Prof Dr Alexandru Trestioreanu Oncology Institute

Bucharest, Romania

Prof Dr Alexandru Trestioreanu Oncology Institute

Bucharest, Romania
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Plesca M.,Prof Dr Alexandru Trestioreanu Oncology Institute | Bordea C.,Prof Dr Alexandru Trestioreanu Oncology Institute | El Houcheimi B.,Prof Dr Alexandru Trestioreanu Oncology Institute | Ichim E.,Prof Dr Alexandru Trestioreanu Oncology Institute | Blidaru A.,Prof Dr Alexandru Trestioreanu Oncology Institute
Journal of medicine and life | Year: 2016

Axillary lymph node evaluation remains essential in breast cancer surgery, first as a prognostic factor, because it indicates the degree of dissemination of the disease to the main lymphatic drainage basin of the breast, and, on the other hand, as an element of preventing the local relapse. In the era of the sentinel lymph node, complete axillary lymphadenectomy, considered valuable until recently, but as therapeutic and diagnostic, has become an intervention performed increasingly rare in selected cases. Axillary lymphatic tissue resections are accompanied by morbidity (lymphedema, paresthesia, limitations of arm movement) and symptom magnitude is proportional to the extension of the intervention. For this reason, a solution to avoid these kinds of complications was looked for. Since Gould, in 1960, who mentioned cancer parotid and continuing with Cabanas, Morton, or Veronesi, many surgeons have contributed to the development of safe techniques with which the multidisciplinary team involved in the surgical treatment for breast cancer could perform a safe oncological intervention and at the same time could conserve the healthy tissue, thus limiting morbidity. To achieve this standard, axillary lymphadenectomy has passed through several stages, from over radical interventions that followed the Halsted era, in which, besides axillary lymph nodes, the internal mammary and jugulo-carotidian lymph nodes were excised, to the absence of axillary surgery and replacing it with radiation therapy.


Radu E.-V.,Bagdasar Arseni Clinical Emergency Hospital | Coman I.-S.,Bagdasar Arseni Clinical Emergency Hospital | David O.-I.,Bagdasar Arseni Clinical Emergency Hospital | Bedereag S.-I.,Bagdasar Arseni Clinical Emergency Hospital | And 12 more authors.
Romanian Journal of Morphology and Embryology | Year: 2016

The polypropylene mesh, although is one of the most used prosthetic biomaterials for abdominal wall defects, proved not to be completely inert, generating from precocious foreign body inflammatory reactions (varying by individual reactivity, the amount of used material and its structure), to late complications such as chronic infections, stercoral fistulae or mesh migration. The present paper was aimed at studying the behavior of implants of this material in three different areas of the body of experimental animals, as follows: intramuscular, intraperitoneal and extraperitoneal. The observation time was 21 days and 90 days. We observed foreign body reactions induced locally by the mesh that remains temporary, generating a moderate number of macrophages and foreign body giant cells. The material did not systemically affect the healing and the scaring of the surgical wounds, but in all three implant areas, the polypropylene mesh generated locally a fibrous proliferation reaction of neoformation tissue, which wrapped and secured the implanted product on all surfaces. © 2016 Editura Academiei Romane. All rights reserved.


Badila E.,Clinical Emergency Hospital | Badila E.,University of Bucharest | Grigore C.,Clinical Emergency Hospital | Daraban A.M.,Clinical Emergency Hospital | And 9 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

The solitary fibrous tumor of the pleura (SFTP) is a rare primary tumor arising from mesenchymal cells in the areolar tissue subjacent to the mesothelial-lined pleura. From an epidemiological standpoint, solitary fibrous tumors of the pleura account for less than 5% of primary pleural tumors, and commonly affect patients in the sixth and seventh decades. We presented the case of a 38-year-old woman, without any significant pathological history, who presented at the emergency room for unspecific respiratory symptoms. Imagistic investigations showed a giant opacity in the upper half part of the left hemithorax. The patient underwent surgery and en bloc resection of the tumor (30/25 cm) in oncological limits was performed. Definite diagnosis-solitary fibrous tumor of the pleura-was obtained through histological examination and immunohistochemistry. Even if SFTP are benign tumors, a long follow-up period is mandatory as even patients with complete resection are at risk of recurrence several years after surgery. © 2014, Editura Academiei Romane. All rights reserved.


Grigorescu A.C.,Prof Dr Alexandru Trestioreanu Oncology Institute | Bala C.,Prof Dr Alexandru Trestioreanu Oncology Institute
Journal of B.U.ON. | Year: 2013

Purpose: The purpose of the present trial was to investigate whether clinical benefit can be obtained by concurrent administration of erlotinib with gemcitabine as first-line treatment in patients with advanced non-small cell lung cancer (NSCLC) and ECOG performance status (PS) 2. Methods: Included were chemotherapy-naive patients with histologically/cytologically documented unresectable advanced and/or metastatic (stage IIIB/IV) NSCLC and ECOG PS 2. In this phase II, single-arm study, all patients received first-line gemcitabine plus erlotinib for 6 cycles or until disease progression, unacceptable toxicity or patient withdrawal due to any reason. The primary study objectives were the evaluation of disease response and the time to progression. Secondary objectives included evaluation of overall survival and the safety profile of gemcitabine plus erlotinib. Results: Nineteen eligible patients were studied. The overall response rate (complete response/CR and partial response/PR) was 15.8% and the clinical benefit rate (CR+PR+stable disease/SD) 36.84%.The median overall survival for the whole study group was 39 weeks (95% CI 27-51) and the median time to disease progression for 19 evaluable patients was 15 weeks (95% CI 7-36). The safety profile of the combination was acceptable with only 2 serious adverse events. Conclusion: Taking into account similar published clinical studies we conclude that gemcitabine plus erlotinib achieve superior response rate and comparable overall survival with acceptable toxicity compared to monochemotherapy with gemcitabine. This combination represents a treatment option for patients with advanced NSCLC and ECOG PS 2.


PubMed | Prof Dr Alexandru Trestioreanu Oncology Institute
Type: Review | Journal: Journal of medicine and life | Year: 2016

Axillary lymph node evaluation remains essential in breast cancer surgery, first as a prognostic factor, because it indicates the degree of dissemination of the disease to the main lymphatic drainage basin of the breast, and, on the other hand, as an element of preventing the local relapse. In the era of the sentinel lymph node, complete axillary lymphadenectomy, considered valuable until recently, but as therapeutic and diagnostic, has become an intervention performed increasingly rare in selected cases. Axillary lymphatic tissue resections are accompanied by morbidity (lymphedema, paresthesia, limitations of arm movement) and symptom magnitude is proportional to the extension of the intervention. For this reason, a solution to avoid these kinds of complications was looked for. Since Gould, in 1960, who mentioned cancer parotid and continuing with Cabanas, Morton, or Veronesi, many surgeons have contributed to the development of safe techniques with which the multidisciplinary team involved in the surgical treatment for breast cancer could perform a safe oncological intervention and at the same time could conserve the healthy tissue, thus limiting morbidity. To achieve this standard, axillary lymphadenectomy has passed through several stages, from over radical interventions that followed the Halsted era, in which, besides axillary lymph nodes, the internal mammary and jugulo-carotidian lymph nodes were excised, to the absence of axillary surgery and replacing it with radiation therapy.


PubMed | Prof Dr Alexandru Trestioreanu Oncology Institute
Type: Clinical Trial, Phase II | Journal: Journal of B.U.ON. : official journal of the Balkan Union of Oncology | Year: 2013

The purpose of the present trial was to investigate whether clinical benefit can be obtained by concurrent administration of erlotinib with gemcitabine as first-line treatment in patients with advanced non-small cell lung cancer (NSCLC) and ECOG performance status (PS) 2.Included were chemotherapy-naive patients with histologically/cytologically documented unresectable advanced and/or metastatic (stage IIIB/IV) NSCLC and ECOG PS 2. In this phase II, single-arm study, all patients received first-line gemcitabine plus erlotinib for 6 cycles or until disease progression, unacceptable toxicity or patient withdrawal due to any reason. The primary study objectives were the evaluation of disease response and the time to progression. Secondary objectives included evaluation of overall survival and the safety profile of gemcitabine plus erlotinib.Nineteen eligible patients were studied. The overall response rate (complete response/CR and partial response7sol;PR) was 15.8% and the clinical benefit rate (CR+PR+stable disease sol;SD) 36.84%.The median overall survival for the whole study group was 39 weeks (95% CI 27-51) and the median time to disease progression for 19 evaluable patients was 15 weeks (95% CI 7-36). The safety profile of the combination was acceptable with only 2 serious adverse events.Taking into account similar published clinical studies we conclude that gemcitabine plus erlotinib achieve superior response rate and comparable overall survival with acceptable toxicity compared to monochemotherapy with gemcitabine. This combination represents a treatment option for patients with advanced NSCLC and ECOG PS 2.

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