Book review

Cancer in childhood is a very different beast to that found in adults. Such factors as tumour biology, cytogenetics, age at presentation and histological grade make a huge difference to prognosis and, therefore management. The surgeon dealing on a regular basis with childhood cancer must have a working knowledge of all aspects of the specialty so that they contribute confidently to the multidisciplinary team that manages childhood cancer. It is impossible for a surgeon to keep up with all the literature from the oncological world. A comprehensive reference textbook is therefore essential.

Principles and Practice is widely accepted to have a pedigree as one of the most comprehensive books in this field. It has been thoroughly revised for its fifth edition. It is organised into six sections: the first three sections cover the biology of childhood cancer; diagnosis and evaluation; and the principles of multimodal therapy. The central section comprehensively covers each of the specific tumours with two final sections on supportive care and the late effects of cancer.

Almost all the contributors are from the USA so it is pleasing to see that the Wilms tumour controversey of primary nephrectomy (the North American model) versus chemotherapy and delayed nephrectomy (the European model) is discussed in detail.

With specific regard to the surgeon there is a very good chapter on the principles of surgical therapy written by some of the big names of North American Paediatric Surgery. This reaffirms the importance of the ‘Paediatric Surgical Oncologist’, and nicely covers the principles of surgery. However, the chapter is aimed more at the trainee in paediatric surgery rather than giving detailed reference information for the established consultant. In particular, the section on vascular access is rather bland and does not really deal with common controversies such as the best position for the line tip, the benefits of open versus percutaneously placed tunnelled lines and the management of blocked lines.

One of the most difficult clinical situations is the management of children presenting with a large anterior mediastinal mass. There is an excellent discussion on the risks of anaesthesia for anterior mediastinal masses with a clear algorithm for pre-operative investigations to assess the risk and provide a guide to the safest method of biopsy.

The main appeal of this book, however, is the fact that the surgeon can easily find detailed information on such things as tumour markers, diagnosis, favourable prognostic markers and a discussion of the various protocols.

In summary, the book covers all aspects of children's cancer in detail. This book is an excellent reference text and would form the cornerstone of knowledge for a busy paediatric surgical oncologist.