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Ymittos Athens, Greece

Hatzipantelis E.,Hippokratio General Hospital | Panagopoulou P.,Hippokratio General Hospital | Sidi-Fragandrea V.,Hippokratio General Hospital | Fragandrea I.,Agios Savvas Anticancer Hospital | Koliouskas D.E.,Hippokratio General Hospital
Journal of Pediatric Gastroenterology and Nutrition | Year: 2010

Background And Objective: Carcinoid tumors of the appendix are rare in childhood and usually have a benign clinical course. Their incidence in appendectomy specimens ranges from 0.1% to 0.9%. The aim of the study was to report the frequency, clinical presentation, tumor characteristics, and outcome of children with appendiceal carcinoid treated in a pediatric oncology department. PATIENTS AND Methods: All of the cases referred during a 19-year period (1990-2008) were studied retrospectively. Demographics, clinical presentation, tumor characteristics, and follow-up results were recorded. Results: Among 839 admissions, 19 patients (9 boys) with appendiceal carcinoid were identified during the study period. Their median age was 10.5 years (range 4.5-13.2 years). In all of the cases, diagnosis was established after appendectomy. The mean tumor diameter was 4.55 (±3.45) mm (range 1-15 mm). Concomitant appendicitis was diagnosed in 12 patients. In 18 children tumor size was ≤10 mm and did not infiltrate surrounding tissues. In 1 patient the size was 15 mm and a microscopic rupture of the appendix with infiltration of the surrounding fat was present. All of the tumors were located at the tip of the appendix and were of the classic histological type. Staging and follow-up consisted of abdominal ultrasound, chest and abdominal computed tomography scans, Tc bone scan, urine 5-hydroxylindoloacetic acid levels, and In octreotide scan. No patient had metastases requiring further therapeutic interventions. No relapses or other neoplasms occurred during a median follow-up period of 45 months (range 6-118 months). Conclusions: Carcinoid tumors of the appendix in children are rare. Long-term follow-up revealed that a good prognosis is possible provided they are diagnosed and surgically removed at an early stage. Copyright © 2010 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Source


Apostolou P.,National Diagnostics | Apostolou P.,National and Kapodistrian University of Athens | Fostira F.,National Diagnostics | Papamentzelopoulou M.,National Diagnostics | And 6 more authors.
Cancer Genetics | Year: 2015

The CHEK2 gene encodes a protein kinase that plays a crucial role in maintenance of genomic integrity and the DNA repair mechanism. CHEK2 germline mutations are associated with increased risk of breast cancer and other malignancies. From a clinical perspective, the most significant mutation identified is the c.1100delC mutation, which is associated with an approximately 25% lifetime breast cancer risk. The distribution of this mutation shows wide geographical variation; it is more prevalent in the Northern European countries and less common, or even absent, in Southern Europe. In order to estimate the frequency of the CHEK2 c.1100delC mutation in Greek breast cancer patients, we genotyped 2,449 patients (2,408 females and 41 males), which was the largest series ever tested for c.1100delC. The mean age of female and male breast cancer diagnosis was 49 and 59years, respectively. All patients had previously tested negative for the Greek BRCA1 founder and recurrent mutations. The CHEK2 c.1100delC mutation was detected in 0.16% (4 of 2,408) of females, all of whom were diagnosed with breast cancer before the age of 50years. Only one c.1100delC carrier was reported with breast cancer family history. The present study indicates that the CHEK2 c.1100delC mutation does not contribute substantially to hereditary breast cancer in patients of Greek descent. © 2015 Elsevier Inc. Source


Triantafyllidou O.,National Diagnostics | Vlachos I.S.,National Diagnostics | Apostolou P.,National Diagnostics | Konstantopoulou I.,National Diagnostics | And 9 more authors.
Journal of B.U.ON. | Year: 2015

Purpose: BRCA mutation carriers can benefit from targeted clinical interventions. On the other hand, families with evident aggregation of breast cancer (BC) cases and a BRCA-negative genetic test can still be considered as of elevated risk, since the underlying genetic factor remains unidentified. In the present study, we compared clinical and demographic characteristics between BRCA1 mutation carriers (BRCAlmut) and non-carriers (non-BRCAl) in a Greek group of BC patients (n=321). Methods: Data were collected and analyzed from 321 women with BC, with 131 patients screened for pathogenic mutations in the high-penetrant genes BRCA1 and BRCA2. Collected data included demographics, pedigrees, tumor histopathology and immunohistochemistry findings. Results: In BRCAlmut patients, their mothers and grandmothers were diagnosed at a younger age compared to non-BRCAl-carriers. Additionally, BRCAlmut patients were diagnosed with mainly estrogen receptor (ER) negative (p<0.001), Her-2 negative (p<0.05) and triple negative (p<0.01) tumors. The youngest generation was diagnosed with familial breast cancer (FBC) 9.7 years earlier than their mothers (p<0.001). Age at BC diagnosis negatively correlated with the nuclear grade of breast tumors (r=-0.3, p<0.05). Among parous individuals, the number of fullterm pregnancies significantly correlated with the age at BC onset (r=0.19, p<0.05). Conclusion: Despite their similarities, FBC cases with identified BRCA1 mutations exhibit a clearly distinct profile. We have identified an anticipation effect in FBC patients, with significantly reduced age at diagnosis in younger generations. Increased parity seems to prevent early BC onset. This is the first study comparing clinical and demographic characteristics of FBC BRCAlmut and non-carriers in a Greek cohort. Source


Tsoukalas N.,Agios Savvas Anticancer Hospital | Tzovaras A.,Agios Savvas Anticancer Hospital | Tolia M.,Agios Savvas Anticancer Hospital | Papakostidi A.,Agios Savvas Anticancer Hospital | And 3 more authors.
Archives of Hellenic Medicine | Year: 2011

Objective The aim of this study was to carry out a multivariate meta-analysis of studies which investigated the predictive value of KRAS mutations in the efficacy of cetuximab in patients suffering from colorectal cancer. Method A systematic literature search was made in the PubMed, Medline and Cochrane databases using a combination of the key words "cetuximab", "anti-egfr" "KRAS or K-RAS" and "colorectal cancer". A 2-dimensional random-effects model was used for the analysis of sensitivity and specificity. Data from each study was entered in 2×2 tables from which sensitivities, specificities and predictive values (negative and positive) were estimated. The statistical program Stata 10 (StataCorp) was used for all the statistical analyses and significant results were considered those with p-value <0.05. Results A total of 26 relevant reports were found from the search of the databases, of which 13 were appropriate for this specific meta-analysis. Initially, it was found that in these studies the specificities were much higher than the sensitivities. On combining the data from the 13 studies, it was found that mutations in the KRAS gene constitute a negative predictive biomarker for the response to cetuximab, with very high specificity, 0.96 (0.84-0.99), but low sensitivity, 0.47 (0.43-0.50), and that publication bias may often occur. Conclusions The clinical importance of these findings is that cetuximab should be administrated only to patients who have the wild type KRASw oncogene. Mutations in the KRAS gene are a negative predictive factor for the response to cetuximab, with very high specificity and low sensitivity. The low value of sensitivity is probably due to the presence of additional mechanisms of resistance to anti-EGFR therapies, such as mutations in BRAF. © Athens Medical Society. Source


Tsoukalas N.,Agios Savvas Anticancer Hospital | Kostakis I.D.,National and Kapodistrian University of Athens | Tolia M.,Agios Savvas Anticancer Hospital | Tryfonopoulos D.,Agios Savvas Anticancer Hospital | And 5 more authors.
International Urology and Nephrology | Year: 2014

Collecting duct carcinoma is a rare renal malignant neoplasm, arising from the medullary collecting duct and accounting for less than 1 % of renal cell carcinomas. It is more common in middle-aged men and is usually presented with hematuria, abdominal mass and back or flank pain. Its immunohistochemical analysis detects the expression of various markers, such as low and high molecular weight keratins, Ulex europaeus agglutinin-1, epithelial membrane antigen and peanut lectin. Here, we present a case of a 29-year-old woman with CDC presented with back pain and supraclavicular lymphadenopathy that produced carcinoembryonic antigen and CA-125. © 2014 Springer Science+Business Media. Source

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