Wendy L. Frankel, MD, and Mark Bloomston, MD, The Ohio State University Medical Center, Columbus, OH
Kisha Mitchell, MD, Yale University, New Haven, CT
Recent advances in surgical treatments and neoadjuvant therapies have led to new challenges in pathologic evaluation of neoplasia throughout the GI tract. Pathologic assessment has become more challenging than ever and is fraught with pitfalls. Additionally, the role of the pathologist has expanded to encompass the evaluation of new prognostic and predictive factors. The interaction between the pathologist and surgical oncologist is vital to optimize patient care, and is facilitated by an understanding of the impact of diagnosis, staging and grading on patient care. Emphasis will be placed on common diagnostic challenges particularly in the neoadjuvant setting. A unique aspect of our course will be the presence of a surgical oncologist, and his perspective on informative reporting and impact on treatment. A case study format will be utilized that will include a discussion on pathology and surgical and oncologic treatment. The cases to be illustrated include: 1) GE junctional adenocarcinoma; 2) GI neuroendocrine tumor; 3) rectal adenocarcinoma; 4) pancreatic neoplasm and frozen section analysis of the margin; and 5) hepatocellular adenoma. Ancillary studies including immunohistochemical and molecular testing will be emphasized where relevant.
Upon completion of this educational activity, the participants should be able to: 1) Understand clinically relevant issues in reporting staging and grading of some GI malignancies; 2) Recognize pathologic changes after neoadjuvant therapy in esophageal and colorectal carcinomas; 3) Understand the surgical impact of frozen section evaluation of the pancreatic margin; 4) Review various surgical and oncologic treatments of select GI malignancies including the importance of immunohistochemical and molecular marker such as Her-2, BRAF, KRAS, MSI and Ki-67; and 5) Employ useful strategies to evaluate liver biopsies of well differentiated hepatocellular neoplasms.
The course is designed for residents, fellows, and general surgical pathologists. Virtual slides and still images, along with histories will be posted on the USCAP website for review by the pre-registrants prior to the meeting. Participants will also receive a syllabus with a reference list at the meeting. After the meeting, participants will receive web access to the presentation given at the Annual Meeting.