# Soft Tissue Sarcoma (lymph nodes) — GCMD Library living collection Experts: Dr. Todd Ponsky, Dr. Daniel von Allmen, Dr. Rae Hanke, Dr. Peter Ehrlich Updated: n/a · 15 episodes · 426 cited statements ## Episodes ### Foundations - [Topics in 10: Neuroblastoma](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659) — podcast · 10:25 · [machine version](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659.md) - [Topics in 10: Wilms Tumor](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583) — podcast · 12:29 · [machine version](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583.md) ### Surgical Management - [Update Course Rewind: Highlighting Collaboration from Surgery & Interventional Radiology in the OR 2024](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109) — video · 10:20 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109.md) ### Evidence & Research - [Wilms Tumor Protocol Violations: Practice Gap discussion at Update Course 2018](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345) — video · 9:55 · [machine version](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345.md) - [BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323) — video · [machine version](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323.md) - [BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343) — video · 5:05 · [machine version](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343.md) - [Appendectomy vs Right Hemicolectomy for Pediatric Neuroendocrine Tumor of the Appendix](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941) — video · 0:49 · [machine version](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941.md) - [Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056) — video · 1:13 · [machine version](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056.md) ### Case-Based Learning - [Lumps & Bumps: Soft Tissue Masses and Lesions](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628) — video · 67:50 · [machine version](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628.md) - [Neuroblastoma](https://library.globalcastmd.com/watch/neuroblastoma-1620) — podcast · 56:19 · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-1620.md) - [Update Course Rewind: Chest Wall Reconstruction 2024](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839) — video · 5:32 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839.md) ### In-Depth Reviews - [Ovarian Tumors Video Podcast](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979) — podcast · 34:06 · [machine version](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979.md) - [Colon Cancer with Conor Delaney](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443) — podcast · 26:50 · [machine version](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443.md) - [Thyroid Disorders](https://library.globalcastmd.com/watch/thyroid-disorders-302) — podcast · 45:51 · [machine version](https://library.globalcastmd.com/watch/thyroid-disorders-302.md) - [Wilms Tumor: Audio Chapter](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487) — podcast · 64:03 · [machine version](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487.md) ## Chapters - [0:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=0) Introduction and Background (Ep 8) - [2:51](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=171) Initial Evaluation of Thyroid Nodules (Ep 8) - [6:57](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=417) Diagnostic Workup and Imaging (Ep 8) - [11:40](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=700) Surgical Management of Papillary Thyroid Cancer (Ep 8) - [17:40](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1060) Postoperative Management and Risk Stratification (Ep 8) - [22:53](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1373) Management of Follicular Lesions (Ep 8) - [27:53](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1673) Benign Nodules and Medullary Thyroid Cancer Introduction (Ep 8) - [33:32](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2012) Multiple Endocrine Neoplasia Syndromes (Ep 8) - [39:46](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2386) Medullary Cancer Follow-up and Special Considerations (Ep 8) - [44:23](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2663) Closing Remarks (Ep 8) - [0:00](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=0) Introduction and Serrated Polyps (Ep 7) - [3:04](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=184) Rectal Cancer Location and Margins (Ep 7) - [7:00](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=420) Staging and Neoadjuvant Therapy (Ep 7) - [12:47](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=767) Transanal Resection and Local Excision (Ep 7) - [17:18](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1038) Radiation Therapy Options (Ep 7) - [18:56](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1136) Colon Cancer Surgical Technique (Ep 7) - [23:40](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1420) Genetic Assessment and Closing (Ep 7) - [0:11](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=11) Introduction and Background (Ep 11) - [1:54](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=114) Study Design and Patient Cohort (Ep 11) - [3:22](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=202) Results and Outcomes Analysis (Ep 11) - [4:23](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=263) Conclusions and Acknowledgments (Ep 11) - [0:01](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=1) Introduction and Course Classification (Ep 12) - [1:32](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=92) Image Guidance Fundamentals and Hybrid OR (Ep 12) - [3:24](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=204) Program Structure and Cross-Training (Ep 12) - [4:40](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=280) Routine Clinical Applications (Ep 12) - [7:38](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=458) Advanced Applications (Ep 12) - [8:35](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=515) Emerging Technologies and Summary (Ep 12) - [0:00](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=0) Case Presentation: Osteosarcoma with Spinal Involvement (Ep 13) - [1:32](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=92) Surgical Technique and Reconstruction Materials (Ep 13) - [3:38](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=218) Outcomes and Complications (Ep 13) - [4:52](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=292) Summary and Future Directions (Ep 13) - [0:00](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=0) Appendectomy vs Right Hemicolectomy for Pediatric Appendiceal Neuroendocrine Tumors (Ep 14) - [0:00](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=0) ICG for Sentinel Lymph Node Mapping in Pediatric Oncology (Ep 15) - [0:01](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=1) Case Presentation and Audience Polling (Ep 1) - [1:52](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=112) Lymph Node Sampling Requirement and Protocol Differences (Ep 1) - [4:33](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=273) Management of Pulmonary Metastases (Ep 1) - [7:12](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=432) Resolution Criteria and Educational Impact (Ep 1) - [0:00](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=0) Introduction and Pyogenic Granuloma (Ep 2) - [7:42](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=462) Spitz Nevus Management (Ep 2) - [14:37](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=877) Pediatric Melanoma (Ep 2) ## Statements Every statement is attributed, typed, and timestamped; the link is the citation. - "Thyroid nodules are less common in children than adults, but when detected in children they are more likely to be malignant" — Diana Deason (epidemiological) [Ep 8 · 6:23](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=383) - "When children present with thyroid cancer, they are more likely to have extension outside of the thyroid, regional lymph node involvement, and distant metastasis compared to adults" — Diana Deason (clinical) [Ep 8 · 6:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=391) - "Risk factors for thyroid nodules and cancer include previous exposure to radiation or alkylating agents, such as treatment for Hodgkin's lymphoma, leukemia, or CNS tumors" — Diana Deason (clinical) [Ep 8 · 4:08](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=248) - "Thyroid conditions and cancers have familial predisposition including MEN syndromes, PTEN hamartoma tumor syndromes, and APC-associated polyposis syndromes" — Diana Deason (clinical) [Ep 8 · 4:27](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=267) - "Current ATA recommendations state that hyperfunctioning nodules (hot nodules) do not need to be biopsied if they are going to be resected" — Diana Deason (guideline) [Ep 8 · 8:08](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=488) - "Ultrasound features suspicious for thyroid malignancy include hypoechoic mass, irregular margins, increased blood flow, and microcalcifications" — Diana Deason (clinical) [Ep 8 · 9:57](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=597) - "In adults, lesions less than 1 centimeter are not biopsied, but in pediatric patients size cutoffs cannot be used as in adults; ultrasound characteristics and clinical context determine biopsy indication" — Diana Deason (guideline) [Ep 8 · 11:12](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=672) - "Papillary thyroid cancer in children shows bilateral disease in up to 30% of patients and multifocal disease in up to 65% of pediatric patients" — Diana Deason (epidemiological) [Ep 8 · 15:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=900) - "Current recommendations for papillary thyroid cancer are total or near-total thyroidectomy due to risk of bilateral disease, multifocal disease, increased recurrence risk with lobectomy alone, and ability to optimize for radioactive iodine therapy" — Diana Deason (guideline) [Ep 8 · 15:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=900) - "Nerve monitoring is used routinely during thyroidectomy; while it does not decrease risk of nerve injury, it is helpful in identifying the recurrent laryngeal nerve, especially in patients with bulky cervical disease" — Diana Deason (opinion) [Ep 8 · 17:07](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1027) - "There is no evidence to support prophylactic lateral neck dissection in pediatric thyroid cancer" — Diana Deason (guideline) [Ep 8 · 18:33](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1113) - "After total thyroidectomy, PTH level less than 10-15 in recovery indicates higher risk for hypocalcemia and warrants starting calcium replacement or calcitriol" — Diana Deason (clinical) [Ep 8 · 19:37](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1177) - "Low-risk papillary thyroid cancer (disease confined to thyroid with no metastatic lymph nodes) requires only postoperative thyroglobulin monitoring with TSH goal of 0.5-1, ultrasound at 6 months then annually for 5 years, and no radioactive iodine" — Diana Deason (guideline) [Ep 8 · 21:12](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1272) - "Intermediate-risk patients (extensive central neck disease or any lateral neck disease) and high-risk patients (extensive regional disease, local invasion, or distant metastasis) receive radioactive iodine postoperatively" — Diana Deason (guideline) [Ep 8 · 21:48](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1308) - "High-risk papillary thyroid cancer patients have TSH suppression goal of less than 0.1, while low-risk patients have goal of 0.5-1" — Diana Deason (guideline) [Ep 8 · 27:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1651) - "Follicular lesions are indeterminate specimens representing about one-third of FNA results, with three subtypes: follicular lesion of undetermined significance, follicular lesion concerning for neoplasm, and suspicious/suggestive of malignancy with follicular component" — Diana Deason (clinical) [Ep 8 · 23:05](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1385) - "Follicular lesions of undetermined significance have 5-15% malignancy risk in adults but approximately 28% in pediatric literature" — Diana Deason (epidemiological) [Ep 8 · 24:07](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1447) - "Follicular neoplasms have reported malignancy rate of 15-30% but more recent data suggests 50-60% in pediatric patients" — Diana Deason (epidemiological) [Ep 8 · 24:18](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1458) - "Most recent ATA recommendations are that all indeterminate lesions in children be resected due to higher malignancy risk compared to adults" — Diana Deason (guideline) [Ep 8 · 23:50](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1430) - "Frozen section cannot distinguish follicular adenoma from follicular carcinoma but can identify papillary component" — Diana Deason (clinical) [Ep 8 · 25:04](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1504) - "Follicular carcinoma with significant vascular invasion or tumor greater than 4 centimeters requires completion thyroidectomy; minimal vascular invasion with smaller tumor can be monitored" — Diana Deason (guideline) [Ep 8 · 26:10](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1570) - "After lobectomy for benign disease, approximately 30% of patients may develop hypothyroidism at some point, requiring thyroid function monitoring" — Diana Deason (epidemiological) [Ep 8 · 27:01](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1621) - "For thyroid masses greater than 4 centimeters, the sensitivity and specificity of FNA is decreased, requiring careful follow-up even if benign" — Diana Deason (clinical) [Ep 8 · 28:49](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1729) - "Benign FNA results should be followed with repeat ultrasound in 6-12 months with repeat biopsy if the mass is enlarging or develops suspicious features" — Diana Deason (guideline) [Ep 8 · 29:02](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1742) - "Inadequate FNA specimens occur in roughly 1-3% of cases and should be repeated in 3-6 months to avoid picking up atypia from trauma of initial FNA" — Diana Deason (clinical) [Ep 8 · 29:49](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1789) - "Sporadic medullary thyroid cancer is unusual in children, so routine calcitonin monitoring is not recommended for every pediatric patient with a thyroid nodule" — Diana Deason (guideline) [Ep 8 · 31:34](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1894) - "Patients with medullary thyroid cancer and calcitonin level greater than 500 at presentation require imaging to exclude metastatic disease including CT neck, CT chest, MRI or CT abdomen, and possibly bone scan" — Diana Deason (guideline) [Ep 8 · 33:01](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1981) - "MEN 2A patients can develop medullary thyroid cancer, pheochromocytomas, and hyperparathyroidism" — Diana Deason (clinical) [Ep 8 · 33:36](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2016) - "MEN 2B patients can develop medullary thyroid cancer, pheochromocytomas, mucosal neuromas, and Marfanoid habitus with elongated features and joint laxity" — Diana Deason (clinical) [Ep 8 · 33:47](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2027) - "MEN 2B patients with RET 918 mutation present with thyroid cancer very early, in infancy, with reported cases as young as 3 months" — Diana Deason (clinical) [Ep 8 · 34:11](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2051) - "MEN 2B patients with 918 mutation should have thyroidectomy before one year of age" — Diana Deason (guideline) [Ep 8 · 34:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2071) - "De novo RET mutations are more likely to be MEN 2B than 2A" — Diana Deason (epidemiological) [Ep 8 · 35:13](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2113) - "MEN 2A patients are classified as high-risk or moderate-risk based on specific RET codon mutations, with different timing recommendations for prophylactic thyroidectomy" — Diana Deason (guideline) [Ep 8 · 35:42](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2142) - "MEN 2A high-risk patients (most commonly RET 634 mutation) should have total thyroidectomy before age 5, with surveillance starting at age 3 including calcitonin, CEA, and ultrasounds" — Diana Deason (guideline) [Ep 8 · 36:03](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2163) - "If calcitonin levels exceed 40 in MEN 2A surveillance, central neck dissection is recommended at time of thyroidectomy" — Diana Deason (guideline) [Ep 8 · 36:27](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2187) - "Children under age 10 have increased risk of complications from thyroidectomy including hypoparathyroidism and nerve injury due to smaller anatomy" — Diana Deason (clinical) [Ep 8 · 36:36](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2196) - "MEN 2A moderate-risk patients have thyroidectomy when serum calcitonin becomes elevated or if parents decline frequent surveillance" — Diana Deason (guideline) [Ep 8 · 36:59](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2219) - "MEN 2A high-risk patients begin pheochromocytoma screening at age 11; moderate-risk patients begin at age 16" — Diana Deason (guideline) [Ep 8 · 37:55](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2275) - "Central lymph node dissection for medullary thyroid cancer is not necessary if prophylactic thyroidectomy is performed before calcitonin levels exceed 40" — Diana Deason (guideline) [Ep 8 · 39:03](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2343) - "After medullary thyroid cancer surgery, if calcitonin levels are greater than 150, imaging is needed to detect metastasis including CT neck, CT chest, MRI or CT abdomen, bone scan, and MRI of pelvis and axial skeleton" — Diana Deason (guideline) [Ep 8 · 40:22](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2422) - "Systemic therapy for medullary thyroid cancer (tyrosine kinase inhibitors and external beam radiation) has significant side effects and is reserved for progressive disease not treatable with surgery, not used routinely for elevated calcitonin alone" — Diana Deason (guideline) [Ep 8 · 41:38](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2498) - "In young children with Graves' disease, surgery is often preferred over radioactive iodine due to concerns about risks of secondary malignancies from radioactive iodine" — Diana Deason (opinion) [Ep 8 · 42:29](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2549) - "Diffuse infiltration of the thyroid (rather than discrete nodule) is a characteristic of papillary thyroid cancer that is more common in children and should prompt biopsy especially if suspicious lymph nodes are present" — Diana Deason (clinical) [Ep 8 · 43:52](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2632) - "Colonoscopy is still the best test for colon cancer detection, finding the vast majority of cancers and polyps, though not perfect" — Conor Delaney (clinical) [Ep 7 · 1:16](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=76) - "Serrated adenomas have good evidence of genetic predisposition and may tie into family cancer syndromes" — Conor Delaney (clinical) [Ep 7 · 2:31](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=151) - "Serrated polyps have a really high risk of cancer" — Conor Delaney (clinical) [Ep 7 · 2:38](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=158) - "Serrated adenomas are often flat and difficult to see, requiring retroflection in the cecum to visualize them on folds or around the ileocecal valve" — Conor Delaney (clinical) [Ep 7 · 3:27](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=207) - "For rectal resection, distal margin should be 5 centimeters if possible, 2 centimeters if achievable, and for very lowest tumors perhaps 1 centimeter as long as they are not poorly differentiated" — Conor Delaney (clinical) [Ep 7 · 6:13](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=373) - "Historical local recurrence rates for rectal cancer from good institutions were 20 to 38% and some up to 50%" — Conor Delaney (epidemiological) [Ep 7 · 10:51](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=651) - "Current local recurrence rates for rectal cancer should be under 10%, and at Cleveland Clinic over the last 10 years it was about 3%" — Conor Delaney (epidemiological) [Ep 7 · 11:04](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=664) - "Total mesorectal excision can be performed with about 5 mL of blood loss because it is a bloodless plane" — Conor Delaney (clinical) [Ep 7 · 12:24](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=744) - "Most accepted guidelines for neoadjuvant therapy are for tumors that are T3 (outside the wall of the rectum) or node positive" — Conor Delaney (guideline) [Ep 7 · 12:54](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=774) - "MRI is probably 90 to mid-90s percent accurate at T-staging and probably high 80s to 90% accurate for nodal staging" — Conor Delaney (clinical) [Ep 7 · 13:37](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=817) - "Endoscopic ultrasound is much more operator dependent and is probably only 70% accurate for predicting nodal involvement" — Conor Delaney (clinical) [Ep 7 · 13:56](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=836) - "Historical local recurrence rates for transanally excised rectal cancers was about 18%, remarkably consistent across outcome data from several big centers" — Conor Delaney (epidemiological) [Ep 7 · 14:51](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=891) - "For rectal cancer, if doing transanal resection it must be full thickness excision, never an ESD-type procedure" — Conor Delaney (clinical) [Ep 7 · 16:24](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=984) - "In Europe, short-course radiation is 5×5 gray given over 5 days with surgery 1-2 weeks later" — Conor Delaney (clinical) [Ep 7 · 18:04](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1084) - "In the US, long-course radiation is 40-45 gray given with chemotherapy over 6 weeks with a 6-8 week waiting period before surgery" — Conor Delaney (clinical) [Ep 7 · 18:12](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1092) - "25 gray over a short period is radiotherapeutically equivalent to 40-45 gray over a longer period" — Conor Delaney (clinical) [Ep 7 · 18:26](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1106) - "For colon cancer, at least 12 lymph nodes should be harvested, though many surgeons hope for at least 16" — Conor Delaney (clinical) [Ep 7 · 19:51](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1191) - "Total mesocolic excision should be performed with 5 mL of blood loss in the plane between embryological peritoneum of retroperitoneum (Toldt's fascia) and embryological peritoneum on mesocolon" — Conor Delaney (clinical) [Ep 7 · 20:21](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1221) - "Scandinavian data showed local recurrence rates for colon cancer were even higher than rectal cancer rates (high 20s%) because adequate colon cancer surgery technique was not being performed" — Conor Delaney (epidemiological) [Ep 7 · 20:48](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1248) - "For cecal lesions, 10 centimeters of small bowel should be taken; for mid-ascending colon, 5 centimeters should be taken" — Conor Delaney (clinical) [Ep 7 · 23:12](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1392) - "Extracorporeal stapled anastomosis for right colectomy has reported leak rates of 0.8% over 1000 cases" — Conor Delaney (epidemiological) [Ep 7 · 24:00](https://library.globalcastmd.com/watch/colon-cancer-with-conor-delaney-3443?t=1440) - "Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old" — Steven Scoville (epidemiological) [Ep 11 · 0:26](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=26) - "Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults" — Steven Scoville (clinical) [Ep 11 · 0:33](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=33) - "Childhood melanoma has unique disease mechanisms compared to adult melanoma" — Steven Scoville (clinical) [Ep 11 · 0:42](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=42) - "Management of pediatric melanoma is based on adult studies" — Steven Scoville (guideline) [Ep 11 · 0:44](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=44) - "Melanoma management is largely based on depth of the tumor and presence of metastatic disease" — Steven Scoville (guideline) [Ep 11 · 0:49](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=49) - "Tumors less than 8 millimeters thick are largely managed with wide local excision" — Steven Scoville (guideline) [Ep 11 · 0:55](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=55) - "Tumors greater than or equal to 8 millimeters or less than 8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies" — Steven Scoville (guideline) [Ep 11 · 1:07](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=67) - "Completion lymph node dissection has a high risk of morbidity" — Steven Scoville (clinical) [Ep 11 · 1:20](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=80) - "Two adult trials (DCOG SLT and MSLT2) showed no significant difference in outcomes for low to intermediate risk patients with positive sentinel lymph node biopsies who were followed with ultrasound observation versus completion lymph node dissections" — Steven Scoville (guideline) [Ep 11 · 1:29](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=89) - "There is no pediatric data to support ultrasound observation versus completion lymph node dissection" — Steven Scoville (epidemiological) [Ep 11 · 1:47](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=107) - "The study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions through PSORC" — Steven Scoville (epidemiological) [Ep 11 · 1:54](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=114) - "Race was predominantly white in the study cohort, consistent with prior literature" — Steven Scoville (epidemiological) [Ep 11 · 2:10](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=130) - "Breslow depth ranged from tumor in situ to 20 millimeters with a median of 2.55 millimeters" — Steven Scoville (epidemiological) [Ep 11 · 2:21](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=141) - "Extent of disease was nearly split between localized and regionalized disease" — Steven Scoville (epidemiological) [Ep 11 · 2:21](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=141) - "Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph nodes (approximately 51%)" — Steven Scoville (epidemiological) [Ep 11 · 2:40](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=160) - "Patients who underwent completion lymph node dissection were significantly older than those who underwent ultrasound observation" — Steven Scoville (epidemiological) [Ep 11 · 3:22](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=202) - "Patients who underwent completion lymph node dissection were more likely to receive adjuvant therapy" — Steven Scoville (epidemiological) [Ep 11 · 3:22](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=202) - "There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups" — Steven Scoville (clinical) [Ep 11 · 3:34](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=214) - "Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group" — Steven Scoville (clinical) [Ep 11 · 3:41](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=221) - "Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease" — Steven Scoville (clinical) [Ep 11 · 3:52](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=232) - "Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden" — Steven Scoville (clinical) [Ep 11 · 4:01](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=241) - "Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death" — Steven Scoville (clinical) [Ep 11 · 4:11](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=251) - "Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate" — Steven Scoville (epidemiological) [Ep 11 · 4:23](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=263) - "Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease" — Steven Scoville (clinical) [Ep 11 · 4:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=270) - "Findings of additional nodal disease in completion lymph node dissection did not significantly correlate with recurrence" — Steven Scoville (clinical) [Ep 11 · 4:38](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=278) - "Recurrence most strongly associated with positive sentinel lymph node biopsies and deeper Breslow depth" — Steven Scoville (clinical) [Ep 11 · 4:47](https://library.globalcastmd.com/watch/bob-ped-surg-2023-steven-scoville-ipso-presentation-6343?t=287) - "The 12th annual update course in pediatric surgery was held in August 2024" — Em Gootee (clinical) [Ep 12 · 0:13](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=13) - "Image-guided surgery session classifies as blue square for promising newer practice" — Em Gootee (guideline) [Ep 12 · 0:56](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=56) - "Image-guided surgery uses real-time imaging including CT, MRI, ultrasound, or fluoroscopy to provide detailed views of internal structures" — Em Gootee (clinical) [Ep 12 · 1:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=75) - "Surgeons may not know what is possible with image guidance so they don't know what to ask for" — Em Gootee (opinion) [Ep 12 · 1:39](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=99) - "Interventional radiologists may not know what surgeons need so they might not know what to offer" — John Ricardo (opinion) [Ep 12 · 1:44](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=104) - "A hybrid operating room is not required for image-guided surgery collaboration" — Timothy Lotz (clinical) [Ep 12 · 2:17](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=137) - "Image-guided collaboration can occur in regular OR by bringing an ultrasound machine, in a hybrid OR, or in dual settings using CT scanner for localization then moving to OR" — Timothy Lotz (clinical) [Ep 12 · 2:23](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=143) - "Cone beam CT is a CT scan performed on a C-arm fluoroscopy unit that rotates around the patient collecting multiple images which are stacked together" — Amanda Bellingford (clinical) [Ep 12 · 2:45](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=165) - "Cone beam CT provides excellent visualization of bony structures making it valuable for maxillofacial, ENT, spine, and orthopedic surgeries" — Em Gootee (clinical) [Ep 12 · 2:59](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=179) - "Many institutions have cone beam CT technology available and don't realize it even if not in a hybrid OR space" — Timothy Lotz (opinion) [Ep 12 · 3:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=195) - "Cincinnati Children's hybrid OR has been open for about 7 years" — John Ricardo (clinical) [Ep 12 · 3:28](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=208) - "Interventional radiologists at Cincinnati Children's help train pediatric surgery fellows including guidance for vascular access" — Em Gootee (clinical) [Ep 12 · 3:36](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=216) - "Having a program manager as liaison between surgeons and interventional radiologists is important because nobody wants to try something new if it will be more complicated and take longer than normal practice" — Amanda Bellingford (opinion) [Ep 12 · 3:54](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=234) - "Leadership engagement from both surgery and radiology chiefs has helped the collaborative program" — Amanda Bellingford (opinion) [Ep 12 · 4:11](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=251) - "The hybrid OR at Cincinnati is used by multiple divisions including urology, neurosurgery, pulmonary, and gynecology for collaborative cases with multiple procedures" — Amanda Bellingford (clinical) [Ep 12 · 4:24](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=264) - "For lymph node localization of difficult-to-palpate supraclavicular nodes, ultrasound guidance with Kopans needle wire can be used in one prep and drape" — Timothy Lotz (clinical) [Ep 12 · 4:44](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=284) - "Ultrasound in OR can localize foreign bodies like glass, and IR colleagues should be called before air introduction makes things virtually invisible" — John Ricardo (clinical) [Ep 12 · 5:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=315) - "During neuroblastoma excisions, ultrasound can be used every 5 minutes to identify celiac artery takeoff while dissecting along the aorta" — Timothy Lotz (clinical) [Ep 12 · 5:40](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=340) - "Ultrasound can confirm vessel patency at end of case including renal flow after challenging neuroblastoma excision where renal hilum has been skeletonized" — Timothy Lotz (clinical) [Ep 12 · 5:52](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=352) - "Pulmonary nodule localization can be done with wire, coil, or dye depending on institutional preference" — Timothy Lotz (clinical) [Ep 12 · 6:19](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=379) - "At one institution, CT-guided coil placement by IR is followed by fluoroscopy in OR under two orthogonal planes to localize and remove pulmonary nodules" — Timothy Lotz (clinical) [Ep 12 · 6:35](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=395) - "Coil approach for pulmonary nodule localization avoids risk of wire displacement" — Timothy Lotz (clinical) [Ep 12 · 6:56](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=416) - "At Cincinnati Children's, pulmonary nodule localization uses methylene blue blood patch with cone beam CT in thoracoscopy position, tattooing visceral pleura with Kopans needle then deploying Kopans wire" — John Ricardo (clinical) [Ep 12 · 7:14](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=434) - "Vascular malformations are often managed in multidisciplinary VLC clinic with IR offering sclerotherapy and surgeons offering resection" — Timothy Lotz (clinical) [Ep 12 · 7:38](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=458) - "For vascular malformations not amenable to sclerotherapy, IR can do angiogram with direct contrast injection and glue placement to ensure complete resection of outpouchings" — Timothy Lotz (clinical) [Ep 12 · 7:52](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=472) - "For transbronchial biopsies, cone beam CT with 3D anatomy segmentation taking about 1 minute allows live fluoroscopy to be superimposed over nodule in AP and lateral views" — John Ricardo (clinical) [Ep 12 · 8:20](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=500) - "Augmented reality uses holographic display superimposed over patient on table by taking pre-procedure CT or MRI imaging, segmenting it out, and co-registering it to the patient" — John Ricardo (clinical) [Ep 12 · 8:46](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=526) - "The institution has about 10 years of experience with chest wall reconstructions" — Margaret Mutch (clinical) [Ep 13 · 0:16](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=16) - "Patient presented with back pain and difficulty walking" — Lizzie Lee (clinical) [Ep 13 · 0:25](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=25) - "Examination revealed incomplete cord injury with absent lower limb reflexes and altered motor and sensation below T6" — Margaret Mutch (clinical) [Ep 13 · 0:27](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=27) - "Tumor arose from 6th rib and extended into spinal canal" — Lizzie Lee (clinical) [Ep 13 · 0:36](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=36) - "Patient underwent emergency posterior laminectomy and partial tumor debulking for cord decompression between T3 and T7" — Margaret Mutch (clinical) [Ep 13 · 0:42](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=42) - "Histopathology confirmed aggressive osteosarcoma" — Lizzie Lee (clinical) [Ep 13 · 0:51](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=51) - "PET scan showed PET avid lesion on right side next to sternum" — Margaret Mutch (clinical) [Ep 13 · 1:04](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=64) - "Radio guided occult lesion localization using technetium 99 was performed" — Lizzie Lee (clinical) [Ep 13 · 1:12](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=72) - "Anterior thoracotomy removed lesion that confirmed aggressive osteosarcoma replacing lymph node" — Margaret Mutch (clinical) [Ep 13 · 1:17](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=77) - "Most reconstruction needs to be tailored to individual needs, location and size of defects" — Margaret Mutch (opinion) [Ep 13 · 1:32](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=92) - "There is lack of clear evidence-based guidelines for reconstructive materials" — Lizzie Lee (guideline) [Ep 13 · 1:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=105) - "Priority is long-term durability, aesthetics, function, and accommodating future growth" — Lizzie Lee (opinion) [Ep 13 · 1:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=105) - "Most literature on chest wall reconstruction comes from adults" — Margaret Mutch (epidemiological) [Ep 13 · 1:55](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=115) - "Spinal surgeons removed all vertebral bodies between T4 and T7 and inserted a cage" — Margaret Mutch (clinical) [Ep 13 · 2:06](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=126) - "Thoracic team resected ribs 4 to 7" — Margaret Mutch (clinical) [Ep 13 · 2:06](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=126) - "Initial mapping showed right lower lobe nodules that were resected during surgery" — Lizzie Lee (clinical) [Ep 13 · 2:21](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=141) - "During surgery, tumor thrombus was found in azygos extending into SVC" — Margaret Mutch (clinical) [Ep 13 · 2:28](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=148) - "Gore-Tex soft tissue patch was placed" — Lizzie Lee (clinical) [Ep 13 · 2:34](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=154) - "Team tends to use resorbable and biosynthetic materials for reconstruction" — Margaret Mutch (clinical) [Ep 13 · 2:44](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=164) - "Two systems used in Australia: one by Stryker and one by KLS with resorbable plates" — Margaret Mutch (clinical) [Ep 13 · 2:51](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=171) - "K-wire drill used to drill through remaining ribs instead of packaged screws" — Lizzie Lee (clinical) [Ep 13 · 3:05](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=185) - "Proline sutures used to secure the implant" — Lizzie Lee (clinical) [Ep 13 · 3:11](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=191) - "Permacol placed on top of implant, followed by latissimus dorsi pedicled flap to cover Permacol" — Margaret Mutch (clinical) [Ep 13 · 3:14](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=194) - "Permacol is a porcine dermal collagen matrix surgical implant" — Lizzie Lee (clinical) [Ep 13 · 3:29](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=209) - "Delta plates or sonic weld system are polylactide and polyglycolide and polydactide plates" — Margaret Mutch (clinical) [Ep 13 · 3:37](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=217) - "Resorbable plates have strength of 78% at 2 months and 50% at 6 months" — Margaret Mutch (clinical) [Ep 13 · 3:47](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=227) - "Patient had relapse 18 months following surgery close to sternum" — Margaret Mutch (clinical) [Ep 13 · 4:05](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=245) - "Further chest wall reconstruction excised entire sternum, costochondrocartilages, and anterior ribs, replaced with cement mesh" — Lizzie Lee (clinical) [Ep 13 · 4:12](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=252) - "Patient currently having adjuvant chemotherapy" — Margaret Mutch (clinical) [Ep 13 · 4:22](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=262) - "One patient had early postoperative wound infection treated with IV antibiotics" — Margaret Mutch (clinical) [Ep 13 · 4:31](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=271) - "Two patients had sterile seromas in early stages, one at 2 months and one at 8 months" — Margaret Mutch (clinical) [Ep 13 · 4:36](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=276) - "Both seroma patients were treated with IR drainage" — Lizzie Lee (clinical) [Ep 13 · 4:42](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=282) - "One case of minor scoliosis on follow-up being followed by spinal team, has not needed intervention so far" — Lizzie Lee (clinical) [Ep 13 · 4:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=285) - "Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions" — Lizzie Lee (opinion) [Ep 13 · 5:17](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=317) - "The speaker is affiliated with Cincinnati Children's Hospital" — Lizzie Lee (clinical) [Ep 14 · 0:06](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=6) - "Traditionally, children with neuroendocrine appendix tumors have been treated the same way as adults with right hemicolectomy" — Lizzie Lee (clinical) [Ep 14 · 0:10](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=10) - "A new national study examined over 1,300 children with neuroendocrine appendix tumors" — Lizzie Lee (epidemiological) [Ep 14 · 0:19](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=19) - "Survival rates were approximately 99% whether patients had appendectomy or right hemicolectomy, even with larger tumors or positive margins" — Lizzie Lee (clinical) [Ep 14 · 0:24](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=24) - "For pediatric patients, appendectomy alone is safe and effective for neuroendocrine tumors of the appendix" — Lizzie Lee (opinion) [Ep 14 · 0:35](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=35) - "Appendectomy avoids putting pediatric patients through a much bigger operation with no added survival benefit compared to right hemicolectomy" — Lizzie Lee (opinion) [Ep 14 · 0:35](https://library.globalcastmd.com/watch/appendectomy-vs-right-hemicolectomy-for-pediatric-neuroendocrine-tumor-of-the-appendix-10941?t=35) - "The study was a multi-center prospective study conducted by PeaceOC evaluating indocyanine green (ICG) for identifying sentinel lymph nodes in pediatric patients with skin and soft tissue malignancies" — Sophia Schermerhorn (clinical) [Ep 15 · 0:05](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=5) - "Peritumoral injection of ICG demonstrated almost 80% sensitivity for detecting a sentinel node" — Sophia Schermerhorn (clinical) [Ep 15 · 0:21](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=21) - "All sentinel nodes that contained malignancy were ICG avid" — Sophia Schermerhorn (clinical) [Ep 15 · 0:28](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=28) - "ICG diagnostic performance is similar to smaller pediatric studies previously evaluating ICG and sentinel lymph node biopsy" — Sophia Schermerhorn (clinical) [Ep 15 · 0:33](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=33) - "ICG may outperform blue dye localization based on previously reported literature" — Sophia Schermerhorn (opinion) [Ep 15 · 0:33](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=33) - "The study did not directly compare the effectiveness of ICG to blue dye localization" — Sophia Schermerhorn (clinical) [Ep 15 · 0:45](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=45) - "ICG in most cases was used in conjunction with standard localization techniques such as technetium" — Sophia Schermerhorn (clinical) [Ep 15 · 0:49](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=49) - "No adverse reactions to ICG were identified within 30 days of surgery" — Sophia Schermerhorn (clinical) [Ep 15 · 0:58](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=58) - "Blue dye can cause permanent tattooing" — Sophia Schermerhorn (clinical) [Ep 15 · 1:02](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=62) - "ICG has a favorable safety profile and lacks the permanent tattooing associated with blue dye, making it an attractive visualization adjunct for pediatric sentinel lymph node biopsy" — Sophia Schermerhorn (opinion) [Ep 15 · 1:02](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=62) - "When doing a nephrectomy for Wilms tumor, lymph nodes must be sampled according to protocols" (guideline) [Ep 1 · 1:54](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=114) - "If lymph nodes are not documented as histologically negative, they are assumed to be positive, which bumps up the stage and requires increased chemotherapy" (guideline) [Ep 1 · 2:01](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=121) - "Failure to sample lymph nodes during Wilms nephrectomy is an identified practice gap by the Cancer Committee and COG publications" (epidemiological) [Ep 1 · 2:19](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=139) - "The management approach is based on US protocols as opposed to European SIOP protocols" (guideline) [Ep 1 · 2:30](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=150) - "In Hong Kong, they tend to go with the American protocol for Wilms tumor but use either European or American protocols for various other tumors" — Ken Wong (clinical) [Ep 1 · 3:23](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=203) - "Just because you have metastatic disease in the lung doesn't mean you shouldn't treat the primary with a nephrectomy" (guideline) [Ep 1 · 4:07](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=247) - "Primary nephrectomy changes whether or not the patient will get radiation therapy" (clinical) [Ep 1 · 4:20](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=260) - "There is a local stage for Wilms tumor and a patient staging for Wilms tumor" (clinical) [Ep 1 · 4:26](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=266) - "On the ACS pediatric surgery blog, overwhelmingly the presence of lymph node mets meant people did biopsy and chemotherapy, which is incorrect" (epidemiological) [Ep 1 · 4:33](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=273) - "Regardless of pulmonary metastatic disease, if you think you have a primary that can come out without removing other organs, you should do that because it decreases radiation therapy" (guideline) [Ep 1 · 4:44](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=284) - "The child will get metastatic stage 4 chemotherapy no matter what, but biopsy counts as local spillage and requires radiation therapy to the flank or abdomen" (clinical) [Ep 1 · 5:04](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=304) - "You should treat local disease differently than systemic disease" (guideline) [Ep 1 · 5:17](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=317) - "Whether to biopsy lung masses depends on how many are present; with multiple lesions, a correct assumption of metastatic disease can be made" (clinical) [Ep 1 · 5:20](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=320) - "Oncologists want measurable disease to see if it responds to chemotherapy" (clinical) [Ep 1 · 5:45](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=345) - "If you treat the patient and lung nodules go away, you presume that is metastatic disease; if there is a residual nodule after treatment, that is an indication to resect it" — Dan (clinical) [Ep 1 · 6:03](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=363) - "Previously, if a nodule wasn't present on plain film, it didn't matter even if seen on CT, but now CT is the diagnostic test of choice and impacts therapy" — Dan (clinical) [Ep 1 · 6:24](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=384) - "For single nodules, patients are treated and if the nodule resolves, it is presumed to be metastatic Wilms tumor" — Dan (clinical) [Ep 1 · 6:41](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=401) - "There are radiographic criteria for single nodules; if it looks like a met you treat it, if it doesn't look like a met you can biopsy it to prove it's not a met and avoid chemotherapy" (clinical) [Ep 1 · 6:54](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=414) - "What you avoid with nodule resolution is radiation therapy to the lungs, not chemotherapy" — Dan (clinical) [Ep 1 · 7:12](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=432) - "If after 6 weeks lung nodules have resolved regardless of number, there is no radiation to the lungs" — Dan (clinical) [Ep 1 · 7:18](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=438) - "To avoid radiation, lung nodules have to disappear; if there is a residual nodule you don't know if it's scar or active tumor and have to biopsy" — Dan (clinical) [Ep 1 · 7:43](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=463) - "Nodules have to resolve to avoid radiation therapy" — Dan (clinical) [Ep 1 · 7:58](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=478) - "In SIOP protocols, they do a percutaneous biopsy of the tumor and treat with chemotherapy" (guideline) [Ep 1 · 8:01](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=481) - "APSA has addressed the lymph node sampling practice gap through expert questions, educational efforts at annual meetings, and the American College of Surgeons registry has seen improvement with fewer patients getting nephrectomies without lymph node sampling" (epidemiological) [Ep 1 · 9:29](https://library.globalcastmd.com/watch/wilms-tumor-protocol-violations-practice-gap-discussion-at-update-course-2018-345?t=569) - "Pyogenic granuloma has lowest recurrence rate with surgical resection at about 3% with gross negative margins" — Danielle Walsh (clinical) [Ep 2 · 4:47](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=287) - "Shave excision with curettage of pyogenic granuloma has about 9.5% recurrence rate" — Danielle Walsh (clinical) [Ep 2 · 5:04](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=304) - "Silver nitrate treatment of pyogenic granuloma has 15% recurrence rate, the highest among treatment options" — Danielle Walsh (clinical) [Ep 2 · 5:20](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=320) - "Retinoid medications for acne are significantly associated with development of pyogenic granulomas in teenagers" — Danielle Walsh (clinical) [Ep 2 · 4:14](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=254) - "80% of characteristic Spitz nevi involute spontaneously" — Danielle Walsh (clinical) [Ep 2 · 8:28](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=508) - "Half of pediatric dermatologists would observe classic Spitz nevi without excision" — Danielle Walsh (clinical) [Ep 2 · 8:44](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=524) - "In a series of 30 patients with incompletely removed Spitz nevi, 24 were observed and none recurred" — Danielle Walsh (clinical) [Ep 2 · 9:43](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=583) - "With 1-3 millimeter margins for Spitz nevi, 20% were still positive on re-excision" — Danielle Walsh (clinical) [Ep 2 · 10:23](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=623) - "About one-third of Spitz nevi cases had nodal micrometastases on sentinel lymph node biopsy" — Danielle Walsh (clinical) [Ep 2 · 11:56](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=716) - "39% of Spitz nevi had positive sentinel lymph node biopsies, but all remained disease-free at 3-year follow-up without further treatment" — Danielle Walsh (clinical) [Ep 2 · 12:18](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=738) - "Pediatric melanoma ABCDE criteria only capture 40% of cases in children under 10 and 60% in children over 11" — Danielle Walsh (clinical) [Ep 2 · 18:28](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1108) - "Melanoma margins: in situ lesions need 5mm, 1mm thick or less need 1cm, 1.1-2mm need 1-2cm, over 2mm need 2cm" — Danielle Walsh (guideline) [Ep 2 · 19:35](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1175) - "Cochrane review suggests 2 centimeter margins are adequate for thick melanomas, not 4 centimeters" — Danielle Walsh (guideline) [Ep 2 · 19:50](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1190) - "Giant congenital nevi have 8% melanoma risk, higher if hairy, with 60% developing melanoma in first decade" — Danielle Walsh (epidemiological) [Ep 2 · 20:12](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1212) - "Pediatric melanoma has higher metastatic rate to lymph nodes at about 25%, especially in children younger than 10 and with thicker lesions" — Danielle Walsh (epidemiological) [Ep 2 · 20:35](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1235) - "If sentinel node is negative in melanoma, probability of subsequent recurrence is only about 5%" — Danielle Walsh (clinical) [Ep 2 · 21:02](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1262) - "Acute unilateral cervical lymphadenopathy is mostly bacterial, likely strep and staph" — Danielle Walsh (clinical) [Ep 2 · 30:57](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1857) - "Acute bilateral cervical lymphadenopathy is usually viral" — Danielle Walsh (clinical) [Ep 2 · 31:20](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1880) - "Chronic subacute unilateral lymphadenopathy suggests atypical mycobacteria, Bartonella, or tuberculosis" — Danielle Walsh (clinical) [Ep 2 · 31:30](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1890) - "Lymphadenopathy may persist for 6 to 8 weeks after antibiotic treatment" — Danielle Walsh (clinical) [Ep 2 · 32:43](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=1963) - "FNA for lymph nodes has about 90% sensitivity and specificity but has higher false negative rate in Hodgkin lymphoma" — Danielle Walsh (clinical) [Ep 2 · 34:58](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=2098) - "Malignancy rate in cervical lymph node biopsies ranges from 10-80% depending on referral patterns and specialty" — Danielle Walsh (epidemiological) [Ep 2 · 35:39](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=2139) - "In randomized multicenter trial, surgery for atypical mycobacteria had 96% cure rate versus 66% for antibiotics alone" — Danielle Walsh (clinical) [Ep 2 · 38:31](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=2311) - "In study of 45 patients with mycobacterial lymphadenitis started on antibiotics, 30 resolved without surgery" — Danielle Walsh (clinical) [Ep 2 · 39:08](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=2348) - "Atypical mycobacteria is not considered contagious and children do not need to be kept out of school or daycare" — Danielle Walsh (clinical) [Ep 2 · 38:07](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=2287) - "Neonatal breast mastitis peaks at 2-4 weeks of age and is mostly staph, though gram negatives are reported" — Danielle Walsh (epidemiological) [Ep 2 · 50:46](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3046) - "In two small series, 2 of 5 and 2 of 7 infants who had I&D for breast mastitis developed breast deformity" — Danielle Walsh (clinical) [Ep 2 · 52:39](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3159) - "Fibroadenomas are the most common breast lesion in patients under age 20" — Danielle Walsh (epidemiological) [Ep 2 · 63:11](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3791) - "10-15% of fibroadenomas are multiple and 10% are bilateral" — Danielle Walsh (epidemiological) [Ep 2 · 63:20](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3800) - "Fibroadenomas typically increase in size over 6-12 months then stabilize and can regress completely" — Danielle Walsh (clinical) [Ep 2 · 63:31](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3811) - "Simple fibroadenomas have no increased cancer risk if no family history and no abnormality in adjacent breast tissue" — Danielle Walsh (clinical) [Ep 2 · 65:57](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3957) - "Complex fibroadenomas with cysts, calcifications, or abnormal surrounding tissue have slight increased risk of breast cancer up to 20 years later" — Danielle Walsh (clinical) [Ep 2 · 66:14](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3974) - "Juvenile fibroadenomas greater than 5 centimeters are difficult to distinguish from cystosarcoma phyllodes even on percutaneous biopsy" — Danielle Walsh (clinical) [Ep 2 · 65:14](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=3914) - "Malignant breast disease in pediatric population is more commonly metastatic from other lesions than primary breast tumor" — Danielle Walsh (clinical) [Ep 2 · 66:42](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=4002) - "Lymphoma patients treated with chest radiation at young ages have up to 25% higher incidence of malignant breast disease" — Danielle Walsh (epidemiological) [Ep 2 · 66:53](https://library.globalcastmd.com/watch/lumps-bumps-soft-tissue-masses-and-lesions-628?t=4013) - "Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old" — Stephen Scoville (epidemiological) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults" — Stephen Scoville (clinical) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Management of pediatric melanoma is based on adult studies despite differences in disease mechanisms" — Stephen Scoville (clinical) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Tumors less than 8 millimeters thick are largely managed with wide local excision" — Stephen Scoville (guideline) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Tumors greater than or equal to 8 millimeters or less than 8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies" — Stephen Scoville (guideline) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Two adult trials (Decog SLT and MSLT2) showed no significant difference in outcomes for patients with positive sentinel lymph node biopsies followed with ultrasound observation versus completion lymph node dissections" — Stephen Scoville (clinical) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "There is no pediatric data to support ultrasound observation versus completion lymph node dissection" — Stephen Scoville (clinical) [Ep 10 · 3:01](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=181) - "Study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions" — Stephen Scoville (clinical) [Ep 10 · 4:10](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=250) - "Breslow depth ranged from 2 millimeters to 20 millimeters with a median of 2.55 millimeters" — Stephen Scoville (clinical) [Ep 10 · 4:10](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=250) - "Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph node biopsies (approximately 51%)" — Stephen Scoville (clinical) [Ep 10 · 5:20](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=320) - "Patients who underwent completion lymph node dissection were significantly older and more likely to receive adjuvant therapy" — Stephen Scoville (clinical) [Ep 10 · 6:30](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=390) - "There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups" — Stephen Scoville (clinical) [Ep 10 · 6:30](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=390) - "Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group" — Stephen Scoville (clinical) [Ep 10 · 7:30](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=450) - "Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease" — Stephen Scoville (clinical) [Ep 10 · 7:30](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=450) - "Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden" — Stephen Scoville (clinical) [Ep 10 · 7:30](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=450) - "Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death" — Stephen Scoville (clinical) [Ep 10 · 8:00](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=480) - "Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate" — Stephen Scoville (clinical) [Ep 10 · 8:31](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=511) - "Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease" — Stephen Scoville (clinical) [Ep 10 · 8:31](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=511) - "Before the Decog and MSLT2 trials, there was a much higher rate of completion lymph node dissection in children, and after those trials the rate has gone down but is still higher than in adults" — Stephen Scoville (clinical) [Ep 10 · 9:15](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=555) - "For most children with positive sentinel lymph nodes, observation is appropriate without moving forward with completion lymph node dissection" — Stephen Scoville (opinion) [Ep 10 · 9:15](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=555) - "Not all patients with positive sentinel lymph nodes receive adjuvant therapy; decision depends on genetic makeup of melanoma and overall risk factors including tumor size" — Stephen Scoville (clinical) [Ep 10 · 10:45](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=645) - "If a lymph node becomes clinically positive during ultrasound surveillance, the likely approach would be to move forward with systemic therapy rather than completion lymph node dissection" — Stephen Scoville (opinion) [Ep 10 · 11:46](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-ipso-winner-steven-scoville-md-6323?t=706) - "In North America, the preferred approach for resectable renal tumors is primary nephrectomy and ureterectomy with lymph node sampling" — Peter Ehrlich (guideline) [Ep 9 · 6:23](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=383) - "Preoperative chemotherapy is recommended if tumor extends into IVC beyond the infrahepatic vena cava" — Peter Ehrlich (guideline) [Ep 9 · 7:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=453) - "Wilms tumors tend to push structures out of the way rather than growing around them, unlike neuroblastoma" — Peter Ehrlich (clinical) [Ep 9 · 4:16](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=256) - "The claw sign on CT scan—normal kidney displaced into horseshoe pattern with tumor in the center—is classic for Wilms tumor" — Peter Ehrlich (clinical) [Ep 9 · 3:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=229) - "Tumors between 13-15 centimeters or larger have higher risk of rupture and may warrant preoperative chemotherapy" — Peter Ehrlich (clinical) [Ep 9 · 14:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=873) - "Core needle biopsy should include 10-20 cores to increase diagnostic accuracy; fine needle aspiration cannot diagnose anaplasia" — Peter Ehrlich (guideline) [Ep 9 · 18:03](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1083) - "Stage 1 and 2 Wilms tumor patients receive only two-drug chemotherapy (vincristine and dactinomycin) for 19 weeks without radiation" — Peter Ehrlich (guideline) [Ep 9 · 20:36](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1236) - "Stage 3 patients receive three-drug chemotherapy (adding doxorubicin) plus abdominal radiation" — Peter Ehrlich (guideline) [Ep 9 · 20:28](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1228) - "A patient with lung metastases but stage 1-2 abdominal disease does not require abdominal radiation if primary tumor is completely resected with negative lymph nodes" — Peter Ehrlich (clinical) [Ep 9 · 24:15](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1455) - "Approximately 40% of patients with pulmonary metastases achieve complete response by 6 weeks of chemotherapy and can avoid pulmonary radiation" — Peter Ehrlich (clinical) [Ep 9 · 26:44](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1604) - "Fifteen percent of girls who receive pulmonary radiation for Wilms tumor develop breast cancer as a late effect" — Peter Ehrlich (epidemiological) [Ep 9 · 26:08](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1568) - "The main late effects of Wilms tumor treatment are renal failure, second malignancies, pregnancy complications, hypertension, and cardiovascular disease, primarily from radiation and doxorubicin" — Peter Ehrlich (clinical) [Ep 9 · 23:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1417) - "Loss of heterozygosity at both 1p and 16q occurs in 5-7% of patients and predicts 10% lower survival in stage 1-2 and 18% lower survival in stage 3-4" — Peter Ehrlich (clinical) [Ep 9 · 54:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3281) - "Patients with tumors less than 550g, stage 1, favorable histology, and age under 2 years can be treated with surgery alone with greater than 95% survival" — Peter Ehrlich (clinical) [Ep 9 · 43:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2621) - "IVC tumor thrombus extension is not a negative prognostic factor if completely resected" — Peter Ehrlich (clinical) [Ep 9 · 46:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2774) - "Major complication rate for tumors extending beyond infrahepatic IVC operated upfront is 26-30% with documented mortality" — Peter Ehrlich (clinical) [Ep 9 · 48:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2929) - "Bilateral Wilms tumor occurs in 8-10% of cases with historically lower survival: 61% event-free and 80% overall compared to 88% and 95% for unilateral disease" — Peter Ehrlich (epidemiological) [Ep 9 · 58:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3531) - "Maximum tumor response to chemotherapy typically occurs by 12 weeks, with early response at 6 weeks predicting late response" — Peter Ehrlich (clinical) [Ep 9 · 59:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3577) - "In bilateral Wilms tumor, there is discordant pathology between kidneys in up to 20% of cases" — Peter Ehrlich (clinical) [Ep 9 · 62:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3734) - "SIOP protocols use preoperative chemotherapy for all patients with post-treatment staging based on blastemal predominance" — Peter Ehrlich (guideline) [Ep 9 · 30:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1831) - "Lymph node positivity is the main prognostic factor in stage 3 disease" — Peter Ehrlich (clinical) [Ep 9 · 32:45](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1965) - "Acquired von Willebrand disease occurs in Wilms tumor patients and may rarely cause significant intraoperative bleeding" — Peter Ehrlich (clinical) [Ep 9 · 35:11](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2111) - "Minimum lymph node sampling should be 5-6 nodes, though more than one may be better based on secondary evidence" — Peter Ehrlich (guideline) [Ep 9 · 39:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2389) - "Taking a rim of adherent diaphragm or liver capsule to avoid tumor violation does not upstage the tumor if the tumor itself is not divided" — Peter Ehrlich (clinical) [Ep 9 · 42:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2551) - "Positive surgical margins automatically make a tumor stage 3" — Peter Ehrlich (guideline) [Ep 9 · 41:24](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2484) - "Favorable histology Wilms tumor has three components: blastemal, stromal, and epithelial; tumors with only two components are still considered favorable" — Peter Ehrlich (clinical) [Ep 9 · 52:52](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3172) - "In COG protocols, the amount of blastema in favorable histology tumors has never correlated with outcome" — Peter Ehrlich (clinical) [Ep 9 · 53:13](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3193) - "Stage 2 patients receive vincristine and dactinomycin for 19 weeks; stage 3 patients receive DD4A regimen (adding doxorubicin) for 25 weeks" — Peter Ehrlich (guideline) [Ep 9 · 53:56](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3236) - "Renal cell carcinoma is the second most common renal tumor in children, with no effective therapy for metastatic disease" — Peter Ehrlich (clinical) [Ep 9 · 56:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3411) - "Rhabdoid tumors have terrible outcomes except for stage 1; most present at stage 3 or 4" — Peter Ehrlich (clinical) [Ep 9 · 57:27](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3447) - "Wilms tumor is the second most common intra-abdominal tumor in children and fifth most common tumor in children overall" — Rae Hanke (epidemiological) [Ep 4 · 0:00](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=0) - "Approximately 75% of Wilms tumor cases occur in children younger than 5 years of age, with peak incidence at 2 to 3 years of age" — Andrew Davidoff (epidemiological) [Ep 4 · 0:28](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=28) - "Survival for patients with Wilms tumor when considered as a whole is currently greater than 90%" — Andrew Davidoff (epidemiological) [Ep 4 · 0:28](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=28) - "Anaplastic histology comprises only about 10% of Wilms tumor cases but contributes to over 50% of Wilms tumor mortality" — Andrew Davidoff (epidemiological) [Ep 4 · 0:28](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=28) - "Children with Wilms tumor typically present with an asymptomatic abdominal mass" — Andrew Davidoff (clinical) [Ep 4 · 1:20](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=80) - "Associated signs and symptoms such as malaise, pain, microscopic or gross hematuria are found in only about 25% of children with Wilms tumor, as is hypertension" — Andrew Davidoff (clinical) [Ep 4 · 1:20](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=80) - "The workup of a child with suspected Wilms tumor usually begins with ultrasound" — Andrew Davidoff (guideline) [Ep 4 · 1:46](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=106) - "CT of the abdomen and pelvis is generally the definitive imaging study of choice for patients suspected of having a renal tumor based on ultrasound" — Andrew Davidoff (guideline) [Ep 4 · 1:46](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=106) - "Intravascular tumor extension occurs in about 6% of Wilms tumor cases" — Andrew Davidoff (epidemiological) [Ep 4 · 1:46](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=106) - "The most common site of metastatic spread of Wilms tumor is the lungs" — Andrew Davidoff (clinical) [Ep 4 · 2:44](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=164) - "A chest CT should be included in the initial evaluation of a child suspected of having a Wilms tumor" — Andrew Davidoff (guideline) [Ep 4 · 2:44](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=164) - "Localized Wilms tumors that are confined within the renal capsule are stage 1" — Andrew Davidoff (guideline) [Ep 4 · 2:59](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=179) - "Wilms tumors that penetrate the renal capsule but are resected with negative margins are stage 2" — Andrew Davidoff (guideline) [Ep 4 · 2:59](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=179) - "Stage 3 Wilms tumor includes circumstances such as biopsy or rupture (preoperative or intraoperative), positive resection margin or gross residual disease, lymph node involvement, or administration of preoperative chemotherapy" — Andrew Davidoff (guideline) [Ep 4 · 2:59](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=179) - "Metastatic disease occurs in about 12% of Wilms tumor patients and is considered stage 4" — Andrew Davidoff (epidemiological) [Ep 4 · 2:59](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=179) - "Patients with synchronous bilateral Wilms tumor are stage 5" — Andrew Davidoff (guideline) [Ep 4 · 2:59](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=179) - "For unilateral tumors, upfront resection with regional lymph node sampling is currently the recommendation from the Children's Oncology Group" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Most Wilms tumors are resectable at presentation because even large tumors rarely invade surrounding structures" — Andrew Davidoff (clinical) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Failure to perform upfront resection and instead administering neoadjuvant chemotherapy in COG results in classification as stage 3, mandating flank irradiation and doxorubicin, each associated with significant long-term toxicities" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Treatment of favorable histology Wilms tumor stage 1 or 2 is limited to vincristine and actinomycin D" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "In rare circumstances when tumor is stage 1, weighs less than 550 grams (tumor plus kidney), and patient is less than 2 years of age, no adjuvant chemotherapy is given" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "The presence of nodal involvement is associated with an increased incidence of tumor relapse and a poorer prognosis" — Andrew Davidoff (clinical) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Lymph node sampling should be performed even in the absence of abnormal nodes on preoperative imaging or gross inspection during operative exploration, since these circumstances don't reliably predict lymph node negativity" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Partial nephrectomy for patients with unilateral non-syndromic disease and laparoscopic nephrectomy are not currently standard of care and should generally only be performed in the context of a clinical trial" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "Anaplastic histology is associated with significantly worse outcome and is treated with more intensive chemotherapy" — Andrew Davidoff (clinical) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "A distinction is made between focal and diffuse anaplasia when determining specific adjuvant therapy" — Andrew Davidoff (guideline) [Ep 4 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=246) - "About 5% of children with Wilms tumor will present with synchronous bilateral disease or stage 5 disease" — Andrew Davidoff (epidemiological) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "Patients with bilateral Wilms tumor receive neoadjuvant chemotherapy with three drugs to shrink tumors prior to surgery and facilitate preservation of normal renal parenchyma due to increased risk of renal failure" — Andrew Davidoff (guideline) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "A biopsy is not required in children with bilateral solid renal masses as bilateral Wilms tumor is the very likely diagnosis" — Andrew Davidoff (guideline) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "Biopsies of bilateral renal masses rarely detect anaplasia even when it does exist in the tumor mass" — Andrew Davidoff (clinical) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "A biopsy in bilateral disease doesn't mandate subsequent radiation as it does in patients with unilateral Wilms tumor" — Andrew Davidoff (guideline) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "Bilateral nephron-sparing surgery should be considered in all patients with bilateral Wilms tumor and should be performed after either 6 or 12 weeks of neoadjuvant chemotherapy" — Andrew Davidoff (guideline) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "Longer courses of preoperative chemotherapy than 6 or 12 weeks are definitely discouraged in bilateral Wilms tumor" — Andrew Davidoff (guideline) [Ep 4 · 6:53](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=413) - "Tumor extension into the renal vein and proximal inferior vena cava can in most cases be removed en bloc with the kidney and tumor" — Andrew Davidoff (clinical) [Ep 4 · 8:42](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=522) - "Primary resection of tumors with extension above the level of the hepatic veins or into the atrium is associated with higher operative morbidity, so neoadjuvant chemotherapy is generally used in these circumstances" — Andrew Davidoff (guideline) [Ep 4 · 8:42](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=522) - "Thrombus extending above the hepatic veins that persists after neoadjuvant chemotherapy probably requires cardiopulmonary bypass to safely remove the full extent of disease" — Andrew Davidoff (guideline) [Ep 4 · 8:42](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=522) - "About 12% of Wilms tumor patients will have evidence of hematogenous metastases at diagnosis with 80% of these being pulmonary metastases" — Andrew Davidoff (epidemiological) [Ep 4 · 9:58](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=598) - "A new response-based approach is being used for patients with stage 4 disease in the Children's Oncology Group" — Andrew Davidoff (guideline) [Ep 4 · 9:58](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=598) - "Stage 4 patients treated with three-drug chemotherapy who have radiographic disappearance of lung metastases or tissue confirmation that residual nodules don't contain viable tumor at week 6 are considered rapid responders and won't receive pulmonary irradiation" — Andrew Davidoff (guideline) [Ep 4 · 9:58](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=598) - "Patients who don't have complete resolution of pulmonary nodules at 6 weeks are considered slow or incomplete responders, will be switched to more intensive chemotherapy regimen, and will receive whole lung irradiation" — Andrew Davidoff (guideline) [Ep 4 · 10:47](https://library.globalcastmd.com/watch/topics-in-10-wilms-tumor-1583?t=647) - "Neuroblastoma is the most common extracranial solid tumor in children" — Rae Hanke (epidemiological) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=0) - "The majority of neuroblastoma cases occur in children less than a year old" — Rae Hanke (epidemiological) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=0) - "Younger patients are often picked up prenatally on ultrasound or as a solid abdominal mass in two- or three-year-olds" — Daniel von Allmen (clinical) [Ep 3 · 0:41](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=41) - "Patients with metastatic disease may present with bony pain or neurologic symptoms from cord compression" — Daniel von Allmen (clinical) [Ep 3 · 0:41](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=41) - "Catecholamines (urine or serum) are one of the most diagnostic laboratory tests for neuroblastoma" — Daniel von Allmen (clinical) [Ep 3 · 1:07](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=67) - "Cross-sectional imaging (CT or MRI) is obtained after initial ultrasound and laboratory workup" — Daniel von Allmen (clinical) [Ep 3 · 1:39](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=99) - "MIBG study is helpful for confirming neuroblastoma diagnosis and demonstrating metastatic disease" — Daniel von Allmen (clinical) [Ep 3 · 1:39](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=99) - "About 10% of neuroblastomas are MIBG negative" — Daniel von Allmen (clinical) [Ep 3 · 2:20](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=140) - "Some centers obtain a PET scan for MIBG-negative cases to look for tumor uptake and metastatic disease" — Daniel von Allmen (clinical) [Ep 3 · 2:20](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=140) - "The INRGSS staging system allows stage assignment before any invasive procedure" — Daniel von Allmen (guideline) [Ep 3 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165) - "Localized tumors without image-defined risk factors are categorized as L1" — Daniel von Allmen (guideline) [Ep 3 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165) - "Localized tumors with image-defined risk factors (encasing nerves or vessels) are L2" — Daniel von Allmen (guideline) [Ep 3 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165) - "Tumors with metastatic disease are categorized as M" — Daniel von Allmen (guideline) [Ep 3 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165) - "MS category is for children less than 18 months with metastases to bone marrow or skin" — Daniel von Allmen (guideline) [Ep 3 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165) - "The INRGSS was created to allow studies from different centers and countries to be compared based on pre-surgical staging" — Daniel von Allmen (guideline) [Ep 3 · 3:36](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=216) - "The prior staging system required tissue diagnosis before assigning a stage" — Daniel von Allmen (guideline) [Ep 3 · 3:36](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=216) - "A patient with a resectable adrenal mass and positive MIBG without metastases can be treated with primary resection via laparotomy or laparoscopy" — Daniel von Allmen (clinical) [Ep 3 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=246) - "For large central abdominal tumors that encase major vasculature, only tissue for diagnosis is needed via open biopsy, laparoscopic biopsy, or core needle biopsy" — Daniel von Allmen (clinical) [Ep 3 · 4:44](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=284) - "NMIC status is the most important biologic risk determinant from biopsy tissue" — Daniel von Allmen (clinical) [Ep 3 · 5:14](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=314) - "1P and 11Q deletions should be assessed in biopsy tissue along with Shimada histology" — Daniel von Allmen (clinical) [Ep 3 · 5:14](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=314) - "Neuroblastoma risk categories are very low risk, low risk, intermediate risk, or high risk" — Daniel von Allmen (guideline) [Ep 3 · 5:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=345) - "Risk distribution is approximately 50-50 between low risk categories and high risk, with a smaller percentage intermediate risk" — Daniel von Allmen (epidemiological) [Ep 3 · 5:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=345) - "NMIC amplification and age greater than 18 months are the most important prognostic determinants for neuroblastoma" — Daniel von Allmen (clinical) [Ep 3 · 6:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=366) - "High-risk patients receive aggressive chemotherapy including peripheral stem cell transplant times 2, aggressive surgery with >90% resection goal, radiation, immunotherapy, and potentially retinoic acid therapy" — Daniel von Allmen (guideline) [Ep 3 · 6:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=366) - "Intermediate risk tumors receive varying cycles of chemotherapy based on biologic risk factors" — Daniel von Allmen (guideline) [Ep 3 · 6:51](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=411) - "For intermediate risk tumors, the surgical goal is at least 50% response from initial primary tumor volume combining neoadjuvant chemotherapy and surgical resection" — Daniel von Allmen (guideline) [Ep 3 · 6:51](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=411) - "Low risk patients, depending on age and diagnosis timing, could be followed with observation alone" — Daniel von Allmen (guideline) [Ep 3 · 7:22](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=442) - "A Children's Oncology Group study led by Jed Nocturne showed patients less than six months with prenatally or early postnatally diagnosed localized mass can be observed with expectation that most will avoid surgery" — Daniel von Allmen (guideline) [Ep 3 · 7:22](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=442) - "Patients with metastatic disease typically receive four or five cycles of neoadjuvant chemotherapy and are then reassessed" — Daniel von Allmen (guideline) [Ep 3 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475) - "If metastatic disease is responding to chemotherapy, the primary tumor site should be resected with attempted >90% resection" — Daniel von Allmen (guideline) [Ep 3 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475) - "If metastatic disease is progressing on chemotherapy, surgery is not indicated" — Daniel von Allmen (guideline) [Ep 3 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475) - "MS disease is for patients less than 18 months with primary site and metastases to liver, skin, or bone marrow (specifically not cortical bone)" — Daniel von Allmen (guideline) [Ep 3 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475) - "MS disease patients can be managed with simple observation; treatment is only elected if they progress or develop complications like respiratory issues from enlarging liver mass" — Daniel von Allmen (guideline) [Ep 3 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475) - "Skin lesions in MS disease can be biopsied to provide diagnosis" — Daniel von Allmen (clinical) [Ep 3 · 8:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=535) - "Ovarian tumors are more common in pediatric surgery than Wilms tumor or neuroblastoma, though most are not malignant" — Frederick Rescorla (epidemiological) [Ep 6 · 2:00](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=120) - "Approximately 10% or less of pediatric ovarian tumors are malignant" — Frederick Rescorla (epidemiological) [Ep 6 · 5:03](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=303) - "Among malignant ovarian tumors in children, germ cell tumors predominate at greater than 50% and in some series up to 80%" — Frederick Rescorla (epidemiological) [Ep 6 · 5:15](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=315) - "In benign ovarian tumors, mature teratoma comprises at least half of cases and immature teratoma accounts for 10-15%" — Frederick Rescorla (epidemiological) [Ep 6 · 5:35](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=335) - "Predominantly cystic ovarian masses have approximately 3-4% malignancy risk" — Frederick Rescorla (clinical) [Ep 6 · 4:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=250) - "Heterogeneous ovarian masses have 15-20% malignancy risk" — Frederick Rescorla (clinical) [Ep 6 · 4:25](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=265) - "Solid ovarian masses have over 25% malignancy risk" — Frederick Rescorla (clinical) [Ep 6 · 4:35](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=275) - "Alpha-fetoprotein (AFP) is the primary tumor marker for ovarian masses in young children; HCG is unlikely to be elevated in this age group" — Frederick Rescorla (clinical) [Ep 6 · 3:25](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=205) - "In a COG study of stage 3 ovarian tumors, 5 out of 20 cases were stage 3 only because peritoneal fluid was positive for malignant cells" — Frederick Rescorla (clinical) [Ep 6 · 8:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=490) - "The six-step oncologic operation for ovarian tumors includes: peritoneal washings, tumor removal, contralateral ovary inspection (biopsy only if abnormal), omental assessment (remove only if adherent), peritoneal cavity assessment, and retroperitoneal lymph node palpation" — Frederick Rescorla (guideline) [Ep 6 · 10:40](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=640) - "Contralateral ovary biopsy is now recommended only if the ovary appears abnormal, not routinely" — Frederick Rescorla (guideline) [Ep 6 · 10:50](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=650) - "Lymph node dissection is not required; only enlarged nodes should be sampled" — Frederick Rescorla (guideline) [Ep 6 · 11:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=670) - "For large predominantly cystic masses with normal markers, the malignancy risk is much less than 1%" — Frederick Rescorla (clinical) [Ep 6 · 15:50](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=950) - "Laparoscopic decompression and cystectomy is appropriate for large purely cystic masses with normal markers" — Frederick Rescorla (opinion) [Ep 6 · 16:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=970) - "Stage 1 ovarian germ cell tumors (confined to ovary) have 96% overall survival" — Frederick Rescorla (clinical) [Ep 6 · 30:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1810) - "Stage 1 ovarian germ cell tumors managed with observation alone have approximately 50% relapse rate but nearly 100% salvage rate with chemotherapy" — Frederick Rescorla (clinical) [Ep 6 · 30:25](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1825) - "Stage 2 and 3 ovarian germ cell tumors treated with chemotherapy have 97% survival" — Frederick Rescorla (clinical) [Ep 6 · 30:55](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1855) - "Stage 4 ovarian germ cell tumors have 80% overall survival, but this breaks down to 92% for patients under 11 years and 60% for patients over 11 years" — Frederick Rescorla (clinical) [Ep 6 · 31:10](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1870) - "Chemotherapy for malignant ovarian germ cell tumors consists of platinum, etoposide, and bleomycin" — Frederick Rescorla (clinical) [Ep 6 · 24:16](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1456) - "There is no role for radiation therapy in pediatric ovarian germ cell tumors" — Frederick Rescorla (guideline) [Ep 6 · 24:15](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1455) - "For solid ovarian masses with elevated AFP, chest CT is required for staging in addition to abdominal imaging" — Frederick Rescorla (guideline) [Ep 6 · 20:53](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1253) - "If malignant ovarian tumor is amenable to resection and confined to the ovary, upfront surgery is preferred to achieve potential stage 1 status and avoid chemotherapy" — Frederick Rescorla (opinion) [Ep 6 · 20:00](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1200) - "Fallopian tube preservation during oophorectomy for malignancy is optional; it should be preserved if not adherent to tumor but can be removed if encased" — Frederick Rescorla (opinion) [Ep 6 · 21:42](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1302) - "Omental biopsy is not required unless the omentum is adherent to the tumor or appears abnormal" — Frederick Rescorla (guideline) [Ep 6 · 23:37](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1417) - "Ovarian cryopreservation is not currently standard practice before chemotherapy for pediatric ovarian tumors but may become more common in the future" — Frederick Rescorla (opinion) [Ep 6 · 24:32](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1472) - "For ovarian torsion, detorsion alone is the standard approach; oophoropexy is recommended for pre-menarchal girls or patients with history of prior torsion of the same ovary" — Frederick Rescorla (guideline) [Ep 6 · 27:00](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1620) - "A study in Fertility and Sterility Journal demonstrated that pre-menarchal girls have higher risk of ovarian torsion" — Frederick Rescorla (clinical) [Ep 6 · 27:00](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1620) - "For torsed ovary with suspected teratoma, detorsion followed by delayed definitive surgery after imaging and marker evaluation is preferred over acute oophorectomy" — Frederick Rescorla (opinion) [Ep 6 · 28:31](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1711) - "Black, torsed ovaries should not be removed; detorsion should be performed" — Frederick Rescorla (opinion) [Ep 6 · 32:25](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1945) - "Ovarian preservation should be performed for all cystic or mixed cystic-solid masses; complete oophorectomy is reserved only for solid malignant tumors" — Frederick Rescorla (guideline) [Ep 6 · 32:44](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1964) - "Pediatric surgeons have improved ovarian preservation rates over the past 20 years, but retrospective analysis shows many tumors were removed where functional ovary could have been preserved" — Frederick Rescorla (opinion) [Ep 6 · 2:20](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=140) - "Partial oophorectomy technique involves scoring the ovarian capsule around the tumor and enucleating the mass, often leaving a thin rim of ovarian tissue" — Frederick Rescorla (clinical) [Ep 6 · 13:34](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=814) - "The glued bag technique for tumor decompression involves using Indermil or Durban to glue a plastic bag directly onto the tumor surface, creating a sealed interface for aspiration" — Frederick Rescorla (clinical) [Ep 6 · 9:20](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=560) - "Pediatric ovarian germ cell tumors are very chemo-responsive, unlike adult epithelial ovarian carcinomas" — Frederick Rescorla (clinical) [Ep 6 · 23:20](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1400) - "Modern CT scans are highly effective at detecting retroperitoneal lymph node involvement and distant metastases in ovarian tumors" — Frederick Rescorla (clinical) [Ep 6 · 22:30](https://library.globalcastmd.com/watch/ovarian-tumors-video-podcast-1979?t=1350) - "Adrenal hemorrhage is the most common prenatal suprarenal mass, more common with history of fetal stress" — Daniel von Allmen (clinical) [Ep 5 · 2:00](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=120) - "Familial neuroblastoma occurs in about 1% of patients" — Tony Sandler (epidemiological) [Ep 5 · 3:27](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=207) - "The GetNucturne study showed that many prenatally diagnosed neuroblastomas can be safely observed without surgery" — Daniel von Allmen (clinical) [Ep 5 · 7:24](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=444) - "Of 84 prenatally diagnosed cases observed in the GetNucturne study, 16 (about 20%) underwent resection, with 98% event-free survival and 100% overall survival" — Tony Sandler (clinical) [Ep 5 · 9:09](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=549) - "Surveillance for prenatally diagnosed neuroblastoma is intensive in the first year with ultrasound and urine catecholamines at birth, 3 weeks, 6 weeks, 12 weeks, then spacing out" — Erika Newman (guideline) [Ep 5 · 9:58](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=598) - "A case occurred where a prenatally diagnosed adrenal mass resolved but the child presented at age 3 with widely metastatic high-risk neuroblastoma" — Daniel von Allmen (clinical) [Ep 5 · 10:23](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=623) - "Five centimeters is used as a size threshold for considering surgical resection of observed neuroblastoma" — Tony Sandler (opinion) [Ep 5 · 12:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=751) - "A 50% increase in tumor volume or 50% increase in urine VMA or HVA prompts consideration of surgery" — Erika Newman (guideline) [Ep 5 · 13:20](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=800) - "Lymph node status in neuroblastoma is not as important for changing therapy as it is in Wilms tumor" — Daniel von Allmen (clinical) [Ep 5 · 14:21](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=861) - "Stage MS (formerly 4S) neuroblastoma with liver metastases can cause respiratory compromise from mass effect" — Erika Newman (clinical) [Ep 5 · 15:14](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=914) - "Stage MS neuroblastoma can be treated with aggressive observation, chemotherapy, radiation, or emergent decompressive laparotomy if respiratory compromise occurs" — Erika Newman (clinical) [Ep 5 · 15:42](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=942) - "Classic findings of stage MS include high urine catecholamines, blue blebs on skin, liver metastases, and adrenal mass" — Tony Sandler (clinical) [Ep 5 · 16:32](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=992) - "NMYC amplification in stage MS changes classification from MS to M (stage 4) and makes it high-risk" — Erika Newman (clinical) [Ep 5 · 17:32](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1052) - "Ten percent of neuroblastomas are not MIBG-avid and might be detected by PET scan" — Daniel von Allmen (clinical) [Ep 5 · 22:12](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1332) - "Open biopsy allows adequate tissue for NMYC amplification, ALK mutation, and ploidy studies" — Tony Sandler (clinical) [Ep 5 · 23:50](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1430) - "Approximately half of children's hospitals use percutaneous biopsy for suspected neuroblastoma" — Erika Newman (epidemiological) [Ep 5 · 26:56](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1616) - "Percutaneous biopsy is equivalent to open biopsy for diagnosis, high versus low risk determination, and NMYC amplification, but falls short for determining 11q loss of heterozygosity" — Erika Newman (clinical) [Ep 5 · 28:10](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1690) - "Optimizing percutaneous biopsy requires 10-12 cores, higher gauge needle, and pathologist performing frozen section to confirm viable tumor" — Erika Newman (clinical) [Ep 5 · 29:10](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1750) - "Open biopsy patients had higher risk of blood transfusion, higher narcotic use, and more hospital admissions compared to percutaneous biopsy" — Erika Newman (clinical) [Ep 5 · 30:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1817) - "NMYC amplification automatically makes neuroblastoma high-risk regardless of other factors" — Tony Sandler (clinical) [Ep 5 · 31:38](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1898) - "Loss of heterozygosity at 11q is the most common segmental chromosomal alteration and can bump NMYC non-amplified patients to high or intermediate risk" — Erika Newman (clinical) [Ep 5 · 33:49](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2029) - "Age cutoff for risk stratification is now 18 months rather than 12 months" — Tony Sandler (guideline) [Ep 5 · 35:25](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2125) - "High-risk neuroblastoma patients require double lumen external central line for bone marrow transplant" — Erika Newman (clinical) [Ep 5 · 37:20](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2240) - "Stem cell harvesting for high-risk neuroblastoma is usually after the second cycle of chemotherapy" — Tony Sandler (clinical) [Ep 5 · 45:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2731) - "Optimal timing for surgical resection is after cycle 3-4 of induction chemotherapy" — Erika Newman (opinion) [Ep 5 · 41:49](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2509) - "Tumor volume does not significantly decrease after cycle 2-3 of chemotherapy" — Daniel von Allmen (clinical) [Ep 5 · 43:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2597) - "After 5-6 cycles of chemotherapy, tumors become more fibrotic and harder to resect" — Erika Newman (clinical) [Ep 5 · 43:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2597) - "Goal of surgery is greater than 90% tumor resection based on COG study showing improved event-free survival" — Daniel von Allmen (clinical) [Ep 5 · 44:04](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2644) - "European neuroblastoma group study of nearly 1000 cases showed >90% resection improved both event-free and overall survival" — Daniel von Allmen (clinical) [Ep 5 · 45:28](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2728) - "About 70% of patients can achieve greater than 90% resection" — Daniel von Allmen (epidemiological) [Ep 5 · 45:28](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2728) - "High-risk neuroblastoma responds well to chemotherapy due to high proliferative rate" — Tony Sandler (clinical) [Ep 5 · 45:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2731) - "Recent German/European publication stated that amount of local disease resection does not make a difference in outcome" — Tony Sandler (clinical) [Ep 5 · 46:00](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2760) - "Patients with high-risk neuroblastoma die of systemic metastatic disease, not local disease" — Tony Sandler (clinical) [Ep 5 · 46:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2800) - "Good local control is achieved with combination of radiation and aggressive surgery" — Daniel von Allmen (clinical) [Ep 5 · 47:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2860) - "There is zero correlation between surgeon's operative note description of resection extent and post-operative imaging findings" — Daniel von Allmen (clinical) [Ep 5 · 52:19](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3139) - "Surgeons frequently overestimate the amount of tumor resection achieved" — Daniel von Allmen (opinion) [Ep 5 · 52:19](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3139) - "Nephrectomy should be avoided in neuroblastoma surgery because it requires reduction of chemotherapy doses" — Tony Sandler (clinical) [Ep 5 · 53:13](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3193) - "Monoclonal antibody against ganglioside GD2 improved two-year survival in high-risk neuroblastoma from 46% to 60%" — Tony Sandler (clinical) [Ep 5 · 53:44](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3224) - "Checkpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor" — Tony Sandler (clinical) [Ep 5 · 54:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3280) ## Changelog - Aug 31: 29 doctors auto-found from episode dossiers - Aug 30: 20 doctors auto-found from episode dossiers - Aug 30: 13 doctors auto-found from episode dossiers - Aug 30: Members-only episodes removed from this collection - Aug 29: 19 doctors auto-found from episode dossiers - Aug 29: 19 doctors auto-found from episode dossiers - Aug 29: Collection generated from campaign corpus: 16 items, 8 dossiers, summaries for 4 audience(s) - Aug 29: Collection reviewed and published - Aug 29: Collection generated from campaign corpus: 10 items, 8 dossiers, summaries for 1 audience(s) - Aug 29: Collection generated from campaign corpus: 10 items, 8 dossiers, summaries for 3 audience(s) --- Educational content from recorded physician discussions — not medical advice. 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