Gospodarowicz MK, Henson DE, Hutter RVP, O'Sullivan B, Sobin LH and Wittekind Ch, editors:

Prognostic Factors in Cancer, 2nd ed, 832 pp, New York, Wiley-Liss, 2001 ($99.95).

Sir William Osler, quoted in the preface of this book, wrote in 1904 that ‘medicine is a science of uncertainty and an art of probability.’ This book, sponsored by the International Union Against Cancer (UICC), shows how successful we have been in removing uncertainty from the science and making probability prediction more science than art.

The first 150 or so pages are devoted to theory of clinical prognostic factors. Nice, probably important and laudable, but unfortunately not my cup of tea. For most clinical oncologists, the remaining 600 pages will be of greater interest. Page by page, chapter by chapter (35 in total), the experts deal with the problems encountered on a daily basis in the practice of oncology. The fact that the roster of editors and contributors contains the names of several pathologists is in itself a sign that it should be of interest to pathologists as well. And indeed it is. Most chapters (except the first few) are peppered with pathology data. ‘Our’ contributions range from classical histopathology to molecular biology; from established, generally accepted facts to investigational results that still need to be validated on a broader base. Clinical-pathologic correlations are a prominent feature of every chapter and are generally well done.

The contributors hail from various parts of the world, reflecting the international nature of the IUCC. The editing of such contributions must be a gargantuan job, and although the overall result is enviably good, there are still significant disparities between the various chapters. Personally I would have appreciated a more structured and a ‘predictably uniform’ approach, which I feel should be mandated for all chapters in the future editions. Nevertheless, the positive aspects of the book definitely outweigh the few negative ones.

I have used the book and found it most useful while preparing for the interdisciplinary oncology conferences and meetings with clinicians. The reason—because it allowed me to review the relevant clinical prognostic data in the shortest possible time frame. I found it also authoritative and dependable. In some aspects it is not exactly as up to date as one would have wished it to be, but that is inevitable for a discipline that is advancing as fast as oncology. It is a work in progress, which I predict will improve with every new edition. The contributors and especially the editors deserve kudos for their concentrated effort to ‘to provide the framework for the … application of prognostic factors in clinical decision making’ in oncology.