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Department of Sarcoma Peritoneal and Rare Tumours (SPRinT)

Our Care Team

Contact Information
 
Singapore General Hospital, Academia, Level 4
 
65 6220 7765
(for departmental matters only)
 

​The SPRinT team comprises of highly trained surgical oncologists specializing in the management of sarcomas, peritoneal disease, gastrointestinal and advanced intra-abdominal malignancies, and skin cancers.  The management of these tumours requires an individualized and holistic approach for each patient. As such, the SPRinT team works closely with specialists from various other sub-specialties to achieve the best outcome for each of our patients.

The SPRinT team are a big part of the weekly multidisciplinary tumour boards meetings, where surgeons, medical oncologists, radiation oncologists, radiologists, nuclear medicine physicians and allied health staff discuss complex cancer cases in order to reach comprehensive treatment decisions.  Our surgical oncologists also push the boundaries for cancer care via collaborative research, state-of-the-art clinical trials and translational laboratory research.  On the education front, the department invests heavily in training the next generation of doctors, surgical trainees and aspiring surgical oncologists in Singapore and the Asia-Pacific region.

Our Clinical Services

Gastrointestinal and Peritoneal Surface Malignancies

The SPRinT team sees patients with a wide spectrum of cancer types as peritoneal surface malignancies can arise from various organs. They can arise primarily from the peritoneum (e.g. mesothelioma, primary peritoneal cancer) or from the spread of a primary cancer (e.g. colorectal, appendix, stomach, ovary, hepatobiliary). Our team has extensive experience in treating these varieties of cancer from early to advanced stages.
Previously regarded as fatal, peritoneal disease of all histological subtypes can now be successfully treated to achieve good outcomes for patients. Our multidisciplinary clinics offer a one-stop service for the evaluation and surgical management of these patients. In conjunction with our medical oncologists, we provide a comprehensive range of treatments for patients with peritoneal disease, including cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
The SPRinT team has been performing CRS and HIPEC since 2001 and currently, has one of the most extensive experience in Asia for CRS and HIPEC for patients with peritoneal-based cancers. The team is also dedicated to pushing the boundaries of clinical care and is involved in numerous clinical trials, including the use of pressurized intraperitoneal aerosol chemotherapy (PIPAC) and prophylactic HIPEC for the treatment of selected patients. Novel therapeutic strategies including the use of small molecule inhibitors and delivery of chemotherapeutics are actively researched and implemented in our unit.

Sarcomas

Soft tissue sarcomas are a group of rare cancers that affect the soft tissues of the body. There are more than 70 different subtypes of soft tissue sarcomas, of which the more common ones are liposarcomas, leiomyosarcomas, solitary fibrous tumors, malignant peripheral nerve sheath tumors, among others.  Combining the latest evidence and collaborating with specialists from all relevant specialties, the SPRinT team provides a comprehensive diagnostic and therapeutic service for this rare disease. We are the most experienced unit performing multi-visceral resections for all forms of sarcoma in Singapore and is one of the few experienced tertiary referral units in Asia dealing with this debilitating disease.

Skin Cancers

Skin cancers provide a diagnostic and therapeutic dilemma for most clinicians.  Accurate diagnosis and staging is crucial to ensure good outcomes.  The SPRinT team works closely with our pathologists and medical oncologists to diagnose and treat various skin malignancies. We perform advanced surgical resections with reconstruction, achieving locoregional staging with sentinel lymph node biopsies, and control via lymph node dissections. We also perform isolated limb perfusion when necessary.  With advancements in the use of biologics and immunotherapy for skin malignancies, the SPRinT team constantly combines surgery with novel chemotherapeutics to provide the most up to date treatment for patients.

Advanced Intra-abdominal Malignancies

Many patients with advanced intra-abdominal malignancies often present a conundrum for the clinical team as the disease does not fall into clearly defined diagnostic groups. Our surgical oncologists in the SPRinT team perform complex multi-visceral and pelvic exenterations for locally advanced intra-abdominal malignancies; working hand-in-hand with medical and radiation oncologists to employ useful neo-adjuvant and adjuvant treatments when necessary.  For example, gastrointestinal tumours (GISTs) with acquired resistance to biologics are resected routinely by our team in close consultation with the medical oncology team. 


Education

As part of the Singhealth Duke-NUS campus, we value the opportunity to educate the next generation of doctors and surgeons-to-be in surgical cancer care and cancer research. The department is active in curriculum planning for Duke-NUS, and clinical teaching for students from Duke-NUS Medical School and Yong Loo Lin School of Medicine. We also actively contribute to the teaching and training of surgical residents.  We welcome applications for attachments not only from local medical students but also from overseas medical students or pre-med students interested in pursuing medicine or oncology research as a career.
Interested applicants please contact Ms Jasmine Pung at <jasmine.pung.b.l@nccs.com.sg> for more information.
For a list of teaching awards given to faculty in our department, refer to this link.

Fellowship program

The goals and objectives of our fellowship program are to train surgeons to provide comprehensive tertiary multidsiciplinary care for patients with complex intra-abdominal, pelvic and peritoneal malignancies.  This is a 6-month full time fellowship program, with plausibility of extension at discretion of supervisor.  Candidates must have completed an accredited specialist training in General Surgery.   For more information, please refer to https://www.nccs.com.sg/education-training/fellowship/surgical-oncology-fellowship-programme

Collaborations

Asian Peritoneal Surface Malignancy Group (APSMG) - a network of professionals and peritoneal treatment units that promotes learning opportunities and collaborations across the member Peritoneal Treatment Centers and units.  The SPRinT team was one of the founding members of this group, and hosts the annual Peritoneal Surface Malignancy Course in Singapore which hosts a diverse range of regional and international oncologic surgeons interested in the latest practice changing updates.  For more information, please refer to http://apsmg.org and https://www.psmconference.org

Singapore Peritoneal Oncology Study group (SPOS) – a collaboration between National Cancer Centre Singapore and surgeons from National Cancer Institute Singapore (NCIS) to advance research and education in peritoneal surface oncology.


Research

As part of the National Cancer Centre – one of the leading centres in Asia engaged in cancer care, we actively seek a global role in pursuing frontline cancer care research in a bid to advance cancer care for our patients. As such, the department is also actively engaged in a wide spectrum of clinical research ranging from clinical audits to ensure best practices to translational lab based research.   

Please refer to the links below for more information

• Please refer to this link for publications published by our team
• For the Laboratory of Applied Human Genetics website: https://www.nccs.com.sg/research-innovation/research-labs/laboratory-of-applied-human-genetics

Clinical Trials

Other than pursuing excellence in clinical care for our patients, we also actively pursue various large-scale clinical trials aimed at optimizing treatment outcomes and pushing the boundaries of cancer care for our patients. The various ongoing trials are detailed below.


Prophylactic HIPEC for Colorectal Cancers at High Risk of Developing Peritoneal Metastasis  (Ongoing)
This trial looks at the feasibility of performing prophylactic HIPEC for colorectal cancer patients at high-risk of developing peritoneal recurrence in our institution, and determine the morbidity associated with such a procedure.  For more information, refer here.


Radical Resection and HIPEC for Recurrent Retroperitoneal Sarcoma (Ongoing)
This trial hypothesizes that HIPEC when coupled with radical surgery will improve locoregional control and survival of patients with retroperitoneal sarcomatosis. For more information, refer here.

Evaluation Of MRI V CT Or PET-CT in the Detection of Peritoneal Surface Malignancies (Completed and awaiting publication)
This trial aims to evaluate the use of MRI scans and compare it to CT scans to determine if it has superior accuracy in early detection of peritoneal disease.


Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) With Oxaliplatin In Patients With Peritoneal Carcinomatosis (PIPAC)(Ongoing)
This research study serves to determine the safety profile and tolerability of PIPAC with oxaliplatin whichmay offer a novel and effective option of treatment for patients with peritoneal carcinomatosis, who, at present have limited options involving the use of systemic chemotherapy.  For more information, refer here.


Perioperative Immunonutrition for Patients Undergoing Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (Ongoing)
This study hypothesizes that perioperative immunonutrition can reduce wound infections and length of hospital stay, and improve perioperative outcomes. For more information, refer here.

Prospective Quality of Life Study for Colorectal Cancer Patients with Peritoneal Carcinomatosis Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (Completed)
This research paper studies patients undergoing CRS and HIPEC and attempts to identify factors that affect quality of life. For more information, refer here.



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