Blog

Operating on sarcomas continues to be one of the most rewarding experiences for a surgical oncologist. Each case demands not only technical mastery but also deep respect for complex anatomy and multidisciplinary collaboration.

Recently, a 50-year-old woman presented with a large retroperitoneal liposarcoma, posing considerable anatomical and technical challenges. Managing such tumors requires meticulous preoperative planning and precise intraoperative execution.

Such cases truly test a surgeon’s anatomical understanding, operative skill, and patience — qualities that lie at the very heart of complex oncologic surgery.

The surgery was successfully completed with complete tumor excision, and the patient made a smooth postoperative recovery, being discharged happily in stable condition.

These experiences reaffirm the joy and fulfillment of surgical oncology — where precision, perseverance, and teamwork come together to deliver meaningful recovery and hope for our patients.

The ESOPEC trial (NEJM 2025) is a landmark phase III study directly comparing perioperative FLOT chemotherapywith neoadjuvant CROSS chemoradiotherapy in resectable esophageal and gastroesophageal junction adenocarcinoma.

✅ Key findings:

Median OS: 66 months (FLOT) vs 37 months (CROSS)

5-year OS: 50.6% vs 38.7%

PFS benefit: HR 0.66 (95% CI 0.51–0.85)

Distinct recurrence and toxicity patterns between arms

Take-home message:
FLOT is the new standard for adenocarcinoma, while CROSS remains pivotal for squamous cell carcinoma.

📺 I’ve broken down the methodology, outcomes, strengths, and limitations of ESOPEC in detail on my YouTube channel – Journal Club Oncology. 👉 Watch the full Journal Club discussion on YouTube:
https://youtu.be/aleVBk9PbbU

The PORTEC-3 trial continues to shape our understanding of adjuvant therapy in high-risk endometrial cancer. With updated 10-year follow-up data, it provides valuable insights into survival outcomes and the role of molecular classification in guiding treatment.

🔑 Key Highlights

Chemoradiotherapy vs Radiotherapy Alone
Long-term benefit in overall survival (OS) and recurrence-free survival (RFS) persists with combined modality treatment.

p53-abnormal (p53-abn) tumors
Patients derive a substantial survival advantage with chemoradiotherapy.

POLE-mutated cancers
Show an excellent prognosis regardless of treatment, supporting treatment de-escalation in this subgroup.

MMR-deficient (MMRd) & NSMP groups
Outcomes highlight the need for immunotherapy approaches and further risk stratification in these subsets.

🎥 Watch my detailed discussion on this trial and its clinical implications on my Journal Club Oncology channel: 👉 PORTEC-3 Trial Discussion – Dr. Pavan Kumar

A 50-year-old woman presented with a left lumbar paraspinal schwannoma, a benign nerve sheath tumor located deep in the retroperitoneal space. MRI revealed two well-defined lesions measuring 10 × 5 cm, extending from L2 to L5, with no intracanalicular extension. She successfully underwent excision of the tumor through a transperitoneal minimally invasive approach, which provided excellent visualization, precise dissection, and safe tumor removal.

Although retroperitoneal masses are often considered a relative contraindication for laparoscopic surgery, in this case the patient underwent safe paraspinal mass removal with no intraoperative complications, minimal blood loss, and faster recovery compared to conventional open surgery.

The postoperative course was uneventful; the patient recovered smoothly and was discharged on the 4th postoperative day without neurological deficits or perioperative complications.

A 52-year-old woman diagnosed with well-differentiated carcinoma endometrium, FIGO stage I, successfully underwent laparoscopic staging surgery. The procedure involved total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy.

https://www.linkedin.com/posts/drpavankumarcg_laparoscopic-bplnd-unedited-activity-7370528564049453056-eQSW?utm_source=share&utm_medium=member_desktop&rcm=ACoAACZEqlcBpUb6T6urp28O92IcuvMoVqRCtz0

The minimally invasive laparoscopic approach provided superior visualization of pelvic anatomy, enabled precise dissection, and ensured an adequate lymph node yield for accurate staging.

Evidence from multiple clinical studies confirms that laparoscopic surgery for early-stage endometrial cancer achieves oncological outcomes equivalent to open surgery, while offering significant benefits to patients. These include:

• Reduced intraoperative blood loss
• Shorter hospital stay
• Faster recovery and return to daily activities
• Less postoperative discomfort

This case was completed smoothly, with no intraoperative complications, and the patient experienced an uneventful postoperative recovery.

Minimally invasive surgery continues to establish itself as the standard of care in early-stage endometrial cancer, combining oncological safety with patient-centered benefits

For the very first time at SDM Hospital, Dharwad, our Surgical Oncology team led by Dr. Pavan Kumar C G has successfully performed HIPEC (Hyperthermic Intraperitoneal Chemotherapy) for a patient with advanced ovarian cancer.
This milestone marks a new era in cancer care for patients across Hubli, Dharwad, and North Karnataka, who can now access this advanced treatment much closer to home.

Esophageal cancer is one of the most aggressive gastrointestinal malignancies, often presenting late and requiring a multimodal approach for effective management. With the advent of minimally invasive and thoracoscopic techniques, surgical outcomes have improved, offering patients quicker recovery and reduced post-operative complications.

Infertility is a well-recognized short- and long-term consequence of cancer treatment. For young patients, particularly women diagnosed with gynecological malignancies, the ability to preserve fertility is of paramount importance. Beyond medical outcomes, fertility preservation directly impacts psychosocial wellbeing, as most patients express a strong preference for biological parenthood over alternatives such as adoption or surrogacy.

At a recent seminar at KCTRI, Hubli, organised by Fertility Preservation  Society of India (FPSI)  Dr. Pavan Kumar C G addressed the principles, techniques, and clinical evidence behind fertility-sparing surgeries (FSS) in gynecological cancers, underscoring their role in balancing oncologic safety with reproductive potential.

We recently managed a rare and technically demanding case of parapharyngeal schwannoma at the Department of Surgical Oncology, SDM Medical College and Hospital.

The role of surgery in cancer treatment is significant. The primary principle is to remove the cancer completely, including its roots. The goal of surgery is to excise the affected or potentially affected tissues entirely, without causing harm to the patient, while also preventing the recurrence of cancer.