Lorenzo Ferri MD PhD
@LFerri123
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Thoracic and Upper GI Surgeon, Professor McGill University, Cancer Biologist, Esophagologist, Chef
Westmount, Québec
Joined March 2020
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Very excited to announce the recruitment of Sara Najmeh to the McGill University Division of Thoracic Surgery. . She returns to
@mcgillsurgery
after completeing a three year cardiothoracoc surgery residency
@DukeSurgery
. Welcome home Sara!
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Completely impacted esophagus in a 67 year old man with lifelong history of chronic dysphagia - suspected Achalasia. Unable to clear food impaction and access EGJ endoscopically. What’s your next step?
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Extremely efficient and professional COVID testing at the MGH. I was in and out in 5 minutes. Thanks to the incredibly committed nurses of the MUHC.
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Great work by our Masters student Sabrina Fried! Two different Esophageal Adenocarcinoma PDOs responding to Docetaxel Cisplatin 5FU. The patient from whom the left organoid was derived had pCR. An ex vivo platform to guide neoadjuvant therapy in EAC is almost here!
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Neoadjuvant Chemorads vs (outdated) Chemo for esophageal adenocarcinoma - no difference in survival. So what does the radiation therapy add other than increased surgical morbidity and long term pulmonary toxicity?
New research - Reynolds et al - Trimodality therapy vs perioperative chemotherapy for locally advanced adenocarcinoma of the oesophagus and oesophagogastric junction: the Neo-AEGIS phase 3 trial
#OncTwitter
#GITwitter
#EsoCSM
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Remarkable results with combined PD1-CTLA4 blockade neoadjuvant immunotherapy in MSI-H gastroesophageal Adenocarcinoma. 60% pCR with this modality!
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There is still a role for left thoraco-abdominal incisions in the management of gastro-esophageal junctional adenocarcinoma. We use this approach for bulky type 3 and some type 2 with retro-peritoneal nodes. MIE/RAMIE is not for all cases.
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So this is what Lysol does to your stomach if you follow the advice of
#Trump
#POTUS
and take it internally. Can someone please prevent this man from spewing false advice and dangerous rumours?
No joke - we had a patient swallow Lysol as a
#disinfectant
a couple of weeks ago to prevent COVID19 infection. He made it out of the hospital after his gastrectomy...
This kind of nonsense is absolutely mind blowing.
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Extremely grateful to
@cancersociety
and
@CIHR_IRSC
for supporting our Breakthrough Team grant investigating therapy resistance in esophageal cancer.
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We have an opening for an oncologist interested in esophageal and stomach cancer. Come join one of North America’s largest upper GI cancer programs. Extensive clinical and translational research opportunities!
@McGillMed
@RIMUHC1
.
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@RexChapman
Doesn’t matter where you are on the political spectrum, this is absolutely gut-splitting hilarious.
As an Italian who speaks with his hands, I’ll keep this video in mind next time I’m in front of a camera lest I risk being given the accordion treatment. Kudos.
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Yet another reason that esophageal stents should be used judiciously in benign strictures.
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Outstanding debate on Chemo vs Chemoradiation for esophago- gastric junction cancers between
@LizzySmyth1
and Karin Haustermans
@esde2023
. Chemo is winning IMHO.
@ISDE_net
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Extremely grateful to the Department of Defense for funding our Impact Grant investigating the stromal drivers of esophageal cancer chemo resistance
@RIMUHC1
@McGillGCRC
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An outstanding tribute to an unparalleled mentor
@mcgillu
and icon in thoracic surgery (and Trauma as well as Sports Medicine!). Thank you Dr Mulder.
@CodeVie_Life
@MThoracics
@cusm_muhc
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Congratulations to Jonathan for this Research Award from the Thoracic Surgery Foundation.
@CTSurgeryFdn
has a special place in my heart as it was my first grant in 2007 and launched my research career. I look forward to Cools meteoric rise in academic thoracic surgery!
Congrats to Dr. Cools-Lartigue of McGill University for receiving the TSF Research Award! He will be investigating the role of tumor derived extracellular vesicles in polarizing polymorphonuclear granulocytes towards a pro-metastatic phenotype.
@STS_CTsurgery
@JonathanCools
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@DoctorJSpicer
Incredible work
@DoctorJSpicer
, you got the ball rolling on this practice changing CM816 trial investigating neoadjuvant
#nivolumab
for lung CA. Recruiting the first patient and the most patients to this trial globally through the McGill lung cancer network you direct.
@NEJM
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Please to see this published - it’s been a long journey! “Soluble factors in malignant ascites promote the metastatic adhesion of gastric adenocarcinoma cells” Key point - malignant ascites perpetuates peritoneal metastases through MIF and VEGF
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Join us at McGill the 4th Annual Symposium on Upper Gastro-Intestinal Cancers with an outstanding panel of speakers including Abe Wu, Magnus Nilsson, Jeff Mosko
@MarkarSheraz
@KlempnerSam
@mivanbh
@SSGisbertz
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Esophagectomy versus observation following endoscopic submucosal dissection of pT1b esophageal adenocarcinoma.
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There is still a role for left thoraco-abdominal incisions in the management of bulky gastro-esoph junctional tumours as
@JamieTankel
has nicely elaborated. Best approach IMHO for large type 3 tumours.
Hot off the press: Life post LTA, take home messages:
1.Esophago-gast > esophago-jej for leaks (17% vs 3%)!
2.Recon technique = equivalent shot / longterm QoLv
3.Reflux ⬆️ with esophago-gast
4.Pts need 3+ years to recover...
@LFerri123
@JonathanCools
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FLOT and DCF + en bloc esophagectomy for locally advanced adenocarcinoma - a 15 year experience.
Bottom line - docetaxel-triplets highly effective for this disease and this impact is durable.
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it’s remarkable how everyone is coming together in the fight against COVID-19. To support HCW’s at the front line, the philanthropic community is stepping up. Huge thanks to one of our generous donors who is providing over 1500 N95 respirators at the MUHC. Faith in humanity.
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Great to see this manuscript finally in print. Take home point - although QoL dips during the first year after esophagectomy, this metric increases and reaches the population mean by 3 years.
@annalsthorsurg
@YonNevo
@tssmn
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As I hunker down to finish off the first of two DoD grants this weekend, I really wish I didn’t have to fly to Japan to access one of these machines.
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Here is our debate: « Chemotherapy is the preferred neoadjuvant treatment of oesophageal adenocarcinoma » Key point - as long as the appropriate surgery is performed the approach that provides the best systemic control is preferred - hence chemo.
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Superb debate by
@FilippoPietran4
in support of chemo over chemo-rads for esoph cancer at
@ISDE_net
this past-weekend. Why have two forms of local therapy when systemic recurrence is the problem? Especially if CROSS didn’t reduce distant mets compared to surgery
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Neo-AEGIS (Neoadjuvant trial in Adenocarcinoma of the Esophagus and Esophago-Gastric Junction International Study): Preliminary results of phase III RCT of CROSS versus perioperative chemotherapy
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I’ve always thought less is more for PEH repair. Dissect and reduce the sac, no Collis, crural repair with simple sutures, partial fundoplication (Dor). And avoid mesh as this manuscript suggest it doesn’t reduce recurrence, so why do so many of our colleagues still use it?
Laparoscopic Paraesophageal Hernia Repair: To Mesh or not to Mesh. Systematic Review and Meta-analysis
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Nice randomized trial from Sweden investigating mesh vs no mesh for hiatal hernia repair. Yet another study demonstrating no benefit for the use of mesh at the hiatus. As with many issues in the surgical realm, less is more.
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Chemotherapy is the preferred neoadjuvant treatment of oesophageal adenocarcinoma | British Journal of Surgery | Oxford Academic
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Remarkable- Esophagectomy with prosthetic extracorporeal restoration of intestinal continuity over a century ago. The current trend in some surgeons’ practice of delayed reconstruction after esophageal resection owes a lot to Torek’s pioneering work, and this woman’s bravery!
German born surgeon Franz Torek (1861-1938) performed the first successful transthoracic esophagectomy for cancer on March 14, 1938, at the German (now Lenox Hill) Hospital in NYC. The patient, a 67 year old woman, survived for 12 years after the operation, dying of pneumonia.
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Join us for an exciting Esophagel Cancer Tumour Board featuring some the the World’s leading experts on this malignancy. This free webinar hosted by
#ISDE
will take place August 20 08:30 EST.
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Very excited to see our data
@ASCO
on neoadjuvant chemo-IO for gastro-esophageal Adenocarcinoma. Spoiler alert: Excellent clinical response and initial survival data despite a heavy disease burden, but no correlation to known biomarkers.
See
#ASCO23
results of our IIT (investigator-initiated trial): mDCF + avelumab in operable gastroesophageal ca
@RIMUHC1
with
@LFerri123
,
@pierrefiset
,
@JonathanCools
,
@gtevaristomd
,
@ArielleElkrief
,
@Ramysaleh86
et al. IIT: a great satisfaction in academic oncology!
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Nice paper from our group investigating the molecular mechanisms underpinning gastric cancer peritoneal metastasis.
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Peri-op FLOT/Trastuzumab/Pertuzumab for resectable HER2+ Gastroesophageal Adenocarcinoma - better pCR and ypN0 rates than FLOT alone. But will it translate to improved survival given the negative JACOB trial?
@JCO_ASCO
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Surprising results comparing MIE vs open esophagectomy. Adopting minimally invasive approaches for complex operations requires a foundation of advanced laparoscopic skills. It’s important to learn to walk before you run. A lesson for all of us in adopting new technology.
Immensely humbled to be part of this important surgical research examining the external validity of MI esophagectomy from RCT to national practice published in JCO
@mivanbh
@SSGisbertz
@melodyni2018
@ASCO
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After a highly successful ISDE meeting last weekend in Toronto covering all things esophageal with global leaders in this field, we are already planning for next year’s meeting in Edinburgh Scotland Sept 22-24 2024. Save the date!
@ISDE_net
.
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Upper Endoscopy in the
#COVID19
era. With a reduction in access to this AGMP we should all expect a spike in advanced esophageal esophageal cancers. Need to find a way to augment access whilst maintaining safety.
@ISDE_net
@ASGEendoscopy
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Thanks to the
@SRC_CRS
for supporting our work investigating the influence of MSI-H status in Gastro-Esophageal adenocarcinoma response to chemotherapy. Proud to be a part of a great team - Veena Sangwan,
@pierrefiset
,
@Sven_Bailey
, Nick Bertos at the
@RIMUHC1
.
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Important study looking at possible mechanisms of ICI resistance in MMR deficient tumours.
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Mixed histology trials for esophageal cancer set us back decades and need to stop! EAC and ESCC are completely different diseases. Why do we still think they should be treated similarly.
@LFerri123
@bmeyck
@ogsurgery
@ASCO_pubs
@ASCO
@bplwijn
@HannekevanLaar1
@GekeHospers
@GrardN
@mivanbh
@wilkberend
Absolutely could not agree more with
@LFerri123
. Plus We must move away from drawing conclusions on merits of oncological therapy from mixed histological subtype trials. This is multimodality therapy with the cornerstone remaining radical quality surgery.
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Definitive chemoradiation for esophageal cancer (ESCC and EAC) - no diff between 50.4 and 61.6 Gy in this randomized trial from Holland. Less is more.
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Nice randomized surgical trial of two stapled anastomotic approaches for esophagectomy. Increased stricture in circular compare to linear. We prefer hand sewn, but as John Wong would tell me as a trainee, just do what works in your own hands and perfect it.
Circular stapled technique versus modified Collard technique for cervical esophagogastric anastomosis after esophagectomy: A randomized controlled trial
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Great work by our fellow Yoni Nevo demonstrating that ERAS protocols for esophagectomy can be further optimized with revisions based on critical analysis of one’s own outcomes.
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Annual Symposium on Upper Gastro-Intestinal Cancers- McGill University. Oct 28 in Montreal. Multidisciplinary and Multinational varied perspectives on esophageal and gastric cancer.
@KlempnerSam
@mivanbh
@SSGisbertz
and more X-less speakers.
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We have an opening for a research associate to take a leadership role in the McGill Thoracic Surgery clinical research program. Looking for a dynamic individual with a PhD in data science/clin epi or biomedical science to join an active team of surgeons and scientists.
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Great work by
@JamieTankel
demonstrating that non-regional retroperitoneal nodes in gastro-esophageal adeno can be treated successfully with curative intent surgery in select cases.
@JournalofGISurg
@SSATNews
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Survival and perioperative outcomes of octo- and nonagenarians with resectable esophageal carcinoma | Diseases of the Esophagus | Oxford Academic
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Nice paper demonstrating location of residual esoph cancer after CRT. cCR does not = pCR. Up to 60% of cCR has residual malignancy as this 74 yo patient of mine nicely depicts with tumour deposits in the submucosa. NEEDS and SANO trials will help guide us for cCR
@BJSurgery
Free in BJS' December issue: Residual disease after neoadjuvant chemoradiotherapy for oesophageal cancer: locations undetected by endoscopic biopsies
@AmyLightnerMD
@bplwijn
@des_winter
@ksoreide
@MalinASund
@evanscolorectal
@robhinchliffe1
@young_bjs
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Can’t agree more with
@DocCatenacci
pCR is a false oncologic surrogate outcome when comparing chemo vs chemorads for esoph adeno, particularly when the tumour ends up in a pathology bucket. If MAGIC=CROSS (neoAegis) and FLOT>MAGIC, then FLOT>CROSS. Without the RT complications.
Multimodality Therapy vs Peri-Operative Chemotherapy for Patients With Esophageal/GE Junction Adenocarcinoma.
📽️ Full interview of Elizabeth Smyth MD interviewing Daniel Catenacci MD on PracticeUpdate:
@LizzySmyth1
@DocCatenacci
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Nice review on a controversial topic that will likely never come to a conclusion. We esophageal surgeons are a fickle group. I recall John Wong
#HKU
telling me it doesn’t make a diff. which technique you do, just do it consistently well in vascularized tissue without tension
Linear Stapled Semi Mechanical (LSSM) is associated with lower leak rates compared to other anastomotic techniques for
#oesophagectomy
Our network meta-analysis now in
@BjsOpen
@OGAAudit
@Augishealth
@ISDE_net
@STS_CTsurgery
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In my opinion, a complete upper GI surgery training reqs comprehensive understanding of Med/Rad oncology and proficiency in interventional endoscopy (ESD, Stenting, etc). On topic, we are accepting applications for our advanced upper GI fellowship for 2022. DM me.
@MThoracics
What should we do for a better
#surgicaltrainig
in
#upperGI
? Happy to share our survey analysis+discussion. Any new ideas?
@UpperGIResUK
@LFerri123
@profgeorgehanna
@MarkarSheraz
@SSGisbertz
@EwenGriffiths
@SalgiFoundation
@UpdatesSurgery
@BjoernBruecher
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One month to go! Join us in Montreal Oct 28th for the Upper GI Cancer Symposium. A day of multidisciplinary discussion on gastric and esophageal cancer.
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COVID quarantine mundane activity # 427 - sharpening my armamentarium of Japanese chefs’ knives.
#Aritsugu
. Eternal gratitude to fellow esophagologist and chef Harushi Osugi for the sharpening stone.
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A truly inspirational talk from Rebecca Fitzgerald on the the molecular drivers of Barrett’s Esophagus progression to adenocarcinoma at the international society for diseases of the esophagus meeting.
@ISDE_net
@RFitzgerald_lab
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Nice work from our group looking at the association of NLR and anastomotic leak.
Our new publication in the Annals of Thoracic Surgery is out!
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Neoadjuvant Nivolumab Plus Ipilimumab and Adjuvant Nivolumab in Localized Deficient Mismatch Repair/Microsatellite Instability–High Gastric or Esophagogastric Junction Adenocarcinoma: The GERCOR NEONIPIGA Phase II Study | Journal of Clinical Oncology
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The oncologic friendly fire casualties in the war against
#COVID
will be devastating. A under 50 patient of mine with esophageal cancer refuses to come into the hospital for neoadjuvant chemo for fear of catching the virus. Wants to wait.
#CollateralDamage
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#CovidCut
night at the Ferri home. As a surgeon I feel I can cut anything: esophageal cancer, lung cancer, the Christmas Turkey, my son’s hair. I could not be more wrong. After turning my poor son into Julius Ceasar he retaliates on me. Hello Billy Ray - 1992
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Proud to be a part of this work demonstrating the lasting and long term benefit of docetaxel based neoadjuvant therapy for esophageal adenocarcinoma in a large North American cohort. Just in time for the ESOPEC trial presentation
@ASCO
!
April Issue: Docetaxel-Based
#NeoadjuvantChemotherapy
Followed by
#EnBlocResection
for
#EsophagealAdenocarcinoma
: A 15-Year Retrospective Analysis from a Regional Upper
#GastrointestinalCancer
Network
@JamieTankel
@LFerri123
@cusm_muhc
0
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Great talk by
@RousseauMC
on neoadjuvant therapies for
#esophagealcancer
at the
@iss_sic
meeting in Vienna.
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Pembrolizumab in Combination with Neoadjuvant Chemoradiotherapy for Patients with Resectable Adenocarcinoma of the Gastroesophageal Junction
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Great work by
@McGillMed
student Nabeel Ahmed and fellow
@JamieTankel
presented at
#ascogi23
. Take home point - 15 yr real world experience with over 250 Esoph. Adenocarcinoma pts - DCF/FLOT highly effective with >65% 3 yr survival. CROSS has met its match!
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So grateful that our team grant investigating and overcoming esophageal cancer therapy resistance has been funded by
@cancersociety
and
@CIHR_IRSC
.
New funding for research of pancreatic, esophageal, brain, lung, liver and stomach cancers announced.
Read more about the Breakthrough Team Grants, funded by
@cancersociety
, CIHR and partners.
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One week to go! Join us in Montreal for the Annual Symposium on Upper Gastro-Intestinal Cancers - Oct 29th.
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For all of you writing grants for
@CIHR_IRSC
or another agency. This photo I took almost a decade ago in Inuyama just popped up on my iPhone and I feel your pain. If only it were this easy!
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Please join us for the 5th Annual McGill Univeristy Symposium on Upper Gastro-Intestinal Cancers - October 29 in Montreal. Outstanding panel of multidisciplinary international speakers - GI, Surgery, Med and Rad Onc.
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Perioperative toripalimab and chemotherapy in locally advanced gastric or gastro-esophageal junction cancer: a randomized phase 2 trial | Nature Medicine
0
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This pretty much sums it up. No benefit gained with routine mesh use in large hiatal hernia repair.
Five Year Follow-up of a Randomized Controlled Trial of Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Versus Nonabsorbable Mesh
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Pleased to see Herculean effort in
@biorxivpreprint
detailing an integrated multi-omic analysis of the stromal drivers of Barrett’s esophagus progression.
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After over 1000 esophagectomies , I’ve tried em all. Still “old school” when it come to anastomoses - single layer, hand sewn. Both open and MIE. End to end. I’m my hands gives the best results.
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Congratulations James! I can’t recall a more productive trainee: >15 published manuscripts, over 100 esophagectomies, and learned VATS lobectomy along the way! Jerusalem is getting a complete academic thoracic surgeon.
Two years since I walked through the doors of the montreal general hospital to start my fellowship in thoracic surgery...its been an incredible and formative time and can't quite believe it's over!
@DoctorJSpicer
@JonathanCools
@LFerri123
@DrCarmenMueller
@sara_najmeh
thank you !
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Really proud and privileged to be part of this outstanding team of scientists investigating the stromal drivers fo chronic inflammation associated cancers including Barrett’s adenocarcinoma, H.P. Gastric adenocarcinoma, and lung squamous cell carcinoma funded by
@CR_UK
Can we better understand how chronic
#inflammation
is linked to cancer? Shout out to our STORMing Cancer team for investigating this challenge across 3 continents - .
@UriAlonWeizmann
@KoleRoybal
@LFerri123
@DonIngber
@GarryPNolan
@mcdona02
@deborahcollyar
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@drchethansathya
@secupp
@jaketapper
@maddow
@goldietaylor
@brianstelter
@RealDoctorMike
Well this is how two cups of Lysol looks in the stomach = total gastrectomy. Luckily the guy left hospital
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This is a very important study. We’ve long suspected that pCR after neoadjuvant treatment for esophageal cancer is overcalled based on sampling error. This study confirms with scRNAseq (granted in one patient) an occult population of persistent cancer cells.
Our latest paper in
@BJSurgery
questions the safety of organ-sparing approaches in oesophageal cancer. 1/12
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Hiring multiple post docs/PhDs to help us with this large team grant investigating esophageal cancer therapy resistance in 1) cancer model systems
#organoids
@mcgill
@RIMUHC1
and 2) computational biology combined with
@wyssinstitute
@Harvard
@isbsci
. Please DM me if interested.
Esophageal cancers generally have poor outcomes, with 16% of people in Canada surviving 5 years after diagnosis. This Breakthrough Team Grant project led by
@LFerri123
aims to understand what causes treatment resistance in this type of cancer and find new treatment options. 1/3
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Trans-oral resection of Submucosal tumours is certainly feasible, but there’s a size limitation. Tough to pull out a 4 cm gastric tumour through the esophagus - I’ve tried and failed! Had to snare it in half - not fun. Loss of blood, sweat, and tears, both mine and the patients!
Great demonstration of the versatility of Peroral Endoscopic Tumor Resection (POET/STERS) by
@MichaelScaffidi
in resecting Submucosal Tumors. Traditionally, this would have likely required a thoracoscopic enucleation.
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@DocCatenacci
@LizzySmyth1
@RussellPetty19
@SteveMaronMD
@luckydoc2
@OncoAlert
@GI_OncologyHub
@KlempnerSam
@JoeChaoMD
@pashtoonkasi
FLOT, and I would add DCF, are indeed >> MAGIC and by extension CROSS. Neo-Aegis once again demonstrates that pCR and R0 are false oncologic surrogates when comparing nCT and nCRT for esophageal adenocarcinoma.
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Outstanding presentation on the use of ICG in predicting anastomotic leak after esophagectomy from Tokai Univeristy -
@ISDE_net
webinar series.
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Congratulations Daniel, incredible work defending your PhD thesis
@mcgill
@RIMUHC1
@mcgillsurgery
on the interplay between tumour derived extracellular vesicles, neutrophil extra cellular traps, and lymph node metastases. You’re on to great things.
Officially Dr. Su MD PhD! Thanks everyone for this amazing journey and looking forward to a new chapter of life!
@LFerri123
@JonathanCools
@Sven_Bailey
@BGiannias
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Neoadjuvant nivolumab or nivolumab plus LAG-3 inhibitor relatlimab in resectable esophageal/gastroesophageal junction cancer: a phase Ib trial and ctDNA analyses | Nature Medicine
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Very nice paper on an important and (still) unanswered question: what do to with clinical complete response after induction therapy for esophageal squams? What we do know is cCR does not = pCR.
In October's BJS:Analysis of trimodal and bimodal therapy in a selective-surgery paradigm for locally advanced oesophageal squamous cell carcinoma
@AmyLightnerMD
@bplwijn
@des_winter
@ksoreide
@MalinASund
@evanscolorectal
@nfmkok
@robhinchliffe1
@young_bjs
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Improved survival after Esophagectomy compared to gastrectomy for Type 2 gastroesophageal junction cancer in this registry based study. Caveats include granularity of data, accuracy of classification, and low rate of Esophagectomy in this series.
#Esophagectomy
or Total
#Gastrectomy
for Siewert 2 Gastroesophageal Junction (
#GEJ
)
#Adenocarcinoma
? A Registry-Based Analysis.
@Sivesh93
@MarkarSheraz
#VisualAbstract
@McMastersKelly
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Great work by a duo of
@McGillMed
students Alex and Michael Chen (unrelated) reporting on over 100 Endoscopic Submucosal Dissections for Upper GI tumours.
@SSATNews
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We are hiring an assistant or associate professor in
#datascience
and
#outcomesresearch
in the
@mcgillu
department of surgery based in the wonderful and multicultural city of
@Montreal
. Please apply or RT! …
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A lesson any person in a leadership position should learn. Kudos to the CEO.
My son Luca and my daughter Bella have received this letter from our CEO
@simonweldonkgh
.
This is a real class act. I am proud to work for
@KettGeneral
.
Thank you Simon!
#Heroes
#COVID19
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Nice meta analysis from Verona challenging drains after gastrectomy. At McGill we have abandoned all drains for subtotal/partial gastrectomies, but I must admit we continue to drain the anastomosis for total gastrectomies. Some old habits die hard.
Should we still use prophylactic drain in gastrectomy for cancer? A systematic review and meta-analysis from
@UniVerona
@me4_so
@ESSOnews
@OncologyAdvance
@BASO_ACS
@SICOBoard
@GastricCancerFD
@polom_karol
#GastricCancer
#UpperGI
#Surgery
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Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett’s oesophagus surveillance: individual-level data analysis | Gut
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As a Brit who grew up in the US but has lived in Canada for the last 30 years, I can only say a heartful “thank you” to my adoptive country. It’s easy to lead in an era of prosperity and health, but true leadership matters in times of difficulty.
'It's like night and day': Trudeau's and Trump's Covid-19 responses fuel wildly different outcomes
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Pathological complete response is a poor oncologic surrogate for esophageal adenocarcinoma. Seeing as distant failure is the problem, If one is going to include resection - best to load up in systemic therapy in the neoadjuvant setting. FLOT>>CROSS
#oesophageal
#cancer
remains a challenge. This is an interesting paper that shows high rates of distant recurrences in patient undergoing neo-adj CRT with complete pathological response. Better systemic rx needed?
#some4surgery
#surgicalresearch
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With all due respect, as a high volume centre with over 100 esophagectomies/year and 70% MIE there remain many cases which open would be more appropriate. The goal of the procedure is R0 resection and resection of appropriate LN stations not MIE.
@LFerri123
Agreed. There is certainly going to be selection bias in these non-randomized studies.
This is also dependent on surgeon & program experience with MIE. As MIE experience ⬆️, more likely that large, bulky tumors with suboptimal response can be done MIE.
@EwenGriffiths
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@SSGisbertz
from Amsterdam gave an outstanding talk on the endoscopic management of post esophagectomy anastomotic leaks using endoscopic vacuum assisted closure at the
@ISDE_net
this past weekend. Truly a game changer in peri-op care for this complex scenario.
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Proud to be part of this excellent multi institution study on ESD outcomes for gastric cancer in North America lead by Saowanee Ngamruengphong from
@JohnsHopkins
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Great work from one of our students Anitha Kammili investigating the transition from open to MIE en bloc esophagectomy. Looks like you can, under some circumstances, teach an old (ish) dog new tricks.
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4 Weeks to go for the 5th Annual Symposium on Upper Gastro-Intestinal Cancers | Division of Thoracic and Upper Gastrointestinal Surgery
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