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Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.
Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.
This book is a practical guide on how best to incorporate advanced radiation therapy techniques into the multimodality treatment of a wide range of gastrointestinal tumors, including esophageal cancer, gastric cancer, hepatobiliary malignancies (primary and metastatic liver tumors, intrahepatic, perihilar, and extrahepatic cholangiocarcinomas, and gallbladder cancer), pancreatic cancer, colorectal cancer, and carcinoma of the anal canal. Practical considerations when treating patients with external beam radiation therapy, intensity-modulated radiation therapy, particle therapy, and stereotactic body radiation therapy are clearly explained. Detailed attention is devoted to the safety and efficacy of radiotherapy in combination with current and emerging systemic therapies (chemotherapy, immunotherapy, and biologic agents), surgery, and ablative therapy, and the advantages and disadvantages of alternative treatment approaches for different tumor types are carefully evaluated. The book will benefit radiation oncologists, medical and surgical oncologists, medical physicists, medical dosimetrists, and other oncology professionals.
Holland-Frei Cancer Medicine, Ninth Edition, offers a balanced view of the most current knowledge of cancer science and clinical oncology practice. This all-new edition is the consummate reference source for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. A translational perspective throughout, integrating cancer biology with cancer management providing an in depth understanding of the disease An emphasis on multidisciplinary, research-driven patient care to improve outcomes and optimal use of all appropriate therapies Cutting-edge coverage of personalized cancer care, including molecular diagnostics and therapeutics Concise, readable, clinically relevant text with algorithms, guidelines and insight into the use of both conventional and novel drugs Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
Rectal cancer is one of the most prevalent cancers world-wide. It is also a paradigm for multimodal management, as the combination of surgery, chemotherapy and radiotherapy is often necessary to achieve the optimal outcome. Recently, international experts met in Heidelberg, Germany to discuss the latest developments in the management of rectal cancer, including the anatomic and pathologic basis, staging tools, surgical concepts including fast-track surgery and laparoscopic resection, functional outcome after surgery and the role of radio- and chemotherapy. This monograph summarizes this meeting and gives an extensive overview of the current concepts in management of rectal cancer.
Colorectal Cancer: Diagnosis and Clinical Management provides colorectal surgeons, gastroenterologists and oncologists with an authoritative, practical guide to best practice in the diagnosis and clinical management of colorectal cancer. Covering all forms of treatment including surgery, chemotherapy and radiotherapy, it examines the various new and emerging therapies, new strategies for screening and prevention, as well as the latest guidance on the most challenging and controversial aspects of managing colorectal cancer. The authors present important information on: Controversies in adjuvant chemotherapy Long versus short course radiotherapy Minimally invasive surgery and robotics Radical colonic resection Each chapter contains key points, tips and tricks and clinical case studies to aid rapid browsing and knowledge of the basic principles, while self-assessment questions allow readers to test their clinical knowledge. With leading international surgeons, gastroenterologists and oncologists combining to offer their considerable wealth of expertise and knowledge, Colorectal Cancer is a well-balanced, indispensable resource for all those involved in colorectal cancer management.
This book is a comprehensive understanding of the evolution of pre-malignant disease, emphasizing common themes in the field, including stem cell biology and histologic modes of cancer progression between the distal esophagus and stomach. Its sixteen chapters discuss metaplastic tissue change in the upper GI, clonalexpansion of early neoplasia, stem cell dynamics in experimental models, pathology of early esophageal squamous cell carcinoma, therapeutic modalities for esophageal squamous cell carcinoma, pathology of Barrett’s esophagus, screening, early detection and novel diagnostic tools for Barrett's esophagus, clonal evolution of Barrett’s esophagus, endoscopic therapeutic modalities of early esophageal cancer, pathology of early gastric cancer, and experimental models for gastric cancer. Stem Cells, Pre-neoplasia and Early Cancer of the Upper Gastrointestinal Tract is an integrative text on both the current state of translational research on every cancer development of the upper gastrointestinal tract as well as on novel clinical diagnostic and therapeutic modalities. It highlights a rapidly growing field within cancer research and is essential reading for oncologists, biochemists and advanced graduate students alike. Springer’s Advances in Experimental Medicine and Biology series presents multidisciplinary and dynamic findings in the broad fields of experimental medicine and biology. The wide variety in topics it presents offers readers multiple perspectives on a variety of disciplines including neuroscience, microbiology, immunology, biochemistry, biomedical engineering and cancer research.
This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.