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.

Despite recent advances in adjuvant therapies of cancer, the regi mens of postoperative adjuvant chemotherapy treatment which are presently available fail to cure the majority of cancer patients. Pre operative (neoadjuvant) chemotherapy represents a new approach in drug scheduling, based on sound theoretical, pharmacokinetic, and experimental principles. The preoperative timing of chemotherapy before definitive sur gery is not a minor change in the therapy of cancer. To be successful, large numbers of practitioners and their patients must participate. Substantial alterations of many aspects of the present management of cancer will have to follow. Therefore, before such therapy can be fully and routinely implemented, results of the novel treatment and its rationale have to be carefully evaluated. In preoperative treatment, other features will likely gain impor tance. For the first time, clinicians have a chance to follow the in vivo response of the tumor exposed to preoperative chemotherapy. The subsequent histological assessment of the tumor sample may likely become an important prognostic guide, permitting more re fined individual approaches to the planning of postoperative adju vant treatment. The value of such a treatment strategy can already be appreciated in the clinical setting, as seen from the therapy of osteosarcoma. Furthermore, preoperative chemotherapy might render previously inoperable tumors operable and hence resectable with a curative intention. The preoperative reduction of tumor bulk may also effectively decrease the need for more radical operations, permitting a more uniform adoption of conservative surgery.

This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.

Upper Urinary Tract Urothelial Carcinoma was at one time felt to be a somewhat rare entity. With the success of various treatments for bladder urothelial carcinoma, the incidence of this disease in the uretere and kidney is rising. Many medical subspecialists encounter these complex patients and a multimodality treatment plan is often required for care.

Updated and expanded, the third edition of Surgery for Ovarian Cancer focuses on essential techniques for the effective management of ovarian cancer. It reflects the most contemporary science and surgical applications for the management of patients with ovarian cancer and related peritoneal surface malignancies. This new edition takes a step-by-step approach and includes new intraoperative photographs and videos illustrating surgical procedures. It is principally devoted to the technical aspects of cytoreductive surgery, with chapters divided according to anatomic region. The chapters cover relevant anatomical considerations, surgical challenges specific to each region, and operative approaches and techniques favored by the authors. The list of contributing authors has been expanded from the previous edition and includes international and world-renowned experts from the fields of gynecologic oncology and surgical oncology. The topics of minimally invasive surgery, secondary cytoreduction, palliative surgery, and postoperative care are also covered in detail. New to the third edition are chapters on preoperative risk stratification, regional therapeutics and peritonectomy procedures, and quality assurance relating to ovarian cancer surgery. This comprehensive text is essential reading for all practitioners working with patients with ovarian cancers.

This monograph summarizes state of the art knowledge regarding peritoneal surface malignancies, with in-depth description of treatment options and the results achieved to date. It explores the most challenging problems on the basis of the authors’ very extensive clinical experience and examines the most relevant clinical trials. A comprehensive summary is provided of all phase 2 studies (the only available completed studies) and of ongoing and future phase 3 studies. Particular attention is paid to the results of integrated treatment comprising cytoreduction (peritonectomy) and hyperthermic intraperitoneal chemotherapy (HIPEC). Helpful background information is also included on the definition and clinical assessment of each clinical form. The book, drawing on data from the entire Italian experience as well as world literature, will be an outstanding benchmark for health professionals and researchers.

More than 80% of patients with cancer will need the services of anesthesiology and perioperative medicine, intensive care medicine, and pain management specialists during their cancer journey for diagnostic, therapeutic, and symptom management needs, as well as for the management of recurrent disease, secondary cancers, and ongoing non-oncologic surgical needs during survivorship. Perioperative Care of the Cancer Patient is today's most up-to-date, authoritative, comprehensive reference on the acute care of surgical patients with cancer, from a team of international experts in this emerging and dynamic specialty. - Covers current clinical practice and perioperative care guidelines during the entire cancer journey for both adult and pediatric patients. - Includes a diverse array of topics on cancer care, such as cancer epidemiology, cancer biology, ethics in cancer care delivery, value proposition in cancer care, opportunities and challenges with research programs in perioperative cancer care, application of big data and computational sciences in cancer medicine and care delivery, and the MD Anderson Cancer Center Moon Shots Program®. - Discusses newer cancer therapies and their perioperative implications, functional assessment and prehabilitation, enhanced recovery programs in cancer care, challenges with novel cancer therapies in the care of the critically ill cancer patient, chronic and interventional pain management in patients with cancer, and more. - An educational resource and clinical reference for surgeons, anesthesia practitioners, hospitalists, internists, pain physicians, intensivists, basic science researchers, and all clinicians involved in the acute care of surgical patients with cancer. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Cancer continues to be one of the major causes of death throughout the developed world, which has led to increased research on effective treatments. Because of this, in the past decade, rapid progress in the field of cancer treatment has been seen. Recent Advances in Cancer Research and Therapy reviews in specific details some of the most effective and promising treatments developed in research centers worldwide. While referencing advances in traditional therapies and treatments such as chemotherapy, this book also highlights advances in biotherapy including research using Interferon and Super Interferon, HecI based and liposome based therapy, gene therapy, and p53 based cancer therapy. There is also a discussion of current cancer research in China including traditional Chinese medicine. Written by leading scientists in the field, this book provides an essential insight into the current state of cancer therapy and treatment. - Includes a wide range of research areas including a focus on biotherapy and the development of novel cancer therapeutic strategies. - Formatted for a broad audience including all working in researching cancer treatments and therapies. - Discusses special traits and results of Chinese cancer research.

An innovative guide to the practice of pelvic exenterative surgery for the management of advanced pelvic neoplasms Exenterative surgery plays an important role in the management of advanced pelvic cancer. However, while a large body of evidence regarding outcomes following pelvic exenteration now exists, practical strategies and management options remain unclear. Surgical Management of Advanced Pelvic Cancer addresses this problem by assembling world-leaders in the field to provide insights into the latest techniques and best practices. It includes detailed coverage of: Surgical anatomy Operative approaches and exenterative techniques Reconstruction options Current evidence on survival and quality of life outcomes Featuring essential information for those managing patients with advanced pelvic neoplasms, Surgical Management of Advanced Pelvic Cancer consolidates the latest data and practical advice in one indispensable guide.

A concise summary of perioperative management of high-risk surgical patients, bridging the gap between the operating theatre and ICU.