Tata Memorial Centre Textbook of Oncology

Preface
Acknowledgements
Contents
Editors and Contributors
	About the Editors
	Contributors
Part I: Basic Principles
	Basic and Translational Science in Oncology
		1	 Introduction
		2	 Hallmarks of Cancer
		3	 Biological Underpinnings of the Cancer Hallmarks
			3.1	 Oncogenes and Tumor Suppressor Genes
				3.1.1	 Oncogene Addiction/Aberrant Cell Signaling
				3.1.2	 Tumor Suppressors
					Retinoblastoma (Rb) Suppressors
					The p53 Gene
					Breast Cancer Susceptibility Genes: BRCA1 and BRCA2
					Phosphatase and Tensin Homologue Deleted on Chromosome 10 (PTEN)
			3.2	 Regulation of Gene Expression
			3.3	 Dysregulation of Cell Cycle Checkpoints
				3.3.1	 The Cyclin–CDK–Rb Axis
				3.3.2	 DNA Damage Response Checkpoints
			3.4	 Avoiding Immune Destruction
			3.5	 Cancer Invasion and Metastasis
		4	 Conclusions
		References
	Surgical Oncology
		1	 Introduction
		2	 Historical Perspective
		3	 Operative Risk Assessment
			3.1	 Preoperative Fitness Assessment and Operative Risk Prediction
		4	 Diagnostic Biopsy in Solid Cancers
			4.1	 Types of Biopsies Performed
			4.2	 Principles of Performing Biopsies in Solid Tumors
		5	 The Role of Surgery
			5.1	 Preventive/Prophylactic Surgery
			5.2	 Criteria for Prophylactic Surgery
			5.3	 Examples of Prophylactic Surgery
		6	 Curative Surgery
			6.1	 Principles of Resection of the Primary Cancer
			6.2	 Minimally Invasive Surgery in Oncology
			6.3	 Resection of Metastatic Disease
		7	 Reconstructive Surgery in Oncology
			7.1	 Principles of Reconstructive Surgery [32]
		8	 Palliative Surgery
		References
	Radiation Oncology
		1	 The Discipline of Radiation Oncology
		2	 The Historical Aspects of Radiation Oncology
		3	 The Biological Basis of Radiotherapy
			3.1	 Direct and Indirect Effects of Radiation
			3.2	 Cellular Targets of Radiation
			3.3	 Factors Influencing the Radiation Effect on Cells
			3.4	 The Acute and Late Effects of Radiation
			3.5	 Fractionation
		4	 QUANTEC and Dose Constraints
		5	 Radiobiology of Brachytherapy
		6	 Radiation Modifiers
		7	 The Physics of Radiotherapy
			7.1	 The Basic Physics of Radiotherapy
		8	 External Beam Radiography
		9	 Brachytherapy
		10	 Special Techniques and Technologies in Radiation Oncology
			10.1	 Total Skin Electron Therapy (TSET)
			10.2	 Stereotactic Radiosurgery (SRS)/Stereotactic Radiotherapy (SRT)
			10.3	 Stereotactic Body Radiotherapy (SBRT)
			10.4	 Total Body Irradiation (TBI)
		References
	Systemic Treatment of Cancer
		1	 Introduction
		2	 The History of Systemic Treatment
		3	 Types of Cancer Systemic Therapies
		4	 Settings for Cancer Systemic Treatment
		5	 The Principles of Chemotherapy
			5.1	 Cancer Cellular Kinetics
			5.2	 Rationale for Chemotherapeutic Combinations
			5.3	 The Concept of Dose Intensity
			5.4	 Cell Cycle and Chemotherapeutic Agents
		6	 The Principles of Hormonal Therapy for Cancer
			6.1	 The Concept of Hormone Dependence
			6.2	 The Effects of Hormonal Therapies on the Cell Cycle
			6.3	 Breast Cancer and the Estrogen Receptor
			6.4	 Prostate Cancer and the Androgen Receptor
			6.5	 Hormones and Other Tumors
		7	 The Principles of Targeted Therapy for Cancer
			7.1	 Druggability of Molecular Targets
		8	 The Principles of Cancer Immunotherapy
			8.1	 The Immune System
			8.2	 Antigen Presentation and Recognition
			8.3	 Immunoevasion
			8.4	 Cancer Immunotherapy
		References
	Pediatric Oncology
		1	 Introduction
		2	 Epidemiology of Childhood Cancers in the World
			2.1	 Published Estimates of Global Cancer Burden
			2.2	 Surveillance, Epidemiology, and End Results (SEER) Data
			2.3	 Estimates of Global Childhood Cancer Survival
		3	 Epidemiology of Childhood Cancers in India
			3.1	 Estimates of Incidence and Patterns
			3.2	 Estimates of Cancer-related Mortality and Survival in India
		4	 Challenges in the Management of Childhood Cancers in LMICs
		References
	Oncopathology
		1	 Principles
		2	 Grossing
			2.1	 Basic Requirements of Dissection/Grossing Room
			2.2	 Receiving Specimens
			2.3	 Specimen Fixation
			2.4	 Grossing/Surgical Cutup
				2.4.1	 Orientation of Specimens
				2.4.2	 The General Principles of Grossing
				2.4.3	 Gross Description
				2.4.4	 Margin Evaluation
			2.5	 Blocking Principles
				2.5.1	 Primary Lesion/Tumor
				2.5.2	 Margins
				2.5.3	 Adjacent Tissues
				2.5.4	 Lymph Nodes (LNs)
				2.5.5	 Bone
		3	 Safety Precautions
		4	 Staining
			4.1	 Hematoxylin and Eosin (H&E) Staining
			4.2	 Special Stains
		5	 Frozen Section (FS)
			5.1	 Basic Frozen Section (FS) Workflow
			5.2	 Indications
			5.3	 Diagnostic
			5.4	 Margin Status
			5.5	 Lymph Node (LN) Status
			5.6	 Frozen Artifacts and Limitations
				5.6.1	 Sampling Errors
				5.6.2	 Technical Errors
				5.6.3	 Interpretative Errors
		6	 Microscopic Techniques
		7	 Cytology
			7.1	 Types of Cytological Specimens
				7.1.1	 Exfoliative Cytology
				7.1.2	 From a Lesion/Mass
				7.1.3	 Selection of Stains and Fixatives
			7.2	 Key Points in the Evaluation of Cytological Specimens
			7.3	 Approach to Evaluation of Cytological Specimens
			7.4	 Cytology in Oncopathology: Interpretative Issues
		8	 Immunohistochemistry
			8.1	 Applications
			8.2	 Diagnostic
			8.3	 Prognostic
			8.4	 Predictive/Theranostic
			8.5	 Genogenic
		9	 Molecular Pathology
			9.1	 Diagnostic
			9.2	 Predictive
			9.3	 Prognostic
		10	 Biorepository
		11	 Digital Pathology
			11.1	 Digital Pathology and Artificial Intelligence
		Further Reading
	Oncological Hematopathology
		1	 Introduction
		2	 Organization and Elements of a Hematopathology Laboratory
			2.1	 Sample Processing
			2.2	 Analysis
		3	 Collection, Transport, and Processing of Samples
			3.1	 Flow Cytometry
			3.2	 Molecular Techniques
		4	 General Techniques
			4.1	 Cell Counts, Morphology, and Cytochemistry
			4.2	 Red Cell Lysis
		5	 Flow Cytometry
			5.1	 Principle
			5.2	 What Happens Inside a Flow Cytometer?
			5.3	 Indications
			5.4	 Additional Indications
			5.5	 An Overview of Immunophenotypic Analysis of Hematolymphoid Malignancies
				5.5.1	 Acute Leukemia
				5.5.2	 Acute Lymphoblastic Leukemia (ALL)
				5.5.3	 Precursor B-Cell Acute Lymphocytic Leukemia (B-ALL)
				5.5.4	 Precursor T-cell Acute Lymphoblastic Leukemia/Lymphoma (T-ALL)
				5.5.5	 Acute Myeloid Leukemia (AML)
				5.5.6	 Recently Described Immunophenotypic Subgroup in AML
				5.5.7	 Blastic Plasmacytoid Dendritic Cell Neoplasms (BPDCNs)
				5.5.8	 Acute Leukemia of Ambiguous Lineage
				5.5.9	 Flow Cytometric Analysis of Mature Lymphoid Neoplasms
					Mature B-Cell Neoplasms
					Classification
					Mature T- and Natural Killer (NK)-Cell Neoplasms
				5.5.10	 Flow Cytometric Analysis in Plasma Cell Neoplasms (PCNs)
				5.5.11	 Flow Cytometric Analysis in Myelodysplastic Syndromes (MDS)
				5.5.12	 Minimal Residual Disease (MRD) Monitoring by FC
			5.6	 The Role of FCI in the Prognosis of Hematolymphoid Neoplasms
		6	 Molecular Hemato-Oncology
			6.1	 An Overview of Molecular Diagnostic Techniques
			6.2	 Molecular Diagnosis of Hematolymphoid Neoplasms
				6.2.1	 Myeloproliferative Neoplasms
					Chronic Myeloid Leukemia (CML)
					Philadelphia-Negative Myeloproliferative Neoplasms
					Myelodysplastic/Myeloproliferative Neoplasms (MDS/MPNs)
				6.2.2	 Myelodysplastic Syndromes
				6.2.3	 Myeloid Neoplasms with Eosinophilia and Gene Rearrangements
				6.2.4	 Myeloid Neoplasms with Germline Predisposition
				6.2.5	 Acute Myeloid Leukemia
				6.2.6	 Clonality Assays in Lymphoproliferative Disorders
				6.2.7	 Precursor B-Cell Acute Lymphoblastic Leukemia/Lymphoma (BCP-ALL)
				6.2.8	 Precursor T-Cell Acute Lymphoblastic Leukemia/Lymphoma (T-ALL)
				6.2.9	 B-Cell Lymphoproliferative Disorders
					Chronic Lymphocytic Leukemia
					Hairy Cell Leukemia
					Lymphoplasmacytic Lymphoma
				6.2.10	 T-Cell Lymphoproliferative Disorders
				6.2.11	 Plasma Cell Neoplasms
		References
	Microbiology in Oncology
		1	 Introduction
		2	 Specimen Selection, Collection, and Processing
			2.1	 Direct Examination
			2.2	 Molecular Diagnostics
			2.3	 General Guidelines for Specimen Processing for Bacterial and Fungal Culture
		3	 Detection and Identification Methods
		4	 Antimicrobial Susceptibility Testing
		5	 Specific Recommendations for Major Infections
			5.1	 The Respiratory Tract
			5.2	 Tissue Diagnosis
			5.3	 Fungal Infections
			5.4	 Blood Stream Infections
			5.5	 The Central Nervous System
			5.6	 The Urinary Tract
			5.7	 Gastrointestinal Specimens
		6	 Conclusions
		Further Reading
	Imaging in Oncology
		1	 Introduction
		2	 Indications for Conventional Radiography in Oncology
		3	 Fluoroscopy and Contrast Studies
		4	 Mammography
		5	 Ultrasonography (USG) in Oncology
		6	 Computed Tomography in Oncology
		7	 Magnetic Resonance Imaging in Oncology
		8	 Response Evaluation in Oncology
		9	 Molecular and Functional Imaging in Oncology
		10	 Conclusions
		References
	Nuclear Medicine in Oncology
		1	 History
		2	 Radiopharmaceuticals
		3	 Positron Emission Tomography (PET)
		4	 Radiommunodiagnostics
		5	 Hybrid Imaging
		6	 Indications of F18-Labeled Radiopharmaceuticals in Clinical Oncology
			6.1	 18F-FDG
				6.1.1	 The Role of FDG PET/CT in Specific Tumors
					Lymphomas
					Lung Cancers
					Esophageal Carcinoma
					Bone and Soft Tissue Tumors
					Head and Neck Malignancies
					Breast Carcinomas
					Melanomas
					Cancer of Unknown Primary
					Colorectal Carcinomas
			6.2	 F18 NaF
			6.3	 18F FLT (3′-Deoxy-3′-18F Fluorothymidine)
			6.4	 F18 FMISO (F18 Fluoromisonidazole)
			6.5	 18F FET (18F-Fluoro-ethyl-tyrosine)
		7	 Radioguided Surgery and Radioguided Biopsy
			7.1	 PET/MRI Hybrid Imaging
				7.1.1	 Specific Indications of PET/MRI in Clinical Oncology
					Head and Neck Cancers
					Liver Metastasis
					Brain Tumors
					Prostate Cancer
					Lung Cancer
					Breast Cancer
					Bone and Soft Tissue Malignancies
					Pediatric Malignancies and Lymphomas
		8	 Therapeutic Nuclear Medicine in Oncology Practice
			8.1	 The Fundamental Principles of Radionuclide Therapy Using Unsealed Sources
		9	 Specific Indications in Clinical Oncology
			9.1	 Thyroid Cancer
				9.1.1	 Remnant Ablation
				9.1.2	 Adjuvant Therapy
				9.1.3	 Treatment of Metastatic Diseases
				9.1.4	 Treatment for Iodine Refractory Thyroid Cancer
			9.2	 Polycythemia Rubra Vera
			9.3	 Bone Pain Palliation
			9.4	 Neuroblastomas
		10	 Theranostics
			10.1	 Receptor-Targeted Therapy in Theranostics
				10.1.1	 Peptide Receptor Radionuclide Therapy (PRRT) in Metastatic Neuroendocrine Tumors (NETs)
				10.1.2	 177Lu-PSMA Therapy (Peptide Receptor Radioligand Therapy: PRRLT) in Metastatic Castrate-Resistant Prostate Carcinoma
		11	 Alpha Therapy
			11.1	 Applications
		12	 Radioimmunotherapy
		References
	Interventional Radiology in Oncology
		1	 Introduction
		2	 Image Guidance for Procedures
		3	 Patient Evaluation and Peri-procedural Care
			3.1	 Laboratory Tests
		4	 Non-vascular Interventions
			4.1	 Percutaneous Image-Guided Biopsy (Fig. 3)
				4.1.1	 Indications
				4.1.2	 Procedure Contraindications
				4.1.3	 Complications
			4.2	 Image-Guided Drainages (Fig. 4)
				4.2.1	 Pre-procedure
				4.2.2	 Post-procedure
			4.3	 Tumor Ablation
				4.3.1	 Thermal Ablation Modalities
					Radiofrequency
					Microwave
					Cryoablation
					Irreversible Electroporation
		5	 Vascular Interventions
			5.1	 Trans-arterial Embolization (Angioembolization)
			5.2	 Transarterial Chemoembolization
			5.3	 Transarterial Chemoinfusion
			5.4	 Transarterial Radioembolization (TARE)
		6	 Pulmonary Interventions
			6.1	 Endobronchial Ultrasound-Transbronchial Needle Aspiration (EBUS-TBNA)
				6.1.1	 Indications
				6.1.2	 Advantages
				6.1.3	 Complications
				6.1.4	Disadvantages
			6.2	 Ablation of Lung Tumors
				6.2.1	 Indications
				6.2.2	 Ablation Techniques
				6.2.3	 Technique
				6.2.4	 Follow-Up
				6.2.5	 Complications (Table 3)
					Outcome
			6.3	 Tracheal Stenting
				6.3.1	 Indications
				6.3.2	 Image Guidance and Procedure
				6.3.3	 Complications
			6.4	 Superior Vena Cava Obstruction
				6.4.1	 Complications
		7	 Hepato-Biliary Interventions
			7.1	 Transjugular Liver Biopsy (TJLB)
				7.1.1	 Indications
			7.2	 Percutaneous Transhepatic Biliary Drainage and Biliary Stenting
				7.2.1	 Indications
				7.2.2	 Contraindications
		8	 Hepatocellular Carcinoma
			8.1	 Ablation
				8.1.1	 Indications
				8.1.2	 Ablation Modalities
			8.2	 Transcatheter Arterial Chemoembolization
				8.2.1	 Complications
			8.3	 Follow-Up
			8.4	 Selective Internal Radiation Therapy (SIRT) or Transarterial Radioembolization (TARE)
				8.4.1	 Follow-Up
				8.4.2	 Complications
		9	 Genitourinary Interventions
			9.1	 Transjugular Renal Biopsy
				9.1.1	 Indications
			9.2	 Percutaneous Nephrostomy and Antegrade Ureteric Stenting
				9.2.1	 Indications
				9.2.2	 Procedure
				9.2.3	 Medications
				9.2.4	 Technique
				9.2.5	 Complications
			9.3	 Renal RFA
				9.3.1	 Indications
				9.3.2	 Ablation Techniques
					Thermal
					Procedure
					Adjuvant Techniques in Renal Tumor Ablation
					Complications
					Outcomes
			9.4	 Renal Angioembolization
				9.4.1	 Indications
		10	 Other Interventions
			10.1	 Central Venous Access
				10.1.1	 Complications
			10.2	 Bone and Soft Tissue Interventions
				10.2.1	 Indications
				10.2.2	 Ablation Modalities
			10.3	 Percutaneous Vertebroplasty
				10.3.1	 Indications
				10.3.2	 Absolute Contraindications
				10.3.3	 Relative Contraindications
				10.3.4	 Procedure
				10.3.5	 Complications
			10.4	 Angioembolization of Bone Tumors
				10.4.1	 Indications
			10.5	 Ophthalmic Artery Chemoinfusion for Retinoblastoma
			10.6	 Lymphangiography and Thoracic Duct Embolization
				10.6.1	 Indications
				10.6.2	 Procedure
		11	 Emergencies
			11.1	 Vascular Intervention
			11.2	 Gastrointestinal Bleeding
				11.2.1	 Causes of Upper GI Bleeding
				11.2.2	 Causes of Lower GI Bleeding
				11.2.3	 Evaluation of the Patient with Bleed (Fig. 19)
					Angioembolization
					Positive Findings
				11.2.4	 Complications
			11.3	 Hemoptysis and Bronchial Artery Embolization
				11.3.1	 Pre-procedural Imaging and Endovascular Treatment
				11.3.2	 Outcomes
				11.3.3	 Complications
				11.3.4	 Management of Hematuria and Bleeding per Vaginum
				11.3.5	 Management of Postoperative Hemorrhage
				11.3.6	 Management of Deep Venous Thrombosis and Pulmonary Thromboembolism
				11.3.7	 Procedure
		References
	Anaesthesia in Oncology
		1	 Introduction
		2	 Preoperative Chemotherapy
		3	 Preoperative Radiotherapy
		4	 Perioperative Care
		5	 Cardiovascular Evaluation in Patients Undergoing Oncologic Surgery
		6	 Frailty and Anaesthesia
		7	 Prehabilitation
		8	 Anaesthesia and Enhanced Recovery After Surgery (ERAS)
		9	 Patient Blood Management
		10	 Intraoperative Techniques that Affect Postoperative Outcome
		11	 Anaesthesia for Head and Neck Surgery
		12	 Laser Resections for Airway Tumours
		13	 Anaesthesia and Thoracic Surgery
		14	 Unique Onco-Surgical Procedures
			14.1	 Cytoreductive Surgery with Intraoperative Chemotherapy (Hyperthermic Intraperitoneal Chemotherapy [HIPEC] and Hyperthermic Intra-thoracic Chemotherapy [HITHOC])
			14.2	 Robotic Surgery
			14.3	 Proton Radiation Therapy
		15	 Acute Pain Management After Cancer Surgery
		16	 Adjuvants
		17	 Anaesthesia and Cancer Recurrence
		18	 Conclusion
		References
	Transfusion Medicine in Oncology
		1	 Introduction
		2	 History of Transfusion Medicine in India
		3	 History of Transfusion Medicine in Oncology
		4	 Physiological Aspects of Blood
			4.1	 Red Cell Kinetics
			4.2	 WBC Kinetics
			4.3	 Platelet Kinetics
			4.4	 Normal Hemostasis
		5	 Blood Group Antigens and Antibodies
		6	 Blood and Blood Components
			6.1	 Whole Blood
			6.2	 Packed Red Blood Cell (pRBC)
			6.3	 Platelet Concentrates
			6.4	 Fresh Frozen Plasma (FFP)
			6.5	 Cryoprecipitate
			6.6	 Granulocyte Concentrate
			6.7	 Components Collected by Apheresis Technology
		7	 Modifications of Blood Components
			7.1	 Leukoreduction
			7.2	 Irradiation
			7.3	 Washing
			7.4	 Pathogen Reduction
		8	 Special Considerations in Oncology Patients
			8.1	 Pretransfusion Testing Issues in Oncology Patients
		9	 Transfusion in Oncology Patients
		10	 Transfusion Reactions
		11	 Conclusion
		References
	Palliative Care in Oncology
		1	 History of Palliative Care in India
		2	 Palliative Care Need in India
		3	 Principles of Palliative Care
		4	 Symptom Management
			4.1	 Guidelines for Cancer Pain Management in Ambulatory Palliative Care Setting
			4.2	 Guidelines for Cancer Pain Management in Acute Inpatient Palliative Care Setting
			4.3	 Guidelines for Cancer Pain Management in Home-Based Palliative Care Setting
			4.4	 Guidelines for Cancer Pain Management in Hospice and End-of-Life Care Patients
		5	 Psychosocial Aspects of Palliative Care
		6	 Ethics of Palliative Care
		7	 End-of-Life Care and Bereavement Support
		8	 Paediatric Palliative Care
			8.1	 End-of-Life Care
			8.2	 Spiritual Care
			8.3	 Symptom Management
			8.4	 Bereavement Support
		9	 Challenges in Delivering Palliative Care in India
		References
	Clinical Pharmacology in Oncology
		1	 Introduction to Clinical Pharmacology
		2	 Pharmacokinetics
			2.1	 Absorption
			2.2	 Distribution
			2.3	 Metabolism
			2.4	 Elimination
			2.5	 Concentration–Time Relationship
			2.6	 Repeated Drug Administration
				2.6.1	 Steady State
		3	 Pharmacodynamics
		4	 Interindividual Variability
			4.1	 Pharmacodynamics
			4.2	 Pharmacokinetics
			4.3	 Therapeutic Drug Monitoring (TDM)
		5	 Risk Versus Benefit
		6	 Pharmacovigilance
		7	 Drug Interactions
		8	 Special Population
			8.1	 Dosing Recommendations in Kidney Disease
			8.2	 Dosing Recommendations in Hepatic Impairment
			8.3	 Dose Modifications in Obesity
		9	 Clinical Pharmacology in Drug Development
			9.1	 Biomarkers
				9.1.1	 Pharmacodynamic Biomarker
				9.1.2	 Predictive Biomarker
					Enrichments Designs
				9.1.3	 Prognostic Biomarkers
				9.1.4	 PK/PD Modelling (Fig. 5)
		10	 Pharmacoeconomics
			10.1	 Assessment of Costs and Outcomes
				10.1.1	 Outcomes
			10.2	 Pharmacoeconomic Evaluation Methods (Fig. 6)
				10.2.1	 Economic Evaluation Methods
				10.2.2	 Humanistic Evaluation Methods
			10.3	 Pharmacoeconomics in Oncology
		11	 Personalized Medicine
			11.1	 Pharmacogenetics and Pharmacogenomics
		References
	Cancer Staging
		1	 Introduction
		2	 Principles and Need of Cancer Staging
			2.1	 The TNM Oncotaxonomy [2, 3]
			2.2	 Groome’s Criteria and the Staging System [4–6]
				2.2.1	 Stage Migration
			2.3	 General Rules of the TNM System [8, 9]
				2.3.1	 Staging Groups
				2.3.2	 The TNM Clinical Classification
				2.3.3	 The TNM Pathological Classification
				2.3.4	 Additional Descriptions
				2.3.5	 Stage Grouping [8–10]
					Staging Rules
			2.4	 Cancer Staging Systems in Clinical Practice [8, 9, 11]
				2.4.1	 Supplementary/Alternate Staging/Grading System to TNM System: Few Examples
				2.4.2	 Publications and Organisations Associated with TNM System [1, 8]
				2.4.3	 The AJCC-UICC Lexicon Project [8]
			2.5	 Evolution of Staging System and Their Implications
				2.5.1	 Concerns Associated with the Revisions in Staging System
				2.5.2	 Types of Changes in the TNM System [10]
			2.6	 Prognostic Factors and ‘Grid’ [9, 12, 13]
				2.6.1	 Grids of Prognostic Factors
			2.7	 Changes Observed in the TNM System
				2.7.1	 C-Factor [8, 9]
			2.8	 Future of Cancer Staging [3, 14]
		References
Part II: Public Health
	Cancer Registration in India
		1	 Establishing Cancer Registries
		2	 Cancer Burden in India
		3	 Regional Diversity in Cancer Burden and Type
		4	 Utility of Cancer Registry Data
		References
	Cancer Screening in India
		1	 Principles of Screening
			1.1	 Disease Condition
			1.2	 Suitable Screening Test
			1.3	 Health System Requirements
			1.4	 Practical Concerns, Harms and Benefits from Screening
		2	 Cervical Cancer Screening
			2.1	 Cervical Cancer Screening Tests
				2.1.1	 Cervical Cytology
				2.1.2	 Visual Inspection with Acetic Acid (VIA)
				2.1.3	 Human Papilloma Virus (HPV) Testing
				2.1.4	 Self-Collected Vaginal Samples
			2.2	 Conclusion
		3	 Breast Cancer Screening
			3.1	 Mammography
			3.2	 Clinical Breast Examination (CBE)
			3.3	 Breast Self-Examination (BSE)
			3.4	 Ultrasonography
			3.5	 Conclusion
		4	 Oral Cancer Screening
			4.1	 Oral Cancer Screening Tests
				4.1.1	 Oral Visual Inspection (OVI)
				4.1.2	 Mouth Self-Examination and Other Screening Methods
		5	 Other Cancers
			5.1	 Prostate Cancer Screening
			5.2	 Lung Cancer Screening
			5.3	 Colorectal Cancer Screening
		References
Part III: Hematological Malignancies
	Adult Lymphoblastic Leukemias
		1	 Acute Myeloid Leukemia
			1.1	 Incidence and Epidemiology
			1.2	 Clinical Presentation
			1.3	 Diagnosis and Classification
			1.4	 Investigations
			1.5	 Evaluation and Risk Stratification
			1.6	 Management of AML
				1.6.1	 Supportive Care for AML
			1.7	 Treatment of AML
				1.7.1	 Treatment of AML in Elderly Patients
			1.8	 Response Assessment and Monitoring
			1.9	 Prognosis and Outcomes
			1.10	 Summary and Practice at TMH (See Table 3)
		2	 Acute Promyelocytic Leukemia
			2.1	 Incidence and Epidemiology in India and Global
			2.2	 Clinical Presentation in India and Global
			2.3	 Evaluation and Work-up
				2.3.1	 Immunophenotyping
				2.3.2	 Cytogenetics
					Fluorescence In Situ Hybridization
					Conventional Karyotype
				2.3.3	 RT-PCR for PML-RARA RNA
			2.4	 Risk Stratification (Table 4)
				2.4.1	 Principles of Management
				2.4.2	 Medical Management and Monitoring
					Induction-Low- or Intermediate-Risk APL
					Induction-High-Risk APML
					Monitoring During Induction
					Other Issues During Induction
						Differentiation Syndrome
						Idiopathic Intracranial Hypertension or Pseudotumor Cerebri
						Response Assessment After Induction
					Consolidation
						Non-High-Risk APML Consolidation
						High-Risk APML
					Maintenance
			2.5	 Prognosis
			2.6	 Management of Resistant/Refractory Disease
			2.7	 Management for APML (Fig. 3)
			2.8	 How We Do It at TMC
		3	 Acute Lymphoblastic Leukemia
			3.1	 Incidence and Epidemiology
			3.2	 Clinical Presentation
			3.3	 Evaluation and Work-Up
			3.4	 Risk Stratification
			3.5	 Principles of Management
			3.6	 Supportive Care
			3.7	 Management of Recurrent Disease
			3.8	 How We Do It at TMC
		4	 Chronic Myeloid Leukemia
			4.1	 Incidence and Epidemiology of CML in India and Global
			4.2	 Clinical Features
			4.3	 Signs
			4.4	 Evaluation and Risk Stratification
				4.4.1	 Blood and Bone Marrow Examination
				4.4.2	 Molecular Tests
				4.4.3	 Prognostic Factors
			4.5	 Treatment at TMH
			4.6	 Practical Management Algorithmwfor CML
			4.7	 Monitoring of CML
			4.8	 Treatment-Free Remission
		5	 Chronic Lymphocytic Leukemia
			5.1	 Incidence and Epidemiology in India and Global
			5.2	 Clinical Presentation in India and Global
			5.3	 Evaluation and Work-Up
			5.4	 Work-Up for Confirmation of Diagnosis
			5.5	 Principles of Management
			5.6	 Medical Management and Monitoring
			5.7	 Management Algorithm According to Risk Stratification (Fig. 6)
			5.8	 Management of Recurrent Disease Including Specific Palliative Measures
			5.9	 How We Do It at TMC
		6	 Hairy Cell Leukemia
			6.1	 Incidence and Epidemiology in India and Global
			6.2	 Clinical Presentation in India and Globally
			6.3	 Evaluation and Work-Up Including Risk Stratification
			6.4	 Principles of Management (an Integrated Brief Overview of Rx Philosophy)
			6.5	 Medical Management and Monitoring
			6.6	 Prognosis with Current Rx
			6.7	 Management of Recurrent Disease Including Specific Palliative Measures
			6.8	 How We Do It at TMC
		References
	Adult Lymphomas
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Features and Staging of Lymphomas
		4	 Evaluation and Work-Up of Lymphomas
			4.1	 Lymphoma Diagnosis: Lab Approach
				4.1.1	 Morphological/Histopathological Approach to Lymphoma Diagnosis
				4.1.2	 Immunophenotyping
				4.1.3	 Cytogenetics
				4.1.4	 Molecular Tests
		5	 Principles of Management of Lymphomas
		6	 Management of Non-Hodgkin Lymphomas
			6.1	 Precursor B- and T-Cell Lymphomas
			6.2	 Mature B-Cell Lymphomas
				6.2.1	 Diffuse Large B-Cell Lymphoma (DLBCL)
				6.2.2	 Burkitt Lymphoma
				6.2.3	 Mantle Cell Lymphoma
				6.2.4	 Marginal Zone Lymphomas
				6.2.5	 Small Lymphocytic Lymphomas/Chronic Lymphoid Leukemia
				6.2.6	 Follicular Lymphoma
				6.2.7	 Peripheral T-Cell Lymphomas
		7	 Management of Hodgkin Lymphoma
			7.1	 Early Stage Favorable
			7.2	 Early Unfavorable
			7.3	 Early-Stage Risk/Response-Adapted Frontline Therapy
		8	 Advanced Hodgkin Lymphoma
			8.1	 Response-Adapted Therapy in Advanced Hodgkin Lymphoma
			8.2	 Role of Radiotherapy in Hodgkin Lymphoma
			8.3	 Long-Term Complications
		References
	Adult Myeloproliferative Disorders/Myelodysplastic Syndromes/Overlap Syndromes
		1	 Introduction
		2	 Epidemiology
		3	 Clinical Presentation
		4	 Evaluation, Work-Up and Risk Stratification
		5	 Principles and Guidelines for Management
		6	 Medical Management Options for MDS
		7	 Medical Management Options for MPN
		8	 Medical Management Options for Overlap Syndromes
		9	 Prognosis with Current Therapy
		10	 Treatment of Relapsed Refractory Disease and Palliative Care Measures
		11	 How We Do It at TMC
		References
	Plasma Cell Dyscrasias
		1	 Introduction
		2	 Incidence and Epidemiology in India and Global
			2.1	 Monoclonal Gammopathy of Unknown Significance and Smoldering Myeloma
			2.2	 Multiple Myeloma
			2.3	 Solitary Plasmacytoma
			2.4	 Systemic (AL) Amyloidosis
		3	 Etiology and Pathogenesis
		4	 Clinical Presentation
		5	 Evaluation and Work-Up Including Risk Stratification
			5.1	 Initial Work-Up
			5.2	 Additional Work-Up
		6	 Minimal Residual Disease (MRD) Monitoring
		7	 Principles of Management
		8	 Medical Management and Monitoring
			8.1	 Indications for Systemic Therapy
			8.2	 Therapy for Newly Diagnosed Myeloma
			8.3	 Initial Therapy
			8.4	 Autologous Stem Cell Transplant (ASCT)
			8.5	 Post ASCT Consolidation/Maintenance
			8.6	 Maintenance Therapy
			8.7	 Prognosis with Current Rx
			8.8	 Management of Recurrent Disease Including Specific Palliative Measures
		9	 Role of Definitive Radiation Therapy (RT) for Solitary Plasmacytoma
			9.1	 RT Dose Consideration for Solitary Plasmacytoma (SP)
		10	 Surgery for Multiple Myeloma
		11	 Multiple Myeloma Palliation with Radiation Therapy
			11.1	 Management Algorithm for Multiple Myeloma at TMC (Fig. 4)
		References
	Immunodeficiency-Associated Lymphoproliferative Disorders
		1	 Lymphomas Associated with HIV Infection
			1.1	 Prevalence
			1.2	 General Features of HIV-Associated Lymphomas
			1.3	 Pathogenesis
			1.4	 Histologic Classification of Lymphomas Associated with HIV Infection
				1.4.1	 Primary CNS Lymphoma (PCNSL) in HIV Patients
				1.4.2	 Diffuse Large B Cell Lymphoma (DLBCL) in HIV Patients
				1.4.3	 Burkitt Lymphoma
				1.4.4	 Polymorphic B Cell Lymphomas
				1.4.5	 Plasmablastic Lymphoma (PBL)
				1.4.6	 Primary Effusion Lymphomas (PEL)
				1.4.7	 Large B Cell Lymphoma Arising in Multicentric Castleman’s Disease (MCD) in HIV Patients
				1.4.8	 Peripheral T Cell Lymphoma
				1.4.9	 Hodgkin Lymphoma (HL) in HIV Patients
			1.5	 Clinical Features and Approach to Patients with HIV-Associated Lymphomas
			1.6	 Treatment
				1.6.1	 Concurrent cART
				1.6.2	 Combination Chemotherapy
			1.7	 Treatment of DLBCL
			1.8	 Treatment of Burkitt Lymphoma
			1.9	 Treatment of Hodgkin Lymphoma
			1.10	 Treatment of Other Lymphomas
			1.11	 Supportive Care in HIV-Associated Lymphomas
			1.12	 CNS Prophylaxis
		2	 LPDS Associated with Primary Immune Disorders
			2.1	 Prevalence
			2.2	 Pathogenesis
			2.3	 Clinical Features and Management
		3	 Post-transplant Lymphoproliferative Disorders (PTLD)
			3.1	 Classification
			3.2	 Etiology
			3.3	 Incidence
			3.4	 Clinical Features
			3.5	 Prognostic Factors
			3.6	 Management
		References
	Histiocytic and Dendritic Cell Neoplasms
		1	 Introduction
		2	 Histiocytes/Macrophages
		3	 Dendritic Cells
			3.1	 Myeloid-Derived DCs
			3.2	 Stromal-Derived DCs
		4	 Spectrum of Histiocytoses
		5	 Histiocytic and Dendritic Cell Neoplasms
		6	 Histiocytic Sarcoma (HS)
		7	 Tumors Derived from Langerhans Cells
			7.1	 Langerhans Cell Histiocytosis (LCH)
			7.2	 Langerhans Cell Sarcoma (LCS)
		8	 Indeterminate Dendritic Cell Tumor
		9	 Interdigitating Dendritic Cell Sarcoma (IDCS)
		10	 Follicular Dendritic Cell Sarcoma (FDCS) and Fibroblastic Reticular Cell Tumor (FRCT)
		11	 Xanthogranulomatous Group of Diseases: Disseminated Juvenile Xanthogranuloma (JXG) and Erdheim Chester Disease
		12	 Rosai–Dorfman Disease/Rosai–Dorfman–Destombes Disease (RDD)/Sinus Histiocytosis with Massive Lymphadenopathy (SHML)
		References
	Pediatric Acute Leukemias
		1	 Introduction
		2	 Acute Lymphoblastic Leukemia
			2.1	 Introduction
			2.2	 Incidence and Epidemiology in India and Global
			2.3	 Clinical Presentation in India and Global
			2.4	 Precursor B-ALL
			2.5	 T-Cell ALL
			2.6	 Special Types of ALL
				2.6.1	 Infant ALL
				2.6.2	 Philadelphia-Chromosome Positive ALL
				2.6.3	 Adolescent ALL
			2.7	 Evaluation and Work-Up Including Risk Stratification
			2.8	 Principles of Management (an Integrated Brief Overview of Rx Philosophy)
				2.8.1	 Remission Induction Phase
				2.8.2	 Intensification/Consolidation Phase
				2.8.3	 Interim Maintenance
				2.8.4	 Re-induction/Delayed Intensification Phase
				2.8.5	 Continuation/Maintenance Phase
				2.8.6	 Central Nervous System (CNS) Directed Therapy
			2.9	 Medical Management and Monitoring
			2.10	 Management Algorithms According to Risk Stratification
			2.11	 Prognosis with Current Rx
			2.12	 Management of Recurrent Disease Including Specific Palliative Measures
		3	 Acute Myeloid Leukemia
			3.1	 Introduction
			3.2	 Incidence and Epidemiology in India and Global
			3.3	 Clinical Presentation in India and Global
			3.4	 Evaluation and Work-Up Including Risk Stratification
			3.5	 Principles of Management (an Integrated Brief Overview of Rx Philosophy)
			3.6	 Risk Stratification
			3.7	 Treatment at TMH
			3.8	 Relapsed AML
			3.9	 Future Directions
		4	 Acute Promyelocytic Leukemia
			4.1	 Introduction
			4.2	 Incidence
			4.3	 Principles of Management
			4.4	 Management and Monitoring
			4.5	 Treatment Algorithm
				4.5.1	 Induction
				4.5.2	 Consolidation
			4.6	 Common Toxicities
			4.7	 Management of Recurrent Disease
		5	 How We Do It at TMC
		References
	Pediatric Hodgkin Lymphoma
		1	 Introduction
		2	 Incidence and Epidemiology in India and Global
		3	 Clinical Presentation in India and Global
		4	 Evaluation and Work-Up Including Risk Stratification
			4.1	 Diagnosis
			4.2	 Immunohistochemistry
			4.3	 Assessment of Involved Regions and Staging
			4.4	 Risk Stratification
		5	 Principles of Management
		6	 Medical Management
			6.1	 Chemotherapy
			6.2	 Radiotherapy (RT)
		7	 Monitoring According to Risk Stratification
			7.1	 Response Assessment
				7.1.1	 Early Response Assessment (ERA)
		8	 Nodular Lymphocyte-Predominant HL (NLPHL)
		9	 Management of Relapsed and Refractory HL
		10	 Late Effects
			10.1	 Cardiac Toxicity
			10.2	 Pulmonary Toxicity
			10.3	 Thyroid Abnormalities
			10.4	 Gonadal Toxicity
			10.5	 Subsequent Neoplasms (SMN)
			10.6	 Growth and Development
		11	 Treatment Algorithms Used in Tata Memorial Hospital (TMH)
		References
	Pediatric Myeloproliferative Disorders/Myelodysplastic Syndromes/Overlap Syndromes
		1	 Introduction
		2	 Incidence and Epidemiology in India and Globally
		3	 Clinical Presentation
		4	 Evaluation and Work-Up Including Risk Stratification
			4.1	 Juvenile Myelomonocytic Leukemia (JMML) and Other Myelodysplastic/Myeloproliferative Disorders
			4.2	 Myeloid Leukemia of Down Syndrome (ML-DS)
			4.3	 Transient Abnormal Myelopoiesis (TAM)
			4.4	 Refractory Cytopenia (RC)
			4.5	 Advanced Pediatric MDS
			4.6	 Principles of Management of MDS
			4.7	 Refractory Cytopenia (RC)
			4.8	 Advanced Primary MDS (RAEB/RAEB-t)
			4.9	 Treatment of Secondary MDS
			4.10	 Principles of Management of JMML
			4.11	 Treatment of CBL Mutation
			4.12	 Treatment of Germline Mutation of KRAS/NRAS
			4.13	 Treatment of Somatic Mutation of KRAS/NRAS/PTPN11 and NF-1
			4.14	 Principles of Management of TAM in Downs Syndrome
			4.15	 Prognosis with Current Treatment
				4.15.1	 MDS
				4.15.2	 JMML
			4.16	 Management of Recurrent Disease in Patients with MDS
			4.17	 Management of Recurrent Disease in Patients with JMML
		5	 How We Do It at TMC
		References
	Hematopoietic Stem Cell Transplantation
		1	 Introduction
		2	 Historical Aspects
		3	 Indications for Hematopoietic Stem Cell Transplant (Table 1)
		4	 Types of Hematopoietic Stem Cell Transplantation
		5	 Biological Principles of High-Dose Chemotherapy and Radiation
		6	 Total Body Irradiation
		7	 Outcomes of HSCT (in Adults) in Various Diseases (Table 3)
		8	 Outcomes of HSCT (in Children) in Various Diseases (Table 4)
		9	 Current Status of HSCT: Indian Perspective
		References
Part IV: Solid Tumors
	Central Nervous System (CNS) Tumors
		1	 Introduction
		2	 Epidemiology (Global and Indian Perspectives)
		3	 Clinical Presentation
		4	 Diagnostic Imaging and Work up
			4.1	 Additional Investigations and Work-Up
		5	 Pathology of CNS Tumors and Tissue Diagnosis
		6	 Surgical Management
			6.1	 Adjuncts in Neuro-oncological Surgery
		7	 Adjuvant Treatment for Brain Tumors
			7.1	 Radiotherapy Techniques
			7.2	 Systemic Therapy/Chemotherapy
		8	 Management of Individual Tumor Types
			8.1	 Circumscribed Gliomas and Glioneuronal/Neuronal Tumors
			8.2	 Adult Diffuse Gliomas
			8.3	 Glioblastoma
			8.4	 Brainstem and Midline Gliomas
			8.5	 Ependymal Tumors
			8.6	 Embryonal Tumors
			8.7	 Meningioma
			8.8	 Pituitary Adenoma
			8.9	 Acoustic Neuroma
			8.10	 Craniopharyngioma
			8.11	 Primary Central Nervous System Lymphoma (PCNSL)
			8.12	 Germ Cell Tumor
			8.13	 Brain Metastases
		9	 Patient Reported Outcomes/Quality of Life (QOL)
			9.1	 Survivorship
			9.2	 Mitigating Adverse Events
		References
	Head and Neck Cancers
		1	 Introduction
		2	 Incidence and Epidemiology in India and Global
		3	 Clinical Presentation in India and Worldwide
		4	 Evaluation and Work-Up
			4.1	 History
			4.2	 Physical Examination
			4.3	 Endoscopy and Biopsy
			4.4	 Radiology
			4.5	 Pathology
			4.6	 Histopathological Examination and Reporting (Synoptic Reporting)
			4.7	 Tumor Markers
			4.8	 Referrals Including Genetic Counseling
		5	 Principles of Management (an Integrated Brief Overview of Treatment Philosophy)
		6	 Surgical Management
			6.1	 Assessment of Resectability
			6.2	 Principles of Resection
			6.3	 Reconstruction Options
			6.4	 Rehabilitation
		7	 Medical Management
		8	 Radiation Management
			8.1	 Definitive Radiotherapy
			8.2	 Brachytherapy
			8.3	 Adjuvant Radiotherapy
		9	 Site-Wise Management Algorithms
			9.1	 Nasopharyngeal Cancer
			9.2	 Target Volumes and Doses
			9.3	 Delineation of GTV
			9.4	 Management Algorithm for Nasopharyngeal Cancer
			9.5	 Oral Cavity
				9.5.1	 Oropharynx
				9.5.2	 Larynx and Hypopharynx
			9.6	 Nasal Cavity and Paranasal Sinuses
			9.7	 Salivary Gland Tumors
		10	 Stage-Wise Prognosis with Current RX
			10.1	 Head and Neck Cancer (Non-nasopharyngeal and HPV −ve Head and Neck Cancer)
			10.2	 Nasopharynx
			10.3	 Oropharynx (HPV+)
		11	 Management of Recurrent Disease Including Specific Palliative Measures
			11.1	 Nasopharynx
				11.1.1	 Role of Surgery
				11.1.2	 Role of Re-irradiation
			11.2	 Oral Cavity
			11.3	 Oropharynx
			11.4	 Larynx and Hypopharynx
			11.5	 Nasal Cavity and Paranasal Sinuses
			11.6	 Salivary Gland Tumors
		12	 How We Do It at TMC (Figs. 3, 4, 5, 6, 7, and 8)
		References
	Thyroid and Parathyroid Cancers
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Differentiated Thyroid Cancers
			3.1	 Clinical Presentation
			3.2	 Evaluation and Work-Up
			3.3	 Principles of Management
				3.3.1	 Surgical Management of Differentiated Thyroid Cancers
					Primary Tumor
				3.3.2	 Radioactive Iodine (RAI) Treatment
				3.3.3	 Radiation Management
				3.3.4	 Thyroxine Replacement Post Thyroidectomy
			3.4	 Stage-Wise Prognosis with Current Treatment
			3.5	 Management of Recurrent Disease Including Specific Palliative Measures
		4	 Medullary Thyroid Cancers (MTC)
			4.1	 Clinical Presentation
			4.2	 Evaluation and Work-Up
			4.3	 Treatment Philosophy and Surgical Management
			4.4	 Radiation Management
			4.5	 Management of Recurrent Disease Including Specific Palliative Measures
		5	 Anaplastic Thyroid Cancers
		6	 Parathyroid Cancers
			6.1	 Incidence and Epidemiology
			6.2	 Clinical Presentation
			6.3	 Evaluation and Work-Up
			6.4	 Principles of Management
				6.4.1	Surgical Management
				6.4.2	Radiation Management
				6.4.3	Medical Management
			6.5	 Stage-Wise Prognosis with Current Treatment
			6.6	 Management of Recurrent Disease Including Specific Palliative Measures
		7	 How Do We Do It at TMC
			7.1	 Differentiated Thyroid Cancers
			7.2	 Medullary Thyroid Cancers
			7.3	 Anaplastic Thyroid Cancers
			7.4	 Parathyroid Carcinoma
		References
	Breast Cancer
		1	 Introduction
		2	 Predictive and Prognostic Markers
		3	 Principles of Management
			3.1	 Early and Locally Advanced Breast Cancer
			3.2	 Metastatic Breast Cancer
		4	 Imaging
			4.1	 Screening
				4.1.1	 Current Status of Screening for Breast Cancer
			4.2	 Diagnostic Imaging
		5	 Surgical Management
			5.1	 Management of Primary
			5.2	 Approach to Axilla
		6	 Role of Radiotherapy
			6.1	 BCS
			6.2	 Postmastectomy
			6.3	 Regional Lymph Node Irradiation
				6.3.1	 Axilla
				6.3.2	 Other Regional Sites
			6.4	 Dose Fractionation
			6.5	 Accelerated Partial Breast Irradiation (APBI)
			6.6	 Role of Radiation Therapy in Metastatic Breast Cancer
				6.6.1	 Bone Metastases (BM)
				6.6.2	 Brain Metastases (Brm)
					Systemic Therapy
		7	 Regimen Selection and Administration
			7.1	 Neoadjuvant Systemic Therapy
			7.2	 Anti-HER2-Targeted Therapy
			7.3	 Endocrine Therapy
				7.3.1	 Premenopausal Women: Choice of Tamoxifen Alone vs. Tamoxifen with OFS
				7.3.2	 Postmenopausal Women
		8	 Metastatic Breast Cancer
			8.1	 Choice of Chemotherapy
			8.2	 Duration of Treatment
		9	 HER2-Positive MBC
			9.1	 First-Line Therapy
				9.1.1	 Trastuzumab
				9.1.2	 Lapatinib
				9.1.3	 Trastuzumab Plus Pertuzumab
			9.2	 Second-Line Therapy
		10	 Hormone Receptor-Positive Metastatic Breast Cancer
		11	 Special Scenarios
			11.1	 Young Women with Breast Cancer
			11.2	 Palpable DCIS (pDCIS)
		References
	Non-Small Cell Lung Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Presentation
		4	 Evaluation and Work-Up
			4.1	 Predictive and Prognostic Biomarkers
		5	 Principles of Management (An Integrated Brief Overview of RX Philosophy)
			5.1	 Localized (T1-3, N0-1) Non-Small Cell Lung Cancer (NSCLC)
			5.2	 Loco-Regionally Advanced (T4 and N3) NSCLC
		6	 Surgical Management
			6.1	 Early-Stage NSCLC
				6.1.1	 Primary Tumour Resection
			6.2	 Nodal Evaluation and Resection
			6.3	 Locally Advanced NSCLC (T1–3, N2)
				6.3.1	 Pre-Operatively Diagnosed N2 Disease
				6.3.2	 Surgically Discovered N2 Disease
		7	 Radiation Management
			7.1	 Early-Stage NSCLC
			7.2	 Locally Advanced, Non-metastatic NSCLC
			7.3	 Postoperative RT (PORT)
			7.4	 Palliative RT
		8	 Medical Management
			8.1	 Early Stage
			8.2	 Locally Advanced
			8.3	 Metastatic NSCLC
				8.3.1	 Targeted Therapy
				8.3.2	 Immunotherapy
		9	 Stage-Wise Management Algorithms
		10	 Toxicity of Treatment
		11	 Stage-Wise Prognosis with Current RX
		12	 How We Do It at TMC
		References
	Small Cell Lung Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Evaluation and Work-Up
		4	 Pathology
		5	 Staging
		6	 Principles of Management
		7	 Limited Stage SCLC
			7.1	 Surgical Management
			7.2	 Radiation Management
				7.2.1	 Timing of Thoracic RT
				7.2.2	 Dose of Thoracic RT
				7.2.3	 Role of PCI
			7.3	 Chemotherapy
		8	 Extensive Stage SCLC
			8.1	 Chemotherapy
			8.2	 Duration of Treatment
			8.3	 Targeted/Immunotherapy
			8.4	 Radiation Therapy
		9	 Relapsed SCLC
		10	 Future Perspective
		11	 How We Do It at TMC (Table 4)
		References
	Mediastinal Tumors
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Presentation
		4	 Evaluation and Work-Up
			4.1	 Tumor Markers
			4.2	 Radiology
			4.3	 Pathology/Tissue Diagnosis
		5	 Management
			5.1	 Thymoma
				5.1.1	 Classification
				5.1.2	 Staging System
				5.1.3	 Presentation
				5.1.4	 Investigations
				5.1.5	 Management
					Stage I/II
					Stage III/IV
				5.1.6	 Prognosis
		6	 Mediastinal Germ Cell Tumors
			6.1	 Teratoma
			6.2	 Seminoma
			6.3	 Nonseminomatous Germ Cell Tumors (NSGCT)
		7	 Posterior Mediastinal Tumors
		References
	Esophageal Cancer
		1	 Introduction
		2	 Risk Factors
		3	 Clinical Presentation
		4	 Diagnosis and Staging
		5	 Staging
		6	 Patient Optimization
		7	 Management
			7.1	 Endoscopic Treatment
			7.2	 Surgery
			7.3	 Surgical Approach (Table 1)
			7.4	 Extent of Lymphadenectomy
			7.5	 Surgical Reconstruction
			7.6	 Neoadjuvant Therapy
			7.7	 Adjuvant Therapy
			7.8	 Definitive Radiation/Chemoradiation
			7.9	 Palliative Treatment
			7.10	 Management of Recurrent Disease
		8	 Summary: How We Do It at TMC
		References
	Biliary Tract Cancer
		1	 Gallbladder Cancer
			1.1	 Introduction
			1.2	 Etiology and Risk Factors
				1.2.1	 Age and Gender
				1.2.2	 Geography and Ethnicity
				1.2.3	 Gallstones
				1.2.4	 Chronic Inflammation
				1.2.5	 Porcelain Gallbladder
				1.2.6	 Infections
				1.2.7	 Primary Sclerosing Cholangitis
				1.2.8	 Obesity
				1.2.9	 Gallbladder Polyps
				1.2.10	 Anomalous Pancreaticobiliary Duct Junction (APBDJ)
				1.2.11	 Genetics
			1.3	 Clinical Features
			1.4	 Diagnosis and Work-Up
				1.4.1	 Blood Investigations
				1.4.2	 Imaging
					Ultrasonography (USG)
					Contrast-Enhanced Ultrasonography (CEUS)
					Computed Tomography (CT) Scan
					Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP)
					Endoscopic Ultrasonography (EUS)
					[18F]-2-Deoxy-D-Glucose (FDG) Positron Emission Tomography (PET)
				1.4.3	 Biopsy and Cytology
				1.4.4	 Staging Laparoscopy
			1.5	 Staging
				1.5.1	 Pathological Evaluation of Routine Cholecystectomy Specimens
				1.5.2	 Treatment
					Surgery
					The Extent of Liver Resection
					Lymph Node Dissection
					Bile Duct Resection
					Role of Multi-Visceral Resection—Major Hepatectomy and Hepatopancreaticoduodenectomy
					Role of Minimal Invasive Surgery
					Early GBC (pTis and pT1a)
					pT1b GBC
					pT2 GBC
					Incidental GBC
					Port Site Resection
					Locally Advanced GBC (T3, T4, and Node-Positive) and Role of Neoadjuvant Treatment
					Role of Neoadjuvant Chemotherapy (NACT)
			1.6	 Adjuvant Therapy
				1.6.1	 Adjuvant Chemotherapy
				1.6.2	 Adjuvant Chemoradiotherapy (CTRT)
			1.7	 Management of Unresectable/Metastatic GBC
			1.8	 Palliative Care
		2	 Cholangiocarcinoma
			2.1	 Introduction
			2.2	 Etiology and Risk Factors
				2.2.1	 Primary Sclerosing Cholangitis
				2.2.2	 Choledochal Cysts
				2.2.3	 Liver Fluke Infestation
				2.2.4	 Others
			2.3	 Clinical Features
			2.4	 Diagnosis and Work-Up
			2.5	 Imaging
			2.6	 Biopsy and Cytology
			2.7	 Staging
			2.8	 Treatment
				2.8.1	 Pre-Operative Management
					Pre-Operative Biliary Drainage
			2.9	 Surgery
				2.9.1	 Intrahepatic CCA
				2.9.2	 Hilar CCA
					Criteria for Unresectability of Hilar CCA [106]
				2.9.3	 Liver Transplantation
			2.10	 Adjuvant Therapy
				2.10.1	 Radiotherapy
				2.10.2	 Combined Chemo-Radiotherapy
				2.10.3	 Chemotherapy
			2.11	 Advanced Disease
				2.11.1	 Radiotherapy
				2.11.2	 SBRT in Unresectable Cholangiocarcinoma
				2.11.3	 Chemotherapy
			2.12	 Palliative Measures
		References
	Liver Cancer
		1	 Introduction
		2	 Epidemiology and Etiology
			2.1	 Epidemiology
			2.2	 Etiology
		3	 Clinical Presentation
		4	 Surveillance and Diagnostic Evaluation
			4.1	 Surveillance
			4.2	 Diagnostic Evaluation
		5	 Staging and Treatment Strategy
			5.1	 Staging Systems in HCC
		6	 Treatment
			6.1	 Liver Resection
			6.2	 Liver Transplantation
			6.3	 Local Ablation
			6.4	 Transarterial Chemoembolization (TACE) and Other Transcatheter Therapies
			6.5	 Systemic Therapy
			6.6	 Immunotherapy
			6.7	 Stereotactic Body Radiation Therapy (SBRT)
			6.8	 Evaluation of Treatment Response and Follow-Up
		References
	Gastric Cancer
		1	 Introduction
		2	 Epidemiology: Indian and Global Scenario
		3	 Risk Factors for Gastric Cancer
		4	 Clinical Presentation
		5	 Evaluation and Work-Up
			5.1	 Tumor Markers
			5.2	 Endoscopy
				5.2.1	 Endoscopic Ultrasonography (EUS)
			5.3	 Pathology
				5.3.1	 Molecular Classification
			5.4	 Radiology
			5.5	 Staging Laparoscopy (SL)
			5.6	 Referrals Including Genetic Counseling
		6	 Principles of Management
			6.1	 Early Gastric Cancers (EGC) [T1a/T1b N0/N+ M0]
			6.2	 Gastric Cancer with Locoregional Disease [T2-T4 N+ M0]
			6.3	 Advanced Gastric Cancers [Unresectable T4 N+ or M1]
		7	 Surgical Management
			7.1	 Surgery for Distal Tumors
			7.2	 Surgery for Proximal Tumors
			7.3	 Surgery for Early Gastric Cancer (EGC)
			7.4	 Role of Bursectomy During Radical Gastrectomy
			7.5	 Lymphadenectomy During Radical Gastrectomy
		8	 Medical Management
			8.1	 General Principles
			8.2	 Perioperative Chemotherapy
			8.3	 Adjuvant Therapy
		9	 Radiotherapy
			9.1	 Neoadjuvant Chemoradiation
			9.2	 Adjuvant Chemoradiation
			9.3	 Radiotherapy Protocol
		10	 Medical Management of Advanced Inoperable/Metastatic Gastric Cancers
			10.1	 Immunotherapy
		11	 Stage-Wise Survival of Gastric Cancer
		12	 How We Do It at TMC
		References
	Colon Cancer
		1	 Introduction
		2	 Incidence and Epidemiology in India and the World
			2.1	 Incidence
			2.2	 World Trends
			2.3	 Domestic Trends
		3	 Etiology and Risk Factors
		4	 Clinical Presentation in India and the World
		5	 Evaluation and Work-Up
			5.1	 Screening
			5.2	 Work-Up
				5.2.1	 Colonoscopy
				5.2.2	 Imaging
				5.2.3	 Tumor Markers
			5.3	 Pathology
				5.3.1	 Gross Pathology
				5.3.2	 Microscopic Pathology
			5.4	 Staging
			5.5	 Referrals Including Genetic Counseling
			5.6	 Lynch Syndrome
				5.6.1	 Amsterdam II Criteria
				5.6.2	 Bethesda Guidelines
				5.6.3	 Familial Adenomatous Polyposis (FAP)
				5.6.4	 Genetic Testing and Counseling
		6	 Principles of Management
		7	 Surgical Management
			7.1	 Endoscopic Resection
			7.2	 Radical Colectomy
			7.3	 Complete Mesocolic Excision (CME)
			7.4	 The Extent of Colectomy in the Setting of Familial Colorectal Cancer
			7.5	 Minimally Invasive Surgery for Colon Cancer
			7.6	 Management of the Obstructed Colon Primary
				7.6.1	 Diversion Colostomy
				7.6.2	 Hartmann’s Procedure
				7.6.3	 Primary Resection and Anastomosis
				7.6.4	 Endoscopic Colonic Stenting
				7.6.5	 Multivisceral Resection for Colon Cancer
				7.6.6	 Surgical Management of Metastatic Colon Cancer
				7.6.7	 Surgical Options for Liver Metastases
			7.7	 Surgical Options for Lung Metastases
			7.8	 Surgical Options for Colorectal Peritoneal Metastasis
		8	 Medical Management
			8.1	 Role of Adjuvant Chemotherapy in Colon Cancer
			8.2	 Role of Chemotherapy in Metastatic Colorectal Cancer
		9	 Radiation Management
		10	 Stage-Wise Management Algorithm
		11	 Stage-Wise Prognosis with Current Treatment
		12	 Management of Recurrent Disease Including Specific Palliative Measures
		13	 How We Do It at TMC (Fig. 5)
		References
	Small Intestine Cancer
		1	 Introduction
		2	 Epidemiology
		3	 Histology
		4	 Etiopathogenesis
			4.1	 Hereditary Cancer Syndromes, Predisposing Conditions and SIA [13] (Table 2)
				4.1.1	 Hereditary Nonpolyposis Colorectal Cancer (HNPCC) Syndrome
				4.1.2	 Peutz–Jeghers Syndrome
				4.1.3	 Familial Adenomatous Polyposis (FAP) Syndrome
			4.2	 Inflammatory Bowel Disease and Chronic Inflammation
			4.3	 Other Associations
		5	 Clinical Presentation
		6	 Evaluation and Work-Up
		7	 Staging
		8	 Management
			8.1	 Surgical Management of SIA
				8.1.1	 Duodenal Adenocarcinomas
				8.1.2	 Jejunal and Ileal Adenocarcinomas
			8.2	 Adjuvant Chemotherapy for Small Bowel Adenocarcinomas
			8.3	 Management of Metastatic Disease
		9	 Prognosis
		10	 How We Do It at TMC (Table 3)
		References
	Anal Canal Cancer
		1	 Introduction
		2	 Incidence and Epidemiology in India and Global
			2.1	 Risk Factors
			2.2	 HPV
			2.3	 HIV
			2.4	 Sexual Activity
			2.5	 Smoking
			2.6	 Chronic Immunosuppression
		3	 Clinical Presentation in India and Global
		4	 Evaluation and Work-Up
		5	 Principles of Management
			5.1	 Radiation Management
				5.1.1	 Evidence
			5.2	 Radiation Planning
			5.3	 Response Assessment
			5.4	 Follow-Up
			5.5	 Complications
		6	 Chemotherapy Management
			6.1	 Evidence
				6.1.1	 Nonmetastatic Disease
				6.1.2	 Concurrent Chemotherapy
			6.2	 Neoadjuvant and Maintenance/Consolidation Chemotherapy
			6.3	 Metastatic Disease
			6.4	 Chemotherapy Schedules
				6.4.1	 Assessment
				6.4.2	 Toxicity
		7	 Surgical Management
		8	 Stage-Wise Management Algorithms (Fig. 1)
		9	 Stage-Wise Prognosis with Current RX (Table 3)
		10	 Management of Recurrent Disease Including Specific Palliative Measures
		References
	Gastroenteropancreatic Neuroendocrine Tumors
		1	 Introduction
		2	 Epidemiology
		3	 Pathology, Who Classification and Staging
		4	 Evaluation and Work-Up
			4.1	 Tumor Markers
				4.1.1	 Serum Chromogranin a (cg a)
			4.2	 Radiological Imaging
				4.2.1	 Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) [16, 17]
				4.2.2	 Endoscopic Ultrasound (EUS) [18]
				4.2.3	 68Ga DOTATATE PET CT and 18FDG PET CT Scan [19–24]
			4.3	 Immunohistochemistry (IHC) [25, 26]
		5	 Clinical Presentation
		6	 Carcinoid Syndrome and Carcinoid Heart Disease [38–40]
		7	 Principles of Management
		8	 Treatment of Localized/Loco-Regional Tumors [35, 41–45]
		9	 Treatment of Advanced/Metastatic/Recurrent Tumors
			9.1	 Somatostatin Analogues (SSA)
			9.2	 Chemotherapy
			9.3	 Targeted Therapy
			9.4	 Peptide Receptor Radionuclide Therapy (PRRT)
			9.5	 Liver-Directed Therapy
		10	 Follow-Up
		References
	Rectal Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Presentation
		4	 Evaluation and Work-up
			4.1	 History
			4.2	 Digital Rectal Examination
			4.3	 Biopsy
			4.4	 Blood Investigations
			4.5	 Colonoscopy
			4.6	 Radiological Examinations
			4.7	 Staging
		5	 Management of Rectal Adenocarcinoma
			5.1	 T1, T2, N0, M0 (MRI Cannot Differentiate Between T1/T2 Cancer, and EUS is Used to Confirm T1 NO Disease)
				5.1.1	 TEMS
				5.1.2	 TAMIS
			5.2	 T3, N any, M0
			5.3	 Laparoscopic Versus Open Approach
		6	 Role of Robotic Surgery in Rectal Cancer
		7	 Transanal Total Mesorectal Excision (TaTME)
		8	 Role of Radiotherapy
			8.1	 The Rationale Behind Pre-operative RT
			8.2	 Preoperative RT vs. Surgery Alone
			8.3	 Pre-operative vs. Post-operative Long-Course Chemoradiotherapy
			8.4	 Indications for Neoadjuvant RT
			8.5	 Addition of Chemotherapy to Pre-operative RT
			8.6	 SCRT vs. NACT-RT
			8.7	 Optimal Interval Between Preoperative RT and Surgery
			8.8	 Reassessment/Response Assessment After NART
			8.9	 Response to Pre-operative CRT as a Predictor of Outcome
			8.10	 Clinical Complete Response and a “Watch-and-Wait” Approach
			8.11	 T3, N any, CRM Involved (on MRI)/T4, N Any/Locally Unresectable/Medically Inoperable
			8.12	 Role of NACTRT Followed by NACT
			8.13	 Role of Adjuvant Chemotherapy
			8.14	 Role of Neoadjuvant Chemotherapy Followed by Chemoradiotherapy (Total Neoadjuvant Therapy Approach)
			8.15	 Role of Beyond TME Surgery
			8.16	 What Is an Adequate Adjuvant Treatment for Up-Front Resected Stage II, III Tumours?
			8.17	 T any, N any, M+
		9	 Treatment of Synchronous Resectable Metastatic Liver/Lung Disease
			9.1	 Neoadjuvant and Adjuvant Therapy for Resectable Metastatic Disease
			9.2	 Dilemma About the Sequencing of Preoperative Treatment Modalities
		10	 Treatment of Patients with Limited Unresectable Disease
		11	 Treatment of Widespread Metastatic Rectal Cancer
		12	 Management of Recurrent Rectal Cancer
		References
	Pancreatic Cancer
		1	 Introduction
		2	 Epidemiology: Indian and Global Scenario
		3	 Risk Factors
		4	 Clinical Presentation
		5	 Evaluation and Work-Up
			5.1	 Tumor Markers
			5.2	 Imaging Modalities
				5.2.1	 Transabdominal Ultrasonography
				5.2.2	 CT Scan
				5.2.3	 MRI
				5.2.4	 PET
			5.3	 Endoscopic Techniques
				5.3.1	 ERCP
				5.3.2	 Endoscopic Ultrasonography
			5.4	 Pathology
				5.4.1	 Histopathology
				5.4.2	 Molecular Pathology
			5.5	 Referrals Including Genetic Counseling
		6	 Principles of Management
		7	 Surgical Management
			7.1	 Indication for Surgery
			7.2	 Surgical Techniques and Other Considerations
		8	 Medical Management
			8.1	 Adjuvant Chemotherapy for Resected Pancreatic Cancer
			8.2	 Neoadjuvant Chemotherapy/Radiotherapy
			8.3	 First-Line Chemotherapy for Metastatic Pancreatic Cancer
			8.4	 Second-Line Chemotherapy for Metastatic Pancreatic Cancer
		9	 Radiotherapy
		10	 Prognosis
		11	 Palliative Management in Advanced Metastatic Disease
		References
	Gastrointestinal Stromal Tumours
		1	 Introduction
		2	 Global Incidence, Epidemiology, and Clinical Presentation: Global and India
		3	 Molecular Basis of GIST
		4	 Evaluation and Work-Up
			4.1	 Endoscopy and Endoscopic Ultrasound (EUS)
			4.2	 Radiology and Nuclear Imaging
			4.3	 Pathology
		5	 Principles of Management (Overview)
		6	 Surgical Management
			6.1	 General Principles
			6.2	 Extent of Surgical Resection
			6.3	 Minimally Invasive Approaches
			6.4	 Management of Small GISTs
			6.5	 Neoadjuvant Imatinib
			6.6	 Unresectable, Recurrent, or Metastatic GIST
		7	 Medical Management
			7.1	 Brief History
			7.2	 Adjuvant Treatment Post Resection of GIST
			7.3	 Neoadjuvant Imatinib in GIST
			7.4	 Treatment of Advanced/Metastatic GIST
			7.5	 Radiation Management
		8	 Special Situations in GIST
			8.1	 Syndromes Associated with GIST
			8.2	 Treatment of Advanced GIST with PDGFRA Mutations
		9	 Stage-Wise Prognosis with Current Management
		References
	Renal Cancer
		1	 Introduction
		2	 Incidence and Epidemiology in India and Worldwide
		3	 Clinical Presentation
		4	 Evaluation and Work-Up
			4.1	 Routine Laboratory Tests
			4.2	 Radiology
			4.3	 Tumor Markers
		5	 Pathology
		6	 Genetic Evaluation
		7	 Anatomical Classification Systems
		8	 Principles of Management
		9	 Surgical Management
			9.1	 Stage 1, 2 Disease (Tumor Limited to the Kidney)
				9.1.1	 Principles of Radical Nephrectomy (RN)
				9.1.2	 Nephron-Sparing Surgery
				9.1.3	 Ablative Techniques
			9.2	 RCC with Tumor Thrombus (Extending to Renal Vein or Inferior Vena Cava [4–10%])
			9.3	 Surveillance Following Surgery for RCC
		10	 Medical Management
			10.1	 Adjuvant Treatment for Localized RCC
		11	 Radiation Therapy
		12	 Stage-Wise Management Algorithms (Figs.1 and 2)
		13	 Stage-Wise Prognosis (Table 3) [39]
		14	 Management of Metastatic Disease
		15	 Systemic Therapy for Metastatic RCC
			15.1	 Targeted Therapy
			15.2	 Immune Checkpoint Inhibitors-Based Combination Therapies
			15.3	 Nonclear Cell metastatic RCCs
		References
	Adrenocortical Carcinoma
		1	 Introduction
		2	 Incidence and Epidemiology: Global and India
		3	 Genetic Predispostion
			3.1	 Inherited/Germline
			3.2	 Acquired
		4	 Clinical Presentation: Global and India
		5	 Evaluation and Work-Up
			5.1	 Biochemical
			5.2	 Radiology
			5.3	 Biopsy
			5.4	 Pathology
		6	 ACC Staging
		7	 Management Principles
		8	 Surgical Management
		9	 Medical Management
			9.1	 Mitotane
			9.2	 Chemotherapy
			9.3	 Targeted Therapy
			9.4	 Radiation Therapy in the Management of ACC
		10	 Algorithms for Stage-Wise Management (Fig. 4)
		11	 Prognosis by Stage with Current Treatment (Table 3)
		12	 Palliative Measures
		References
	Urinary Bladder Cancer
		1	 Introduction
		2	 Incidence
		3	 Epidemiology
		4	 Clinical Presentation in India and Globally
		5	 Investigations
		6	 Tumor Markers
		7	 Endoscopy
			7.1	 Principles of Cystoscopy + TURBT
			7.2	 Enhanced Cystoscopy
			7.3	 Fluorescence Cystoscopy (Blue Light Cystoscopy)
			7.4	 Narrow Band Imaging
			7.5	 Microscopic Imaging Techniques
			7.6	 Molecular Imaging
		8	 Radiology
			8.1	 Ultrasonography of the Abdomen and Pelvis
			8.2	 CECT Urography
			8.3	 MRI for Local Staging of Invasive Bladder Cancer
			8.4	 Comparison of CT and MRI for Local Staging
			8.5	 Metastatic Work-Up
			8.6	 Role of PET-CT Scan in Metastatic Work-Up
		9	 Pathology
			9.1	 Histological Grading
		10	 Genetic Counselling
		11	 Principles of Management
		12	 Surgical Management
			12.1	 Management of Non-muscle Invasive Bladder Cancer
			12.2	 Single Post TURBT Instillation
			12.3	 Additional Adjuvant Intravesical Therapy
			12.4	 Recommended Strategies for Treatment of BCG Failure
			12.5	 Cystectomy for Non-muscle Invasive Bladder Cancer
			12.6	 Management of Carcinoma-In-Situ
			12.7	 Follow-Up Schedules in NMIBC
			12.8	 Management of Muscle-Invasive Bladder Cancer
				12.8.1	 Surgery
			12.9	 Indications of Urethrectomy [49]
			12.10	 Urinary Diversion or Reconstruction
			12.11	 Enhanced Recovery after Surgery Pathway Outcomes
		13	 Minimally Invasive Surgery for Bladder Cancer
		14	 Role of Chemotherapy in Bladder Urothelial Carcinoma
			14.1	 Neoadjuvant Chemotherapy Before Radical Cystectomy
			14.2	 Adjuvant Therapy
			14.3	 Chemotherapy for Metastatic Bladder Cancer
			14.4	 Emerging Bladder Cancer Treatments
		15	 Role of Radiotherapy
			15.1	 Bladder Preservation
			15.2	 Role of Adjuvant Radiotherapy
		References
	Upper Tract Urothelial Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
			2.1	 Environmental Factors
			2.2	 Genetic Factors
		3	 Clinical Presentation
		4	 Evaluation and Work-up
			4.1	 Imaging
				4.1.1	 Ultrasonography (USG)
				4.1.2	 Computerized Tomography (CT)
				4.1.3	 Magnetic Resonance Imaging (MRI)
			4.2	 Endoscopy
			4.3	 Tumor Markers
			4.4	 Pathology
			4.5	 Genetic Counseling
		5	 Principles of Management (an Integrated Brief Overview of Rx Philosophy)
		6	 Surgical Management
			6.1	 Radical Nephroureterectomy
			6.2	 Adrenalectomy
			6.3	 Minimal Invasive RNU
			6.4	 Lymphadenectomy (LND)
			6.5	 Adjuvant Bladder Instillation
			6.6	 Conservative Surgery
			6.7	 Ureteroscopic Management (Table 4)
			6.8	 Percutaneous Management (Table 5)
			6.9	 Adjuvant Therapy Following Endoscopic Treatment
		7	 Medical Management
			7.1	 Neoadjuvant Chemotherapy (Table 6)
			7.2	 Adjuvant Chemotherapy (Table 7)
		8	 Radiation Management
		9	 Stage-Wise Management Algorithms (Figs. 5 and 6)
		10	 Stage-Wise Prognosis with Current Rx (Table 8) [52]
		11	 Management of Recurrent Disease Including Specific Palliative Measures
		12	 How We Do It at TMC
		References
	Prostate Cancer
		1	 Epidemiology
		2	 Clinical Features [2, 4]
			2.1	 Symptoms
			2.2	 Clinical Examination
		3	 Evaluation of Prostate Cancer [5]
			3.1	 Serum PSA
			3.2	 TRUS
			3.3	 Prostate Biopsy
			3.4	 PSMA PETCT
			3.5	 FDG PETCT
			3.6	 Tc99Bone Scan
			3.7	 MRI Pelvis
			3.8	 CT Scan
			3.9	 Blood Investigations
			3.10	 Prostascint
		4	 Screening
		5	 Principles of Treatment
			5.1	 Localized Prostate Cancer
			5.2	 Locally Advanced Prostate Cancer
			5.3	 Metastatic Prostate Cancer
			5.4	 Castrate-Resistant Prostate Cancer (CRPC)
		6	 Radical Prostatectomy [4]
			6.1	 Indications
			6.2	 Methods/Types
				6.2.1	 Open Radical Prostatectomy
				6.2.2	 Laparoscopic Radical Prostatectomy
				6.2.3	 Robotic/Robotic-Assisted Radical Prostatectomy
				6.2.4	 Salvage Prostatectomy
			6.3	 Main Steps of Prostatectomy
			6.4	 Post-Operative Care
			6.5	 Complications
			6.6	 Contraindications
			6.7	 Adjuvant Therapy after Surgery
			6.8	 Evidence
			6.9	 Advantages
			6.10	 Disadvantages
		7	 Active Surveillance (as) [16]
			7.1	 Definition
			7.2	 Rationale
			7.3	 Indications
			7.4	 Components of AS
				7.4.1	 Selection of Patients Who Are at Low Risk of Disease Progression
				7.4.2	 Surveillance Strategy
				7.4.3	 Criteria for Switching from AS to Definitive Treatment
			7.5	 Guidelines
			7.6	 Outcomes
			7.7	 Advantages
			7.8	 Disadvantages
			7.9	 Evidence
		8	 Focal Ablation [27, 28]
			8.1	 Rationale
			8.2	 Indications
			8.3	 Contraindications
			8.4	 Methods
			8.5	 Follow-Up and Outcome Assessment
			8.6	 Advantages
		9	 Radiotherapy
			9.1	 Definitions
			9.2	 EBRT Techniques
			9.3	 Indications
		10	 Definitive Radiotherapy
			10.1	 Low Risk
			10.2	 Intermediate Risk
			10.3	 High Risk
			10.4	 LDR Brachytherapy Boost
			10.5	 Locally Advanced/Very High Risk/Regional
		11	 Adjuvant Radiotherapy
		12	 Salvage Radiotherapy (SRT)
			12.1	 Artistic Meta-Analysis Presented at the ESMO Congress 2019
		13	 Hypofractionation Radiotherapy (HFX)
			13.1	 Moderate Hypofractionation
			13.2	 Ultra-Hypofractionation (SBRT)
			13.3	 Complications
		14	 Chemotherapy
			14.1	 Metastatic Disease
				14.1.1	 Castration/Hormone-Sensitive Prostate Cancer (CSPC/HSPC)
					Surgical Orchiectomy
					Medical Orchiectomy
			14.2	 Combinations with Anti-Androgen Therapy
			14.3	 ADT plus Docetaxel
			14.4	 ADT plus Abiraterone
			14.5	 ADT plus Enzalutamide
			14.6	 ADT plus Apalutamide
				14.6.1	 Castration-Resistant Prostate Cancer (CRPC)
					Definition
			14.7	 Non-Metastatic CRPC
			14.8	 Metastatic CRPC
				14.8.1	 Abiraterone
					Chemotherapy-Naive
					Post-Docetaxel
				14.8.2	 Enzalutamide
					Chemotherapy naïve
					Post-Docetaxel
				14.8.3	 Docetaxel
				14.8.4	 Cabazitaxel
				14.8.5	 Sipuleucel-T
				14.8.6	 Pembrolizumab
				14.8.7	 Radium-223
				14.8.8	 PARP Inhibitors
		References
	Penile Cancer
		1	 Introduction
		2	 Incidence and Epidemiology in India and Globally
			2.1	 Risk Factors and Premalignant Conditions
			2.2	 Premalignant Condition
		3	 Clinical Presentation in India and Globally
		4	 Evaluation and Work-up
			4.1	 Diagnosis
			4.2	 Pathology
		5	 TNM Staging of Penile Cancers [32]
		6	 Principles of Management
		7	 Surgical Management
		8	 Management of Lymph Nodes
			8.1	 Relevant Anatomy
			8.2	 Management of Patients with Clinically Normal Groin
			8.3	 Dynamic Sentinel Lymph Node Biopsy (DSNB)
			8.4	 Modified Inguinal Lymphadenectomy
			8.5	 Management of Patients with Node-Positive Disease
			8.6	 Pelvic Lymph Node Dissection (PLND) [49]
				8.6.1	 Inguinal Wounds Post Groin Node Dissection
			8.7	 Timing of Inguinal Lymphadenectomy
			8.8	 Complications of Inguinal Lymph Node Dissection
			8.9	 Minimally Invasive Inguinal Lymphadenectomy
		9	 Medical Management
			9.1	 Chemotherapy
			9.2	 Radiation Therapy (RT)
				9.2.1	 RT for the Primary
				9.2.2	 RT for Nodal Disease
			9.3	 Role of Targeted Therapy
		10	 Stage-Wise Treatment Algorithms
			10.1	 Stage 1 and 2 Disease (Figs. 6 and 7)
			10.2	 Stage 3 Nodal disease—cN1, cN2 (Fig. 8). Treatment of Primary as in Stage 1 and 2 Disease
			10.3	 Stage 4 Disease—N3, T4, and M1 (Fig. 9)
			10.4	 Management of Recurrent Disease Including Specific Palliative Measures
		11	 Stage-Wise Prognosis with Current Rx
			11.1	 Follow-Up
		12	 How We Do It at TMC (Table 3)
		References
	Testicular Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Histological Classification
		4	 Clinical Presentation
		5	 Evaluation and Work-Up
			5.1	 Testicular Ultrasonography
			5.2	 Orchidectomy
			5.3	 Tumor Markers
			5.4	 Radiological Evaluation
			5.5	 Clinical Staging
			5.6	 Pathologic Staging
			5.7	 Prognostic Value and Risk Stratification
		6	 Management of Clinical Stage I Disease
			6.1	 Surveillance
			6.2	 Adjuvant Chemotherapy
			6.3	 Pure Seminoma Stages IIA and IIB
				6.3.1	 Follow-up for Pure Seminoma Stages IIA and Nonbulky IIB
					After Primary Treatment
			6.4	 Pure Seminoma Stages IIC and III
				6.4.1	 Primary Treatment for Pure Seminoma Stages IIC and III
				6.4.2	 Immediate Follow-Up of Pure Seminoma Stages IIA, IIB, IIC and III
				6.4.3	 Follow-Up for Pure Seminoma Bulky Stage II and Stage III After Chemotherapy
			6.5	 Nonseminomatous Germ Cell Tumor
			6.6	 Surveillance
			6.7	 RPLND
			6.8	 Adjuvant Chemotherapy
			6.9	 Stage IS
			6.10	 Clinical Stage IIA
			6.11	 Nonseminoma Stage IIB
			6.12	 Advanced Metastatic Nonseminoma
			6.13	 Primary Treatment for Good-Risk Nonseminoma
			6.14	 Primary Treatment for Intermediate-Risk (Stage IIIB) Nonseminoma
			6.15	 Primary Treatment for Poor-Risk (Stage IIIC) Nonseminoma
			6.16	 Management of Good-, Intermediate- and Poor-Risk Nonseminoma
			6.17	 Central Nervous System Metastases
			6.18	 Choriocarcinoma Syndrome
		7	 Management of Recurrent Disease
			7.1	 Post-Second-Line Therapy
			7.2	 Palliative Therapy
			7.3	 Retroperitoneal Lymph Node Dissection (RPLND)
		References
	Uterine Cancer
		1	 Introduction
		2	 Incidence
		3	 Epidemiology
		4	 Risk Factors
		5	 Clinical Presentation
		6	 Evaluation and Work-up
			6.1	 Genetic Counselling
		7	 Staging (Table 1) [13]
			7.1	 Principles of Management
				7.1.1	 Fertility-Preserving Treatment
		8	 Surgical Management
			8.1	 Role of Lymphadenectomy
			8.2	 Role of Sentinel Lymph Node Mapping in EC
		9	 Pathology
			9.1	 Pathological Reporting
		10	 Radiation Management
			10.1	 Risk Stratification
			10.2	 Low-Risk Endometrial Cancer
			10.3	 Intermediate-Risk Endometrial Cancer
			10.4	 High-Intermediate-Risk Endometrial Cancer
			10.5	 High-Risk Endometrial Cancer
			10.6	 High-Risk, Stage II Endometrial Cancer
			10.7	 High-Risk, Stage III Endometrial Cancer
			10.8	 High-Risk, Non-Endometrioid Cancers
		11	 Medical Management
			11.1	 High-Intermediate Risk
			11.2	 High-Risk Patients
		12	 Advanced and Recurrent Disease
			12.1	 Systemic Therapy in Recurrent/Metastatic Disease
		References
	Cervical Cancer
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Presentation
		4	 Evaluation and Work-Up
		5	 Pathology
			5.1	 Squamous Carcinoma
			5.2	 Adenocarcinoma
			5.3	 Neuroendocrine Carcinomas
			5.4	 Mesenchymal Tumors
		6	 Principles of Management
		7	 Surgical Management
			7.1	 Piver–Rutledge Classification (1974)
			7.2	 Querleu–Morrow Classification (2008)
			7.3	 Fertility-Conserving Surgeries
		8	 Radiation and Medical Management
			8.1	 External Beam Radiation Therapy (EBRT)
			8.2	 Brachytherapy (BT)
			8.3	 Recent Advances in Cervical Brachytherapy
			8.4	 Combined EBRT and BT Doses
			8.5	 Side Effects Related to Radiation Therapy
			8.6	 Concurrent Chemoradiation
			8.7	 Neoadjuvant Chemotherapy in Cervical Cancers
				8.7.1	 Neoadjuvant Chemotherapy and Surgery
				8.7.2	 Neoadjuvant and Adjuvant Chemotherapy and Radiation Therapy/Chemoradiation
			8.8	 Systemic Therapy
			8.9	 Palliative Treatment
		9	 Cervical Cancer and Pregnancy
		10	 Cervical Cancer and HIV
		11	 Management of Other Histologies
			11.1	 Adenocarcinomas, Adenosquamous, Adenoid Cystic Carcinomas
			11.2	 Neuroendocrine Small Cell Carcinomas
		12	 Management of Recurrent Disease
			12.1	 Local Recurrence After Primary Surgery
			12.2	 Local Recurrence After Primary Radiotherapy
		13	 Prognosis and Outcome
			13.1	 Disease Outcome
			13.2	 Follow-Up
		References
	Vulvar and Vaginal Cancers
		1	 Introduction
		2	 Aetiology
		3	 Pre-Invasive Disease of the Vulva
			3.1	 Clinical Features and Presentation
				3.1.1	 VIN, Usual Type
				3.1.2	 VIN, Differentiated Type
			3.2	 Diagnosis
			3.3	 Treatment
				3.3.1	 Medical Treatment of VIN
			3.4	 Surgical Interventions
				3.4.1	 Wide Local Excision and Superficial Vulvectomy
				3.4.2	 CO2 Laser Surgery
			3.5	 HPV Vaccination
			3.6	 Follow-up
		4	 Vulval Cancer
			4.1	 Introduction
			4.2	 Clinical Presentation
			4.3	 Pre-treatment Evaluation
			4.4	 Management
				4.4.1	 Principles of Management
				4.4.2	 Stage-Wise Management
					Stage I/II Tumours
						Tumours ≤2 cm in Size with DOI of the Vulvar Stroma ≤1 mm
						Tumours with DOI of the Vulvar Stroma of >1 mm, >2 cm in Size
						Sentinel Inguinal Lymph Node Biopsy (SLNB)
			4.5	 Adjuvant Radiation
				4.5.1	 Primary Site
				4.5.2	 Nodal Irradiation
				4.5.3	 Stage III and IV
				4.5.4	 Radiation Technique and Volumes
				4.5.5	 Systemic Chemotherapy
				4.5.6	 Vulvar Melanoma
				4.5.7	 Recurrent Vulvar Cancer
			4.6	 Summary
		5	 Vaginal Cancer
			5.1	 Introduction
			5.2	 Pathology
			5.3	 Clinical Presentation
				5.3.1	 Patterns of Spread
			5.4	 Diagnostic Work-Up and Staging
			5.5	 Stage-Wise Management
				5.5.1	 Carcinoma In Situ
				5.5.2	 Stage I
				5.5.3	 Stage II–III
				5.5.4	 Stage IVA
				5.5.5	 Stage IV B
				5.5.6	 Vaginal Melanoma
				5.5.7	 Management of Recurrent Disease
			5.6	 Summary
		References
	Gestational Trophoblastic Disease
		1	 Introduction
		2	 Epidemiology
		3	 Clinical Presentation
		4	 Imaging
		5	 Laboratory Evaluation
			5.1	 Interpretation of Beta hCG Levels
				5.1.1	 Phantom hCG Syndrome
			5.2	 False-Positive hCG
			5.3	 Quiescent GTN
			5.4	 Hook Effect of hCG
		6	 Staging and Risk Stratification
		7	 Management of Molar Pregnancy
			7.1	 Uterine Evacuation
			7.2	 Follow-up
			7.3	 Prophylactic Chemotherapy
			7.4	 Contraception
			7.5	 Future Pregnancy
		8	 Management of Low-Risk GTN
			8.1	 Methotrexate Versus Actinomycin D
			8.2	 Monitoring
			8.3	 Management of Resistant Disease
		9	 Management of High-Risk GTN
			9.1	 Salvage Therapy
		10	 Early Mortality
		11	 CNS Metastasis
		12	 Role of Surgery in GTN
		13	 Placental Site Trophoblastic Tumor
		14	 Surveillance
			14.1	 Molar Pregnancy
			14.2	 Contraception
		15	 Future Pregnancy
		16	 Long-Term Toxicities
		17	 Psychosocial Issues
		18	 Tata Memorial Centre Experience
		19	 Summary and Key Points for Management of GTN
			19.1	 Diagnosis
			19.2	 Staging
			19.3	 Treatment
				19.3.1	 Low-Risk Disease
				19.3.2	 High-Risk Disease
				19.3.3	 Resistant or Recurrent GTN
			19.4	 Follow-Up
				19.4.1	 During Treatment
		References
	Epithelial Ovarian Cancer
		1	 Introduction
		2	 Risk Factors
		3	 Evaluation and Work-up
			3.1	 Tumor Markers
				3.1.1	 CA 125
				3.1.2	 CEA
				3.1.3	 CA 19.9
				3.1.4	 Germ Cell Tumor Markers
			3.2	 Endoscopy
			3.3	 Radiology: Imaging of Ovarian Malignancies
				3.3.1	 USG of Abdomen and Pelvis
				3.3.2	 MRI of Abdomen and Pelvis
				3.3.3	 CECT of Abdomen and Pelvis (±Thorax)
				3.3.4	 Chest X-Ray
				3.3.5	 Mammography
			3.4	 Pathological Diagnosis
				3.4.1	 Cytology
				3.4.2	 Biopsy
			3.5	 Genetic Clinic Referrals
		4	 Pathology
			4.1	 Molecular Classification of Epithelial Ovarian Cancer
		5	 Borderline Ovarian Tumors
		6	 Epithelial Ovarian Cancer
			6.1	 Principles of Management
			6.2	 Surgical Management
				6.2.1	 Principles of Surgical Staging for Ovarian Cancer
				6.2.2	 Surgery for Early Ovarian Cancer
				6.2.3	 Surgery for Advanced Ovarian Cancer
					Primary Debulking Surgery
					Interval Debulking Surgery (IDS)
			6.3	 Medical Management
				6.3.1	 Principles of Systemic Therapy
					Chemotherapy
					Antiangiogenic Agents
					PARP Inhibitors
					Immunotherapy
				6.3.2	 Early-Stage Ovarian Cancer
				6.3.3	 Advanced Stage Ovarian Cancer
					Intraperitoneal Chemotherapy
					Hyperthermic Intraperitoneal Chemotherapy
					Maintenance Strategies
					Maintenance Strategy -which One?
					Hormonal Maintenance in Low-Grade Serous Carcinomas
				6.3.4	 Follow-up
				6.3.5	 Recurrent Ovarian Cancer
					Recurrent Ovarian Cancer—To Treat or Not to Treat
				6.3.6	 The Concept of Platinum Sensitivity
				6.3.7	 Platinum-Sensitive Relapse
					Systemic Therapy
					Secondary Cytoreduction
				6.3.8	 Platinum Refractory and Resistant Relapse
					Systemic Therapy
					Immunotherapy
			6.4	 Radiotherapy
				6.4.1	 Palliative Radiation
				6.4.2	 Adjuvant/Consolidation Radiotherapy
			6.5	 Palliative Care
				6.5.1	 Malignant Ascites/ Pleural Effusions
				6.5.2	 Malignant Bowel Obstruction (MBO)
				6.5.3	 Symptom Management in MBO
			6.6	 Pain
		7	 Conclusion
		References
	Non-Epithelial Ovarian Cancers
		1	 Germ Cell Tumor
			1.1	 Presentation
			1.2	 Diagnosis
			1.3	 Pathology
			1.4	 Surgical Management
			1.5	 Chemotherapy
				1.5.1	 Chemotherapeutic Drugs
					Bleomycin
					Etoposide
					Cisplatin
				1.5.2	 Adjuvant Chemotherapy
					Whom Not to Give Chemotherapy—Surveillance
					To Give or Not to Give—Surveillance an Option
					Whom to Give Adjuvant Chemotherapy?
					How Many Cycles of Chemotherapy?
				1.5.3	 Neoadjuvant Chemotherapy
			1.6	 Follow-Up
			1.7	 Reproductive Outcomes
			1.8	 Recurrent Disease Management
			1.9	 Late Effects of Treatment
			1.10	 Survivorship—Cure and Care
		2	 Sex Cord Stromal Tumors
			2.1	 Pathology
			2.2	 Prognostic Factors
			2.3	 Presentation
			2.4	 Diagnosis
			2.5	 Surgery
			2.6	 Role of Adjuvant Chemotherapy
				2.6.1	 Stage IA/B
					Granulosa Cell Tumor (Adult or Juvenile)
					Sex Cord Stromal Tumors
				2.6.2	 Stage IC
					Granulosa Cell Tumor
					Adult Granulosa Cell Tumor
					Sex Cord Stromal Tumors
				2.6.3	 Stages II–IV
				2.6.4	 Chemotherapy
			2.7	 Recurrent Disease
			2.8	 Follow-Up
		3	 Small Cell Carcinoma Ovary of the Hypercalcemic Type
		4	 Conclusion
		References
	Bone Sarcomas
		1	 Epidemiology and Pathogenesis
		2	 Diagnosis
			2.1	 Radiological Imaging of the Involved Bone
			2.2	 Biopsy
			2.3	 Staging
		3	 Osteosarcoma
			3.1	 Conventional High-Grade Osteosarcoma
			3.2	 Parosteal Osteosarcoma
			3.3	 Periosteal Osteosarcoma
			3.4	 High-Grade Surface Osteosarcoma
			3.5	 Telangiectatic Osteosarcoma
			3.6	 Small Cell Osteosarcoma
			3.7	 Low-Grade Central Osteosarcoma
		4	 Chondrosarcoma
			4.1	 Conventional Intramedullary Chondrosarcoma
			4.2	 Clear Cell Chondrosarcoma
			4.3	 Juxtacortical Chondrosarcoma
			4.4	 Mesenchymal Chondrosarcoma
			4.5	 Dedifferentiated Chondrosarcoma
		5	 Treatment
		6	 Osteosarcoma
			6.1	 Tumor Kinetic Principles and Cell Kill Models
			6.2	 Our Institute Practice for Osteosarcoma
			6.3	 Prognostic Markers in Osteosarcoma
			6.4	 Metastatic Disease
			6.5	 Recurrent Disease
			6.6	 Role of Radiation in Osteosarcoma
			6.7	 Future Directions
		7	 Chondrosarcoma
		8	 Surgery in Bone Sarcomas
			8.1	 Principles of Extremity Reconstruction
		9	 Surveillance and Follow-up
		References
	Soft-Tissue Sarcoma
		1	 Introduction
		2	 Incidence and Epidemiology in India and Globally
		3	 Clinical Presentation in India and Globally
		4	 Evaluation and Work-up
			4.1	 Ultrasonography (USG)
			4.2	 Plain Radiograph
			4.3	 Magnetic Resonance Imaging (MRI)
			4.4	 Computed Tomography (CT)
			4.5	 Positron Emission Tomography-Computed Tomography
			4.6	 Recommendations for Local Evaluation
			4.7	 Recommendations for STAGING
			4.8	 Biopsy
		5	 Pathology
		6	 Staging
		7	 Referrals Including Genetic Counseling
		8	 Principles of Management
		9	 Surgical Management
		10	 Medical Management
			10.1	 Isolated Limb Perfusion
		11	 Role of Radiation in the Management of Soft-Tissue Sarcomas
		12	 Prognosis
		13	 Surveillance
		14	 Management of Recurrent Disease Including Specific Palliative Measures
		References
	Ewings Sarcoma
		1	 History
		2	 Epidemiology
		3	 Biology and Histology
		4	 Clinical Presentation and Staging
		5	 Treatment Philosophy for Ewing Sarcoma
		6	 Evolution of Chemotherapy for Localized Ewing Sarcoma
		7	 Local Therapy in ES
		8	 Recurrent Ewing Sarcoma
		9	 Ewing Sarcoma in the Adolescent and Young Adults (AYA)
		10	 Long-Term Complications in Survivors of Ewing Sarcoma
		11	 How We Do It at TMC
		References
	Wilms Tumor
		1	 Introduction
		2	 Epidemiology
		3	 Embryology and Pathology
		4	 Genetics and Epigenetics
		5	 Clinical Presentation
		6	 Evaluation and Workup
		7	 Principles of Management
			7.1	 Staging of Wilms Tumor
			7.2	 Treatment of Wilms Tumor
				7.2.1	 Surgery
				7.2.2	 Chemotherapy
					SIOP Approach: Preoperative Chemotherapy
					Postoperative Chemotherapy
					COG Approach: Adjuvant Chemotherapy
					Wilms Tumor with Pulmonary Metastases
					Bilateral Wilms Tumor
			7.3	 Radiotherapy
			7.4	 Tackling Special Situations
				7.4.1	 Nephroblastomatosis
				7.4.2	 Wilms Tumor with Tumor Thrombus
				7.4.3	 Inadequate Surgery
				7.4.4	 Dosing in Infants
				7.4.5	 Supportive Care
					Hepatic Sinusoidal Obstruction Syndrome (SOS), Previously Known as Veno-occlusive Disease (VOD)
					Cardiac Dysfunction
					Hypertension
		8	 Molecular Prognostic Markers in Wilms Tumor
			8.1	 LOH 1p and 16q
			8.2	 1q Gain
			8.3	 TP53 Mutation
			8.4	 11p15 Methylation
		9	 Management of Relapse of Wilms Tumor
		10	 Treatment Algorithms Used in Tata Memorial Hospital
		References
	Neuroblastoma
		1	 Introduction
		2	 Incidence and Epidemiology in India and Global
		3	 Molecular Pathology
		4	 Clinical Presentation in India and Global
		5	 Paraneoplastic Syndromes
			5.1	 Opsomyoclonus Syndrome (OMS)
			5.2	 VIP Syndrome (Kerner–Morrison Syndrome)
		6	 Evaluation and Work-Up
			6.1	 Tumor Markers
			6.2	 Bone Marrow Aspiration and Biopsy
			6.3	 Radiology
			6.4	 Pathology
			6.5	 Referrals Including Genetic Counseling
		7	 Staging
		8	 Principles of Management
		9	 Surgical Management
		10	 Medical Management
		11	 Radiation Management
		12	 Metaiodobenzylguanidine (MIBG) Therapy
		13	 Risk-Wise Management Algorithms
			13.1	 Low-Risk Neuroblastoma
			13.2	 Intermediate-Risk Neuroblastoma
			13.3	 High-Risk Neuroblastoma
		14	 Risk-Wise Prognoses with Current Treatment
			14.1	 Low-Risk Neuroblastoma
			14.2	 Intermediate-Risk Neuroblastoma
			14.3	 High-Risk Neuroblastoma
		15	 Management of Recurrent Neuroblastoma
		16	 Summary
		References
	Retinoblastoma
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Biology of Retinoblastoma
		4	 Clinical Presentation
		5	 Evaluation and Workup
			5.1	 Examination Under Anesthesia (EUA)
			5.2	 Ultrasonography (B-Scan)
			5.3	 MRI with Contrast
			5.4	 Bone Marrow Studies and CSF Examination
		6	 Grouping and Staging of Retinoblastoma
		7	 Prognostic Factors
			7.1	 Histopathologic Risk Factors
		8	 Genetic Testing and Genetic Counseling
		9	 Principles of Management
			9.1	 Treatment Options
				9.1.1	 Enucleation
				9.1.2	 Focal Therapies
					Laser Photocoagulation
					Cryotherapy
					Transpupillary Thermotherapy (TTT)
					Plaque Radiotherapy
				9.1.3	 Systemic Chemotherapy
					Chemoreduction
					Chemoprophylaxis
					Chemoprevention
				9.1.4	 Local Delivery of Chemotherapy
					Intra-arterial Chemotherapy (IAC)
					Intravitreal Chemotherapy (IViC)
					Intracameral Chemotherapy (ICC)
				9.1.5	 External Beam Irradiation (EBRT)
		10	 Tata Memorial Hospital Management Algorithms for Retinoblastoma (Figs. 5 and 6)
			10.1	 Treatment of Extraocular Retinoblastoma
				10.1.1	 Orbital Retinoblastoma
				10.1.2	 Retinoblastoma with Systemic Metastasis
		11	 Long-Term Effects of Retinoblastoma Therapy
			11.1	 Second Malignant Neoplasms (SMN)
			11.2	 Impaired Orbital Growth
			11.3	 Visual Outcome
		References
	Rare Pediatric Tumors
		1	 Definition, Incidence and Caveats
		2	 Profiles of Rare Tumors
			2.1	 Nasopharyngeal Carcinoma
				2.1.1	 Epidemiology
				2.1.2	 Risk Factors
				2.1.3	 Histology and Pathogenesis
				2.1.4	 Clinical Presentation
				2.1.5	 Diagnostic Work-Up
				2.1.6	 Staging and Therapy
				2.1.7	 Doses of Radiation
				2.1.8	 Late Effects
			2.2	 Pleuropulmonary Blastoma
				2.2.1	 Epidemiology
				2.2.2	 Classification
				2.2.3	 Prognostic Factors
				2.2.4	 Clinical Features
				2.2.5	 Diagnostic Work-Up
				2.2.6	 Therapy
			2.3	 Adrenocortical Carcinoma
				2.3.1	 Epidemiology
				2.3.2	 Clinical Features
				2.3.3	 Diagnostic Work-up
				2.3.4	 Treatment
				2.3.5	 Follow-up
			2.4	 Pancreatoblastoma
				2.4.1	 Epidemiology
				2.4.2	 Clinical Features
				2.4.3	 Diagnostic Work-up
				2.4.4	 Treatment
			2.5	 Desmoplastic Small Round Cell Tumor (DSRCT)
				2.5.1	 Epidemiology
				2.5.2	 Clinical Features
				2.5.3	 Diagnostic Work-up
				2.5.4	 Treatment
			2.6	 Undifferentiated Embryonal Sarcoma of the Liver
				2.6.1	 Epidemiology
				2.6.2	 Clinical Features
				2.6.3	 Treatment and Outcomes
		References
	Childhood and Adolescent Extracranial Germ Cell Tumors
		1	 Introduction
		2	 Incidence and Epidemiology
		3	 Clinical Presentation
		4	 Evaluation and Work-Up
			4.1	 History and Clinical Examination
				4.1.1	 Tumor Markers
				4.1.2	 Imaging
			4.2	 Histopathological Examination
				4.2.1	 Role of Micro-RNAs [23]
		5	 Principles of Management
			5.1	 Surgical Management [26]
				5.1.1	 Surgical Management of Testicular Tumors
				5.1.2	 Surgical Management of Ovarian Tumors [27]
				5.1.3	 Surgical Management of Sacrococcygeal Tumors
			5.2	 Surgical Management of Mediastinal Tumors
			5.3	 Chemotherapeutic Approaches
				5.3.1	 Clinicolaboratory Work-Up (Summarized in Table 4)
					Chemotherapy
					Bleomycin in Pediatric GCTs
			5.4	 Radiation Therapy
		6	 Toxicities of Treatment
		7	 Late Effects
		8	 Management of Recurrent/Relapsed Disease
			8.1	 Surgery
			8.2	 Chemotherapy
		9	 Recent Advances
			9.1	 Role of miRNAs
			9.2	 Targeted Therapy
		10	 How We Do It at TMC
		References
	Hepatoblastoma
		1	 Introduction
		2	 Incidence and Epidemiology in India and Globally
		3	 Clinical Presentation in India and Globally
		4	 Evaluation and Work-Up
			4.1	 Tumor Markers
			4.2	 Radiology
			4.3	 Pathology
		5	 Principles of Management of Hepatoblastoma
		6	 Risk Stratification and Prognostic Factors
		7	 Surgical Management
			7.1	 Surgery for Lung Metastases
			7.2	 Role of Orthotropic Liver Transplantation [42]
		8	 Medical Management
		9	 Other Modalities of Treatment
		10	 Toxicity of Treatment in Hepatoblastoma
			10.1	 Ototoxicity
			10.2	 Nephrotoxicity
			10.3	 Cardiotoxicity
		11	 Stage-Wise Prognosis with Current Treatment
		12	 Management of Recurrent Disease Including Specific Palliative Measures
		References
Part V: Special Topics in Oncology
	Emergencies
		1	 Tumor Lysis Syndrome
			1.1	 Incidence and Risk Factors
			1.2	 Pathophysiology
			1.3	 Prevention and Treatment
				1.3.1	 Hydration
				1.3.2	 Electrolyte Abnormalities
				1.3.3	 Renal Replacement Therapy
				1.3.4	 Alkalinization of Urine
				1.3.5	 Antihyperuricemic Therapy
					Allopurinol
					Febuxostat
					Rasburicase
		2	 Conclusion
			2.1	 Pediatric Emergencies
			2.2	 Cardiothoracic Emergencies
				2.2.1	 Superior Vena Cava Syndrome
				2.2.2	 Cardiac Tamponade
			2.3	 Abdominal Oncologic Emergencies
				2.3.1	 Intestinal Obstruction and Intussusception
				2.3.2	 Acute Pancreatitis
			2.4	 Neutropenic Colitis
		3	 Brain Metastases and Spinal Cord Compression
			3.1	 Imaging
			3.2	 Treatment
			3.3	 Surgery
			3.4	 Adjuvant Radiotherapy
			3.5	 One to Four BM
			3.6	 Neurocognitive Sparing
			3.7	 More than Four Metastases
			3.8	 Systemic Therapy
			3.9	 Medical Management with Targeted Therapy
			3.10	 Immunotherapy
			3.11	 Spinal Cord Compression
				3.11.1	 Mechanical Stability of the Spine
			3.12	 Radiosensitivity of the Neoplasm
				3.12.1	 Overall Prognosis of the Disease
		4	 Febrile Neutropenia
			4.1	 Definition
			4.2	 Epidemiology
			4.3	 Pathophysiology
			4.4	 Differential Diagnosis
			4.5	 CECT (Thorax and Abdomen and Pelvis)
			4.6	 Management
				4.6.1	 Primary Options
				4.6.2	 Prophylactic Use of GCSF
				4.6.3	 Antibacterial and Antifungal Prophylaxis
				4.6.4	 Secondary Prevention
			4.7	 Complications
			4.8	 Prognosis
		5	 Hypercalcemia of Malignancy
			5.1	 Pathophysiology
			5.2	 Diagnosis
				5.2.1	 Laboratory Evaluation
				5.2.2	 Radiology Evaluation
			5.3	 Management
				5.3.1	 Asymptomatic Patients with Mild Hypercalcemia
				5.3.2	 Symptomatic Patients with Serum Ca Levels Greater than 12 Mg/dL
				5.3.3	 Vitamin D (1,25-Dihydroxyvitamin D)-Mediated Hypercalcaemia
				5.3.4	 Ectopic Parathyroid Hormone Production
			5.4	 Monitoring
		6	 Thrombocytopenia
			6.1	 History and Physical Examination
			6.2	 Physical Examination
			6.3	 Laboratory Testing
				6.3.1	 RBC and WBC Abnormalities
			6.4	 Management
				6.4.1	 Treatment of ITP
		References
	Pain Management
		1	 Introduction
		2	 Pain as a Symptom in Oncology
			2.1	 Barriers to Pain Relief
		3	 Pathophysiology of Cancer Pain
		4	 Evaluation and Grading of Cancer Pain
		5	 Management of Cancer Pain
		6	 Nonopioid Analgesics
		7	 Opioid Analgesics
		8	 Adjuvant Drugs
		9	 Interventional Therapies
			9.1	 Peripheral Blocks
				9.1.1	 Somatic Blocks
				9.1.2	 Visceral and Sympathetic Blocks
			9.2	 Central Blocks
			9.3	 Intrathecal Implantable Pumps
		References
	Intensive Care
		1	 Introduction
		2	 Integrated Approach to Oncologic Critical Care
		3	 Admission into Oncology Critical Care Units
		4	 Management of Critically Ill Oncology Patient Admitted to an ICU
		5	 Management of Oncologic Emergencies
			5.1	 Respiratory Failure
				5.1.1	 Management of Acute Respiratory Distress Syndrome
			5.2	 Sepsis
				5.2.1	 Management of Sepsis in ICU
			5.3	 Tumor Lysis Syndrome (TLS)
				5.3.1	 Management of Tumor Lysis Syndrome
			5.4	 Dyselectrolytemia
			5.5	 Airway Emergencies
			5.6	 Cardiac Dysfunction
			5.7	 Acute Abdomen
			5.8	 Emergencies of the Central Nervous System
			5.9	 Adrenal Crisis or Adrenal Insufficiency
		6	 Postoperative Care in Oncology
		7	 Chemotherapy in ICU
		8	 Infection Control in ICU
		9	 Nutrition in Oncology Critical Care
			9.1	 Recommendations for the Use of Parenteral Nutrition as Put Forward by the American Society for Parenteral and Enteral Nutrition (ASPEN) [42]
		10	 Outcomes of Critically Ill Cancer Patients
		11	 Palliative Care in ICU
		12	 End-of-Life Care (EOLC) in ICU
		13	 Summary
		References
	Vascular Access
		1	 Introduction
		2	 Classification of Venous Access Devices
		3	 Valved Catheters
		4	 Choosing the Ideal Catheter
		5	 Choice of CVAD
		6	 Preoperative Assessment
		7	 Technique of Insertion
		8	 Catheter Tip Position
		9	 Catheter Care
		10	 Complications Associated with VAD
			10.1	 Complications of PVAD
			10.2	 Complications of CVAD
			10.3	 Early Insertion-Related Complications
			10.4	 Late Complications
				10.4.1	 Infection
				10.4.2	 Mechanical Complications
		11	 Special Concerns of CVAD in Pediatrics
		12	 Summary
		References
	Comorbidities in the Cancer Patient
		1	 Introduction
		2	 Cardiovascular Diseases
		3	 Hypertension
		4	 Diabetes
		5	 Chronic Obstructive Pulmonary Disease (COPD)
		6	 Interstitial Lung Disease (ILD)
		7	 Tuberculosis
		8	 Latent TB Infection (LTBI)
		References
	Hereditary Cancers
		1	 Principles of Genetics in Oncology
		2	 Germline and Somatic Variants
		3	 Oncogenes and Tumor Suppressor Genes
		4	 Classification and Reporting of Genetic Variants
		5	 Hereditary Cancer Syndromes
			5.1	 Universal Features of Hereditary Cancers and the Knudson’s Two-Hit Hypothesis
			5.2	 Specific Features of Hereditary Cancer Syndromes
		6	 Genetic Risk Assessment and Genetic Counseling
		7	 Germline Genetic Testing
		8	 Cancer Screening and Prevention
		9	 Conclusion
		References
	Library and Information
		1	 Introduction
		2	 Growth of Literature
		3	 Information Needs
		4	 Example of Clinical Query
		5	 Example for Research Need Query
		6	 Patient Education
		7	 Preferences of Sources and Searching
		8	 Summary
		9	 Example of Search Strategy (PUBMED) Using Boolean Operators
		10	Evidence based Medicine
		11	 EBM Example
		12	 Staying Updated
		13	 Summary
		References
	Oncology Training and Education in India
		1	 Overview
		2	 Education and Training at Tata Memorial Centre (TMC), Mumbai
		3	 The National Cancer Grid (NCG)
		4	 Summer School in Oncology
		5	 “KEVAT” Patient Navigation Program
		6	 Online Oncology Tutorial Series
		7	 National Knowledge Network (NKN)
		8	 Oncology Training for the Future
			8.1	 Genetics
			8.2	 Research
			8.3	 Sub-specialization
			8.4	 Mentor/Mentee Program
		References