By Richard P. Billingham (auth.), Prof. Dr. med. Dr. h.c. Markus W. Büchler, PD Dr. med. Jürgen Weitz, Prof. Dr. med. Bernward Ulrich, Professor Richard John Heald (eds.)
Rectal melanoma is without doubt one of the so much generic cancers world-wide. it's also a paradigm for multimodal administration, because the mixture of surgical procedure, chemotherapy and radiotherapy is frequently essential to in attaining the optimum end result. lately, foreign specialists met in Heidelberg, Germany to debate the newest advancements within the administration of rectal melanoma, together with the anatomic and pathologic foundation, staging instruments, surgical suggestions together with fast-track surgical procedure and laparoscopic resection, sensible end result after surgical procedure and the function of radio- and chemotherapy. This monograph summarizes this assembly and provides an intensive review of the present ideas in administration of rectal cancer.
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Extra resources for Rectal Cancer Treatment
The accuracy of endosonography for rectal tumours decreases after introduction of the method into the everyday clinical routine. Nonetheless, apart from magnetic resonance imaging with an endorectal coil, rectal endosonography is still the most accurate staging modality for rectal tumours and allows adequate selection of patients for different therapeutic regimes. As the major problem of rectal endosonography is overstaging, more patients are likely to undergo overtreatment rather than undertreatment.
Ueno et al. examined lateral (iliac) lymph nodes from 70 consecutive patients with low rectal cancer for occult microscopic metastasis using serial sectioning . They detected occult microscopic foci in 5 patients (7%), whereas the overall incidence of lateral spread was 24% (17/70 patients), and the highest incidence of positive lymph nodes was found in the middle rectal root region along the middle rectal artery . With the use of immunohistochemistry Shimoyama et al. 3%) pa- Is the Lateral Lymph Node Compartment Relevant?
Lancet 344:707–711 Birbeck KF, Macklin CP, Tifﬁn MJ, Parsons W, Dixon MF, Finan PJ, Johnston D, Quirke P (2002) Rates of circumferential margin involvement vary between surgeons and predict outcomes in rectal cancer surgery. Ann Surg 235:449–457 Cawthorn SJ, Parums DV, Gibbs NM, A’Hern RP, Caffarey SM, Broughton CIM, Marks CG (1990) Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer. Lancet 335:1055–1059 Compton C, Fenoglio-Preiser CM, Pettigrew N, Fielding LP (2000) American Joint committee on cancer prognostic factors consensus conference—colorectal working group.