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Clinical Trials That Have Informed the Modern Management of Breast Cancer
Randomized controlled trials have informed the historical evolution of breast cancer management, distilling operative and nonoperative treatments to achieve disease control and improve survival while maximizing quality of life and minimizing complications. The authors describe landmark trials investigating and influencing the following aspects of breast cancer care: extent of breast surgery; axillary management; neoadjuvant and adjuvant therapies; and selection of chemotherapy versus endocrine therapy via application of genomic assays. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Laura K. Krecko, Meeghan A. Lautner, Lee G. Wilke Source Type: research

Clinical Trials in Melanoma
This article discusses the details of the trials that have influenced these treatment decisions, in addition to discussing ongoing trials and possible future directions. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Cimarron E. Sharon, Georgia M. Beasley, Giorgos C. Karakousis Source Type: research

The Perioperative and Operative Management of Esophageal and Gastric Cancer
Optimal management of esophageal and gastric cancer during the perioperative period requires a coordinated multidisciplinary treatment effort. Accurate staging guides treatment strategy. Advances in minimally invasive surgery and endoscopy have reduced risks associated with resection while maintaining oncological standards. Although the standard perioperative chemo-and radiotherapy regimens have not yet been established, randomized control trials exploring this subject show promising results. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Amn Siddiqi, Fabian M. Johnston Source Type: research

Past, Present, and Future Management of Localized Biliary Tract Malignancies
Most of the patients with gallbladder cancer (GBC), intrahepatic cholangiocarcinoma (iCCA), and peri-hilar cholangiocarcinoma (pCCA) present with advanced disease. Complete staging with multiphasic liver imaging is essential to determine the extent of disease. Operative goals should include a margin-negative resection, portal lymphadenectomy for staging, and sufficient remnant liver volume. Biliary tract malignancies have distinct mutational drivers (GBC and pCCA  = ERBB2 in 20%; iCCA = fibroblast growth factor receptor 2 or isocitrate dehydrogenase 1 in 20%) amenable to therapy with inhibitors. Clinical trials assessi...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Janet Li, Flavio G. Rocha, Skye C. Mayo Source Type: research

An Overview of Clinical Trials in the Treatment of Resectable Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide. Partial hepatectomy, one of a few curative therapeutic modalities, is plagued by high recurrence rate of up to 70% at 5 years. Throughout the past 3  decades, many clinical trials have attempted to improve HCC recurrence rate following partial hepatectomy using adjuvant and neoadjuvant treatment modalities such as antiviral therapy, brachytherapy, systemic chemotherapy, immunotherapy, transarterial chemoembolization and radioembolization, and r adiotherapy. The goal of this review is to discuss the clinical trials pertaining...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Nicole M. Nevarez, Gloria Y. Chang, Adam C. Yopp Source Type: research

Colorectal Cancer Liver Metastases
Despite a steady decline in incidence and mortality rates, colorectal cancer (CRC) remains the second most common cancer diagnosis in women and the third most common in men worldwide. Notably, the liver is recognized as the most common site of CRC metastasis, and metastases to the liver remain the primary driver of disease-specific mortality for patients with CRC. Although hepatic resection is the backbone of curative-intent treatment, management of CRLM has become increasingly multimodal during the last decade and includes the use of downstaging chemotherapy, ablation techniques, and locoregional therapy, each of which ar...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Berk Aykut, Michael E. Lidsky Source Type: research

Evidence for the Current Management of Soft-tissue Sarcoma and Gastrointestinal Stromal Tumors and Emerging Directions
This article summarizes prospective evidence to date informing our treatment of STS. Key future directions will include advancing our understanding of fundamental tumor biology and mechanisms of response and recurrence, as well as defining the optimal provision of regional, systemic, and targeted therapies, including the role of immunotherapy. Ongoing global collaborations will be integral to progress in treating these rare tumors. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Fahima Dossa, Rebecca A. Gladdy Source Type: research

Surgeon-Led Clinical Trials in Pancreatic Cancer
The review also highlights key landmark adjuvant, neoadjuvant and perioperative trials with an emphasis on surgeon-run clinical trials that have helped to define the pancreatic cancer treatment paradigms. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Akhil Chawla, Cristina R. Ferrone Source Type: research

Primary Colorectal Cancer
Over the last few decades, the colorectal surgery world has seen a paradigm shift in the care of patients. The introduction of minimally invasive techniques led to the development of procedures resulting in reduced patient morbidity and hospital stay. The vetting process of minimally invasive colorectal surgery involved rigorous studies to ensure that oncologic outcomes were not being compromised. In this chapter, we discuss the most relevant randomized controlled trials that support the practice of minimally invasive colorectal surgery. The multimodal treatment of rectal cancer has developed rapidly, resulting in improved...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Alexander Dowli, Alessandro Fichera, James Fleshman Source Type: research

The Evolving Landscape of Neuroendocrine Tumors
Neuroendocrine tumors (NETs) represent a heterogeneous group of tumors, with variable presentation based on the location of origin and degree of metastatic spread. There are no randomized control trials to guide surgical management; however, surgery remains the mainstay of treatment for most gastroenteropancreatic NETs based on retrospective studies. Metastatic disease is common at the time of presentation, particularly in the liver. There is a role for cytoreduction for improvement of both symptoms and survival. Robust prospective randomized data exists to support the use of medical therapies to improve progression-free a...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Ashley Russo, Alexandra Gangi Source Type: research

Advances in Endocrine Surgery
Recent changes in the landscape of endocrine surgery include a shift from total thyroidectomy for almost all patients with papillary thyroid cancer to the incorporation of thyroid lobectomy for well-selected patients with low-risk disease; minimally invasive parathyroidectomy with, and potentially without, intraoperative parathyroid hormone monitoring for patients with well-localized primary hyperparathyroidism; improvement in the management of parathyroid cancer with the incorporation of immune checkpoint blockade and/or targeted therapies; and the incorporation of minimally invasive techniques in the management of patien...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Michael S. Lui, Aditya S. Shirali, Bernice L. Huang, Sarah B. Fisher, Nancy D. Perrier Source Type: research

Diversity, Equity, and Inclusion in Clinical Trials
Minority groups are vastly underrepresented in clinical trial participants and leadership. Because these studies provide innovative and revolutionary treatment options to patients with cancer and have the potential to extend survival, it is imperative that public and private stakeholders, as well as hospital and clinical trial leadership, prioritize equity and inclusion of diverse populations in clinical trial development and recruitment strategies. Achieving equity in clinical trials could be an important step in reducing the overall cancer burden and mortality disparities in vulnerable populations. (Source: Surgical Onco...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Grace Keegan, Angelena Crown, Kathie-Ann Joseph Source Type: research

Clinical Trials in Surgical Oncology
As physicians and research scientists, we can affect change and improve cancer outcomes in many ways. Historically, physicians work at the ground level managing individual patients. At this level, we diagnose their illness, help them make decisions, treat their cancers, and follow them long term. This interaction is noble and defines our profession. In addition to this, as researchers, we can also affect change at a population level. Research scientists can define new mechanisms and targets in the laboratory that can lead to drug development and new treatment options for patients. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Syed A. Ahmad, Shishir K. Maithel Tags: Preface Source Type: research

Clinical Trials in Surgical Oncology
This issue of the Surgical Oncology Clinics of North America focuses on clinical trials in oncology. Clinical trials are critical to develop and test new treatment modalities for a broad range of disease states. In fact, over the past two years we have witnessed and benefited from clinical trials related to COVID-19 that have made headlines, saved millions of lives, as well as given us the chance to return to some degree of normalcy. In the field of cancer, each of us has also witnessed the important “game-changing” and potentially lifesaving opportunities afforded to our patients through clinical trials. (Source: Surg...
Source: Surgical Oncology Clinics of North America - November 3, 2022 Category: Surgery Authors: Timothy M. Pawlik Tags: Foreword Source Type: research

Molecular Imaging for Estrogen Receptor-Positive Breast Cancer
18F-fluoroestradiol (18F-FES) is a Food and Drug Administration-approved radiopharmaceutical used for molecular imaging of the estrogen receptor (ER). When combined with PET, 18F-FES may improve the diagnosis of ER-positive breast cancer in the metastatic setting and provide insights into tumor heterogeneity. In this article, we review data on the use of 18F-FES imaging for treatment selection, staging, imaging lobular breast cancer, and the novel breast specific imaging tool, dedicated breast PET. (Source: Surgical Oncology Clinics of North America)
Source: Surgical Oncology Clinics of North America - October 1, 2022 Category: Surgery Authors: Kent Goodman, Mary Kathryn Abel, Courtney Lawhn-Heath, Julissa Molina-Vega, Ella F. Jones, Rita A. Mukhtar Source Type: research