BOOK REVIEW

Clinical Oncology, Second Edition

Martin D. Abeloff, James O. Armitage, Allen S. Lichter, John E. Niederhuber, eds. New York (NY): Churchill Livingstone, 2000. 3040 pp., illus. $225. ISBN 0-443-07545-X

Eric J. Seifter

Correspondence to: Eric J. Seifter, M.D., Johns Hopkins at Greenspring Station, 10755 Falls Rd., Lutherville, MD 21093.

The first edition of Clinical Oncology appeared in 1995, setting a new standard for its reader-friendly style. The prominent use of algorithms clearly distinguished this textbook from its two competitors, Cancer: Principles and Practice of Oncology, presently in its fifth edition, and Cancer Medicine, presently in its fourth edition. Outlines of treatment approaches and personal recommendations were set off from the main text with a red-shaded box. The editors hoped that this more accessible format would allow a diverse readership beyond only oncology specialists. This textbook became the reference of choice for the novice.

The second edition of Clinical Oncology is now available, and I was most interested to gauge the extent of the revisions. The first edition lacked a separate section on prevention and screening; in the second edition, a chapter has been included, although a stronger emphasis would have been welcome. The opening chapters, on the scientific underpinnings of cancer therapy, have been updated and contain substantially more information. I was disappointed that many of the algorithms were identical in the treatment sections and that most of the revisions were in the text, not in the figures. Many authors made no attempt to make their treatment sections more user-friendly by including doses for common regimens. For example, in the chapters on the lung, recipes for common protocols were listed in Table 56-13 in the first edition, but no doses were provided in Table 57-14 in the second edition. In the chapter on prostate cancer, many new chemotherapy regimens were listed in Table 68-22 in the second edition, but no doses were given. In the first edition, I could find no mention of extrapulmonary small-cell carcinoma. I fared no better with the second edition.

A more interesting exercise is to check which authors were "fired" from the first edition, resulting in a completely revised chapter for the second edition. The chapter on skin was markedly better; biologic therapies and chemotherapy for malignant melanoma were hardly mentioned in the first edition. However, there was only one algorithm and no personal recommendations given in this new version. Graphic design elements were seemingly ignored. The chapter on the colon and rectum was also completely rewritten, but there were no algorithms and only one terse personal recommendation about adjuvant therapy, presumably for rectal cancer only (but not clearly specified). No personal recommendations or algorithms regarding chemotherapy or radiotherapy were included in the new chapter on bladder cancer. Why were these new authors oblivious to the design elements and innovated format that characterized both the first and the second editions? The editors should point to the revised chapter on hairy cell leukemia, which is the model for the proper integration of text algorithms, illustrations, and figures.

All of those who enjoyed owning and using the first edition of Clinical Oncology will surely want to upgrade to the second edition. I will still recommend this textbook for new trainees and nonspecialists. I am disappointed that the revisions did not include significant new graphic design elements and many more algorithms, ignoring the very features that so distinguished this textbook from it competitors. For now, I will continue to use all three textbooks, despite the potential economic consequences of this decision.



             
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