Gastrointestinal Cancers


A Rustgi (ed)
Published by Sanders (2003) Distributed in Australia by Elsevier
ISBN: 0-7216-8963-9. 732 pages plus index.
RRP: A$324.50


This large textbook of gastrointestinal cancer has 81 contributing multidisciplinary authors who are mainly from the US although 11 contributors are international. It combines a review of the molecular and cellular biology, physiology and pathology of gastrointestinal malignancies with clinical aspects of diagnosis, evaluation and management. The book is designed for both clinicians as well as basic science researchers.

The book is divided into two parts. The first covers the fundamentals of gastrointestinal oncology, with sections on principles of oncogenesis, pathology of gastrointestinal cancers, diagnostic and therapeutic approaches and principles of patient care. The oncogenesis chapter begins from first principles with the cell cycle progressing through the role of cyclin dependent kinases, signal transduction, oncogenes, proto-oncogenes, tumour suppressor genes and peptide growth factors. Mechanisms of tumour invasion and metastasis including the role of angiogenic factors, adhesion molecules and proteinases are covered. The second part of the book is on organ-based oncology and builds on the fundamentals of the first part. It covers in great detail the epidemiology, risk factors, molecular genetics, screening, clinical presentation, diagnosis, therapy and future directions for each tumour type.

The book has been edited to make it relevant to an international multidisciplinary audience. For example data regarding incidence of each malignancy include figures from a range of Western and underdeveloped countries to compare and contrast geographical variations. Comparisons are made of Japanese and US staging systems for gastric cancer. There is a chapter on iaparoscopy discussing its role, oesophagastric, colon, pancreatic and liver cancers. Another good chapter analyses the issues of the strength of evidence on efficacy and cost effectiveness of colorectal screening, surveillance of ulcerative colitis and Barrett’s oesophagus.

The chapters are in general up-to-date (circa 2001) and cover the role of new drugs such as oxaliplatin and irinotecan in colorectal cancer and imatinib mesylate in gastrointestinal stromal tumours. Mention is made of the rationale behind novel agents undergoing evaluation such as the monoclonal antibody C225, farnesyl transferase inhibitors, matrix metaloproteinase inhibitors, COX-2 inhibitors and gene therapy techniques using adenoviral vectors. Some chapters suffer from an American bias where important European studies have not been mentioned.

In summary this is a comprehensive GI oncology text that would be a good reference for gastroenterologists, surgeons, oncologists and scientists alike.

D Yip
Medical Oncology Unit
The Canberra Hospital
Garran, ACT

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