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Wake Forest School of Graduate COMPLEX GENERAL SURGICAL Welcome Complex General Surgical Oncology Program

The Complex General Surgical Oncology Fellowship Surgical Oncology is a key component of the Fellowship highlights include: is a two-year program focused on clinical and Comprehensive Center and the • Oncology operative skills in surgical oncology, while Department of General . The • Surgical emphasizing complex surgical procedures for overarching goals of the Surgical Oncology problems seen in a tertiary referral center. Service are to provide exemplary state-of-the- • Medical Oncology art care in a setting linked to research and • Radiation Oncology education at all levels. The service is • Involvement in research and academic extensively involved in multimodality endeavors consultations for the care of patients with melanoma, sarcoma, endocrine tumors and include: diseases of the breast, as well as the full • Breast Care Center spectrum of gastrointestinal from • Hyperthermic Intraperitoneal esophagus to anus. The service serves as a Chemotherapy (HIPEC) referral source for the region’s cancer patients. • Hepatobiliary & Pancreatic Surgery This leads to a very busy clinical service with approximately 1,500 major operative cases • Endocrine Surgery and more than 8,000 outpatient visits per year. • Melanoma/Sarcoma Surgery

Faculty members of Surgical Oncology are Our rotations include: dedicated to teaching the next generation of to care for those with oncologic • Surgical Oncology diseases. Trainees on service are part of a • Endocrine team that brings considerable clinical • Breast expertise to caring for patients who require • Radiation Oncology , treatment and follow-up due • to primary, recurrent or metastatic malignancy. • Medical Oncology A substantial portion of clinical effort is also devoted to the resection of metastatic • Thoracic Surgical Oncology disease, including that of the liver, lung, • peritoneum and lymph nodes. Extensive clinical experience in a tertiary referral setting also provides the surgical know-how for dealing with rare and unusual .

2 3 Subspecialties

BREAST CARE CENTER Clinical trials and basic research. By inserts cannulas through the abdominal wall and has led to hope and even cures of combining laboratory and clinical research, and temporarily closes the incision. The patients thought to be untreatable elsewhere. The Breast Care Center offers a full spectrum we provide our patients with the latest cannulas are attached to a pump which advances in breast cancer diagnosis and completes a circuit that moves a heated Our team has been honored with numerous of services to improve breast health. Services prestigious medical publications and has include screening and diagnostics, breast treatment, including: sentinel lymph-node anti-cancer drug fluid into the abdominal mapping, breast-conserving surgery, cavity and then back out for a constant flow. trained performing the procedure cancer treatment for both benign and at other leading institutions. The Surgical malignant breast disease and prevention immediate breast reconstruction and The hyperthermia improves the drug’s radiation implants. effectiveness, particularly in patients for Oncology Service has performed over 1,500 and survivor programs. Wake Forest Baptist of these procedures, representing one of the was also first in the region to be granted full whom there was previously no hope. This Genetic screening is offered by the Genetic approach can add years of life for patients, most experienced teams worldwide. accreditation by the National Accreditation Counseling Program for a variety of Program for Breast Centers, administered by including breast, colorectal, ovarian and the American College of Surgeons. We are melanoma. Our genetic counselors work with also an accredited Breast Imaging Center of us in and support genotyping in Excellence through the American College of appropriate patients prior to operative . interventions. Resources include:

A Breast Imaging Center of Excellence incorporating mammography, ultrasound, HYPERTHERMIC MR and image-guided biopsy staffed by experts in breast imaging. INTRAPERITONEAL CHEMOTHERAPY (HIPEC) Multidisciplinary care. We have developed a system that streamlines breast cancer Since 1991, patients have been treated at diagnosis, treatment and follow-up of our Wake Forest Baptist with this promising and patients. In addition, our surgical oncologists innovative therapy. Currently, there are only a and plastic surgeons work in tandem to plan handful of experienced centers and surgeons and perform breast reconstructions. across the country. Our world-class expertise Specialists who are experts at breast in HIPEC draws patients from all over the cancer treatment. Our physicians, who are United States for both established treatments all fellowship-trained, work collaboratively to and clinical trials. The logic behind the identify the most effective treatment options procedure is that delivering antineoplastic for each breast cancer patient. agents into the peritoneal cavity after maximal cytoreduction has a substantial Personalized breast cancer treatment pharmacokinetic dosing advantage over even plans. Most patients get the opportunity to the most aggressive systemic . meet with multiple physicians in a single day During the procedure, the removes and leave with a treatment plan in place. all visible growth from the patient’s abdomen,

4 5 HEPATOBILIARY & CLINICAL TRIALS PANCREATIC SURGERY (HPB) Our Surgical Oncology research program has HPB surgery consists of the general surgical about 30 trials open. treatment for benign and malignant diseases This program features: of the liver, pancreas, gallbladder and bile ducts. These are among the most challenging • Cooperative group oncology trials and complex surgical procedures performed • Investigator-initiated trials in and require a high degree of expertise and skill. • Database-driven retrospective trials (HIPEC, liver, breast, esophagus, melanoma and Wake Forest Baptist has a dedicated pancreas) multidisciplinary team committed to the • Collaborative data-sharing studies diagnosis and treatment of complex diseases of the liver bile duct, gallbladder and • Tissue procurement infrastructure pancreas. Our team specializes in minimally • Quality of life/outcome trials invasive approaches including laparoscopic, robotic and endoscopic techniques. We are a National Pancreas Foundation-accredited center for pancreatic cancer.

ROBOTIC SURGERY

We currently have three DaVinci Robotic Surgical Systems — one Si and two Xi (one with training console) systems in the operating room. There is a dedicated robotic OR time for General Surgical Oncology and fellows are expected to receive full credentialing in robotic surgery if they have not already done so in residency.

6 Reese W. Randle, MD Marissa Howard-McNatt, MD Assistant Professor, Surgical Associate Professor, Surgical Sciences – Oncology Sciences – Oncology Publications and Presentations Director, Breast Care Center

Medical School: University of Texas – Houston : Harvard Medical School Residency: Wake Forest Baptist Medical Residency: West Virginia University The surgical oncology research program led changing MSLT-2 trial, which showed that Center to 66 authorships for faculty in 51 individual complete lymphadenectomy is not routinely Fellowship: Endocrine Surgery – Fellowship: Massachusetts General peer-reviewed manuscripts in 2018. required for melanoma metastatic to sentinel University of Wisconsin Hospital Further, our efforts to make research lymph nodes. We were also well represented available to trainees has borne fruit, as nine at major surgical conferences including six residents and fellows were co-authors on presentations at the Society of Surgical Akiko Chiba, MD Russell Howerton, MD our manuscripts in 2018. Our clinical Oncology meeting in March, and major Assistant Professor, Surgical Wake Forest Baptist Medical research was highlighted by a publication in presentations at national and international Sciences – Oncology Center Chief Medical Officer the New England Journal of Medicine HIPEC symposia, and GI-ASCO (co-authored by Dr. Levine) on the practice Professor, Surgical Sciences – Oncology

Medical School: St. George’s University School Medical School: Vanderbilt University School of of Medicine Medicine Residency: Maimonides Medical Center Residency: Tufts-New England Medical Fellowship: Oncology Research, National Center Faculty Cancer Institute (NCI) Fellowship: Mt. Sinai Hospital of Cleveland Breast Surgical Oncology, London Hammersmith Mayo Clinic Hospital – United Kingdom

Clancy Clark, MD Edward Levine, MD Perry Shen, MD Konstantinos Votanopoulos, Associate Professor, Surgical Chief, Surgical Oncology Professor, Surgical Sciences MD Sciences – Oncology Professor, Surgical Sciences – Oncology Professor, Surgical Sciences Associate Program Director, – Oncology Program Director, Complex – Oncology General Surgery Residency Tumor Bank Core Director, General Surgical Oncology Fourth-year Medical Comprehensive Cancer Center Fellowship Clerkship Director, Surgery Senior Advisor to the Center Director, Liver and Pancreas Medical School: Aristotle University School of Medical School: Ohio State University College Director, Comprehensive Surgery Program Medicine – Greece of Medicine Cancer Center Medical School: University of Southern PhD: Aristotle University School of Residency: Virginia Mason Medical California School of Medicine Medicine – Greece Medical School: Finch University of Health Center Residency: University of Southern Residency: Baylor College of Medicine Sciences – Chicago Medical Fellowship: Surgical Research, Virginia California Affiliated Fellowship: Roswell Park Cancer Institute School Mason Medical Center Fellowship: John Wayne Cancer Institute Residency: Michael Reese Hospital and Hepatobiliary and Pancreatic Medical Center Surgery, Mayo Clinic Fellowship: University of Illinois

8 9 Wake Forest Baptist Health Facts

QUICK FACTS: 2019 • 1941 Bowman Gray School of Medicine opens in Winston-Salem with 75 students. • Total Licensed Beds: 1,535 • 1942 First General Surgery residency program graduate. • Inpatient Admissions: 58,344 • 1957 The Medical Center becomes the first in • Emergency Department Visits: 158,344 the state to use cobalt to treat cancer patients. • Other Outpatient Visits: 1.86 million • 1964 The first hand re-implantation in the • Total Research Awards: $205 million United States is performed by Jesse • School of Medicine Faculty: 1,247 Meredith, MD. • Total Physicians: More than 2,000 • 1969 The Medical Center is the first in the nation to use ultrasound to detect prostate • Registered Nurses: 5,019 cancer. • Medical Students: 980 • 1974 Cancer Center is accredited by the NCI. • Total Medical Center Workforce: 20,542 • 1978 Commission on Cancer accreditation by • $199.2 million in estimated unreimbursed the American College of Surgeons. care • 1990 Cancer Center is designated as a • $56.9 million in charity care “Comprehensive” Cancer Center. • $117.8 million in education, unfunded • 1991 First HIPEC procedure performed at research and community health initiatives, Wake Forest. operations, programs and donations. • 1998 Breast cancer sentinel node mapping program initiated. • 2000 Multimodality Breast Care Clinic opens. OUR HISTORY • 2004 Outpatient Cancer Center Building opens containing Surgical Oncology . • 1902 Wake Forest College Medical School • 2009 Surgical Oncology Fellowship initiated. is founded as a two-year program on the • 2009 National Accreditation Program for campus of Wake Forest College in Wake Breast Cancer (NAPBC) approval. Forest, North Carolina. • 2013 A 282,800-square-foot addition to the • 1923 North Carolina Baptist Hospital Comprehensive Cancer Center opens, opens in Winston-Salem as an 88-bed consolidating inpatient and outpatient facility with a School of . services under one roof. Cancer Center • 1939 A trust fund of $750,000 established inpatient units open. in the will of Bowman Gray Sr. is pledged • 2014 Surgical Oncology accreditation to relocate the Wake Forest Medical granted by ACGME and American Board School to Winston-Salem and expand its of Surgery. program to four years.

11 Winston-Salem, North Carolina

Winston-Salem, a city of about 235,000 Winston-Salem is about an hour away from people, is located in Forsyth County in the Hanging Rock and Pilot Mountain state parks Piedmont Area of North Carolina. and the Blue Ridge Parkway. Driving time to the Carolina beaches varies from four to five It has been named among America’s most hours. North Carolina is a home to a livable cities, and features low traffic, a low burgeoning number of local wineries, many cost of living, a low crime rate and four distinct, of which are within short drives of yet temperate seasons. Winston-Salem. The city’s vibrant downtown area includes the The city is home to the University of North Stevens Center for the Performing Arts, the Carolina School of the Arts, the only state- Milton Rhodes Center for the Arts and BB&T supported school for the arts in the nation. Ballpark, home of the minor-league Winston- Also in the city are the Winston-Salem Salem Dash baseball team, as well as a Orchestra, Piedmont Opera, the Southeastern growing number of apartments, Center for Contemporary Art (SECCA), condominiums, lofts, craft bars and Reynolda House with its gardens and restaurants. The Downtown Arts District, American art collection, the museum of Early centered on Trade Street, is home to an Southern Decorative Arts (MESDA) and Old ever-expanding lineup of unique galleries Salem, the site of the Moravian town founded and shops. in 1766, from which the present city grew. Ten miles west, just off Interstate 40, is Forsyth For more information about the region, go to County’s Tanglewood Park, with its PGA visitwinstonsalem.com championship golf courses, tennis courts, swimming pool, picnic grounds, horseback riding, paddle boats and playing fields. There are more than 30 local golf courses.

12 13 14 Complex General Surgical Oncology Fellowship Surgery Administration 5th Floor Watlington Hall Medical Center Boulevard Winston-Salem, NC 27157

NOTE: Some photos were shot prior to the COVID-19 pandemic. Since that time, all patients, faculty and staff are required to wear masks at Wake Forest Baptist Health facilities.