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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.
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
Colorectal cancer is the third most commonly diagnosed condition in oncology, affecting around 1.23 million individuals per year, according to recent statistics. Of these patients, about 50% will develop liver metastases and approximately 20% will present a stage IV disease at diagnosis. These statistics make colorectal liver metastases (CLM) an issue of major importance in current oncology. The area of CLM is subject to great and continuous advances, as its pathophysiologic mechanisms are better understood and more therapeutic and surgical options are developed. Consequently, all professionals involved with the diagnosis, treatment and follow up of CLM should be kept up to date with the latest advances on the field, to provide high standard medical care to their patients. This book is designed to present the state-of-the-art in CLM management and, in doing so, to review the current evidence on CLM, discussing all important topics in the field. Coverage is broad and comprehensive, encompassing introductory topics (history, definitions, epidemiology, etc.), basic science subjects (molecular biology, genetics, dissemination process, etc.) and practical clinical topics (tumor behavior, diagnosis, drug therapy, radiation therapy, surgery, ablation, multidisciplinary teams, etc.). Although comprehensive on the coverage and selection of topics, each chapter is concise and objective, dissecting topics in a practical and direct format. Evidences and recommendations are included. Chapters display a brief introduction of the common knowledge, go straight to the detailed revision of the most recent years of the literature, and end with practical closing observations. This book is a tool for professionals (general and cancer surgeons, HPB surgeons, clinical oncologists, gastroenterologists and medical residents) and interns who search for a qualified and reader friendly revision on topics concerning Colorectal Cancer Liver Metastases.
This book covers all liver tumors and lesions that clinically and radiologically mimic liver tumors. It provides readers with a comprehensive overview of this complex and rapidly evolving field. All aspects of surgical pathology are addressed, supplemented by detailed presentations of the lesions’ cell-biologic and molecular features. In addition, the methods employed for diagnosis and diagnostic algorithms are discussed. It appeals to pathologists and hepatologists and serves as an invaluable aid to diagnosis.The field of liver tumors and tumor-like lesions in adults and children has experienced tremendous advances in recent years. Specifically, the recognition of novel entities, deepened insights into known tumors, and refinement of classifications have necessitated continual updates and reappraisals. In addition, previous understanding of hepatic carcinogenesis and tumor progression has been transformed by the very rapid evolution of our understanding of cell biology, genomics, signaling pathways, cell interactions, and mechanisms of invasion and spread of hepatic tumor cells. These general pathology issues must be combined with surgical pathology if a comprehensive understanding of liver tumor pathology is to be achieved.
This handbook provides a clinically relevant, succinct, and comprehensive overview of image-guided brachytherapy. Throughout the last decade, the utility of image guidance in brachytherapy has increased to enhance procedural development, treatment planning, and radiation delivery in an effort to optimize safety and clinical outcomes. Organized into two parts, the book discusses physics and radiobiology principles of brachytherapy as well as clinical applications of image-guided brachytherapy for various disease sites (central nervous system, eye, head and neck, breast, lung, gastrointestinal, genitourinary, gynecologic, sarcoma, and skin). It also describes the incorporation of imaging techniques such as CT, MRI, and ultrasound into brachytherapy procedures and planning. Featuring procedural and anesthesia care, extensive images, contouring examples, treatment planning techniques, and dosimetry for the comprehensive treatment for each disease site, Handbook of Image-Guided Brachytherapy is a valuable resource for practicing radiation oncologists, physicists, dosimetrists, residents, and medical students.
In the past few years, striking progress has been made in the diagnosis and treatment of liver malignancies. This book, written by leading experts from throughout the world, provides a comprehensive and up-to-date overview of the role of diagnostic and interventional radiology in respect of liver malignancies. Following background chapters on anatomy, epidemiology, and clinicopathologic features, each of the diagnostic imaging techniques is carefully discussed and appraised, focusing on new developments in equipment and contrast agents. The interventional therapeutic approaches to primary and secondary hepatic malignancies are then described in depth. In particular, full consideration is given to newer sophisticated techniques of liver tumor ablation. The volume also includes special topics such as liver tumors in children and hepatic transplantation. This book will prove an indispensable source of information for clinicians and researchers involved in the diagnostic and therapeutic management of patients with liver malignancies.
There is an enormous sense of excitement in the communities of cancer research and cancer care as we move into the middle third of the ?rst decade of the 21st century. For the ?rst time,there is a true sense of c- ?dence that the tools provided by the human genome project will enable cancer researchers to crack the code of genomic abnormalities that allow tumor cells to live within the body and provide highly speci?c, virtually non-toxic therapies for the eradication,or at least ?rm control of human cancers. There is also good reason to hope that these same lines of inquiry will yield better tests for screening, early detection, and prev- tion of progression beyond curability. While these developments provide a legitimate basis for much op- mism, many patients will continue to develop cancers and suffer from their debilitating effects, even as research moves ahead. For these in- viduals, it is imperative that the cancer ?eld make the best possible use of the tools available to provide present day cancer patients with the best chances for cure, effective palliation, or, at the very least, relief from symptoms caused by acute intercurrent complications of cancer. A modality that has emerged as a very useful approach to at least some of these goals is tumor ablation by the use of physical or physiochemical approaches.
This comprehensive and critical review of current and established treatment modalities for malignant liver tumors is designed to help you sort through the proliferation of competitive approaches and choose the best treatment options for your patient. Dr. Clavien and his contributors consider all the options – radiological, surgical, pharmaceutical, and emerging/novel therapies – and help you find the best single or combined therapy. Building on the success of the previous edition, this extremely thorough revision: features a new section on Guidelines for Liver Tumors, where you will find specific strategies for treating common liver malignancies; the guidelines were prepared by the Associate Editors and take into account national and international society guidelines reflects actual practice by taking a multidisciplinary approach, with contributions from international experts who have extensive experience with this patient population achieves comprehensive and balanced coverage by having each chapter reviewed by the Editor, Deputy Editor, two Associate Editors, and at least one external reviewer includes 16 new chapters that cover liver anatomy, histologic changes in the liver, epidemiology and natural history of HCC, CCC and colorectal liver metastases, strategies of liver resection, and economic aspects as well as novel therapies facilitates the kind of daily interaction among hepatologists, hepatic surgeons, medical oncologists, radiotherapists, and interventional radiologists that is essential when treating patients with complex liver malignancies In 44 chapters organized into six major sections, the book covers the full range of liver tumors. The perfect blend of evidence and experience, Malignant Liver Tumors: Current and Emerging Therapies, 3rd Edition, illuminates the path to better patient care.
Although pediatric surgery is a distinct and evolving specialty, it still remains an integral part of most general surgical and paediatric medical practice. Nevertheless, surgery in children does differ from adult practice in various fundamental ways, and there are key physiological and anatomical differences that constantly need underlining. Progress and improvement in outcome has also been rapid but it is sometimes difficult for practitioners to keep themselves up-to-date with the usual surgical or paediatric text books. This book will give a concise overview of all important topics and is designed to provide information in order to recognise the common surgical conditions; namely typical symptoms and signs, investigation and then treatment management. It will also provide an anatomical and physiological background to aid understanding, in addition to emphasising logical, and where possible, evidence-based practice by the use of flow charts, tables and algorithms. Authored by an international range of leading contributors, this is the first book of its kind to offer comprehensive coverage to this topic in a quick reference, pocket-book format.