Table Of ContentOXFORD MEDICAL PUBLICATIONS
Surgical Oncology
Published and forthcoming Oxford Specialist Handbooks
General Oxford Specialist Oxford Specialist Handbooks in
Handbooks Paediatrics
A Resuscitation Room Guide Paediatric Endocrinology and
Addiction Medicine Diabetes
Perioperative Medicine, Paediatric Dermatology
second edition Paediatric Gastroenterology,
Post-Operative Complications, Hepatology, and Nutrition
second edition Paediatric Haematology and
Oncology
Oxford Specialist Handbooks Paediatric Nephrology
in Anaesthesia Paediatric Neurology
Cardiac Anaesthesia Paediatric Radiology
General Thoracic Anaesthesia Paediatric Respiratory Medicine
Neuroanaethesia
Obstetric Anaesthesia Oxford Specialist Handbooks in
Paediatric Anaesthesia Psychiatry
Regional Anaesthesia, Stimulation and Child and Adolescent Psychiatry
Ultrasound Techniques Old Age Psychiatry
Oxford Specialist Handbooks in Oxford Specialist Handbooks in
Cardiology Radiology
Adult Congenital Heart Disease Interventional Radiology
Cardiac Catheterization and Musculoskeletal Imaging
Coronary Intervention
Echocardiography Oxford Specialist Handbooks in
Fetal Cardiology Surgery
Heart Failure Cardiothoracic Surgery
Hypertension Hand Surgery
Nuclear Cardiology Hepato-pancreatobiliary Surgery
Pacemakers and ICDs Oral and Maxillofacial Surgery
Neurosurgery
Oxford Specialist Handbooks in Operative Surgery, second edition
Critical Care Otolaryngology and Head and Neck
Advanced Respiratory Critical Care Surgery
Paediatric Surgery
Oxford Specialist Handbooks in Plastic and Reconstructive Surgery
End of Life Care Surgical Oncology
End of Life Care in Cardiology Urological Surgery
End of Life Care in Dementia Vascular Surgery
End of Life Care in Nephrology
End of Life Care in Respiratory
Disease
End of Life in the Intensive Care Unit
Oxford Specialist Handbooks in
Neurology
Epilepsy
Parkinson’s Disease and Other
Movement Disorders
Stroke Medicine
Oxford Specialist
Handbooks in Surgery
Surgical
Oncology
Edited by
M. Asif Chaudry
Specialist Registrar in Surgery, London
& Surgical Research Fellow,
Division of Surgery & Interventional Science,
University College London,
London, UK
Marc C. Winslet
Professor of Surgery, Head of Department & Chairman of
Division of Surgery & Interventional Science,
University College London,
London, UK
1
1
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First published 2009
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British Library Cataloguing in Publication Data
Data available
Library of Congress Cataloging-in-Publication Data
Chaudry, M. Asif.
Surgical oncology / M. Asif Chaudry, Marc Winslet.
p. ; cm. -- (Oxford specialist handbooks in surgery)
Includes index.
ISBN 978-0-19-923709-8 (alk. paper)
1. Cancer--Surgery--Handbooks, manuals, etc. I. Winslet, M. C. (Marc
C.) II. Title. III. Series: Oxford specialist handbooks in oncology.
[DNLM: 1. Neoplasms--surgery--Handbooks. QZ 39 C496s 2009]
RD651.C43 2009
616.99’4059--dc22
2009008905
Typeset by Cepha Imaging Private Ltd., Bangalore, India
Printed in China
on acid-free paper through
Asia Pacifi c Offset
ISBN 978–0–19–923709–8
10 9 8 7 6 5 4 3 2 1
Oxford University Press makes no representation, express or implied, that the drug dosages in
this book are correct. Readers must therefore always check the product information and clinical
procedures with the most up to date published product information and data sheets provided by
the manufacturers and the most recent codes of conduct and safety regulations. The authors and
publishers do not accept responsibility or legal liability for any errors in the text or for the misuse
or misapplication of material in this work.
Some of the medication discussed in this book may not be available through normal channels
and only available by special arrangements. Other examples used in research studies and recom-
mended in international guidelines are unlicensed or may be subject to being used outside of their
licensed dosage ranges within the UK. We suggest consulting the BNF and local prescribing guide-
lines/protocols before using unfamiliar medication.
v
Foreword
The editors and authors of this book are to be congratulated on the pro-
duction of an excellent manuscript which will be of immense value both
to specialist registrars in general surgery and to anyone who wants a con-
temporary reference text on their bookshelf.
Over the past decade especially, and in almost every sub-speciality of
surgical oncology, there have been major changes in routine management
as a result of improvement in technology and systemic therapies. Some of
these changes have been dramatic and have taken many of us by surprise.
The changes include staging techniques, neo– and adjuvant therapies and
especially new surgical tools which have had a profound effect on our sur-
gical practice. It is now more diffi cult then ever to keep abreast of changes
in near-parallel sub-specialities which previously was not diffi cult.
This book will help to overcome some of these diffi culties and will be of
great value for life-long students of surgery. Throughout the book, the results
of major trials which have brought about these changes are discussed and
easy references provided. I have nothing but praise for this book which has
been written by highly motivated members of our profession. The quality
of the writing, its content, and presentation is exceptionally good and
one is left with a sense of admiration for the authors and the reassurance
that the future of surgery in this complex and challenging area is secure.
J Meirion Thomas MS FRCP FRCS
Professor of Surgical Oncology
Royal Marsden Hospital and Imperial College
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vii
Preface
How should surgeons deal with cancer patients? The cornerstone of
effective treatment is a multidisciplinary collaboration between many
specialties in which surgeons are not only concerned about operative
accessibility and technique, but rather have a deep understanding of the
fundamental biology of the malignancy they are dealing with and appre-
ciate the reach of multi-modal treatment.
Higher surgical trainees regularly moving to the variety of general
surgical sub-specialties are required to rapidly assimilate updated clinical
algorithms based on evidence-based guidelines that go beyond the basic
level achieved at the MRCS. This is essential if we are to ensure that the
clinical trajectory of our cancer patients is optimal. Clinical guidelines
issued by national bodies usually run into hundreds of pages of dense
text, as do the many textbooks of surgical oncology that often provide
encyclopaedic reference material and conceptual information, but are
not targeted at immediate practice.
In writing this handbook, our aim has been to provide a summarized
yet reliable compendium of all of those books and resources online that
both our colleagues and ourselves have quickly peered into on so many
occasions: after reading a pathology report or CT scan in the outpatient’s
clinic; before presenting a case at a multidisciplinary team meeting at a
regional cancer centre; or perhaps, before asking our seniors or colleagues
for advice about surveillance for a complex case and before proceeding to
the operating theatre. It is also the book that many were in search of when
preparing for exams that contained the breadth of surgical oncology that
had to be studied from an array of sub-specialty sources. It is an essen-
tial practical handbook that draws together all the varied guidelines and
source materials that form the basis of this complex subject.
MAC
MCW
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ix
Acknowledgements
We acknowledge all those who have helped in producing this book at
OUP namely Susan Crowhurst and Suzy Armitage.
We gratefully acknowledge that many fi gures in this book have been
reproduced from Operative Surgery, second edition, (2006) edited by
Greg R. McLatchie and David J. Leaper (Oxford: Oxford University Press).
We are deeply thankful to and acknowledge the assistance of Dr Dhiren
Shah, St Thomas’s Hospital, London, who provided the radiological images
used in this book.
We thank Christopher Liao for his invaluable input throughout.
We also thank Mr Don Menzies, ICENI Centre, Colchester, UK, for the
laparoscopic images used—and Tino Solomon, ICENI Centre, Colchester,
UK, for his assistance in the compilation of this book.
We gratefully acknowledge Mr Daren Francis, Chase Farm Hospital,
Enfi eld, for his suggestions in the anal and colorectal chapters.
