Book Review: Cancer Surgery

Although several recently published textbooks and handbooks havesome variation of "Surgical Oncology" in the title,a new text, Cancer Surgery, edited by McKenna and Murphy,shifts the emphasis from oncology to surgery. This focus is explicitlystated in the Preface, as the editors note that "this bookhas been prepared for the practicing surgeon," and they "havenot included the neoplasms for which surgery plays little or norole." Over 90% of the 66 contributing authors are in thefield of surgery or the surgical subspecialties. The editors haveappropriately limited the discussion of chemotherapy and radiationtherapy to situations in which it is used as an adjuvant or adjunctin combination with primary surgical treatment.

Of the book's 47 chapters, 40 are organized by organ system orspecific disease, with additional offerings on history, biopsyapproaches, and specific problems, including venous access, nutrition,and immunocompromised hosts. The book is nicely illustrated and,although a full-sized text at 835 pages, is not so unwieldy asto hinder use.

The editors, each of whom has served as president of both theAmerican Cancer Society and the Society of Surgical Oncology,have garnered contributions from nationally known figures in mostareas, and this expertise is the main strength of the book. Thechapter on colorectal cancer by Glenn Steele, Jr, is one of themost up-to-date, comprehensive, and informative presentationson this disease currently available. The 60 pages in this chapterinclude 42 figures and 40 tables, and concisely cover all aspectsof this disease, including a discussion of innovative treatmentstrategies, such as laparoscopic surgery.

Other gems include the historical overview featured in the firstchapter, the chapter on vascular access devices, and certain shortchapters on unusual tumors, such as appendiceal primaries. Thesubspecialty areas of thoracic, gynecologic, and urologic oncologyreceive generous coverage, comprising over 40% of the book's chapters.

The major deficiencies of this book-inconsistent presentation,redundancy, and occasional omissions-reflect the problems thattypically plague the first edition of a multi-authored text coveringa wide range of subjects. The organization, focus, and contentof the individual chapters is highly variable: The hepatic, bileduct, and gallbladder chapter is six pages long with no figuresor tables; the endometrial cancer and bladder cancer chapterscontain atlas-style descriptions of the performance of specificsurgical procedures; and the sarcoma chapter is essentially aseries of case reports void of factual content, with 110 figures(mostly intraoperative photographs) and no tables.

Unnecessary redundancy is exemplified by separate presentationson liver metastases in the liver chapter, the colorectal chapter,the recurrent malignancy chapter, and a chapter entitled "Surgeryfor Liver Metastases," with no apparent attempt to coordinateor cross-reference this information. One area with a definitesurgical flavor that is not covered in this book is peritonealcarcinomatosis and malignant ascites, although malignant pleuraleffusions warrants its own separate chapter.

In summary, the editors' stated goal is to make available an easilyaccessible reference on pertinent aspects of cancer surgery forthe practicing clinician. This goal is accomplished in some casesbut not in others, and the reader must sort through the variablepresentation of information to obtain that goal.