Modern Management of Cancer of the Rectum

Name: Modern Management of Cancer of the Rectum
Brand: Springer
Price: 96.29 EUR
Availability: OnlineOnly

Walter E. Longo Vikram Reddy Riccardo A. Audisio(Herausgeber*in)

Springer (Verlag)

2. Auflage

Erschienen am 27. November 2014

XVII, 472 Seiten

E-Book

PDF mit Wasserzeichen-DRM

Systemvoraussetzungen

978-1-4471-6609-2 (ISBN)

96,29 €inkl. 7% MwSt.

Systemvoraussetzungen

für PDF mit Wasserzeichen-DRM

E-Book Einzellizenz

Als Download verfügbar

Beschreibung

Weitere Details

Weitere Ausgaben

Inhalt

Intro
Foreword
Preface to the Second Edition
Contents
Contributors
1: The Evolving Treatment of Rectal Cancer
Introduction
Origins of Rectal Cancer Treatment
Early Extirpative Procedures: Perineal, Sacral and Vaginal Approaches
Emergence of the Abdominoperineal Resection
Advent of Restorative Procedures
Sphincter Preservation and Pouch Surgery
Total Mesorectal Excision and Autonomic Nerve Preservation
Combined Multimodality Therapy
Other Forms of Therapy: Local Treatments and Transanal Excision
The Emergence of Minimally Invasive Procedures
Surgery for Locally Recurrent Disease
Future Perspectives
References
2: Epidemiology and Burden of Rectal Cancer
Incidence of Rectal Cancer
Geographical Variations
Temporal Trends
Mortality Rates and Trends
Cancer Survival and Prognosis
Non-modifiable Risk Factors
Age
Personal History of Adenomatous Polyps
Personal History of Inflammatory Bowel Disease
Family History of Colorectal Cancer or Adenomatous Polyps
Inherited Genetic Risk
Environmental Risk Factors
Nutritional Practices
Physical Activity and Obesity
Cigarette Smoking
Heavy Alcohol Consumption
Economics and Financial Issues
Conclusion
References
3: Anatomy and Physiology of the Rectum and Anus
Introduction
Structural Overview
Embryological Overview
Embryology of the Anorectum
Anatomy of the Rectum
Blood Supply to the Rectum
Venous Drainage of the Rectum
Operative Significance
Lymphatic Drainage of the Rectum
Nerve Supply to the Rectum
Fascial Layers of the Pelvis
Posterior Compartment
Anterior Compartment
Oncological and Functional Significance of the Mesorectal Fascia
Anatomy of the Anus
Anal Mucosa
Anal Submucosa
Anal Sphincter Complex
The Pelvic Floor
Nerve Supply
The Perineum
Operative Significance
Defecatory Physiology of the Rectum and Anus
Muscular Function
Recto-Anal Inhibitory Reflex (RAIR)
Anorectal Sensation
Rectal Cancer Management Implications
Conclusion
Further Reading
4: Pathology and Staging of Rectal Cancer
Introduction
Rectal Cancer Specimen Handling
Transanal Excision/Transanal Endoscopic Microsurgery (TEM)
Mesorectal Excisions
Lymph Node Dissection
Histological Features of Rectal Cancer and Their Prognostic/Predictive Significance
Histologic Types
Tumor Grading
Invasive Growth Pattern and Lymphocytic Infiltration
Microsatellite Instability-High Morphology
Tumor Budding
Lymphatic and Venous Invasion
Perineural Invasion
Tumor Deposits
Serosal (Peritoneal) Involvement
Circumferential (Radial) Resection Margin (CRM)
Neoadjuvant Therapy Effect
The Staging of Rectal Cancer
Dukes Staging System
TNM Staging System
TNM Descriptors
T Category Considerations
N Category Considerations
M Category Considerations
Anatomic Stage/Prognostic Groups
Site-Specific Prognostic Factors and Molecular Markers
Summary
References
5: Genetics, Screening, and Chemoprevention
Introduction
Genetics of Colorectal Cancer
Oncogenes
RAS Family
c-Myc
BRAF
Tumor Suppressor Genes
Adenomatous Polyposis Coli (APC)
p53
Deleted in Colon Cancer (DCC)
Mismatch Repair
Colorectal Cancer Screening
Average Risk
Moderate Risk
Increased Risk
Chemoprevention
Folate
Vitamin B6 (Pyridoxine)
Calcium and Vitamin D
Aspirin
Sulindac, DFMO and Other NSAIDs
Hormone Therapy
Statins
Antioxidants
References
6: The Role of Imaging in the Diagnosis and Staging of Primary and Recurrent Rectal Cancer
Introduction
Optimal Local Staging - Why MRI?
Imaging-Based Risk-Stratification
MRI Technique
Prognostic Factors in Primary Rectal Cancer
Tumour Depth
Nodal Disease - N Staging
Extramural Venous Invasion - EMVI
Height of Tumour
Specific Challenges Associated with Recurrent Rectal Cancer
Conclusion
References
7: The Surgeon's Perspective on Neoadjuvant Chemoradiation for Rectal Cancer
Introduction
Who Should Receive Chemoradiation?
Tumor Downstaging and Sphincter Preservation
Interval Between Completion of Neo-adjuvant Treatment and Surgery
Clinical and Pathological Complete Response
Side Effects and Surgical Implications of Neoadjuvant Chemoradiation
Conclusion
References
8: Contact X-Ray Brachytherapy for Rectal Cancer
Introduction
Case Selection
Inclusion Criteria
Exclusion Criteria
Investigations
Preparation of Patient
Treatment Protocol
Possible Side Effects
Follow-Up
Evidence of Efficacy for Contact X-Ray Brachytherapy
Salvage for Residual Disease, Re-growths or Recurrences
Radiation Dose Escalation to Improve Outcomes
Rectal Brachytherapy for Radiation Dose Escalation
X-Ray Contact Brachytherapy
HDR Rectal Brachytherapy
Interstitial Implants
Discussion
Conclusion
References
9: Local Excision of Rectal Cancer
Introduction
Risk Factors for Lymph Node Metastases
Local Staging
T Stage Classification
N Stage Classification
Defining High-Risk and Low-Risk Patients
Techniques of Local Excision
Preoperative Preparation
Traditional or Standard Transanal Local Excision
Minimally Invasive Options
Transanal Endoscopy Microsurgery (TEM)
TAMIS (Transanal Minimally Invasive Surgery)
Transcoccygeal Excision
Morbidity and Mortality
Outcomes
T1 Rectal Cancer - Local Excision Alone
Local Excision and Adjuvant Therapy
Neoadjuvant CRT Followed by Local Excision
Local Recurrence
Tumor Fragmentation, Tumor Scatter and Local Excision After CRT
ypT0 - TEM or Watch and Wait?
Perspectives
Sentinel Node
Transanal Total Mesorectal Excision
References
10: Abdominosacral Resection for Rectal Cancer
Introduction
Patterns of Recurrence
Surgery for Locally Advanced Primary and Recurrent Rectal Cancer
Abdominosacral Resection
Local Staging of Primary and Recurrent Rectal Cancer
Endorectal Ultrasound
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Diffusion Weighted Magnetic Resonance Imaging (DW-MRI)
PET and PET/CT
Summary of Strengths and Weaknesses of CT, MRI and PET
Imaging to Exclude Distant Metastases
Selection Criteria for Surgery
Distant Recurrence
Resectable Local Recurrence
Contraindications for Surgical Resection
Irresectable Local Recurrence
The Role of a Multidisciplinary Team (MDT)
Neo-adjuvant Therapy
Neo-adjuvant Radiotherapy
Neo-adjuvant Chemotherapy
Abdominosacral Resection
Results
Adjuvant Medical Therapy
Follow-Up
Clinical Review
Blood Tests: Serum Tumor Markers
Flexible Endoscopy/Colonoscopy
Imaging
Conclusion
References
11: Abdominoperineal Resection
Historical Context
Indications
Outcomes
Contemporary Open Abdominoperineal Resection
Laparoscopic Abdominoperineal Resection (LAPR)
Robotic APR (RAPR)
Surgical Technique
Open APR
Laparoscopic APR (LAPR)
Controversies
Patient Positioning for APR
Perineal Reconstruction
Prevention of Parastomal Herniation
References
12: Total Mesorectal Excision with Autonomic Nerve Preservation: "Optimized Surgery"
Introduction
Advent of Total Mesorectal Excision (TME)
Rationale for TME and Its Relationship to Anatomy of Spread of Rectal Cancer
Genitourinary Complications of Pelvic Dissection
Pelvic Autonomic Nerve Anatomy
Technical Aspects of TME and ANP
Intraoperative Nerve Monitoring
Laparoscopic TME
Robotic TME
Lymphadenectomy and Vascular Ligation
Extended Lateral Lymphadenectomy
Tumor Specific TME, Role of TME in Upper Rectal Cancer
Circumferential Radial Margin
Documentation Quality Analysis and Grading of TME
Summary
References
13: Lateral Lymph Node Dissection for Rectal Cancer
Introduction
History of Lateral Lymph Node Dissection
Definition of Lateral Pelvic Lymph Nodes
Rationale for Lateral Lymph Node Dissection
Indication Criteria for Lateral Lymph Node Dissection
Therapeutic and Prophylactic Lateral Lymph Node Dissection
Procedure for Prophylactic Lateral Lymph Node Dissection
Confirmation of Autonomic Nerves
Common and Proximal Internal Iliac Node Dissection
External Iliac Lymph Node Dissection
Obturator Lymph Node Dissection
Distal Internal Iliac Node Dissection
Procedure for Therapeutic Lateral Lymph Node Dissection
Future of Lateral Lymph Node Dissection
Conclusion
References
14: Laparoscopic and Robotically Assisted Proctectomy
Laparoscopic Proctectomy
Introduction
Technique
Hand-Assisted Laparoscopic Proctectomy (HALS) and Single-Port Techniques
Outcomes
Laparoscopic Learning Curve
Oncological Outcome
Functional Outcome
Robotic- Assisted Proctectomy
Technique
Learning Curve
Perceived Benefits
Oncologic Outcomes
Quality of Dissection
Surgeon Fatigue
Conversion Rates
Genitourinary Function
Cost
The Future
References
15: Restorative Proctectomy and Colonic Reservoirs
Introduction
Indications for Restorative Proctectomy
Technique
Hand-Sewn Versus Stapled Anastomosis
Colonic Reservoirs
Colonic J Pouch
Transverse Coloplasty
End-to-Side Anastomosis
Colonic Rotation and Interposition
Fecal Diversion
Complications and Functional Outcomes
Conclusion
References
16: Anorectal Reconstruction
Introduction
Selection Criteria
Principles of Total Anorectal Reconstruction
Neo-rectal Reservoir
Neo-sphincter
Smooth Muscle Sphincter
Skeletal Muscle Sphincter
Gluteus Maximus
Adductor Longus
Gracilis
Artificial Bowel Sphincter
Antegrade Continence Enema
Outcomes
Conclusion
References
17: Postoperative Chemoradiation for Rectal Cancer
Introduction
Post-operative Chemoradiation
Selective Postoperative Chemoradiation
Randomised Trials Evaluating Post-operative CRT Versus Surgery Alone (Table 17.1)
NSABP R-01
GITSG 7175
NCCTG 79-47-51
NSABP R-02
European Studies
Randomised Trials Evaluating the Optimal Concurrent Chemotherapy Regimen (Table 17.2)
Intergroup/NCCTG 86-47-51 Trial
Intergroup 0114
Intergroup 0144
Greek Study
German Study
Randomised Trials Comparing Preoperative and Postoperative CRT (Table 17.3)
The German CAO/ARO/AIO - 94 Trial
NSABP R-03
Korean Trial
If Preoperative CRT Is Omitted, Which Patients Should Receive Postoperative CRT?
The Quality of the Mesorectum
The Impact of Chemotherapy on Local Recurrence
Local Excision/TEM
Radiotherapy Target Delineation/Planning
Target Delineation Following Radical Surgery
Target Delineation Following Local Excision
Complications of Postoperative CRT After Radical Surgery
Conclusion
Postoperative Chemoradiation Learning Points
References
18: Patient Surveillance After Curative-Intent Treatment for Rectal Carcinoma
References
19: Surgical Approach to Locally Recurrent Disease
Introduction
Risk Factors
Anatomic
Pathologic
Surgical
Diagnosis
Imaging Studies
Treatment Approach
Preoperative Treatment
Surgical Considerations
Surgery and Location of Recurrence
Intraoperative Radiation
Reconstruction
Patient Outcomes
Conclusion
References
20: Metastatic Rectal Cancer
Introduction
General Principles and Goals of Therapy
Systemic Therapy for Metastatic Colorectal Cancer
Short Overview of the Available Agents for Systemic Therapy
Predictive and Prognostic Molecular Markers
Initial Therapy
The Role of Biologic Drugs
Treatment Interruptions and Maintenance Therapy
Treatment of Elderly Patients and Patients with Impaired Performance Status
Chemotherapy and Liver Resections
Evaluation of Patients While on Therapy
Conclusion
References
21: Locally Advanced Disease
Introduction
Initial Evaluation
Staging
Neoadjuvant Therapy
Adjuvant Therapy
Surgical Management
Total Mesorectal Excision and Circumferential Margins
Distal Resection Margins
Sphincter Preservation
Locally Invasive Tumors
Multivisceral Resection
Intraoperative Radiotherapy
Minimally Invasive Surgery
"Wait and See" Techniques
Conclusion
References
22: Less Common Rectal Tumors
Introduction
Carcinoid Tumors of the Rectum
Clinical Presentation and Diagnosis
Treatment and Prognosis
Lymphoma of the Rectum
Primary Lymphoma of the Rectum
Clinical Presentation and Diagnosis
Treatment and Prognosis
Secondary Lymphoma of the Rectum
Anorectal Melanoma
Clinical Presentation and Diagnosis
Treatment and Prognosis
Neuroendocrine Carcinoma (NEC) of the Rectum
Clinical Presentation and Diagnosis
Treatment and Prognosis
Vascular Lesions
Diffuse Cavernous Malformation
Pathology
Clinical Presentation and Diagnosis
Treatment and Prognosis
Lymphangioma
Hemangiopericytoma
Squamous Cell and Adenosquamous Carcinoma of the Rectum
Squamous Cell Carcinoma of the Rectum
Clinical Presentation and Diagnosis
Treatment and Prognosis
Adenosquamous Carcinoma of the Rectum
Sarcomas of the Rectum
Leiomyosarcoma of the Rectum
Pathology
Clinical Presentation and Diagnosis
Treatment and Prognosis
Rectal Gastrointestinal Stromal Tumor
Pathology
Clinical Presentation and Diagnosis
Treatment and Prognosis
Kaposi's Sarcoma of the Rectum
Clinical Presentation and Diagnosis
Pathology
Treatment and Prognosis
References
23: Quality of Life in Rectal Cancer Patients
Introduction
Conceptual Definition of Quality of Life
Quality of Life Measurement
Response Shift Phenomenon
Interpretation of Quality of Life Results
Quality of Life After Rectal Cancer Surgery
Bowel Dysfunction
Urinary Dysfunction
Sexual Dysfunction
Quality of Life with or Without a Permanent Colostomy
Impact of Laparoscopic Surgery on Quality of Life
The Impact of Neoadjuvant Therapy on Quality of Life
Quality of Life After Complex Rectal Surgery for Primary Advanced Rectal Cancer and Locally Recurrent Rectal Cancer
Conclusion
References
24: Palliative Options in Patients with Stage 4 Rectal Cancer
Introduction
Evaluation
Operative Intervention
Obstruction
Perforation
Bleeding
Palliative Resection
Endoscopic Interventions
Rectal Stents for Obstruction
Laser Therapy for Obstruction and Bleeding
Chemotherapy
Radiation
Conclusion
References
25: Rectal Cancer Treatment in the Elderly
Introduction
Frailty and Performance of the Elderly
Do We Need to Work-Up the Elderly Differently?
Neo-adjuvant Treatment
Surgery and Its Morbidity
Surgery and Its Mortality
Anastomosis or Permanent Stoma?
Post-operative Care
Elderly and the Role of Local Excision
The Wait and See Approach
Stenting
Tailored Approach, Quality of Life and Shared Decision
Centralization and Auditing
Conclusion
References
26: Costs of Rectal Cancer Patient Management
Introduction
Methods
Literature Review
Cost Analyses
Results
Lifetime and Treatment-Phase Specific Costs
Advanced Cancer Care Costs
Surgery (TME, AP, APR) with or Without Preoperative Radiotherapy
TEM
Stomas and Anastomotic Leakage
Open Versus Laparoscopic Surgery
Conclusion
References
27: Quality Assurance in Rectal Cancer Management
Introduction
What Is Quality Assurance?
Tools for Quality Improvement
Cancer Registries
European Audits
Quality Indicators
Guideline Formation
Multidisciplinary Team
Care Pathways
Volume-Outcome Measures
Checklists
Patient Involvement in Decision Making
References
28: Remedial Surgery Following Failed Colorectal or Coloanal Anastomosis
Introduction
Technical Issues When Considering Redo Surgery for Failed CRA or CAA
Procedure 1: The Retroileal Transmesenteric Colorectal Anastomosis
Procedure 2: The Deloyers Procedure
Procedure 3: Subtotal Colectomy with Cecorectal End-to-End Anastomosis
Descent of the Colon Through the Pelvis: The Soave Procedure
Literature Review of Studies Dealing with Redo Surgery for Failed Colorectal or Coloanal Anastomosis
Conclusion
References
29: Complications of Rectal Cancer Surgery
Introduction
Small Bowel Obstruction
Ureteral Injury
Bladder Injury
Urethral Injury
Urinary and Sexual Dysfunction
Bleeding
Surgical Site Infection
Clostridium Difficile
Thromboembolism
Anastomotic Issues
Anastomotic Bleeding
Anastomotic Leak
Anastomotic Stricture
Incisional and Parastomal Hernia
Perineal Hernia
Ostomy Issues
Bowel Dysfunction
Conclusion
References
Index

Inhalt (PDF)

Systemvoraussetzungen

Als PDF speichern Als Link merken

Modern Management of Cancer of the Rectum

Beschreibung

Rezensionen / Stimmen

Weitere Details

Weitere Ausgaben

Inhalt

Systemvoraussetzungen