Principles and Practice Cancer Field Surgery in Gynecologic Oncology

This book encompasses the results of two decades of research on locoregional spread of gynecologic cancer, which put forth the ontogenetic cancer field model and its clinical translation in terms of ontogenetic tumor staging and cancer field surgery, particularly for carcinomas of the lower female genital tract. The ontogenetic cancer field model describes the propagation of malignant tumors within distinct permissive tissue regions determined by the development of the tissue from which the neoplasm originated. As the morphogenesis of multicellular animals proceeds stepwise through bifurcational cell fate specification within tissue regions dictated by the positional identity and plasticity of the precursor cell populations, tumor formation during malignant progression occurs as a stepwise process in the reverse direction with regard to positional identity and plasticity.

This principle of order can be exploited for diagnosis, treatment and prognosis of cancer in general.

The motivation to study in depth the topography of tumor spread arose from the insight that the conventional view of local cancer propagation as an unlimited isotropic process is falsified by numerous inconsistencies with clinical facts. Consequently, conventional cancer therapy based on this model cannot achieve optimal outcomes.

The cancer field model and its application in gynecologic oncology has been published in highly ranked journals.
However, the complexity of the principles and practice need the format of a well-structured book for their successful transmission to gynecologic surgeons, clinical oncologists, cancer researchers and postgraduate medical students.

●  Presents the ontogenetic cancer field model of locoregional spread of carcinomas

●  Features step-by-step procedures with the help of images, anatomic drawings, schemes, and videos

●  Brings valuable insight on planning surgical interventions in female tract malignancies

Table of contents

Introduction Pages 1-8

Basics: The Paradigm of Ontogenetic Cancer Fields Pages 9-9

Ontogenetic Anatomy and the Cancer Field Model of Local Tumor Progression Pages 11-23

Ontogenetic Anatomy of the Female Genital Ducts: Local Progression of Cervix Carcinoma Pages 25-55

Ontogenetic Anatomy of the Female External Genitalia: Local Progression of Vulvar Carcinoma Pages 57-74

The Ontogenetic Cancer Field Model for the Regional Spread of Carcinomas Pages 75-84

Ontogenetic Anatomy of the Lower Human Body’s Lymphatic System: Lymphatic Network of the Female Genital Tract—Regional Progression of Gynecologic Carcinomas Pages 85-101

Clinics: Cancer Field Surgery

Front Matter Pages 103-103

Ontogenetic Staging of Gynecologic Cancer: Diagnostic Management and Findings Pages 105-136

Total and Extended Mesometrial Resections with Defense Line-Directed Lymph Node Dissection Pages 137-168

Peritoneal Mesometrial Resection, Lymph-Collector-Guided First-Line Lymph Node Dissection and Extended Procedures
Pages 169-186

Laterally Extended Endopelvic Resections Pages 187-210

Vulvar Field Resection and Immunolgic Defense Line-Directed Lynph Node Dissection Pages 211-233

Surgical Reconstruction of the Vulva Following Vulvar Field Resection and Extended Regional Treatment Pages 235-247

Treatment Algorithms and Clinical Results Pages 249-262

Back Matter Pages 263-270