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Operative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colon
Ann Thorac Surg 2015;100:2421
BOOK REVIEW
2421
REVIEW OF RECENT BOOKS Operative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colon by American College of Surgeons Clinical Research Program, Alliance for Clinical Trials in Oncology, Heidi D. Nelson, and Kelly K. Hunt 2015, Philadelphia, Lippincott Williams & Wilkins 368 pp, $85.49 ISBN: 978-1451194753 Reviewed by Richard J. Battafarano, MD, PhD, Baltimore, MD Operative Standards for Cancer Surgery is a new book that has been produced through the cooperation of the American College of Surgeons and the Alliance for Clinical Trials in Oncology. Dr. Winchester and Dr. McKellar clearly describe the essence of this book in their editorial as they state “this is not just another surgical manual.” They continue by highlighting the five critical attributes that separate this book from virtually all other previous texts focused on cancer surgery: (1) the essential operative steps are evidence based, (2) the strengths and weaknesses of the evidence are cited, (3) the text chronicles how an extensive literature search supports the recommended steps, (4) the book poses controversial questions for each cancer site that could best be answered through a clinical trial, and (5) the text makes the important distinction between the right and the wrong thing to do during a cancer operation. Section II, Lung, fully achieves the high standards that the editors have set for each of the sections in this book. The authors accurately emphasize that the appropriate care of lung cancer patients requires a multidisciplinary lung cancer team that includes medical oncologists, radiation oncologists, thoracic surgeons, pulmonary pathologists, chest radiologists, and pulmonologists. Working within this multidisciplinary lung cancer team, the clinical and radiographic stage can then be determined before an optimal treatment plan is devised for each lung cancer patient. The authors appropriately devote four chapters to the importance of invasive mediastinal staging techniques, including bronchoscopy
with endobronchial ultrasound-guided lymph node biopsies (EBUS), upper endoscopy with ultrasound-guided lymph node biopsies (EUS), cervical mediastinoscopy, and video-assisted and open approaches to mediastinal nodal assessment. These chapters clearly describe the advantages and limitations of each technique with regard to the staging and treatment of lung cancer, based on an exhaustive review of the currently available literature. The remaining chapters of the lung section focus on the concept that anatomic resection of lung cancer combined with lymphadenectomy, or at least systematic lymph node sampling, is the optimal surgical care for lung cancer patients. In an era when computed tomographic imaging is identifying an increasing number of small peripheral lung cancers, the authors systematically review the literature examining the advantages and potential limitations of anatomic segmentectomy compared with lobectomy in the treatment of patients with stage IA lung cancer. This analysis provides evidence-based guidelines suggesting that segmentectomy should be abandoned in favor of lobectomy when the tumor crosses the anatomic segmental boundaries, when the interlobar or hilar lymph nodes contain metastatic lung cancer, or in the presence of visceral pleural invasion. The final chapter on pneumonectomy clearly describes a systematic intraoperative approach for assessing the potential utility of a sleeve lobectomy as an alternative to pneumonectomy in the care of lung cancer patients. In cases in which a lesser resection is not possible, the authors stress the importance of intraoperative technique and postoperative care in limiting the morbidity and potential mortality associated with pneumonectomy. In summary, the lung section in Operative Standards for Cancer Surgery is an outstanding reference for general surgery residents, cardiothoracic surgery residents, and thoracic surgeons who care for lung cancer patients. The authors have more than achieved their stated goal of describing a “minimal standard for the actions that should be taken in the surgical care of lung cancer patients.” I am confident that this text will be an integral component of surgical education in the care of cancer patients for many years to come.
MISCELLANEOUS
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
Ann Thorac Surg 2015;100:2421 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2015.08.037
BOOK REVIEW
2421
REVIEW OF RECENT BOOKS Operative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colon by American College of Surgeons Clinical Research Program, Alliance for Clinical Trials in Oncology, Heidi D. Nelson, and Kelly K. Hunt 2015, Philadelphia, Lippincott Williams & Wilkins 368 pp, $85.49 ISBN: 978-1451194753 Reviewed by Richard J. Battafarano, MD, PhD, Baltimore, MD Operative Standards for Cancer Surgery is a new book that has been produced through the cooperation of the American College of Surgeons and the Alliance for Clinical Trials in Oncology. Dr. Winchester and Dr. McKellar clearly describe the essence of this book in their editorial as they state “this is not just another surgical manual.” They continue by highlighting the five critical attributes that separate this book from virtually all other previous texts focused on cancer surgery: (1) the essential operative steps are evidence based, (2) the strengths and weaknesses of the evidence are cited, (3) the text chronicles how an extensive literature search supports the recommended steps, (4) the book poses controversial questions for each cancer site that could best be answered through a clinical trial, and (5) the text makes the important distinction between the right and the wrong thing to do during a cancer operation. Section II, Lung, fully achieves the high standards that the editors have set for each of the sections in this book. The authors accurately emphasize that the appropriate care of lung cancer patients requires a multidisciplinary lung cancer team that includes medical oncologists, radiation oncologists, thoracic surgeons, pulmonary pathologists, chest radiologists, and pulmonologists. Working within this multidisciplinary lung cancer team, the clinical and radiographic stage can then be determined before an optimal treatment plan is devised for each lung cancer patient. The authors appropriately devote four chapters to the importance of invasive mediastinal staging techniques, including bronchoscopy
with endobronchial ultrasound-guided lymph node biopsies (EBUS), upper endoscopy with ultrasound-guided lymph node biopsies (EUS), cervical mediastinoscopy, and video-assisted and open approaches to mediastinal nodal assessment. These chapters clearly describe the advantages and limitations of each technique with regard to the staging and treatment of lung cancer, based on an exhaustive review of the currently available literature. The remaining chapters of the lung section focus on the concept that anatomic resection of lung cancer combined with lymphadenectomy, or at least systematic lymph node sampling, is the optimal surgical care for lung cancer patients. In an era when computed tomographic imaging is identifying an increasing number of small peripheral lung cancers, the authors systematically review the literature examining the advantages and potential limitations of anatomic segmentectomy compared with lobectomy in the treatment of patients with stage IA lung cancer. This analysis provides evidence-based guidelines suggesting that segmentectomy should be abandoned in favor of lobectomy when the tumor crosses the anatomic segmental boundaries, when the interlobar or hilar lymph nodes contain metastatic lung cancer, or in the presence of visceral pleural invasion. The final chapter on pneumonectomy clearly describes a systematic intraoperative approach for assessing the potential utility of a sleeve lobectomy as an alternative to pneumonectomy in the care of lung cancer patients. In cases in which a lesser resection is not possible, the authors stress the importance of intraoperative technique and postoperative care in limiting the morbidity and potential mortality associated with pneumonectomy. In summary, the lung section in Operative Standards for Cancer Surgery is an outstanding reference for general surgery residents, cardiothoracic surgery residents, and thoracic surgeons who care for lung cancer patients. The authors have more than achieved their stated goal of describing a “minimal standard for the actions that should be taken in the surgical care of lung cancer patients.” I am confident that this text will be an integral component of surgical education in the care of cancer patients for many years to come.
MISCELLANEOUS
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
Ann Thorac Surg 2015;100:2421 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2015.08.037