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Resection of the Primary Tumor in Stage IV Colorectal Cancer: When Is It Necessary?

Feo, Leandro; Polcino, Michael; Nash, Garrett M
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention. Palliative measures for local control of the primary tumor include colonic stents, laser therapy, and fulguration.
PMID: 28501253
ISSN: 1558-3171
CID: 5047552

Leadership trends in plastic surgery

Addona, Tommaso; Polcino, Michael; Silver, Lester; Taub, Peter J
BACKGROUND: The authors examined the recent trends in the composition, appointment, and turnover of chairpersons in academic plastic surgery. METHODS: A survey regarding the characteristics of the current and former department chairpersons in plastic surgery was mailed to the 89 existing academic plastic surgery programs. The survey focused on the age, gender, subspecialty, interim tenure, and overall tenure of the two groups. RESULTS: An initial response was received from 60 chairpersons. The majority of current chairpersons are male (81 of 89, 91 percent), which is slightly lower than the group of immediate past chairs, of whom 98 percent (87 of 89) were male. From the questionnaires, it was noted that for both the current and former groups of chairpersons, the 40- to 50-year age range was the most frequent age group at which an individual was appointed to that position. Approximately one-third (35.7 percent) of the current group consider themselves 'general plastic surgeons.' This differs from their predecessors, of whom 56.0 percent reported the same designation. An increase in the promotion of existing faculty to chairpersons was also noted. As compared with 44.2 percent of the previous group, 69.5 percent of the current chairpersons were promoted from within the department. CONCLUSIONS: The population of academic chairpersons in plastic surgery is changing. Today, more chairpersons appear to be younger and specialty trained. Examining the history of academic leadership and identifying trends in any field of medicine can only help to better prepare the specialty for the future
PMID: 19182639
ISSN: 1529-4242
CID: 93479