Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.
"The WHO Classification of Tumours of the Digestive System presented in this book reflects the views of a Working Group that convened for an Editorial and Consensus Conference at the International Agency for Research on Cancer (IARC), Lyon, December 10-12, 2009"--P. [5].
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.
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.
Carcinoma of the prostate increasingly dominates the attention of urologists for both scientific and clinical reasons. The search for an explanation and the prediction of the variable behaviour of the malignant prostatic cell continues unabated. The search for more precise tumour staging and more effective treatment is equally vigorous. Editors Andrew Bruce and John Trachtenberg have assembled acknowledged leaders in prostate cancer to present those areas of direct interest to the clinician. There are a number of other topics that might have been considered but most of these, such as experimental tumour models or biochemical factors affecting cell growth, still lack immediate application for the clinician. Carcinoma of the prostate continues to have its highest incidence in the western world, and the difference in comparison with the incidence in the Far East appears to be real and not masked by diagnostic or other factors. A number of other epidemiological aspects need careful analysis: Is the incidence increasing? Is the survival improving? Is the prognosis worse in the younger patient? Epidemiological data are easily misused and misinterpreted so that a precise analysis of the known facts makes an important opening chapter to this book.
Morson and Dawson's Gastrointestinal Pathology is one of the 'Gold Standards' of pathology textbooks. It has been completely revised to incorporate the latest advances in this rapidly evolving field including the developments in gastric cancer and Helicobacter pylori and the revised classification of other common gastrointestinal conditions. This new edition features a wealth of new material presented in full colour for the first time.
Digestive System Tumours is the first volume in the fifth edition of the WHO series on the classification of human tumors. This series (also known as the WHO Blue Books) is regarded as the gold standard for the diagnosis of tumors and comprises a unique synthesis of histopathological diagnosis with digital and molecular pathology. These authoritative and concise reference books provide indispensable international standards for anyone involved in the care of patients with cancer or in cancer research, underpinning individual patient treatment as well as research into all aspects of cancer causation, prevention, therapy, and education.
Confronted with myriads ofTs, N's and M's in the VICC TNM booklet, classifying a malignancy may seem to many cancer clini cians a tedious, dull and pedantic task. But then when he looks into the TNM-Atlas all of a sudden lifeless categories become vi vid images, challenging his know-how and his investigational skills. Prof. Dr. Brigit van der Werf-Messing, Chairman of the International TNM-Committee of the VICC. Preface In 1938 the League of Nations Health Organization published an "Atlas illustrating the division of cancer of the uterine cervix into four stages according to the anatomo-clinical extent of the growth". Since this work appeared, the idea of visual representation of the anatomical extent of malignant tumours at the different stages of their development has been repeatedly discussed. At its meeting in Copenhagen in July 1954, the VICC adopted as part of its programme "the realization of a clinical atlas". However, the time to do the planned illustration work was not ripe until the National Committees and international organiza tions had officially recognized the 28 classifications of malignant tumours at various sites as presented in the 3rd edition of the "TNM Booklet" (1978) edited by M. Harmer. This was all the more important since in 1980, in addition to the "Booklet", a "Brochure of Checklists" edited by A.H. Sellers was made available as a further aid in the practical application of the TNMsystem