Editor Martin D. Goodman MD FACS
Assistant Professor of Surgery Tufts Medical Center Director of the Peritoneal Surface Malignancy Program
Boston, Massachusetts, USA
7Contributors
Headquarter
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Email: jaypee@jaypeebrothers.com
Overseas Offices
JP Medical Ltd
83 Victoria Street London
SW1H 0HW (UK)
Phone: +44-2031708910
Fax: +02-03-0086180
Email: info@jpmedpub.com
Jaypee-Highlights medical publishers Inc
City of Knowledge, Bld 237, Clayton
Panama City, Panama
Phone: +507-301-0496
Fax: +507-301-0499
Email: cservice@jphmedical.com
Website: www.jaypeebrothers.com
Website: www.jaypeedigital.com
© 2012, Jaypee Brothers Medical Publishers
All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permission of the publisher.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editor specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editor. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Regional Therapeutics for Advanced Malignancies
First Edition: 2012
9789350258873
Printed at
5Dedicated to
My kids Rachel, Max and Simon Who make me proud to be called their Dad.
- Abby Crume DO
- Surgical Resident
- Maine Medical Center
- Portland, Maine, USA
- Andrea Cercek MD
- Assistant Attending
- Gastrointestinal Oncology Service
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Andrew Hayes MA PhD FRCS
- Consultant Surgeon
- Sarcoma and Melanoma Unit
- Royal Marsden Hospital
- London, United Kingdom
- Anne Garrison MD
- Assistant Professor
- Division of Gynecologic Oncology
- University of Massachusetts Medical Center
- Worcester, Massachusetts, USA
- Benedict D.T. Daly MD
- Professor and Chairman
- Department of Cardiothoracic Surgery
- Boston Medical Center
- Boston, Massachusetts, USA
- C. William Helm MA MB.BChir
- Professor, Gynecologic Oncology
- Gynecology and Women's Health Saint Louis University
- School of Medicine
- St Louis, Missouri, USA
- Chaitan K. Narsule MD
- Fellow, Department of Cardiothoracic Surgery
- Boston Medical Center
- Boston, Massachusetts, USA
- Daniel C. Wiener MD
- Assistant Professor of Surgery
- Division of Thoracic Surgery
- Tufts Medical Center
- Boston, Massachusetts, USA
- David L. Bartlett MD FACS
- Bernard Fisher Professor of Surgery
- Vice Chairman Surgical Oncology
- Director of the David D. Koch Regional Perfusion Cancer Therapy Center
- Director of the Multidisciplinary Disease Site Clinical and Research Programs
- University of Pittsburgh Medical Center and Research Institute
- Pittsburgh, Pennsylvania, USA
- Douglas L. Fraker MD FACS
- Jonathan E. Rhoads Professor of Surgical Science
- Chief Division of Endocrine and Oncologic Surgery
- Hospital of the University of Pennsylvania
- Philadelphia, Pennsylvania, USA
- Giorgos C. Karakousis MD
- Assistant Professor of Surgery
- Hospital of the University of Pennsylvania
- Philadelphia, Pennsylvania, USA
- H. Richard Alexander Jr MD FACS
- Professor of Surgery
- Associate Chairman for Clinical Research, Surgery
- Division of Surgical Oncology
- University of Maryland School of Medicine, Baltimore, Maryland, USA
- Haroon A. Choudry MD FACS
- Assistant Professor of Surgery
- University of Pittsburgh Medical Center and Research Institute
- Pittsburgh, Pennsylvania, USA
- Hebat Allah Mohamed Saad El-Din Fouad
- Assistant Lecturer at the Department of Radiology
- Faculty of Medicine
- Cairo University Hospitals (Kasr Al-Ainiteaching Hospital)
- Cairo, Egypt
- Hiran C. Fernando MBBS FRCS FACS
- Associate Professor
- Department of Cardiothoracic Surgery
- Director
- Minimally Invasive Thoracic Surgery
- Boston Medical Center
- Boston, Massachusetts, USA
- Jesus Esquivel MD FACS
- Director
- Peritoneal Surface Malignancy Program
- St Agnes Hospital
- Baltimore, Maryland, USA
- Lisa Rutstein MD FACS
- Associate Professor of Surgery
- Department of Surgical Oncology
- Maine Medical Center
- Portland, Maine, USA
- Martin D. Goodman MD FACS
- Assistant Professor of Surgery
- Director of the Peritoneal Surface Malignancy Program
- Tufts Medical Center
- Boston, Massachusetts, USA
- Nancy E. Kemeny MD
- Attending Physician
- Memorial Sloan-Kettering Cancer Center
- Professor of Medicine
- Weill Medical College at Cornell University, New York, NY, USA
- Neil A. Christie MD FRCS(C) FACS
- Assistant Professor of Surgery
- Department of Cardiothoracic Surgery
- University of Pittsburgh Medical
- Center, Pittsburgh, Pennsylvania, USA
- Paul H. Sugarbaker MD FACS FRCS
- Director, Program in Peritoneal Surface Malignancy
- Washington Hospital
- Washington DC, USA
- Robert C.G. Martin II MD PhD FACS
- Sam and Lolita Weakley Endowed Chair in Surgical Oncology
- Professor of Surgery
- Director, Division of Surgical Oncology
- University of Louisville School of Medicine
- Sarah H. Hughes MD
- Assistant Professor
- Division of Gynecologic Oncology
- University of Massachusetts Medical Center
- Worcester, Massachusetts, USA
- Sarah McPartland MD
- Surgical Resident
- Tufts Medical Center
- Boston, Massachusetts, USA
- Susan B. Kesmodel MD FACS
- Assistant Professor
- Division of Surgical Oncology
- University of Maryland School of Medicine
- Baltimore, Maryland, USA
- Terence C. Chua BMedSc (Hons) MBBS MRCS (Ed)
- Hepatobiliary and Surgical Oncology Unit, St George Hospital
- Sydney, Australia
- Tim Pencavel MB BS MRCS
- Surgical Research Fellow
- Sarcoma/Melanoma Unit
- The Royal Marsden Hospital
- London, United Kingdom
As I started my career, I never thought I would be a surgical oncologist treating patients with advanced and metastatic malignancies. As treatment modalities improve, more and more patients are living longer. Palliation for patients has been shown to improve not only quality of life but improve survival. At times, when there appeared to be no hope, advanced treatments can turn a hopeless situation into a chronic problem. Over the past 25 years, the use of multimodality treatments has been proven time and time again to be the approach to treat cancer. Regional therapies have been developed and proven in the literature to not only palliate symptoms, but to prolong survival, improve quality of life, and sometimes even cure in what seems a hopeless situation.
In-transit metastasis of a limb from melanoma or peritoneal disease only from colon cancer can be looked at not as a systemic disease but a regional disease. This book Regional Therapeutics for Advanced Malignancies is the most comprehensive collaboration of some of the world's experts on this topic. More and more centers across the world are changing their approach to regional disease and treatments. This book will help educate and guide medical professionals who treat patients with these difficult scenarios.
I would like to thank the authors for their time and knowledge in creating and contributing to Regional Therapeutics for Advanced Malignancies. I would also like to acknowledge Payal Bharti of Jaypee Brothers Medical Publishers, New Delhi, India for her expertise and guidance in the preparation of this project.
Martin D. Goodman
If children have the ability to ignore all odds and percentages, then may be we can all learn from them. When you think about it, what other choice is there but to hope? We have two options, medically and emotionally: give up, or fight like hell.
–Lance Armstrong