Surgical oncology (Boston)

Question 1

Goals for this class

Answer 1

• how to approach a tumor case
• biopsy principles
• doses of surgery
• basic surgical oncology

Question 2

Questions about a cancer case

Answer 2

1. What kind of tumor is it
2. Where is the tumor
3. How bad is the tumor

Question 3

Cytology

Answer 3

• epithelial
• mesenchymal
• discrete cell/round cell

Question 4

Tumors easy to dx

Answer 4

• mast cell tumor
• lipomas

Question 5

Incisional Biopsy

Answer 5

• Goals
  
  • Histological dx
  • minimal disruption of fascial planes
• Small skin incision
  
  • biopsy tract removed with definitive resection
• avoid central portion of mass

Question 6

Histological Diagnosis and Grade

Answer 6

• Histologic dz is important
• Histological description is very important
• Grade helps us predict the biological behavoir of the tumor

Question 7

Stage

Answer 7

• extent of a cancer in the body
• size of the tumor
• regional lymph nodes contain cancer
• distant spread

Question 8

Grade

Answer 8

• Microscopic variables
  
  • ​Degree of differentiation
  • Mitotic index
  • % necrosis
  • invasion of lymphatic or blood vessels

Question 9

Surgical dose

What is the goal?

Answer 9

• Palliative
  
  • ​intralesional excision: you leave and can see tumor cells
  • Marginal excition: get down to microscopic dz and then radiation
• ​Curative potential
  
  • ​Wide excition
  • Radical excision

Question 10

Fascial plane

Answer 10

• Fascia
• Muscle
• Bone
• Chest wall

Question 11

Not a fascial plane

Answer 11

• Pseudocapsule
• SQ tissue
• Fat