II. Vinzenz Czerny (1842-1915): grand seigneur of oncologic surgery--life, influence, and work of the Second Congress President of the ISS/SIC. International Society of Surgery/Société Internationale de Chirurgie

An Ailment with Which I Will Contend: A Narrative Review of 5000 Years of Esophagogastric Cancers and Their Treatments, with Special Emphasis on Recent Advances in Immunotherapeutics

Esophagogastric cancers are among the most common and deadly cancers worldwide. This review traces their chronology from 3000 BCE to the present. The first several thousand years were devoted to palliation, before advances in operative technique and technology led to the first curative surgery in 1913. Systemic therapies were introduced in 1910, and radiotherapy shortly thereafter. Operative technique improved massively over the 20th century, with operative mortality rates reducing from over 50% in 1933 to less than 5% by 1981. In addition to important roles in palliation, endoscopy became a key nonsurgical curative option for patients with limited-stage disease by the 1990s. The first nonrandomized studies on combination therapies (chemotherapy ± radiation ± surgery) were reported in the early 1980s, with survival benefit only for subsets of patients. Randomized trials over the next decades had similar overall results, with increasing nuance. Disparate conclusions led to regional variation in global practice. Starting with the first FDA approval in 2017, multiple immunotherapies now encompass more indications and earlier lines of therapy. As standards of care incorporate these effective yet expensive therapies, care must be given to disparities and methods for increasing access.

Tsugishige Kondo, The Father of Japanese Surgery: Exploring the History of Hideyo Noguchi's Hand Reconstruction With a Forearm Flap Before the Establishment of Plastic Surgery in Japan

ABSTRACT

Hideyo Noguchi is one of the most famous scientists in Japan's history, and his portrait has adorned the ¥1,000 banknotes since 2004. He had a childhood burn injury resulting in severe hand scarring and contracture that plagued his early life and education.The resulting hand deformity required 3 separate reconstructions with the third and most complex surgery performed by Professor Tsugishige Kondo just before Noguchi's final medical doctor license examination in 1897. In this surgery, Kondo released the contractures using the first radial forearm flap performed in Japan long before the establishment of plastic surgery in the country.Reviewing the history of Kondo, we find that he likely learned the art of reconstructive surgery along with many other surgical techniques during his stay in Europe from 1891 to 1896 where he was mentored by 4 prominent surgeons of the era: Christian Albert Theodor Billroth, Vincenz Czerny, James Israel, and Carl Nicoladoni. During this period, Czerny reported performing the world's first breast reconstruction using lipoma transfer, and Nicoladoni performed the world's first thumb reconstruction with a chest flap and with toe-to-thumb transfer. Kondo may have watched these world's first operations and may have also been taught these innovative techniques including the forearm flap directly by these pioneers. He returned to Japan and successfully applied these reconstructive surgery methods in his practice and teaching, as evidenced by the landmark surgery of Hideyo Noguchi's hand, and laid the foundations for the development of plastic surgery in Japan.

Nominee and nominator, but never Nobel Laureate: Vincenz Czerny and the Nobel Prize

PURPOSE

The Heidelberg surgeon Vincenz Czerny (1842-1916) is remembered as pioneer of innovative operations as well as entrepreneur of interdisciplinary cancer therapy. The purpose of this paper is to describe his role during the early history of the Nobel Prize in physiology or medicine.

METHOD

Based on documents from the Nobel Archive, this paper investigates how Czerny contributed, both as nominee and nominator, in shaping the early years of Nobel Prize history.

RESULTS

Vincenz Czerny was nominated at least three times for the Nobel Prize, but he was never selected. Czerny's own nomination letters pinpoint important trends in medicine around the turn of the century. At least seven of the candidates he put forward, became Nobel Laureates.

CONCLUSION

Czerny-like many other internationally renowned surgeons during the first decades of the twentieth century-missed out on the Nobel Prize, partly because it is not a lifetime award and his work would have to have been more recent. However, with his nominations, Czerny helped to shape the Nobel Prize to become the most important scientific award worldwide.