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The Veteran's Affairs Puget Sound Health Care System is the major tertiary referral center of the VA Health Care System for one of the largest geographic areas in the United States, including Washington, Alaska, Idaho, and parts of Oregon. The Surgical Service at VA Puget Sound is thoroughly integrated with the Department of Surgery at all levels – faculty, residents, and students. Residents and students gain experience from rotations at the Seattle VA at all stages of their training.   VA Puget Sound Health Care Web Site >>

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wuBy Peter C. Wu, MD

Advanced gastrointestinal (GI) cancers treated with chemotherapy and radiation exhibit disappointingly low 5–30% complete response rates. The majority of tumors are limited to only partial responses and surgery continues to be the mainstay treatment for most GI cancers despite poor overall survival rates. For example, chemoradiotherapy for advanced rectal cancer often results in detectable tumor volume reduction following early treatment, but is often succeeded by tumor progression despite additional therapy.

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