EANS Training Course Moscow, 5 th 8 th May 2019 Tumours

Transcription

1 EANS Training Course Moscow, 5 th 8 th May 2019 Tumours SUNDAY, MAY 5 th, :00 09:10 Welcome 09:15 10:30 Tumours Chair: Meling 09:15 09:30 Molecular biology of brain tumours Reinert 09:30 09:45 Imaging of brain tumours Iliescu 09:45 10:00 Radio- & chemotherapy for brain tumours Pallud 10:00 10:15 Future approaches for the treatment of gliomas Watts 10:15 10:30 Cognition & quality of life Clusmann 10:45 11:15 Coffee break 11:15 12:40 Discussion Groups (two rotations - details on page TBC) 12:45 13:45 Lunch / Training Committee meeting 13:45-15:45 Breakout sessions 1 & 2 Breakout session 1. Topic: Brain abscess and infection. Case presenter: Foroglou. Moderator: Jaskolski Expert: Alimehmeti Facilitators: Auslands, Clusmann, Gonzalez- Lopez, Ivanov, Omerhodzic, Roche, Bosnjak, Rasulic Breakout session 2. Topic: Brain metastasis. Case presenter: XXX. Moderator: Freyschlag. Expert: Lubrano Facilitators: van Santbrink, Pallud, Smrcka, Rocka, Reinert, Schucht, Sames, Watts 15:45 16:15 Coffee break 16:15 16:45 How I do it Chair: Konovalov 16:15 16:25 How I do it: Brain biopsy Skjøth- Rasmussen 16:25 16:35 How I do it: Planning & performing a craniotomy Rocka 16:35 16:45 How I do it: Awake craniotomy Meyer 16:55 18:20 Discussion Groups (two rotations - details on page TBC) 1

2 AIM The EANS programme aims to prepare the neurosurgical trainee in the principles of managing surgical neuro- oncology - including the multi- disciplinary management of patients with intracranial intrinsic and extrinsic neoplasia; image- guidance, intra- operative imaging and neuro- monitoring applied to the management of patients with intracranial tumours; the operative management of intrinsic and extrinsic tumours; the operative management of skull base tumours; outcome assessment; the management of paediatric brain tumours and hydrocephalus. At the end of the course, participants should be able to: General & intrinsic brain tumours 1 1. Outline the natural history and pathology of benign and malignant intracranial neoplasia 2. Classify benign and malignant intracranial neoplasia 3. Request and interpret appropriate diagnostic images 4. Formulate principles of fractionated radiotherapy, stereotactic radiotherapy and radiosurgery 5. Define the role of adjuvant chemotherapy 6. Apply principles of clinical trials to the study of neuro- oncology 7. Assess patients with raised intracranial pressure and space occupying lesions 8. Evaluate ways of maximising multi- disciplinary management of patients with intracranial neoplasia 9. Assess outcome following inter- disciplinary management of brain tumours 2

3 MONDAY, MAY 6th, :00 10:00 Intrinsic tumours in adults Chair: Meyer 09:00 09:15 Surgery for HGG: limits and limitations Watts 09:15 09:30 Management of LGG DiMeco 09:30 09:45 Central region and eloquent area tumours Raabe 09:45 10:30 How I do it Chair: Gabrovski 09:45 09:55 How I do it: Monitoring & mapping Raabe 09:55 10:05 How I do it: Tricks & new techniques in HGG surgery Meyer 10:05 10:35 Coffee break 10:35 12:00 Discussion Groups (two rotations - details on page TBC) 12:00 13:00 Lunch / Training Committee meeting 13:00 14:00 Intrinsic tumours in adults Chair: Lubrano 13:00 13:15 Management of recurrent disease Thomé 13:15 13:30 Cerebral metastasis Papanastassiou 13:30 13:45 Central nervous system lymphoma Gonzalez- Lopez 13:45 14:00 Complication avoidance Meyer 14:00 14:30 Coffee break 14:30 15:00 Trainee lectures Chair: Meling 14:30 14:40 To be confirmed 14:40 14:50 To be confirmed 14:50 15:00 To be confirmed 15:15 17:30 Discussion Groups (three rotations - details on page TBC) Intrinsic brain tumours 2 1. Interpret CT and MRI scans 2. Formulate steps to achieve biopsy of supratentorial tumour 3. Justify indications for operative management of supra- tentorial intrinsic tumours 4. Demonstrate knowledge of applied surgical anatomy 5. Know principles and techniques and indications for intra- operative mapping and monitoring 6. Formulate principles of peri- operative care 7. Anticipate complications of surgery 3

4 TUESDAY, MAY 7th, :00 10:00 Extrinsic brain tumours in adults (1) Chair: Smrcka 09:00 09:15 Meningiomas, their biology and classification Watts 09:15 09:30 Clinics/management of meningioma Spektor 09:30 09:45 CPA tumours Omerhodzic 09:45 10:00 Stereotactic radiosurgery of intracranial tumours Lubrano 10:10 10:40 How I do it Chair: Auslands 10:10 10:20 How I do it: Convexity meningioma Laakso 10:20 10:30 How I do it: Anterior base meningioma Cerejo 10:30 10:40 How I do it: Middle fossa meningioma Spektor 10:40 11:10 Coffee break 11:10 12:35 Discussion Groups (two rotations - details on page TBC) 12:35 13:35 Lunch/Training Committee meeting 13:35 14:35 Extrinsic brain tumours in adults (2) Chair: Rasulic 13:35 13:50 Skull base anatomy Destrieux 13:50 14:05 Principles and practice of skull base surgery Roche 14:05 14:20 Endoscopic approaches to the skull base Netuka 14:20 14:35 Chordoma/chondrosarcoma Samy 14:35 15:05 Extrinsic brain tumours in adults (2) Chair: van Santbrink 14:35 14:50 Orbital tumours Meling 14:50 15:05 Monitoring CN & brainstem Sala 15:05 15:35 Coffee break 15:35 16:55 How I do It Chair: Ivanov 15:35 15:45 How I do it: Retrosigmoid approach Thomé 15:45 15:55 How I do it: Midline posterior fossa approach Lehecka 15:55 16:05 How I do it: Metastasis Laakso 16:15 17:50 Discussion Groups (two rotations - details on page TBC) Extrinsic & skull base tumours (TUESDAY) 1. Justify indications for operative management of a convexity meningiomas 2. Describe relevant surgical anatomy 3. Anticipate complications of surgery 4. Use of internal tumour decompression 4

5 5. Justify indications for operative management of patients with anterior and middle fossa tumours 6. Relate pathology and surgical goals 7. Describe relevant microsurgical anatomy of the anterior and middle cranial fossae 8. Formulate principles of intra- operative management of patients undergoing resection of anterior and middle fossa tumours including olfactory groove, planum sphenoidale, parasellar and sphenoid wing and falcine meningiomas 9. Interpret relevant CT and MRI scans CPA tumours 1. Justify indications for surgical management of patients with cerebellopontine angle tumours 2. Compare relative indications for surgery, radiosurgery, and conservative management 3. Plan intra- operative management of patients undergoing resection of CP angle tumours including vestibular schwannomas and meningiomas 4. Apply and explain cranial nerve and brainstem monitoring 5. Describe relevant microsurgical anatomy of the CP angle, brainstem and lower cranial nerves 6. Justify relative indications for retrosigmoid, middle fossa, and translabyrinthine approaches with respect to hearing preservation, tumour size, and position 7. Assess and plan pre- operative care for patients with CP angle tumours. 8. Interpret CT & MRI scans 5

6 WEDNESDAY, MAY 8th, :00 09:30 Pituitary and midline tumours Chair: Thomé 09:00 09:15 Pituitary tumours Vajkoczy 09:15 09:30 Craniopharyngiomas Meling 09:35 10:05 How I do it Chair: Thomé 09:35 09:45 How I do it: Microsurgical pituitary surgery Kalinin 09:45 09:55 How I do it: Endoscopic pituitary Netuka 09:55 10:05 How I do it: Pineal tumours Gabrovski 10:05 10:35 Coffee break 10:35 12:10 Discussion Groups (two rotations - details on page TBC) 12:15 13:15 Lunch/Training Committee meeting 13:20 14:05 Paediatric Chair: Skjøth- Rasmussen 13:20 13:35 Supratentorial tumours Sala 13:35 13:50 Posterior fossa tumours Skjøth- Rasmussen 13:50 14:05 Phacomatoses & cerebral tumours Sala 14:10 14:30 How I do it Chair: Sames 14:10 14:20 How I do it: Posterior fossa tumours in children Bilginer 14:20 14:30 How I do it: Third ventricular tumours Smolanka 14:30 15:00 Coffee break 15:00 16:25 Discussion Groups (two rotations - details on page TBC) 16:25 16:55 Coffee break 17:00 17:45 Hydrocephalus Chair: Jaskolski 17:00 17:15 Hydrocephalus in children Tisell 17:15 17:30 Hydrocephalus in adults Rohde 17:30 17:45 CSF New Developments for dummies Vukic 17:45 18:35 How I do it Chair: Alimehmeti 17:45 17:55 How I do it: shunts in adults Jaskolski 17:55 18:05 How I do it: shunt in paediatric age Bilginer 18:05 18:15 How I do it: IIIrd ventriculostomy Gonzalez 18:15 18:25 How I do it: arachnoid cysts Tisell 18:25 18:35 How I do it: VA shunt Skjøth- Rasmussen 18:45-19:15 Course conclusion and critique Plenary room Pituitary tumours 1. Justify indications for transsphenoidal approaches to the pituitary fossa and resection of pituitary adenomas 6

7 2. Outline pathophysiology of the hypothalamic- pituitary axis 3. Compare surgical approaches: sublabial, transnasal and endoscopic 4. Describe relevant surgical anatomy of the skull base 5. Plan peri- operative care 6. Anticipate complications of surgery and their management 7. Assess and prepare patients with pituitary, sellar, and parasellar tumours for surgery 8. Interpret CT and MRI scans Midline tumours 1. Justify indications for surgical management of patients with midline sellar, parasellar, pineal, and third ventricular tumours 2. Describe relevant surgical anatomy of midline structures 3. Select appropriate surgical approach including principles of endoscopic biopsy and/or resection 4. Formulate a surgical plan for patients undergoing resection of midline sellar, para- sellar, pineal, and third ventricular tumours including colloid cysts 5. Anticipate complications of surgery and their management 6. Assess and prepare patients with midline tumours for surgery. 7. Interpret CT and MRI scans 8. Formulate a plan for a open and endoscopic approaches Posterior fossa tumours 1. Justify indications for surgical management of superficial, hemispheric, and midline intrinsic posterior fossa tumours and metastases 2. Select appropriate surgical approach 3. Outline relevant surgical anatomy 4. Plan peri- operative care 5. Anticipate complications of surgery and their management 6. Assess and prepare patients with fossa malignant tumours, for surgery. 7. Interpret CT and MRI scans Pediatric brain tumours: 1. Describe the most common pediatric brain tumours and their treatment. 2. Understand the different prognosis in pediatric vs adult brain tumours. 3. Understand the new WHO classification from a pediatric brain tumour perspective and the implications for treatment and survival in medulloblastoma and ependymoma. 4. Be able to name the most frequent paediatric brain tumours 5. Understand the role of adjuvant treatment in pediatric tumours. 6. Know the short- term complications and long term side effects following multidisciplinary treatment of brain tumours in childhood Hydrocephalus 1. Know epidemiology, aetiology and symptomatology of hydrocephalus in children and in adults 2. Understand mechanics and pathophysiology of hydrocephalus in children and adults 7

8 3. Understand role of CSF pressure monitoring in indication making and be able to choose the most relevant type of monitoring. 4. Describe the limitations in documentation of true normal ICP values 5. Recognize the classic signs of raised intracranial pressure according to different age groups. 6. Make correct choice of indication and treatment; including a weighted choice between ETV and a shunt device. 7. Understand mechanics of the two different valve types and added shunt devices (anti- siphon devices) 8. Understand signs and symptoms of shunt failure 9. Be able to describe and interpret typical Kaplan Meyer survival statistics for shunts 10. Know common complications of shunt surgery including average rates for infection, shunt blockage sites and disconnection 11. Evaluate and manage shunt failure 12. Describe indication and role of endoscopic CSF diversion, i.e. in 3rd ventriculostomy 13. Interpret CT & MRI scans, be able to identify obstruction sites, and be able to describe indications for specific image sequences and how these can aid surgical decision- making 8

9 Discussion Groups Sunday & Monday 1. Indications and limitations of awake Meyer/Laakso/Thomé 2. Cortical anatomy/imaging Destrieux/Iliescu 3. Monitoring in intracranial surgery Sala/Raabe 4. Decision making in low grade gliomas DiMeco/Ringel/Novak 5. Fluorescence- guided surgery for high grade gliomas (together with Leica) Papanastassiou/Watts/Schucht 6. Intraventricular tumours Smrcka/Smolanka/Gabrovski 7. Management of neurofibromatosis Vukic/Rasulic/Alimehmeti 8. Choice of approach to the anterior and middle fossa Roche/Samy/Omerhodzic 9. Choice of approach to the posterior fossa Clusmann/Lehecka/Sufianov Tuesday & Wednesday 10. Decision making in meningioma management Cerejo/Schaller/Foroglou 11. Management of pituitary macro- and microadenoma Vajkoczy/Kalinin/ Netuka 12. Hypothalamic and chiasmatic tumours Spektor/Rocka 13. Management of paediatric brain tumours Bilginer/Skjøth- Rasmussen 14. Controversies in the management of brain tumors Broekman/Mathiesen/van Roost 15. Management of hydrocephalus and choosing the right shunt Rohde/Jaskolski 16. Shunts and complications Novak/Tisell/Sames 17. Fibertracking and trajectory planning in glioma surgery (together with BrainLab)Freyschlag/Sampron 9