Clinical Challenges in Surgical Oncology: Gastric Cancer

Behind The Knife: The Surgery Podcast

Medicine, Health & Fitness, Education, Science

4.8 • 1.4K Ratings

🗓️ 23 May 2024

⏱️ 30 minutes

🔗️ Recording | iTunes | RSS

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Summary

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastric cancer.

Hosts:
- Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center
- Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University.
- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center
- Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center

Learning Objectives:
In this episode, we review the basics of gastric cancer, including presentation, work-up, staging, and treatment modalities as well as high yield topics including the Siewert classification system. We also briefly discuss trials establishing peri-operative chemotherapy regimens for gastric cancer and the controversy of D1 vs. D2 lymphadenectomy.

Links to Papers Referenced in this Episode

Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer.
NEJM 2006 Jul;355(1):11-20.
https://www.nejm.org/doi/full/10.1056/NEJMoa055531

Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesphageal junction adenocarcinoma (FLOT4): a randomized, phase2/3 trial
Lancet 2019 May;393(10184):1948-1957.
https://pubmed.ncbi.nlm.nih.gov/30982686/

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Transcript

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0:00.0	Behind the surgery podcast, relevant and engaging content designed to help you dominate the day.
0:13.0	Hi everyone and welcome back to another episode of Behind the Knife with a surgical oncology
0:26.1	team.
0:27.1	This is Elizabeth Carpenter, Lexi Adams, Connor Chick, and Dr. Reelands.
0:31.9	Today we'll be discussing gastric cancer.
0:34.0	We're pretty excited about this episode because I don't think gastric cancer has actually ever
0:38.0	been talked about on behind the knife outside of the great oral board review that our own Dr. Dan Nelson created and we do
0:44.6	recommend everyone check that out as well. Yeah I think Gaster Cancer is a good
0:48.3	topic for behind the knife because it comes up frequently on tests and clinically is actually fairly rare.
0:54.4	So people like to test things that are rare to see whether or not you studied.
0:58.0	So hopefully get you guys prep for any tests that you may have oral board scenarios and for real life as well.
1:04.5	But I think it's a very interesting topic just because it is pretty rare in the United States,
1:08.6	but is often testing.
1:10.6	Yeah, perfect.
1:11.4	So let's dive into a case. Okay, so Lexi, you're seeing a 62-year-old man with a 30-pack
1:16.8	here smoking history and a history of time of retention. He's been referred to you from
1:20.8	his primary care doctor after recently re-establishing here.
1:24.4	He has had four months of deep up at the gastric pain
1:26.6	with early society, dyspepsia, and a 15-pound weight loss.
1:30.5	He's also had occasional dark stools
1:32.1	and two attributes to his iron supplements that his primary care Dr.
1:34.9	Britaman a year ago for anemia.
	...

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