Frederick Rescorla

90 timestamped statements across 1 collection — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Soft Tissue Sarcoma (lymph nodes) · guest expert

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▶ Ep 6 · 2:00
I think ovarian is a great topic. One, it's pretty common. And I think most of us as pediatric surgeons see a lot of ovarian tumors. We see more of them than we see of like Wilms neuroblastoma or other types of tumors, even though among the ovarian tumors, most of them are not malignant.
quote · Soft Tissue Sarcoma (lymph nodes)
▶ Ep 6 · 2:00
I think ovarian is a great topic. One, it's pretty common. And I think most of us as pediatric surgeons see a lot of ovarian tumors. We see more of them than we see of like Wilms neuroblastoma or other types of tumors, even though among the ovarian tumors, most of them are not malignant.
quote · Soft Tissue Sarcoma (lymph nodes)

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Soft Tissue Sarcoma (lymph nodes) 90 entries

Ovarian Tumors Video Podcast

▶ Ep 6 · 2:00
quote I think ovarian is a great topic. One, it's pretty common. And I think most of us as pediatric surgeons see a lot of ovarian tumors. We see more of them than we see of like Wilms neuroblastoma or other types of tumors, even though among the ovarian tumors, most of them are not malignant. ↗
▶ Ep 6 · 2:00
quote I think ovarian is a great topic. One, it's pretty common. And I think most of us as pediatric surgeons see a lot of ovarian tumors. We see more of them than we see of like Wilms neuroblastoma or other types of tumors, even though among the ovarian tumors, most of them are not malignant. ↗
▶ Ep 6 · 2:25
quote I think it's also something where it's very important for us as pediatric surgeons to emphasize ovarian preservation. When we see things like torsion or tumors, since so many are benign, we often can preserve the ovarian. ↗
▶ Ep 6 · 2:25
quote I think it's also something where it's very important for us as pediatric surgeons to emphasize ovarian preservation. When we see things like torsion or tumors, since so many are benign, we often can preserve the ovarian. ↗
▶ Ep 6 · 2:45
quote There's evidence that we're doing better at that. But there's also some evidence that there are a lot of tumors that have been taken out in the last 20 years where we probably could have, in retrospect, preserved some functional ovary and not done a complete oophorectomy. ↗
▶ Ep 6 · 2:45
quote There's evidence that we're doing better at that. But there's also some evidence that there are a lot of tumors that have been taken out in the last 20 years where we probably could have, in retrospect, preserved some functional ovary and not done a complete oophorectomy. ↗
▶ Ep 6 · 3:25
clinical Alpha-fetoprotein (AFP) is the primary tumor marker for pediatric ovarian tumors; HCG is unlikely to be elevated in young children but is checked routinely ↗
▶ Ep 6 · 3:25
clinical Alpha-fetoprotein (AFP) is the primary tumor marker for pediatric ovarian tumors; HCG is unlikely to be elevated in young children but is checked routinely ↗
▶ Ep 6 · 3:55
quote I think when you look at the child, you know, one thing we're always trying to determine is, what is the risk of malignancy from the imaging? ↗
▶ Ep 6 · 3:55
quote I think when you look at the child, you know, one thing we're always trying to determine is, what is the risk of malignancy from the imaging? ↗
▶ Ep 6 · 4:03
quote I think there's very good data that if it's predominantly cystic, probably the chance of malignancy is probably 3% or 4%. If it's kind of more heterogeneous, the malignancy rate might be more like 15% to 20%. And if it's solid, it's probably over 25% at least. ↗
▶ Ep 6 · 4:03
epidemiological Predominantly cystic ovarian masses have approximately 3-4% malignancy risk ↗
▶ Ep 6 · 4:03
epidemiological Predominantly cystic ovarian masses have approximately 3-4% malignancy risk ↗
▶ Ep 6 · 4:03
quote I think there's very good data that if it's predominantly cystic, probably the chance of malignancy is probably 3% or 4%. If it's kind of more heterogeneous, the malignancy rate might be more like 15% to 20%. And if it's solid, it's probably over 25% at least. ↗
▶ Ep 6 · 4:25
epidemiological Heterogeneous ovarian masses have 15-20% malignancy rate ↗
▶ Ep 6 · 4:25
epidemiological Heterogeneous ovarian masses have 15-20% malignancy rate ↗
▶ Ep 6 · 4:32
epidemiological Solid ovarian masses have over 25% malignancy risk ↗
▶ Ep 6 · 4:32
epidemiological Solid ovarian masses have over 25% malignancy risk ↗
▶ Ep 6 · 4:38
quote I think it emphasized that when we do take her to the operating, we have to sort of try to preserve the principles of an oncologic operation. ↗
▶ Ep 6 · 4:38
quote I think it emphasized that when we do take her to the operating, we have to sort of try to preserve the principles of an oncologic operation. ↗
▶ Ep 6 · 5:03
epidemiological Approximately 10% or less of all pediatric ovarian tumors are malignant ↗
▶ Ep 6 · 5:03
epidemiological Approximately 10% or less of all pediatric ovarian tumors are malignant ↗
▶ Ep 6 · 5:18
epidemiological Among malignant pediatric ovarian tumors, germ cell tumors predominate at greater than 50%, possibly up to 80% in some series ↗
▶ Ep 6 · 5:18
epidemiological Among malignant pediatric ovarian tumors, germ cell tumors predominate at greater than 50%, possibly up to 80% in some series ↗
▶ Ep 6 · 5:43
epidemiological Among benign pediatric ovarian tumors, mature teratoma comprises at least half of cases ↗
▶ Ep 6 · 5:43
epidemiological Among benign pediatric ovarian tumors, mature teratoma comprises at least half of cases ↗
▶ Ep 6 · 5:51
epidemiological Immature teratoma accounts for approximately 10-15% of benign ovarian tumors ↗
▶ Ep 6 · 5:51
epidemiological Immature teratoma accounts for approximately 10-15% of benign ovarian tumors ↗
▶ Ep 6 · 8:10
quote I think one interesting thing I saw a few years ago in one of Dr. Deborah Billmar's papers was a group of stage 3 ovarian tumors. I think there were 20 of them. Five of them were stage 3 only because their peritoneal fluid was positive for malignant cells. ↗
▶ Ep 6 · 8:10
quote I think one interesting thing I saw a few years ago in one of Dr. Deborah Billmar's papers was a group of stage 3 ovarian tumors. I think there were 20 of them. Five of them were stage 3 only because their peritoneal fluid was positive for malignant cells. ↗
▶ Ep 6 · 8:10
host_summary In a study of 20 stage III ovarian tumors, 5 were stage III only because peritoneal fluid was positive for malignant cells; without checking washings they would have been considered stage I with likely higher recurrence ↗
▶ Ep 6 · 8:10
clinical In a study of 20 stage III ovarian tumors, 5 were stage III only because peritoneal fluid was positive for malignant cells; without checking washings they would have been considered stage I with likely higher recurrence ↗
▶ Ep 6 · 8:35
quote I really, you know, these are pretty simple tests. They're not very hard to do. They don't hurt the child. It just takes a few extra minutes for us in there. I think it's a good principle to have kind of the standard operation in your mind all the time and for the most part to do that. ↗
▶ Ep 6 · 8:35
quote I really, you know, these are pretty simple tests. They're not very hard to do. They don't hurt the child. It just takes a few extra minutes for us in there. I think it's a good principle to have kind of the standard operation in your mind all the time and for the most part to do that. ↗
▶ Ep 6 · 10:40
guideline For ovarian tumor surgery, six oncologic steps are recommended: peritoneal washings, tumor removal, contralateral ovary inspection (biopsy only if abnormal), omental assessment (remove if adherent to tumor), peritoneal cavity assessment for implants, and retroperitoneal lymph node palpation (remove only if enlarged) ↗
▶ Ep 6 · 10:40
guideline For ovarian tumor surgery, six oncologic steps are recommended: peritoneal washings, tumor removal, contralateral ovary inspection (biopsy only if abnormal), omental assessment (remove if adherent to tumor), peritoneal cavity assessment for implants, and retroperitoneal lymph node palpation (remove only if enlarged) ↗
▶ Ep 6 · 10:54
guideline Contralateral ovarian biopsy is now recommended only if the ovary appears abnormal, not routinely ↗
▶ Ep 6 · 10:54
guideline Contralateral ovarian biopsy is now recommended only if the ovary appears abnormal, not routinely ↗
▶ Ep 6 · 15:57
epidemiological For large predominantly cystic ovarian masses with normal markers, the malignancy risk is much less than 1% ↗
▶ Ep 6 · 15:57
epidemiological For large predominantly cystic ovarian masses with normal markers, the malignancy risk is much less than 1% ↗
▶ Ep 6 · 20:53
guideline Chest CT is required for staging of malignant ovarian tumors and should be obtained preoperatively ↗
▶ Ep 6 · 20:53
guideline Chest CT is required for staging of malignant ovarian tumors and should be obtained preoperatively ↗
▶ Ep 6 · 21:31
clinical For malignant ovarian tumors amenable to resection, primary surgical resection is preferred even if metastases are present ↗
▶ Ep 6 · 21:31
clinical For malignant ovarian tumors amenable to resection, primary surgical resection is preferred even if metastases are present ↗
▶ Ep 6 · 21:42
clinical Fallopian tube preservation during oophorectomy is optional; the tube should be preserved if not encased by tumor but can be removed if adherent or difficult to separate ↗
▶ Ep 6 · 21:42
clinical Fallopian tube preservation during oophorectomy is optional; the tube should be preserved if not encased by tumor but can be removed if adherent or difficult to separate ↗
▶ Ep 6 · 22:48
clinical Peritoneal washings are the main factor that can upstage an otherwise apparent stage I tumor to a higher stage ↗
▶ Ep 6 · 22:48
clinical Peritoneal washings are the main factor that can upstage an otherwise apparent stage I tumor to a higher stage ↗
▶ Ep 6 · 23:20
clinical Pediatric surgeons manage primarily germ cell tumors (chemo-responsive) while gynecologic oncologists manage primarily epithelial tumors, explaining differences in surgical approach including lymph node dissection ↗
▶ Ep 6 · 23:20
clinical Pediatric surgeons manage primarily germ cell tumors (chemo-responsive) while gynecologic oncologists manage primarily epithelial tumors, explaining differences in surgical approach including lymph node dissection ↗
▶ Ep 6 · 24:07
guideline Omental biopsy is not routine; omentum should be removed only if adherent to tumor or if abnormal on palpation ↗
▶ Ep 6 · 24:07
guideline Omental biopsy is not routine; omentum should be removed only if adherent to tumor or if abnormal on palpation ↗
▶ Ep 6 · 24:16
clinical Radiation therapy has no role in treatment of pediatric germ cell ovarian tumors ↗
▶ Ep 6 · 24:16
clinical Radiation therapy has no role in treatment of pediatric germ cell ovarian tumors ↗
▶ Ep 6 · 24:32
opinion Ovarian cryopreservation is not currently standard practice but may be considered in the future for patients receiving chemotherapy ↗
▶ Ep 6 · 24:32
opinion Ovarian cryopreservation is not currently standard practice but may be considered in the future for patients receiving chemotherapy ↗
▶ Ep 6 · 26:57
epidemiological Pre-menarchal girls have a higher risk of ovarian torsion compared to post-menarchal adolescents ↗
▶ Ep 6 · 26:57
host_summary Pre-menarchal girls have a higher risk of ovarian torsion compared to post-menarchal adolescents ↗
▶ Ep 6 · 26:57
clinical For acute ovarian torsion with unclear mass characteristics, detorsion can be performed and the ovary left in place with delayed resection after obtaining markers and better imaging ↗
▶ Ep 6 · 26:57
clinical For acute ovarian torsion with unclear mass characteristics, detorsion can be performed and the ovary left in place with delayed resection after obtaining markers and better imaging ↗
▶ Ep 6 · 27:12
host_summary Oophoropexy is recommended for pre-menarchal girls with ovarian torsion or for patients with recurrent torsion of the same ovary ↗
▶ Ep 6 · 27:12
guideline Oophoropexy is recommended for pre-menarchal girls with ovarian torsion or for patients with recurrent torsion of the same ovary ↗
▶ Ep 6 · 28:50
clinical A one-week delay for re-operation after detorsion makes no oncologic difference and allows for proper workup and ovarian-preserving surgery ↗
▶ Ep 6 · 28:50
clinical A one-week delay for re-operation after detorsion makes no oncologic difference and allows for proper workup and ovarian-preserving surgery ↗
▶ Ep 6 · 30:20
epidemiological Stage I malignant germ cell ovarian tumors have 96% overall survival ↗
▶ Ep 6 · 30:20
epidemiological Stage I malignant germ cell ovarian tumors have 96% overall survival ↗
▶ Ep 6 · 30:33
epidemiological Stage I germ cell tumors managed with observation alone have approximately 50% relapse rate ↗
▶ Ep 6 · 30:33
epidemiological Stage I germ cell tumors managed with observation alone have approximately 50% relapse rate ↗
▶ Ep 6 · 30:43
epidemiological Salvage rate for relapsed stage I germ cell tumors is nearly 100% ↗
▶ Ep 6 · 30:43
epidemiological Salvage rate for relapsed stage I germ cell tumors is nearly 100% ↗
▶ Ep 6 · 30:55
epidemiological Stage II and III germ cell ovarian tumors have 97% survival with chemotherapy ↗
▶ Ep 6 · 30:55
epidemiological Stage II and III germ cell ovarian tumors have 97% survival with chemotherapy ↗
▶ Ep 6 · 31:15
epidemiological Stage IV germ cell ovarian tumors have approximately 80% overall survival ↗
▶ Ep 6 · 31:15
epidemiological Stage IV germ cell ovarian tumors have approximately 80% overall survival ↗
▶ Ep 6 · 31:23
epidemiological Stage IV germ cell tumors in patients under 11 years have 92% survival ↗
▶ Ep 6 · 31:23
epidemiological Stage IV germ cell tumors in patients under 11 years have 92% survival ↗
▶ Ep 6 · 31:33
epidemiological Stage IV germ cell tumors in patients over 11 years have 60% survival ↗
▶ Ep 6 · 31:33
epidemiological Stage IV germ cell tumors in patients over 11 years have 60% survival ↗
▶ Ep 6 · 31:40
quote I think if you're over 11 and have a stage four tumor, you're high risk. If you're under 11 and you have a stage four tumor, or if you have stage two or three, you're kind of intermediate risk. ↗
▶ Ep 6 · 31:40
quote I think if you're over 11 and have a stage four tumor, you're high risk. If you're under 11 and you have a stage four tumor, or if you have stage two or three, you're kind of intermediate risk. ↗
▶ Ep 6 · 32:00
guideline Standard chemotherapy for intermediate-risk germ cell tumors is platinum, etoposide, and bleomycin ↗
▶ Ep 6 · 32:00
guideline Standard chemotherapy for intermediate-risk germ cell tumors is platinum, etoposide, and bleomycin ↗
▶ Ep 6 · 32:13
clinical Metastatic sites in stage IV germ cell tumors do not require biopsy if clearly metastatic on imaging; they are followed with imaging ↗
▶ Ep 6 · 32:13
clinical Metastatic sites in stage IV germ cell tumors do not require biopsy if clearly metastatic on imaging; they are followed with imaging ↗
▶ Ep 6 · 32:32
clinical Black, torsed ovaries should not be removed; detorsion alone is appropriate ↗
▶ Ep 6 · 32:32
clinical Black, torsed ovaries should not be removed; detorsion alone is appropriate ↗
▶ Ep 6 · 32:44
clinical Ovarian-preserving procedures (partial oophorectomy) are appropriate for cystic or mixed cystic-solid masses; oophorectomy is reserved for solid tumors ↗
▶ Ep 6 · 32:44
quote I think that is the sort of change over time that is something that I want to emphasize, and I think you wanted to emphasize, is that these ovaries do not need to come out unless it's a solid tumor. ↗
▶ Ep 6 · 32:44
clinical Ovarian-preserving procedures (partial oophorectomy) are appropriate for cystic or mixed cystic-solid masses; oophorectomy is reserved for solid tumors ↗
▶ Ep 6 · 32:44
quote I think that is the sort of change over time that is something that I want to emphasize, and I think you wanted to emphasize, is that these ovaries do not need to come out unless it's a solid tumor. ↗