New Recording 9

Jun 14, 2026 10:42 · 2:51:00 · English · Whisper Large V3 · 8 Խոսողներ
Այս տեքստը կավարտվի 17 օրեր Ավելացնել մշտական պահպանման համար →
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0:21
S… Speaker 1 (New Recording 9)
Thank you.
1:03
S… Speaker 1 (New Recording 9)
Oh, yeah.
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S… Speaker 1 (New Recording 9)
What's my tower?
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S… Speaker 1 (New Recording 9)
Thank you very much.
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S… Speaker 1 (New Recording 9)
Anyway, we have a local reference to U.S.T.E.K.A.T.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
That's why it doesn't...
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S… Speaker 1 (New Recording 9)
It doesn't... It doesn't matter.
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S… Speaker 1 (New Recording 9)
It doesn't matter.
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S… Speaker 1 (New Recording 9)
It doesn't matter. It doesn't matter. It doesn't
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S… Speaker 1 (New Recording 9)
matter.
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S… Speaker 1 (New Recording 9)
This case,
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S… Speaker 1 (New Recording 9)
how do you see
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S… Speaker 1 (New Recording 9)
that?
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S… Speaker 1 (New Recording 9)
What else is that?
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
You're the
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S… Speaker 1 (New Recording 9)
1 .04 for the paper.
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S… Speaker 1 (New Recording 9)
Exactly.
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S… Speaker 1 (New Recording 9)
Around this,
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S… Speaker 1 (New Recording 9)
we can get a little bit,
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S… Speaker 1 (New Recording 9)
a little bit.
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S… Speaker 1 (New Recording 9)
But it's not
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S… Speaker 1 (New Recording 9)
surgery. Surgery is not here,
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S… Speaker 1 (New Recording 9)
it's just medical medicine.
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S… Speaker 1 (New Recording 9)
For example,
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S… Speaker 1 (New Recording 9)
surgery is not gradation therapy.
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S… Speaker 1 (New Recording 9)
It's not systemic therapy.
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S… Speaker 1 (New Recording 9)
Do you want to go to the board?
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S… Speaker 1 (New Recording 9)
Do you want to
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S… Speaker 1 (New Recording 9)
go to the board?
20:50
S… Speaker 1 (New Recording 9)
This is a great place, but it's a great place.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
How are you?
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S… Speaker 1 (New Recording 9)
How
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S… Speaker 1 (New Recording 9)
are you?
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S… Speaker 1 (New Recording 9)
How are
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S… Speaker 1 (New Recording 9)
you?
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
Keep it, keep it.
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S… Speaker 1 (New Recording 9)
Thank you.
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S… Speaker 1 (New Recording 9)
That's why
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S… Speaker 1 (New Recording 9)
The name I know
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S… Speaker 1 (New Recording 9)
Assalamu alaikum.
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S… Speaker 1 (New Recording 9)
Good afternoon.
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S… Speaker 1 (New Recording 9)
My name is Guthamma Amr.
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S… Speaker 1 (New Recording 9)
I am the general manager of Merck and Saladin.
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S… Speaker 1 (New Recording 9)
First of all,
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S… Speaker 1 (New Recording 9)
I would like really to thank you for the time,
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S… Speaker 1 (New Recording 9)
for spending,
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S… Speaker 1 (New Recording 9)
I would say, a good part.
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S… Speaker 1 (New Recording 9)
of the weekend with us in lovely Riyadh.
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S… Speaker 1 (New Recording 9)
Yes, the weather is,
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S… Speaker 1 (New Recording 9)
yeah, but it's a lovely weather.
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S… Speaker 1 (New Recording 9)
Actually,
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S… Speaker 1 (New Recording 9)
yeah, we will be spending today a couple of hours discussing a
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patient population that may have been a bit overlooked with little,
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I would say, or like few therapeutic options.
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And that meant we are really proud,
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glad that soon we will bring,
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I would say, one of the therapeutic options for those patients.
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And with that,
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I would like really to thank and welcome Dr.
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S… Speaker 1 (New Recording 9)
Ashwaq Al -Alayan.
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S… Speaker 1 (New Recording 9)
I don't think she needs her introduction,
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S… Speaker 1 (New Recording 9)
but I will do it anyway.
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S… Speaker 1 (New Recording 9)
So,
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S… Speaker 1 (New Recording 9)
Dr.
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S… Speaker 1 (New Recording 9)
Ashwaq, she's the head of the Adult Medical Oncology
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S… Speaker 1 (New Recording 9)
in the National Guard Hospital in Riyadh.
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S… Speaker 1 (New Recording 9)
Yes.
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S… Speaker 1 (New Recording 9)
And yeah,
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S… Speaker 1 (New Recording 9)
thank you so much,
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S… Speaker 1 (New Recording 9)
Dr. Ashwaq,
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S… Speaker 1 (New Recording 9)
and she will guide us and lead us through the day.
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S… Speaker 1 (New Recording 9)
Thank you so much.
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S… Speaker 1 (New Recording 9)
Thank you,
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S… Speaker 1 (New Recording 9)
everyone, for attending,
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S… Speaker 1 (New Recording 9)
and thank you,
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S… Speaker 1 (New Recording 9)
Merck, for pulling this.
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So we'll talk just a little bit about the objective of the meeting,
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and we know,
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like, there's more tumors,
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S… Speaker 1 (New Recording 9)
a rare tumor,
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S… Speaker 1 (New Recording 9)
but we know to look at the current patient
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journey and identify the critical gaps in diagnosis and
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referring to the patient and,
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S… Speaker 1 (New Recording 9)
at the end,
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S… Speaker 1 (New Recording 9)
treatment pathway.
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S… Speaker 1 (New Recording 9)
We are looking for career internal diagnosis,
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referral efficiency and access to specialized center.
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S… Speaker 1 (New Recording 9)
We need to understand because you're at the top oncologist who's treating a dysmorphic
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S… Speaker 1 (New Recording 9)
tumor, what's the fact that that influence...
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S… Speaker 1 (New Recording 9)
choosing the treatment option.
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S… Speaker 1 (New Recording 9)
We have various options,
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S… Speaker 1 (New Recording 9)
surgery,
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S… Speaker 1 (New Recording 9)
filtration, systemic therapy,
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S… Speaker 1 (New Recording 9)
or watch and wait.
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S… Speaker 1 (New Recording 9)
So we need to understand.
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I hear one of these people I want to learn from you guys.
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S… Speaker 1 (New Recording 9)
So we look to gather information about your experience because we
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S… Speaker 1 (New Recording 9)
all have an experience with taking eye.
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S… Speaker 1 (New Recording 9)
But probably of the new medication,
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S… Speaker 1 (New Recording 9)
I think you have two patients or three patients.
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Yet, I don't have any patient.
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I ordered the medication and I'm waiting.
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So we're going to discuss the DeFi trial and
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we're going to look at the real -world experience about the new medication and Dr.
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S… Speaker 1 (New Recording 9)
Abdullah,
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he will talk about a case.
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So without any further delay,
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we'll start with Dr.
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Canaan.
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Dr.
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Canaan is a non -medical oncologist.
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He's the director of the MENA NCCN.
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And here we'll talk about the overview,
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impact,
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and disease problems.
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S… Speaker 1 (New Recording 9)
So it's an overview,
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then we're going to hear again from him.
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I'd
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S… Speaker 1 (New Recording 9)
like to thank Mark for giving me the opportunity to talk to distinguished
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experts in Sankoma.
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So today's topic is going to be,
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or at least my talk is going to be,
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a brief overview on this one's tumors.
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I'll speak for about 15 minutes,
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then I think Dr.
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Ashwar will take the lead with regards to discussion.
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So what are these tumors?
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They're locally aggressive fibroblastic tumors
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that have or that are supposed to not metastasize.
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They are locally aggressive,
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locally infiltrative.
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S… Speaker 1 (New Recording 9)
Their disease course is unpredictable.
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S… Speaker 1 (New Recording 9)
Some of them will regress.
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spontaneously and of course surgery used
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to be the mainstay of therapy and there are high rates of records after
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surgery.
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Quite rare.
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I think because we are sarcoma oncologists,
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I think most of us should have this point to us.
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However, if we're talking about general population or general cancer population,
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it does represent 0 .03 % of all cancers.
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So very rare.
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Less than 3 % of all soft tissue sarcomas.
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And peak age at diagnosis is quite valuable.
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So you have probably your FAP patients,
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which are diagnosed at an earlier age,
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and you have your...
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other patients who are diagnosed at a later age.
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There is a slight female predominance.
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There is no significant racial or ethnic predilection.
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And about 5 to 50 % of patients are
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actually FAB related.
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I'll talk about the risk factors in the next few slides.
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So we do divide checkpoint tumors
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into...
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are too major sometimes.
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You have your sporadic ones,
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which are the majority.
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They represent about 85 % of these cases.
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Some of them have antecedent major trauma.
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Some of them don't.
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Molecularly,
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the majority of them would have CTNNB1 mutations.
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activating or an active beta -catenin pathway.
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And there are your FAP -related desmoids.
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These are less common.
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They represent between 5 % to 15 % of all
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desmoid cases.
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These cases are known to have an APC gene mutation,
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a germline one.
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So they do require germline testing and sort of genetic counseling.
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In terms of when a patient has basically
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FAP,
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the likelihood that they're going to develop a dysmoid is about 20%.
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So,
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as I mentioned,
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FAP carries a risk of development
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of dysmoids at about 20%.
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It is an autosomal dominant syndrome caused by a germline
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APC mutation.
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FAP associated desmoids anatomically typically go
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intra -abdominally or abdominal wall and
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there is a syndrome called Garner syndrome and this is when you
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have FAP,
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desmoid,
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osteomas,
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epidermal cysts and supernumerary teeth.
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Now, patients with FAP have a higher likelihood
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of developing colon cancer,
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and I think their lifetime risk of developing colon cancer is about 70%.
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So these patients,
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when identified,
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should receive genetic counseling,
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should see a cancer geneticist,
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and the majority of them should actually have an indication for
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doing prophylactic connectivity.
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So, just like I mentioned,
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the risk factors,
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the biggest one is antecedent
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trauma,
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about 30 % of sporadic desmoid tumors.
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Then you have your FAP,
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probably 5 to 15%.
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And,
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of course, hormonal or pregnancy.
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With pregnancy,
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you get your high estrogen surge.
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And if you actually have a desmoid tumor,
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the likelihood that it's going to grow is actually quite significant.
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Some of these patients postpartum due to a
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rapid decline in hormones,
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they do get postpartum regression.
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Molecularly,
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we have two major pathways.
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You have the beta -catenin pathway,
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where dysregulation of this wind beta -catenin pathway is
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implicated in the pathogenesis of this one tumors.
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So you get,
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basically,
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activation of this pathway.
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You get your beta -catenin,
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and it goes intranuclei,
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where you get proliferation and propagation of...
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types of tumors when you have an activating mutation in this gene.
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There is your NOTCH pathway which is also active
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in dysmoid tumors.
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When it is dysregulated,
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NOTCH does activate downstream pathways.
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You get your gamma secretanes which cleaves part
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of this.
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Then you get your NOTCH intercellular domain which goes inside
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the nucleus,
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causes propagation and progression.
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And this is where,
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basically,
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Neurogesis tend to work as it is a gamma -syncrasy inhibitor.
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Now,
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the intercalation or the crosstalk between your beta -catenin
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pathway and the notch pathway causes,
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may further contribute to this point,
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progression or hyphogenesis.
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How do these patients present?
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I think the majority of them do present with a
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measurable mass,
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whether it's painful or painless.
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They can develop virtually at any body site.
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However, we do like to divide them into extremity,
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abdominal wall,
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and intra -abdominally.
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The intra -abdominal ones are the ones that are harder to treat due to
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their surgical difficulty and resection.
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And the majority of FAB patients actually have intra -abdominal
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test points.
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They can be multifocal at N1 sites.
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I do have a couple of patients with extremity samples
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that have multifocal type of tumors.
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These are very difficult to insect.
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And symptoms depend on vocation and size.
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So, how common is each anatomical location?
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So, we're going to talk about extra -abdominal,
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well,
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actually, let's start with abdominal wall,
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because that's probably the easiest.
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It represents about 20 % of these dyspoints.
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Your intra -abdominal,
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which are the difficult ones to treat,
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are about 20%.
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Your joints and extremities are 30%,
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and everything else is going to be 34%.
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extra abdominal,
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other than joint extremity,
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so your head and neck,
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neck or chest wall.
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What symptoms
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do these patients complain of?
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So there is the physical part,
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and of course there is the psychological impact.
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If we're going to talk about the physical part,
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the spigament,
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these patients typically have enlarging masses
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that are difficult to control.
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The majority of them would actually present,
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unfortunately,
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late.
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So these patients,
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because of the location,
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do get neuropathic type of pain,
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decreased range of motion,
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especially the extremity ones,
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pain and fatigue.
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And of course,
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psychologically,
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it has a major impact as well on these patients.
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The majority of them have some psychological
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issues,
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such as fear,
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insomnia,
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and concern about lack of knowledge about healthcare providers.
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We lack a lot of knowledge.
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In
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S… Speaker 1 (New Recording 9)
terms of symptom burden,
41:11
S… Speaker 1 (New Recording 9)
the majority or the highest burden of symptom would actually
41:15
S… Speaker 1 (New Recording 9)
be pain.
41:16
S… Speaker 1 (New Recording 9)
And I suspect also issues with
41:20
S… Speaker 1 (New Recording 9)
movements specifically when tumors are close to joints or
41:25
S… Speaker 1 (New Recording 9)
are in extremities.
41:27
S… Speaker 1 (New Recording 9)
And of course there is an impact on quality of life,
41:29
S… Speaker 1 (New Recording 9)
difficulty in doing certain activities,
41:32
S… Speaker 1 (New Recording 9)
whether they're moderate or vigorous,
41:35
S… Speaker 1 (New Recording 9)
hopelessness,
41:36
S… Speaker 1 (New Recording 9)
frustration,
41:38
S… Speaker 1 (New Recording 9)
insomnia,
41:40
S… Speaker 1 (New Recording 9)
and fear of the unknown.
41:42
S… Speaker 1 (New Recording 9)
And this is basically data
41:46
S… Speaker 1 (New Recording 9)
from a natural history study on testosterone tumors.
41:49
S… Speaker 1 (New Recording 9)
How do we biopsy these tumors?
41:53
S… Speaker 1 (New Recording 9)
Cold biopsies is mandated.
41:57
S… Speaker 1 (New Recording 9)
We always argue against excisional biopsies
42:01
S… Speaker 1 (New Recording 9)
because there is a risk when you do an excisional biopsy that you leave tumor
42:05
S… Speaker 1 (New Recording 9)
behind and the risk of progression would actually be higher.
42:09
S… Speaker 1 (New Recording 9)
And of course there is also a theoretical risk of seeding.
42:13
S… Speaker 1 (New Recording 9)
With coronatal biopsy,
42:17
S… Speaker 1 (New Recording 9)
I think pathologists are...
42:20
S… Speaker 1 (New Recording 9)
known to actually diagnose these studies.
42:22
S… Speaker 1 (New Recording 9)
Immunohistochemically,
42:24
S… Speaker 1 (New Recording 9)
these tumors have positivity environmentin,
42:28
S… Speaker 1 (New Recording 9)
smooth muscle actin,
42:30
S… Speaker 1 (New Recording 9)
and nuclear beta -catenin.
42:32
S… Speaker 1 (New Recording 9)
Molecular testing is encouraged,
42:35
S… Speaker 1 (New Recording 9)
so doing a large panel NGS,
42:38
S… Speaker 1 (New Recording 9)
working for CT and MP1 mutations.
42:41
S… Speaker 1 (New Recording 9)
These are highly sensitive for core biopsies,
42:43
S… Speaker 1 (New Recording 9)
and these are diagnostics of these good tumors.
42:49
S… Speaker 1 (New Recording 9)
What about FAPs?
42:51
S… Speaker 1 (New Recording 9)
I'm not sure what my other colleagues are doing,
42:54
S… Speaker 1 (New Recording 9)
but any patient who's young who comes to us with this one should
42:58
S… Speaker 1 (New Recording 9)
be referred to our cancer genetics clinic to get H &Y testing
43:03
S… Speaker 1 (New Recording 9)
looking specifically for FAP.
43:04
S… Speaker 1 (New Recording 9)
So getting an accurate family history is
43:08
S… Speaker 1 (New Recording 9)
essential, specifically for colorectal cancer,
43:11
S… Speaker 1 (New Recording 9)
and 70 % of FAP patients should develop colorectal cancer
43:15
S… Speaker 1 (New Recording 9)
at any one point.
43:17
S… Speaker 1 (New Recording 9)
patients should be offered the colonoscopy and germline genetic testing.
43:20
S… Speaker 1 (New Recording 9)
If they have more than or equal
43:25
S… Speaker 1 (New Recording 9)
to one of these two,
43:25
S… Speaker 1 (New Recording 9)
their age at presentation is less than 40,
43:29
S… Speaker 1 (New Recording 9)
they have a retroabdominal or retroperitoneal dyspoin tumor,
43:33
S… Speaker 1 (New Recording 9)
or they have multifocal disease,
43:35
S… Speaker 1 (New Recording 9)
or there is a family history of colorectal cancer.
43:39
S… Speaker 1 (New Recording 9)
I mentioned,
43:39
S… Speaker 1 (New Recording 9)
I think, previously in a prior talk,
43:42
S… Speaker 1 (New Recording 9)
one of my first patients was a 28 -year -old guy with rectal cancer
43:46
S… Speaker 1 (New Recording 9)
who developed colorectal cancer and had
43:50
S… Speaker 1 (New Recording 9)
two of his family members die from colorectal cancer.
43:53
S… Speaker 1 (New Recording 9)
We did her blood testing and he actually had fat.
43:56
S… Speaker 1 (New Recording 9)
I have a question for the
44:02
S… Speaker 1 (New Recording 9)
previous slide
44:07
S… Speaker 1 (New Recording 9)
regarding do you really have evidence about the seeding?
44:27
S… Speaker 1 (New Recording 9)
I'm not sure there is a specific evidence,
44:30
S… Speaker 1 (New Recording 9)
but I have seen a case where this has actually seen
44:34
S… Speaker 1 (New Recording 9)
it. At this point it is fibromatosis,
44:36
S… Speaker 1 (New Recording 9)
it is car tissue.
44:38
S… Speaker 1 (New Recording 9)
So if you puncture it and pull it,
44:40
S… Speaker 1 (New Recording 9)
well, if you do an excisional biopsy,
44:42
S… Speaker 1 (New Recording 9)
non -oncological biopsy where you actually cut through the
44:46
S… Speaker 1 (New Recording 9)
tumor, I think the risk of progression and perhaps ceiling is actually there.
44:50
S… Speaker 1 (New Recording 9)
The overall chance
44:54
S… Speaker 1 (New Recording 9)
of finding FAB without prior history is 45%,
44:57
S… Speaker 1 (New Recording 9)
so it is relatively low if you have any FAB.
45:00
S… Speaker 1 (New Recording 9)
Family history,
45:00
S… Speaker 1 (New Recording 9)
they should be managed as per the cancer genetics sort of guidelines.
45:05
S… Speaker 1 (New Recording 9)
And when you have an APC mutation found,
45:07
S… Speaker 1 (New Recording 9)
then this is a clear diagnosis and patients should
45:11
S… Speaker 1 (New Recording 9)
be offered a prophylactic colectomy after discussion with
45:15
S… Speaker 1 (New Recording 9)
a cancer geneticist.
45:16
S… Speaker 1 (New Recording 9)
And of course,
45:17
S… Speaker 1 (New Recording 9)
they should get on -road at this point surveillance.
45:21
S… Speaker 1 (New Recording 9)
What's the best imaging modality?
45:23
S… Speaker 1 (New Recording 9)
It is actually MRI.
45:24
S… Speaker 1 (New Recording 9)
There are certain MRI characteristics for disjoint
45:29
S… Speaker 1 (New Recording 9)
tumors and basically in the T2 signaling
45:33
S… Speaker 1 (New Recording 9)
you get hypo -intense bands in about 90 % of
45:37
S… Speaker 1 (New Recording 9)
your abdominal wall at disjoints and this is very characteristic.
45:41
S… Speaker 1 (New Recording 9)
When you give contrast with gadolinium it does
45:45
S… Speaker 1 (New Recording 9)
enhance and over time with
45:49
S… Speaker 1 (New Recording 9)
treatment.
45:51
S… Speaker 1 (New Recording 9)
This T2 signal should decrease and this may actually indicate
45:55
S… Speaker 1 (New Recording 9)
treatment response.
45:57
S… Speaker 1 (New Recording 9)
And of course,
45:57
S… Speaker 1 (New Recording 9)
this should be done by our expert radiologists.
46:01
S… Speaker 1 (New Recording 9)
This is the last part of the first
46:05
S… Speaker 1 (New Recording 9)
talk.
46:05
S… Speaker 1 (New Recording 9)
Thank
46:11
S… Speaker 1 (New Recording 9)
you, Kenan.
46:11
S… Speaker 1 (New Recording 9)
We'll now move to the discussion.
46:14
S… Speaker 1 (New Recording 9)
I want to hear from all of you.
46:16
S… Speaker 1 (New Recording 9)
Please use the mic because most of the questions are
46:20
S… Speaker 1 (New Recording 9)
driven by the surveying.
46:25
S… Speaker 1 (New Recording 9)
Okay, this is one of the surveys.
46:27
S… Speaker 1 (New Recording 9)
If you look,
46:29
S… Speaker 1 (New Recording 9)
a colonist is radiology,
46:31
S… Speaker 1 (New Recording 9)
100 % for biopsy,
46:34
S… Speaker 1 (New Recording 9)
and we have 43 % talking about genetic tests.
46:39
S… Speaker 1 (New Recording 9)
So,
46:40
S… Speaker 1 (New Recording 9)
the question here,
46:42
S… Speaker 1 (New Recording 9)
do you have a pathologist specialized in sarcoma in your center?
46:46
S… Speaker 1 (New Recording 9)
Maybe we'll start with Dr.
46:49
S… Speaker 1 (New Recording 9)
Abdullah, then Dr.
46:50
S… Speaker 1 (New Recording 9)
Aisha.
46:51
S… Speaker 1 (New Recording 9)
Yes,
46:54
S… Speaker 1 (New Recording 9)
we are.
47:22
S… Speaker 1 (New Recording 9)
Yes,
47:23
S… Speaker 1 (New Recording 9)
we do have Yes,
47:27
S… Speaker 1 (New Recording 9)
we do have
47:33
S… Speaker 1 (New Recording 9)
Like all suspected dismalate cases reviewed by
47:37
S… Speaker 1 (New Recording 9)
them or only complex certain cases?
47:40
S… Speaker 1 (New Recording 9)
I think,
47:42
S… Speaker 1 (New Recording 9)
sorry.
47:43
S… Speaker 1 (New Recording 9)
They want to hear you.
47:45
S… Speaker 1 (New Recording 9)
Yeah,
47:47
S… Speaker 1 (New Recording 9)
they are reviewed by soft tissue and sarcoma.
47:50
S… Speaker 1 (New Recording 9)
Everything, not only the complex cases,
47:52
S… Speaker 1 (New Recording 9)
Dr.
47:52
S… Speaker 1 (New Recording 9)
Ayesha.
47:53
S… Speaker 1 (New Recording 9)
Yes, usually most of the dysmoid cases,
47:56
S… Speaker 1 (New Recording 9)
we try as much as possible to present them in our sarcoma
48:00
S… Speaker 1 (New Recording 9)
MDT, where it's usually attended by the
48:05
S… Speaker 1 (New Recording 9)
pathologist where they go through the slide and also confirm the diagnosis.
48:09
S… Speaker 1 (New Recording 9)
So even dysmoid cases,
48:11
S… Speaker 1 (New Recording 9)
intra -abdominal,
48:13
S… Speaker 1 (New Recording 9)
discussed in the sarcoma MDT?
48:13
S… Speaker 1 (New Recording 9)
Yes.
48:14
S… Speaker 1 (New Recording 9)
Most of the cases that are presented to us are discussed
48:18
S… Speaker 1 (New Recording 9)
in the sarcoma MDT meeting.
48:21
S… Speaker 1 (New Recording 9)
For us,
48:22
S… Speaker 1 (New Recording 9)
we'll send for a second expert opinion for the difficult cases.
48:26
S… Speaker 1 (New Recording 9)
So where are they in Jeddah?
48:27
S… Speaker 1 (New Recording 9)
Mostly they go to a campus in the area.
48:29
S… Speaker 1 (New Recording 9)
Oh, okay.
48:30
S… Speaker 1 (New Recording 9)
Great.
48:31
S… Speaker 1 (New Recording 9)
So what was you?
48:33
S… Speaker 1 (New Recording 9)
Same?
48:34
S… Speaker 1 (New Recording 9)
Actually,
48:35
S… Speaker 1 (New Recording 9)
the one who will decide to sit or not is the pathologist.
48:38
S… Speaker 1 (New Recording 9)
Okay.
48:39
S… Speaker 1 (New Recording 9)
But many cases sit as Dr.
48:41
S… Speaker 1 (New Recording 9)
Rahman said outside.
48:42
S… Speaker 1 (New Recording 9)
Okay.
48:42
S… Speaker 1 (New Recording 9)
So what's up?
48:44
S… Speaker 1 (New Recording 9)
Actually,
48:46
S… Speaker 1 (New Recording 9)
you, but in our...
48:47
S… Speaker 1 (New Recording 9)
We have a sarcoma pathologist,
48:49
S… Speaker 1 (New Recording 9)
so most of the case is diagnostic.
48:56
S… Speaker 1 (New Recording 9)
Most of the cases diagnosed in our center,
48:58
S… Speaker 1 (New Recording 9)
however,
48:59
S… Speaker 1 (New Recording 9)
they still have a reference with King Faisal,
49:03
S… Speaker 1 (New Recording 9)
and also we do have a clinic as well.
49:05
S… Speaker 1 (New Recording 9)
In the meantime,
49:06
S… Speaker 1 (New Recording 9)
we raised an important element.
49:08
S… Speaker 1 (New Recording 9)
For the intra -abdominal,
49:10
S… Speaker 1 (New Recording 9)
it is discussed in the GI tumor board.
49:13
S… Speaker 1 (New Recording 9)
But for the moid of the extremities,
49:16
S… Speaker 1 (New Recording 9)
we are discussing in the sarcoma tumor board.
49:19
S… Speaker 1 (New Recording 9)
Exactly, because the GI or the surgical oncology is doing the intra -abdominal.
49:24
S… Speaker 1 (New Recording 9)
Yes, so similar to Dr.
49:26
S… Speaker 1 (New Recording 9)
Meribeth,
49:27
S… Speaker 1 (New Recording 9)
so most of the abdominal and intra -abdominal are discussed initially
49:31
S… Speaker 1 (New Recording 9)
in the GI tumor board,
49:32
S… Speaker 1 (New Recording 9)
but eventually then they will be discussed again in the GI tumor
49:37
S… Speaker 1 (New Recording 9)
board.
49:37
S… Speaker 1 (New Recording 9)
Okay.
49:39
S… Speaker 1 (New Recording 9)
What are the main gaps in pathology diagnosis for this morning?
49:44
S… Speaker 1 (New Recording 9)
Do you think there is gaps in diagnosis in terms of pathology?
49:48
S… Speaker 1 (New Recording 9)
If we have a specialized pathologist,
49:52
S… Speaker 1 (New Recording 9)
do you think there is?
49:54
S… Speaker 1 (New Recording 9)
I think maybe the main gap is the availability
49:59
S… Speaker 1 (New Recording 9)
of the tissue.
50:00
S… Speaker 1 (New Recording 9)
Sometimes it's difficult to get enough tissue for the
50:04
S… Speaker 1 (New Recording 9)
diagnosis.
50:04
S… Speaker 1 (New Recording 9)
Sometimes you need to repeat the biopsia again to reach the
50:08
S… Speaker 1 (New Recording 9)
final diagnosis.
50:09
S… Speaker 1 (New Recording 9)
But overall,
50:11
S… Speaker 1 (New Recording 9)
if there is enough tissue,
50:12
S… Speaker 1 (New Recording 9)
the diagnosis by an expert pathologist is not
50:17
S… Speaker 1 (New Recording 9)
difficult.
50:19
S… Speaker 1 (New Recording 9)
Yeah, it is the same like Dr.
50:21
S… Speaker 1 (New Recording 9)
Ali pointed.
50:22
S… Speaker 1 (New Recording 9)
So I believe the initial part is the time
50:26
S… Speaker 1 (New Recording 9)
of the biopsy.
50:27
S… Speaker 1 (New Recording 9)
And because we do have MSK,
50:30
S… Speaker 1 (New Recording 9)
which is the musculoskeletal team for the IR,
50:34
S… Speaker 1 (New Recording 9)
for the extremities,

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