Stephen D. Cassivi, M.D., M.S.

Location

SUMMARY

Stephen D. Cassivi, M.D., is a thoracic surgeon (chest surgeon) with both clinical and research activities. His clinical interests and experience span the breadth of thoracic surgery with a specific expertise in minimally invasive thoracic surgery.

Focus areas

Lung cancer

• Early detection of lung cancer. Along with his colleagues in the Department of Radiology and Division of Pulmonary and Critical Care Medicine, Dr. Cassivi is involved in studying the use of low-dose spiral CT scans for detection of asymptomatic and early-stage lung cancer.
• Minimally invasive brachytherapy delivery options. Brachytherapy is a form of localized radiation therapy that is used to supplement surgically treated cancers. Dr. Cassivi is working to develop minimally invasive delivery devices for lung cancer surgery.
• Clinical trials for the treatment of early and advanced lung cancer. Currently, Dr. Cassivi and the Mayo Clinic Division of General Thoracic Surgery are involved in a number of clinical trials investigating the optimal surgical and postoperative treatment of early- and late-stage lung cancer. These trials are conducted at Mayo Clinic with the collaboration of the American College of Surgeons Oncology Group (ACOSOG) and other major cancer collaborative study groups. Most patients are potential candidates for one or more of these ongoing trials.

Esophageal diseases

• Esophageal replacement project. Using various technologies, including tissue engineering and stem-cell based options, Dr. Cassivi is working with colleagues to develop better options for replacing segments of the esophagus. These treatments would be utilized as part of therapies to treat esophageal cancer and various benign esophageal diseases.

• Esophageal cancer and Barrett's esophagus. The Barrett's Esophagus Genomic Study Group is composed of 154 physicians from varying practice environments who collaborate to identify families in which three or more members have classic long-segment Barrett's esophagus (a pre-malignant disorder) with or without esophageal cancer, in order to collect blood specimens for genetic linkage analysis.

  The Mayo Clinic Esophageal Adenocarcinoma and Barrett's Esophagus (EABE) Registry is an unprecedented resource combining phenotype, genotype and environmental risk factor analysis. This collaborative venture represents the efforts of 48 Mayo Clinic physicians in gastroenterology and hepatology, genetic epidemiology, biostatistics, medical oncology, molecular biology, genetics, pathology, pulmonary medicine, psychology, radiation oncology, thoracic (chest) surgery, and the Mayo Clinic Comprehensive Cancer Center.

  The aims of the EABE Registry loosely include identification of candidate loci for gastroesophageal reflux disease (GERD) symptoms and its complications, and contributing to the scientific literature regarding the genomic steps necessary for the transformation from Barrett's esophagus to invasive cancer. The registry has begun to be utilized for gene discovery projects. In addition, identification of genomic polymorphisms that are associated with distant metastasis or that confer survival benefit may also prove possible using the EABE Registry.

Lung regeneration and lung transplantation

• Lung regeneration. Using tissue engineering and stem cell technology, Dr. Cassivi and his colleagues are working to develop regenerative treatment options for patients with end-stage lung diseases such as emphysema and pulmonary fibrosis.
• Gene therapy. Dr. Cassivi continues to be involved and interested in the utility and feasibility of gene therapy strategies in the area of lung disease (in general) and lung transplantation (in particular). With proper application, genetically targeted therapies may be able to decrease or prevent the two main hurdles of clinical lung transplantation: ischemia-reperfusion injury and obliterative bronchiolitis, a manifestation of chronic graft dysfunction.

Surgical quality

• Patient-centered outcomes research. In an effort to better define the surgical process with the patient's interests as the focal point, Dr. Cassivi is developing ways to define and measure quality processes and outcomes in thoracic surgery. Working with a multidisciplinary team, this project focuses on determining the best practices in treating patients with thoracic surgical diseases.