Modern Management of Cancer of the Rectum
2nd Edition
Published on 27. November 2014
XVII, 472 pages
978-1-4471-6609-2 (ISBN)
Description
Modern Management of Cancer of the Rectum is intended to provide a comprehensive overview of all aspects of rectal neoplasms. It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic surgery. A greater understanding of prognostic factors, patterns of spread and natural history has occurred during the past decade; together with new diagnostic modalities this has led to significant changes in the management of patients with rectal cancer. This book will be invaluable for all those who treat rectal cancer.
Reviews / Votes
From the book reviews:
"This is the second edition of a thorough book that covers all aspects of rectal cancer management, providing complete information on this multidisciplinary topic. . This is a must-read for any practitioner involved in the care of rectal cancer patients. It is easy to read, thoughtfully organized, thorough, and thoroughly referenced. In addition, it has wonderful illustrations and photographs." (Jennifer Erin Hrabe, Doody's Book Reviews, March, 2015)
More details
Series
Edition
2nd ed. 2015
Language
English
Place of publication
London
United Kingdom
Target group
Professional and scholarly
Product notice
Reflowable
Illustrations
XVII, 472 p. 120 illus., 108 illus. in color.
File size
17,52 MB
ISBN-13
978-1-4471-6609-2 (9781447166092)
DOI
10.1007/978-1-4471-6609-2
Schweitzer Classification
Other editions
Additional editions
Walter E. Longo | Vikram Reddy | Riccardo A. Audisio
Modern Management of Cancer of the Rectum
Book
12/2014
2nd Edition
Springer
€106.99
Shipment within 15-20 days
Content
- 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
