Book Review

Gastrointestinal Oncology

N Engl J Med 1993; 328:519February 18, 1993

Article

Gastrointestinal Oncology
Edited by James D. Ahlgren and John S. MacDonald. 659 pp., illustrated. Philadelphia, J.B. Lippincott, 1992. $95. ISBN: 0-397-51150-7

The integration of medical, surgical, and radiation oncology is central to the management of gastrointestinal solid tumors. This combined-treatment approach is the guiding principle of Gastrointestinal Oncology, a useful reference for all physicians who are involved in the treatment of gastrointestinal cancers and an excellent textbook for oncology fellows. Outstanding features of this work are its well-organized format and the excellent use of tables.

The book is divided into seven parts. The first establishes the pattern followed throughout the book in chapters discussing general principles of diagnosis and staging, surgery, chemotherapy, and radiation therapy. The next four parts are devoted to single organs: the esophagus, stomach, pancreas, and colon and rectum. The same format is followed for each part, with equal weight given to surgery, radiation therapy, and chemotherapy, with an emphasis on the interaction among all three. In part 6, individual chapters devoted to the remaining gastrointestinal cancers repeat the pattern on a smaller scale. Topics outside the boundaries of traditional methods of treatment, such as laser applications, regional chemotherapy, and monoclonal antibodies, are discussed in part 7. The use of a virtually identical format for each section and chapter makes this book very user friendly and reinforces the importance of the combined-treatment approach.

This book was particularly useful to me as a reference for an introductory talk on colorectal cancer that I gave to first-year oncology fellows. The chapters on radiation and chemotherapy make excellent use of tables to provide clear and comprehensive comparisons of clinical trials. These tables summarize data oncologists need to make informed decisions about therapy. The inclusion of historical data on the development of staging systems and treatments provides an excellent framework for understanding and designing clinical trials. This feature should prolong the usefulness of the book even in the rapidly changing field of oncology.

The number of pages allotted to each cancer is generally an appropriate reflection of the disease's prevalence and the range of therapeutic options, with colorectal cancer dominating the book. The one exception is the relatively brief chapter devoted to hepatocellular carcinoma. Given the prevalence of this disease worldwide, a more detailed review would have been welcome. For oncologists practicing in most parts of the United States, however, the information provided is an adequate introduction.

There is some repetition, particularly in the discussions of fluorouracil and the staging of colorectal cancer, which occur in several chapters. This is probably inevitable in a work that is meant as a reference rather than a book to be read cover to cover, and it is a minor flaw. Overall, this book is well written, comprehensive, and an excellent addition to any oncology library.

Elizabeth G. Trehu, M.D.
New England Medical Center, Boston, MA 02111