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"In recent years, cancer stem cells have been recognized as important component in carcinogenesis and they seem to form the basis of many (if not all) tumor types. Cancer stem cells or "cancer cell like stem cells" have been isolated from various cancers of different origin (blood, breast, brain, skin, head and neck, thyroid, cervix, lung, retina, colon, pancreas and so on). Cancer stem cells - rare cells with indefinite proliferative potential that drive the formation and growth of tumours- seem to show intriguing relationships with physiological stem cells. Specifically, these cancer cells show significant similarities in the mechanisms that regulate self-renewal of normal stem cells. Moreover, tumour cells might directly arise from normal stem cells. Further, the cellular biology of cancer stem cells show a lot of similarities with normal stem cells."

"Kanker vulva merupakan kanker ginekologi yang kejadiannya relative sedikit. Pasien umumnya datang pada stadium lanjut, terapi radiasi pada stadium lanjut tidak memberi prognosis yang baik. Dua modalitas utama pengobatan kanker vulva yaitu terapi pembedahan dan terapi radiasi. Terapi radiasi dapat dilakukan pula pada stadium awal, tetapi terapi pembedahan dinilai mempunyai beberapa kelebihan, antara lain faktor efek samping pada ovarium/gangguan fungsi reproduksi, faktor higienis pasien dan kemudahan terapi bila terjadi residif. Berbagai variasi teknik pembedahan kanker vulva, antarannya adalah vulvektomi radikal dengan insisi kupu-kupu (VRIK), vulvektomi radikal dengan insisi terpisah (VRIP).Tujuan penelitian adalah melihat keuntungan pembedahan vulvektomi radikal dengan insisi terpisah dibandingkan dengan insisi kupu-kupu dalam hal lamanya pembedahan, penyembuhan luka, kejadian infeksi, lamanya perawatan. Penelitian ini merupakan uji klinik. Selama kurun waktu 1990-2000 terdapat 15 kasus kanker vulva yang dilakukan pembedahan, 14 kasus stadium II dan 14 kasus dengan histologi karsinoma sel skuamosa dan 1 kasus dengan adenokarsinoma. Lama pembedahan pada VRIP rata-rata 168 menit, lebih singkat dibandingkan VRIK yang mencapai rata-rata 275 menit. Kejadian infeksi pada kelompok VRIP 3 dari 11 kasus (27.27%) sedangkan pada kelompok VRIK seluruh kasus mengalami infeksi pada luka pembedahan. Kegagalan aproksimasi luka operasi 1 dari 12 kasus ( 9.99% ) sedangkan pada VRIK seluruh kasus mengalami kegagalan sehingga memerlukan pembedahan kosmetik. Lama perawatan pasca bedah kelompok VRIP 12.3 hari sedangkan VRIK 21.5 hari. Dengan demikian pembedahan VRIP lebih kecil komplikasinya dan lebih pendek lama pembedahan dan lebih pendek masa perawatan pasca bedah. (Med J Indones 2003; 12: 103-8)

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Vulvar cancer is a gynecological cancer whose incidence rate is relatively low. Patients generally were admitted at advanced stage, and radiation therapy at advanced stage does not provide favorable prognosis. Two main modalities in the treatment of vulvar cancer are surgery and radiation therapy. However, radiation can be performed in early stage vulvar cancer but surgery is thought to have more benefits, such as in side effect on the ovary/ reproductive function disorder, patient's hygiene factor, and the ease in performing therapy if recurrence occurs. There are various techniques of vulvar cancer surgery, such as radical vulvectomy with butterfly incision (RVBI) and radical vulvectomy with separated incision (RVSI).

The objective of this study was to identify the benefits of radical vulvectomy with separated incision in comparison with radical vulvectomy with butterfly incision in terms of the length of surgery, wound recovery, infection incidence, length of hospital stay. This study was a clinical trial performed during the period of 1990-2000. Fifteen cases of vulvar cancer were found and underwent surgery. Fourteen cases were at stage II and 14 cases were histologically defined as squamous-cell carcinoma and 1 case was adenocarcinoma. The average length of surgery in RVSI was 168 minutes, this was shorter than that in VRBI which reached an average of 275 minutes. The incidence of infection in RVSI group was 3 of 11 cases (27.27%), while in RVBI group all cases had infection in surgical wound. Failure of surgical wound approximation was 1 of 12 cases (9.99%), while in RVBI all cases experienced the failure such that cosmetic surgery was required. Length of postoperative care in RVSI group was 12.3 days, while in RVBI 21.5 days. Thus, complications in VRBI were lower, and length of surgery and length of postoperative care were shorter. (Med J Indones 2003; 12: 103-8)"

"ABSTRACTPurpose: Whether or not gastrectomy is feasible for very elderly gastric cancer patients is unclear. This study aimed to clarify the feasibility and safety of surgical treatment for patients in this age group.Method: The study included 55 very elderly patients with resectable gastric cancer who underwent gastrectomy (≥ 85 years of age; very-E group). The surgical outcomes were compared with those of 611 elderly patients (75-84 years old; E group).Results: Female sex, a poor physical and performance status, and a low serum albumin level patients were more frequent in the very-E group than in the E group. Lymphadenectomy was less aggressive in the very-E group than in the E group (P < 0.001). The overall postoperative complication rate was not significantly different between the groups (46 vs 33%; P = 0.073). A multivariate analysis to predict the overall survival identified male sex (hazard ratio 1.75, 95% confidence interval 1.30-2.36), low body mass index (2.19, 1.52-3.16), poor performance status (2.14, 1.60-2.86), low serum albumin level (1.84, 1.37-2.48), and advanced tumor stage (1.71, 1.29-2.27) but not age (1.31, 0.84-2.03) as independent prognostic factors.Conclusion: Chronological age alone is not a contraindicative factor for gastrectomy in very elderly patients."