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 SPECIFICATION
SURGICAL ONCOLOGY: FUNDAMENTALS, EVIDENCE-BASED APPROACHES & NEW TECHNOLOGY (hb)2011
Author: BARTLETT
ISBN: 9789350250518
Year: 2011
Publisher: JAYPEE BROTHERS MEDICAL PUBLISHERS PVT LTD.
Category: MEDICAL BOOKS  >-- SURGERY & TRAUMA  >-- SURGERY & TRAUMA Untitled Document
Edition: 1
Format: Hard Cover
Language: English
Pages: 616
 ABOUT THE TITLE
Untitled Document
 TABLE OF CONTENTS
SECTION 1
INTRODUCTION AND BACKGROUND
1. Surgical Oncology—Definition, History, Scope, Philosophy .................................................... 3
Kamran Idrees, David L Bartlett, Bernard Fisher
Introduction 3, Society of Surgical Oncology 4, Clinical Trial Programs 4, Historic Operations 6, Summary and
Recent Advances 14, Landmark Papers 15
2. Multidisciplinary Approach ............................................................................................................ 16
Haroon A Choudry, David L Bartlett
Introduction 16, Multidisciplinary Care Models 17, Multidisciplinary Approach: Understanding the Molecular
Basis of Cancer 17, Multidisciplinary Approach: Progress in Molecular Imaging 18, Multidisciplinary Approach:
Progress in Molecular Biomarker Assays and Targeted-agent Therapy 19, Multidisciplinary Approach: Progress
in Pre-emptive Diagnosis and Therapy 19, Multidisciplinary Approach: Progress in Minimally Invasive Approaches
20, Multidisciplinary Approach: Progress in Conventional Chemo-Radiotherapy 20, Multidisciplinary Approach:
Progress in Biological Therapy 20, Multidisciplinary Approach: The Extended Team 22, Multidisciplinary Approach:
Research 22, Summary 22, Landmark Papers 22
3. Ethical Considerations in Surgical Oncology .............................................................................. 23
Thomas McDonald, Daniel E Hall
Introduction to Surgical Oncology as Applied Ethics 23, Establishing the Goals of Care 24, Informed Consent and
Advance Directives 25, Spirituality in Patient Care 28, Medical Errors 29, Aggressive Care 30, Medical Futility
31, Ethical Aspects of Research and Innovation 32, Summary 34 , Landmark Papers 34
SECTION 2
FUNDAMENTALS AND BASICS OF CANCER
4. Molecular and Cellular Biology of Cancer ................................................................................... 37
Tara J Loux, Pawel Kalinski
Introduction 37, Replication and its Limitations 38, Tumorigenic Growth Factors and Downstream Signaling 40,
Endogenous Inhibitors of Cancerous Growth 46, Aberrations of Cell Death in Cancer 47, Gene Stability and DNA
Repair Mechanisms 48, Angiogenesis 49, Invasion and Metastasis 50, Conclusion 52, Landmark Papers 52
5. Methods of Investigation of Cancer ............................................................................................... 53
Jan Franko, Pragatheeshwar Thirunavukarasu
Formulating a Research Question 53, Primary and Secondary Research Questions 53, Assembling and Motivating
Research Team 54, Development of Protocol 54, Data Description and Analysis 54, Statistical Software and Internet
Resources 55, Cancer Epidemiology 55, Cross-sectional Studies 57, Case-control Studies 58, How to Detect Causality
58, Prospective Trials 58, Measures of Outcome and Endpoints 59, Statistical Analysis of Survival Endpoints 61,
Using Existing Database for Research 62, Selection of Publication Methods 63, Landmark Papers 63
6. Principles of Pathology ..................................................................................................................... 64
Leo A Neimeier, Jon M Davison
Introduction 64, Communicating with the Surgical, Pathology Laboratory 64, Care of the Surgical Specimen Prior
to Pathologic Evaluation 65, Intraoperative Surgical Pathology Consultation 65, The Surgical Pathology Report
67, Cytopathology 72, Summary 72, Landmark Papers 72
7. Diagnostic Imaging in Cancer ......................................................................................................... 74
Gregory Vorona, Frances Austin, Kurian Puthenpurayil
Introduction 74, Overview of Imaging by Modality 74, Assessment of Imaging Modalities for the Detection of
Malignancy 82, Examples of Imaging Utilization with Specific Cancers 83, Landmark Papers 89, Level of Evidence
Table 91
8. Vascular Access and Infusion Pumps ............................................................................................ 95
Theodore H Yuo, Rabih A Chaer
Overview 95, Venous Access 95, Hepatic Arterial Infusion for Colorectal Cancer 100, Conclusions 101, Level of
Evidence Table 101, Landmark Papers 103
9. Endovascular Applications in Surgical Oncology ..................................................................... 104
Donald T Baril, Rabih A Chaer
Introduction 104, Diagnostic Applications of Endovascular, Techniques 104, Therapeutic Applications of
Endovascular Techniques 105, Conclusion 111, Summary 111, Landmark Papers 111
10. Nutrition in Surgical Oncology ..................................................................................................... 113
Deepa Magge, Fateh Entabi, Juan Ochoa
Introduction 113, Starvation and Malnutrition 113, Nutritional Requirements 114, Nutrition and the Systemic
Inflammatory Response Syndrome 115, The Myth of Hyperalimentation 115, Malnutrition in Patients with Cancer
115, Nutritional Assessment in the Surgical Patient 116, Nutritional Interventions 116, Preoperative Nutrition
117, Postoperative Nutrition 117, Different Options for Nutritional Interventions 118, Data on Nutritional
Intervention in Specific Cancers 119, Summary 120, Landmark Papers 121, Level of Evidence
Table 121
11. Pain and Palliative Care in Surgical Oncology .......................................................................... 123
Julie W Childers, Linda King, Robert Arnold
Assessment of Pain 123, Pain Mechanisms 123 , Management of Pain 124, Pharmacologic Management of Cancer
Pain 124, Nausea and Vomiting 129, Dyspnea 130, Delirium 130, Fatigue 131, Anorexia and Cachexia 131,
Depression 132, Hospice 132, Palliative Care Specialists 133, Level of Evidence Table 133, Landmark
Papers 134
SECTION 3
PRINCIPLES AND PHILOSOPHY OF CANCER THERAPY
12. Principles of Surgical Therapy ...................................................................................................... 137
Jason A Breaux, Steven A Ahrendt
Introduction 137, Indications and Rationale for Surgical Intervention in Cancer 138, Preoperative Assessment 146,
Operative Approach 149, Minimally Invasive Surgical Oncology: Present and Future 153
13. Principles of Chemotherapy .......................................................................................................... 154
Benedito A Carneiro, Nathan Bahary
Introduction 154 , Combination Chemotherapy 156, Drug Resistance 156, Treatment Modalities 156, Standard
Chemotherapy Drug Classes 158, Molecularly Targeted Agents 166, Conclusions 171, Landmark Papers 171
14. Principles of Radiotherapy ............................................................................................................ 172
Joel S Greenberger
Introduction 172, Therapeutic Ratio 172, Normal Tissue Tolerance and Modern Principles of Radiotherapy 174,
Tumor Radiosensitizers 174, Selective Tumor vs Normal Tissue Radiobiologic Effects 175, Benefits of Minimally
Invasive Surgery in Radiotherapy Patients 175, Benefits of Continuous Low Dose Infusion Chemotherapy in
Radiotherapy Patients 175, Radiotherapy in Cancer Care of the Future 175, Conclusions 176 , Landmark
Papers 176
15. Principles of Biologic Therapy ...................................................................................................... 178
Antonio Romo de Vivar Chavez, Michael E de Vera, Michael T Lotze
Introduction 178, Inflammation and Immune Responses in the Origin, Progression and Treatment of
Cancer 178, Brief History of Biologic Therapy 178, Immunotherapy 180, Conclusion 192, Landmark Papers 193
SECTION 4
SUPERFICIAL TISSUES
16. Nonmelanoma Skin Cancer........................................................................................................... 197
A Serhat Gur, Bulent Unal, Atilla Soran, Howard Edington
Risk Factors in Skin Carcinogenesis 197, Host Factors 197, Prevention of Nonmelanoma Skin Cancer 200, Basal Cell
Carcinoma 200, Clinical Types 201, Squamous Cell Carcinoma (SCC) 201, Other Skin Tumors 203, Treatment
Options for NMSC 203, Medical Methods 206, Summary 207, Landmark Papers 208, Level of Evidence Table 208
17. Melanoma......................................................................................................................................... 210
Bulent Unal, A Serhat Gur, Atilla Soran, Howard Edington
Risk Factors for Melanoma 210, Melanocytic Lesions 211, Sunscreen, Clothing and Pigment Traits 211, Hereditary
Factors 212, Melanoma Growth Patterns 212, Diagnosis of Melanoma 213, Findings Suspicious of Melanoma 213,
Biopsy of the Suspected Melanoma 213, Prognostic Factors 214, Treatment 215, Elective Regional Lymph Node
Dissection 216, Sentinel Lymph Node Biopsy 216, Recognition of Local Recurrence, In-transit or Metastases of
Melanoma 217, Adjuvant Treatment of Melanoma 217, Hormones 218, Vaccines 218, Radiation Therapy 218,
Postsurgical Managemen 218, Landmark Papers 219, Level of Evidence Table 220
18. Soft Tissue Sarcoma ........................................................................................................................ 222
Marco A Alcala, Rahul Narang, Haroon A Choudry
Background 222, Etiology 222, Clinical Presentation 223, Diagnosis 223, Prognosis 224, Staging 225, Management
of Extremity Soft Tissue Sarcomas 226, Hyperthermia and Radiation 229, Hyperthermic Isolated Limb Perfusion
229, Management of Retroperitoneal Soft Tissue Sarcomas 229, Landmark Papers 230, Level of Evidence Table 231
19. Noninvasive and Benign Breast Tumors .................................................................................... 233
Atilla Soran, A Serhat Gur, Bulent Unal, Marguerite Bonaventura
Introduction 233, Fibroepithelial Lesions 233, Infiltrative Pseudomalignant Lesions 236, Cystic Lesions 237,
Hyperplastic Epithelial Lesions 237, Inflammatory Disorders 238, Miscellaneous Lesions 238, Noninvasive Breast
Cancers (Precursor and Preinvasive Lesions) 239, Landmark Papers 250, Level of Evidence Table 251
20. Invasive Breast Cancer .................................................................................................................... 253
Yewching Teh, Ronald Johnson, Gretchen Ahrendt
History of Breast Cancer and Therapy 253, Epidemiology 253, Risk Factors and Risk Assessment 253, Genetic
Predisposition and Counseling 254, Prevention 255, Presentation 255, Screening 256, Diagnostic Modalities 256,
Pathology and Histology 258, Prognostic Factors 259, Staging of Disease 259, Management 259, Anatomic and
Technical Considerations 266, Adjuvant Chemotherapy 269, Endocrine Therapy 269, Targeted Therapy—
Trastuzumab 270, Radiation Therapy 270, Recurrence and Management of Metastatic Disease 271, Follow-up and
Surveillance 272, Outcomes 272, New Frontiers 272, Summary 273, Landmark Papers 273, Level of Evidence
Table 274
SECTION 5
ENDOCRINE ORGANS
21. Thyroid Cancer ............................................................................................................................... 279
Ibrahim Yazji, Jennifer B Ogilvie
History 279, Epidemiology 279, Risk Factors 280, Presentation 280, Diagnosis 281, Histopathology and
Pathophysiology 283, Staging 285, Management 287, Follow-up and Surveillance 293, New Frontiers and
Controversies 294, Landmark Papers 294, Level of Evidence Table 295
22. Parathyroid ....................................................................................................................................... 298
Michael T Stang, Sally E Carty
Epidemiology 298, Risk Factors 298, Presentation and Features of HPT 299, Pathology and Histology 300,
Evaluation and Management 300, Complications, Follow-up and Surveillance 306, Parathyroid Surgery in Inherited
Syndromes, Cysts and Carcinoma 307, Landmark Papers 308, Level of Evidence Table 309
23. Adrenal Tumors ............................................................................................................................... 311
Linwah Yip
Primary Aldosteronism 311, Cushing’s and Subclinical Cushing’s Syndrome 312, Pheochromocytoma 313,
Malignant Pheochromocytoma 315, Evaluation of the Incidental Adrenal Lesion 316, Adrenocortical Carcinoma
318, Metastases to the Adrenal 320, Adrenalectomy 320, Bilateral Adrenalectomy 322, Summary 322, Landmark
Papers 323, Level of Evidence Table 323
SECTION 6
GASTROINTESTINAL TRACT
24. Esophageal Cancer .......................................................................................................................... 327
Edward Cheong, Farzaneh Banki, Arjun Pennathur, James D Luketich
Incidence 327, Pathogenesis of Esophageal Adenocarcinoma 327, Prevention 328, Surveillance 329, Clinical
Presentations 329, Staging of Esophageal Cancer 329, Treatment 332, MIE with Ivor-Lewis Anastomosis—Operative
Technique at UPMC 334, Mortality and Morbidity of Esophagectomy 339, Quality of Life After Esophagectomy
345, Future Directions 346, Summary 346, Landmark Papers 346, Level of Evidence Table 347
25. Gastric Cancer .................................................................................................................................. 349
Patricio M Polanco, Steven Hughes
Introduction 349, Gastric Adenocarcinoma—Epidemiology 349, Etiology and Risk Factors 349, Clinical Presentation
351, Pathology 351, Diagnosis, Preoperative Evaluation and Staging 352, Prevention and Screening Programs
354, Primary Treatment: Surgery 354, Adjuvant Therapy 360, Palliative Management of Unresectable Gastric
Cancer 361, Follow-up and Surveillance 361, Gastric Lymphoma—Epidemiology 361, Clinical Presentation 362,
Pathology 362, Diagnosis and Staging 362, Treatment and Follow-up 362, Gastrointestinal Stromal Tumors
(GIST)—Epidemiology 363, Pathology and Risk of Malignant Behavior 363, Landmark Papers 365, Level of
Evidence Table 366
26. Small Bowel Cancer ........................................................................................................................ 368
Raymond Eid, Herbert J Zeh III
Epidemiology 368, Pathogenesis 368, Risk Factors 369, Clinical Presentation 370, Diagnosis 370, Adenocarcinoma
372, Carcinoid Tumors 373, Intestinal Lymphoma 376, Gastrointestinal Stromal Tumor 378, Other Mesenchymal
Tumors 379, Landmark Papers 380, Level of Evidence Table 381
27. Colon Cancer ................................................................................................................................... 382
Amber Wooten, Pragatheeshwar Thirunavukarasu, Richard Fortunato, Wolfgang Schraut
Background 382, Risk Factors 382, Colonic Polyps 383, Genetics of Colon Cancer 386, Hereditary Colon Cancer
388, Pathology of Colon Cancer 389, Presentation of Colon Cancer 390, Staging 390, Screening 391, Preoperative
Work-up 391, Carcinoembryonic Antigen 392, Prognosis 392, Preoperative Preparation for Colorectal Surgery
394, Surgical Management 394, Adjuvant Therapy for Resected Disease 400, Follow-up and Surveillance 401,
Landmark Papers 401, Level of Evidence Table 402
28. Cancer of the Rectum and Anus ................................................................................................... 404
Richard Fortunato, Linda M Farkas
Introduction 404, Epidemiology 404, Presentation 404, Rectal Polyps 404, Pre-therapy Staging 405, Principles of
Surgical Management 405, Neoadjuvant Therapy 409, Adjuvant Therapy 409, Metastatic and Unresectable Rectal
Cancer 410, Complications, Follow-up and Surveillance 411, New Frontiers and Controversies 411, Anal Cancer—
xx / Surgical Oncology: Fundamentals, Evidence-based Approaches and New Technology
Introduction 411, Anatomy 412, Risk Factors 412, Presentation 413, Pathology 413, Staging and Prognosis 413,
Screening 414, Treatment 414, Results 415, Follow-up/Recurrence 415, Other Anal Canal Tumors 415, Other Anal
Margin Tumors 416, New Frontiers and Controversies 417, Landmark Papers 417, Level of Evidence Table 418
SECTION 7
HEPATOBILIARY SYSTEM
29. Liver Cancer ..................................................................................................................................... 423
Tsafrir Vanounou, Kevin Tri Nguyen, T Clark Gamblin
Surgical Anatomy of the Liver 423, Preoperative Evaluation 424, Patient Factors 424, Liver Pathology and Reserve
425, Liver Anatomy and Tumor Topography 427, Benign and Premalignant Liver Lesions 428, Summary 431,
Malignant Liver Lesions 432, Summary 434, Primary Liver Tumors 434, Summary 438, Cholangiocarcinoma
438, Summary 444, Role of Liver Transplantation for Liver Malignancy 445, Hepatic Resection 446, Landmark
Papers 450, Level of Evidence Table 451
30. Gallbladder Cancer ......................................................................................................................... 453
Mario Lora, Narcis Octavian Zarnescu, A James Moser
Epidemiology 453, Risk Factors 453, Pathology 454, Genetics of Gallbladder Cancer 454, Clinical Presentation
455, Diagnosis 455, Staging and Prognosis 456, Surgical Management 456, Adjuvant Therapy 460, Palliative
Procedures 460, Summary 461, Landmark Papers 461, Level of Evidence Table 462
31. Bile Duct Cancer .............................................................................................................................. 463
Mario Lora, Isam W Nasr, Narcis Octavian Zarnescu, A James Moser
Epidemiology 463, Classification of CCA 464, Molecular Biology and Genetics of CCA 464, Clinical Presentation
464, Diagnosis 464, Staging 466, Surgical Management 468, Liver Transplantation 471, Multimodality Therapy
471, Palliative Care 472, Management Overview 472, Landmark Papers 472, Level of Evidence Table 473
32. Endocrine Pancreas ......................................................................................................................... 475
Gary Nace, Kenneth KW Lee, Christopher J Bartels
Introduction and Background 475, Epidemiology 475, Localization and Work-up 477, Pathology, Staging and
Prognosis 478, Insulinoma 479, Gastrinoma 481, Vasoactive Intestinal Polypeptidoma 484, Glucagonoma 484,
Somatostatinoma 484, Rarer yet: GRFoma, ACTHoma and PTHoma 485, Non-functional and PPoma 485, Incidental
Pancreatic Neuroendocrine Tumors 485, Treatment for Advanced Disease 486, Summary 488, Landmark Papers
488, Level of Evidence Table 489
33. Pancreatic Cancer ............................................................................................................................. 491
Narcis Octavian Zarnescu, Isam W Nasr, Mario Lora, A James Moser
Introduction 491, Anatomy of the Pancreas 491, Epidemiology 491, Risk Factors 492, Clinical Presentation 493,
Pittsburgh Algorithm for Treating Pancreatic Cancer 493, Biochemical Tests 493, Radiographic Evaluation 493,
Endoscopic Ultrasound 494, Laparoscopy 494, Peritoneal Cytology 495, Pancreatic Intraepithelial Neoplasia 495,
Surgical Resection 495 , Adjuvant Therapy for Resected Pancreatic Cancer 497, Treatment of Locally Advanced
Pancreatic Cancer 498, Treatment of Metastatic Pancreatic Cancer 498, Palliation of Symptoms 499, Acinar Cell
Carcinoma 499, Other Periampullary Cancers 499, Cystic and Intraductal Papillary Mucinous Neoplasms 500,
Future Directions 502, Landmark Papers 502, Level of Evidence Table 503
SECTION 8
SPECIAL TOPICS
34. Splenectomy .................................................................................................................................... 509
Evie Carchman, Matthew P Holtzman
Anatomy 509, Physiology 510, Indications for Splenectomy 510, Summary 518, Landmark Papers 518, Level of
Evidence Table 519
35. Gynecologic Oncology.................................................................................................................... 521
William C McBee, Scott D Richard, Robert P Edwards
Uterine Cancer 521, Ovarian Cancer 526, Cervical Cancer 531, Lower Genital Tract 537, Level of Evidence
36. Leukemia and Lymphoma: The Role of the Surgical Oncologist .......................................... 544
Bruce O Hough, Joshua T Rubin
Overview 544, Clinical Presentation 544, Role of the Surgeon in Diagnosis 545, Role of the Surgeon in Treatment
546, Role of the Surgeon in Facilitating Therapy 548 , Role of the Surgeon in Treating Complications of Disease or
Therapy 548, Landmark Papers 549
37. Pediatric Surgical Oncology .......................................................................................................... 550
Kevin P Mollen, David A Rodeberg
General Principles 550, Children’s Oncology Group 550, Genetics of Childhood Cancer 550, Principles of Surgery
550, Mature and Immature Teratomas 566, Malignant Gonadal Germ Cell Tumors 566, Malignant Extragonadal
Germ Cell Tumors 566, Summary 566, Landmark Papers 567, Level of Evidence Table 568
38. Surgical Emergencies ...................................................................................................................... 569
Marcus K Hoffman, Joshua T Rubin
Bleeding and Obstruction 569, Biliary Obstruction 569, Neutropenic Colitis 569, Perforation 570, Clostridium
Difficile Colitis 570, Splenic Rupture 571, Pericardial Effusion 571, Landmark Papers 571
39. Minimally Invasive Approaches in Surgical Oncology ........................................................... 573
Kent Zettel, Andrew R Watson
Introduction 573, History of Laparoscopic Surgery 573, Introduction of Minimally Invasive Surgical Approaches
to the Oncology 573, Minimally Invasive Colorectal Surgery 575, Laparoscopic Gastric Resections 577, Laparoscopic
Pancreatic Procedures 577, Laparoscopic Hepatic Resections 579, Laparoscopic Splenectomy 579, Laparoscopic
Peritoneal Access Ports for Chemoperfusion 580, Additional Topics: Port Placement and Special Patient Circumstances
581, Conclusion 582, Summary 583, Level of Evidence Table 583
40. Robotic Surgery and NOTES ........................................................................................................ 586
Au H Bui, Sri Chalikonda
The da Vinci Robotic System in Surgery 586, Robotic-assisted Surgery 588, Colorectal Cancer 589, Esophageal
Cancer 589, Gastric Cancer 590, Other Abdominal Surgeries 590, Natural Orifice Transluminal Endoscopic
Surgery (NOTES) 590, Conclusion 591, Landmark Papers 592
41. Surgical Management of Metastases ............................................................................................ 593
James F Pingpank Jr
Hepatic Metastases 593, Peritoneal Carcinomatosis 598, Management 603, Metastatic Cutaneous Melanoma 606,
Landmark Papers 606, Level of Evidence Table 608
Index ................................................................................................................................................... 611
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MR AND MRS. JINNAH: THE MARRIAGE THAT SHOOK INDIA
JASMINE AND JOURNEYS: THE LIFE QUEST OF A SOUTH ASIAN WOMAN
THE SPY
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