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EUROPEAN SOCIETY OF SURGICAL ONCOLOGY
U. Veronesi (Editor-in-Chief) Surgical Oncology A European Handbook B. Arnesj0, I. Burn, L. Denis and F. Mazzeo (Co-Editors) Foreword by I. Burn With 222 Figures and 227 Tables Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong
Professor Dr. UMBERW VERONESI Direttore Generale Istituto Nazionale per 10 Studio e la Cura dei Tumori Via Venezian, 1, 20133 Milano, Italy Professor Dr. Bo ARNESJ0 Department of Surgery, Haukeland University Hospital University of Bergen 5021 Bergen, Norway Professor Dr. IAN BURN Charing Cross Hospital Fulham Palace Road London W6 8RF, United Kingdom Professor Dr. LOUIS DENIS Department of Urology A. Z. Middelheim, Vrue Universiteit Brussel Lindendreef 1, 2020 Antwerpen, Belgium Professor Dr. FRANCESCO MAZZEO Universita di Napoli Cattedra di Chirurgia Generale, II facolta' Via Pansini, 5, 80131 Napoli, Italy Editorial Secretariat Scientific Secretaries: Dr. Vittorio Quagliuolo, Dr. Alberto Azzarelli Editorial Secretary: Ms. Sheila McGrath ISBN-13:978-3-642-72648-4 e-ISBN-13:978-3-642-72646-0 DOl: 10.1007/978-3-642-72646-0 Library of Congress Cataloging-in-Publication Data Surgical oncology: a European handbook / U. Veronesi (editor-in-chief) ; B. Arnesjo ... let al.], co-editors. p. cm. Includes bibliographies and index. ISBN-13:978-3-642-72648-4 (U.S.):l.Cancer-Surgery- Handbooks, manuals, etc. I. Veronesi, Umberto. II. Arnesjo, B. (Bo) [DNLM: 1. Neoplasms - surgery. QZ 268 S96113] RD651.S933 1989 616.99'4059 - dc20 DNLM/DLC for Library of Congress This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its version of June 24, 1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1989 Softcover reprint of the hardcover 1st edition 1989 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 2123/3145-543210 - Printed on acid-free paper
Foreword
The concept of the surgical oncologist is a strange one. Surgeons are a special
breed of human beings, whose work requires a degree of pragmatism which is
almost unique. Cancer would seem to be altogether too diffuse a subject to con-
tain within the usual surgical boundaries and almost foreign to the traditional
precision of surgical thinking. And yet, the responsibility for initial diagnosis and
primary management of the vast majority of patients with malignant disease has
always been vested in the surgeon.
For some forms of cancer, there is reason to be fairly satisfied with what has
been achieved. Apart from the natural distaste of anyone to submit him- or her-
self to the surgeon's knife, there would seem to be little cause to seek a change
of therapy. Why change a winning horse? It is true that for other forms of malig-
nant disease, however, surgical endeavour has seen little reward in terms of cure
of the disease. The analysis of such results, about which the literature is volumi-
nous, frequently shows that ultimate failure is due to the advanced stage of the
cancer at the time of first diagnosis, rather than to an integral fault of the proce-
dure. In other words, given an earlier cancer, the same procedure will effect cure.
But perhaps the argument is too facile, certainly for the patient with advanced
cancer. We can never expect that all cancers will be diagnosed early enough for
the surgeon, with his or her present techniques, to cure the majority. Patients
will continue to present to the doctor with varying stages of malignant disease.
The therapist must adapt to allow for this.
Here then lies the challenge for the surgical oncologist. Patients with cancer
need to be studied before vital decisions on therapy are made. This study will be
possible only if there is complete familiarity with the natural history of the dis-
ease and with the true potential of all available methods of treatment. Above all,
knowledge must incorporate the disadvantages of these methods so as to ensure
that the situation is not made worse.
Where is the knowledge to come from to enable surgeons to be more com-
pletely equipped to deal with cancer in the modem era? The "surgical oncolo-
gist" may be defined as a trained surgeon with a committed interest in the study
of cancer and in the care of patients with malignant disease. Such individuals
must have the opportunity and facilities to study cancer, and this is going to re-
quire some radical re-thinking in the corridors of surgical power.
Hopefully those responsible for surgical decision-making throughout the
world will recognise the need for surgical oncology and will support the concept
in a positive way. Trainee surgeons with a declared interest in the topic must be
given the encouragement and support to pursue their interest. Their educational
needs must be provided. Posts must be created in hospitals and institutes within
which the surgical oncologists can ply their trade alongside other specialist on-
cologists. To date, this has happened only to a small degree in a few enlightened
areas in the world.VI Foreword
Fortunately, there have been some positive moves on behalf of surgical onco-
logy, which have at least made a start in the creation of educational facilities.
Notable has been the emergence of a number of surgical oncology societies and
journals. Some of these are now well established and provide a continuing excit-
ing forum for debate and the exchange of information. Also, the last few years
have seen the production of a number of text books on surgical oncology, which
will undoubtedly help to foster interest in the subject.
The European Handbook of Surgical Oncology was spawned out of discus-
sions which took place between members of the European Society of Surgical
Oncology shortly after its formation 5 years ago. The book contains contribu-
tions from oncologists from all over Europe. It is truly comprehensive in its ap-
proach to the subject. To practise cancer surgery confidently requires a depth of
knowledge about the disease which goes far beyond the simple attributes of
diagnosis and dissection. This book provides that knowledge, donated by some
of the most experienced oncologists of this century. It is also, notably, an interna-
tional effort, which is the only logical way to deal with a disease which is a mas-
sive threat to the whole human race.
IAN BURN
President, European
Society of Surgical OncologyTable of Contents Introduction: The Role of Surgery in Cancer Treatment (U. VERONESI) . . .. 1 Biology of Cancer. . . . . . . . . . . . . . . . 7 The Cancer Cell (N. S. E. SARGENT and M. M. BURGER) 9 Biology of Cancer Invasion and Metastasis (P. SmAuLI) 20 Cancer Epidemiology (c. S. MUIR and M.-C. GRAN) . . . 31 Detection and Diagnosis . 45 Cancer Staging (I. BESZNYAK) . . . . . . . . . . . . . . . . . . . . . . . 47 Cancer Detection and Screening: High-Risk Groups (D. M. PARKIN) . . 55 A Modern View of Histopathological Diagnosis and Classification of Cancer (F. RILKE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Modern Imaging Techniques in Diagnosis Staging and Follow-up of Cancer (P. HAEHNEL, M. DREYFUS, and D. JAECK) . . . . . . . . . . . . . . . . . .. 84 Endoscopy in the Diagnosis and Treatment of Cancer (P. SPINELLI) . . . .. 97 Monoclonal Antibodies in the Diagnosis and Management of Colorectal Carcinomas (J. P. MACH, F. BUCHEGGER, J. PETIA VEL, A. BISCHOF-DELALOYE, and B. DELALOYE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 General Concepts in Cancer Treatment . . . . . . . . . . 121 Principles of Surgery in the Primary Treatment of Cancer (I. BURN) . . . . . 123 Surgery in the Treatment of Recurrent and Metastatic Cancer (J. PETIAVEL, 1. COSTA, P. DOUGLAS, A. BESSON, M. SAVARY, and N. DE TRIBOLET) 131 Irradiation in Cancer Treatment (M. TuBIANA) . . . . . . . . . . . . . . . 142 Intraoperative Radiotherapy (H. J. HOEKsmA and F. A. CALVO) . . . . . . 150 The Biologic Basis of Cancer Chemotherapy (M. BROWER and D. CARNEY) 162 Chemotherapy in Cancer Treatment (E. BOVEN and H. M. PINEDO) .. 174 Liver Infusion Chemotherapy (P. SCHLAG and C. HERFARTH) . . . . . . 188 Adjuvant Systemic Therapy (G. BONADONNA, F. FOSSATI-BELLANI, and P. VALAGUSSA) . . . . . . . . . . . . . . . . . 200 Hormones in Cancer Treatment (F. CAVALLI) . . . . . . . . . . . . . . 218
VIII Table of Contents Immunotherapy of Cancer (P. ROMKE) . . . . . . . . . . . . . . . . . . .. 228 Transplantation and Cancer (H. PICHLMAIER and R GRUND MANN) . . . . .. 237 Wound Healing and Cancer (B. ZEDERFELDT, P. BLOMQUIST, H. JIBORN, and P. UDEN) . . . . . . . . . . . . . . . . . . . . . . . . . . . 246 Nutrition and Cancer (L. L. MOLDAWER and T. SCHERSTEN) . 254 Infection in Cancer Patients (P. DEJACE and J. KLASTERSKY) 260 Psychological Aspects of Surgical Oncology (P. MAGUIRE) 272 Pain Treatment in Cancer (Y. VENTAFRIDDA and A. SBANOTfO) 282 Terminal Care (R TwYCROSS) . . . . . . . . . . . . . . . . . 296 Emergencies in Cancer Disease . . . . . . . . . . . . . . . . . . . . 307 Increased Intracranial Pressure and Spinal Cord Compression (E.-O. BACKLUND) . . . . . . . . . . . . . . . . . . . . . . 309 Vascular Emergencies (D. BERGQVIST and S.-E. BERGENlZ) . . . . 315 Metabolic Disorders (K. LUNDHOLM) . . . . . . . . . . . . . . . 320 Haemorrhage, Obstruction, Perforation, and Infection in Head and Neck Cancer (I. A. McGREGOR) . . . . . . . . . . . . . . . . . . . . . . . . . .. 327 Obstruction, Perforation, Infection, and Haemorrhage in Thoracic Cancer (T. M. SCHEININ and P. J. ROBERTS) . . . . . . . . . . . . . . . . . . . . . .. 331 Emergencies in Gastrointestinal Cancer (G. WILLEMS) . . . . . . . . . . .. 337 Obstruction, Perforation, Inflammation, and Haemorrhage in Urological Cancer (RRHALL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 341 Hemorrhage, Obstruction, Perforation, and Inflammation in Gynecological Cancer (w. H. MATTHEIEM). . . . . . . . . . . . . . . . . . . . . . . . . 345 Early and Late Complications of Oncological Treatment (G. C. DAVIES) ... 348 Rehabilitation Procedures . . . . . . . . . . . . . . . . . . . . . . . 363 Plastic and Reconstructive Surgery in Breast Cancer Patients (H. BOHMERT) . 365 Microsurgical Reconstruction of Large Defects after Tumor Surgery in the Head and Neck Region (RG.H.BAUMEISTER and H.BOHMERT) . . . . . . . . 383 Orthopaedic Procedures in the Rehabilitation of Cancer Patients (R KOlZ and A. AZZARELLI) . . . . . . . . . . . . . . 386 Stoma Construction and Care (L. HULTEN) . . . . . . . . . . . . . . . . . . . 399 Planning and Evaluation of Cancer Treatment 413 Regional Treatment Programmes and Cancer Registration (T. R MOLLER and T. LANDBERG). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415 Follow-up of Surgical Cancer Patients (H. WHITE and M. C. PARKER) . . . 424 Clinical Trials (M. STAQUET) . . . . . . . . . . . . . . . . . . . . . . . . . 446 Statistical Analysis of Survival and Disease Recurrence Data (M. BUYSE) 451 Measurement of Quality of Life in Cancer Research (N. K. AARONSON and F.CALAISDASILVA) . . . . . . . . . . . . . . . . . . . . . . . . . . 458 Controlled Clinical Trials 1988: Ethical Considerations (H. TAGNoN) . . .. 467
Table of Contents IX Treatment of Cancer of Different Organs . . . 473 Cancer of the Head and Neck Region (G. B. SNOW) . . . . . . . . . . . .. 475 Cancer of the Respiratory Tract, Pleural Cavity, Mediastinum, and Chest Wall (P. GOLDSlRAw) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495 Cancer of the Oesophagus (R. GIULi) . . . . . . . . . . . . . . . . . . . . 514 Cancer of the Cardia: Extended Esophagogastrectomy (E. M. GONZALEZ, M. GOMEZ, J. M. JOYER, J. CALLEJA, I. LANDA, J. ARIAS, F. ESCUDERO, and I. GARCIA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537 Cancer of the Stomach (F. MAZZEO, N. MOZZILLO and P. FORESllERI) . . . 544 Pancreatic and Periampullar Carcinoma (W. HOHENBERGER, H. ZIRNGIBL and F. P. GALL) . . . . . . . . . . . . . . . . . . . . . . . . . . . 578 Cancer of the Liver (0. J. GARDEN and H. BISMUlH) . . . . . 622 Cancer of the Biliary Tract (0. S0REIDE and L. H. BLUMGART) 636 Small Bowel Cancer (U. METZGER) . . . . . . . . . . . . . . 653 Cancer of the Colon and Rectum (B. ARNESJ0, J. F. HALVORSEN and AO.MYKING) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 657 Tumours of the Anal Region 0. M. A NORlHOYER and J. P. S. THOMSON) . 675 Cancer of the Kidneys (w. VAHLENSIECK and N.JAEGER) . . . . . . . . . 683 Cancers of the Urinary Bladder, Ureters and Urethra (L. DENIS, R. HALL and G. JAKSE) . . . . . . . . . . . . . . . . . . . . 705 Carcinoma of the Prostate (F. H. SCHROEDER) 720 Carcinoma of the Penis 0. P. BLANDY) . . . . 746 Cancer of the Testis (G. PIZZOCARO) . . . . . 756 Cancer of the Ovary (F. DI RE and R. FONTANELLI) 768 Cancer of the Uterus 0. P. WOLFF) . . . . . . . . 783 Primary Adult Vaginal Cancer (G. MICHEL and A GERBAULET) . 809 Cancer of the Vulva (G. MICHEL and A GERBAULET) . . . . . . 817 Cancer of the Breast (U. VERONESI, A COSTA and P. VERONESI) 827 Thyroid and Parathyroid Carcinoma (P.-O. GRANBERG, M. BACKDAHL, B. CEDER MARK, B. HAMBERGER, G. LUNDELL, T. LbWHAGEN, and G. WALLIN) 879 Gastrointestinal and Adrenal Tumours (F. STADIL and H. KEHLET) . 897 Melanoma of the Skin (N. CASCINELLI and C. CLEMENTE) . 90 0 Cancer in Childhood-Solid Tumours 0. PLASCHKES) 930 Soft-Tissue Sarcomas (A KULAKOWSKI) . . . . . . . 955 Bone Sarcomas (N. TRAPEZNIKOV) . . . . . . . . . 962 Surgery in Hematologic Malignancies (K. SOLHEIM) 970 Metastatic Cancer from Unknown Primary Site (K. LOTE) . 976 Subject Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 985
List of Contributors
AARONSON, N. K. BERGQVIST, D.
E. O. R. T. C. Study Group Department of Surgery
on Quality of Life University of Lund
The Netherlands Cancer Institute General Hospital
Plesmanlaan 121 Malmo, Sweden
1066 CX Amsterdam, The Netherlands
BESSON, A.
ARIAS, J. Facuite de Medecine
Instituto Nacional de la Salud Service de Chirurgie A du CHUV
Servicio de Chirurgia de 1011 Lausanne, Switzerland
Aparato Digestivo II
Hospital 1. Octubre BESZNYAK, 1.
Carretera de Andalucia, km 5 National Cancer Institute
28041 Madrid, Spain Department of Surgery
1125 Rath Gy. u. 7-9
ARNESJ0, B. Budapest, Hungary
Department of Surgery
Haukeland University Hospital BISCHOF-DELALOYE, A.
5021 Bergen, Norway CHUV
Division of Nuclear Medicine
BACKLUND, E. O. 1011 Lausanne, Switzerland
Department of Neurosurgery
University of Bergen BISMUTH, H.
Haukeland Hospital Unite de Chirurgie Hepato-Biliaire
5016 Bergen, Norway Hopital Paul Brousse
94800 Villejuif, France
BA-CKDAHL, M.
BLANDY, J. P.
Karolinska Hospital
The London Hospital Medical College
10401 Stockholm 60, Sweden
Turner Street
London E1 2AD, UK
BAUMEISTER, R. G. H.
Abteilung Plastische Chirurgie der BLOMQUIST, P.
Chirurgischen Klinik und Poliklinik Malmo General Hospital
Klinikum Grosshadern Department of Surgery
Marchioninistrasse 15 University of Lund
8000 Munchen 70, FRG 21401 Malmo, Sweden
BERGENTZ, S.-E. BLUMGART, 1. H.
Department of Surgery Klinik fUr Viszerale und
University of Lund Transplantationschirurgie
General Hospital Inselspital
Malmo, Sweden 3010 Bern, SwitzerlandXII List of Contributors
BOHMERT, H. CALVO, F.A.
Abt. Plastische Chirurgie der Department of Oncology
Chirurgischen Klinik und Poliklinik University Clinic Navarra
Klinikum Grosshadem Apartado 192
Marchioninistrasse 15 31080 Pamplona, Spain
8000 Miinchen 70, FRG
CARNEY, D.N.
BONADONNA, G. Mater Misericordiae Hospital
Istituto Nazionale per 10 Dublin 7, Ireland
Studio e la Cura dei Tumori
Divisione Oncologia Medica
CASCINELLI, N.
Via Venezian, 1
Istituto Nazionale per 10
20133 Milano, Italy
Studio e la Cura dei Tumori
BOVEN, E. Divisione Oncologia Chirurgia B
Free University Hospital Via G. Venezian, 1
Department of Oncology 20133 Milano, Italy
De Boelelaan 1117
1081 HV Amsterdam, The Netherlands CAVALLI, F.
Ospedale San Giovanni
BROWER, M.
Oncologia Medica
University of Rochester Cancer Center
6500 Bellinzona, Switzerland
Rochester General Hospital
Department of Oncology
1425 Portland Avenue CEDERMARK, B.
Rochester, NY 14621, USA Karolinska Hospital
10401 Stockholm, Sweden
BUCHEGGER, F.
Biochemistry Institute CLEMENTE, C.
University of Lausanne Istituto Nazionale per 10
1066 Epalinges, Switzerland Studio e la Cura dei Tumori
BURGER, M.M.
Divisione Anatomia Patologica
Friedrich-Miescher-Institut Via G. Venezian, 1
Postfach 2543 20133 Milano, Italy
4002 Basel, Switzerland
COSTA, A.
BURN, I. Istituto Nazionale per 10
Charing Cross Hospital Studio e la Cura dei Tumori
Fulham Palace Road Divisione Oncologia Chirurgia C
London W6 8RF, U.K. Via G. Venezian, 1
BUYSE, M. 20133 Milano, Italy
E. o. R. T. C. Data Center
Boulevard de Waterloo, 125 COSTA, J.
1000 Bruxelles, Belgium Faculte de Medecine
Service de Chirurgie A du CHUV
CALAIS DA SILVA, F. 1011 Lausanne, Switzerland
Praceta Bento Moura 2-1 Esq.
Hospital Desterro DAVIES, G.c.
Venda Nova Department of Clinical Surgery
2700 Amadora, Portugal The Royal Infirmary
CALLEJA, J. University of Edinburgh
Instituto Nacional de la Salud Edinburgh EH3 9YW, UK
Servicio de Chirurgia de
Aparato Digestivo II DE TRIBOLET, N.
Hospital 1. Octubre Faculte de Medecine
Carretera de Andalucia, km 5 Service de Chirurgie A du CHUV
28041 Madrid, Spain 1011 Lausanne, SwitzerlandList of Contributors XIII
DEJACE, P. FORESTIERI, P.
Section of Infectious Diseases Cattedra di Chirurgia Generale
Department of Medicine II Divisione di Chirurgia
Tulane University Medical School II Facolta', Universita' di Napoli
1430 Tulane Avenue Via S. Pansini, 5
New Orleans, LA 70112, USA 80131 Napoli, Italy
FOSSATI-BELLANI, F.
DELALOYE, B.
Istituto Nazionale per 10
CHUV
Studio e la Cura dei Tumori
Division of Nuclear Medicine
Divisione Oncologia Medica Pediatrica
1011 Lausanne, Switzerland
Via Venezian, 1
20133 Milano, Italy
DENIS, L.
Department of Urology GALL, F.P.
A. Z. Middelheim Chirurgische Klinik mit Polikiinik
Vrue Universiteit Brussel Universitat Erlangen-Niirnberg
Lindendreef 1 Maximiliansplatz
2020 Antwerpen, Belgium 8520 Erlangen, FRG
DIRE, F. GARCIA, I.
Istituto Nazionale per 10 Instituto Nacional de la Salud
Studio e la Cura dei Tumori Servicio de Chirurgia de
Divisione Oncologia Chirurgica Aparato Digestivo II
Ginecologia Hospital 1. Octubre
Via G. Venezian, 1 Carretera de Andalucia, km 5
20133 Milano, Italy 28041 Madrid, Spain
GARDEN, O. J.
DOUGLAS, P. Department of Surgery
Facuite de Medecine University of Edinburgh
Service de Chirurgie A du CHUV Royal Infirmary
1011 Lausanne, Switzerland Edinburgh EH 3 9YW, UK
DREYFUS, M. GERBAULET, A.
Service de Chirurgie Institut Gustave Roussy
Generale et Endocrinienne Rue Camille Desmoulins
Hopital Universitaire de Hautepierre 94805 Villejuif Cedex, France
67098 Strasbourg Cedex, France
GIULi, R.
Service de Chirurgie Digestive
ESCUDERO, F.
Hopital Beaujon
Instituto Nacional de la Salud
92110 Clichy-Paris, France
Servicio de Chirurgia de
Aparato Digestivo II
GOLDS'IRAW, P.
Hospital 1. Octubre Brompton Hospital
Carretera de Andalucia, km 5 Fulham Road
28041 Madrid, Spain London SW3 6HP, UK
FONTANELLI, R. GOMEZ, M.
Istituto Nazionale per 10 Instituto Nacional de la Salud
Studio e la Cura dei Tumori Servicio de Chirurgia de
Divisione Oncologia Chirurgica Aparato Digestivo II
Ginecologia Hospital 1. Octubre
Via G. Venezian, 1 Carretera de Andalucia, km 5
20133 Milano, Italy 28041 Madrid, SpainXIV List of Contributors
GONZALEZ, E. M. HOEKSlRA, H.J.
Instituto Nacional de la Salud Division of Surgical Oncology
Servicio de Chirurgia de Department of Surgery
Aparato Digestivo II Groningen University Hospital
Hospital 1. Octubre P. O. Box 30001
Carretera de Andalucia, km 5 9700 RB Groningen, The Netherlands
28041 Madrid, Spain
HOHENBERGER, W
GRAN, M.e. Chirurgische Klinik mit Poliklinik
International Agency for Universitat Erlangen-Nurnberg
Research on Cancer Maximiliansplatz
Descriptive Epidemiology 8520 Erlangen, FRG
150, Cours Albert Thomas
69372 Lyon Cedex 08, France
HULTEN, L.
GRANBERG, P.-O. University of Goteborg
Department of Surgery Department of Surgery II
Karolinska Hospital Sahlgrenska sjukhuset
10401 Stockholm, Sweden 41345 Goteborg, Sweden
GRUNDMANN, R. JAECK, D.
Chirurgische Universitatsklinik Service de Chirurgie Generale et Endo-
Joseph-Stelzmann-Strasse 9 crinienne
5000 KOin 41, FRG Hopital Universitaire de Hautepierre
67098 Strasbourg Cedex, France
HAEHNEL, P.
Service de Chirurgie
JAEGER, N.
Gimerale et Endocrinienne
University Urological Clinic
Hopital Universitaire de Hautepierre
Sigmund-Freud-Strasse 25
67098 Strasbourg Cedex, France
5300 Bonn, FRG
HAEMMERLI, G.
Institut fur Pathologie JAKSE, G.
Aussenstation Universitat Zurich Department of Urology
Birchstrasse, 95 Technische Universitat
8050 Zurich 8000 Munchen, FRG
HALL, R.R. JIBORN, H.
Department of Urology Malmo General Hospital
Freeman Hospital Department of Surgery
Freeman Road, High Heaton University of Lund
Newcastle upon Tyne NE7 7DN, UK 21401 Malmo, Sweden
HALVORSEN, J.F.
JOVER, J. M.
Department of Surgery Instituto Nacional de la Salud
Haukeland University Hospital Servicio de Chirurgia de
5021 Bergen, Norway Aparato Digestivo II
Hospital 1. Octubre
HAMBERGER, B.
Carretera de Andalucia, km 5
Karolinska Hospital
28041 Madrid, Spain
10401 Stockholm 60, Sweden
HERFARlH, C. KEHLET, H.
Chirurgische Universitatsklinik Surgical Department
Abteilung fur Onkologie Rigshospitalet
1m Neuenheimer Feld 110 Afd. C 2122, Blegdamsvej 9
6900 Heidelberg, FRG 2100 Copenhagen, DenmarkList of Contributors XV
KLASTERSKY, J. MACH, J.P.
Service de Medecine et Biochemistry Institute
Laboratoire d'lnvestigation University of Lausanne
Clinique H. J. Tagnon, Institut Jules 1066 Epalinges, Switzerland
Bordet
Centre des Tumeurs de l'Universite Libre MAGUIRE, P.
de Bruxelles Department of Psychiatry
1 Rue Heger-Bordet Withington Hospital
1000 Bruxelles, Belgium West Didsbury
Manchester M20 8LR, UK
K01Z, R.
Allgemeines Krankenhaus der Stadt Wien MATIHEIEM, W H.
Orthopadische Universitatsklinik Head, Breast & Pelvic Surgical Clinic
9, Garnisongasse 13 Surgical Oncology
1090 Wien, Austria Free University of Brussels
Institut Jules Bordet
KULAKOWSKI, A. Bruxelles, Belgium
Instytut Onkologii
im. Marii Sklodowskiej-Curie MAZZEO, F.
ul. Wawelska 15 Universita' di Napoli
00-973 Warszawa, Poland Cattedra di Chirurgia Generale
II facolta'
LANDA, I. Via S. Pansini, 5
Instituto Nacional de la Salud 80131 Napoli, Italy
Servicio de Chirurgia de
Aparato Digestivo II MCGREGOR, I. A.
Hospital 1. Octubre West of Scotland Regional Plastic
Carretera de Andalucia, km 5 and Oral Surgery Unit
28041 Madrid, Spain Canniesburn Hospital
Bearsden
LANDBERG, T. Glasgow G61, 1QL, UK
Department of Oncology
Malmo General Hospital METZGER, U.
21401 Malmo, Sweden Surgical Oncology
Department of Surgery
LbWHAGEN, T. University Hospital Zi.irich
Karolinska Hospital 8091 Zi.irich, Switzerland
10401 Stockholm 60, Sweden
MICHEL, G.
LOTE, K. Institut Gustave Roussy
Department of Oncology Rue Camille Desmoulins
Haukeland Sykehus 94805 Villejuif Cedex, France
Postboks 1
5016 Haukeland, Norway MbLLER, T. R.
Department of Oncology and Southern
LUNDELL, G. Swedish Regional Tumor Registry
Karolinska Hospital University Hospital
10401 Stockholm 60, Sweden 22185 Lund, Sweden
LUNDHOLM, K. MOLDA WER, L. L.
University of Goteborg Department of Surgery I
Department of Surgery I Sahlgrenska sjukhuset
Sahlgrenska sjukhuset University of Goteborg
41345 Goteborg, Sweden 41345 Goteborg, SwedenXVI List of Contributors
MOZZILLO, N. PLASCHKES, J.
Cattedra di Chirurgia Generale Department of Pediatric Surgery
II Divisione di Chirurgia University Children's Hospital
II facolta', Universita' di Napoli Inselspital, Freiburgstrasse
Via S. Pansini, 5 3010 Bern, Switzerland
80131 Napoli, Italy
RILKE, F.
MUIR, C.S.
Istituto Nazionale per 10
International Agency for
Studio e la Cura dei Tumori
Research on Cancer
Divisione Anatomia Pathologica
Descriptive Epidemiology
150, Cours Albert Thomas Via G. Venezian, 1
20133 Milano, Italy
69372 Lyon Cedex 08, France
MYKING, A. O. ROBERTS, P. J.
Department of Pathology IV Department of Surgery
Gades Institute University of Helsinki
Haukeland University Hospital Kaserngatan 11-13
5021 Bergen, Norway 00130 Helsinki 13, Finland
NOR1HOVER, J. M. A.
Imperial Cancer Research Fund ROMKE, P.
Colorectal Cancer Unit The Netherlands Cancer Institute
St. Mark's Hospital Antoni van Leeuwenhoek Huis
City Road Immunology and Internal Medicine
London, ECIV 2PS, UK Plesmanlaan 121
1066 CX Amsterdam, The Netherlands
PARKER, M. C.
95, Harley Street SARGENT, N. S. E.
London WIN IOF, UK Friedrich-Miescher-Institut
PARKIN, D.M. Postfach 2543
International Agency for 4002 Basel, Switzerland
Research on Cancer
150, Cours Albert Thomas SAVARY, M.
69372 Lyon Cedex 08, France Faculte de Medecine
Service de Chirurgie A du CHUV
PElTAVEL, J. 1011 Lausanne, Switzerland
Faculte de Medecine
Service de Chirurgie A du CHUV
SBANOlTO, A.
1011 Lausanne, Switzerland
Istituto Nazionale per 10
PICHLMAIER, H. Studio e la Cura dei Tumori
Chirurgische Universitatsklinik Divisione di Terapia del Dolore e Cure
Joseph-Stelzmann-Strasse 9 Palliative
5000 Koln 41, FRG Via Venezian, 1
20133 Milano, Italy
PINEDO, H. M.
Free University Hospital SCHEININ, T. M.
Department of Oncology
IV Department of Surgery
De Boelelaan 1117 University of Helsinki
1081 HV Amsterdam, The Netherlands
Kaserngatan 11-13
PIZZOCARO, G. 00130 Helsinki 13, Finland
Istituto Nazionale per 10
Studio e la Cura dei Tumori SCHERSTEN, T.
Divisione di Oncologia Chirurgica Department of Surgery I
Urologica Sahlgrenska sjukhuset
Via G. Venezian, 1 University of Goteborg
20133 Milano, Italy 41345 Goteborg, SwedenList of Contributors XVII
SCHLAG, P. TAGNON, H.J.
Chirurgische Universitiitsklinik University of Brussels
Abteilung fiir Onkologie Institut Jules Bordet
1m Neuenheimer Feld 110 Boulevard de Waterloo, 125
6900 Heidelberg, FRG 1000 Bruxelles, Belgium
SCHRODER, F.H. THOMSON, J.P.S.
Erasmus University Hospital Imperial Cancer Research Fund
P. O. Box 1738 Colorectal Cancer Unit
3000 DR Rotterdam, The Netherlands St. Mark's Hospital
City Road
SNOW, G.B. London, ECIV 2PS, UK
Department of Otolaryngology/
Head and Neck Surgery TRAPEZNIKOV, N.N.
Free University Hospital Institute of Experimental & Clinical
De Boelelaan 1117 Oncology
1081 HV Amsterdam, The Netherlands USSR Academy of Medical Sciences
Kashirskoye shosse, 6
SOLHEIM, K. M-115478 Moscow, U.S.S.R.
Surgical Department
University of Oslo TuBiANA, M.
Ulleval Hospital Institut Gustave Roussy
Kirkeveien 166 Rue Camille Desmoulins
0407 Oslo 4, Norway 94805 Villejuif Cedex, France
S0REIDE, O. TwYCROSS, R.
Department of Surgery Sir Michael Sobell House
National Hospital Churchill Hospital
University of Oslo Headington
Oslo, Norway Oxford OX3 7LJ, UK
SPINELLI, P. UDEN, P.
Istituto Nazionale per 10 Malmo General Hospital
Studio e la Cura dei Tumori Department of Surgery
Divisione di Endoscopia University of Lund
Via G. Venezian, 1 21401 Malmo, Sweden
20133 Milano, Italy
VAHLENSIECK, W.
STADIL, F. University Urological Clinic
Surgical Department Sigmund-Freud-Strasse 25
Rigshospitalet 5300 Bonn, FRG
Afd. C 2122, Blegdamsvej 9
2100 Copenhagen, Denmark V ALAGUSSA, P.
Istituto Nazionale per 10
STAQUET, M. Studio e la Cura dei Tumori
E. O. R. T. C. Data Center Via Venezian, 1
Boulevard de Waterloo, 125 20133 Milano, Italy
1000 Bruxelles, Belgium
VENTAFRIDDA, V.
S1RAULI, P. Istituto Nazionale per 10
Institut fiir Pathologie Studio e la Cura dei Tumori
Abteilung fiir Krebsforschung Divisione di Terapia del Dolore e Cure
Aussenstation Universitiit Ziirich Palliative
Birchstrasse 95 Via Venezian, 1
8050 Ziirich, Switzerland 20133 Milano, ItalyXVIII List of Contributors
VERONESI, P. WILLEMS, G.
Divisione di Chirurgia II Department of Heelkunde
Ospedale San Raffaele Akademisch Ziekenhuis V U. S.
Via Olgettnia, 60 Laarbeeklaan 101
20090 Segrate (Mi), Italy 1090 Bruxelles, Belgium
WOLFF, J.P.
VERONESI, U. Service de Gynecologie
Direttore Generale Institut Gustave Roussy
Istituto Nazionale per 10 Rue Camille Desmoulins
Studio e la Cura dei Tumori 94805 Villejuif Cedex, France
Via Venezian, 1
20133 Milano, Italy ZEDERFELDT, B.
Malmo General Hospital
Department of Surgery
WALLIN, G. University of Lund
Karolinska Hospital 21401 Malmo, Sweden
10401 Stockholm 60, Sweden
ZIRNGIBL, H.
Chirurgische Klinik mit Poliklinik
WHITE, H. UniversiHit Erlangen-Niimberg
95, Harley Street Maximiliansplatz
London WIN IDF, UK 8520 Erlangen, FRGYou can also read
