The 18th International Congress of Lymphology, Genoa, Italy, Sept. 3-7, 2001

As presenters and conference participants packed their bags to return home, many reflected fondly on the twists and turns of Genoa's medieval alleys (carruggi), the beautiful nearby fishing ports of Portifino and Santa Margherita of the Italian riveria, and the stunning historic castles and palaces which are so commonplace in Italy.

But between these glimpses of Italian history and art, many of those who attended the Lymphology conference in Genoa in early September made important contacts and shared information with colleagues from a wide range of disciplines in this still very neglected area of medicine.

Some highlights of the Congress proceedings included:

Announcements of:

• Human trials in genetic treatment of lymphatic disorders using the genes VEGF-C and VEGF-D to stimulate vessel growth, to be jointly undertaken by Professor K. Alitalo of University of Helsinki, Finland and Professor Stanley Rockson of the Stanford University Medical Centre, California;
• A systematic review of research on the effectiveness of lymphatic treatments using Cochrane technique, being undertaken by Caroline Badger through the Royal College of Nursing Institute in the U.K. Three subjects have been chosen for this particular review:
  - the use of prophylactic antibiotic/anti-inflamatory drugs to reduce inflamatory attacks in lymphedema
  - the use of benzo-pyrones to reduce and control lymphedema
  - the use of physical therapies to reduce and control lymphedema
• An initiative to establish an international patients association - the International Lymphedema Advocacy Coalition - by Saskia Thiadens of the National Lymphedema Network in the U.S.

Discussions of clinical research on:

• Research on the relationship of lymphatic system to other conditions such as retinal damage and Crohn's disease (of the colon) by Drs. S. Mandolesi and P. Tonelli of Italy and the need for more investigation in these areas
• The effectiveness of new measurement techniques to facilitate better study of tissue changes during treatment of lymphatic conditions by Professor Neil Piller of Australia and Canada's Robert Harris of the Vodder School
• Quality of life determinants and the role of patient associations by speakers from France, Italy, Australia, Czech Republic and the U.S.
• Skin care challenges in dermatology
• Lymphatic disorders related to AIDS/HIV (lymphedema is common in some types of Kaposi's sarcoma)
• Treatment of lymphedema and lymphatic filariasis in developing countries such as India and Africa - with several presentations on the importance of preventing infection so that individuals could continue to work
• Experimental use of vacines in Brazil to prevent infection in breast cancer survivors

Other issues discussed at the conference included workshops on massage and other non-surgical interventions to treat lymphatic conditions and a number of sessions on surgical techniques. A presentation by Drs. C. Becker, J. Assouad and M. Riquet of France on their experiences re-constructing breast tissue using abdominal tissue with lymph nodes attached, was the talk of the conference. This technique showed much promise in treating lymphedema in breast cancer survivors.

Dr. Campisi, chair of the Congress and a surgeon with the Lymphology and Microsurgery Centre in Genoa, had hoped the sessions on surgery would raise the awareness generally of surgeons on lymphatic conditions. The positive response of surgical specialists who made presentations at the Congress will result in a handbook being published parallel with proceedings of the Congress, entitled Lymphology for Surgeons.

Throughout the conference the gap between those who could afford the high tech diagnostic tools and treatment and those who could not, in both "first world" nations and developing countries, was evident. A number of presenters and participants pointed out the importance of developing diagnostic indicators which health practitioners could use in any situation, and the use of more traditional techniques of measurements and treatment in situations where affordability was a consideration. (The International Society of Lymphology has attempted to address this problem by establishing diagnostic stages and forms of lymphedema for general practitioners).

Research was also presented from a number of institutions in Asia. Representatives of China expressed frustration with language barriers which have prevented a free exchange of information with practitioners in that country.

Many participants stressed the need for increased rigour and standards by practitioners and those undertaking research to improve the status and credibility of work in this area. Several representatives of the International Society of Lymphology (ISL) called for involvement by scientists from the Microcirculatory Society in gatherings held by the ISL.

This year International Society of Lymphology awarded a number of grants to young scientific practitioners (young lymphologists) to enable them to participate in information-sharing at the conference. This will be a continuing practice by the association to encourage new blood into this important area of study.

Much credit for the success of the Congress must go to the gracious Dr. Campisi, who as the Congress chair made a number of presentations at the session while at the same time overseeing a range of activities and exhibits for participants which kept them stimulated and engaged. Drs. Marlys and Charles Witte, editors of the Lymphology Journal (the official publication of the ISL), helped to co-ordinate the program and contributed to many of the sessions with research and practical experience they have undertaken at the University of Arizona in Tucson, U.S.A.

For information on the Congress proceedings and research presented at its sessions, contact the International Society of Lymphology at: www.u.arizona.edu/~witte/ISL.htm or Dr. Campisi at: campisi@unige.it

Note to readers: The International Society of Lymphology (ISL) was founded during the First International Symposium of Lymphology in Zurich, July, 1966. Now in its 34st year of existence, the Society has some 375 members from 42 nations. Affiliated groups are: The Japanese Society of Lymphology, The North American Society of Lymphology, The German Speaking Section of Lymphology, The Groupement Européen de Lymphologie, the Association de Lymphologie de Langue Française, the British Lymphology Interest Group, Club de Linfologia (Spain), Asociation Argentina de Linfologia, and the Latin-Mediterranean Chapter.