Earl A. Surwit – Författare

Where do you begin to look for a recent, authoritative article on the diag­ nosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals fre­ quently publish good in-depth reviews of cancer topics, and published sym­ posium lectures are often the best overviews available. Unfortunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes which aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, revised frequently to keep the coverage up to date, easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion. First, by di­ viding the oncology literature into specific subdivisions such as lung cancer, genitourinary cancer, pediatric oncology, etc. Second, by asking eminent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diagnosis, staging, markers, all forms of treatment modalities, basic biology, and more.

Cytological screening for the identification of intraepithelial neoplasia of the cervix as a precursor lesion for cervical cancer has been well established as an effective means for decreasing the incidence of invasive carcinoma. Despite these screening efforts, carcinoma of the cervix remains one of the more common malignancies in women and it is the leading cause of cancer death in many countries in the western hemisphere. It is estimated that in 1986 there will still be 14,000 new cases of invasive cancer, with 6,800 deaths in the United States alone. Unfortunately, many of these patients present with advanced disease, posing difficult management problems for the clinician responsible for their care. The treatment of early stage invasive carcinoma of the cervix (lesions confined to the cervix and vagina) remains either radical surgery, radical radiation therapy or a combination thereof This approach is extraordinarily effective in the vast majority of patients. However, there remains a subset of patients with early stage disease that are at high risk for recurrence. Dr Kjorstad (Chapter 2) has identified adenocarcinomas and adenosqua­ mous carcinomas as having a particularly poor prognosis. In addition, patients with more than three positive lymph nodes or with involvement of lymph nodes outside of the pelvis have a very poor prognosis. He has iden­ tified the CEA as a potentially predictive marker for these patients with poor prognosis, especially in patients with adenocarcinomas.

The incidence of endometrial cancer rose sharply in the United States in the early 1970s, paralleling changes in the use of postmenopausal estrogens by American women. A sizeable body of evidence supports the role of both excessive endogenous estrogen and exogenous estrogen in the etiology of endometrial cancer. There is growing evidence that inadequate progesterone has the opposite effect, in that progesterone supplementation of postmeno­ pausal estrogen therapy reduces the incidence of endometrial cancer. Despite this new awareness of the hormonal role that is played in carcino­ ma of the endometrium, the disease still plagues the oncologist. The general approach to carcinoma of the endometrium in the United States is that of primary surgical staging. This provides the maximum amount of information to best plan postoperative radiation therapy and/or chemotherapy for these patients. In general, patients who are considered candidates for surgical staging are those with advanced disease or high-risk stage I endometrial carcinoma. High-risk endometrial carcinoma is defined as those patients with moderately differentiated lesions with deep myometrial invasion, poor­ ly differentiated carcinoma of the endometrium, and the high-risk histolo­ gies such as papillary carcinoma and clear-cell carcinomas. The surgical staging has extended in most institutions to patients with occult stage II carcinoma of the endometrium, i. e.

Cytological screening for the identification of intraepithelial neoplasia of the cervix as a precursor lesion for cervical cancer has been well established as an effective means for decreasing the incidence of invasive carcinoma. Despite these screening efforts, carcinoma of the cervix remains one of the more common malignancies in women and it is the leading cause of cancer death in many countries in the western hemisphere. It is estimated that in 1986 there will still be 14,000 new cases of invasive cancer, with 6,800 deaths in the United States alone. Unfortunately, many of these patients present with advanced disease, posing difficult management problems for the clinician responsible for their care. The treatment of early stage invasive carcinoma of the cervix (lesions confined to the cervix and vagina) remains either radical surgery, radical radiation therapy or a combination thereof This approach is extraordinarily effective in the vast majority of patients. However, there remains a subset of patients with early stage disease that are at high risk for recurrence. Dr Kjorstad (Chapter 2) has identified adenocarcinomas and adenosqua­ mous carcinomas as having a particularly poor prognosis. In addition, patients with more than three positive lymph nodes or with involvement of lymph nodes outside of the pelvis have a very poor prognosis. He has iden­ tified the CEA as a potentially predictive marker for these patients with poor prognosis, especially in patients with adenocarcinomas.