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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.
THE ESOPHAGUS The Esophagus investigates the anatomy, physiology, and pathology of the esophagus. This sixth edition, revised and updated throughout, also explores the diagnosis and treatment of various esophageal conditions. It includes treatment guidelines approved by the two largest gastroenterology societies, the ACG and AGA, as befits a work co-edited by two former presidents of those organizations. Advancements in diagnostics are presented, as are developments in the surgical and drug therapies. Presented in full colour, and boasting an unrivalled team of editors and contributing authors, The Esophagus Sixth Edition will find a home wherever the anatomy, physiology, and pathology of the esophagus are studied and taught. This book is accompanied by a website containing all the figures from the book in PowerPoint format. www.wiley.com/go/richter/esophagus6e Praise for the Fifth Edition: “There is absolutely no doubt that this edition of the textbook will maintain its status as the go-to reference for esophageal conditions, and will remain a highly utilized and clinically useful resource for novice and experienced physicians and surgeons alike.” (Gastroenterology, 1 July 2013)
The third triennial congress of the International Society for Diseases of the Esophagus (lSDE) was held in Munich in September 1986 under the presidency of J. Rudiger Siewert. The very well organized and epoch-making meeting was part of the International Esophageal Week and was held in conjunction with the International Conference of Esophageal Diseases, the European Study Group of Diseases of the Esophagus (GEEMO), and International Organization for Statistical Studies of Esophageal Diseases (OESO). I am very pleased that it has been possible to publish the proceedings of the congress so rapidly. The problems associated with diseases of the esophagus are multifaceted, varying considerably according to locality; their study thus neces sitates a large international forum, which is one of the founding aims of the ISDE. We hope that this volume, by virtue of the in-depth and up-dated reports it contains, can playa role in advancing the work being done in this field. Finally I should like to express my heartfelt appreciation to Professor Siewert and Dr. Holscher for their contribution toward the success of the congress. Kiyoshi Inokuchi, M.D., F.A.C.S. President of the ISDE Preface The scientific knowledge about esophageal diseases and their treatment has rapidly developed and increased within the last 10 years. The present book reproduces for 1987 the topical state of the art about pathology, pathophysiology, diagnostic, and therapy of benign and malignant diseases of the esophagus.
"In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review
This Atlas presents a state-of-the-art review of VATS and robotic approaches to managing lung and esophageal cancers. It discusses cancer staging, physiological evaluation of patients, and patient selection for minimally invasive surgery. The atlas offers detailed descriptions of individual operations accompanied by anatomic drawings, intraoperative images, and 3-dimensional anatomic reconstructions. Written by recognized experts in the field, it provides readers with an unparalleled resource for advancing their skills in managing these cancers. It is a valuable reference work for thoracic surgeons in training as well as in practice who want to pursue minimally invasive surgery. It is unique in offering fully illustrated, step-by-step descriptions of the operative procedures.
Recent randomized controlled trials comparing neoadjuvant chemoradiation plus surgery or perioperative chemotherapy plus surgery with surgery alone showed significant survival benefits for combined modality treatment of patients with localized esophageal adenocarcinoma. However, head-to-head comparisons of neoadjuvant chemoradiation and perioperative chemotherapy applying contemporary treatment protocols are lacking. The present trial was initiated to obtain valid information whether neoadjuvant chemoradiation or perioperative chemotherapy yields better survival in the treatment of localized esophageal adenocarcinoma. Proceeds from the sale of this book go to support an elderly disabled person.
Esophageal cancer causes an estimated 386,000 deaths worldwide and is the sixth most common cause of death for men. The background characteristics of esophageal cancer treatment are markedly different between Asian and Western countries, however. In tumor histology, squamous cell carcinoma associated with smoking and alcohol consumption is overwhelmingly prevalent in Asia, whereas adenocarcinoma associated with Barrett’s metaplasia is markedly prevalent in the West. In Asia, especially in Japan, the key persons who play important roles in the management of esophageal cancer patients are surgeons; in the West those roles are filled by medical and radiation oncologists as well as surgeons. The philosophy of surgeons regarding cancer surgery varies from locoregional to local tumor control, particularly in focusing on lymph node dissection. Physicians’ approach to surgical adjuvant therapy differs, therefore, between Asia and the West. Considering these East–West differences in esophageal cancer treatment, the currently available results of Western evidence should not be considered directly applicable to esophageal cancer in Asia. In this book, the authors discuss the knowledge base in Japan in terms of treatment of esophageal squamous cell carcinoma. Since this volume contains a wide spectrum of current information and addresses topics surrounding the treatment of patients with esophageal squamous cell carcinoma, it is highly relevant to Asian physicians and researchers as well as to their counterparts in the West.
Human life relies on two basic supplies, oxygen and food. Oxygen can be utilized directly, but food has to go through a long process of digestion to become usable nutrients. The esophagus is the beginning part of this long journey. Because of its critical location, any abnormalities in this part of the body can be devastating and life-threatening and difficult to treat. This book covers many aspects of esophageal disorders, from congenital diseases to cancer. It includes 11 chapters written by highly experienced scholars from all over the world. It is our intention to provide readers an update in esophageal study and to raise the awareness how important this organ to our entire body system.
This book serves as a practical guide for the use of carbon ions in cancer radiotherapy. On the basis of clinical experience with more than 7,000 patients with various types of tumors treated over a period of nearly 20 years at the National Institute of Radiological Sciences, step-by-step procedures and technological development of this modality are highlighted. The book is divided into two sections, the first covering the underlying principles of physics and biology, and the second section is a systematic review by tumor site, concentrating on the role of therapeutic techniques and the pitfalls in treatment planning. Readers will learn of the superior outcomes obtained with carbon-ion therapy for various types of tumors in terms of local control and toxicities. It is essential to understand that the carbon-ion beam is like a two-edged sword: unless it is used properly, it can increase the risk of severe injury to critical organs. In early series of dose-escalation studies, some patients experienced serious adverse effects such as skin ulcers, pneumonitis, intestinal ulcers, and bone necrosis, for which salvage surgery or hospitalization was required. To preclude such detrimental results, the adequacy of therapeutic techniques and dose fractionations was carefully examined in each case. In this way, significant improvements in treatment results have been achieved and major toxicities are no longer observed. With that knowledge, experts in relevant fields expand upon techniques for treatment delivery at each anatomical site, covering indications and optimal treatment planning. With its practical focus, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists, and senior nurses whose work involves radiation therapy, as well as medical oncologists and others who are interested in radiation therapy.