By T. Wiegel, INTERNATIONAL SYMPOSIUM ON SPECIAL ASPEC
This quantity discusses diagnostic and healing thoughts together with present arguable concerns within the administration of gastrointestinal tumors. particular emphasis is given to rectal and pancreatic melanoma. the 1st half provides the most recent diagnostic advancements for rectal melanoma with a spotlight at the function of preoperative radiotherapy and radio-chemotherapy. additionally thought of is the surgical means of overall mesorectal excision. Recurrent rectal melanoma is one other very important factor less than dialogue. a wide component of the e-book is dedicated to the analysis and interdisciplinary remedy of pancreatic melanoma. Controversies in regards to the position of adjuvant radiochemotherapy are provided intimately. the ultimate half is devoted to the remedy of liver metastases and describes the result of surgical resection and new healing methods reminiscent of in situ ablation and radiosurgery. This e-book bargains an interdisciplinary viewpoint on gastrointestinal tumor treatment.
Read or Download Controversies in Gastrointestinal Tumor Therapy: 6th International Symposium on Special Aspects of Radiotherapy, Berlin, September 5-7, 2002 (Frontiers of Radiation Therapy and Oncology) PDF
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Extra resources for Controversies in Gastrointestinal Tumor Therapy: 6th International Symposium on Special Aspects of Radiotherapy, Berlin, September 5-7, 2002 (Frontiers of Radiation Therapy and Oncology)
Fig. 2. Sites of recurrence in all patients: areas involved only once excluded. Multicenter Analysis of Patients with Recurrent Rectal Cancer 45 Fig. 3. Sites of recurrence in all patients: areas involved in less than 5% excluded. Fig. 4. Sites of recurrence after low anterior resection: areas involved in less than 10% excluded. Höcht/Hammad/Thiel/Wiegel/Siegmann/Willner/Wust/ Herrmann/Eble/Carstens/Flentje/Neumann/Hinkelbein 46 Fig. 5. Sites of recurrence after abdominoperineal resection: areas involved in less than 10% excluded.
This is based on a virtual 3-dimensional double-contrast technique. The limitations of CT are based on the limited differentiation of the wall layers. Additionally, partial volume effects lead to overstaging, especially T2 versus T3 and T3 versus T4, as well as limited information on the tumor involvement of lymph nodes. Local recurrence of rectal cancer meets the following criteria in CT: an enlargement of a presacral mass with an inhomogeneous appearance; additionally, asymmetric outlines and relevant contrast uptake indicate possible tumor recurrence.
Invasion of the adjacent organs was quite common (table 2), Höcht/Hammad/Thiel/Wiegel/Siegmann/Willner/Wust/ Herrmann/Eble/Carstens/Flentje/Neumann/Hinkelbein 42 Table 1. Initial patient characteristics % T stage T1 T2 T3 T4 Unknown Nodal involvement N0 N1 N2 Metastases M0 M1 Unknown Grading G1 G2 G3 Not stated Initial surgery APR LAR Others1 With TME Without TME Unknown Adjuvant therapy Chemotherapy Radiotherapy2 2 24 60 13 1 54 23 23 89 7 4 2 64 28 6 41 36 23 9 21 69 64 17 APR ϭ Abdominoperineal resection; LAR ϭ low anterior resection; TME ϭ total mesorectal excision.