Behind The Knife: The Surgery Podcast

Among patients with colorectal cancer and synchronous liver metastases, the subgroup with a primary cancer in the rectum is especially challenging. Compared with colon cancer, most patients with stage IV rectal cancer will have locally advanced primary tumors at increased risk for obstructive and/or post-operative complications resulting in delays in systemic therapy. In this episode from the HPB team at Behind the Knife, listen in on the discussion about treatment sequencing for synchronous liver metastasis from rectal cancer Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center.  Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center. Learning Objectives ·      Develop an understanding of the three treatment sequences for resection of disease in patients with synchronous liver metastasis from a primary rectal cancer (reverse, combined, and classic approach) ·      Develop an understanding of the benefits, risks, and nuances of each of the three treatment sequences ·      Develop an understanding of which patient cases each treatment sequence is ideal for as well as which cases they are not suitable for. Papers Referenced (in the order they were mentioned in the episode): 1)    Conrad C, Vauthey JN, Masayuki O, et al. Individualized Treatment Sequencing Selection Contributes to Optimized Survival in Patients with Rectal Cancer and Synchronous Liver Metastases. Ann Surg Oncol. 2017 Dec;24(13):3857-3864.  https://pubmed.ncbi.nlm.nih.gov/28929463/ 2)    Maki H, Ayabe RI, Nishioka Y, et al. Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer. Ann Surg Oncol. 2023 Sep;30(9):5390-5400. doi: 10.1245/s10434-023-13656-4. Epub 2023 Jun 7. Erratum in: Ann Surg Oncol. 2023 Sep;30(9):5405. https://pubmed.ncbi.nlm.nih.gov/37285096/ Additional Suggested Reading Mentha G, Majno PE, Andres A, Rubbia-Brandt L, Morel P, Roth AD. Neoadjuvant chemotherapy and resection of advanced synchronous liver metastases before treatment of the colorectal primary. Br J Surg. 2006 Jul;93(7):872-8.  https://pubmed.ncbi.nlm.nih.gov/16671066/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid, which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series.  Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife.  Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid, which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series.  Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife.  Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid, which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series.  Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife.  Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.