Book Review

Management of Colorectal Cancer

N Engl J Med 1998; 339:709September 3, 1998

Article

Management of Colorectal Cancer
Edited by Harry Bleiberg, Philippe Rougier, and Hans-Joachim Wilke. 397 pp., illustrated. London, Martin Dunitz, 1998. (Distributed by Mosby, St. Louis.) $125. ISBN: 1-85317-377-0

Colorectal cancer is the fourth most common type of cancer worldwide and accounts for considerable mortality. Refinements in surgical technique and reductions in perioperative mortality have improved outcomes substantially in recent years, and little further progress can be anticipated from traditional surgical therapy. However, adjuvant therapy has now been shown to reduce the recurrence rate and to improve survival. Advances in this form of treatment and enhanced understanding of tumor biology will now lead the way in improving the care of patients with colorectal cancer. The well-written textbook Management of Colorectal Cancer provides readers with a concise overview of the management of this type of cancer. The variety of specialties represented by the contributing authors reflects the multidisciplinary approach that is necessary for optimal management of this disease. Although the many international contributors give the book a global view, the perspective remains distinctly European.

The contents of the book are well organized and are laid out in a consistent style. Each chapter follows a set design, beginning with a list of the topics it covers. The authors address all the pertinent issues and give an inclusive overview that achieves breadth without attempting the in-depth coverage that would be expected of a comprehensive reference book. The subject matter is heavily weighted toward chemotherapy. Of the 35 chapters, 4 concern the pathologic, epidemiologic, and biologic aspects of colorectal cancer; 5 deal with surgical issues; and 3 address the role of radiation therapy. In contrast, 23 chapters focus on adjuvant therapy. Perhaps this emphasis is justified because advances in the management of colorectal cancer will in all likelihood arise from studies of adjuvant therapy and related fields. A chapter about new biologic therapies is thought provoking, and concluding chapters on measurement of quality of life, randomized trials, and meta-analysis are of substantial interest. Simple line drawings add clarity to the discussions, and there is liberal use of figures and tables to summarize the results of the many clinical trials that underpin current approaches to management.

This well-referenced and up-to-date book addresses controversial issues in management, such as factors that determine optimal surgical resection; the indications, timing, and methods of radiation therapy; and many issues pertaining to adjuvant chemotherapy. It appropriately emphasizes recent advances, including novel cytotoxic drugs, and points to new molecular targets for therapy, such as matrix metalloproteinase, farnesyltransferase, and tumor angiogenesis.

This book will appeal to a broad spectrum of clinicians and trainees who seek an overview of current practice in the management of colorectal cancer and a glimpse into its future.

W. Douglas Wong, M.D.
Memorial Sloan-Kettering Cancer Center, New York, NY 10021