criteria, methodologies, evidence presented in this talk are based on studies in early

More information

Ductal Carcinoma in Situ (DCIS)

Ductal Carcinoma in Situ (DCIS) Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Ductal Carcinoma in Situ (DCIS) Ductal Carcinoma in Situ DCIS Version 2002: Gerber Version 2003 2009: Audretsch / Brunnert

More information

Pancreatic masses: What is there besides cancer

Pancreatic masses: What is there besides cancer Pancreatic masses: What is there besides cancer Poster No.: C-0201 Congress: ECR 2010 Type: Educational Exhibit Topic: Abdominal Viscera (Solid Organs) Authors: M. A. Portilha, C. Ruivo, I. Santiago, M.

More information

Sigmoid Stenosis caused by diverticulitis versus carcinoma: Can they be differentiated by ultrasound?

Sigmoid Stenosis caused by diverticulitis versus carcinoma: Can they be differentiated by ultrasound? Sigmoid Stenosis caused by diverticulitis versus carcinoma: Can they be differentiated by ultrasound? T Ripollés, MD; MJ Martínez, MD; C Fernández, MD; J Vizuete, MD; D Gómez, MD; G Martín, MD. Department

More information

Kidney Cancer OVERVIEW

Kidney Cancer OVERVIEW Kidney Cancer OVERVIEW Kidney cancer is the third most common genitourinary cancer in adults. There are approximately 54,000 new cancer cases each year in the United States, and the incidence of kidney

More information

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA O.E. Stakhvoskyi, E.O. Stakhovsky, Y.V. Vitruk, O.A. Voylenko, P.S. Vukalovich, V.A. Kotov, O.M. Gavriluk National Canсer Institute,

More information

GENERAL CODING. When you review old cases that were coded to unknown, make corrections based on guidelines in effect at the time of diagnosis.

GENERAL CODING. When you review old cases that were coded to unknown, make corrections based on guidelines in effect at the time of diagnosis. GENERAL CODING When you review old cases that were coded to unknown, make corrections based on guidelines in effect at the time of diagnosis. Exception: You must review and revise EOD coding for prostate

More information

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D.

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D. Breast Cancer: from bedside and grossing room to diagnoses and beyond Adriana Corben, M.D. About breast anatomy Breasts are special organs that develop in women during puberty when female hormones are

More information

The Incidental Pancreatic Cyst

The Incidental Pancreatic Cyst The Incidental Pancreatic Cyst Alec J. Megibow, MD, MPH a, *, Mark E. Baker, MD b, Richard M. Gore, MD c, Andrew Taylor, MD d KEYWORDS Pancreatic cyst Incidental finding MRI MDCT Management The discovery

More information

See MP/H rules on the slides if you do not have your manual.

See MP/H rules on the slides if you do not have your manual. Quiz 1 1. Which of the following statements about the incidence of melanoma in the US over the last 30 years is true? a. Melanoma incidences have been going down for both men and women. b. Melanoma incidences

More information

were same. Fig. 1. Diagramatic representation of peripheral calcification types of the thyroid tumors. A. Type 1: peripheral nodular calcification

were same. Fig. 1. Diagramatic representation of peripheral calcification types of the thyroid tumors. A. Type 1: peripheral nodular calcification 401 Fig. 2. A 38-year-old man with papillary carcinoma. Longitudinal sonogram of right thyroid lobe shows a solid mass with Type 1 peripheral nodular calcification. The histopathologic results of preoperative

More information

Lung Cancer Surveillance using low Dose CT scanning Where are We Now?

Lung Cancer Surveillance using low Dose CT scanning Where are We Now? Lung Cancer urveillance using low Dose CT scanning Where are We Now? cott wanson Professor Thoracic urgery Brigham and Women s Hospital and Harvard Medical chool Disclosures These slides were kindly provided

More information

Male. Female. Death rates from lung cancer in USA

Male. Female. Death rates from lung cancer in USA Male Female Death rates from lung cancer in USA Smoking represents an interesting combination of an entrenched industry and a clearly drug-induced cancer Tobacco Use in the US, 1900-2000 5000 100 Per Capita

More information

Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins

Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins The American Journal of Surgery 190 (2005) 521 525 George Peter s Award Winner Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins Heather R. MacDonald,

More information

Survival analysis of 220 patients with completely resected stage II non small cell lung cancer

Survival analysis of 220 patients with completely resected stage II non small cell lung cancer 窑 Original Article 窑 Chinese Journal of Cancer Survival analysis of 22 patients with completely resected stage II non small cell lung cancer Yun Dai,2,3, Xiao Dong Su,2,3, Hao Long,2,3, Peng Lin,2,3, Jian

More information

Preoperative drainage is always indicated in malignant CBD strictures PRO. Horst Neuhaus Evangelisches Krankenhaus Düsseldorf, Germany

Preoperative drainage is always indicated in malignant CBD strictures PRO. Horst Neuhaus Evangelisches Krankenhaus Düsseldorf, Germany Preoperative drainage is always indicated in malignant CBD strictures PRO Horst Neuhaus Evangelisches Krankenhaus Düsseldorf, Germany Background Jaundice is associated with high perioperative morbidity

More information

Paranasal sinus anatomy

Paranasal sinus anatomy Paranasal sinus anatomy Sphenoid Nasopharynx Respiratory mucosa Pseudostratified, goblet & ciliated cells Seromucinous glands Nasopharyngeal mucosa/carcinoma Squamous metaplasia (?) with CIS Normal respiratory

More information

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology Lung Carcinomas New 2015 WHO Classification Spasenija Savic Pathology ***EXPECTED SPRING 2015*** This authoritative, concise reference book provides an international standard for oncologists and pathologists

More information

David R. DeHaas, Jr. MD Sacred Heart Medical Center at RiverBend

David R. DeHaas, Jr. MD Sacred Heart Medical Center at RiverBend David R. DeHaas, Jr. MD Sacred Heart Medical Center at RiverBend 1. To review the surgical history of the Whipple procedure for periampullary tumors. 2. To review the differential diagnosis for patients

More information

PET/CT in Lung Cancer

PET/CT in Lung Cancer 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

More information

Center for Endoscopic Research & Therapeutics

Center for Endoscopic Research & Therapeutics Center for Endoscopic Research & Therapeutics 5758 South Maryland Avenue (MC9028) Chicago, Illinois 60637 (773) 702-1459 www.uchospitals.edu Center for Endoscopic Research & Therapeutics To refer a patient

More information

Il percorso diagnostico del nodulo tiroideo: il ruolo dell analisi molecolare

Il percorso diagnostico del nodulo tiroideo: il ruolo dell analisi molecolare Il percorso diagnostico del nodulo tiroideo: il ruolo dell analisi molecolare Maria Chiara Zatelli Sezione di Endocrinologia Direttore: Prof. Ettore degli Uberti Dipartimento di Scienze Mediche Università

More information

2003 2007 STUDIES OF QUALITY OUTCOMES /BRAIN TUMORS ASTROCYTOMA. Introduction

2003 2007 STUDIES OF QUALITY OUTCOMES /BRAIN TUMORS ASTROCYTOMA. Introduction 2003 2007 STUDIES OF QUALITY OUTCOMES /BRAIN TUMORS ASTROCYTOMA Introduction Astrocytoma represents an important subtype of glial tumors. Its name derives from the fact that the involved cells have the

More information

Nicole Kounalakis, MD

Nicole Kounalakis, MD Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Goal of Breast Evaluation The goal of breast evaluation is to classify findings as: normal physiologic variations

More information

Protocol for the Examination of Specimens From Patients With Carcinoma of the Exocrine Pancreas

Protocol for the Examination of Specimens From Patients With Carcinoma of the Exocrine Pancreas Protocol for the Examination of Specimens From Patients With Carcinoma of the Exocrine Pancreas Protocol applies to all epithelial tumors of the exocrine pancreas. Endocrine tumors and tumors of the ampulla

More information

Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50

Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50 General Data Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50 The vast majority of the patients in this study were diagnosed

More information

Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014

Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014 Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014 Prof. Dr. Chris Verslype, Leuven Prof. Dr. Aurel Perren, Bern Menue Challenges: 1. Gastric NET 2. Appendiceal NET 3. Rectal NET SEER,

More information

WHAT S WRONG WITH MY GALL BLADDER? GALL BLADDER POLYPS

WHAT S WRONG WITH MY GALL BLADDER? GALL BLADDER POLYPS WHAT S WRONG WITH MY GALL BLADDER? GALL BLADDER POLYPS This is a patient information booklet providing specific practical information about gall bladder polyps in brief. Its aim is to provide the patient

More information

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project Data Forms and Fields in CRAB Electronic Data Capture System - Reduced Set - Pivotal data elements for developing

More information

The Proportional Odds Model for Assessing Rater Agreement with Multiple Modalities

The Proportional Odds Model for Assessing Rater Agreement with Multiple Modalities The Proportional Odds Model for Assessing Rater Agreement with Multiple Modalities Elizabeth Garrett-Mayer, PhD Assistant Professor Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University 1

More information

330 Diagnostic Cytopathology, Vol 34, No 5 # 2006 WILEY-LISS, INC.

330 Diagnostic Cytopathology, Vol 34, No 5 # 2006 WILEY-LISS, INC. Does Hurthle Cell Lesion/Neoplasm Predict Malignancy More Than Follicular Lesion/Neoplasm on Thyroid Fine-Needle Aspiration? Robert T. Pu, M.D., Ph.D., 1 * Jack Yang, M.D., 2 Patricia G. Wasserman, M.D.,

More information

LATERAL NECK DISSECTION 4 th post-grad course in Endocrine Surgery 2012

LATERAL NECK DISSECTION 4 th post-grad course in Endocrine Surgery 2012 LATERAL NECK DISSECTION 4 th post-grad course in Endocrine Surgery 2012 MAURICE STEVENS ( ENT, Head and Neck ) ROYAL BRISBANE AND WOMENS HOSPITAL Head and Neck Multidiciplinary Clinic PAPILLARY THYROID

More information

ESD for colorectal lesions I am in favour. Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy

ESD for colorectal lesions I am in favour. Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy ESD for colorectal lesions I am in favour Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy Surgery for early colonic lesions 51 pts referred for lap colectomy

More information