when I was a fellow, I was that if it's black, you take it out and now what we're learning from some of our GYN colleagues is that many of these black colored ovaries are actually do have follicles in them that are viable
when I was a fellow, I was that if it's black, you take it out and now what we're learning from some of our GYN colleagues is that many of these black colored ovaries are actually do have follicles in them that are viable
quotemost ovarian masses are gonna be teratomas, of course, 80% of them↗
▶Ep 3 · 1:25
epidemiological80% of ovarian masses are teratomas↗
▶Ep 3 · 1:25
epidemiological80% of ovarian masses are teratomas↗
▶Ep 3 · 1:25
quotemost ovarian masses are gonna be teratomas, of course, 80% of them↗
▶Ep 3 · 1:50
epidemiologicalIn the year 2000, girls with ovarian germ cell tumors have almost 100% survival↗
▶Ep 3 · 1:50
quotein the year 2000, the girls have almost 100% survival↗
▶Ep 3 · 1:50
quotein the year 2000, the girls have almost 100% survival↗
▶Ep 3 · 1:50
epidemiologicalIn the year 2000, girls with ovarian germ cell tumors have almost 100% survival↗
▶Ep 3 · 2:14
quoteovarian tumors are limited to the ovary. We used to give, uh, chemotherapy for some of those. Now those are only limited to the ovary. Do not receive chemotherapy, but only oophorectomy.↗
▶Ep 3 · 2:14
guidelineStage one ovarian tumors limited to the ovary now receive only oophorectomy without chemotherapy↗
▶Ep 3 · 2:14
guidelineStage one ovarian tumors limited to the ovary now receive only oophorectomy without chemotherapy↗
▶Ep 3 · 2:14
quoteovarian tumors are limited to the ovary. We used to give, uh, chemotherapy for some of those. Now those are only limited to the ovary. Do not receive chemotherapy, but only oophorectomy.↗
▶Ep 3 · 2:26
guidelineMicroscopic residual and lymph node involvement in ovarian tumors require chemotherapy↗
▶Ep 3 · 2:26
guidelineMicroscopic residual and lymph node involvement in ovarian tumors require chemotherapy↗
▶Ep 3 · 3:16
epidemiological25% of girls with ovarian germ cell tumors will be missed if peritoneal cytology and washings are not performed↗
▶Ep 3 · 3:16
quoteyou have about a 2, 25% of the girls that you'll miss if you don't do the peritoneal cytology and you don't do the washings↗
▶Ep 3 · 3:16
quoteyou have about a 2, 25% of the girls that you'll miss if you don't do the peritoneal cytology and you don't do the washings↗
▶Ep 3 · 3:16
epidemiological25% of girls with ovarian germ cell tumors will be missed if peritoneal cytology and washings are not performed↗
▶Ep 3 · 3:54
clinicalIf staging procedures are omitted from the operative report, oncologists will treat ovarian tumors as stage 2↗
▶Ep 3 · 3:54
clinicalIf staging procedures are omitted from the operative report, oncologists will treat ovarian tumors as stage 2↗
▶Ep 3 · 4:41
clinicalGliomatosis peritonei is a benign disease appearance associated with ovarian teratomas with nearly 100% survival↗
▶Ep 3 · 4:41
clinicalGliomatosis peritonei is a benign disease appearance associated with ovarian teratomas with nearly 100% survival↗
▶Ep 3 · 5:37
guidelineIn bilateral ovarian disease, tumors larger than 10 cm should definitely be biopsied↗
▶Ep 3 · 5:37
guidelineIn bilateral ovarian disease, tumors larger than 10 cm should definitely be biopsied↗
▶Ep 3 · 8:07
clinicalIf alpha-fetoprotein and beta-HCG levels are normal preoperatively, there is some comfort about draining a cyst without contamination↗
▶Ep 3 · 8:07
clinicalIf alpha-fetoprotein and beta-HCG levels are normal preoperatively, there is some comfort about draining a cyst without contamination↗
▶Ep 3 · 13:40
clinicalMany black-colored ovaries from torsion have viable follicles and ovarian preservation should be the goal↗
▶Ep 3 · 13:40
quotewhen I was a fellow, I was that if it's black, you take it out and now what we're learning from some of our GYN colleagues is that many of these black colored ovaries are actually do have follicles in them that are viable↗
▶Ep 3 · 13:40
quoteovarian torsion of course is most common in teenage girls, but what, the way it's being seen is to be an urgent and not an emergent situation if you're always aiming to preserve the ovary↗
▶Ep 3 · 13:40
guidelineOvarian torsion is an urgent but not emergent situation if the goal is to preserve the ovary↗
▶Ep 3 · 13:40
clinicalMany black-colored ovaries from torsion have viable follicles and ovarian preservation should be the goal↗
▶Ep 3 · 13:40
quotewhen I was a fellow, I was that if it's black, you take it out and now what we're learning from some of our GYN colleagues is that many of these black colored ovaries are actually do have follicles in them that are viable↗
▶Ep 3 · 13:40
quoteovarian torsion of course is most common in teenage girls, but what, the way it's being seen is to be an urgent and not an emergent situation if you're always aiming to preserve the ovary↗
▶Ep 3 · 13:40
guidelineOvarian torsion is an urgent but not emergent situation if the goal is to preserve the ovary↗
▶Ep 3 · 15:44
epidemiological76% of ovaries removed for torsion had normal ovarian tissue, only 13% had no ovarian tissue, and only 11% were completely necrotic↗
▶Ep 3 · 15:44
quotemost of them will have normal ovarian tissue↗
▶Ep 3 · 15:44
epidemiological76% of ovaries removed for torsion had normal ovarian tissue, only 13% had no ovarian tissue, and only 11% were completely necrotic↗
▶Ep 3 · 15:44
quotemost of them will have normal ovarian tissue↗
▶Ep 3 · 15:49
quoteyou have 76% of them that had normal tissue in them, but you have 13, only 13% that had no ovarian tissue and only only 11% where it was actually completely necrotic↗
▶Ep 3 · 15:49
quoteyou have 76% of them that had normal tissue in them, but you have 13, only 13% that had no ovarian tissue and only only 11% where it was actually completely necrotic↗
▶Ep 3 · 16:34
clinicalPain after oophoropexy is usually short-lived and resolves in about a week↗
▶Ep 3 · 16:34
clinicalPain after oophoropexy is usually short-lived and resolves in about a week↗
▶Ep 3 · 16:58
clinicalThe ability to preserve ovarian function after torsion is related to age, with pediatric patients having more active follicles than older adults↗
▶Ep 3 · 16:58
clinicalThe ability to preserve ovarian function after torsion is related to age, with pediatric patients having more active follicles than older adults↗
▶Ep 3 · 21:03
clinicalUltrasound Doppler for ovarian torsion has sensitivity and specificity in the 50-60% range↗
▶Ep 3 · 21:03
clinicalUltrasound Doppler for ovarian torsion has sensitivity and specificity in the 50-60% range↗
▶Ep 3 · 21:06
quotethe ultrasound, if they say there's blood flow or not blood flow, I, I take little stock in that↗
▶Ep 3 · 21:06
quotethe ultrasound, if they say there's blood flow or not blood flow, I, I take little stock in that↗
▶Ep 3 · 25:58
quoteHalf of them are rhabdomyosarcomas, but the other half are the non-rhabdos↗
▶Ep 3 · 25:58
epidemiologicalHalf of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdo sarcomas↗
▶Ep 3 · 25:58
quoteHalf of them are rhabdomyosarcomas, but the other half are the non-rhabdos↗
▶Ep 3 · 25:58
epidemiologicalHalf of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdo sarcomas↗
▶Ep 3 · 26:22
quotethe patients that we see the most often, of course, are the abdominal, pelvic, retroperineal ones, and those are the ones that have the worst survival↗
▶Ep 3 · 26:22
epidemiologicalAbdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival while orbital rhabdomyosarcomas have the best survival↗
▶Ep 3 · 26:22
quotethe patients that we see the most often, of course, are the abdominal, pelvic, retroperineal ones, and those are the ones that have the worst survival↗
▶Ep 3 · 26:22
epidemiologicalAbdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival while orbital rhabdomyosarcomas have the best survival↗
▶Ep 3 · 27:04
clinicalEven small tumors in the extremity or abdomen can only achieve stage 2 at best (not stage 1) in rhabdomyosarcoma staging↗
▶Ep 3 · 27:04
clinicalEven small tumors in the extremity or abdomen can only achieve stage 2 at best (not stage 1) in rhabdomyosarcoma staging↗
▶Ep 3 · 27:15
quoteYou as a surgeon determine the clinical group. If you remove everything, it's a group 1. If you leave microscopic residual behind, it's a group 2, and if you can't get it out and you just do a biopsy, it's a group 3.↗
▶Ep 3 · 27:15
guidelineSurgical extent determines clinical group in rhabdomyosarcoma: group 1 is complete resection, group 2 is microscopic residual, group 3 is biopsy only↗
▶Ep 3 · 27:15
quoteYou as a surgeon determine the clinical group. If you remove everything, it's a group 1. If you leave microscopic residual behind, it's a group 2, and if you can't get it out and you just do a biopsy, it's a group 3.↗
▶Ep 3 · 27:15
guidelineSurgical extent determines clinical group in rhabdomyosarcoma: group 1 is complete resection, group 2 is microscopic residual, group 3 is biopsy only↗
▶Ep 3 · 27:27
clinicalGroup 1 and 2 rhabdomyosarcoma patients have excellent prognosis while group 3 patients do more poorly↗
▶Ep 3 · 27:27
clinicalGroup 1 and 2 rhabdomyosarcoma patients have excellent prognosis while group 3 patients do more poorly↗
▶Ep 3 · 27:44
opinionInability to resect a large rhabdomyosarcoma is a biologic determination, not a reflection of surgical skill, and aggressive resection with high morbidity will not improve outcome↗
▶Ep 3 · 27:44
quoteThis doesn't mean that the, the good surgeons, quote unquote, they're ones that can get it down to group 2. This is basically a biologic determination.↗
▶Ep 3 · 27:44
opinionInability to resect a large rhabdomyosarcoma is a biologic determination, not a reflection of surgical skill, and aggressive resection with high morbidity will not improve outcome↗
▶Ep 3 · 27:44
quoteThis doesn't mean that the, the good surgeons, quote unquote, they're ones that can get it down to group 2. This is basically a biologic determination.↗
▶Ep 3 · 29:15
quotenow we are requiring sentinel lymph node biopsies for all of these patients↗
▶Ep 3 · 29:15
guidelineSentinel lymph node biopsy is now required for all trunk and extremity rhabdomyosarcomas↗
▶Ep 3 · 29:15
quotenow we are requiring sentinel lymph node biopsies for all of these patients↗
▶Ep 3 · 29:15
guidelineSentinel lymph node biopsy is now required for all trunk and extremity rhabdomyosarcomas↗
▶Ep 3 · 29:31
quoteyou do not do a completion node dissection, you just get radiation therapy↗
▶Ep 3 · 29:31
guidelineFor rhabdomyosarcoma, completion node dissection is not performed for positive sentinel nodes; radiation therapy is given instead↗
▶Ep 3 · 29:31
quoteyou do not do a completion node dissection, you just get radiation therapy↗
▶Ep 3 · 29:31
guidelineFor rhabdomyosarcoma, completion node dissection is not performed for positive sentinel nodes; radiation therapy is given instead↗
▶Ep 3 · 30:10
guidelineSentinel lymph node mapping for rhabdomyosarcoma should be performed at the time of re-excision if initial excisional biopsy had positive margins↗
▶Ep 3 · 30:10
guidelineSentinel lymph node mapping for rhabdomyosarcoma should be performed at the time of re-excision if initial excisional biopsy had positive margins↗
▶Ep 3 · 30:36
epidemiological40-50% of biopsied lymph nodes are positive in rhabdomyosarcoma, and clinically negative nodes may also be positive↗
▶Ep 3 · 30:36
epidemiological40-50% of biopsied lymph nodes are positive in rhabdomyosarcoma, and clinically negative nodes may also be positive↗
guidelineHistologic grade is now critical in non-rhabdo soft tissue sarcomas, not just the diagnosis↗
▶Ep 3 · 31:27
quoteIf you have a low-grade tumor, all you're gonna do is resect that patient and they're only gonna get observed. There's no need for radiation or chemotherapy.↗
▶Ep 3 · 31:27
guidelineLow-grade soft tissue sarcomas require only resection with observation, no chemotherapy or radiation↗
▶Ep 3 · 31:27
guidelineLow-grade soft tissue sarcomas require only resection with observation, no chemotherapy or radiation↗
▶Ep 3 · 31:27
quoteIf you have a low-grade tumor, all you're gonna do is resect that patient and they're only gonna get observed. There's no need for radiation or chemotherapy.↗
guidelineUnresectable soft tissue sarcomas should receive both preoperative radiation and chemotherapy (previously only chemotherapy was recommended)↗
▶Ep 3 · 31:49
guidelineUnresectable soft tissue sarcomas should receive both preoperative radiation and chemotherapy (previously only chemotherapy was recommended)↗
▶Ep 3 · 32:07
clinicalChemotherapy-sensitive soft tissue sarcomas include synovial sarcoma and undifferentiated sarcoma↗
▶Ep 3 · 32:07
clinicalChemotherapy-sensitive soft tissue sarcomas include synovial sarcoma and undifferentiated sarcoma↗
▶Ep 3 · 32:25
clinicalChemotherapy-insensitive soft tissue sarcomas include alveolar soft part sarcoma, malignant epithelioid sarcoma, and clear cell sarcoma, which are primarily treated with surgery and radiation↗
▶Ep 3 · 32:25
clinicalChemotherapy-insensitive soft tissue sarcomas include alveolar soft part sarcoma, malignant epithelioid sarcoma, and clear cell sarcoma, which are primarily treated with surgery and radiation↗
▶Ep 3 · 32:51
clinicalA 5 cm tumor in a child less than 3 years old is equivalent to a 3 cm tumor in a larger patient, so 3 cm should be the cutoff for excision versus biopsy in toddlers↗
▶Ep 3 · 32:51
clinicalA 5 cm tumor in a child less than 3 years old is equivalent to a 3 cm tumor in a larger patient, so 3 cm should be the cutoff for excision versus biopsy in toddlers↗
▶Ep 3 · 33:22
clinicalLow-grade non-rhabdo sarcomas with negative margins can be cured with surgery alone without chemotherapy↗
▶Ep 3 · 33:22
clinicalLow-grade non-rhabdo sarcomas with negative margins can be cured with surgery alone without chemotherapy↗
▶Ep 3 · 34:07
guidelineCore needle biopsies are acceptable for soft tissue sarcomas if 3-4 good non-necrotic cores are obtained↗
▶Ep 3 · 34:07
quoteCore biopsies are acceptable. Uh, you'll, you'll need to have your pathologist check the core before the interventional radiologist is finished to make sure that it's not all necrotic↗
▶Ep 3 · 34:07
quoteCore biopsies are acceptable. Uh, you'll, you'll need to have your pathologist check the core before the interventional radiologist is finished to make sure that it's not all necrotic↗
▶Ep 3 · 34:07
guidelineCore needle biopsies are acceptable for soft tissue sarcomas if 3-4 good non-necrotic cores are obtained↗
