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Terminó hace 8 meses

22 de feb 08:30 - 23 de feb 17:30

"The field of Rectal Cancer management is shifting as never before : beset indeed by "angels and demons" -
Angels - Unprecedented opportunities for improvement  - robotics to increase precision in surgery, image guidance, intensity modulation and target stabilisation to refine radiation. 
Demons - the confusion of recent studies and the mounting morbidity of current protocols. 
The Champalimaud Foundation has brought together, perhaps uniquely, the “Watch and Wait" thinking of Habr-Gama and her team with the imaging and radiotherapy skills to exploit superior radiation technology  ...
On 22nd-23rd February we will share with you the many dogmas that now need to be challenged by the modern Colorectal Cancer MDT and the many improvements that now seem possible for the patients of tomorrow."
Prof Bill Heald, Chairman of the “Colorectal Cancer Project”, The Champalimaud Institute for the Unknown, Lisbon, Portugal
Speakers
BILL HEALD, Champalimaud Foundation, Lisbon
ANE APPELT, University of Leeds, UK
SVETLANA BALYASNIKOVA, Royal Marsden, UK
RODRIGO PEREZ, Faculdade de Medicina da Universidade de S. Paulo, Brazil
SOREN LAURBERG, Aarhaus University, Denmark
CARLOS CARVALHO, Champalimaud Foundation, Portugal
KRZYSZTOF BUJKO, Maria Sklodowska-Curie Memorial Cancer Center, Poland
ROB GLYNNE-JONES, Mount Vernon Hospital, UK
ORIOL PARES, Champalimaud Foundation, Portugal
QUENTIN DENOST, Bordeaux University Hospital, France
GEERARD BEETS, The Netherlands Cancer Institute, Netherlands
REGINA BEETS-TAN, The Netherlands Cancer Institute, Netherlands
NUNO FIGUEIREDO, Champalimaud Foundation, Portugal
TORBJORN HOLM, Karolinska University, Sweden
TAHSEEN QURESHI, Poole Hospital, UK
PIETER TANIS, Academic Medical Centre, Netherlands
CORNELIS VAN DER VELDE, Leiden University Medical Centre, Netherlands
AMJAD PARVAIZ, Champalimaud Foundation, Portugal
INÊS SANTIAGO, Champalimaud Foundation, Portugal
ANTONY HIGGINSON, Portsmouth Hospital, UK
RICARDO RIO-TINTO, Champalimaud Foundation, Portugal
ROEL HOMPES, Academic Medical Centre, Netherlands
ARTHUR SUN-MYINT, Clatterbridge-Papillon, UK
ANGELITA HABR-GAMA, Instituto Angelita Habr-Gama, Brazil
MIT DATTANI, Pelican Cancer Foundation, UK
NICKOLAS PAPANIKOLAOU, Champalimaud Foundation, Portugal
FRANCK PAGÈS, Hôpital Européen Georges Pompidou, France
MARKUS MAEURER, Champalimaud Foundation, Portugal
RITA FIOR, Champalimaud Foundation, Portugal
CARLOS CORDON-CARDO, Mount Sinai Health System, USA
LAURA FERNANDEZ, Instituto Angelita Habr-Gama, Brazil
Programme:
DAY 1, 22 February
 
7.45 - REGISTRATION
8:15 - OPENING REMARKS – BILL HEALD 
8:30
A.     RADIATION AND SURGERY
1.     Halsted is still alive – “Positive” nodes must be treated?
1.1.   Preoperative radiation
Positive nodes must receive radiation? – ANE APPELT - 8 min
Nodes are not the main indication – SVETLANA BALYASNIKOVA - 8 min
1.2.   Persistent lateral nodes after radiation
Take them by lateral dissection – RODRIGO PEREZ - 8 min 
Surgery has a high price and may not achieve much – SOREN LAURBERG – 8 min
DISCUSSION AND VOTING 15 min – CARLOS CARVALHO
9:20
2.     Radiation strategy
When do I prefer short-course radiation? – KRZYSZTOF BUJKO - 8 min
When do I prefer long-course chemo-radiation? – ROB GLYNNE-JONES - 8 min
Current delineation “standards” – ANE APPELT - 8 min
Total Mesorectal Irradiation – ORIOL PARES - 8 min
DISCUSSION AND VOTING 15 min – SOREN LAURBERG
10:10
3.     Evaluating response
6-7 weeks is best to take decisions? – QUENTIN DENOST - 8 min
6-7 weeks may be too soon for many patients – GEERARD BEETS - 8 min
TRG is the better tool – SVETLANA BALYASNIKOVA - 8 min
TRG is not enough - diffusion may be very useful – REGINA BEETS-TAN - 8 min
MRI is not enough – endoscopy and DRE are very important – NUNO FIGUEIREDO - 8 min
 DISCUSSION AND VOTING 15 min – RODRIGO PEREZ
11.10 COFFEE 
11:30
4.     Surgery after radiation
4.1.   Planning the operation
What’s the guide - the initial tumor OR the response – TORBJORN HOLM - 8 min
4.2.   Margins are still at risk
Extensive surgery may be the only option – GEERARD BEETS - 8 min
4.3.   Defunctioning ostomy
YES – It’s always needed – TAHSEEN QURESHI - 8 min
NO – It’s NOT always needed – PIETER TANIS - 8 min
 DISCUSSION AND VOTING 15 min – CORNELIS VAN DER VELDE
12:20
5.     Functional damage
Can we reduce it with better radiation? – ORIOL PARES - 8 min 
Can we reduce it with better surgery? – AMJAD PARVAIZ - 8 min
Can we really improve the damaged function?  – SOREN LAURBERG - 8 min
 DISCUSSION AND VOTING 15 min – KRZYSZTOF BUJKO
 
13:00 LUNCH
 
14:00
B.     SURGICAL OPTIONS
1.     Imaging is the key
MRI is better for treatment strategy – INÊS SANTIAGO - 10 min
MRI and ultrasound may help in some decisions – ANTONY HIGGINSON – 10 min
Low tumors need different staging criteria – SVETLANA BALYASNIKOVA - 10 min
DISCUSSION AND VOTING 15 min – REGINA BEETS-TAN
14:45
2.“Early” tumors
Endoscopic mucosal resections – RICARDO RIO-TINTO – 10 min
Local excision and “adjuvant” radiation – ROEL HOMPES – 10 min
Endo-cavitary radiation – what are the best candidates – ARTHUR SUN-MYINT - 10 min
 DISCUSSION AND VOTING – PIETER TANIS – 15 min
15:30 COFFEE
15:50
3.     Open, Laparoscopic and Robotic TME
There are still indications for laparotomy in the mini-invasive era – GEERARD BEETS – 10 min
For some patients APE is still the better operation – TORBJORN HOLM – 10 min 
Non-APE options are feasible in most patients – AMJAD PARVAIZ – 10 min
DISCUSSION AND VOTING 10 min – QUENTIN DENOST
16:30
Laparoscopic TME is the current standard - we don’t need more toys – QUENTIN DENOST - 10 min
 DISCUSSION 10 MIN – AMJAD PARVAIZ
16:50
Laparoscopic TME is not good enough – robotic offers a better alternative – AMJAD PARVAIZ - 10 min
 DISCUSSION 10 MIN – QUENTIN DENOST
 17:10
TA-TME – real advantage OR higher risks – ROEL HOMPES - 10 min
DISCUSSION 10 min – NUNO FIGUEIREDO
17:30
PANEL DISCUSSION AND VOTING – BILL HEALD - 15 MIN
DAY 2, 23 February
8:30
C.     ORGAN PRESERVATION
1.              Which patients?
Lower tumors may benefit the most – ANGELITA HABR-GAMA – 8 min
T2 tumors may respond better to chemo-radiation – LAURA FERNANDEZ - 8 min
The functional cost of unneeded irradiation - surgery is still better in many lower risk patients – SOREN LAURBERG - 8 m
What’s the patient’s preference? – ROB GLYNNE-JONES - 8 min
 DISCUSSION AND VOTING 15 min – GEERARD BEETS
9:20
2.     When can we wait longer?
Complete or near-complete clinical response? – GEERARD BEETS - 8 min
To biopsy or not to biopsy? – BILL HEALD - 8 min
How to deal with radiation induced ulcers? – NUNO FIGUEIREDO - 8 min
 DISCUSSION AND VOTING 15 min – ROB GLYNNE-JONES
10:00
3.     Managing tumor “regrowth”
Local excision – problems and pitfalls – RODRIGO PEREZ - 8 min
”Beyond TME” is rarely necessary – GEERARD BEETS - 8 min
”Later” surgery is still very safe – NUNO FIGUEIREDO - 8 min
DISCUSSION AND VOTING 15 min – AMJAD PARVAIZ
10:40 COFFEE
11.00
4.     Measuring the outcomes
Local failures and overall survival – ANGELITA HABR-GAMA  - 10 min
Functional outcomes – GEERARD BEETS - 10 min
DISCUSSION AND VOTING 15 min – SOREN LAURBERG
         11:35
We may still need a randomized trial – ROB GLYNNE-JONES - 10 min
Randomization is nonsense and even unethical – BILL HEALD - 10 min
DISCUSSION AND VOTING 15 min - KRZYSZTOF BUDJKO
12:10
Watch and Wait in a rectal cancer centre – NUNO FIGUEIREDO - 10 min
Meta-analysis – MIT DATTANI – 10 min
The International Watch and Wait Database – big data and new questions – CORNELIS VAN DER VELDE - 10 min
DISCUSSION AND VOTING 15 MIN – RODRIGO PEREZ
13:00 LUNCH
 
14:00
D. IMPROVING RESPONSE AND SURVIVAL
1.     More Radiation
Better tailoring and good targeting – ORIOL PARES - 10 min
The higher the dose the better the response? – ANE APPELT - 10 min
DISCUSSION AND VOTING 10 MIN – ROB GLYNNE-JONES
14:30
2.     More Chemotherapy
2.1.   Adjuvant chemotherapy
Adjuvant chemotherapy is not useful after chemo-radiation – CARLOS CARVALHO  - 10 min
2.2.   Consolidation chemotherapy
It’s the natural option during the waiting period – KRZYSZTOF BUDJKO - 10 min
Best responders do not need it – GEERARD BEETS - 10 min
TRG may guide decisions – SVETLANA BALYASNIKOVA - 10 min
2.3.   Induction chemotherapy
It may be better in more aggressive or less radiosensitive tumors – ROB GLYNNE-JONES - 10 min
         DISCUSSION AND VOTING 15 MIN – CARLOS CARVALHO
15:40 COFFEE
16:00
E. NEW HORIZONS
1. Vision from the unseen – NICKOLAS PAPANIKOLAOU - 10 min
2. Liquid biopsy and response – RODRIGO PEREZ - 10 min
3. Immunity and response – FRANCK PAGÈS - 10 min
4. Immuno-surgery – MARKUS MAEURER – 10 min
5. Drug Avatars – RITA FIOR - 10 min
6. To be or not to be – CARLOS CORDON-CARDO – 10 min 
17:00
F.     FINAL CONCLUSIONS
1.     Questions and answers – NUNO FIGUEIREDO - 15 min
2.     Training surgeons for the FUTURE – AMJAD PARVAIZ - 15 min
3.     The FUTURE of Watch and Wait – ANGELITA HABR-GAMA - 15 min
4.     Angels and Demons in rectal cancer – BILL HEALD - 15 min
18:00       END
Event organisers: 
R. J. (Bill) Heald. CBE
Oriol Parés
Carlos Carvalho
Inês Santiago
Nuno Figueiredo
Amjad Parvaiz 
Geerard Beets
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