This book provides surgeons and oncologists with a well-founded and detailed overview of the available treatment options for peritoneal malignancy and differential selection of the appropriate forms of therapy. Systemic chemotherapy options are also considered, as are surgical cytoreduction (CRS) and all forms of intraperitoneal chemotherapy (IPC) especially hyperthermic IPC (HIPEC), and immunotherapy, including specific procedures such as PIPAC. Subsequent chapters address perioperative care, complications and recurrences, as well as psycho-oncological, palliative medical and nursing care. The process of parietal and visceral peritonectomy in the large and small intestine is additionally illustrated by three video clips accessible online. Covering a broad range of aspects, including peritoneal metastasis and intraperitoneal chemotherapy, the book offers a valuable tool for surgeons, oncologists and anesthesiologists alike.

Paul Sugarbaker and his colleagues have persevered in the study and treat ment of peritoneal carcinomatosis. The peritoneal cavity has many unique and incompletely appreciated properties. These properties, coupled with the biologic behavior of many cancers, results in the seeding and growth of these cancers on the peritoneum. Many of these cancers remain localized to the peritoneum only, never metastasizing to other sites. One possible reason for this may be the obstruction of the afferent lymphatics on the undersurface of the diaphragm. The mucopolysaccharides produced by many of these neoplasma are probably viscous enough to obstruct these lymphatics, leading to the syndrome of pseudomyxoma peritonei. Many of the neoplasms taking residence on the peritoneum have extremely long cell-cycle times and are resistant to radiotherapy and many chemotherapeutic agents. How ever, much can be done for these patients - resection of primary cancers, omentectomies to reduce ascites formation, management of recurrent ascites, management of intestinal obstruction, nutritional care, and, hopefully, intraperitoneal chemotherapy. We have reviewed many of these problems in the past [1-7]. Dr. Sugarbaker and his colleagues have organized the current state of knowledge and technology for continuing use. The book provides a basis for thoughtful, prospective research planning. John S. Spratt, M. D. , F. A. C. S. Professor of Surgery The James Graham Brown Cancer Center University of Louisville Louisville, Kentucky References 1. Long RTL, Spratt JS, Dowling E.

The widespread acceptance among the oncology community at large of cytoreductive surgery and HIPEC as a potentially curative treatment for peritoneal metastases has paved the way for innovative new therapies that could benefit a larger proportion of patients. Much has been and continues to be published on this subject. This book provides comprehensive reviews on the various aspects of managing peritoneal metastases. The authors highlight essential practical issues that surgical oncologists encounter in their day-to-day practice, and try to before provide evidence based answers to address them. All chapters were written and/or reviewed by leading experts in this field.

This monograph summarizes state of the art knowledge regarding peritoneal surface malignancies, with in-depth description of treatment options and the results achieved to date. It explores the most challenging problems on the basis of the authors’ very extensive clinical experience and examines the most relevant clinical trials. A comprehensive summary is provided of all phase 2 studies (the only available completed studies) and of ongoing and future phase 3 studies. Particular attention is paid to the results of integrated treatment comprising cytoreduction (peritonectomy) and hyperthermic intraperitoneal chemotherapy (HIPEC). Helpful background information is also included on the definition and clinical assessment of each clinical form. The book, drawing on data from the entire Italian experience as well as world literature, will be an outstanding benchmark for health professionals and researchers.

This book covers some well-known and some unexplored pathological aspects of management of peritoneal metastases and should be read by both surgeons and pathologists involved in the management of peritoneal surface malignancies. The evaluation of cytoreductive surgery specimens is explored for the prognostic information it can provide and recommendations for evaluation of such specimens are provided. The pathways and patterns of peritoneal dissemination and their clinical implications on the extent of surgery performed and other aspects of management are discussed for some common peritoneal tumours. The exploratory studies presented here provide a new perspective on the surgical resection of peritoneal metastases. Other important aspects of pathological evaluation like pathological response to chemotherapy, diagnosis and classification of rare peritoneal tumors have also been covered in different chapters. Keeping in sync with the progress in molecular oncology, the role of molecular oncology in the current and future management of peritoneal metastases is addressed for different tumors.

Peritoneal carcinomatosis dominates the clinical picture of many patients with gastrointestinal, gynecological and urological cancers. For many of them its dev astating effects contribute directly to their death. Most clinicians consider peritoneal carcinomatosis an incurable metastatic disease and give palliative treatment, re stricted to limited surgery and systemic chemotherapy. Contrary to this view, Paul Sugarbaker and his collegues base their approach on the concept that peritoneal carcinomatosis represents regional tumor spread, similar in its impact on treatment and prognosis to that of lymph node metastases in other malignancies. This concept emphasises the value of regional tumor control, as a potentially curative measure. In this book the combination of aggressive cytoreduction and intraperitoneal chemotherapy to control peritoneal carcinomatosis is extensively explored. Basic to this approach is the observation that most cancer cells show only relative resistence against commonly available drugs, which can be overcome by a sufficient increase of drug concentrations in tumor tissue. After intraperitoneal delivery, drugs will reach high tissue concentrations in the superficial few cell layers, while plasma concentrations will remain below toxic levels. Patients with only limited residual tumor at the peritoneal surface after cytoreduction may therefore benefit from intraperitoneal chemotherapy.

Ideal for trainees and practicing radiologists, Diagnostic Imaging: Gastrointestinal, 3rd Edition provides comprehensive coverage of every important topic in abdominal and gastrointestinal imaging. Featuring an increased number of illustrations, graphics, and multimodality imaging, this updated medical reference book will aid you in recognizing the characteristic and variant appearances of both common and uncommon abdominal disorders. User-friendly bulleted text and a uniform chapter layout allow fast and effortless access to the crucial knowledge you need! Expanded coverage of the most important topics and trends in fluoroscopic evaluation of the GI tract, including evaluation of patients before and after bariatric surgery, fundoplication, and surgery for esophageal carcinoma. Updated sections covering disorders of the liver, biliary tract, and pancreas with information and images regarding new classification and treatment implications for pancreatitis, including autoimmune (IgG4-related) pancreatitis. Increased number of illustrations of all appropriate imaging modalities, such as multiplanar CT, sonography, MR, and PET/CT. Offers information on all forms of acute and chronic hepatitis and cirrhosis, as well as critical knowledge regarding imaging techniques that allow radiologists to distinguish among focal lesions in the cirrhotic liver. Essential information is distilled into a succinct, bulleted format with numerous high-quality images and "Key Facts" boxes to facilitate learning.