Handbook of Gastrointestinal Cancers : Evidence-Based Treatment and Multidisciplinary Patient Care

Handbook of Gastrointestinal Cancers is a practical guide to the management of colorectal, pancreatic, hepatocellular, gastric, and esophageal cancers as well as other cancers of the upper and lower gastrointestinal tract. Edited by a multidisciplinary group of oncologists from leading institutions, this book is an essential day-to-day reference for evidence-based treatment and patient care. The handbook focuses on treatment strategies and approaches to cancerous gastrointestinal tumors that are transforming the recent oncological landscape, including expert-given guidance on methods such as neoadjuvant and adjuvant chemotherapy, surgical transplant, radiation therapy, molecular diagnostic testing leading to molecularly targeted therapy, and immunotherapy. With so many advances in the current field, it is increasingly difficult for early-career practitioners to grasp the entirety of practices and for seasoned oncologists to keep up with newly approved therapies, side effects to treatments, and special clinical management considerations, but this handbook addresses it all. Organized by major gastrointestinal disease sites and featuring “How I Treat” case vignettes from world experts for common and uncommon management considerations, the handbook brings an experience-based perspective to these tough-to-treat areas. The treatment strategies and applications set forth in the chapters are pertinent to situations and decision-making encountered in practice. Handbook of Gastrointestinal Cancers is a valuable resource for medical oncologists, radiation oncologists, and surgeons treating and managing gastrointestinal cancers as well as trainees in medical, radiation, and surgical oncology programs needing an accessible point of care resource. KEY FEATURES: Provides treatment plans and recommendations for each stage of a range of gastrointestinal cancers, including colorectal, pancreatic, and hepatocellular cancers plus more Includes “How I Treat” patient vignettes told from the physician’s point of view within each clinical chapter Outlines special considerations for the elderly and for survivors of gastrointestinal cancers Highlights important clinical guidance on nutritional and palliative concerns commonly seen in patients with gastrointestinal cancers Cover Title Copyright Contents Contributors Foreword Preface Share: Handbook of Gastrointestinal Cancers Part 1: Colorectal Cancer Chapter 1: Epidemiology of Colorectal Cancer References Chapter 2: Diagnosis and Staging of Colorectal Cancer Introduction Stage Distribution and Cancer Survival References Cjapter 3: Molecular Diagnostic Guidelines for Colorectal Cancer Introduction Molecular Tests for Egfr, Braf, and Her2 Directed Therapy Mismatch Repair Deficiency Screening Molecular Tests for Other Potentially Actionable Genes Sources of Biopsy for Molecular Analysis Conclusion References Chapter 4: Early-stage Colon Cancer Through Surgery Introduction Workup Colon Enhanced Recovery After Surgery (ceras) Protocol The Operative Technique Chemotherapy The Malignant Polyp Follow-up Summary References Chapter 5: Early-stage Colon Cancer with Adjuvant Therapy: Who and How Long? Introduction Adjuvant Treatment Regimens Timing of Adjuvant Treatment Adjuvant Therapy: Patient Selection and Treatment Choice Optimal Duration of Treatment Additional Readings References Chapter 6: Early-stage Rectal Cancer with Neoadjuvant Radiation Therapy Introduction Short-course Preoperative Radiotherapy Standard-course Preoperative Chemoradiotherapy Preoperative Versus Selective Postoperative Radiation Short-course Preoperative Radiotherapy Versus Standard-course Preoperative Chemoradiotherapy Radiotherapy-to-surgery Interval Selective Nonoperative Management Intensity-modulated Radiation Therapy Reirradiation Treatment Techniques Conclusions References Chapter 7: Early-stage Rectal Cancer Through Surgery Introduction Presentation Diagnosis Workup Treatment Technical Details Radical Surgical Resection Suggested Readings References Chapter 8: Early-stage Rectal Cancer with Adjuvant Therapy Introduction Patient Selection Neoadjuvant Therapy Adjuvant Therapy Future Directions References Chapter 9: Oligometastatic Colorectal Cancer Through Surgery Introduction Anatomic Considerations Anatomic Optimization Strategies Biologic Considerations Conditional Considerations References Chapter 10: Oligometastatic Colorectal Cancer with Neoadjuvant Chemotherapy Introduction Neoadjuvant Chemotherapy for Oligometastatic Resectable Liver Metastases Neoadjuvant Therapy for Oligometastatic Potentially Resectable Liver Metastases Special Considerations: Extrahepatic Oligometastatic Disease References Chapter 11: Oligometastatic Colorectal Cancer Through Local Nonsurgical Approaches Introduction Interventional Radiology’s Role in Colorectal Cancer with Liver Metastasis Percutaneous Ablation Ablative Therapies Intra-arterial Therapies Management of Concurrent Colorectal Metastasis in the Lungs Ablative Therapies References Chapter 12: Oligometastatic Colorectal Cancer with Adjuvant Chemotherapy Introduction Rationale and Evidence for Adjuvant Chemotherapy Targeted Therapy Hepatic Arterial Infusion (hai) Plus Systemic Chemotherapy Esmo and Nccn Guidelines Perspectives Recommendations and Conclusions References Chapter 13: Oligometastatic Colorectal Cancer with Debulking/hipec in Limited Peritoneal Disease Introduction Patient Selection for Peritoneal Cytoreduction from Crc Crs and Hipec—conduct of the Operation Surgical Technique Hipec Administration Re-exploration and Definitive Closure Clinical Trials Conclusions References Chapter 14: Metastatic Colorectal Cancer with Chemotherapy and Choice of Biologics Introduction and Historical Context of Survival in Metastatic Colorectal Cancer (mcrc) Combinatorial Chemotherapy for Mcrc Antiangiogenic Therapies in Mcrc Anti–Epidermal Growth Factor Receptor (egfr) Therapies in Mcrc Combined Antiangiogenic and Anti-egfr Therapies: More Is Not Always Better Braf Mutant Mcrc Her2 Amplification Primary Tumor Sidedness and the Effect of Anti-egfr Therapies on Survival in Mcrc Systemic Chemotherapy Options for Mcrc Beyond Folfox, Folfiri, Anti-vegf, and Anti-egfr Therapies Conclusions References Chapter 15: Metastatic Colorectal Cancer with Maintenance Therapies Introduction Maintenance Therapy with a Fluoropyrimidine Alone Maintenance Therapy with the Combination of a Fluoropyrimidine and Bevacizumab Maintenance Therapy with Bevacizumab Alone Maintenance Therapy with Erlotinib Plus Bevacizumab Conclusions on Maintenance Therapy Back to Our Case References Chapter 16: Metastatic Colorectal Cancer with Emerging Therapeutic Strategies Introduction Kras Met Her2 Braf Egfr New and Emerging Targets Conclusions References Chapter 17: Metastatic Colorectal Cancer with Immunotherapy Nivolumab or Pembrolizumab Should Be Offered to Msi/dmmr Metastatic Colorectal Cancer Results New Issues Arising from Immunotherapy On the Horizon Summary References Part II: Pancreatic Cancer Chapter 18: Epidemiology of Pancreatic Cancer Introduction Modifiable and Genetic Risk Factors Signs and Symptoms Outcomes References Chapter 19: Biological Basis for Pancreatic Cancer Introduction Key Biologic Properties and Mutations of Relevance to Pancreatic Cancer The Stroma Is a Unique Feature of the Microenvironment in Pancreatic Cancer Controversial Role of the Stroma in the Pancreatic Disease Process Targeting Dominant Pathways in the Tumor Microenvironment Future Advances That Will Improve Our Understanding of Pancreatic Cancer Biology References Chapter 20: Diagnosis and Staging of Pancreatic Cancer Introduction Clinical Presentation Diagnosis Staging and Resectability References Chapter 21: The Role and Timing of Surgery in Pancreatic Cancer Pancreas Cancer: the Role and Timing of Surgery References Chapter 22: Resectable Pancreatic Cancer with Adjuvant Therapy Introduction Adjuvant Systemic Chemotherapy Role of Radiation Therapy Chemotherapy Post Neoadjuvant Treatment Supportive Care Role of Biomarkers Surveillance References Chapter 23: Resectable Pancreatic Cancer with Neoadjuvant Therapy Introduction Current Standard of Care Rationale for Neoadjuvant Therapy Current Evidence for Neoadjuvant Therapy Key Ongoing Studies of Neoadjuvant Therapy Summary References Chapter 24: Borderline Resectable and Locally Advanced Pancreatic Cancer Introduction Borderline Resectable Pancreatic Cancer Locally Advanced Pancreatic Cancer References Chapter 25: Metastatic Pancreatic Cancer with Chemotherapy Introduction Initial Assessment Frontline Treatment Second-line Treatment Third-line Chemotherapy Specific Population: Microsatellite Instability High (msi-h) and Deficient Mismatch Repair (dmmr) Treating the Patient References Chapter 26: Metastatic Pancreatic Cancer with Emerging Therapies Introduction Stroma and Enzymatic Stromal Disruption and Pegph20 Immunotherapy Immune Microenvironment Modulation Cxcr4 Ccr2 Targeted Therapies Metabolic Targeting Targeting Dna Damage Repair Deficiency Treating the Patient References Part III: Hepatocellular Cancer Chapter 27: Epidemiology of Hepatocellular Cancer Introduction Hepatitis B Virus Hepatitis C Virus Impact of Effective Anti-hcv Therapy on Hcc Alcohol-related Hcc Nonalcoholic Steatohepatitis/nonalcoholic Fatty Liver Disease References Chapter 28: Diagnosis and Staging of Hepatocellular Cancer Introduction Screening Definition for At-risk Population That May Benefit from Surveillance Staging References Chapter 29: Cellular and Molecular Pathology of Hepatocellular Cancer Introduction Characterizing Mutational Signature References Chapter 30: Early-stage Hepatocellular Cancer Through Transplant Introduction Surveillance for Hcc Diagnostic Evaluation and Staging Resection for Very Early and Early Hcc Locoregional Therapy Liver Transplantation for Early and Intermediate Hcc Technical Considerations in Liver Transplantation Posttreatment Monitoring and Evaluation for Hcc Recurrence Future Directions References Chapter 31: Early-stage Hepatocellular Cancer Through Surgery Introduction Evaluation for Hepatic Resection: Tumor and Staging Characteristics Evaluation for Surgical Resection: Patient and Hepatic Characteristics Operative Considerations Outcomes Summary References Chapter 32: Early-stage Hepatocellular Cancer with Local Nonsurgical Approaches (io) Locoregional and Transcatheter Approaches Patient Selection Locoregional and Transcatheter Therapies What to Look Out for Selection of Locoregional Techniques Future Directions Additional Readings References Chapter 33: Early-stage Hepatocellular Cancer with Local Nonsurgical Approaches (radiation) Introduction Radiation Tolerance of the Liver Conformal Radiation Therapy Stereotactic Body Radiation Therapy (sbrt) Portal Vein Thrombosis Proton Beam Therapy (pbt) Choosing Protons or Photons Conclusions References Chapter 34: Advanced Hepatocellular Cancer with Multikinase Inhibitors and Other Targeted Therapies Introduction First-line Therapy Second-line Therapy Conclusion References Chapter 35: Advanced Hepatocellular Cancer with Immunotherapy Introduction Immunotherapy Agents Currently in Clinical Practice Indications and Risk Assessment for Immunotherapy Common Adverse Events and Management Emerging and Novel Therapies Conclusion References Part IV: Gastric and Esophageal Cancer Chapter 36: Epidemiology of Gastric and Esophageal Cancer Introduction References Chapter 37: Diagnosis and Staging of Gastric and Esophageal Cancer Esophageal Cancer Gastric Cancer References Chapter 38: Molecular Diagnostic Guidelines of Gastric and Esophageal Cancer Molecular Diagnostic Guidelines References Chapter 39: Early-stage Gastric and Esophageal Cancer with Neoadjuvant Therapy Evidence References Chapter 40: Early-stage Gastric and Esophageal Cancer with Surgery Esophageal Cancer Gastric Cancer References Chapter 41: Metastatic Gastric and Esophageal Cancer with Chemotherapy and Choice of Biologics Introduction First-line Chemotherapy Regimens for Metastatic Gastric and Esophageal Cancer Incorporation of Biologics to First-line Therapy Second-line Chemotherapy Regimens and Beyond Second-line Chemotherapy Incorporation of Biologics to Second-line Therapy and Beyond Case Study Summary References Chapter 42: Metastatic Gastric and Esophageal Cancer with Immunotherapy Introduction Molecular Clues May Explain Susceptibility to Immunotherapy Immunotherapy of Esophagogastric Cancer Future Directions References Part V: Rare Gastrointestinal Cancers Chapter 43: Molecular Diagnostic Guidelines of Cancers of the Bile Ducts and Gallbladder Epidemiology Risk Factors Diagnosis Conclusions References Chapter 44: Surgery for Early-stage Cancers of the Bile Ducts and Gallbladder Introduction Preoperative Considerations Resection for Curative Intent Role of Lymphadenectomy Outcomes Conclusions References Chapter 45: Adjuvant Therapy for Early-stage Cancers of the Bile Ducts and Gallbladder Introduction Historical Perspective Prospective Clinical Trials Future Directions References Chapter 46: Chemotherapy for Advanced Cancers of the Bile Ducts and Gallbladder Introduction First-line Chemotherapy Chemotherapy Options in the Second Line and Beyond Other Therapeutic Considerations Special Circumstances Summary References Chapter 47: Emerging Therapies for Advanced Cancers of the Bile Ducts and Gallbladder Introduction Molecular Subtypes in Btcs Key Molecular Pathways and Potential Emerging Therapies Conclusion References Chapter 48: Neuroendocrine Tumors Small-intestinal (midgut) Nets Gastric Nets Appendiceal Nets Colorectal Nets Pancreatic Nets Tumor Biology and Genetic Syndromes Diagnostic Procedures Diagnostic Imaging Treatment of Localized Tumors Systemic Therapy Conclusions References Chapter 49: Early-stage Anal Cancer Introduction Anatomy Epidemiology Pathogenesis and Anal Cancer Biology Evaluation and Staging Management Toxicity and Symptom Management Surveillance Conclusion References Chapter 50: Metastatic Anal Cancer Introduction Treatment of Metastatic Anal Cancer Fluoropyrimidine and Platinum Drug Regimens Taxanes Immunotherapy (immune Checkpoint Inhibitors—anti-pd1 Drugs) Ongoing and Future Trials Other Therapies/trials Treating Patients with Concurrent Hiv and Anal Cancer Prognosis References Chapter 51: Gastrointestinal Stromal Tumors Introduction Epidemiology Risk Stratification of Gist Molecular Characterization of Gist Diagnosis of Gist Staging of Gist Tumors Treatment of Gist Management of Metastatic Gist Relevant Clinical Trials Immunotherapy in Gist Global Evidence and Implementation Summit Guidelines Additional Reading/bibliography References Part VI: Special Clinical Considerations for Gastrointestinal Cancer Patients Chapter 52: Nutritional Needs for Gastrointestinal Cancer Patients Nutrition Nutrient Absorption Colorectal Cancer Gastric Cancer Summary References Chapter 53: Palliative Care for Gastrointestinal Cancer Patients Palliative Care Hospice Communication Advance Care Planning Eol Care Symptom Management Pearls References Chapter 54: Care for Elderly Gastrointestinal Cancer Patients Introduction Assessing the Older Patient with Cancer Incorporating Assessments into Oncologic Practice Older Adult Specific Gi Trials Clinical Approach to the Older Adult Patient with a Gi Malignancy Conclusion References Chapter 55: Survivorship Care for Gastrointestinal Cancer Patients Background on Survivorship Postsurgical Issues Post-rt Issues Postchemotherapy Issues Life After Cancer Conclusion References Index

Handbook of Gastrointestinal Cancers is a practical guide to the management of colorectal, pancreatic, hepatocellular, gastric, and esophageal cancers as well as other cancers of the upper and lower gastrointestinal tract. Edited by a multidisciplinary group of oncologists from leading institutions, this book is an essential day-to-day reference for evidence-based treatment and patient care. The handbook focuses on treatment strategies and approaches to cancerous gastrointestinal tumors that are transforming the recent oncological landscape, including expert-given guidance on methods such as neoadjuvant and adjuvant chemotherapy, surgical transplant, radiation therapy, molecular diagnostic testing leading to molecularly targeted therapy, and immunotherapy.

With so many advances in the current field, it is increasingly difficult for early-career practitioners to grasp the entirety of practices and for seasoned oncologists to keep up with newly approved therapies, side effects to treatments, and special clinical management considerations, but this handbook addresses it all. Organized by major gastrointestinal disease sites and featuring “How I Treat” case vignettes from world experts for common and uncommon management considerations, the handbook brings an experience-based perspective to these tough-to-treat areas. The treatment strategies and applications set forth in the chapters are pertinent to situations and decision-making encountered in practice. Handbook of Gastrointestinal Cancers is a valuable resource for medical oncologists, radiation oncologists, and surgeons treating and managing gastrointestinal cancers as well as trainees in medical, radiation, and surgical oncology programs needing an accessible point of care resource.

KEY FEATURES:

• Provides treatment plans and recommendations for each stage of a range of gastrointestinal cancers, including colorectal, pancreatic, and hepatocellular cancers plus more
• Includes “How I Treat” patient vignettes told from the physician’s point of view within each clinical chapter
• Outlines special considerations for the elderly and for survivors of gastrointestinal cancers
• Highlights important clinical guidance on nutritional and palliative concerns commonly seen in patients with gastrointestinal cancers

Handbook Of Gastrointestinal Cancers Is A Practical Guide To The Management Of Colorectal, Pancreatic, Hepatocellular, Gastric, And Esophageal Cancers As Well As Other Cancers Of The Upper And Lower Gi Tract. Edited By A Multidisciplinary Group Of Oncologists From Leading Institutions, This Book Is An Essential Day-to-day Reference For Evidence-based Treatment And Patient Care. The Handbook Focuses On Treatment Strategies And Approaches To Cancerous Gi Tumors That Are Transforming The Recent Oncological Landscape, Including Expert-given Guidance On Methods Such As Neoadjuvant And Adjuvant Chemotherapy, Surgical Transplant, Radiation Therapy, Molecular Diagnostic Testing Leading To Molecularly Targeted Therapy, And Immunotherapy. With So Many Advances In The Current Field, It Is Increasingly Difficult For Early-career Practitioners To Grasp The Entirety Of Practices And For Seasoned Oncologists To Keep Up With Newly Approved Therapies, Side Effects To Treatments, And Special Clinical Management Considerations, But This Handbook Addresses It All. Organized By Major Gi Disease Sites And Featuring How I Treat Case Vignettes From World Experts For Common And Uncommon Management Considerations, The Handbook Brings An Experience-based Perspective To These Tough-to-treat Areas. The Treatment Strategies And Applications Set Forth In The Chapters Are Pertinent To Clinical Situations And Clinical Decision-making Encountered In Practice. Handbook Of Gastrointestinal Cancers Is A Valuable Resource For Medical Oncologists, Radiation Oncologists, And Surgeons Treating And Managing Gastrointestinal Cancers As Well As Trainees In Medical, Radiation, And Surgical Oncology Programs Needing An Accessible Point Of Care Resource. Key Features: Provides Treatment Plans And Recommendations For Each Stage Of A Range Of Gastrointestinal Cancers, Including Colorectal, Pancreatic, And Hepatocellular Cancers Plus More Includes Patient Vignettes Told From The Physician's Point Of View Within Each Clinical Chapter Outlines Special Considerations For The Elderly And For Survivors Of Gi Cancers Highlights Important Clinical Guidance On Nutritional And Palliative Concerns Commonly Seen In Patients With Gi Cancers __Handbook of Gastrointestinal Cancers__ is a practical guide to the management of colorectal, pancreatic, hepatocellular, gastric, and esophageal cancers as well as other cancers of the upper and lower gastrointestinal tract. Edited by a multidisciplinary group of oncologists from leading institutions, this book is an essential day-to-day reference for evidence-based treatment and patient care. The handbook focuses on treatment strategies and approaches to cancerous gastrointestinal tumors that are transforming the recent oncological landscape, including expert-given guidance on methods such as neoadjuvant and adjuvant chemotherapy, surgical transplant, radiation therapy, molecular diagnostic testing leading to molecularly targeted therapy, and immunotherapy. **KEY FEATURES:**