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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 Contributors

Introduction

1 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

References

2 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

References

3 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

References

4 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

References

5 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 Procedures

7 Abdominoperineal Resection

8 Total Mesorectal Excision with Autonomic Nerve Preservation: "Optimized Surgery"

9 Laparoscopic Resections for Large Bowel malignancy

10 Minimal Access Surgery for Rectal Cancer

11 Postoperative Adjuvant Combined Modality Therapy

12 Follow-up After Potentially Curative Therapy for Rectal Cancer

13 Surgical Approach to Locally Recurrent Disease

14 Metastic Rectal Cancer

15 Rare Histiotypes

16 Quality of Life and Palliative Care in Rectal Cancer Patients

17 Costs of Rectal Cancer Patient Management

Index

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书籍介绍

Modern Management of Cancer of the Rectum is intended to provide a comprehensive overview of all aspects of rectal neoplasms. It 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.