Nicholas J. Petrelli, M.D., medical director of the Helen F. Graham Cancer Center at Christiana Care, participated in the Society of Surgical Oncology’s “Great Debates” series during the 66th SSO Annual Cancer Symposium Saturday, March 9, in National Harbor, Md.
Intended to provoke lively and educational discussions about treatment strategies to combat cancers that impact large patient populations, the Great Debates are a highlight of the symposium. Only past presidents of the society can participate.
“The Great Debates are an enjoyable academic exercise that gives us a chance to pose challenging questions in front of an international audience of surgical oncologists,” Dr. Petrelli said. “To be chosen was an honor, and it was one of the high points of my career.”
Dr. Petrelli and Mitchell C. Posner, M.D., chief of general surgery and surgical oncology from the University of Chicago, were given the debate topic “Surgery Alone Versus Surgery Plus Chemotherapy for Resectable Colorectal Liver Metastases.” Dr. Petrelli argued in favor of surgery alone; Dr. Posner argued in favor of both surgery and chemotherapy.
During his portion of the debate, Dr. Petrelli, who has authored published studies on the subject and developed national prospective randomized trials, noted that it is important to determine whether the treatment offers value to patients’ lives. Randomized prospective studies have shown that there is no improvement in overall survival for patients who receive surgery and chemotherapy, with its added toxicity and cost.
“The real crux of the matter here is surgical resection and avoiding the toxicity and the cost of these agents, which have absolutely no impact on overall survival as shown by prospective randomized trials,” Dr. Petrelli said during the debate. “Randomized trials are the gold standard in oncology.”
At the Helen F. Graham Cancer Center, patients benefit from a multidisciplinary care model that includes a surgeon, a medical oncologist and a radiation oncologist. In the real world, Dr. Petrelli said, the vast majority of patients with resectable liver metastases from colorectal cancer will be treated by both surgery and chemotherapy.
“Our treatments are based on national guidelines that come down to what is best for the individual patient, and our decisions include the individual desires of the patient,” Dr. Petrelli said. “We work with our patients to create the most appropriate and effective plan of treatment for their cancer, whether that treatment is surgery alone or whether it is surgery and chemotherapy.”