National Center for Spinal Disorders, Budapest, Hungary
I'm the medical director of the National Center for Spinal Disorders in Budapest. The center is a large institution, carrying out over 2,000 surgeries a year. My primary job is as a spine tumor surgeon. I am also involved with disc and spine pathologies.
- What do you expect from the Knowledge Forum?
- AOSpine is quite rational about how to develop its research and educational activities. The establishment of the Knowledge Forums was a very good idea, perhaps one of the best in the last years. The Knowledge Forums provide us with a good framework to organize the research structure and have great impact on education, as well. This pyramid-like structure from the KFs gives us the possibility to organize specialists at the local, national and international levels. This knowledge-sharing structure might just be the most effective!
- How is it organized?
- It´s a steering of committee, established at the highest international level. The members are chosen based on primary research goals by the committee.
Within the work goals, we are presently in the middle of the retrospective primary tumor database collection, which is a very important issue because this is the first large international database on spine tumors. The first objective is to build up the basic database. The second objective is to term the prospective data collection according to the diagnostic characteristic to the pathological behavior of a tumor, especially directing at the different kinds of therapeutic modalities. The most interesting question is: how the oncological outcome of the patient will relate to the original decision-making process? Answers are the main goal of this Knowledge Forum.
- For how long have you been participating in the activities of AOSpine? How have the issues evolved over the years?
- I've been involved with spine surgery for more than 10 years and with AOSpine since 2005. Tumor has always been a main topic, but during the recent years, metastatic tumor has become greater in the everyday clinical experience in the spine surgery. To obtain better education, homogeneous care, proper levels of care... almost every spine surgeon has to learn the basic techniques and/or about the metastatic issues.
Another issue is that more and more tumors are discovered at the early stage of the disease. This patient has to be housed at geographical centers or in international centers. Metastatic tumors are real diseases; primary tumors are not common. Metastatic has a great importance in the everyday experience. Primary is a kind of high-quality job, which has to be concentrated in real centers.
- Some 90% of the tumors are metastatic, right? What's the origin?
- All kinds of tumors, lung, breast, kidney, gastrointestinal tract, in a special stage of the disease gives the so called “far metastasis", and about 80% of these metastasis are spinal, local-motor or on the bone.
- What sort of tumors have you been treating more frequently?
- In my own clinical experience, tumor takes about 50%. We're a real center, an international center. My specialty is the sacrum and the pelvis, which is a kind of very special art.
- Which is the most common kind of tumor?
- Low grade malignance; cordoma and condrosarcoma are the most characteristic tumors that require surgery. The others respond to chemotherapy or radiotherapy, but cordoma and controsarcoma group, according to our recent knowledge, don´t respond to chemo or radiotherapy. These patients are primary candidates for surgery and this is a great challenge for us.
- You will be faculty on the Masters Knowledge Forum Tumor. Why should participants attend the Forum and what can they expect from it?
- I believe, this Masters is a unique opportunity to listen to up-to-date opinions, based on the personal experience of the KF members. The structure of the symposium is quite clear and comprehensive, where practically all KF member comment on cases of each special pathology. We will review and discuss some of the "hottest" pathologies through case presentations, complete with experts' opinions, comments, update lectures and finally case solutions. This is an effective way to give take home messages, and has immediate impact on the improvement of the participants' everyday clinical experience.
Otherwise, I think, participants have a chance to communicate directly—what is usually one of the main advantages of Davos courses, and even single case discussions could be performed with leading experts of the field.