TheManual of Clinical Oncology, Ninth Edition, published with the International Union Against Cancer (UICC), provides a concise, accessible and feasible reference covering state of art multidisciplinary clinical oncology in order to meet the needs of clinicians caring for cancer patients throughout the world.

Edited by world-renowned practising oncologists and written by key opinion leaders, this book contains authoritative and up-to-date information on cancer detection, diagnosis and treatment alongside topics such as survivorship, special populations and palliative care.

Remodelled and revised for the ninth edition to provide practical information to oncology workers, theUICC Manual of Clinical Oncology is structured in two parts. Part 1 covers general principles of cancer diagnosis and management with additional attention to special settings in oncology, including supportive care and survivorship, and Part 2 covers site-specific multidisciplinary cancer management. The edition includes up-to-date summaries of all treatment modalities (medical, surgical and radiation) for all tumour sites. It also contains the latest TNM classifications outlined in theTNM Classification of Malignant Tumours.

The ninth edition includes:Practical presentation with bullet points, tables, and flow charts intended to facilitate quick reference for day-to-day clinical practice in busy oncology environments,Representation of multidisciplinary care for site specific management,Evidence-based approaches to management, including specific treatment recommendations and investigations guided by clinical practice guidelines,State of art evidence-based recommendations that take into consideration the lack of availability of certain medications or resources, as well as practice variations, in different and remote regions of the world, andContemporary topics on cancer treatment, such as cancer informatics, evidence levels, principles of prognostication, survivorship and cancer in pregnancy.

Oncologists, oncologists-in-training, nurses working with cancer patients and other health professionals responsible for treating and caring for those with cancers will find theUICC Manual of Clinical Oncology an indispensable and comprehensive resource.

Brian OSullivan, MD, FRCPC, FRCPI, FFRRCSI (Hon), FASTRO (Editor-in-Chief)

Professor, Department of Radiation Oncology

Bartley-Smith / Wharton Chair in Radiation Oncology

Princess Margaret Cancer Centre / University of Toronto

Toronto, Ontario, Canada

James D Brierley, BSc, MB, FRCP, FRCR, FRCPC (Associate Editor)

Professor, Department of Radiation Oncology

Princess Margaret Cancer Centre / University of Toronto

Toronto, Ontario, Canada

Anil K. DCruz MS, DNB, FRCS (Associate Editor)

Professor, Department of Head and Neck Surgical Oncology

Tata Memorial Hospital, Mumbai, India

Martin F. Fey, MD (Associate Editor)

Professor, Department of Medical Oncology

Inselspital and University Hospital

Bern, Switzerland

Raphael Pollock, MD, PhD (Associate Editor)

Director of Surgical Oncology, Chief of Surgical Services

The James NCICCC/Ohio State University

Columbus, OH, USA

Jan B. Vermorken, MD, PhD (Associate Editor)

Emeritus Professor of Oncology

Faculty of Medicine and Health Sciences,

University of Antwerp, Antwerp, Belgium

Department of Medical Oncology

Antwerp University Hospital

Edegem, Belgium

Shao Hui Huang, MD, MSc, MRT(T) (Editorial coordinator)

Assistant Professor

Department of Radiation Oncology

Princess Margaret Cancer Centre / University of Toronto

BIOGRAPHIES

Brian OSullivan is a Professor in the Department of Radiation Oncology at the University of Toronto, Toronto, Ontario, Canada. He also holds the Bartley-Smith/Wharton Distinguished Chair in Radiation Oncology in the Department of Radiation Oncology at the Princess Margaret Cancer Centre, University of Toronto. He is the Head and Neck Oncology Program Chair at Princess Margaret Cancer Centre, the co-Chair of the US NCI Head and Neck Steering Committee, Coordinating Center for Clinical Trials, CTEP, and a full standing member of the Commission of the International Commission on Radiation Units (ICRU). He is the recipient of numerous international awards, and research grants.  He has published almost 300 peer reviewed papers, in excess of 50 book chapters, and has written or edited 6 oncology textbooks.  His interests include sarcoma and head and neck cancer, translational research, IMRT delivery and the principles of image guided radiotherapy, chemo-radiotherapy and molecular targeting. He is a member of the TNM Committee of the Union for International Cancer Control (UICC), Chair of the UICC Prognostic Classification Sub-Committee and represents the UICC as liaison in several oncology sites to the American Joint Committee on Cancer (AJCC).

James Brierley is a Professor in the Department of Radiation Oncology at the University of Toronto, Princess Margaret Cancer Centre. He obtained his medical degree from Westminster Medical School, University of London. He initially did postgraduate training in Internal Medicine before transferring to Clinical Oncology. He is interested in the management of gastrointestinal malignancy and thyroid malignancy and cancer staging and surveillance. He has written extensively on thyroid cancer, the role of radiation in gastrointestinal malignancy and cancer staging and surveillance and is actively involved in research into the role of radiation in the management of gastrointestinal and endocrine malignancies and ensuring staging data is collected and used on a population basis. He is the previous head of the Gastrointestinal Site Group at the Princess Margaret Cancer Centre and is currently the Canadian Partnership Against; Cancer  Expert Lead, Staging and Surveillance. He is a Member of the AJCC Executive and Chair of the AJCC Education and Promotions Working Group,  Co-Chair of the UICC TNM Prognostic Factors Core Group and Co-Editor of the UICC 8th edition TNM Classification of Malignant Tumours.

Anil DCruz is Director at the Tata Memorial Hospital, Mumbai, India as well as Professor& Surgeon, Department of Head& Neck Surgery.   He is a distinguished leader in the field of oncology and on the Board of Directors of the Union for International Cancer Control (UICC), Geneva, Foundation of Head Neck Oncology India and the Asian Society of Head Neck Oncology.. He has more than 150 peer-reviewed publications and chapters to his name and is also an editor for a two volume text book on Head and neck Surgery. He is Associate Editor of Head Neck Oncology Journal and member of the Editorial Board of many reputed national and international journals. He has delivered more than 250 invited lectures and 50 orations.

Martin Fey is a Professor and Head of Department of Medical Oncology at the University of Berne, Switzerland. He is also Head of the Department of Oncology, Laboratory medicine and Hospital Pharmacy at the Inselspital Bern. He received his medical degree from the Berne University Medical School. He was the recipient of Robert-Wenner Award of the Swiss Cancer League and Ellermann Award of the Swiss Society of Haematology. He has more than 250 peer-reviewed publications to his credit, mainly in clinical and experimental haematological oncology. He leads clinical trials in leukaemia, lymphoma, breast cancer and other types of tumours. He was the Chairman of the Leukaemia Group of the Swiss Group for Clinical Cancer Re¬search (SAKK) from 1990-1995 and a Principal Investigator of the SAKK and the International Breast Cancer Study Group (IBCSG) from 1993-2002. His interests include leukaemia, lymphoma, breast cancer, and the design of clinical trials. He is a member of the Cantonal Ethics Committee for Clinical Trials of the Canton of Bern, Switzerland.

Raphael Pollock, M.D., Ph.D. was born in Chicago, Illinois and graduated from Oberlin College, Oberlin, Ohio in 1972. This was followed by medical school at the St. Louis University School of Medicine Chicago, IL residencies in General Surgery at the University of Chicago and Rush Medical College, a fellowship in Surgical Oncology at The University of Texas M. D. Anderson Cancer Center, and a Ph.D. in Tumor Immunology from the Graduate School of the Biological Sciences at the University of Texas-Houston Health Sciences Center. Dr. Pollock joined the Department of Surgical Oncology at The University of Texas M. D. Anderson Cancer Center as a faculty member in 1984.  Dr. Pollock became Chairman of the Department of Surgical Oncology in 1993 and became Head of the Division of Surgery at The University of Texas M. D. Anderson Cancer Center in 1997. In 2006-07 Dr. Pollock served as President of the Society of Surgical Oncology; from 1999-2011 he served as Editor-in-Chief of Cancer. In 2013 Dr. Pollock left MD Anderson to become Director and Professor, Division of Surgical Oncology and Chief of Surgical Services at The James Comprehensive Cancer Center at The Ohio State University Medical Center, Columbus, Ohio. Dr. Pollock serves as Director of the Sarcoma Research Laboratory at The Ohio State University Medical Center and is the Principal Investigator on behalf of the US NIH/NCI SARC Sarcoma SPORE grant program. Dr. Pollock is a member of the US NIH/NCI Board of Scientific Counselors.

Jan B. Vermorken was born in 1944,  graduated in 1970 from the University of Amsterdam, the Netherlands and became a board-certified specialist in internal medicine in 1975. Since that time he has worked in the field of Medical Oncology and was officially registered as a Medical Oncologist in the Netherlands in 1992. He received his PhD in Medical Sciences in 1986 from the Vrije Universiteit in Amsterdam.  From May 1997 until October 1, 2009, he was Professor of Oncology at the University of Antwerp (UA), and head of the Department of Medical Oncology at the University Hospital Antwerp (UZA), in Edegem, Belgium. After his retirement he remains connected to both University (emeritus Professor) and University Hospital.

His main fields of interest are gynecologic oncology, and head and neck oncology. He devotes a significant amount of time to teaching, professional training, and continuing medical education.

Professor Vermorken is member of various scientific societies, is member of several editorial boards of International journals, reviewer multiple cancer journals and author or co-author of more than 500 publications in international journals. From January 1, 2009 until January 1, 2014 he was Editor-in-Chief of Annals of Oncology, the official journal of the European Society for Medical Oncology and the Japanese Society of Medical Oncology. On March 1, 2013 he received the title of Commander in the Order of Leopold for his contributions to oncology.

Foreword x

Preface xi

About the Editors xiii

Contributors xvi

PART 1 General principles of cancer diagnosis and management 1

Principles of knowledge generation and translation

1 Cancer epidemiology 3

2 Levels of evidence, guidelines and standards 12

3 Prognosis and classification of cancer 23

4 Principles of cancer staging 34

5 Assessment of treatment outcome 40

6 Cancer informatics 53

Principles of cancer diagnosis

7 Imaging 63

8 Pathology 83

Principles of treatment

9 Principles of surgery 98

10 Principles of radiotherapy 108

11 Principles of systemic therapy 124

Special settings, supportive care and survivorship

12 Treatment in pregnancy 134

13 Treatment in the elderly 139

14 Oncology emergencies 145

15 Supportive care during curative treatment 155

16 Pain management in cancer 168

17 Palliative care 174

18 Survivorship 184

19 Rehabilitation 194

PART 2 Site-specific multidisciplinary cancer management 203

Thoracic malignancies

20 Lung 205

Breast

21 Breast 221

Gastrointestinal malignancies

22 Liver 241

23 Biliary tract and pancreas 263

23.1 Biliary tract 263

23.2 Pancreas 270

24 Oesophagus 280

25 Stomach 297

26 Colon, rectum and anus 308

26.1 Colon and rectum 308

26.2 Anus 327

Genitourinary malignancies

27 Prostate 333

28 Bladder and other urothelium 343

29 Kidney 354

30 Testicular germ cell tumours 368

31 Penis 384

Haematological malignancies

32 Lymphoma 392

33 Myeloma 415

34 Leukaemia 427

Gynaecological cancers

35 Cervix 449

36 Uterus 467

37 Ovary and fallopian tube 479

Head and neck cancer

39 General principles of head and neck cancer management 503

40 Nasopharynx 512

41 Oral cavity 524

42 Larynx and hypopharynx 542

43 Oropharynx 559

44 Major salivary glands 571

45 Nasal cavity and paranasal sinus 586

46 Head and neck unknown primary 597

Endocrine tumors

47 Pituitary 609

48 Thyroid 626

49 Adrenal tumours 641

50 Neuroendocrine tumours 656

Dermatological cancer

51 Skin: Basal cell carcinoma, squamous cell carcinoma and Merkel cell carcinoma 674

52 Melanoma 689

Central nervous system and ocular cancers

53 Central nervous system 706

54 Eye: Choroidal melanoma, retinoblastoma, ocular adnexal lymph

Sarcoma

55 Bone (osteosarcoma) 745

56 Soft tissue 754

Childhood malignancies

57 Paediatric tumors 768

Specific cancer situations

58 Cancer of unknown primary (no 59 HIV and transplant-related neoplasms 797

59.1 HIV-related neoplasms 797

59.2 Post-transplantation lymphoproliferative disease 809

59.3 Cancer following solid organ transplantation 812

Index 815