Lawrence D. Wagman, MD, FACS

This management guide covers the risk factors, symptoms, diagnosis, staging, and treatment of liver, gallbladder, and biliary tract cancers using radiation, surgery, and medical treatment.

With many centers seeking to adopt IORT, there are licensing, proctoring, staffing, technical support, and reimbursement issues that need to be considered. We have reviewed the current international experience and describe one community cancer center’s experience with initiating an IORT breast cancer program.

For independent physician practices, the realities of overhead expenses, time available for patient care, and regulatory requirements can only be assessed when the specific requirements for reporting and reimbursement are clear.

Preface

Worldwide, hepatocellular carcinoma is the fifth most common malignancy and the third most common cause of cancer mortality. Most patients with hepatocellular carcinoma suffer from cirrhosis primarily caused by alcoholism or chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV); decades may pass between infection with viral hepatitis and development of this cancer. The approximately equal annual incidence and mortality of 1 million reported around the world stands as evidence of its lethality.

The combined-modality care of the patient with colon or rectal cancer metastatic to the liver demands a team approach. It is little wonder that there is much confusion about this topic, given the number of unique treatment options that are delivered in a sequential and reiterative process. The concept of multidisciplinary approaches to complex cancer challenges has been adopted for a variety of tumor types and situations.

Surgical oncology, as its name suggests, is the specific application of surgical principles to the oncologic setting. These principles have been derived by adapting standard surgical approaches to the unique situations that arise when treating cancer patients.

CMHB Jonathan Test Article Chapter One

Surgical oncology, as its name suggests, is the specific application of surgical principles to the oncologic setting. These principles have been derived by adapting standard surgical approaches to the unique situations that arise when treating cancer patients.

The fundamental principle behind this book, as stated by the publisher, The Oncology Group (also publisher of the journal ONCOLOGY and news magazine Oncology News International) was to provide a truly integrated, multidisciplinary approach to the management of cancer patients. For this updated 10th edition, the editors have enlisted 114 medical, surgical, and radiation oncologists, whose contributions provide an excellent overview of the important principles of cancer management.

Tremendous gains have been made regarding the treatment of breastcancer. The combination of chemotherapy, radiation therapy, and surgeryhave vastly improved patient course. Hepatic manifestations ofmetastatic breast cancer are extremely difficult to treat. Traditionally,chemotherapy and hormonal treatment of hepatic metastases of breastcarcinoma have not significantly improved survival. For patients withbreast cancer metastases isolated to the liver, operative treatment isincreasingly being used to prolong life and disease-free intervals. Thisarticle reviews the use of surgery for treatment of isolated breast cancermetastases to the liver.

Surgical oncology, as its name suggests, is the specific application of surgicalprinciples to the oncologic setting. These principles have been derived by adaptingstandard surgical approaches to the unique situations that arise when treatingcancer patients.

Dr. Kozuch and coauthors havewritten a comprehensive reviewof gallbladder and biliarytract carcinoma. We would like to updateseveral issues related to this topic,with particular emphasis on new chemotherapystrategies and drug combinationsfor improving outcomes.

This is a comprehensive 701-page volume filled with excellent illustrations, photographs, tables, and schematics. The overall structure of the book takes the reader from molecular oncology issues through pathology, diagnosis, staging, treatment, and a

Drs. McCarty and Kuhn have brought the readers up-to-date on a new technology--cryosurgery--that is available to treat malignant and benign tumors in the liver. The authors are cautiously optimistic regarding the ultimate success of this therapy. They present the current data, which were generated in patient groups that are the most difficult to treat--those with "unresectable" disease.