Current standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)
Current standard for bilateral Wilms tumor is to start chemotherapy, give 2 cycles, and stop when tumor shrinkage plateaus (defined as less than 50% volume reduction).
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy, give 2 cycles, and stop when tumor shrinkage plateaus (defined as less than 50% volume reduction).↗
▶Ep 4 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation.↗
▶Ep 4 · 4:44
clinicalBilateral nephron-sparing surgery for Wilms tumor can be performed by placing kidneys on ice, clamping vessels, and performing sharp tumor dissection—surprisingly feasible even for large tumors.↗
▶Ep 4 · 5:58
quoteI never like to stick around for post-op complications.↗
▶Ep 4 · 7:56
opinionIt is debated whether anaplasia in Wilms tumor is present initially or develops secondary to chemotherapy-induced differentiation; most pathologists believe it is present primarily, making these heterogeneous tumors.↗
▶Ep 4 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, so biopsy is not needed upfront—chemotherapy should be started empirically.↗
▶Ep 4 · 12:54
clinicalFor gastroschisis closure using Tegaderm technique, if the fascia is not cut to widen the defect, most umbilical hernias will close spontaneously and do not require repair.↗
▶Ep 4 · 14:52
clinicalTegaderm can be applied directly over reduced gastroschisis without Betadine or other topical agents, left in place for approximately 3 days, then converted to dry dressing once tissues are adherent.↗
▶Ep 4 · 15:32
clinicalEven when a gastroschisis silo fails and the defect dilates significantly, Tegaderm-only closure can achieve successful cicatrization over 8 weeks.↗
▶Ep 4 · 19:26
clinicalWhen gastroschisis is reduced without closing the fascia, ambient intra-abdominal pressure is lower than with fascial closure, which may benefit bowel function.↗
▶Ep 4 · 19:48
quoteI wasn't smart enough to bring it out through the umbilicus.↗
▶Ep 4 · 22:07
clinicalRe-exploration at 2 weeks after initial gastroschisis reduction (rather than the traditional 4-6 weeks) can reveal that inflamed 'gastroschisis bowel' has transformed into viable intestine suitable for anastomosis.↗
▶Ep 4 · 24:21
clinicalFor apple-peel ileal atresia with ischemic distal bowel, if the bowel does not pink up on the operating table and is not twisted, resection with primary anastomosis is appropriate.↗
▶Ep 4 · 25:37
clinicalPlication of massively dilated proximal bowel in intestinal atresia is helpful and the plication typically unravels over time, preserving bowel length for later lengthening procedures if needed.↗
▶Ep 4 · 28:10
clinicalIn newborns with questionable short-gut syndrome, tapering should be avoided to preserve bowel for potential lengthening procedures later; plication is preferred.↗
▶Ep 4 · 28:23
clinicalIf a child has extensive bowel length and only a segment is dilated, tapering is reasonable.↗
Compiled Sandler Rapid Fire Sessions: Update Course 2015
▶Ep 8 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 8 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 8 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 8 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 8 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 8 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 8 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 8 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 8 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 8 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 8 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 8 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 8 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 8 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 8 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 8 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 8 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 8 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 8 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 8 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 8 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 8 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 8 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 8 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 8 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 8 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 8 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 8 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 8 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 8 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 8 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
▶Ep 8 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
Tony's statements about Adrenal Tumors16 statements
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 2 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 2 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 2 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 2 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 2 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 2 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 2 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 2 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 2 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 2 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 2 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 2 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 2 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 2 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 2 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Tony's statements about Colorectal / ARM & Hirschsprung16 statements
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 74 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 74 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 74 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 74 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 74 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 74 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 74 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 74 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 74 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 74 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 74 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 74 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 74 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 74 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 74 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Tony's statements about Etiologies (Gastroschisis/NEC/Atresia/Volvulus)48 statements
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy, give 2 cycles, and stop when tumor shrinkage plateaus (defined as less than 50% volume reduction).↗
▶Ep 5 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation.↗
▶Ep 5 · 4:44
clinicalBilateral nephron-sparing surgery for Wilms tumor can be performed by placing kidneys on ice, clamping vessels, and performing sharp tumor dissection—surprisingly feasible even for large tumors.↗
▶Ep 5 · 5:58
quoteI never like to stick around for post-op complications.↗
▶Ep 5 · 7:56
opinionIt is debated whether anaplasia in Wilms tumor is present initially or develops secondary to chemotherapy-induced differentiation; most pathologists believe it is present primarily, making these heterogeneous tumors.↗
▶Ep 5 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, so biopsy is not needed upfront—chemotherapy should be started empirically.↗
▶Ep 5 · 12:54
clinicalFor gastroschisis closure using Tegaderm technique, if the fascia is not cut to widen the defect, most umbilical hernias will close spontaneously and do not require repair.↗
▶Ep 5 · 14:52
clinicalTegaderm can be applied directly over reduced gastroschisis without Betadine or other topical agents, left in place for approximately 3 days, then converted to dry dressing once tissues are adherent.↗
▶Ep 5 · 15:32
clinicalEven when a gastroschisis silo fails and the defect dilates significantly, Tegaderm-only closure can achieve successful cicatrization over 8 weeks.↗
▶Ep 5 · 19:26
clinicalWhen gastroschisis is reduced without closing the fascia, ambient intra-abdominal pressure is lower than with fascial closure, which may benefit bowel function.↗
▶Ep 5 · 19:48
quoteI wasn't smart enough to bring it out through the umbilicus.↗
▶Ep 5 · 22:07
clinicalRe-exploration at 2 weeks after initial gastroschisis reduction (rather than the traditional 4-6 weeks) can reveal that inflamed 'gastroschisis bowel' has transformed into viable intestine suitable for anastomosis.↗
▶Ep 5 · 24:21
clinicalFor apple-peel ileal atresia with ischemic distal bowel, if the bowel does not pink up on the operating table and is not twisted, resection with primary anastomosis is appropriate.↗
▶Ep 5 · 25:37
clinicalPlication of massively dilated proximal bowel in intestinal atresia is helpful and the plication typically unravels over time, preserving bowel length for later lengthening procedures if needed.↗
▶Ep 5 · 28:10
clinicalIn newborns with questionable short-gut syndrome, tapering should be avoided to preserve bowel for potential lengthening procedures later; plication is preferred.↗
▶Ep 5 · 28:23
clinicalIf a child has extensive bowel length and only a segment is dilated, tapering is reasonable.↗
Compiled Sandler Rapid Fire Sessions: Update Course 2015
▶Ep 12 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 12 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 12 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 12 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 12 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 12 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 12 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 12 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 12 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 12 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 12 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 12 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 12 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 12 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 12 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 12 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 12 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 12 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 12 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 12 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 12 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 12 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 12 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 12 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 12 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 12 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 12 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 12 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 12 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 12 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 12 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
▶Ep 12 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
Tony's statements about Intestinal Rehab48 statements
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy, give 2 cycles, and stop when tumor shrinkage plateaus (defined as less than 50% volume reduction).↗
▶Ep 6 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation.↗
▶Ep 6 · 4:44
clinicalBilateral nephron-sparing surgery for Wilms tumor can be performed by placing kidneys on ice, clamping vessels, and performing sharp tumor dissection—surprisingly feasible even for large tumors.↗
▶Ep 6 · 5:58
quoteI never like to stick around for post-op complications.↗
▶Ep 6 · 7:56
opinionIt is debated whether anaplasia in Wilms tumor is present initially or develops secondary to chemotherapy-induced differentiation; most pathologists believe it is present primarily, making these heterogeneous tumors.↗
▶Ep 6 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, so biopsy is not needed upfront—chemotherapy should be started empirically.↗
▶Ep 6 · 12:54
clinicalFor gastroschisis closure using Tegaderm technique, if the fascia is not cut to widen the defect, most umbilical hernias will close spontaneously and do not require repair.↗
▶Ep 6 · 14:52
clinicalTegaderm can be applied directly over reduced gastroschisis without Betadine or other topical agents, left in place for approximately 3 days, then converted to dry dressing once tissues are adherent.↗
▶Ep 6 · 15:32
clinicalEven when a gastroschisis silo fails and the defect dilates significantly, Tegaderm-only closure can achieve successful cicatrization over 8 weeks.↗
▶Ep 6 · 19:26
clinicalWhen gastroschisis is reduced without closing the fascia, ambient intra-abdominal pressure is lower than with fascial closure, which may benefit bowel function.↗
▶Ep 6 · 19:48
quoteI wasn't smart enough to bring it out through the umbilicus.↗
▶Ep 6 · 22:07
clinicalRe-exploration at 2 weeks after initial gastroschisis reduction (rather than the traditional 4-6 weeks) can reveal that inflamed 'gastroschisis bowel' has transformed into viable intestine suitable for anastomosis.↗
▶Ep 6 · 24:21
clinicalFor apple-peel ileal atresia with ischemic distal bowel, if the bowel does not pink up on the operating table and is not twisted, resection with primary anastomosis is appropriate.↗
▶Ep 6 · 25:37
clinicalPlication of massively dilated proximal bowel in intestinal atresia is helpful and the plication typically unravels over time, preserving bowel length for later lengthening procedures if needed.↗
▶Ep 6 · 28:10
clinicalIn newborns with questionable short-gut syndrome, tapering should be avoided to preserve bowel for potential lengthening procedures later; plication is preferred.↗
▶Ep 6 · 28:23
clinicalIf a child has extensive bowel length and only a segment is dilated, tapering is reasonable.↗
Compiled Sandler Rapid Fire Sessions: Update Course 2015
▶Ep 19 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 19 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 19 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 19 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 19 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 19 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 19 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 19 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 19 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 19 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 19 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 19 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 19 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 19 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 19 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 19 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 19 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 19 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 19 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 19 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 19 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 19 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 19 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 19 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 19 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 19 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 19 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 19 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 19 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 19 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 19 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
▶Ep 19 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
Tony's statements about Neuroblastoma29 statements
quoteThe priority during the pregnancy is the mom. And once the baby is born, then we'll learn more and the first thing we'll do is get more information once the baby is born.↗
▶Ep 1 · 4:39
epidemiologicalFamilial neuroblastoma occurs in about 1% of patients↗
▶Ep 1 · 5:34
guidelineCT scan or MRI not needed for 3 cm lesion unless urine catecholamines are elevated↗
▶Ep 1 · 10:39
epidemiologicalOf 84 observed patients in Nocktern study, 16 (approximately 20%) underwent resection for growth or family preference↗
▶Ep 1 · 14:36
guideline5 centimeters is used as size cutoff for surgical intervention in observed prenatal masses↗
▶Ep 1 · 22:56
clinicalUltrasound is important for Wilms tumor to assess venous extension↗
▶Ep 1 · 23:50
guidelineComplete staging workup includes bone marrow biopsy, MIBG scan, chest CT to rule out metastasis, and head CT if clinical symptoms present↗
▶Ep 1 · 23:50
clinicalLarge mass encasing aorta and celiac axis with microcalcifications represents L2 INRG classification↗
▶Ep 1 · 27:10
clinicalNMYC amplification can be obtained from bone marrow, but additional biology studies require tumor tissue↗
▶Ep 1 · 27:10
opinionMultiple percutaneous biopsies may not provide adequate tissue for biology studies↗
▶Ep 1 · 27:10
opinionTransperitoneal laparoscopic biopsy may not allow adequate bleeding control for large tumors↗
▶Ep 1 · 27:10
opinionOpen retroperitoneal biopsy provides adequate tissue size for pathology and biology studies↗
▶Ep 1 · 28:28
clinicalBiology studies beyond NMYC include ALK mutation and ploidy status↗
Neuroblastoma
▶Ep 3 · 3:27
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 3 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 3 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 3 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 3 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 3 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 3 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 3 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 3 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 3 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 3 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 3 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 3 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 3 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 3 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 3 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Tony's statements about Neuroblastoma29 statements
quoteThe priority during the pregnancy is the mom. And once the baby is born, then we'll learn more and the first thing we'll do is get more information once the baby is born.↗
▶Ep 3 · 4:39
epidemiologicalFamilial neuroblastoma occurs in about 1% of patients↗
▶Ep 3 · 5:34
guidelineCT scan or MRI not needed for 3 cm lesion unless urine catecholamines are elevated↗
▶Ep 3 · 10:39
epidemiologicalOf 84 observed patients in Nocktern study, 16 (approximately 20%) underwent resection for growth or family preference↗
▶Ep 3 · 14:36
guideline5 centimeters is used as size cutoff for surgical intervention in observed prenatal masses↗
▶Ep 3 · 22:56
clinicalUltrasound is important for Wilms tumor to assess venous extension↗
▶Ep 3 · 23:50
clinicalLarge mass encasing aorta and celiac axis with microcalcifications represents L2 INRG classification↗
▶Ep 3 · 23:50
guidelineComplete staging workup includes bone marrow biopsy, MIBG scan, chest CT to rule out metastasis, and head CT if clinical symptoms present↗
▶Ep 3 · 27:10
opinionOpen retroperitoneal biopsy provides adequate tissue size for pathology and biology studies↗
▶Ep 3 · 27:10
opinionTransperitoneal laparoscopic biopsy may not allow adequate bleeding control for large tumors↗
▶Ep 3 · 27:10
opinionMultiple percutaneous biopsies may not provide adequate tissue for biology studies↗
▶Ep 3 · 27:10
clinicalNMYC amplification can be obtained from bone marrow, but additional biology studies require tumor tissue↗
▶Ep 3 · 28:28
clinicalBiology studies beyond NMYC include ALK mutation and ploidy status↗
Neuroblastoma
▶Ep 6 · 3:27
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 6 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 6 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 6 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 6 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 6 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 6 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 6 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 6 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 6 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 6 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 6 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 6 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 6 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 6 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 6 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Tony's statements about Pediatric Oncology61 statements
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy, give 2 cycles, and stop when tumor shrinkage plateaus (defined as less than 50% volume reduction).↗
▶Ep 53 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation.↗
▶Ep 53 · 4:44
clinicalBilateral nephron-sparing surgery for Wilms tumor can be performed by placing kidneys on ice, clamping vessels, and performing sharp tumor dissection—surprisingly feasible even for large tumors.↗
▶Ep 53 · 5:58
quoteI never like to stick around for post-op complications.↗
▶Ep 53 · 7:56
opinionIt is debated whether anaplasia in Wilms tumor is present initially or develops secondary to chemotherapy-induced differentiation; most pathologists believe it is present primarily, making these heterogeneous tumors.↗
▶Ep 53 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, so biopsy is not needed upfront—chemotherapy should be started empirically.↗
▶Ep 53 · 12:54
clinicalFor gastroschisis closure using Tegaderm technique, if the fascia is not cut to widen the defect, most umbilical hernias will close spontaneously and do not require repair.↗
▶Ep 53 · 14:52
clinicalTegaderm can be applied directly over reduced gastroschisis without Betadine or other topical agents, left in place for approximately 3 days, then converted to dry dressing once tissues are adherent.↗
▶Ep 53 · 15:32
clinicalEven when a gastroschisis silo fails and the defect dilates significantly, Tegaderm-only closure can achieve successful cicatrization over 8 weeks.↗
▶Ep 53 · 19:26
clinicalWhen gastroschisis is reduced without closing the fascia, ambient intra-abdominal pressure is lower than with fascial closure, which may benefit bowel function.↗
▶Ep 53 · 19:48
quoteI wasn't smart enough to bring it out through the umbilicus.↗
▶Ep 53 · 22:07
clinicalRe-exploration at 2 weeks after initial gastroschisis reduction (rather than the traditional 4-6 weeks) can reveal that inflamed 'gastroschisis bowel' has transformed into viable intestine suitable for anastomosis.↗
▶Ep 53 · 24:21
clinicalFor apple-peel ileal atresia with ischemic distal bowel, if the bowel does not pink up on the operating table and is not twisted, resection with primary anastomosis is appropriate.↗
▶Ep 53 · 25:37
clinicalPlication of massively dilated proximal bowel in intestinal atresia is helpful and the plication typically unravels over time, preserving bowel length for later lengthening procedures if needed.↗
▶Ep 53 · 28:10
clinicalIn newborns with questionable short-gut syndrome, tapering should be avoided to preserve bowel for potential lengthening procedures later; plication is preferred.↗
▶Ep 53 · 28:23
clinicalIf a child has extensive bowel length and only a segment is dilated, tapering is reasonable.↗
Compiled Sandler Rapid Fire Sessions: Update Course 2015
▶Ep 72 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 72 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 72 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 72 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 72 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 72 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 72 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 72 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 72 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 72 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 72 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 72 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 72 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 72 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 72 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 72 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
Neuroblastoma
▶Ep 184 · 3:51
quoteThe priority during the pregnancy is the mom. And once the baby is born, then we'll learn more and the first thing we'll do is get more information once the baby is born.↗
▶Ep 184 · 4:39
epidemiologicalFamilial neuroblastoma occurs in about 1% of patients↗
▶Ep 184 · 5:34
guidelineCT scan or MRI not needed for 3 cm lesion unless urine catecholamines are elevated↗
▶Ep 184 · 10:39
epidemiologicalOf 84 observed patients in Nocktern study, 16 (approximately 20%) underwent resection for growth or family preference↗
▶Ep 184 · 14:36
guideline5 centimeters is used as size cutoff for surgical intervention in observed prenatal masses↗
▶Ep 184 · 22:56
clinicalUltrasound is important for Wilms tumor to assess venous extension↗
▶Ep 184 · 23:50
clinicalLarge mass encasing aorta and celiac axis with microcalcifications represents L2 INRG classification↗
▶Ep 184 · 23:50
guidelineComplete staging workup includes bone marrow biopsy, MIBG scan, chest CT to rule out metastasis, and head CT if clinical symptoms present↗
▶Ep 184 · 27:10
opinionOpen retroperitoneal biopsy provides adequate tissue size for pathology and biology studies↗
▶Ep 184 · 27:10
opinionTransperitoneal laparoscopic biopsy may not allow adequate bleeding control for large tumors↗
▶Ep 184 · 27:10
opinionMultiple percutaneous biopsies may not provide adequate tissue for biology studies↗
▶Ep 184 · 27:10
clinicalNMYC amplification can be obtained from bone marrow, but additional biology studies require tumor tissue↗
▶Ep 184 · 28:28
clinicalBiology studies beyond NMYC include ALK mutation and ploidy status↗
Neuroblastoma
▶Ep 252 · 3:27
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 252 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 252 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 252 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 252 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 252 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 252 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 252 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 252 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 252 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 252 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 252 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 252 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 252 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 252 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 252 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Tony's statements about Soft Tissue Sarcoma (lymph nodes)16 statements
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 5 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 5 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 5 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 5 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 5 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 5 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 5 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 5 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 5 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 5 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 5 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 5 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 5 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 5 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 5 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
Compiled Sandler Rapid Fire Sessions: Update Course 2015
▶Ep 4 · 0:28
quoteI congratulate you for putting on an incredible symposium↗
▶Ep 4 · 1:32
guidelineCurrent standard for bilateral Wilms tumor is to start chemotherapy without biopsy, typically 2 cycles, and continue until tumor shrinkage plateaus (defined as less than 50% size reduction)↗
▶Ep 4 · 4:19
clinicalWhen Wilms tumors stop shrinking with chemotherapy, it is usually due to mesenchymal differentiation rather than anaplastic transformation↗
▶Ep 4 · 4:44
clinicalBilateral nephron-sparing surgery is feasible even in large bilateral Wilms tumors by placing kidneys on ice, clamping vessels, and performing sharp dissection↗
▶Ep 4 · 5:58
quoteI never like to stick around for post-op complications. I, I'm that's a joke, sorry.↗
▶Ep 4 · 6:46
quoteThey gotta look a lot. You have to look a lot.↗
▶Ep 4 · 7:56
opinionMost pathologists believe anaplasia in Wilms tumor is present primarily rather than induced by chemotherapy↗
▶Ep 4 · 9:12
epidemiological97% of bilateral kidney tumors in children are Wilms tumor, with only a small percentage being other diagnoses↗
▶Ep 4 · 12:54
clinicalUmbilical hernias after gastroschisis closure will close spontaneously if no fascia was cut; if fascia is cut, a permanent defect results↗
▶Ep 4 · 14:52
clinicalTegaderm closure of gastroschisis without fascial closure allows cicatrization over 3 days to 8 weeks, with feeding started when bowel function returns rather than waiting for complete closure↗
▶Ep 4 · 15:32
clinicalWhen gastroschisis defect dilates during silo reduction attempts, Tegaderm closure alone can still achieve successful cicatrization without fascial closure↗
▶Ep 4 · 21:01
clinicalIn vanishing gastroschisis with markedly inflamed bowel, it is impossible to determine bowel viability or the extent of remaining intra-abdominal bowel from external examination↗
▶Ep 4 · 21:11
quoteYou cannot tell what's going on with this bowel, whatever you, whatever you do. Now, something strange we did and absolutely not take it out, never take it out.↗
▶Ep 4 · 22:07
clinicalRe-exploration at 2 weeks after gastroschisis closure (rather than the traditional 4-6 weeks) can reveal that inflamed gastroschisis bowel has transformed into functional intestine suitable for anastomosis↗
▶Ep 4 · 26:13
clinicalPlication of dilated bowel in ileal atresia usually unravels with time, allowing the bowel to be used later for lengthening procedures↗
▶Ep 4 · 28:10
clinicalIn neonatal ileal atresia with dilated proximal bowel, plication is preferred over tapering to preserve bowel length for potential future lengthening procedures↗
Neuroblastoma
▶Ep 9 · 3:27
epidemiologicalFamilial neuroblastoma occurs in approximately 1% of patients↗
▶Ep 9 · 8:41
quoteI think one of the other things when you speak to the family, it's really important to reassure them that even if the mass increases in size and you take it out, it is likely to be a very, very low risk tumor.↗
▶Ep 9 · 9:09
clinicalIn the GetNucturne observation study of 84 patients, 16 (approximately 20%) underwent resection for growth or family preference, with 98% event-free survival and 100% overall survival↗
▶Ep 9 · 12:43
opinionFive centimeters is the size cutoff where most experts recommend surgical resection of neonatal neuroblastoma↗
▶Ep 9 · 23:50
clinicalOpen biopsy via retroperitoneal approach allows adequate tissue for NMEC amplification, ALK mutation, ploidy, and 11q status↗
▶Ep 9 · 31:38
clinicalNMEC amplification automatically means high-risk neuroblastoma regardless of other factors↗
▶Ep 9 · 32:32
quoteI sort of think of it like imperforate anus. And you think of it as there's different ways of classifying imperforate anus. But for me, practically, there's high and there's low.↗
▶Ep 9 · 33:10
quoteIf NMEC is amplified, it is automatically high-risk disease, irrespective of any other categorization.↗
▶Ep 9 · 35:25
guidelineAge cutoff for neuroblastoma risk stratification is 18 months (previously was 12 months)↗
▶Ep 9 · 45:31
clinicalStem cell harvesting for high-risk neuroblastoma typically occurs after cycle 2 of chemotherapy↗
▶Ep 9 · 46:50
clinicalRecent German/European publication stated unequivocally that extent of resection does not make a difference in neuroblastoma outcomes↗
▶Ep 9 · 47:20
quoteI think the bottom line is patients don't die of local disease. They die of systemic disease, in neuroblastoma.↗
▶Ep 9 · 47:40
clinicalHigh-risk neuroblastoma patients die of metastatic disease, not local disease recurrence↗
▶Ep 9 · 53:13
clinicalNephrectomy should be avoided in neuroblastoma resection because kidney removal requires chemotherapy dose reduction↗
▶Ep 9 · 53:44
clinicalAnti-GD2 monoclonal antibody improved high-risk neuroblastoma two-year survival from 46% to 60%↗
▶Ep 9 · 54:40
clinicalCheckpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor↗
