Precision Medicine and Pancreatic Cancer
For several decades, cytotoxic chemotherapy was the mainstay of treatment for pancreatic ductal adenocarcinoma (PDAC). Advances in molecular profiling have identified predictive genomic alterations in PDAC —the germline and somatic genome are now routinely interrogated in patients with PDAC because of their therapeutic relevance. The composite role of the epithelial cell compartment and the tumor microenvironment in defining PDAC biology needs further elucidation to deconvolute the spatiotemporal he terogeneity appreciated in this disease. Novel clinical trial approaches leveraging signal seeking, adaptive statistica...
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Ben George Source Type: research

Evolving Concepts Regarding Radiation Therapy for Pancreatic Cancer
In todays practice most institutions individualize the use of adjuvant, neoadjuvant, and definitive RT based on their interpretation of the available data. This review highlights novel concepts and approaches to the use of RT that should be considered by the surgical oncologist. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: William A. Hall, Beth Erickson, Christopher H. Crane Source Type: research

Current Controversies in Neoadjuvant Therapy for Pancreatic Cancer
Over the last two decades, there have been significant changes in the management of patients with localized pancreatic cancer. The rationale for an evolution toward a neoadjuvant approach and summary of relevant clinical trials is reviewed. Controversies in identifying optimal neoadjuvant therapeutic approaches are discussed. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Erin P. Ward, Herbert J. Zeh III, Susan Tsai Source Type: research

Pancreaticoduodenectomy and Vascular Reconstruction
Pancreaticoduodenectomy with vascular resection/reconstruction can be safely completed following 6 standard steps plus basic principles of vascular surgery. Particular attention is paid to the location of the tumor relative to the 2 first-order vein branches, portal vein —splenic vein –superior mesenteric vein confluence, inferior mesenteric vein, and the presence of arterial perineural invasion. Successful resection following neoadjuvant therapy can result in median survival 3 times that of historical controls. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Kathleen K. Christians, Douglas B. Evans Source Type: research

Health Care Disparities and the Future of Pancreatic Cancer Care
There have been tremendous advances in the diagnosis and treatment of pancreatic cancer in the past decade, yet we are failing to achieve equitable outcomes for all patient populations. Disparities exist in the incidence, diagnosis, treatment, and outcomes of patients with pancreatic cancer. Inequities are based on racial and ethnic group, sex, socioeconomic status, and geography. To address disparities, future steps must focus on research methods, including collection and methodology, and policy measures, including access, patient tools, hospital incentives, and workforce diversity. Through these comprehensive efforts, we...
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Marianna V. Papageorge, Douglas B. Evans, Jennifer F. Tseng Source Type: research

Updates on the Management of Pancreatic Cancer
Management of pancreatic cancer has evolved rapidly over the past decade. The use of multimodality therapy has produced superior patient outcomes and has fueled the acceptance of neoadjuvant therapy as the standard approach to operable pancreatic cancer at most high-volume centers. The complexities of delivering neoadjuvant therapy requires the commitment of a multidisciplinary team. The focus of this issue is to highlight the importance of a multidisciplinary approach, and to that end, the issue is organized to provide a comprehensive overview of the management of pancreatic cancer from diagnosis to staging and treatment....
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Susan Tsai, Douglas B. Evans Tags: Preface Source Type: research

Pancreatic Cancer
This issue of the Surgical Oncology Clinics of North America focuses on the management of pancreatic cancer. Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide with over 430,000 related deaths annually.1 Unlike some other cancers, the incidence of pancreatic cancer continues to increase with relatively little improvement in survival. Despite some advances over the last several decades, pancreatic cancer has been characterized by tumor cell resistance to chemotherapy agents, which has resulted in the failure of many traditional cancer treatments. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Current Management of Pancreatic Cancer
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Authors: Susan Tsai, Douglas B. Evans Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, MTS, PhD, FACS, FRACS (Hon.) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Source Type: research

Forthcoming Issues
Disparities and Determinants of Health in Surgical Oncology (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - September 10, 2021 Category: Surgery Source Type: research

Pathology and Molecular Characteristics of Pancreatic Cancer
This article focuses on the molecular and pathology alterations in PDAC. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 22, 2021 Category: Surgery Authors: Joseph F. Kearney, Volkan Adsay, Jen Jen Yeh Source Type: research

Evolution of Systemic Therapy in Metastatic Pancreatic Ductal Adenocarcinoma
Pancreatic ductal adenocarcinoma is characterized by early systemic dissemination, a complex tumor microenvironment, as well as significant intratumoral and intertumoral heterogeneity. Treatment options and survival in pancreatic ductal adenocarcinoma have improved steadily over the last 3  decades. Although cytotoxic chemotherapy is currently the mainstay of treatment for pancreatic ductal adenocarcinoma, evolving therapeutic strategies are aimed at targeting the tumor microenvironment, metabolism, and the tumor–host immune balance. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 22, 2021 Category: Surgery Authors: Mandana Kamgar, Sakti Chakrabarti, Aditya Shreenivas, Ben George Source Type: research

Multimodality Imaging for the Staging of Pancreatic Cancer
This article reviews key principles of the acquisition, interpretation, and reporting of pancreatic ductal adenocarcinoma imaging with computed tomography scanning and highlights potential roles for newer and supplemental imaging technologies. We discuss the importance of structured interpretation and reporting for providing the most complete and accurate assessment of tumor stage and resectability. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 22, 2021 Category: Surgery Authors: Martin McKinney, Michael O. Griffin, Parag P. Tolat Source Type: research

Therapeutic Targeting of Autophagy in Pancreatic Cancer
This article provides a brief review of the therapeutic opportunity of inhibiting autophagy in pancreatic cancer. The autophagic process, importance of autophagy in pancreatic cancer, relevant clinical trials, and new agents in preclinical and clinical development are discussed. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Mona Foth, Ignacio Garrido-Laguna, Conan G. Kinsey Source Type: research

Inherited Pancreatic Cancer Syndromes and High-Risk Screening
Pancreatic cancer is the third leading cause of cancer death in the United States, with a 5-year survival rate of 9%. Individuals with inherited pancreatic cancer syndromes are at an increased risk for developing pancreatic cancer and may benefit from pancreatic cancer surveillance with the goal to detect and intervene on early-stage cancer or high-risk precursor lesions. Given the screening implications for family members and therapeutic implications for probands, all patients diagnosed with pancreatic cancer are recommended to undergo germline genetic testing. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Leah H. Biller, Brian M. Wolpin, Michael Goggins Source Type: research

Advanced Endoscopic Techniques for the Diagnosis of Pancreatic Cancer and Management of Biliary and GastricOutlet Obstruction
Following high-quality imaging studies for staging, endoscopic ultrasound examination fine needle aspiration/biopsy is the preferred modality for tissue diagnosis of pancreatic cancer. Endoscopic retrograde cholangiopancreatography with metal stent placement is used for palliation of malignant biliary obstruction. Metal stents can be placed in patients with resectable pancreatic cancer in whom surgery is going to be delayed. For palliation of gastric outlet obstruction, endoscopic enteral stenting is often selected because of its less invasiveness. Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruc...
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Yousuke Nakai, Zachary Smith, Kenneth J. Chang, Kulwinder S. Dua Source Type: research

Minimally Invasive Techniques for Pancreatic Resection
There is increasing interest in the role of minimally invasive surgery (MIS) for pancreatectomy. Prospective data indicate significant advantages for MIS when performed for left-sided pancreatic pathologies and may be deemed as the standard of care. However, there is reluctance in implementing this technique to pancreaticoduodenectomy because of the complexity of the operation and the mixed results from randomized trials. A detailed description of the technical aspects of robotic pancreaticoduodenectomy and distal pancreatectomy is presented in this article in addition to a summary of the most important prospective and coh...
Source: Surgical Oncology Clinics of North America - July 21, 2021 Category: Surgery Authors: Ibrahim Nassour, Alessandro Paniccia, A. James Moser, Amer H. Zureikat Source Type: research

Current Guidelines for Integration of Palliative Care in Oncology
Multiple cancer societies and professional medical organizations recommend integration of palliative care into routine oncology care. A growing body of literature supports the benefits of palliative care in patients with cancer. Palliative care improves pain and other symptoms, enhances quality of life, and reduces depression. The best method and timing for integration of palliative care is unclear. Multiple barriers exist that prevent optimal palliative care integration; these barriers will require additional education and research to overcome. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Bridget N. Fahy Source Type: research

Considerations in the Management of Malignant Bowel Obstruction
Malignant bowel obstruction is a challenging clinical problem encountered in patients with advanced abdominal and pelvic malignancies. Although medical therapies form the foundation of management, some patients may be suitable candidates for surgical and procedural interventions. The literature is composed primarily of retrospective single-institution experiences and the results of prospective trials are pending. Given the high symptom burden and limited life expectancy of these patients, management may be best informed by multidisciplinary teams with relevant expertise. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Caitlin T. Yeo, Shaila J. Merchant Source Type: research

A Palliative Approach to Management of Peritoneal Carcinomatosis and Malignant Ascites
In addition to severe, life-limiting complications such as malignant bowel obstruction, fistulae, and malignant ascites, peritoneal carcinomatosis frequently causes life-impacting symptoms such as pain, nausea, anorexia, cachexia, and fatigue. A variety of medical, interventional, and surgical therapies are now available for management of both complications and symptoms. Although surgery in this population is often associated with a relatively high risk of morbidity and mortality, operative intervention can offer effective palliative treatment in appropriately selected patients. Early involvement of palliative care special...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Josh Bleicher, Laura A. Lambert Source Type: research

Artificial Nutrition in Patients with Advanced Malignancy
Cancer is a progressive disease that can lead to malnutrition and cachexia. Artificial nutrition is a medical therapy used to combat malnutrition in these patients. In this article, the authors discuss factors affecting the decision to use artificial nutrition, including the patient ’s mental and physical health, technical factors of the procedures used to deliver artificial nutrition, and the oncologic factors affecting treatment. Through this review, the authors provide guidelines on who is and is not likely to benefit from therapy, available routes of administration, and n ecessary factors to consider for appropri...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Ramses Saavedra, Bridget N. Fahy Source Type: research

Selecting Patients for Palliative Procedures in Oncology
Surgical palliation in oncology can be defined as “procedures employed with non-curative intent with the primary goal of improving symptoms caused by an advanced malignancy,” and is an important aspect of the end-of-life care of patients with incurable malignancies. Palliative interventions may provide great benefit, but they also carry high ri sk for morbidity and mortality, which may be minimized with careful patient selection. This can be done by consideration of the patient and his or her indication for the given intervention via open communication, as well as prediction of benefits and risks to define the ...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Cassandra S. Parker, Thomas J. Miner Source Type: research

Palliative Radiotherapy for Advanced Cancers
Palliative radiotherapy (PRT) is well-tolerated, effective treatment for pain, bleeding, obstruction, and other symptoms/complications of advanced cancer. It is an important component of multidisciplinary management. It should be considered even for patients with poor prognosis, because it can offer rapid symptomatic relief. Furthermore, expanding indications for treatment of noncurable disease have shown that PRT can extend survival for select patients. For those with good prognosis, advanced PRT techniques may improve the therapeutic ratio, maximizing tumor control while limiting toxicity. PRT referral should be consider...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Graeme R. Williams, Shwetha H. Manjunath, Anish A. Butala, Joshua A. Jones Source Type: research

Palliative Chemotherapy and the Surgical Oncologist
Outcomes are improving for patients with advanced cancer, in part because of increasing diversity and efficacy of systemic therapy, often described as “palliative chemotherapy.” Patients with advanced cancer receiving systemic treatment sometimes require surgical interventions, and their cancer care teams must collaborate to optimally manage medical and surgical challenges while also considering patients’ goals and values. Structured communi cation can overcome the inherent ambiguity of the term “palliative chemotherapy” and facilitate optimal quality of care and quality of life for patients w...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Elizabeth Wulff-Burchfield, Lori Spoozak, Esm é Finlay Source Type: research

Role of Palliative Medicine Training in Surgical Oncology
The importance of integrated palliative care in surgical oncology has been established by high-level evidence demonstrating improved patient-centered outcomes. There has been substantial improvement in efforts to incorporate palliative medicine training into medical and surgical education over the last decade. However, although trainees may feel confident in managing patients at the end of life, they may not have the insight or proficiency to provide optimal palliative care. Surgeons and palliative care physicians should collaborate on methods to optimize palliative care education for both trainees and practicing surgeons....
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Alexandra C. Istl, Fabian M. Johnston Source Type: research

Navigating Difficult Conversations
Surgeons who provide care for patients with cancer are sometimes tasked with challenging conversations. Approaching difficult communications using a structured approach for delivering difficult news and exploring goals of care can help surgeons provide support to patients and their families. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Elizabeth J. Lilley Source Type: research

Strategies for Optimizing Perioperative Pain Management for the Cancer Patient
Effective management of pain in patients with cancer impacts quality of life and willingness to receive disease-directed treatment. This review focuses on preoperative, intraoperative, and postoperative strategies for management of perioperative pain in the patient with cancer. Managing perioperative pain in special populations, including patients with preoperative opioid use, those with a history of substance abuse, and patients near the end of life are also addressed. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Breana L. Hill, Carolyn Lefkowits Source Type: research

Evaluation and Management of Malignant Biliary Obstruction
There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved significantly. The previous preponderant place of surgical procedures now is replaced by endoluminal and percutaneous techniques for the management of symptoms of MBO. Because quantity of life often is the primary and sole outcome for evaluation of various interventions, the main focus of patient quality of life may be erroneously deemphasized. Lagging behind scientific advances are th...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Nadia V. Guardado, Kaysey Llorente, Benoit Blondeau Source Type: research

Ethical Considerations in Caring for Patients with Advanced Malignancy
This article uses a case-based approach to explore the balance between prognostication and directive counsel; affective forecasting and decisional regret; hope and the therapeutic misconception; and issues of patient ownership and abandonment at the end of life. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Alyssa K. Ovaitt, Susan McCammon Source Type: research

Palliative Care in Surgical Oncology
This issue of the Surgical Oncology Clinics of North America focuses on Palliative Care in Surgical Oncology. The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.”1 Palliative care improves the quality of life of patients and that of their families who are facing challenges associated w...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Understanding the Surgeons' Role in Palliation of the Oncology Patient
Much has changed since the last issue of Surgical Oncology Clinics of North America was devoted to the topic of palliative surgical oncology in 2004. That issue, guest edited by Dr Lawrence Wagman with consulting editor Dr Nicholas Petrelli, focused on many of the key issues of surgical palliative care in oncology, including unique aspects related to palliation of various malignancies and surgical management of malignant bowel obstruction. As Dr Petrelli astutely noted in his foreword to the issue, “I would have to say that this issue is probably the most important for surgical oncology fellows to read. (Source: Surg...
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: Bridget N. Fahy Tags: Preface Source Type: research

Palliative Care in Surgical Oncology
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Authors: BRIDGET N. FAHY Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, MTS, PhD, FACS, FRACS (Hon.) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Source Type: research

Forthcoming Issues
Management of Pancreatic Cancer (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - May 28, 2021 Category: Surgery Source Type: research

Pediatric Gastrointestinal Stromal Tumors and Neuroendocrine Tumors
This article highlights the vast differences between adult and pediatric parameters and provides recommendations on optimal and novel surgical approaches in children. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Authors: Hanna Garnier, Caitlyn Loo, Piotr Czauderna, Sanjeev A. Vasudevan Source Type: research

Liver Tumors in Pediatric Patients
The most recent advance in the care of children diagnosed with hepatoblastoma and hepatocellular carcinoma is the Pediatric Hepatic International Tumor Trial, which opened to international enrollment in 2018. It is being conducted as a collaborative effort by the pediatric multicenter trial groups in North America, Europe, and the Far East. This international effort was catalyzed by a new unified global risk stratification system for hepatoblastoma, an international histopathologic consensus classification for pediatric liver tumors, and a revised 2017 collaborative update of the PRE-Treatment EXTent of disease radiographi...
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Authors: Rebecka Meyers, Eiso Hiyama, Piotr Czauderna, Greg M. Tiao Source Type: research

An Introduction to Pediatric Surgical Oncology
Cancer is the leading disease-related cause of death in children and adolescents. Pediatric surgical oncology has emerged as a newer subspecialty within the field of pediatric surgery. The explosion in precision medicine paralleled in adult oncology has revolutionized the management of patients with pediatric cancer. This paradigm shift in the genetic classification of tumors has advanced the ability to predict prognosis and tailor treatment regimens accordingly. Multimodal therapy is the norm for most pediatric tumors; however, with accurate risk stratification, certain tumors may be observed, or treated with surgery only...
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Authors: Roshni Dasgupta Tags: Preface Source Type: research

Pediatric Cancer
This issue of the Surgical Oncology Clinics of North America focuses on the management of Pediatric Cancer. Despite advances over the last several decades, pediatric cancer remains among the top causes of death in children. While the profession of pediatrics has a tradition of treating a broad range of diseases, a specific focus on pediatric oncology was established in the mid-twentieth century. Specifically, Dr Odile Schweisguth is generally recognized as the first pediatric oncologist, after she was appointed to the Consultant post in 1948 at the Institute Gustave Roussy to establish a new pediatric section at this renow...
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Pediatric Cancer
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Authors: Roshni Dasgupta Source Type: research

Copyright
ELSEVIER (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Source Type: research

Contributors
TIMOTHY M. PAWLIK, MD, MPH, MTS, PhD, FACS, FRACS (Hon.) (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Source Type: research

Contents
Timothy M. Pawlik (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Source Type: research

Forthcoming Issues
Palliative Care in Surgical Oncology (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - March 9, 2021 Category: Surgery Source Type: research

A Surgical Approach to Pulmonary Metastasis in Children
Decisions regarding the role of surgery in pulmonary metastasis need to take into account histology and biology of the cancer. Response to chemotherapy and radiotherapy, balanced with toxicities, factors into decisions about metastasectomy. The less sensitive the tumor is to adjuvant therapy, the more likely that metastasectomy may be beneficial. Broad principles include the following: the aims of resection are localized resections with clear margins, with the aim of preserving adequate lung volume; unnecessary toxic therapy sometimes is avoided with accurate diagnosis; tumor type is of utmost importance; and number of met...
Source: Surgical Oncology Clinics of North America - February 10, 2021 Category: Surgery Authors: Jonathan Karpelowksy, Guido Seitz Source Type: research

Minimally Invasive Techniques in Pediatric Surgical Oncology
Minimally invasive approaches to pediatric cancer surgery are increasingly used, not only for the benefits of smaller incisions, but also for better field visualization and precise dissection. Advances in technology and surgeon experience have facilitated this trend. However, the appropriate indications for its use remain to be determined, and oncologic principles should not be compromised. We discuss the current and potential future uses, and new technologies that are being developed and introduced to assist with and enhance the role of minimally invasive surgery in the management of children with cancer. (Source: Surgica...
Source: Surgical Oncology Clinics of North America - February 10, 2021 Category: Surgery Authors: Marc W.H. Wijnen, Andrew M. Davidoff Source Type: research

Fertility Considerations in Pediatric and Adolescent Patients Undergoing Cancer Therapy
Survivors of pediatric cancer are at increased risk for infertility and premature hormonal failure. Surgeons caring for children with cancer have an important role to play in understanding this risk, as well as advocating for and performing appropriate fertility preservation procedures. Fertility preservation options in males and females vary by pubertal status and include nonexperimental (oocyte harvest, ovarian tissue cryopreservation, sperm cryopreservation) and experimental (testicular tissue cryopreservation) options. This review summarizes the basics of risk assessment and fertility preservation options and explores ...
Source: Surgical Oncology Clinics of North America - February 10, 2021 Category: Surgery Authors: Timothy B. Lautz, Karen Burns, Erin E. Rowell Source Type: research