Multimodal Therapy for Esophageal Cancer
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The best of the best free papers submitted for ISDE 2020 will be featured across three ISDE webinars. In the first of these 9 free papers that each address a cutting edge issue relevant to the management of esophageal cancer will be presented. From novel basic research to the outcomes of practice changing randomized trials these papers will deliver the information you need to stay abreast of the field. Complementing the free papers, Professor John Reynolds will deliver a state of the art update on multimodal therapy for esophageal cancer from the perspective of the practicing surgeon. This 2 hour focused webinar will deliver what you need to keep your esophageal cancer practice up to date. 

After attending this event, the participant should be able to state the correct use of surgery, chemotherapy and radiotherapy for cancerous conditions of the esophagus.

 

Cancer Cells Persist After Complete Pathological Response in Esophageal Adenocarcinoma
Rob Walker
UK, University of Southampton, Southampton General Hospital
Cancer Cells Persist After Complete Pathological Response in Esophageal Adenocarcinoma
In esophageal adenocarcinoma (EAC) with apparent pathological complete response (pCR) to neoadjuvant therapy (NAT) debate remains as to whether esophagectomy is required. Recurrence after pCR is not limited to distant metastases outside radiation or resection fields. It is unknown if cancer persists below the lower detection limit of current diagnostic technology. Trials randomising patients with apparent pCR to esophagectomy or active surveillance are currently recruiting in an attempt to spare patients the morbidity of esophagectomy.
Rob Walker  
UK, University of Southampton, Southampton General Hospital
Rob Walker is a Cancer Research UK Clinical Research Fellow and esophago-gastric surgical trainee at the University of Southampton, UK. Working under the mentorship of Professor Tim Underwood, he is completing a PhD on the tumor micro-environment in esophageal adenocarcinoma. His research focusses on single cell RNA sequencing to detect rare cell types and interpreting the cell-cell interactions. He has published on both the molecular biology and clinical management of esophageal cancer and was awarded the British Journal of Surgery prize paper at the Association of Upper Gastrointestinal Surgery (AUGIS) congress in 2019 for his research.
Genomic Analysis of Response to Neoadjuvant Chemotherapy in Esophageal Adenocarcinoma
Fereshteh Izadi
UK, University of Southampton, Southampton General Hospital
Genomic Analysis of Response to Neoadjuvant Chemotherapy in Esophageal Adenocarcinoma
In the UK, neoadjuvant chemotherapy (NAC) for locally advanced esophageal adenocarcinoma (EAC) is the standard of care. Unfortunately, response to NAC, following surgery is often low (<30%) and survival benefit at 2 years is only 5.1%. The EAC genome is complex and heterogeneous between patients, where specific mutagenic processes and mutations may result in chemotherapy resistance. Here we report preliminary results from whole-genome sequencing (WGS) of 48 patients who were subsequently treated with NAC.
Fereshteh Izadi  
UK, University of Southampton, Southampton General Hospital
Fereshteh Izadi completed a PhD in comparing gene regulatory networks by microarray and RNA-seq in July 2017. Shortly after she started her first postdoctoral job in University College London as a bioinformatician on single cell RNA-seq data analysis. Afterwards she started her second job at University of Southampton working on multi comics data analysis in oesophageal adenocarcinoma.
Volatile Organic Compound Profiling for Detection of Esophageal Cancer in Exhaled Breath
Ravi Vissapragada
Australia, Flinders University
Volatile Organic Compound Profiling for Detection of Esophageal Cancer in Exhaled Breath
Endoscopic surveillance for Barrett’s esophagus (BE) is invasive but remains the standard modality for early diagnosis of esophageal adenocarcinoma (EAC) and intervention. Human breath contains an array of volatile organic compounds (VOC) that change in disease conditions. VOC detection provides a potential source of biomarkers for non-invasive, real-time identification of EAC. This study aimed to characterize a VOC-profile applicable to the detection of EAC and to provide pilot data to design a future validation trial.
Ravi Vissapragada  
Australia, Flinders University
Ravi Vissapragada is a general surgical trainee from Adelaide, Australia. He is currently pursuing a Ph.D. from Flinders University. His research interests are in detection of Barrett's Esophagus and Esophageal cancer in Volatile Organic Compounds in exhaled breath and improving cost-effectiveness of endoscopic surveillance of Barrett's Esophagus.
Visualisation of Thoracic Duct During Esophagectomy by Real-Time Fluorescent Imaging - A Technique in Evolution
Subramanyeshwar Rao Thammineedi
India, Basavatarakam Indoamerican Cancer Hospital
Visualisation of Thoracic Duct During Esophagectomy by Real-Time Fluorescent Imaging - A Technique in Evolution
Recognition and repair of thoracic duct and its injury make the management of chyle leak difficult. Traditional methods like lymphoscintigraphy, lymphangiography and preoperative oral cream ingestion to identify the thoracic duct find limited use in intraoperative identification with poor contrast and precision. Near-infrared (NIR) fluorescence by indocyanine green dye (ICG) provides a feasible, real-time imaging of thoracic ductal anatomy during thoracoscopic surgery, thereby potentially reducing injury of thoracic duct.
Subramanyeshwar Rao Thammineedi  
India, Basavatarakam Indoamerican Cancer Hospital
Dr. Subramanyeshwar Rao Thammineedi M.S (Gen. Surgery ), M.Ch(Surgical Oncology Professional positions: Formerly: Professor of Surgical Oncology, Osmania Medical College ,Hyderabad Presently: Director & Chief Surgical Oncologist, Indo-American Cancer Hospital, Hyderabad Organisational positions: Past Secretary – Indian Association of Surgical Oncology Past President - ASI Telangana Vice President - Hyderabad Surgeons Society Chief Patron - Hockey Warangal Author of 84 Publications. Reviewer: Journals in Surgical Oncology, Gynecologic Oncology and Thoracic Oncology
10-Year Follow-Up of a Randomised Controlled Trial Comparing Neoadjuvant Chemoradiotherapy Plus Surgery Versus Surgery Alone for Oesophageal Cancer (CROSS)
Ben Eyck
The Netherlands, Erasmus MC - University Medical Center Rotterdam
10-Year Follow-Up of a Randomised Controlled Trial Comparing Neoadjuvant Chemoradiotherapy Plus Surgery Versus Surgery Alone for Oesophageal Cancer (CROSS)
Neoadjuvant chemoradiotherapy according to the Dutch randomised controlled ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) has become standard of care for patients with cancer of the oesophagus or oesophagogastric junction. The aim of this study was to provide more insight into the ultra-long-term impact of CROSS neoadjuvant chemoradiotherapy on survival and disease recurrence for patients with oesophageal cancer.
Ben Eyck  
The Netherlands, Erasmus MC - University Medical Center Rotterdam
Ben Eyck is MD, PhD student at Dept. of Surgery of the Erasmus MC - University Medical Centre in Rotterdam, the Netherlands. His PhD thesis focuses on neoadjuvant treatment, active surveillance after neoadjuvant treatment, and surgical treatment for esophageal cancer.
Surgical Morbidity and Mortality from The Neoresii Trial: Standard Vs. Prolonged Time to Surgery After Neoadjuvant Chemoradiotherapy For Esophageal Cancer
Klara Nilsson
Sweden, Karolinska University Hospital
Surgical Morbidity and Mortality from The Neoresii Trial: Standard Vs. Prolonged Time to Surgery After Neoadjuvant Chemoradiotherapy For Esophageal Cancer
For carcinoma of the esophagus or esophagogastric junction the time to surgery (TTS) has traditionally been 4-6 weeks after completed neoadjuvant chemoradiotherapy (nCRT). However, the optimal timing is not known. A majority of previous non-randomized studies addressing this issue, have not detected any significant differences in complication rates comparing patients operated with standard TTS compared to prolonged TTS. The aim of this sub-study was to investigate if prolonged TTS after completed nCRT improves postoperative outcomes.
Klara Nilsson  
Sweden, Karolinska University Hospital
Klara Nilsson is a PhD student at Karolinska Institute and 5th year resident in general surgery at Karolinska University Hospital. Her academic work is mainly focused on the timing of surgery after neoadjuvant chemoradiotherapy in the treatment of esophageal cancer.
Chemoradiotherapy Followed by Active Surveillance Versus Surgery for Esophageal Cancer: A Systematic Review and Individual Patient Data Meta-Analysis
Berend van Der Wilk
The Netherlands, Erasmus MC - University Medical Center Rotterdam
Chemoradiotherapy Followed by Active Surveillance Versus Surgery for Esophageal Cancer: A Systematic Review and Individual Patient Data Meta-Analysis
Up to 50% of patients with esophageal cancer have a pathologically complete response after neoadjuvant chemoradiotherapy (nCRT) plus surgery. An active surveillance strategy may be feasible in patients with a complete clinical response (cCR) after nCRT. The aim of this study was to perform a meta-analysis using data of individual patients that underwent active surveillance with surgery for recurrent disease versus standard surgery after nCRT.
Berend van Der Wilk  
The Netherlands, Erasmus MC - University Medical Center Rotterdam
Berend van der Wilk is a PhD candidate at the department of Surgery in Erasmus MC - University Medical Center. He is one of the coordinators of the randomized SANO-trial (Surgery As Needed for Oesophageal cancer). His promotor is Prof. Dr. JJB van Lanschot.
Definitive Chemoradiotherapy Compared to Neoadjuvant Chemoradiotherapy with Esophagectomy for Loco-Regional Esophageal Cancer: National Population-Based Cohort Study
Sivesh Kathir Kamarajah
UK, Royal Victoria Infirmary
Definitive Chemoradiotherapy Compared to Neoadjuvant Chemoradiotherapy with Esophagectomy for Loco-Regional Esophageal Cancer: National Population-Based Cohort Study
Ongoing randomized controlled trials seek to evaluate the potential organ-preservation strategy of definitive chemoradiotherapy as a primary treatment for esophageal cancer. This population-based cohort study aimed to assess survival following definitive chemoradiotherapy (DCR) with or without salvage esophagectomy (SALV) in the treatment of esophageal cancer.
Sivesh Kathir Kamarajah  
UK, Royal Victoria Infirmary
Sivesh Kamarajah is currently an NIHR Academic Clinical Fellow in General Surgery at University Hospital Birmingham NHS Trust. He is currently steering committee member for the Student Audit and Research in Surgery (STARSurg) National Collaborative, the International, multicentre prospective cohort study, Oesophagogastric Anastomosis Audit (OGAA), and the CovidSurg Collaborative.
Length of Hospital Stay and The Association with Readmission After Uncomplicated Esophagectomy. Significant Hospital Variation in The Netherlands
Daan Michiel Voeten
The Netherlands, Amsterdam University Medical Center
Length of Hospital Stay and The Association with Readmission After Uncomplicated Esophagectomy. Significant Hospital Variation in The Netherlands
Prolonged length of hospital stay is a negative outcome of esophageal cancer surgery, not only for the patient; it also leads to increased hospital costs. Within the scope of value-based health care, this study aimed to analyze Dutch hospital performance in terms of length of hospital stay and to investigate its association with readmission rates. Since both parameters are influenced by the occurrence of complications, this study only included patients after an uncomplicated esophagectomy.
Daan Michiel Voeten  
The Netherlands, Amsterdam University Medical Center
Daan M Voeten is a PhD candidate at the Dutch Institute for Clinical Auditing and the Amsterdam University Medical Center under supervision of Prof. Dr. van Berge Henegouwen and Prof. Dr. van Hillegersberg. The main focus of his work is assessment of quality of Dutch surgical upper gastrointestinal care at the Dutch Upper Gastrointestinal Cancer Audit (DUCA).
Multimodal Therapy for Esophageal Cancer – A Surgeon’s Perspective
John Reynolds
Ireland, St. James’s Hospital
Multimodal Therapy for Esophageal Cancer – A Surgeon’s Perspective
John Reynolds  
Ireland, St. James’s Hospital
Professor Reynolds is Professor of Clinical Surgery at the St. James’s Hospital and Trinity College Dublin. He is the National Lead for oesophageal and gastric cancer. He is Cancer Lead at St. James’s Hospital and the Trinity School of Medicine, and a Principal Investigator in the Trinity Translational Medicine Institute. He has formerly held Fellowship positions with the University of Pennsylvania and Wistar Institute in Philadelphia and at the Memorial Sloan-Kettering Cancer Centre in New York. He was a Senior Lecturer at St. James’s University Hospital in Leeds (1994-6). Professor Reynolds has obtained numerous research awards and has published widely in cancer research, with over 250 publications and approximately €5m research grant income. His clinical interest is in diseases of the oesophagus and stomach. His research interest is in four areas: (1) pathogenesis of Barrett’s oesophagus and progression; (2) prediction of response and resistance to chemotherapy and radiation therapy; (3) obesity, altered metabolism, and cancer; (4) malnutrition and peri-operative nutrition.
Speakers
Rob Walker MD
UK, University of Southampton, Southampton General Hospital
Rob Walker is a Cancer Research UK Clinical Research Fellow and esophago-gastric surgical trainee at the University of Southampton, UK. Working under the mentorship of Professor Tim Underwood, he is completing a PhD on the tumor micro-environment in esophageal adenocarcinoma. His research focusses on single cell RNA sequencing to detect rare cell types and interpreting the cell-cell interactions. He has published on both the molecular biology and clinical management of esophageal cancer and was awarded the British Journal of Surgery prize paper at the Association of Upper Gastrointestinal Surgery (AUGIS) congress in 2019 for his research.
Fereshteh Izadi MD
UK, University of Southampton, Southampton General Hospital
Fereshteh Izadi completed a PhD in comparing gene regulatory networks by microarray and RNA-seq in July 2017. Shortly after she started her first postdoctoral job in University College London as a bioinformatician on single cell RNA-seq data analysis. Afterwards she started her second job at University of Southampton working on multi comics data analysis in oesophageal adenocarcinoma.
Ravi Vissapragada MD
Australia, Flinders University
Ravi Vissapragada is a general surgical trainee from Adelaide, Australia. He is currently pursuing a Ph.D. from Flinders University. His research interests are in detection of Barrett's Esophagus and Esophageal cancer in Volatile Organic Compounds in exhaled breath and improving cost-effectiveness of endoscopic surveillance of Barrett's Esophagus.
Subramanyeshwar Rao Thammineedi MD
India, Basavatarakam Indoamerican Cancer Hospital
Dr. Subramanyeshwar Rao Thammineedi M.S (Gen. Surgery ), M.Ch(Surgical Oncology Professional positions: Formerly: Professor of Surgical Oncology, Osmania Medical College ,Hyderabad Presently: Director & Chief Surgical Oncologist, Indo-American Cancer Hospital, Hyderabad Organisational positions: Past Secretary – Indian Association of Surgical Oncology Past President - ASI Telangana Vice President - Hyderabad Surgeons Society Chief Patron - Hockey Warangal Author of 84 Publications. Reviewer: Journals in Surgical Oncology, Gynecologic Oncology and Thoracic Oncology
Ben Eyck MD
The Netherlands, Erasmus MC - University Medical Center Rotterdam
Ben Eyck is MD, PhD student at Dept. of Surgery of the Erasmus MC - University Medical Centre in Rotterdam, the Netherlands. His PhD thesis focuses on neoadjuvant treatment, active surveillance after neoadjuvant treatment, and surgical treatment for esophageal cancer.
Klara Nilsson MD
Sweden, Karolinska University Hospital
Klara Nilsson is a PhD student at Karolinska Institute and 5th year resident in general surgery at Karolinska University Hospital. Her academic work is mainly focused on the timing of surgery after neoadjuvant chemoradiotherapy in the treatment of esophageal cancer.
Berend van Der Wilk MD
The Netherlands, Erasmus MC - University Medical Center Rotterdam
Berend van der Wilk is a PhD candidate at the department of Surgery in Erasmus MC - University Medical Center. He is one of the coordinators of the randomized SANO-trial (Surgery As Needed for Oesophageal cancer). His promotor is Prof. Dr. JJB van Lanschot.
Sivesh Kathir Kamarajah MD
UK, Royal Victoria Infirmary
Sivesh Kamarajah is currently an NIHR Academic Clinical Fellow in General Surgery at University Hospital Birmingham NHS Trust. He is currently steering committee member for the Student Audit and Research in Surgery (STARSurg) National Collaborative, the International, multicentre prospective cohort study, Oesophagogastric Anastomosis Audit (OGAA), and the CovidSurg Collaborative.
Daan Michiel Voeten MD
The Netherlands, Amsterdam University Medical Center
Daan M Voeten is a PhD candidate at the Dutch Institute for Clinical Auditing and the Amsterdam University Medical Center under supervision of Prof. Dr. van Berge Henegouwen and Prof. Dr. van Hillegersberg. The main focus of his work is assessment of quality of Dutch surgical upper gastrointestinal care at the Dutch Upper Gastrointestinal Cancer Audit (DUCA).
John Reynolds MD
Ireland, St. James’s Hospital
Professor Reynolds is Professor of Clinical Surgery at the St. James’s Hospital and Trinity College Dublin. He is the National Lead for oesophageal and gastric cancer. He is Cancer Lead at St. James’s Hospital and the Trinity School of Medicine, and a Principal Investigator in the Trinity Translational Medicine Institute. He has formerly held Fellowship positions with the University of Pennsylvania and Wistar Institute in Philadelphia and at the Memorial Sloan-Kettering Cancer Centre in New York. He was a Senior Lecturer at St. James’s University Hospital in Leeds (1994-6). Professor Reynolds has obtained numerous research awards and has published widely in cancer research, with over 250 publications and approximately €5m research grant income. His clinical interest is in diseases of the oesophagus and stomach. His research interest is in four areas: (1) pathogenesis of Barrett’s oesophagus and progression; (2) prediction of response and resistance to chemotherapy and radiation therapy; (3) obesity, altered metabolism, and cancer; (4) malnutrition and peri-operative nutrition.
Chair / Co-Chair
David Watson MD
Australia, Flinders University
Philip Chiu MD
Hong Kong, The Chinese University of Hong Kong
John Reynolds MD
Ireland, St. James’s Hospital


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