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"Cet ouvrage présente les communications du 12e Cours supérieur francophone sur le cancer du sein qui s’est déroulé du 19 au 22 Janvier 2011 au Palais des congrès de Nice. Ce cours réunit chaque année près de 200 conférenciers, experts francophones du domaine, et plus de 700 participants.L’objectif est de faire le point sur l’actualité de la prise en charge de cette pathologie de plus en plus fréquente. La première journée du cours était consacrée aux soins oncologiques de support et aux actualités en chirurgie. Trente oncologues ont présenté, à partir d’une veille bibliographique, l’état des connaissances dans toutes les disciplines couvertes : chirurgie, anatomopathologie, radiothérapie, traitements systémiques sans oublier d’aborder les prises en charge particulières des formes métastatiques, des patientes non ménopausées ou des patientes âgées."

"Although there has been a slow but steady decrease in incidence, gastric cancer remains the second leading cause of cancer death worldwide. Several aspects of the oncological and surgical management are still controversial and so gastric cancer represents a challenge for the surgeon. This book aims to delineate the state of the art in the surgical and oncological treatment of gastric cancer, describing the new TNM staging system, the extent of visceral resection and lymphadenectomy focusing on the different open and minimally invasive surgical techniques and discussing intraoperative chemohyperthermia and neoadjuvant and adjuvant treatment. Operative endoscopy and endoscopic ultrasonography are also discussed, as these now have an important role in both diagnostic work-up and palliative care of gastric cancer patients. Only a multidisciplinary approach involving the surgeon, gastroenterologist, and oncologist can produce the comprehensive and integrated overview that today constitutes a winning strategy for the optimization of results.What we hope we have achieved is a flexible, up-to-date, exhaustive publication, rich in illustrations and consistent with evidence-based medicine."

"A general introduction to the principles of diagnosis and treatment of children with brain tumors is presented. Molecular characterization of solid tumors is also presented. Molecular pathways provide putative targets for new therapies. High resolution magic spinning NMR spectroscopy is explained, which is used to determine metabolic profiles for small pieces of intact tissue and whole cells in culture. The differences between adult and pediatric brain tumors are outlined. Various neuroradiological imaging modalities in children with leukemia are detailed. Also are detailed results of clinical trials in pediatric brain tumors, such as medulloblastoma, ependymoma, craniopharyngioma, low-grade glioma, high-grade glioma, brainstem glioma, and germ cell tumors, using radiotherapy. Considering the clinical importance of epilepsy in the primary brain tumors in children, its symptoms, diagnosis, and treatments (surgery and antiepileptic drugs) are discussed."

"Colpiscono circa 170 mila italiani, con un trend in forte ascesa. Si chiamano Malattia di Crohn e colite ulcerosa: malattie autoimmuni, ovvero causate da un errore del sistema immunitario che si scatena contro se stesso. Perché? Come fermare questa furia distruttiva? Sono stati fatti grandi passi avanti ma molto resta ancora da scoprire e molte sono le questioni controverse: dalle cause della malattia ai metodi di diagnosi più tempestiva, alle terapie. Le malattie autoimmuni dell'intestino colpiscono in giovane età, tra i 15 e i 45 anni, hanno un impatto molto negativo sulla qualità della vita di chi si ammala e pongono questioni di primissimo piano: come si convive con una diagnosi di questo tipo, qual è il migliore accesso alle cure, quali le disposizioni di legge che facilitano la vita dei malati. Questo libro vuole raccontare la vita e la battaglia quotidiana delle persone colpite da queste malattie, le scelte che devono fare e gli ostacoli che si trovano ad affrontare, dal punto di vista di uno dei massimi esperti mondiali della materia, Silvio Danese, e da quello di un giovane paziente, Marco Greco, che ha trasformato la sua lotta quotidiana in una battaglia condotta a nome di tutti i malati. Gettando luce su uno dei più straordinari misteri della medicina moderna, le malattie autoimmuni, questo volume affronta senza omissioni il grande tema sanitario dell’Italia di oggi, la cronicità, la condizione sociale e medica di milioni di persone costrette a convivere con la malattia per decenni."

"ABSTRACTPurposes This study compared the effectiveness of 1 day vs 3 days antibiotic regimen to prevent surgical site infection (SSI) in open liver resection.MethodWe performed a randomized controlled non inferiority trial in 480 patients at 39 hospitals across Japan (registered as UMIN000002852). Patients with hepatocellular carcinoma scheduled to undergo resection were randomly assigned to receive either a 1 day regimen for antimicrobial prophylaxis, or a 3 day regimen. The primary endpoint was the incidence of SSI.ResultsAmong 480 randomized patients, 232 assigned to the 1 day regimen and 235 to the 3 day regimen were included in the full analysis set. Baseline characteristics of the two groups were well balanced. SSI was diagnosed in 22 patients (9,5%) in the 1 day group vs 23 patients (9,8%) in the 3 day group (difference, -0,30; 90% CI -4,80 to 4,19% (95% CI -5,66% to 5,05%); one sided P = 0,001 for non inferiority), meeting the non inferiority hypothesis. In both groups, remote site infection (16 (6,9%) vs 22 (9,4%), P 0,001 for non inferiority) and drain-related infection (5 (2,2%) vs 4 (1,7%), P 0.001 for non inferiority) were comparable.ConclusionTo prevent SSI in liver cancer surgery, a 1 day regimen of flomoxef sodium is recommended for antimicrobial prophylaxis because of confirming the non-inferiority to longer usage."

"The work describes a new method of sphincter salvage in surgery of rectal cancer. Low tumors of the rectum are traditionally treated with amputation of the rectum. However, this operation is not well-received by patients, since it results in a permanent colostomy. By contrast, intersphincteric resection allows sphincter salvage even in low tumors and is now widely accepted among experts in the field of colorectal surgery. The book will describe the basics (pathology,physiology, radiology) as well as the surgical technique and its different modifications."

"Latar Belakang: MnSOD adalah antioxidant yang paling umum untuk melindungi sel-sel dari stres radical oksidatif Endogenous dan exogenous radical bebas superoksida . Sel punca kanker diketahui untuk bertahan dalam keadaan hipoksia dan kelangsungan hidup sel punca kanker dipengerahi oleh level ekspresi MnSOD. Namun, efek hipoksia terhadap ekspresi gen MnSOD SOD2 masih belum diketahui.Tujuan: Penelitian ini dilakukan untuk menginvestigasi tingkat ekspresi MnSOD dalam berbagai interval waktu hipoksia dalam induksi hipoksia kepada CD24-/44 sel punca kanker payudara. Metode: Sampel kanker payudara diperoleh dalam klinik dan dipisahkan dengan Magnetic cell Sorting MACs . Sampel berikut di induksi hipoksia dalam interval 0 jam, 30 menit, 4 jam, 6 jam dan 24 jam di dalam ruangan hipoksia. Kemudian, mRNA diisolasi dan dipotimasi untuk primer annealing. C t value Cycle threshold diperoleh dari qRT-PCR dan dilakukan kalkulasi untuk mengetahui ekspresi relatif MnSOD terhadap ekspresi gen 18s. Hasil PCR akan dilakukan elektroforesis untuk mengkonfirmasi amplifikasi MnSOD. Hasil: Tingkat ekspresi MnSOD menurun di setiap interval hipoksia. Ekspresi MnSOD diturunkan paling rendah setelah 4 jam setelah diinduksi hipoksia. Kesimpulan: Semua sel punca kanker payudara CD44 /CD24- yang telah diinduksi dalam interval hipoksia yang berbeda-beda telah berdiferensiasi, hasil ditunjukan dengan penurunan dalam ekspresi MnSOD."

"The first laparoscopy-assisted gastrectomy for gastric cancer was performed in Japan in 1991. In the ensuing 20 years, at first through a process of trial and error, then through the sharing of master surgeons’ accumulated experience, the procedure has been honed and refined to its current high level. From the beginning, it soon became evident that this much less invasive form of gastrectomy, in comparison with traditional open surgery, led to improved quality of life for postsurgical patients, and use of the procedure spread rapidly among gastric surgeons. Early on, however, there were calls for the establishment of standard techniques and procedures to be followed, with a recognized need to improve the level of safety and the quality of lymph node dissection for local control in cancer treatment. Toward that end, the Laparoscopy-Assisted Gastrectomy Club was formed in 1999. In the following year, because both Japan and Korea experience a high rate of gastric cancer, specialists from those two nations came together to form the Japan–Korea Laparoscopic gastrectomy joint seminar, to facilitate and encourage the exchange of vital information. The result has been to achieve an evolving consensus among specialists in the field of endoscopic surgery in Japan and Korea with expertise that can be shared worldwide. A compilation of the current state-of-the-art is now presented in this volume, with accompanying DVD, which will be of great value to all endoscopic surgeons who perform laparoscopic gastrectomy."

"ABSTRACTPurposeGeriatric surgery poses specific challenges due to patient vulnerability in relation to aging. We analyzed perioperative challenges concerning super-elderly patients with breast cancer.MethodsBetween 2013 and 2018, 908 patients with breast cancer were treated surgically. Of these, two patient groups were compared: Group A (≥ 85 years old, n = 34, 3,7%) and Group B (75-84 years old, n = 136, 15%).ResultsIn Groups A and B, 26,4% and 36,8% of patients lived alone, respectively. Group A patients had higher rates of psychiatric and cardiovascular disease (32,4% and 41,2%) than Group B (8,8% and 16,2%) (p = 0,0009 and p = 0,0031, respectively). There was no marked difference in the type of surgery or length of hospital stay between groups, and most complications involved surgical site disorders. Postoperatively, Group A had a higher rate of delirium (29,4%) than Group B (3,7%) (p < 0,0001). The 30-day postoperative mortality rate was 0, and 76,5% of Group A and 45,6% of Group B patients received no adjuvant therapy (p = 0,0024).ConclusionsAge alone does not constitute a contraindication for appropriate surgery, although there are some challenges necessary to consider for super-elderly patients."