EUROPEAN UNIVERSITARY DIPLOMA HEPATIC-PANCREATIC AND BILIARY CANCERS : ONCOSURGICAL STRATEGIES 2017 / 2018 Program

Session 1 / Generalities on HPB cancers. Primary hepatic malignancies and Biliary Cancers December 11 – 14, 2017

Monday, December 11th Hepatocellular Carcinoma (HCC)

Discussion Panel : C. Guettier, F. Kunslinger, D. Samuel, R.Adam 08h30 – 9h00 Welcome address R. Adam 09h00 – 10h00 Epidemiology, carcinogenesis, natural history of HCC D. Samuel 10h00 – 11h00 Imaging of HCC F. Kunstlinger 11h00 – 12h00 Pathology of HCC C. Guettier 12h00 – 13h00 Diagnosis of HCC: Practical attitude. When is it definitive? R. Adam What to do in doubtful cases ? Indications of the biopsy,

Discussion Panel : Th. De Baere, M. Ducreux, R. Adam, X. Mirabel 14h00 – 15h00 Chemotherapy of HCC: new drugs / new indications J.F. Morere 15h00 – 16h00 Transarterial Chemoembolization S. Awad 16h00 – 17h00 Stereotactic radiotherapy for HCC X. Mirabel 17h00 – 18h00 Radiofrequency, Cryotherapy, Alcohol injection Th. De Baere 18h00 – 19h00 Imaging follow up of HCC treated by tumor ablation F. Kunstlinger or chemoembolization

Tuesday, December 12th HCC / Non-biliary Primary Hepatic Malignancies

Discussion Panel : E. Vibert, D. Cherqui, 09h00 – 10h00 Translational Research. Applications in HPB cancers J. Faivre 10h00 – 11h00 Portal Embolization and Post operative Liver failure E. Vibert Normal vs cirrhotic liver 11h00 – 12h30 Liver Resection. What patients to resect ?. D. Cherqui Principles. Results. Role of laparoscopic surgery 12h30 – 13h00 New tools in liver surgery E. Vibert

Discussion Panel : F. Kunstlinger, J. Lerut, S. Branchereau 14h00 – 15h00 Transplantation for HCC : Indications and results R. Adam Resection or Transplantation as first treatment option? R. Adam 15h00 - 16h30 Liver transplantation for HCC. How far can we go? J. Lerut Vascular Liver tumors J. Lerut 16h30 – 17h30 Primary hepatic malignancies in children S. Branchereau

6/04/18 1 Wednesday, December 13th Biliary tract cancers

Discussion Panel : E. Vibert, C. Guettier, J. Figueras 09h00 – 10h00 Surgical Anatomy of the biliary tract E. Vibert 10h00 – 11h00 Imaging of biliary tract Cancers (intra and extrahepatic) M. Lewin 11h00 – 12h00 Pathology of Cholangiocarcinoma : Intrahepatic/ Klatskin C. Guettier 12h00 – 13h00 Staging of resectability of Klatskin tumors J. Figueras

Discussion Panel : J. Figueras, D. Cherqui, G. Pelletier 14h00 – 15h00 Preoperative biliary drainage : Yes or No ? J. Figueras Portal embolization : When ? 15h00 – 16h00 Klastskin tumors: Palliative and curative surgery D. Cherqui 16h00 – 17h00 Role of liver transplantation in biliary tract Cancers E. Vibert What selection of patients? 17h00 – 17h30 What about “Pseudo Klatskin tumors”: The role of spyglass technology Endoscopic treatment of klastskin tumor G. Pelletier

Thursday, December 14th Biliary tract cancers (2)

Discussion Panel :, C. Hennequin, M. Adham, J.F. Morere 09h00 – 9h30 Chemotherapy of biliary cancers and IH cholangiocarcinoma J.F. Morere 9h30 - 10h30 Congenital abnormalities of the extrahepatic biliary tract G. Nappo / Risk of malignancy – Indications of surgery M. Adham 10h30 – 12h00 Radiotherapy of biliary tract Cancers C. Hennequin / F. Huguet

Discussion Panel: O. Farges A. Sauvanet, E. Vibert 13h00 – 14h00 Intrahepatic Cholangiocarcinomas O. Farges 14h00 – 15h00 Adenocarcinoma of the gallbladder O. Farges 15h00 – 16h00 Adenocarcinoma of the Ampulla of Vater A. Sauvanet Indications and role of local surgery 16h00 – 17h00 Presentation of clinical cases of HCC or cholangiocarcinomas (case +video)

6/04/18 2 Session 2 / Liver Metastases from Colorectal Cancer February 5 – 9, 2018 Monday, February 5th

Discussion Panel: T. André, C. Guettier, A. Lemoine, M. Lewin 09h00 – 10h00 What Follow-up after colorectal cancer and what type Th. André of adjuvant chemotherapy? 10h00 – 11h00 Imaging by ultrasound, CT Scan and MRI M. Lewin 11h00 – 13h00 Hepatic Metastases: new prognostic markers (RAS, B Raf…) Inpact of Molecular Biology on treatment and prognosis A. Lemoine Pathology : New prognostic markers C. Guettier

Discussion Panel: E. Vibert, F. Kunstlinger, 14h00 – 15h00 Intraoperative liver ultrasound E.Vibert 15h00 – 16h00 In practice: What check up for an optimal imaging ? F. Kunstlinger

Tuesday, February 6th Discussion Panel : A. De Gramont, J. Figueras, R. Adam 09h00 – 10h00 Systemic Chemotherapy in metastases CRC: A. De Gramont What is the optimal treatment ? Resectability : a new end point ? 10h00 – 11h00 Liver resection. Principles, prognostic factors, practical policy J. Figueras 11H00 – 12H30 Resection of non resectable metastases after chemotherapy R. Adam - Impact of targeted therapies - Complete response after chemotherapy : a goal to achieve ? - What to do in case of complete radiological response ?

Discussion Panel : F. Lévi, M. Ducreux, R. Adam 13h30 – 14h30 Chrono-modulated chemotherapy : Principles, Indications F. Lévi 14h30 – 15h30 Intra-arterial Chemotherapy : The reappraisal ? M. Ducreux, F. Lévi 15h30 -16h30 Pet-Scan. Improvements in Diagnosis and in E. Zerbib therapeutic strategy

Wednesday, February 7th Discussion Panel : R. Adam, S. Fenwick, 09h00 – 10h00 Resectability of liver metastases : Better definition S. Fenwick Towards an international standard ? What impact on classification? 10h00 – 12h00 Synchronous liver metastases Chemotherapy first or surgery of the primary ? (30 min) M. Faron One-stage Resection ? (30 min) or F. Faitot Delayed Resection ? (30 min) R. Adam Discussion (30 min) 12H00 – 13H00 Metachronous Liver Metastases: R. Adam Rationale for neoadjuvant chemotherapy of resectable metastases When Is it useful ?

6/04/18 3 Discussion Panel : F. Kunslinger, M. Sebagh, R. Adam 14h00 – 15h00 Effects of chemotherapy on the liver. Clinical Implications M. Sebagh, 15h00 – 16h00 Radiological assessment of chemotoxicity on the liver F. Kunstlinger 16h00 – 17h00 Elderly patients : What oncosurge strategy ? E. Paillaud/ 17h00 – 18h00 «LiverMetSurvey»: an international registry of patients operated F. Caillet for colorectal metastases: rationale and results R. Adam, D. Delvart

Thursday, February 8th How to Increase the resectablity of Liver Metastases ?

Discussion Panel : E. Vibert, F. Kunstlinger, D. Goéré, R. Adam 09h00 – 10h00 Portal Embolization E. Vibert 10h00 – 11h00 How to increase resectability with hepatic arterial infusion? D. Goere 11h00 – 12h00 Two-stage hepatectomy and ALPPS R. Adam 12h00 –13h00 Extreme Liver surgery: total vascular exclusion, extracorporeal M. Gelli / R. Adam bypass, hepatic cooling

Discussion Panel : D. Cherqui, R. Adam, G. Tozilli 14h00 – 15h00 The use of IOUS by the hepatic surgeon. Application to G. Torzilli IOUS-guided one stage hepatectomy for multiple metastases 15h00 – 16h00 Laparoscopic surgery: Present indications and results D. Cherqui 16h00 – 17h00 Discussion : which procedure for which patients ? R. Adam 17h00 – 18h00 Liver transplantation: is there any rationale to be revisited R. Adam

Friday, February 9th Recurrence of metastases

Discussion Panel : R Adam, F. Kunstlinger, A Uluzakarya 09h00 – 10h00 Risks and prognostic factors of recurrence G. Pittau 10h00 – 11h00 How to prevent it ? A.Ulusakarya Adjuvant chemotherapy after hepatectomy : how and when? 11h00 – 12h00 How to detect it ? Imaging: What optimal follow-up ? F. Kunstlinger 12h00 – 13h00 How to treat it ? Repeat hepatectomy: Indications and results. O. Ciacio

Discussion Panel : F. Kunstlinger, D. Goéré , R. Adam 14h00 – 15h00 Radiofrequency : an alternative to repeat resection? F. Deschamps 15h00 – 16h00 Surgery of pulmonary metastases R. Adam 16h00 – 17h00 Surgery of extrahepatic metastases (other sites) D. Goéré 17h00 – 18h00 Discussion forum: case Reports R. Adam, E. Vibert

6/04/18 4 Session 3 / Non-Colorectal Liver Metastases – Cancer of the Pancreas May 14- 18, 2018

Monday, May 14th Non colorectal, Non Endocrine Metastases : Metastases of known origin

Discussion Panel : M. Ducreux, F. Kunstlinger 09h00 –10h00 Liver Metastases from Upper GI cancer M. Ducreux, R. Adam 10h00 – 11h00 From Melanoma P. Mariani, 11h00 –12h00 From Urinary tract cancers R. Adam

Discussion Panel : S. Giacchetti, A. Le Cesne, R. Adam 13h00 – 14h00 From Breast cancer S. Giacchetti, R. Adam 14h00 – 15h00 From Uterus, Ovarian or Testis carcinoma D. Goéré 15h00 – 16h00 GIST and other sarcomas A. Le Cesne, 16h00 – 17h00 Summary: When to propose surgery of non colorectal R. Adam non endocrine metastases ?

Tuesday, May 15th Non colorectal, Non Endocrine Metastases : Metastases of unknown origin

Discussion Panel : M. Lewin, C. Guettier, J.P. lotz, R Adam 9h00 – 10h00 What diagnostic and therapeutic strategy to propose ? J. Gligorov 10h00 – 11h00 Tumor Imaging : Specificity in relation to the primary M. Lewin 11h00 – 12h00 How can the liver biopsy help the diagnosis of the primary ? C. Guettier 12h00 – 13h00 Pathology of endocrine tumors C. Guettier

Carcinoid and Endocrine Metastases

Discussion Panel : M. Lewin, M. Ducreux, C. Guettier, R. Adam

14h00 – 15h00 Imaging of hepatic metastases from endocrine tumors M. Lewin 15h00 – 16h00 Clinical presentation and biological aspects M. Ducreux 16h00 – 17h00 Place of chemotherapy and chemoembolization M. Ducreux, 17h00 – 18h00 Liver resection and Transplantation A. Sa Cunha Respective indications and results

Wednesday, May 16th Cancer of the Pancreas Discussion Panel : J.R. Delpero, A. Sa Cunha, J.Y. Scoazec, M. Zins, 9h00 – 10h00 Surgical anatomy of the pancreas J.R Delpero 10h00 – 11h00 Pathology of malignant tumors of the pancreas J.Y. Scoazec 11h00 – 12h00 Imaging of malignant tumors of the pancreas M. Zins 12h00 – 13h00 Diagnostic and interventional echoendoscopy E. Bories

Discussion Panel : J.R. Delpero, A. Sa Cunha, A. Sauvanet 14h00 – 15h00 Preoperative check up. Staging of resectability A. Sauvanet Preoperative biliary drainage: yes or no ? 15h00 – 16h00 Margings of resection => Critical Study J.R. Delpero 16h00 – 17H00 Place of radiofrequency for pancreatic adenocarcinoma E. Deutsch

6/04/18 5 Thursday, May 17th Cancer of the Pancreas (2)

Discussion Panel : J.R. Delpero, A. Sa Cunha, C. Louvet, 9h00 – 10h00 Adjuvant treatment after resection C. Louvet Today and perspectives 10h00 – 11h00 Translational research. Results and perspectives J.B. Bachet 11h00 – 12h00 Borderline and locally advanced P. Hammel How to manage?

Discussion Panel : J.R. Delpero, C. Louvet, A. Sa Cunha 13h00 –14h00 Vascular resection with pancreatectomy P. Bachellier 14h00 – 15h00 Surgery after neoadjuvant treatment A. Sa Cunha 15h00 – 16h00 Lessons from the French 5 years experience J.R. Delpero

Friday, May 18th Tumors of the Pancreas

Discussion Panel : J.R. Delpero, A. Sa Cunha, M. Adham, F. Paye 9h00 – 10h00 Endocrine Tumors: Classification and staging system A. Couvelard 10h00 – 11h00 Endocrine Tumors: Diagnostic and treatment P. Pessaux 11h00 – 12h00 Diagnosis algorithm and decision making for M. Adham / a cystic pancreatic tumour Dr Nappo 12h00 – 13h00 Intrapancreatic papillary and mucinous tumors. F. Paye Arguments for malignancy, Indications for resection

Discussion Panel : J.R. Delpero, M. Adham, A. Sa Cunha 14h00 – 15h00 Methods of resection for invasive and non invasive IPNMs A. Sa Cunha 15h00 – 16h00 Follow-up of resected and non resected IPNMS V. Rebours

16h30-17h30 Final Examination

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