By T. Wiegel, INTERNATIONAL SYMPOSIUM ON SPECIAL ASPEC
This quantity discusses diagnostic and healing recommendations together with present debatable matters within the administration of gastrointestinal tumors. distinct emphasis is given to rectal and pancreatic melanoma. the 1st half provides the newest diagnostic advancements for rectal melanoma with a spotlight at the function of preoperative radiotherapy and radio-chemotherapy. additionally thought of is the surgical means of overall mesorectal excision. Recurrent rectal melanoma is one other vital factor lower than dialogue. a wide element of the ebook is dedicated to the prognosis and interdisciplinary therapy of pancreatic melanoma. Controversies concerning the function of adjuvant radiochemotherapy are offered intimately. the ultimate half is devoted to the remedy of liver metastases and describes the result of surgical resection and new healing methods reminiscent of in situ ablation and radiosurgery. This publication bargains an interdisciplinary point of view on gastrointestinal tumor treatment.
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Additional resources for Controversies in Gastrointestinal Tumor Therapy: 6th International Symposium on Special Aspects of Radiotherapy, Berlin, September 5-7, 2002 (Frontiers of Radiation Therapy and Oncology)
Williams NS, Dixon MF, Johnson D: Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum. Br J Surg 1983;70:150–154. Lazorthes F, Fages P, Chiotasso P, Lemozy J, Bloom E: Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum. Br J Surg 1986;73: 136–138. 01 randomized trial. J Clin Oncol 1999;17:2396–2402. Hyams DM, Mamounas EP, Petrelli N, Rockette H, Jones J, Wieand S, Deutsch M, Wickerham L, Fisher B, Wolmark N: A clinical trial to evaluate the worth of preoperative multimodality therapy in patients with operable carcinoma of the rectum.
Using virtual endoscopy, secondary lesions within the bowel might be identified in the sigmoid colon. This is based on a virtual 3-dimensional double-contrast technique. The limitations of CT are based on the limited differentiation of the wall layers. Additionally, partial volume effects lead to overstaging, especially T2 versus T3 and T3 versus T4, as well as limited information on the tumor involvement of lymph nodes. Local recurrence of rectal cancer meets the following criteria in CT: an enlargement of a presacral mass with an inhomogeneous appearance; additionally, asymmetric outlines and relevant contrast uptake indicate possible tumor recurrence.
The Swedish Rectal Cancer Group suggested that pre-operative therapy would approximately half the risk of local recurrence in any given group at risk . This led to the consensus that irradiation reduced local recurrence, but the survival benefit remained unproven and neo-adjuvant radiotherapy is not without associated morbidity. The North Trent audit showed a higher than expected anastomotic leak rate (15%) and perineal wound infection rates (18%) following the introduction of pre-operative radiotherapy .