Author: Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

SABCS 2019: 10-Year Follow-up of Adjuvant Accelerated Partial-Breast Irradiation vs Adjuvant Whole-Breast Irradiation

December 15, 2019December 15, 2019 Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉A 10-year follow-up study of patients with breast cancer who had been treated with accelerated partial-breast irradiation (APBI) after surgery showed that their rates of disease recurrence were similar to those of patients who had received whole-breast irradiation (WBI), according to data presented by Meattini et al at the 2019 San Antonio Breast Cancer Symposium (Abstract GS4-06).

👉The study results suggest that the less invasive partial-breast procedure may be an acceptable choice for patients with early breast cancer.

👉Many patients diagnosed with early breast cancer undergo lumpectomy followed by a course of radiation.

👉Postoperative radiation still represents a mainstay of adjuvant treatment for breast cancer, able to significantly reduce the local relapse occurrence rate, explained the study’s lead author, Icro Meattini, MD, of the University of Florence, in a statement.

👉In recent years, researchers have sought to determine whether APBI might be as effective as WBI in preventing recurrence.

Study Methods

👉Dr. Meattini’s study examined 10-year follow-up data for women enrolled in the APBI IMRT trial, a randomized phase III trial.

👉The 5-year follow-up from the trial showed no significant difference in tumor recurrence or survival rates.

👉The APBI IMRT trial enrolled 520 women over age 40 who had either stage I or II breast cancer.

👉Between 2005 and 2013, the patients were randomly assigned 1:1 to receive either APBI or WBI.

👉The patients in the APBI arm received a total of 30 Gy of radiation to the tumor bed in five daily fractions, whereas those in the WBI arm received a total of 50 Gy in 25 daily fractions to the whole breast, plus a boost of 10 Gy to the tumor bed in five daily fractions.

👉Both treatment arms were comparable in terms of age, tumor size, tumor type, and adjuvant endocrine treatment, and both achieved a median 10-year follow-up.

👉The majority of the patients had hormone receptor–positive, HER2-negative breast cancer, and most were over age 50.

KEY POINTS

After 10 years, 3.3% of patients in the APBI group had experienced a recurrence of breast cancer compared to 2.6% in the group that received WBI.
Overall survival at the 10-year mark was similar between the two groups: 92.7% for the women who had received APBI and 93.3% for the women who received WBI.
The authors mentioned that APBI may also be less likely to cause cosmetic changes and is less expensive to administer than WBI.

10-Year Follow-up

👉The study showed that after 10 years, 3.3% of patients in the APBI group had experienced a recurrence of breast cancer compared to 2.6% in the group that received WBI.

👉These results were comparable to the 5-year results, in which the group that received APBI had a 2.4% recurrence rate, and the group that received WBI had a 1.2% recurrence rate.

👉Neither difference was statistically significant.

👉Overall survival at the 10-year mark was also very similar between the two groups: 92.7% for the women who had received APBI and 93.3% for the women who received WBI.

👉Breast cancer–specific survival was 97.6% for those who received APBI and 97.5% for those who received WBI.

👉The distant metastasis-free survival rate was 96.9% both for the women who received APBI and for those who received WBI.

👉These results reinforce the initial promising results from the previous study,” said Dr. Meattini.

👉APBI can produce excellent disease control.

👉The study’s chief limitation is its relatively small size.

👉In well-selected cases, there is no difference in patients’ outcomes whether they are treated with APBI or WBI.

👉A once-daily regimen of external APBI might also produce an improved quality of life with less toxicity, and can potentially reduce the overall treatment time.

👉Dr. Meattini added that APBI may also be less likely to cause cosmetic changes and is less expensive to administer than WBI.

👉Partial-breast irradiation is one of the primary examples of effective deescalation of treatment in breast oncology.

👉For many patients, partial-breast irradiation may be an optimal choice that is cost-effective, safe, and efficacious.

Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

Es experto en el manejo del cáncer de mama.

Es miembro de la American Society of Breast Surgeons:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

Histological structure of the vocal fold

December 14, 2019 Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉The histological structure of the vocal fold can be separated into five or six tissues, depending on the source:

– Which can then be grouped into three sections as the: the cover, the transition, and the body.

Vocal fold histologic section demonstrating structural layers.

👉The cover is composed of the epithelium (mucosa), basal lamina (or basement membrane zone), and the superficial layer of the lamina propria.

👉The transition is composed of the intermediate and deep layers of the lamina propria.

👉The body is composed of the thyroarytenoid muscle.

– This layered structure of tissues is very important for vibration of the true vocal folds.

👉The free edge of the vibratory portion of the vocal fold, the anterior glottis, is covered with stratified squamous epithelium.

– This epithelium is five to twenty-five cells thick with the most superficial layer consisting of one to three cells that are lost to abrasion of the vocal folds during the closed phase of vibration.

👉The posterior glottis is covered with pseudostratified ciliated epithelium.

– On the surfaces of the epithelial cells are microridges and microvilli.

– Lubrication of the vocal folds through adequate hydration is essential for normal phonation to avoid excessive abrasion, and the microridges and microvilli help to spread and retain a mucous coat on the epithelium.

What is Head and Neck Surgery?:
- It is a surgical sub-specialty that deals mainly with benign and malignant tumors of the head and neck region, including:
  - The scalp, facial region, eyes, ears, nose, nasal fossae, paranasal sinuses, oral cavity, pharynx (nasopharynx, oropharynx, hypopharynx), larynx (supraglotic larynx, glottis larynx, subglotic larynx), thyroid gland, parathyroid gland, salivary glands (parotid glands, submandibular glands, sublingual glands, minor salivary glands), soft tissues of the neck, skin of the head and neck region.
    - The head and neck surgeon’s work area:
      - Does not cover tumors or diseases of the brain and other areas of the central nervous system or those of the cervical spine:
        
        This is the neurosurgeon field.
- Among the diagnostic procedures performed by the head and neck surgeon, are the following:
  - Nasopharyngolaryngoscopy:
    - Performed to examine, evaluate and, possibly perform a biopsy, of oral cavity, pharyngeal and laryngeal lesions.
- The surgeries most commonly performed by the head and neck surgeon are:
  - Total or near total thyroidectomies
  - Hemithryoidectomies (lobectomies)
  - Comprehensive neck dissections
  - Selective neck dissections
  - Maxillectomies:
    - Total maxillectomy
    - Subtotal maxillectomy
    - Infrastructure maxillectomy
    - Suprastructure maxillectomy
    - Medial maxillectomy
  - Mandibulectomy:
    - Segmental
    - Marginal
  - Tracheostomy
  - Salivary gland surgeries:
    - Parotid gland operations:
      - Limited superficial parotidectomy with identification and preservation of the facial nerve
      - Superficial parotidectomy with identification and preservation of the facial nerve
      - Near total parotidectomy with identification and preservation of the facial nerve
      - Total parotidectomy
    - Submandibular gland resection
    - Sublingual gland resection
  - Resection of tumors of the oral cavity:
    - Glossectomy
    - Resection of the floor of the mouth tumors
  - Resection of tumors of the pharynx
  - Resection of tumors of the larynx
  - Split-thickness skin grafts
  - Full-thickness skin grafts
  - Sentinel lymph node mapping and sentinel lymph node biopsy
  - Resection of malignant skin tumors (BCC, SCC, melanoma) of the head and neck region
The formation of the head and neck surgeon includes mastering the following subjects:
- Surgical Anatomy
- History and Basic Principles of Head and Neck Surgery
- Epidemiology, Etiology, and Pathology of Head and Neck Diseases
- Diagnostic Radiology of the Head and Neck Region
- Tumors of the Scalp, Skin and Melanoma
- Eyelids and Orbit
- Nasal Cavity and Paranasal Sinuses
- Skull Base and Temporal Bone
- Lips and Oral Cavity
- Pharynx and Esophagus
- Larynx and Trachea
- Cervical Lymph Nodes
- Thyroid and Parathyroid Glands
- Salivary Glands
- Neurogenic Tumors and Paragangliomas
- Soft Tissue Tumors
- Bone Tumors and Odontogenic Lesions
- Reconstructive Surgery
- Oncologic Dentistry and Maxillofacial Prosthetics
- Principles of Radiation Oncology
- Principles of Chemotherapy
- Molecular Oncology, Genomics and Immunology
- Nutrition
- Biostatistic

Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon / endocrine surgeon / surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

prof_739_20190417135234

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

#Teacher

#Surgeon

#Cirujano

#ThyroidExpert

#ThyroidSurgeon

#CirujanodeTiroides

#ExpertoenTiroides

#ExpertoenParatiroides

#Paratiroides

#Hiperparatiroidismo

#CancerdeTiroides

#ThyroidCancer

#PapillaryThyroidCancer

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

#CirujanodeCancer

#HeadandNeckSurgeon

#CirugiaEndocrina

#CirujanodeTumoresdeCabezayCuello

#OralCavityCancer

Ductal Calcifications in Breast Mammograms

December 14, 2019 Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Ductal calcifications have a wide variety of presentations depending upon the underlying process that created them.

👉When coarse rod-like ductal calcifications are diffuse, bilateral, and not confined to a single lobe, they can be confidently assumed to result from plasma cell mastitis, and they do not require further evaluation or biopsy.

👉The process is called secretory disease because there is a stagnant, viscous fluid that eventually petrifies and results in the smooth contoured calcifications.

👉Some of them are branching and look like malignant casting type calcifications, but the key distinguishing feature is the diffuse, multilobe, bilateral nature of the process.

👉Calcifications become much more worrisome when they are confined to a single lobe.

👉The most frequent malignant, ductal “casting type” calcifications are fragmented, linear, and branching, and they are the most reliable mammographic sign of malignancy.

👉The presence of fragmented and/or dotted casting type calcifications on the mammogram restricted to one lobe is a pathognomonic sign of a diffuse, grade 3 breast cancer subtype that originates in the major ducts and usually has a solid or micropapillary pattern.

👉Traditionally, this subtype has been called “comedo carcinoma.”

👉The cancer cells either produce a viscous, proteinaceous fluid which gradually concentrates and eventually calcifies, or they undergo necrosis (apoptosis) followed by calcification.

👉In both instances the intraluminal pressure increases, distending the ducts considerably.

👉Dotted casting type calcifications have been referred to as “snake skin-like calcifications” and they accumulate in the fluid produced by either micropapillary or solid cancer cell growth patterns.

👉The tips of the micropapillary growths may become detached and eventually calcify, contributing to the intraluminal calcifications.

The micropapillary growths break off and calcify in the lumen, resulting in the individual dots of calcification (the dark, almost black stained structures).

Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad Quirúrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

Es experto en el manejo del cáncer de mama.

Es miembro de la American Society of Breast Surgeons:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

SABCS 2019: 6-Year Analysis of the Addition of Pertuzumab to Trastuzumab Plus Chemotherapy as Adjuvant Therapy

December 14, 2019 Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Data from the 6-year analysis of the APHINITY trial showed that adding pertuzumab to the previous standard treatment of trastuzumab plus chemotherapy after surgery continued to reduce the risk of recurrence and death in patients with HER2-positive early breast cancer, according to findings presented by Piccart et al at the 2019 San Antonio Breast Cancer Symposium (Abstract GS1-04).

👉Fewer deaths were seen in patients treated with pertuzumab, although the survival benefit was not statistically significant at this time.

👉The addition of trastuzumab to chemotherapy after surgery has revolutionized treatment outcomes for patients with HER2-positive early breast cancer, yet roughly 30% of patients will still experience recurrence of their disease, a condition for which effective treatments are now available but cure is no longer possible.

👉By adding a different yet complementary HER2 inhibitor—pertuzumab—to this treatment regimen, the researchers hope to further reduce the risk of recurrence and advanced disease in this patient poo population.

👉Earlier results from the phase III APHINITY trial comparing pertuzumab vs placebo added to adjuvant chemotherapy plus trastuzumab in patients with operable HER2-positive early breast cancer have been previously reported in The New England Journal of Medicine.

👉They showed that patients treated with pertuzumab had improved rates of estimated 3-year invasive disease–free survival compared with those in the placebo arm (94.1% vs 93.2%, respectively).

👉The addition of pertuzumab reduced the relative risk of recurrence by 19%—a statistically significant finding.

👉The overall survival did not significantly differ between the two arms in the earlier analysis.

👉The current study reports on the 6-year interim analysis of overall survival, and an updated descriptive analysis of invasive disease–free survival and cardiac safety.

👉Between November 2011 and August 2013, the APHINITY trial randomly assigned 2,400 patients to the pertuzumab arm and 2,405 patients to the placebo arm.

👉The data cutoff for this updated overall survival analysis was June 19, 2019, corresponding to a median follow-up time of 74.1 months.

👉After 6 years of follow-up, Dr. Piccart and colleagues found that patients in the pertuzumab arm had a 24% reduced relative risk of breast cancer recurrence or death compared with those in the placebo arm.

KEY POINTS

After 6 years of follow-up, patients in the pertuzumab arm had a 24% reduced relative risk of breast cancer recurrence or death compared with those in the placebo arm.
Among patients with node-positive disease, the invasive disease–free survival in the pertuzumab arm was 87.9%, while the invasive disease–free survival in the placebo arm was 83.4%.
In this updated analysis, one additional primary cardiac event was reported in the pertuzumab arm and one additional secondary cardiac event was reported in each arm; no new cardiac safety concerns emerged.

👉Similar to their previous findings, the researchers found that patients whose cancer had spread to their lymph nodes continued to derive greatest clinical benefit with the addition of pertuzumab to standard treatments.

👉In the 6-year updated analysis, the researchers found that among patients with node-positive disease, the invasive disease–free survival in the pertuzumab arm was 87.9%, while the invasive disease–free survival in the placebo arm was 83.4%.

👉The addition of pertuzumab to trastuzumab and chemotherapy after surgery translated to a reduced relative risk of recurrence by 28%.

👉In this updated analysis, one additional primary cardiac event was reported in the pertuzumab arm and one additional secondary cardiac event was reported in each arm; no new cardiac safety concerns emerged.

👉Incidence of primary cardiac events remains less than 1% in both arms (0.8% in the pertuzumab arm vs 0.3% in the placebo arm), providing further evidence that adding pertuzumab to trastuzumab and chemotherapy is safe in the long term.

👉Following this interim analysis, the evidence is now even stronger that adding pertuzumab to the previous standard of care reduces the risk of disease recurrence for patients with HER2-positive breast cancer.

👉Altogether, the clinical benefit of pertuzumab, which is exemplified by its treatment effect against breast cancer and its lack of additional significant side effects, is enhanced for women at high risk of breast cancer recurrence in this curative setting.

👉A main limitation of APHINITY is that although we have seen fewer deaths among the patients who received treatment with pertuzumab, our data is still immature and have not shown definitive improvement in overall survival.

👉A longer follow-up is needed to see any significant survival benefit.

👉The next interim analysis is scheduled to take place in 2022.

👉Ongoing research using the biological specimens and clinical data collected from this very large study would help in refining the characteristics of the patients who will most benefit from pertuzumab, particularly among those considered to be at lower risk of recurrence only on the basis of absence of lymph node disease.

#Arrangoiz

#BreastSurgeon

#BreastCancer

#CancerSurgeon

#SurgicalOncologist

#Teacher

#Surgeon

Laryngeal Cancer Statistics

December 13, 2019December 18, 2019 Rodrigo Arrangoiz MS, MD, FACS, FSSO

presentation1pptx-radiological-anatomy-of-the-larynx-and-trachea-1-638

Number of New Cases and Deaths per 100,000:
- The number of new cases of laryngeal cancer was 3.0 per 100,000 men and women per year.
- The number of deaths was 1.0 per 100,000 men and women per year.
  - These rates are age-adjusted and based on 2012 to 2016 cases and deaths.
Lifetime Risk of Developing Cancer:
- Approximately 0.3% of men and women will be diagnosed with laryngeal cancer at some point during their lifetime:
  - Based on 2014 to 2016 data.
Prevalence of This Cancer:
- In 2016, there were an estimated 96,351 people living with laryngeal cancer in the United States.

How Many People Survive 5-Years Or More after Being Diagnosed with Laryngeal Cancer?

Relative survival statistics:
- Compare the survival of patients diagnosed with cancer with the survival of people in the general population who are the same age, race, and sex and who have not been diagnosed with cancer.
Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient:
- No two patients are entirely alike, and treatment and responses to treatment can vary greatly.

Survival by Stage

Cancer stage at diagnosis:
- Which refers to extent of a cancer in the body, determines treatment options and has a strong influence on the length of survival:
  - In general, if the cancer is found only in the part of the body where it started it is:
    - Localized (sometimes referred to as stage 1).
  - If it has spread to a different part of the body, the stage is:
    - Regional or distant.
- The earlier laryngeal cancer is caught, the better chance a person has of surviving five years after being diagnosed.
- For laryngeal cancer:
  - 54.0% are diagnosed at the local stage:
    - The 5-year survival for localized laryngeal cancer is 77.4%.

How Common Is This Cancer?

Compared to other cancers, laryngeal cancer is rare.

In 2019:
- It is estimated that there will be 12,410 new cases of laryngeal cancer
- Estimated 3,760 people will die of this disease.

Who Gets This Cancer?

Laryngeal cancer becomes more common with age.
Is more common in men than in women.
Smoking is a major risk factor for this cancer, and reduction smoking rates in recent years has led to a downturn in both incidence and mortality.
The number of new cases of laryngeal cancer was:
- 3.0 per 100,000 men and women per year:
  - Based on 2012 to 2016 cases.

Who Dies From This Cancer?

The number of deaths was:
- 1.0 per 100,000 men and women per year:
  - Based on 2012 to 2016 deaths.

What is Head and Neck Surgery?:
- It is a surgical sub-specialty that deals mainly with benign and malignant tumors of the head and neck region, including:
  - The scalp, facial region, eyes, ears, nose, nasal fossae, paranasal sinuses, oral cavity, pharynx (nasopharynx, oropharynx, hypopharynx), larynx (supraglotic larynx, glottis larynx, subglotic larynx), thyroid gland, parathyroid gland, salivary glands (parotid glands, submandibular glands, sublingual glands, minor salivary glands), soft tissues of the neck, skin of the head and neck region.
    - The head and neck surgeon’s work area:
      - Does not cover tumors or diseases of the brain and other areas of the central nervous system or those of the cervical spine:
        
        This is the neurosurgeon field.
- Among the diagnostic procedures performed by the head and neck surgeon, are the following:
  - Nasopharyngolaryngoscopy:
    - Performed to examine, evaluate and, possibly perform a biopsy, of oral cavity, pharyngeal and laryngeal lesions.
- The surgeries most commonly performed by the head and neck surgeon are:
  - Total or near total thyroidectomies
  - Hemithryoidectomies (lobectomies)
  - Comprehensive neck dissections
  - Selective neck dissections
  - Maxillectomies:
    - Total maxillectomy
    - Subtotal maxillectomy
    - Infrastructure maxillectomy
    - Suprastructure maxillectomy
    - Medial maxillectomy
  - Mandibulectomy:
    - Segmental
    - Marginal
  - Tracheostomy
  - Salivary gland surgeries:
    - Parotid gland operations:
      - Limited superficial parotidectomy with identification and preservation of the facial nerve
      - Superficial parotidectomy with identification and preservation of the facial nerve
      - Near total parotidectomy with identification and preservation of the facial nerve
      - Total parotidectomy
    - Submandibular gland resection
    - Sublingual gland resection
  - Resection of tumors of the oral cavity:
    - Glossectomy
    - Resection of the floor of the mouth tumors
  - Resection of tumors of the pharynx
  - Resection of tumors of the larynx
  - Split-thickness skin grafts
  - Full-thickness skin grafts
  - Sentinel lymph node mapping and sentinel lymph node biopsy
  - Resection of malignant skin tumors (BCC, SCC, melanoma) of the head and neck region
The formation of the head and neck surgeon includes mastering the following subjects:
- Surgical Anatomy
- History and Basic Principles of Head and Neck Surgery
- Epidemiology, Etiology, and Pathology of Head and Neck Diseases
- Diagnostic Radiology of the Head and Neck Region
- Tumors of the Scalp, Skin and Melanoma
- Eyelids and Orbit
- Nasal Cavity and Paranasal Sinuses
- Skull Base and Temporal Bone
- Lips and Oral Cavity
- Pharynx and Esophagus
- Larynx and Trachea
- Cervical Lymph Nodes
- Thyroid and Parathyroid Glands
- Salivary Glands
- Neurogenic Tumors and Paragangliomas
- Soft Tissue Tumors
- Bone Tumors and Odontogenic Lesions
- Reconstructive Surgery
- Oncologic Dentistry and Maxillofacial Prosthetics
- Principles of Radiation Oncology
- Principles of Chemotherapy
- Molecular Oncology, Genomics and Immunology
- Nutrition
- Biostatistic