Malignant Liver Tumors: Current and Emerging Therapies | Date: 27 April 2011, 10:04
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From The New England Journal of Medicine
Hepatocellular carcinoma, although uncommon in the United States, is one of the few forms of cancer that is rising in incidence in the developed Western world. The second edition of this book consists of 36 chapters that are printed on nearly 500 pages of glossy paper. The editor-in-chief, Pierre-Alain Clavien of Switzerland, has four associate editors from the United States and 63 authors and coauthors from around the world. The book emphasizes the management of hepatocellular carcinoma in Western countries, as distinct from Africa and Asia (including Japan), where the disease is more common but seems to present differently. The book also deals with cholangiocarcinoma, metastatic liver cancer, and other rare liver tumors. It does appear to have something of a surgical bias -- but this is probably not a bad thing, given that surgical resection and liver transplantation are still the treatments that offer the best outcome for patients who have most types of primary or secondary liver cancers. Malignant Liver Tumors contains a moderate number of high-quality black-and-white figures. These include many reproductions of radiologic images, pathological specimens, and line drawings of surgical techniques, with the occasional flowchart, bar graph, and cartoon of pathophysiological processes. The text is very readable, with large subheadings on almost every page. Every chapter is fully referenced, and many also include an annotated list of selected readings. The book has five major sections -- "Epidemiology, Diagnosis, and Algorithms for Treatment," "Systemic and Regional Therapies," "Tumor Ablation," "Emerging Therapies," and "Special Tumors and Populations and Special Considerations." Most of the subjects can logically be assigned to one of these sections, but, interestingly, the chapters on resection and transplantation are in the section on tumor ablation, side by side with the latest information on thermal ablation, ethanol injection, and cryoablation. The section on emerging therapies offers an update on the status of the "dream list" of treatments, including vaccine-based, viral-based, and antibody treatment and the induction of apoptosis. The chapter on antiangiogenic agents is particularly useful, because this approach appears promising for hepatocellular carcinoma. This section also contains a comprehensive chapter on alternative and complementary treatments, which makes interesting reading, although little of the information presented is specific to the treatment of liver cancer. Some of the special considerations dealt with include liver tumors in children and pregnant women and variations in the pathogenesis and presentation of liver tumors in different parts of the world, including Asia, Africa, and South America -- with a chapter given to each of these regions. There is considerable overlap among a number of the chapters, which may represent a planned redundancy or incomplete editing. For example, radio-frequency ablation is given two dedicated chapters and is mentioned in several others. The chapter on therapy for liver tumors in patients with cirrhosis overlaps extensively with chapters on resection and transplantation, among others. Some aspects of liver cancer could have been dealt with in more detail, including staging and prognostication and the algorithms for deciding which treatment should be applied to which patient. If I were a physician who was consulting this book for advice on how to treat my patient, I would be impressed by how many treatment options my patient had, but I would have no idea how to pick the best one. In summary, this book is a comprehensive reference on the diagnosis and management of primary and secondary malignant tumors of the liver, which will be valuable to hepatologists, oncologists, and others involved in diagnosing and treating liver cancer and an essential guide for surgical oncologists, liver surgeons, and transplantation surgeons. Adrian M. Di Bisceglie, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an alternate Hardcover edition.
Review
"The book provides the clear and critical approach to current theraputic procedures and possiblities of new methods. The detailed text with numerous tables and interesting examples of images will call attention of all workers engaged with management of patients with this disease - from medical students to specialists in various fields".
(Klinicka Onkologie) --This text refers to an out of print or unavailable edition of this title.
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