Day 1 :
Keynote Forum
Mecker G Moller
University of Miami, USA
Keynote: Novel regional therapies in the treatment of unresectable melanoma
Time : 10:00-10:30
Biography:
Mecker G Moller is an Academic Surgical Oncologist and Associate Professor of Surgery at University of Miami, USA. She completed her general surgery training at Michigan State University (USA) and her Surgical Oncology Fellowship at University of South Florida Moffitt Cancer Center and Research Institute. Her areas of clinical practice and research include breast cancer, soft tissue malignancies including melanoma and peritoneal carcinomatosis. She has significant experience in translational and clinical research and is an international speaker. She belongs to multiple prestigious surgical organizations and has served in several committees of the American College of Surgeons (USA).
Abstract:
Background: Intraoperative peritoneal carcinomatosis index (I-PCI) and completeness of cytoreduction surgery (CRS) are predictors of survival in patients with peritoneal surface malignancy (PCM) from multiple gastrointestinal malignancies. However, I-PCI is not a reliable predictor in patients with PCM from appendiceal origin. We sought to analyze the impact of postoperative radiological PCI (PR-PCI) on survival rates in this population.
Methodology: From August 2002 to January 2015, 29 consecutive patients with PCM from appendiceal origin undergoing CRS/HIPEC (hyperthermic intraperitoneal chemotherapy) were included in the analysis. Patient demographics, tumor characteristics and perioperative outcomes were collected. Kaplan- Meier survival analysis and Cox proportional hazards model evaluated factors associated with increased mortality. PCI cutoff of 16 was used for both PR-PCI and I-PCI.
Results: Tumor characteristics, intraoperative variables (including PCI, HR 2.41, 95% CI 0.49-11.77) and postoperative complications were not identified as predictors of survival. Mean I-PCI and PR-PCI were 19.1±11.3 and 6.6±10.4 (p<0.001), respectively. PR-PCI <16 was associated with increased survival rates (HR 4.53, 95% CI 1.10-18.69, p=0.030)
Conclusions: PR-PCI seems to be a more reliable predictor of survival than conventional I-PCI in patients with PCM from appendiceal origin undergoing CRS/HIPEC, likely due to a superior correlation with completeness of resection.
Keynote Forum
Chong Zhong
The First Affiliated Hospital of Guangzhou University of Chinese Medicine, China
Keynote: Hepatic resection versus TACE in UICC stage T3 Hepatocellular carcinoma patients: A propensity scores matching study
Time : 10:30-11:00
Biography:
Abstract:
Keynote Forum
Gary Haynes
Tulane University School of Medicine, USA
Keynote: Anesthesia practice: US and international trends in anesthesiology manpower and practice management
Time : 11:00-11:30
Biography:
Abstract:
Statement of the Problem: Anesthesia practice management requires the availability of well-trained medical professionals who can enter, and be retained in practice settings. Estimating both the needed, and the available professional personnel, and aligning educational programs to meet those needs is a tremendous challenge. Several studies conducted in the US during the past 25 years failed to assess correctly future manpower requirements. During this same period the US healthcare system experienced continuing growth despite major efforts made to reshape the national healthcare system. Coupled with numerous financial challenges, practice management must evolve with the growth of medical education, advances in anesthetic and surgical care, and growing demands for anesthesia services outside the traditional operating room environment. The problem of aligning anesthesia clinicians with demand is a major issue in the United States; however, it is likely an even greater international problem.
Methodology & Theoretical Orientation: Analyzing anesthesia manpower is a longitudinal problem that requires combining information over the span of decades. Analysis of published manpower studies, surveys, institutional and government reports provides the basis for practice management forecasting.
Findings: Past efforts to estimate future anesthesia manpower needs consistently underestimated the actual requirement for anesthesia personnel. Multiple factors including incorrect study assumptions, evolving demographic trends in patient populations, expansion of medical education, changing characteristics in anesthesia professionals, and growth in the use of anesthesia services outside the traditional operating room environment provide some of the explanations for the unexpected results.
Conclusion & Significance: Developed countries will likely have a continuing need for anesthesia professional staff for many years. The need is far greater in many areas of the world. New technological solutions and changes in the delivery of perioperative care will be sought as alternative solutions to the constraints of anesthesia professionals.