The Surgery of Childhood Tumors

THE SURGERY OF CHILDHOOD TUMORS. Edited by Robert Carachi, Amir F. Azmy and Jay L. Grosfeld. 495 pp. Illust. Arnold, London, UK; Oxford University Press Canada, Toronto. 1999. Can$432. ISBN 0-340-69269-3

Very few textbooks are devoted exclusively to the rapidly developing field of pediatric surgical oncology, so this additional reference work is welcome. This comprehensive textbook is different from previous works because of the international flavour brought by the 30 contributors from Europe, the United Kingdom and the United States who are all respected world experts in their field. This international contribution is the strength of the book. It stands out as providing the up-to-date worldwide treatment options for cancer in childhood. Proto cols and approaches from both the European and North American schools are discussed at length.

The book consists of 3 sections. The first covers the epidemiology of cancer, tumour biology and cytogenetics, tumour markers, imaging, general pathological features, and chemotherapy, radiotherapy and immunotherapy. A good overview of the worldwide epidemiologic characteristics of childhood cancer is provided in the first chapter. A chapter on genetic counselling provides a clear, concise, easy-to-read summary, which is helpful to all clinicians who treat children with cancer. Too much information is included, in my opinion, on screening for tumours, which makes it difficult to determine the role and usefulness of markers for diagnosis and prognosis. The chapter on tumour pathology is well illustrated and provides an excellent synopsis. Overall, this section on the scientific basis of tumours is well documented and easily understood by all clinicians.

The second part includes 7 chapters covering tumours encountered in the neonatal period, neuroblastoma and nephroblastoma, liver tumours, malignant germ-cell tumours, softtissue sarcoma and lymphoma. The chapters on Wilms’ tumours and neuroblastomas are excellent and extremely well referenced. However, the section on other adrenal tumours could have been more comprehensive. Malignant germ-cell tumours are commonly encountered in busy pediatric surgical services, and this subject could have been covered in more depth. This chapter was the most disappointing for me. The up-to-date treatment of lymphoma was well described, especially the role of surgery.

The next section contains chapters on bone tumours and limb salvage, head and neck tumours, brain and thoracic tumours. Also included in this section are chapters on rare tumours, reconstructive surgery and surgical complications. Finally, counselling and supportive care are discussed. A useful international list of parents’ associations and support groups closes the book.

The book is well illustrated with multiple colour figures that are pertinent to the text. Another strength of the book is the coverage of technical details of surgical procedures. Moreover every chapter is extensively referenced.

Like all pediatric surgical texts this one is expensive, and this probably constitutes the only serious drawback to the purchase of this book. Some typographical errors have slipped by and I did find a few minor mistakes, but these are probably explained by the fact that this is a first edition and the errors will likely be corrected in any subsequent edition.

I recommend this book to all clinicians who treat children with tumours. It provides a global and detailed view of the treatment of childhood cancers that will be useful to all members of a multidisciplinary team caring for such children.