Although several recently published textbooks and handbooks have some variation of "Surgical Oncology" in the title, a new text, Cancer Surgery, edited by McKenna and Murphy, shifts the emphasis from oncology to surgery. This focus is explicitly stated in the Preface, as the editors note that "this book has been prepared for the practicing surgeon," and they "have not included the neoplasms for which surgery plays little or no role." Over 90% of the 66 contributing authors are in the field of surgery or the surgical subspecialties. The editors have appropriately limited the discussion of chemotherapy and radiation therapy to situations in which it is used as an adjuvant or adjunct in combination with primary surgical treatment.
Of the book's 47 chapters, 40 are organized by organ system or specific disease, with additional offerings on history, biopsy approaches, and specific problems, including venous access, nutrition, and immunocompromised hosts. The book is nicely illustrated and, although a full-sized text at 835 pages, is not so unwieldy as to hinder use.
The editors, each of whom has served as president of both the American Cancer Society and the Society of Surgical Oncology, have garnered contributions from nationally known figures in most areas, and this expertise is the main strength of the book. The chapter on colorectal cancer by Glenn Steele, Jr, is one of the most up-to-date, comprehensive, and informative presentations on this disease currently available. The 60 pages in this chapter include 42 figures and 40 tables, and concisely cover all aspects of this disease, including a discussion of innovative treatment strategies, such as laparoscopic surgery.
Other gems include the historical overview featured in the first chapter, the chapter on vascular access devices, and certain short chapters on unusual tumors, such as appendiceal primaries. The subspecialty areas of thoracic, gynecologic, and urologic oncology receive generous coverage, comprising over 40% of the book's chapters.
The major deficiencies of this book-inconsistent presentation, redundancy, and occasional omissions-reflect the problems that typically plague the first edition of a multi-authored text covering a wide range of subjects. The organization, focus, and content of the individual chapters is highly variable: The hepatic, bile duct, and gallbladder chapter is six pages long with no figures or tables; the endometrial cancer and bladder cancer chapters contain atlas-style descriptions of the performance of specific surgical procedures; and the sarcoma chapter is essentially a series of case reports void of factual content, with 110 figures (mostly intraoperative photographs) and no tables.
Unnecessary redundancy is exemplified by separate presentations on liver metastases in the liver chapter, the colorectal chapter, the recurrent malignancy chapter, and a chapter entitled "Surgery for Liver Metastases," with no apparent attempt to coordinate or cross-reference this information. One area with a definite surgical flavor that is not covered in this book is peritoneal carcinomatosis and malignant ascites, although malignant pleural effusions warrants its own separate chapter.
In summary, the editors' stated goal is to make available an easily accessible reference on pertinent aspects of cancer surgery for the practicing clinician. This goal is accomplished in some cases but not in others, and the reader must sort through the variable presentation of information to obtain that goal.
A 52-year-old man presented with an erythematous lesion in the axilla of unknown duration. Surgical excision was performed. What is your diagnosis?
