James D. Luketich: future for esophageal cancer patients is bright with growing technology and better therapy
Expert introduction
Prof. Luketich’s areas of interest include thoracic and esophageal surgery. These include gastroesophageal reflux disease, management of hiatal hernias, management of giant paraesophageal hernias, and other disorders of the esophagus, including diverticulitis, strictures, and many others. He has particular expertise in the multi-disciplinary management (combined chemotherapy/radiation and surgery) of esophageal and gastroesophageal cancer, Barrett’s esophagus, and lung cancer. He performs numerous complex operations on disorders such as these using minimally invasive techniques, for which he has become world renowned, performing over 2,500 minimally invasive esophagectomies.
Prof. Luketich is the principal investigator or co-investigator on numerous research grants and has published over 400 peer-reviewed manuscripts, 150 invited reviews, textbook chapters, and editorials, and 350 abstracts. He is frequently invited as an honored speaker around the world to present topics that relate to his research and minimally invasive techniques.
Prof. Luketich serves on the editorial boards of the Annals of Surgery, The Annals of Thoracic Surgery, the Journal of Gastrointestinal Surgery, and others. Prof. Luketich is a Fellow of the American College of Surgeons, and is a member of many prestigious surgical societies including the American Surgical Association, the American Association for Thoracic Surgery, and the Society of Thoracic Surgeons, among many others.
Prior to joining UPMC in 1995, Prof. Luketich was a senior instructor in surgery at Memorial Sloan-Kettering Cancer Center in New York. He has additionally held academic positions at Cornell University Medical College and the University of Pennsylvania.
Prof. Luketich received his medical degree from the Medical College of Pennsylvania in 1986 and completed his general surgery residency in 1992 at the Hospital at the University of Pennsylvania, where he was the chief resident of surgery from 1992-1993. He completed his cardiothoracic and thoracic training at New York Hospital, Cornell Medical Center, and Memorial Sloan-Kettering Cancer Center.
Editor’s notes
The 2017 Beijing International Academic Conference on Thoracic Surgery and the 5th National Cancer Center Annual Conference was held grandly from 29th June to 2nd July in Beijing, China. Gathering experts all over the world, the four-day conference attached much attention to the thoracic disease and covered dozens of top international academic researches. The conference, which has been the largest academic conference on thoracic disease nationwide so far, promoted our thoracic research and treatment to a world-scale level.
During the conference, Prof. James D. Luketich (Figure 1), from the University of Pittsburgh Medical Center, deeply impressed all the attendees with his presentation on Minimally Invasive Esophagectomy. Taking this opportunity, the Editorial Office of Journal of Visualized Surgery was honored to do an interview with Prof. Luketich and invited him to share the treatment, recent progress and outlook of esophageal cancer, and his advice for young surgeons.
At the beginning of the interview, Prof. Luketich told that in the past decades, one of the big advancement for the treatment and management for esophageal cancer lies in the lowering of morbidity and the risk of mortality from surgery for esophageal cancer with the minimally invasive techniques (laparoscopic, thoracoscopic technique, etc.). In the past, mortality frequently exceeded 10% or more but now with the application of minimally invasive techniques, and the development of centers of excellence for esophageal surgery, several reports show that the mortality can be as low as 1%, which is a significant progress in the surgical side of treating esophageal cancer through minimally invasive techniques.
When it comes to the technology that influences surgery, Prof. Luketich stated that in addition to the advancement of the video technology which bring us great laparoscopic and thoracoscopic views of surgical field, we also have new technology that allows us to perform relatively bloodless surgery, like the harmonic scalpel or the sonic shears, articulating endoscopic staplers, and a number of other devices that allow us to divide blood vessels relatively rapidly without complications. Furthermore, the field of robotic surgical approaches is also growing. The benefits of the robotic approach over traditional minimally invasive approach have not yet been clearly demonstrated but numerous surgeons have expressed their opinion that the robot facilitates their doing more operations minimally invasively, which as could lower the morbidity possibly even further in the future by impacting on the learning curve for some surgeons.
Based on his rich experience in the multi-disciplinary management of esophageal cancer, Prof. Luketich shared with us his view about this aspect and emphasized the importance of multi-disciplinary cooperation when treating esophageal cancer patients.
Speaking of the expectation to the future treatment for esophageal cancer, Prof. Luketich instantly said “technology will continue to grow”, new robots will be designed for more diseases; more and better chemotherapy will come out; the better understanding of the specific markers and receptors for esophageal cancer will also allow us to personalize treatment for esophageal cancer patients, etc. Prof. Luketich also expressed his high expectation for the pharmaceutical company, which will deliver a better and more direct-targeted therapy, and his hopes for the immunotherapy, which will help to turn on patients’ own immune system so as to fight various malignancies. To the future, Prof. Luketich is optimistic and believed that a number of advances in immunotherapy, chemotherapy and surgical therapy will all continue to be released with more favorable outcomes anticipated.
At the end of the interview, Prof. Luketich gave his precious advice for young surgeons for improvement: not only to obtain the best basic training, but also to seek out advanced specialty training, fellowship training in high volume academic centers of excellence (for example, a very busy center at least doing 100–200 esophagectomies per year).
When looking back to the early experience as a young surgeon, what’d you like to say to yourself? Want to know Prof. Luketich’s answer? Just click the video (Figure 2)!
Interview questions
- What do you think the progress/advancement for the treatment and management for esophageal cancer in the past decades?
- Is there any progress or technique that impressed you or influence you in the daily clinical work?
- What do you think about the multi-disciplinary management of esophageal cancer?
- What’ll be your expectation to the future treatment for esophageal cancer based on the current techniques?
- As a mentor and instructor, what’ll be your focus when teaching the young surgeons? What’ll you encourage the young surgeons to do for improvement?
- What quality you think a qualified mentor should have?
- You’re now a successful and well-known expert in the world. When looking back to the early experience as a young surgeon, what’d you like to say to yourself or what’ll you like to conclude your early experience?
Acknowledgements
None.
Footnote
Conflicts of Interest: The authors have no conflicts of interest to declare.
References
- Gao S, Lee P. James D. Luketich: future for esophageal cancer patients is bright with growing technology and better therapy. Asvide 2018;5:124. Available online: http://www.asvide.com/article/view/23383
(Science Editors: Skylar Gao, Pengcheng Lee, JOVS,
Cite this article as: Gao S, Lee P. James D. Luketich: future for esophageal cancer patients is bright with growing technology and better therapy. J Vis Surg 2018;4:52.
