直肠癌的现代治疗 Modern Management of Cancer of the Rectum

2001-8  

北京科文图书业信息技术有限公司  

Longo, W.  

234  

addresses such topics as 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.

List of ContributorsIntroduction1 Evolution of the Surgical Management of Rectal Cancer Introduction Perineal Approach Transanal Excision Transsacral Resection Abdominosacral Resection Abdominoperineal Resection Abdominoanal Approach Anterior Resection The Present References2 Pathology and Staging Introduction Resection Specimen Total Mesorectal Excision Histological Features of Rectal Cancer and Their Prognostic Significance Histological Type Tumour Differentiation Invasive Growth Pattern and Peritumoral Lvmphocytic Infiltration Completeness ofExcision Serosal Involvement LYmph Node Metastases ExtramuralVascular Invasion SurgicalResectionMargins andLocalRecurrence Local Recurrence Longitudinal Resection Margin Circumferential Resection Margin Staging ofRectal Cancer Staging Systems Currently in Existence DukesStaging TNM Staging System DukesStagingVersus TNM Role of Pathology in Assessing the Quality of Rectal Cancer Surgery Quality of Preoperative Imaging and Pathology Reporting，and the Use ofReporting Proformas Conclusions References3 Genetics，Screening and Chemoprevention Introduction Genetics Tumor Suppressor Genes MMR Genes Oncogenes Screening Average Risk Moderate Risk Increased Risk Chemoprevention NSAIDS Calcium AntioxidantVitamins Circumin Perillyl Alcoh01 Oltipraz Selenium References4 The Role of Imaging in the Diagnosis and Staging of Primary and Recurrent Rectal Cancer Introductionl Diagnostic Imaging in the Staging of Primary Rectal CancerI Clinical Evaluation Contrast Examinations Endorectal Ultrasound Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography Radioimmunoscintigraphy Diagnostic Imaging in the Dia19nosis and Staging of Recurrent Rectal Cancer Ultrasound Techniques Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography and Immunoscintigraphy Conclusions References5 Ne0adjuvant Therapy Introduction Preoperative Therapy Rationale Predictors ofResponsetoPreoperativeTherapy Results ofPreoperative Therapy Intensive ShortCourse PreoperativeRadiation Sphincter Preservation with Preoperative Radiation Is Aduvant Therapy Necessary in Patients Undergoing a Total Mesorectal Resection7 Investigational Approaches Altered Radiation Fractionation Schemes New Chemotherapeutic Agents 6 Restorative Procedures7 Abdominoperineal Resection8 Total Mesorectal Excision with Autonomic Nerve Preservation: "Optimized Surgery"9 Laparoscopic Resections for Large Bowel malignancy10 Minimal Access Surgery for Rectal Cancer11 Postoperative Adjuvant Combined Modality Therapy12 Follow-up After Potentially Curative Therapy for Rectal Cancer13 Surgical Approach to Locally Recurrent Disease14 Metastic Rectal Cancer15 Rare Histiotypes16 Quality of Life and Palliative Care in Rectal Cancer Patients17 Costs of Rectal Cancer Patient ManagementIndex

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