Liver-directed Therapy for Primary and Metastatic Liver Tumours

Reviewed by:


M Talamonti et al (eds)
Published by Kluwer Academic Publishers (2001).
321 pages plus index.
RRP: US$220.00

Sometimes you look at the liver and it’s all too hard and unpleasant. It’s very tempting to push it to one side and just eat the chips. Even in units with a special interest in cancers involving the liver there can be uncertainty and a lack of consensus about how to proceed. Many of us have tried surgical approaches, ablative therapies, infusions into the hepatic artery as well as systemic therapies. Most of us can recall an occasional responder, but in general, the outlook for these patients is very poor and I have often wondered if our interventions have helped or harmed them. We need a clear and coherent overview of the state of the art so as to allow better application of the science. A diet of chips alone is no good for anyone.

This book might just be the gravy we need. It contains a series of comprehensive reviews of all aspects of management of cancers involving the liver. The chapters cover topics ranging from the clinical and epidemiological features of liver malignancies, through the various imaging options, covering surgical approaches including a very good chapter on liver transplantation, and on to other local, regional and systemic therapies. There is a good number of figures, although some of these lose their impact being printed only in black and white. The chapter on imaging in particular contains many useful example radiographs. The biliary epithelium is not forgotten, although there is very little mention of combined chemoradiotherapy. Even paediatric liver tumours rate a mention in the last chapter.

It is difficult to find too many faults with this book. I became weary of reading the epidemiology of HCC time and again, and this could have been trimmed by the editors. On inspection of the author list one could be forgiven for thinking that only American authors know anything about this field. Brachytherapy is mentioned only in passing in the discussion of cholangiocarcinoma. A closing chapter on experimental approaches such as targeted therapies, immunotherapy or other biological therapies such as antiangiogenic agents or small molecule inhibitors would have rounded the book out well.

The book is expensive at US$220 for 312 pages but I have found it to be a very useful reference. It will appeal to both surgeons and physicians involved in the care of these patients and I recommend it strongly to any unit with an interest in the management of these patients. That probably means most of us, so you’ll need to keep your strength up: make sure you eat your vegies too.

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