Book Review

Musculoskeletal Oncology: A Multidisciplinary Approach

N Engl J Med 1993; 328:68January 7, 1993

Article

Musculoskeletal Oncology: A Multidisciplinary Approach
Edited by Michael M. Lewis. 529 pp., illustrated. Philadelphia, W.B. Saunders, 1992. $95. ISBN: 0-7216-5771-0

Without question this is an ambitious, well-organized, comprehensive, but surprisingly slim book in which a multidisciplinary group of experts covers the wide-ranging field of musculoskeletal oncology. Under the editorship of Dr. Michael Lewis of New York's Mt. Sinai Hospital, 54 contributors cover subjects ranging from the preoperative workup to treatment, rehabilitation, and nursing, in 27 chapters. New in this work is the inclusion of individual chapters on tumors in various anatomical regions, thus providing a clear focus on the special clinicopathological problems at these locations. This regional anatomical approach to musculoskeletal oncology is quite successful and clearly presented. Despite unavoidable repetitions, the separate, concise discussions of tumors of the vertebral axis, the cervical and thoracolumbar spine, the thoracic skeleton, the pelvis, the hand, the shoulder girdle, and the proximal femur and lesions of the knee region are covered well. One exception is the chapter on tumors of the foot and ankle, which is less well organized than the others, does not identify the most common tumors at these sites, and does not cover the important surgical options. This chapter is a stark contrast to the excellent one on tumors of the hand, which clearly outlines the unique problems in this area.

The introductory chapter on the evaluation of bone and soft-tissue tumors by Springfield is especially well written. The author stresses the importance of the preoperative workup, tumor staging, and maintaining communication among pathologists, radiologists, and surgeons. This chapter is useful for orthopedic surgeons at all levels of training and is accompanied by a good bibliography. The chapter on bone grafting, the biology of allografts, and bone banking, by Friedlaender and Mankin, is also successful. Chapter 6, on adult oncology, could have been improved by tighter editorial attention to detail and clarity. Unique to this book is the outstanding treatise on musculoskeletal tumors in the geriatric population by Butler. The four chapters on rehabilitation, behavioral medicine and cancer, the psychosocial dimensions of bone cancer, and nursing considerations are valuable.

Looking at the cover or the spine of this book, one would have the false impression that this book has a single author. On turning to the acknowledgments, one finds that there are three contributing editors and one associate editor. Why not clearly designate this as an edited work and give proper credit to the other editors?

Medical students, residents, and fellows will find this book useful in guiding their often bewildering exploration of the intricacies of the diagnosis and treatment of bone tumors. Those who are more intimately involved with the everyday orthopedic care of patients affected by these rare neoplasms will find this an authoritative and comprehensive work, but one not too exhaustive to be consulted on a case-by-case basis. The book must be supplemented, however, by more detailed textbooks on the various special aspects of the wide multidisciplinary field of musculoskeletal oncology.

Andrew G. Huvos, M.D.
John Braun, M.D.
Memorial Sloan-Kettering Cancer Center, New York, NY 10021