University of WashingtonDepartment of Orthopaedics and Sports Medicine

Musculoskeletal Oncology2016 - 2017 Fellowships

University of WashingtonDepartment of Orthopaedics & Sports Medicine

2016-2017 Musculoskeletal Oncology Fellowship

University of Washington Department of Orthopaedics and Sports Medicine

Musculoskeletal Oncology Service

Department of Orthopaedics and Sports MedicineThe Department of Orthopaedics and Sports Medicine at the University of Washington provides expert current management of musculoskeletal disorders across all subspecialties within Orthopaedics. Our department’s active basic science and clinical research results in contributions to international literature. The faculty is also actively involved in a renowned residency training program and post-graduate fellow education.

Musculoskeletal Oncology ServiceThe Musculoskeletal Service provides comprehensive evaluation and management of pediatric and adult musculoskeletal tumors in a multi-disciplinary setting. We treat benign and malignant bone and soft tissue tumors, including metastatic bone disease. We collaborate closely with other oncologic, radiologic and surgical services to provide “all encompassing” care for patients with musculoskeletal tumors.

Our ApproachWe provide patient care within a multi-disciplinary care team from initial evaluation to definitive treatment and surveillance. Care is provided in a pediatric-specific hospital and an adult outpatient clinic and hospital setting.

Advanced Clinical Experience (ACE) in Musculoskeletal Oncology

The Orthopaedic MSK Oncology Fellowship at the University of Washington provides a combined adult and pediatric one-year program emphasizing multi-disciplinary care, innovative surgical management, and related research. Our facility is the only dedicated, academic multi-disciplinary sarcoma center in the Pacific Northwest and Alaska regions. This Fellowship has trained sarcoma surgeons for over twenty-eight years, a large number of whom currently direct academic programs across the country. We usually select two ACE Fellows per year. Weekly activities include both adult and pediatric multi-disciplinary conferences, clinic, operative responsibilities, and dedicated research time.

Clinical: Our patients come from a wide area, predominantly the states of Washington, Montana, Idaho, and Alaska. This provides a vast spectrum of oncologic problems presenting for management. Pediatric patients are treated entirely at Seattle Children’s Hospital. Adult patients are seen as outpatients at the Bone & Joint Center or Seattle Cancer Care Alliance (SCCA). Surgical managment and inpatient care are provided at the University of Washington Medical Center. Call requirements are minimal.

Teaching: Our educational commitment is to provide students, residents, post-graduates, and

practicing physicians with the most up-to-date information and techniques on the evaluation and management of oncologic issues. The ACEs play a major role in the education of the residents on the Tumor Service.

Research: Research opportunities in basic sciences, biomechanics, and clinical research are available. Many of our ongoing projects are collaborative with other service providers in Oncology. One research project is expected to be submitted for publication by the end of the fellowship year. Plans for an additional research year can be made if that interest arises.

Clinical research opportunities focus on patient outcomes for both oncologic and health-related quality of life perspective. The basic science research program associated with the musculoskeletal tumor service collaborates with scientists located primarily within the Department of Orthopaedics. There are multiple genetic and molecular oncology studies currently in progress, in addition to several prospective clinical studies.

Education: The educational goal of this fellowship is to train orthopaedic oncologists in the evaluation and management of musculoskeletal oncology diseases, pathology, and both basic science and clinical research.

Our Faculty

Dr. Chappie Conrad is a professor of orthopaedic surgery in the Department of Orthopaedics and Sports Medicine at the University of Washington and Seattle Children’s Hospital. He joined the faculty in 1986 after completing his training at the Hospital for Special Surgery in New York City. He also completed a musculoskeletal tumor fellowship with Dr. William Enneking and a pediatric orthopaedic fellowship with Dr. Mercer Rang. When he joined the Department of Orthopaedics, he instituted the University of Washingtons’ Division of Musculoskeletal Oncology and Transplantation. He is the Director of the Tumor Service Division of Ortho-paedic Surgery at the University of Washington and serves as the Medical Director at LifeNet Health - Northwest, a regional nonprofit tissue center with a national investment

in tissue distribution and research.

Dr. Conrad’s research projects include multiple clinical studies in pediatric and adult tumors with a special interest in pediatric limb-sparing procedures, benign pediatric tumors, and soft-tissue sarcomas in adults. His research interests include the metabolic imaging of sarcomas with the use of PET scans, clinical and biologic descriptions of hereditary multiple exostoses, the use of intraoperative navigation in orthopaedic oncology, and the biomechanic performance of oncologic implants.

Sarcobase, our database for tracking patients’ demographics, treatment descriptors, and func-tional outcome data in both pediatric and adult patients, has been in use since 2002. Also in 2002, a bone and soft tissue tumor bank was initiated. Adult patients are approached for inclu-sion before surgical procedure during which a tumor sample and adjacent normal tissue are frozen and saved for future research.

Ernest “Chappie” Conrad, MDProfessor

Darin J. Davidson, MDAssistant Professor

Prior to joining the University of Washington, Dr. Darin Davidson completed his Residency at the University of British Columbia in Vancouver, a Fellowship in pediatrics at Boston Children’s Hospital, and a Fellowship in musculoskeletal oncology at Mt. Sinai Hospital in Toronto. During his residency, he completed his Master of Health Science degree in clinical epidemiology.

In 2011, Dr. Davidson joined the University of Washington Department of Orthopaedics and Sports Medicine with a clinical emphasis on benign and malignant bone and soft tissue tumors. This is combined with interests in oncology education and clinical research, emphasizing quality of life and comparative effectiveness research.

Current Research and Clinical Interests:• Comparison of the EQ-5D and SF-6D properties in patients treated for soft tissue sarcoma • Validation of the step-counter for evaluation of physical function following management of bone and soft tissue sarcoma• Evaluation of functional outcomes for elderly patients with sarcoma• Comparison of outcome of leiomyosarcoma of bone with other primary bone sarcoma• Assessment of inter-observer and intra-observer agreement of response to neoadjuvant che-motherapy as determined by PET and MRI• Estimation of risk of VTE events amongst sarcoma patients in comparison with non-sarcoma patients

Howard A. Chansky, MDProfessorActing ChairChief, UW Arthroplasty Services

Dr. Howard Chansky is a professor and Acting Chair of the Department of Orthopaedics & Sports Medicine at the Uni-versity of Washington. He is also Chief of Orthopaedics at the University of Washington Medical Center. For the last thirteen years he has been Chief of Orthopaedics at Veterans Affairs Puget Sound Health Care System. Dr. Chansky is a graduate of Cornell University and the University of Pennsylvania School of Medicine. His orthopaedic residency at the University of Penn-sylvania was followed by an orthopaedic oncology fellowship at the University of Washington.

He is a specialist in hip and knee surgery, particularly complex joint replacement, as well as bone and soft tissue tumors. He practices primarily at UW Medical Center and the VA Puget Sound Health Care System.

Dr. Chansky has authored more than 100 journal articles, book chapters, scientific abstracts and presentations. Some of his research interests include clinical outcomes in total joint replacement and the molecular biology of sarcomas.

Antoinette W. Lindberg, MD

Dr. Antoinette Lindberg joined the pediatric orthopae-dics faculty at Seattle Children’s Hospital in 2012 after completing both a pediatrics fellowship and a musculo-skeletal oncology fellowship. She was born and raised in the Seattle area and attended the University of Wash-ington before going to medical school in New York and doing residency training at the University of Southern California. Her pediatrics fellowship was through Seat-tle Children’s followed by a University of Washington orthopaedic oncology fellowship. Currently, her practice is completely based at Seattle Children’s and consists of a mix of general pediatric orthopaedics and trauma as well as benign and malignant musculoskeletal tumors in children and adolescents. Her research interests include studies on access to care, patient-centered outcomes, and quality-of-life after tumor treatment.

Assistant Professor

Our Facilities

The University of Washington Orthopae-dics and Sports Medicine Musculoskeletal Oncology Service operates on patients at the Surgery Pavilion at the main UWMC building.

The UWMC is a 396-bed general medical and surgical facility with 18,919 admis-sions in the most recent year reported. It performed 7,272 annual inpatient and 7,865 outpatient surgeries. Its emergency room had 25,602 visits.

University of Washington Medical Center

Seattle Children’s HospitalThe Department of Orthopedics and Sports Medicine at Seattle Children’s Hospital is known for developing innovative treatment and providing world-class care. In 2011, U.S. News & World Report magazine ranked Children’s Orthopedics and Sports Medicine program one of the best in the country.Seattle Children’s has the first clinic in the United States where doctors who specialize in bones, joints and muscles (orthopedists) and cancer specialists (oncologists) work together in the same program. For 20 years, doctors, nurses and staff in the Bone Tumor and Sarcoma Clinic have specialized in diag-nosing tumors. Each year we see about 350 new patients at our Bone Tumor and Sarcoma Clinic, roughly 90% of whom have benign bone tu-mors. Between 50 and 60 children are treated every year for malignant bone tumors at this clinic and we also see approximately 30 children with malignant soft tissue tumors each year.

Surgical Pavilion

Seattle Cancer Care Alliance

SCCA, Fred Hutchinson Cancer Research Center, UW Medicine, and Seattle Children’s form the only NCI-designated comprehensive cancer center in the Northwest. This group of organizations is one of the top-funded cancer centers in the country.

In 2012, more than 300 oncologists, surgeons, radiation oncologists, and other clinicians treated over 5,500 patients for many types of cancers including leukemia, lymphoma, breast, prostate, lung, and colon cancer. SCCA pa-

Bone & Joint Center

The Bone & Joint Center Roosevelt is our outpatient adult benign tumor clinic. This facility is located near the University of Washington Medical Center on Roosevelt Way N.E. in Seattle. The clinic provides complete health care and preventive treatment for a variety of bone and joint problems, including complex fractures and bone tumors. The center has highly trained physicians and surgeons from the UW School of Medicine’s Depart-ment of Orthopaedics that are experts in such fields as tumors, bone transplantation, joint replacement, spine and lower back problems, hand surgery, arthritis, and foot and ankle treatment.

tients have access to the latest cancer treatments including stem cell and bone marrow transplan-tation, gene therapy, high-dose chemotherapy, radiation therapy, immunotherapy, minimally invasive surgical techniques, and other specialized therapies. SCCA patients may be seen at the SCCA outpatient clinics at Lake Union, UW Medical Center, Evergreen Health, and Northwest Hospi-tal. Pediatric patients may be seen at the SCCA outpatient clinic and Seattle Children’s. The adult multi-disciplinary sarcoma clinic is housed at SCCA. This is a collaborative clinic where surgeons, clinicians and radiation oncologists all see patients with in the same clinic.

Our Service Schedule

Monday Tuesday Wednesday Thursday FridayConrad Clinic at

Seattle Cancer Care Alliance

Clinic at Seattle Children’s Hospital

OR (inpatient) at Seattle Children’s Hospital

Pavilion OR (inpatient)

Clinic at Seattle Children’s Hospital

Davidson Pavilion OR (inpatient)

Clinic at Seattle Cancer Care Alliance

Clinic at the Bone and Joint Center

Research / Administative

Pavilion OR (inpatient)

Educational Activities:• Adult Sarcoma Tumor Board (weekly)• Pediatric Sarcoma Tumor Board (weekly)• Case Conference (twice monthly)• Orthopaedics Department Grand Rounds (monthly)• Orthopaedics Department M&M Rounds (monthly)• Journal Club (every two months)• Orthopaedic Pathology Conference (annually)

Current Tumor ACEs

Yi Guo, MD

Yi joins us from Shandong University in China.

guoyi@uw.edu

Mital Patel, MD

Mital joins us from Maharaja Sayajirao University of Baroda in India.

mitalp@uw.edu

2013-2014 Vincent Y. Ng, M.D. University of Maryland Medical Center Baltimore, MD 21201

2012-2014 Jodie Miles, M.D. Intermounain Orthopaedic Specialty Group Murray, UT 84107 2011-2012 Antoinette Lindberg, MD Seattle Childrens’ Hospital Seattle, WA 98105 2010-2011 Jennifer S. Barr, MD University of Mississippi Jackson, MS 39216 2009-2010 Kevin MacDonald, MD Virginia Mason Hospital & Medical Center Seattle, WA 98101 2008-2009 Thomas Scharschmidt, MD Ohio State University Columbus, OH 94310 2007-2008 Philip J. Krueger, MD West Bay Orthopaedic Medical Group Daly City, CA 94015

2006-2007 Jennifer W. Lisle, MD University of Vermont Burlington, VT 05405 2005-2006 Josh C. Pratt, MD Carolinas Medical Center Charlotte, NC 28203

Past Tumor ACEs

2004-2005 Andrew G. Howlett, MD Sacred Heart Medical Center Spokane, WA 99204 2003-2004 Jason S. Weisstein, MD Boca Raton Orthopaedic Group Boca Raton, FL 33431 2002-2003 Timothy B. Rapp, MD New York University New York, NY 10012

2001-2002 Hannah Morgan Castrucci, MD Eastern Maine Medical Center Bangor, ME 04401 2000-2001 Scott Helmers, MD Naval Medical Center San Diego, CA 92134 1999-2000 Joel Mayerson, MD Ohio State University Columbus, OH 94310

1998-1999 J. Dominic Femino, MD City of Hope Duarte, CA 91010 1997-1998 R. Lor Randall, MD University of Utah Salt Lake City, UT 84112

Past Tumor ACEs Cont.

1996-1997 Philip Z. Wirganowicz, MD The Permanente Medical Group Oakland, CA 94611

1995-1996 Mark T. Clayer, MD The Queen Elizabeth Hospital Adelaide, Australia 1994-1995 Richard J. O’Donnell, MD University of California, San Francisco San Francisco, CA 94143

1993-1994 Lyle Sorensen, MD Virginia Mason Hospital & Medical Center Seattle, WA 98101

1992-1993 Howard A. Chansky, MD University of Washington Seattle, WA 98195

1991-1992 Cengiz Tuncay, MD Baskent University Hospital Ankara, Turkey 1990-1991 James D. Bruckner, MD Overlake Medical Center Bellevue, WA 98004

Past Tumor ACEs Cont.

Contact InformationFacilities:

University of Washington Medical Center Information (206) 598-3300 Paging (206) 598-6190

Department of Orthopaedics and Sports Medicine Website: www.orthop.washington.edu Facebook: www.facebook.com/UWOrthopaedicsSportsMedicine Twitter: www.twitter.com/UWOrthopaedics YouTube: www.youtube.com/user/HuskyOrthopaedics Orthopaedics Main Line (206) 543-3690

Bone and Joint Center Front Desk (206) 598-4288 Backline (206) 598-9787

Seattle Children’s Hospital Front Desk (206) 987-2109

Seattle Cancer Care Alliance Front Desk (206) 288-7222

Contacts:

Ernest “Chappie” Conrad III, MD ernestchappie.conrad@seattlechildrens.org Karen Polson (206) 987-3077 Darin J. Davidson, MD djdavi@uw.edu Orthopaedics Main Line (206)543-3690

Sarah Pressl Program Coordinator sep720@uw.edu (206) 221-4469