Surgical oncology clinics of North America
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The incidence of esophageal adenocarcinoma (EAC) has increased dramatically in the western world, and there also appears to have been an increase in the incidence of Barrett's esophagus and gastroesophageal reflux disease in recent years. The contemporaneous increase in obesity has focused interest on whether obesity is a risk factor for EAC and its precursors. This article reviews current evidence for the role that overweight/obesity and body fat distribution have in development of the esophagitis metaplasia-dysplasia-adenocarcinoma sequence. Particular attention is paid to the stage at which adiposity may act to influence the risk of EAC, because this determines the importance of weight control and weight loss at each stage in the disease spectrum for the prevention of EAC.
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Surg. Oncol. Clin. N. Am. · Jul 2009
ReviewMedical treatment of Barrett's esophagus: can it prevent cancer?
The challenge of the title of this article is attention getting. How can medical therapy prevent cancer if anti-reflux surgery cannot prevent the neoplastic progression of Barrett's esophagus? Can anything short of esophagectomy prevent cancer? In the face of the increasing incidence of adenocarcinoma of the esophagus into the twenty-first century, the medical therapy of Barrett's esophagus and its potential role in preventing cancer are explored.
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Surg. Oncol. Clin. N. Am. · Jan 2009
ReviewThyroid cancer genetics: multiple endocrine neoplasia type 2, non-medullary familial thyroid cancer, and familial syndromes associated with thyroid cancer.
Familial thyroid cancer accounts for 25% of medullary thyroid cancer (MTC) and 5% of non-medullary thyroid cancer. All patients who have familial MTC have one of three variants of multiple endocrine neoplasia type 2 that are defined by specific mutations in the rearranged during transfection (RET) proto-oncogene. ⋯ Thyroid cancer also is associated with a number of familial syndromes. This article focuses on the genetics and management of familial thyroid cancers and the syndromes associated with thyroid cancer.
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Surg. Oncol. Clin. N. Am. · Jan 2009
ReviewManagement of familial melanoma and nonmelanoma skin cancer syndromes.
The clinical manifestations of hereditary skin cancer syndromes depend upon the interplay between environmental and genetic factors. Familial melanoma occurs in the setting of hereditary susceptibility, with a complex phenotype of early age of onset, multiple atypical moles, multiple primary melanomas, multiple melanomas in the family, and in some instances pancreatic cancer. ⋯ Consequently, the surgeon as one of the primary caregivers should be familiar with hereditary skin cancer syndromes and their pathogenesis, diagnosis, management, and surveillance recommendations. This article discusses a practical approach for some of the issues likely encountered by the surgeon in the management of familial melanoma and non-melanoma skin cancer.
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Surg. Oncol. Clin. N. Am. · Jul 2008
ReviewLaparoscopic resection for colorectal cancer: evidence to date.
This article highlights the individual merits and weaknesses of laparoscopic as compared with open surgery as the primary treatment of colorectal cancer. Although results clearly suggest that laparoscopic surgery for colorectal cancer results in an earlier postoperative recovery, it is more difficult to comment on rarer complications. To date, results from laparoscopic colorectal resections suggest that the resected specimen is oncologically comparable that obtained with open surgery, but more long-term data on cancer recurrence and survival at 3 and 5 years postoperatively are eagerly awaited.