Gastrointestinal Oncology: Principles and Practice - Hardcover

Hardcover

ISBN 10: 0781722306 ISBN 13: 9780781722308

Publisher: Lippincott Williams & Wilkins, 2001

Synopsis

Kelsen MD, David P., Daly, John M., Kern, Scott E., Levin, Bernard, Tepper, Joel E.

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Reviews

Gastrointestinal oncology has long been dominated by the competing interests of various specialists. Recent advances have now begun to lead to the integration of many of these groups and have led to the recognition of gastrointestinal oncology as a cohesive, if still complex, medical field. A textbook that merges the views of molecular biologists, pathologists, radiation oncologists, medical oncologists, and surgeons is therefore a welcome and much-needed addition to the bookshelves of both academic and community-based medical practitioners. Gastrointestinal Oncology: Principles and Practice is reminiscent of DeVita's classic textbook, Cancer: Principles and Practice of Oncology (6th ed., Lippincott Williams & Wilkins, 2001) and is in fact distributed by the same publisher. Like its distinguished relative, Gastrointestinal Oncology begins with several chapters on general principles before it addresses the specific cancers of the gastrointestinal tract. These initial chapters, in many cases, succeed brilliantly in providing a broad overview of the field. A chapter on the epidemiology of gastrointestinal cancers, for example, ties together common risk factors and trends in incidence among the various cancers and provides a description of new developments in the burgeoning field of genetic epidemiology and gene-environment interactions. Other general overviews prove more problematic. It seems an impossible challenge to write a single introductory chapter on gastrointestinal surgical oncology or gastrointestinal medical oncology. The authors of these chapters clearly rise to the occasion, but one can almost sense their desire to delve more deeply into their fields than was possible in the space allotted to them. The author of the overview chapter on the genetics of gastrointestinal cancer seems to have avoided this challenge altogether by focusing almost exclusively on familial colorectal cancer. The result is an outstanding review of familial adenomatous polyposis and hereditary nonpolyposis colon cancer. I fear, however, that interested readers will turn directly to the subsequent section on colorectal cancer, missing this jewel. The main section of the textbook is disease-oriented, with comprehensive reviews of esophageal, pancreatic, biliary, hepatocellular, and colorectal cancers. A final section deals with anal cancer and neuroendocrine tumors. Chapters on the molecular genetics of each disease are one of the book's main strengths. Outstanding descriptions of the molecular underpinnings of pancreatic, gastric, and hepatocellular cancer rival, in both scope and detail, the section on the more established field of the genetics of colorectal cancer. Additional chapters describe risk factors for each gastrointestinal cancer. A chapter on environmental and lifestyle risk factors for colorectal cancer is of particular interest, addressing the effects of physical activity, hormone-replacement therapy, nonsteroidal antiinflammatory agents, and diet on the risk of colorectal cancer. At the heart of each section on a particular cancer is a chapter on clinical management. Medical, radiation, and surgical oncologists are coauthors of these chapters. This strategy avoids the compartmentalization that occurs when treatment approaches (i.e., surgery, radiation therapy, and chemotherapy) are discussed in separate sections. Its advantages are most evident in the chapters on pancreatic, gastric, and rectal cancer, in which discussions of the various approaches to treatment merge seamlessly. Nevertheless, this interdisciplinary strategy may not work for everyone. Although medical oncologists are probably well served by it, surgeons seeking specific guidance on surgical techniques may want more information than these chapters provide. A single chapter on clinical management is also not sufficient for all diseases, and for this reason, the editors have added chapters to fill the gaps. These chapters do not always help the general flow of the text. Palliative interventions for biliary and duodenal obstruction, for example, are first discussed in the general chapter on clinical management of pancreatic cancer and are then described in detail in a subsequent chapter on the palliation of advanced disease. For the most part, however, these additional chapters are helpful. A particularly valuable chapter on the palliation of esophageal cancer discusses esophageal dilation as well as newer techniques, such as laser ablation, electrocoagulation, and photodynamic therapy. As they peruse this book, gastrointestinal oncologists are likely to gravitate toward the more controversial topics in the field. One such topic is the role of preoperative chemoradiation for esophageal cancer. The chapter on this approach leaves little doubt about its efficacy in selected patients, although objective data are conflicting. The discussion of the optimal chemotherapy regimen for patients with metastatic colorectal cancer -- another unresolved issue -- is remarkably balanced, and the authors and editors apparently had the foresight to leave room for a discussion of developments that were occurring while the textbook was in press. Gastrointestinal Oncology is a notable achievement, providing a clear, comprehensive, and up-to-date review of the field. It is perhaps a sign of its relevance that continued progress, including the use of targeted biologic agents for the treatment of gastrointestinal cancers, may soon leave readers of this textbook wanting even more. This is surely a good sign for both the editors and the publisher, and I hope they will soon be at work on a second edition. Matthew H. Kulke, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Edition details

• Publisher: Lippincott Williams & Wilkins
• Publication date: 2001
• Language: English
• ISBN 10: 0781722306
• ISBN 13: 9780781722308
• Binding: Hardcover
• Edition number: 1
• Number of pages: 957
• Editor: Daly John M., Levin Bernard, Kern Scott E. M.D., Tepper Joel E. M.d., Kelsen David P.