Full Description
This textbook provides a practically applicable resource for understanding the surgical oncology management of pancreatic cancer. It discusses relevant aspects of anatomy and pathophysiology along with the latest diagnostic techniques. Insightful descriptions are then provided detailing how to perform critical surgical procedures when treating these patients. Relevant perioperative management strategies and emerging themes in cancer biology critical to understanding and treating the disease are also described.
The need for cross-discipline collaboration to facilitate and enhance innovation within the discipline is reinforced throughout the text. Each chapter presents the relevant current clinical standards along with areas of controversy in both research and clinical practice within "pearls and pitfalls" sections.
Textbook of Pancreatic Cancer: Principles and Practice of Surgical Oncology is a detailed work covering the basic material important to trainees as well as advanced curriculum for established specialists in the field from a multi-disciplinary perspective. Therefore, it is crucial resource for all practicing and trainee professionals who encounter these patients in their day-to-day clinical practice.
Contents
Section 1 defining the disease burden.- Pancreatic cancer in the population.- Pancreatic cancer biology.- Pancreatic cancer precursors (pancreas cysts).- Genetic syndromes and screening.- PDAC pathways.- Centralization of surgery and volume-outcome issues.- Education & training in pancreatic surgery.- research and progress in pancreatic surgery .- Section 2 Anatomy and physiology .- Anatomy and embryology.- Anatomical variants.- Vascular supply - Important arterial and venous variants.- Lymphatic drainage and variants.- Section 3 Symptoms and presentation (with pathophysiology) .- Intro: PDAC as a difficult disease to diagnose.- Jaundice .- cachexia and sarcopenia.- pain.- diabetes (new onset diabetes) Section 4 Imaging and preoperative staging .- Intro: goals of imaging /staging.- CT - protocol, pearls and pitfalls; resectable/borderline; locally advanced.- imaging after neoadjuvant therapy.- MRI - protocol, added value, cancer, cysts, accuracyetc.- Standard for reporting imaging results.- EUS - cancer, cysts, FNAC, biopsy, sens/spec, accuracy, markers.- ERCP - indications, stenting.- MDT - multidisciplinary team meeting; tumor board.- when a diagnosis can not be confirmed.- Section 5 Pathology and laboratory - reporting and research .- Intro: personalized medicine and precision medicine.- gross pathology - important aspects and standards.- histopathology - important aspects and standard template.- tissue sampling for research - fresh frozen.- sampling from formalin fixed tissue- aspects.- tumor markers (and biomarker research).- blood samples for research - liquid biopsy, proteomics etc.- Genomics, NGS, molecular classification.- Section 6 Chemotherapy and radiation therapy.- history of chemoradiotherapy in PDAC.- Available drugs - mechanisms, effect and side-effects.- role and mechanisms of radiotherapy.- Adjuvant chemotherapy - best evidence.- Neoadjuvant treatment in upfront resectable - principles and ongoing trials.- NAT in borderline or locally advanced - indiuction chemo.- Use of organoid modles to monitor/choose chemotherapy.- something here on novel therapies: immunotherapy etc? Section 7 Perioperative management .- Anesthesia and peri-op management.- Enhanced recovery - principles and standards.- Nutritional support and therapy in pancreatic surgery.- use of drains.- use of high-dependency unit/ICU/ward.- Section 8 Surgery .- Intro: Surgery as a curative apporach to PDAC.- Surgery for pancreatic head cancers.- Surgery for body and tail cancers.- central resections and enucleations.- Artery-first approach.- Minimal invasive pancreatic surgery.- Venous resection .- Arterial resection.- Reconstruction techniques, variations.- DP-CAR.- Extended resection criteria - multiorgan, M1 disease etc .- total pancreatectomy.- Lymphadenecomty.- Should we resect PDAC with solitary metastatis (liver, lung).- Research gaps.
