- Email: [email protected]
Digestive tract tumors: Fundamental and clinical aspects
BOOK
REVIEWS
Howard M. Spiro, M.D. Book Review Editor Yale University School of Medicine 333 Cedar Street, Box 3333 New Haven, Connecticut Of3510
Digestive Tract Tumors: Fundamental and Clinical Aspects. Edited by K. Inokuchi, G. P. Murphy, H. Sugano, T. Sugimura, and U. Veronesi. 279 pp., 7 figures, $69.50. Plenum Press, New York, New York, 1966. ISBN O-306-42297-2. A medical text should not merely be a collection of journal articles reproduced and anchored with a hard cover. The title of this volume suggests the former, but the substance reveals the latter. Anticipating a sojourn through recent developments carefully presented in the light of historical review, I was disappointed. Multiauthored by the participants of the UICC Fukuoka Symposium held in the fall of 1964 in Japan, it lacks critical editorial intervention. Five editors are listed, although their contribution outside of a brief [and useless) preface is nowhere to be seen. More than half of the articles are from Japan, and a review of’ the English grammar in translation must have been cursory. Hence, the title of one section: “Long Term Survival and Combined Modality by Digestive Tract Cancer.” Solecism abounds, and reading through the text is, at times, a chore. A detailed classification of the histopathology and growth patterns of gastric cancer by Inokuchi leaves the reader with the impression that the more well-differentiated cancers are associated with the highest incidence of lymph node metastasis and the poorest 5-year survival. Another chapter by Sugano et al. used similar terms to refer to a different c!assification and left me bewildered. Inconsistency is common when multiple authors collaborate. An excellent review of preoperative radiotherapy in esophageal cancer is followed by an analysis of adjuvant chemotherapy in gastric cancer that draws outlandish conclusions based on historical controls. The text, however, is not without merit. The section entitled “Risk of Carcinoma After Partial Gastrectomy” is excellent. Two reports on the incidence of gastric carcinoma in a murine model after innovative surgical procedures accompany a review of the role of intestinal flora in carcinogenesis and two fascinating epidemiologic studies from Sweden and Japan. Introductory remarks by Tomio Hirohata serve to summarize the data and provide sagacious guidance. The editors should look to thjs section as a paradigm of future publications. Other highlights include the discussion of adenomacarcinoma sequence in colon cancer by Muto et al. and the description of balloon cytology in esqphageal cancer by Huang, Shen, and Nabeya. The disappearance of medical texts by a single author is in response to the tremendous expansion of information in recent years. The gains in reliable up-to-date data must be
balanced against the lack of continuity, readability, and consistency. In most respects, this volume falls short of the ideal in this balance. Conclusions regarding controversial topics such as adjuvant chemotherapy in ga@ric cancer are based on unsound analysis without proper perspective and make this a particularly poor volume for students and generalists. The position of editor must be more than a sinecure. Careful supervision of contributors, frequent intervention providing analysis, and active participation in achieving balance can convert a col!ection of studies into a valuable educational experience. Back to the editors’ desk with this one. THOMAS J. LESTER, M.D.
Katonah, New York
This well-written monograph (Digestive Tract Tumors: Fundamental and Ciinical Aspects) reporting a symposium held in Fukuoka in 1964, most of whose papers suggest the editorial hand of a native English speaker, supplies a superb overview of GI cancer for the gastroenterologist. The book is lavishly printed on coated paper, the illustrations are clear, and it is of a size to read, rather than.to study, in a pleasant evening. There are six sections: Carcinogenesis, Tumor Characteristics, New Trends in cancer Diagnosis, Long Term Survival and Combined Modality by Digestive Tract Cancer, Risk of Carcinoma After Partial Gastrectomy, and Multidisciplinary Approach to Cancer Prevention. Many of the contributors are, as is only natural, Japanese and for this reason the book is of importance to the western gastroenterologist. One point of interest turned out to be a difference in the risk of gastric stump cancer. In Sweden it is very high, but in Japan-surprisingly enough-it is so far no more frequent than usual. That, of course, could be because Japan has such a high incidence of gastric cancer to begin with, or as Hirohata suggests, a change in dietary habits after partial gastrectomy in Japan could have led to a decreased risk of carcinoma. Mqreover, he points out, that as stump cancer in Sweden is much more common after 17 years of follow-up, the remarkably complete and lengthy follow-ups in Sweden may have led to a “detection bias.” All in all this is a useful book. I would not rush out to buy it unless I was a gastrointestinal oncologist, but I would urge my library to buy it and I would take it home for several days. There is nothing in the book that you cannot find elsewhere, but it is all brought together in one place. HOWARD SPIRO, M.D. New Haven, Connecticut
REVIEWS
Howard M. Spiro, M.D. Book Review Editor Yale University School of Medicine 333 Cedar Street, Box 3333 New Haven, Connecticut Of3510
Digestive Tract Tumors: Fundamental and Clinical Aspects. Edited by K. Inokuchi, G. P. Murphy, H. Sugano, T. Sugimura, and U. Veronesi. 279 pp., 7 figures, $69.50. Plenum Press, New York, New York, 1966. ISBN O-306-42297-2. A medical text should not merely be a collection of journal articles reproduced and anchored with a hard cover. The title of this volume suggests the former, but the substance reveals the latter. Anticipating a sojourn through recent developments carefully presented in the light of historical review, I was disappointed. Multiauthored by the participants of the UICC Fukuoka Symposium held in the fall of 1964 in Japan, it lacks critical editorial intervention. Five editors are listed, although their contribution outside of a brief [and useless) preface is nowhere to be seen. More than half of the articles are from Japan, and a review of’ the English grammar in translation must have been cursory. Hence, the title of one section: “Long Term Survival and Combined Modality by Digestive Tract Cancer.” Solecism abounds, and reading through the text is, at times, a chore. A detailed classification of the histopathology and growth patterns of gastric cancer by Inokuchi leaves the reader with the impression that the more well-differentiated cancers are associated with the highest incidence of lymph node metastasis and the poorest 5-year survival. Another chapter by Sugano et al. used similar terms to refer to a different c!assification and left me bewildered. Inconsistency is common when multiple authors collaborate. An excellent review of preoperative radiotherapy in esophageal cancer is followed by an analysis of adjuvant chemotherapy in gastric cancer that draws outlandish conclusions based on historical controls. The text, however, is not without merit. The section entitled “Risk of Carcinoma After Partial Gastrectomy” is excellent. Two reports on the incidence of gastric carcinoma in a murine model after innovative surgical procedures accompany a review of the role of intestinal flora in carcinogenesis and two fascinating epidemiologic studies from Sweden and Japan. Introductory remarks by Tomio Hirohata serve to summarize the data and provide sagacious guidance. The editors should look to thjs section as a paradigm of future publications. Other highlights include the discussion of adenomacarcinoma sequence in colon cancer by Muto et al. and the description of balloon cytology in esqphageal cancer by Huang, Shen, and Nabeya. The disappearance of medical texts by a single author is in response to the tremendous expansion of information in recent years. The gains in reliable up-to-date data must be
balanced against the lack of continuity, readability, and consistency. In most respects, this volume falls short of the ideal in this balance. Conclusions regarding controversial topics such as adjuvant chemotherapy in ga@ric cancer are based on unsound analysis without proper perspective and make this a particularly poor volume for students and generalists. The position of editor must be more than a sinecure. Careful supervision of contributors, frequent intervention providing analysis, and active participation in achieving balance can convert a col!ection of studies into a valuable educational experience. Back to the editors’ desk with this one. THOMAS J. LESTER, M.D.
Katonah, New York
This well-written monograph (Digestive Tract Tumors: Fundamental and Ciinical Aspects) reporting a symposium held in Fukuoka in 1964, most of whose papers suggest the editorial hand of a native English speaker, supplies a superb overview of GI cancer for the gastroenterologist. The book is lavishly printed on coated paper, the illustrations are clear, and it is of a size to read, rather than.to study, in a pleasant evening. There are six sections: Carcinogenesis, Tumor Characteristics, New Trends in cancer Diagnosis, Long Term Survival and Combined Modality by Digestive Tract Cancer, Risk of Carcinoma After Partial Gastrectomy, and Multidisciplinary Approach to Cancer Prevention. Many of the contributors are, as is only natural, Japanese and for this reason the book is of importance to the western gastroenterologist. One point of interest turned out to be a difference in the risk of gastric stump cancer. In Sweden it is very high, but in Japan-surprisingly enough-it is so far no more frequent than usual. That, of course, could be because Japan has such a high incidence of gastric cancer to begin with, or as Hirohata suggests, a change in dietary habits after partial gastrectomy in Japan could have led to a decreased risk of carcinoma. Mqreover, he points out, that as stump cancer in Sweden is much more common after 17 years of follow-up, the remarkably complete and lengthy follow-ups in Sweden may have led to a “detection bias.” All in all this is a useful book. I would not rush out to buy it unless I was a gastrointestinal oncologist, but I would urge my library to buy it and I would take it home for several days. There is nothing in the book that you cannot find elsewhere, but it is all brought together in one place. HOWARD SPIRO, M.D. New Haven, Connecticut