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The mission of the Division of Surgery is to advance oncologic surgery in the nation and the world through safe, high-quality, multidisciplinary patient care, research and education. In the pages that follow we’ll demonstrate the breadth of cancer care provided by each of our nine departments. Through innovation and the dedication of our providers, we have simultaneously achieved exceptionally low mortality rates and high clinical volumes. This publication contains detailed data on our surgical outcomes and volumes from each of our nine departments. In each department’s section, you will learn about the care provided, the care providers, innovative procedures, and hear from a patient about his or her cancer journey. Each section of this report also profiles researchers who are changing cancer care paradigms, like the Melanoma Moon Shot, which is discovering immune therapies for melanoma, as well as ways to decrease tanning bed use across the globe. Our surgeon-scientists and co-investigators in their respective labs are also studying areas such as genetic and targeted cancer therapies, the microenvironment of tumors and the development of novel flaps for tissue reconstruction, to name a few. Many are leading the way in advancing national trends, like precision medicine and eliminating opioid addiction. Our vision is to be the most transformative oncologic surgery program in the world. To do so, we are expanding our network and providing advanced surgical care in multiple Houston-area locations, including League City, West Houston, Memorial City, Sugar Land and The Woodlands, and with national partners in Arizona, Florida, New Jersey, California and other locations. Surgical care of cancer patients can be challenging for all involved. With this report, we renew our commitment to our partners and patients to provide the most compassionate and expert care possible. We hope you find the pages that follow as interesting, informative and inspiring as we do. Stephen Swisher, M.D. Head, Division of Surgery Adolfo Chavez 4 MD Anderson Cancer Center BY THE NUMBERS FY18 cases by service Breast Surgical Oncology 10% Gynecologic Oncology 6% Head and Neck Surgery 14% Neurosurgery 5% Orthopaedic Oncology 4% Plastic Surgery 10% Surgical Oncology 26% Thoracic & Cardiovascular Surgery 8% Urology 17% FY18 active grants Active Federal Training Grant 3 Active P01 Grant 1 Active Peer Reviewed Federal Grant 33 Active Peer Reviewed Non Federal Grant 18 Active Peer Reviewed Sub Contract 46 Active Spore Grant 3 Active U Cooperative Agreement 6 Other 177 outpatient surgeries in FY 14 $12.9 million FY 18 $22 million Research funding activity 71,462 FY18 total surgery hours Division of Surgery | Surgical Outcomes FY18 5 BRINGING INNOVATION TO THE OR At MD Anderson, our surgeons are known for making procedures once deemed impossible, possible, helping our patients celebrate birthdays they wondered if they’d ever see or experience a quality a life they thought they could only dream of. In summer 2017, Jesse Selber, professor of Plastic Surgery, led a team of five plastic surgeons in performing a news-making twin tissue transplant. The patient, Marian Fields, had been struggling with an undiagnosed cancer for years. When she finally came to MD Anderson, she was diagnosed with plexiform fibrohistiocytic sarcoma, an aggressive skin cancer so rare that only about 150 cases have been confirmed in the US since 1980. When Selber met with Marian, he explained that the tumor couldn’t be removed only because Marian didn’t have enough tissue to close the wound completely. That’s when Marian’s twin sister Mary Jane came to the rescue. Without hesitation, Mary Jane volunteered to donate her own tissue to Marian. In a 14-hour surgery, surgeons removed a section of flesh — 21.5 inches by 8.5 inches and 2 inches deep – from Mary Jane’s abdomen, stitched it closed in a large tummy-tuck and transferred it to Marian’s back after the tumor was removed by connecting eight different arteries and veins. “It’s probably the largest free tissue transfer I’ve ever seen, and the most extensive twin transplant that’s ever been done,” says Selber, who just a few years before led a team of surgeons in the first-ever scalp transplant. Both surgeries were made possible by a technique called microsurgery, a type of robotic surgery in which surgeons reconnect very small blocked vessels, nerves and lymphatic vessels with tiny stitches – some thinner than a hair and difficult to see with the human eye. It’s just one type of new technology and innovation we’ve embraced. Over the past 10 years, our surgeons have performed more than 7,000 robotic surgeries and microsurgeries, using Da Vinci robots. Equipped with miniature surgical tools and 3-D cameras with magnification of the operative view, the five robots allow our skilled surgeons to operate with extreme
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