Saint Savvas Hospital

Athens, Greece

Saint Savvas Hospital

Athens, Greece
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Kyriazoglou A.I.,Saint Savvas Hospital | Dimitriadis E.,Saint Savvas Hospital | Arnogiannaki N.,Saint Savvas Hospital | Teixeira M.R.,Biomedical science Institute ICBAS | Pandis N.,Saint Savvas Hospital
Cancer Genetics | Year: 2012

Extraskeletal osteosarcomas are rare tumors with neoplastic cells synthesizing bone, usually associated with poor prognosis. We present the case of a 40-year-old man with an extraskeletal osteosarcoma that was treated by surgery and adjuvant radiotherapy. Thirteen years after the diagnosis, he remains disease-free, without any recurrences or metastases. Histopathological analysis favored the diagnosis of chondroblastic extraskeletal osteosarcoma grade II. G-banding, comparative genomic hybridization (CGH), and real-time PCR for the MDM2 and CDK4 genes were performed to describe the genetic profile of this tumor and revealed aberrations that are common findings of parosteal osteosarcomas. Ring chromosomes, giant marker chromosomes, and a telomeric association were found with G-banding. CGH revealed that 12q was amplified in the ring and giant markers identified by G-banding. Real-time PCR for MDM2 and CDK4 confirmed the amplification of these genes located in 12q. Our findings suggest that a variant of extraskeletal osteosarcoma, which is genotypically similar to parosteal osteosarcoma, exists and is associated with good prognosis. © 2012 Elsevier Inc.

PubMed | Institute of Oncology, Hospital Universitario Central Of Asturias, University of Groningen, University of Udine and 2 more.
Type: Journal Article | Journal: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery | Year: 2016

Trismus indicates severely restricted mouth opening of any aetiology. A mouth opening of 35 mm or less should be regarded as trismus. Aim of this study was to review the etiopathogenesis, incidence, treatment and prevention of trismus in patients with head and neck cancer.Trismus is frequently seen in patients suffering from malignant tumours of the head and neck. The reported prevalence of trismus in those patients varies considerably in the literature and ranges from 0 to 100% depending on the tumour site and extension. Trismus may worsen or remain the same over time, or the symptoms may reduce, even in the absence of treatment. When a patient presents with trismus after tumour treatment, it is important to determine whether the trismus is the result of the treatment, or is the first sign of a recurrence. Restricted mouth opening may impede inspection of the oral cavity as needed for dental care, and particularly for oncologic follow-up.Mouth opening after radiotherapy (RT) decreases on average by approximately 20% compared to mouth opening prior to RT. The prevalence of trismus increases with increasing doses of RT to mastication structures. The use of intensity-modulated RT seems to lower the percentage and severity of RT-induced trismus. Treatment of trismus can be conservative (with either medical or physical therapy) or surgical. Exercise therapy is the mainstay of treatment and exercise should start as soon as possible after treatment. The prevention of trismus, rather than its treatment, is the most important objective.

Mathioudaki K.,Saint Savvas Hospital | Scorilas A.,National and Kapodistrian University of Athens | Ardavanis A.,Saint Savvas Hospital | Lymberi P.,Hellenic Pasteur Institute | And 4 more authors.
Tumor Biology | Year: 2011

Methylation of arginine residues has been implicated in many cellular activities like mRNA splicing, transcription regulation, signal transduction and protein- protein interactions. Protein arginine methyltransferases are the enzymes responsible for this modification in living cells. The most commonly used methyltransferase in man is protein arginine methyltransferase 1 (PRMT1). Since methylation processes appear to interfere in the emergence of several diseases, including cancer, we investigated the localisation of the protein in cancer tissue and, for the first time, the relation that possibly exists between the expression of PRMT1 gene and breast cancer progression. We used tumour specimens from 62 breast cancer patients and semi-quantitative RT-PCR to determine the expression of PRMT1 gene and was found to be associated with patient's age (p=0.002), menopausal status (p=0.006), tumour grade (p=0.03), and progesterone receptor status (p=0.001). Survival curves revealed that PRMT1-v1 status-low expression relates to longer disease-free survival (DFS; p=0.036). To the contrary, PRMT1-v2 status is not associated neither with the clinical or pathological parameters nor with DFS (p=0.31). PRMT1-v3 was not statistically significantly expressed in breast cancer tissue. Selected cancer and normal breast samples were stained for PRMT1. In both normal and cancerous breast tissues, staining was in the cytoplasm and only in rare cases the cell nucleus appeared stained. Present results show a potential use for this gene as a marker of unfavourable prognosis for breast cancer patients. © 2010 International Society of Oncology and BioMarkers (ISOBM).

Talieri M.,Saint Savvas Cancer Hospital | Alexopoulou D.K.,Saint Savvas Cancer Hospital | Scorilas A.,National and Kapodistrian University of Athens | Kypraios D.,Saint Savvas Hospital | And 4 more authors.
Tumor Biology | Year: 2011

Kallikrein-related peptidases (KLKs) represent a serine protease family having 15 members. KLK10 is a secreted protease with a trypsin-like activity. The function of KLK10 is poorly understood, although it has been suggested that KLK10 may function as a tumor suppressor gene. In human cancer, KLK10 gene shows organ-specific up- or down-regulation. Since KLKs are promising tumor biomarkers, the examination of KLK10 mRNA expression and its association with colorectal cancer (CRC) progression was studied using semi-quantitative PCR. One hundred and nineteen primary CRC specimens were examined for which follow-up information was available for a median period of 29 months (range, 1-104 months). KLK10 expression was found to be significantly associated with TNM stage (p=0.028). Cox proportional hazard regression model using univariate analysis revealed for the first time that high status KLK10 expression is a significant factor for disease-free survival (DFS; p= 0.002) and overall survival (OS; p=0.026) of patients. Kaplan-Meier survival curves demonstrated that KLK10 expression of low status is significantly associated with longer DFS (p=0.001) as well as OS (p=0.021), suggesting that KLK10 gene expression may be used as a marker of unfavorable prognosis for CRC. As the epigenetics of cancer are unraveled, KLK10 may represent not only a novel biomarker, but also a promising future therapeutic target for the disease. © International Society of Oncology and BioMarkers (ISOBM) 2011.

Talieri M.,Saint Savvas Hospital | Devetzi M.,Saint Savvas Hospital | Scorilas A.,National and Kapodistrian University of Athens | Prezas P.,Saint Savvas Hospital | And 3 more authors.
Anticancer Research | Year: 2011

Background: Kallikrein-related peptidases (KLKs) have been proposed as potential cancer biomarkers. Contradictions in literature led us to clarify the role of KLK5 as a breast cancer predictor, as well as its association with KLK7 expression. Patients and Methods: Semi-quantitative RT-PCR detected KLKs 5 and 7 in 80 breast tissues, 74 neoplastic and 6 normal. Steroid hormone receptors were quantified in all samples. Associations between KLK5 status and clinicopathological variables, as well as disease-free survival (DFS) and overall survival (OS) of patients were analyzed. Results: Forty tumor tissues showed high KLK5 expression, which was significantly associated with estrogen receptor status. Significant co-expression of KLKs 5 and 7 was observed in the same cancer samples (p=0.02). Increased KLK5 expression was a statistically significant independent prognostic factor for DFS (p=0.009 univariate analysis and p=0.028 multivariate analysis) and OS of patients (p=0.014, univariate analysis). Conclusion: Increased KLK5 expression can contribute to the prognosis of DFS and OS of breast cancer patients. KLKs 5 and 7 are co-expressed in breast cancer.

Kapritsou M.,Saint Savvas Hospital | Korkolis D.P.,Saint Savvas Hospital | Konstantinou E.A.,National and Kapodistrian University of Athens
Gastroenterology Nursing | Year: 2013

Laparoscopic surgery for colorectal cancer has been used with success since 1991. During the last decade, many studies have compared laparoscopic surgery with open colectomy. The aim of this retrospective study was to present the advantages and disadvantages of laparoscopic and open colectomy for cancer, focusing on the postoperative care of patients. Eighty-eight consecutive patients suffering from cancer of the colon and rectum, surgically treated, were studied. They were divided into 2 groups: Group A patients (n = 48) underwent laparoscopic colectomy, and Group B patients (n = 40) were treated with an open procedure. For postoperative care of the patients, analgesia, median hospital stay, overall cost, and complications between the 2 groups were studied and statistically compared. Laparoscopic colectomy was associated with a shorter average hospital stay, fewer complications, earlier start of a normal diet, and better control of postoperative pain. Nonetheless, the cost of surgical instruments used in laparoscopic operation is higher. Laparoscopic surgery, despite its higher cost, seems to add significant advantages in the postoperative recovery of patients suffering from colorectal cancer. Copyright © 2013 Society of Gastroenterology Nurses and Associates.

PubMed | University of Michigan, Institute of Oncology, Netherlands Cancer Institute, Hospital Universitario Central Of Asturias and 9 more.
Type: Journal Article | Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery | Year: 2016

HPV-related (HPV+) oropharyngeal cancer (OPC) has a better prognosis compared to HPV unrelated (HPV-) OPC. This review summarizes and discusses several of the controversies regarding the management of HPV+ OPC, including the mechanism of its treatment sensitivity, modern surgical techniques, chemotherapy regimens, and treatment de-intensification protocols. We also discuss and reconsider potential adverse prognostic factors such as tumor EGFR expression, tumor hypoxia, and patient smoking history, as well as the significance of retropharyngeal adenopathy. Finally, we discuss elective nodal treatment of uninvolved lymph node stations. While this review does not exhaust all controversies related to the management of HPV+ OPC, it aims to highlight some of the most clinically relevant ones.

PubMed | 71 Leoforos Alexandras and Saint Savvas Hospital
Type: Journal Article | Journal: Medical dosimetry : official journal of the American Association of Medical Dosimetrists | Year: 2016

From 1989 to 1991, 27 patients with glioblastoma multiforme or anaplastic astrocytoma of the brain were treated with radiotherapy. Fifteen of twenty-seven patients were treated through limited volume fields, with a thrice-a-day (1.1 Gy/f) or twice-a-day (1.4 Gy/f) hyperfractionated regimen to a total physical dose of 62-92 Gy (median dose 76 Gy). The remaining 12 were treated with whole brain irradiation (40 Gy of total conventionally fractionated dose) and a localised boost to a total dose of 60 Gy. The hyperfractionated regimen was well tolerated and there was no sign of increased brain oedema to indicate the insertion of a split. Of six patients who received a NTD10 (normalised total dose for / =10) higher than 71 Gy, five showed CR (83% CR rate) versus three of 21 patients who received a lower NTD10 (14% CR rate). For 13 patients who received a NTD10 higher than 66 Gy, the 18-months survival was 61% (8/13) versus 28% (4/14) for 14 patients who received a NTD10 less than 66 Gy. As far as the late morbidity is concerned, of six patients treated with 76-92 Gy of physical dose, none died because of radiation-induced brain necrosis within 18-42 months of follow-up, and three of them are without evidence of disease 18-31 months after the end of radiation treatment. None of our 15 patients who received less than whole brain irradiation relapsed outside the radiation portals. The present study strongly suggests the use of limited volume hyperfractionated radiotherapy schemes, so as to increase the local tumor dose (NTD10) to values higher than 79 Gy, at the same time keeping the NTD2 (NTD for / = 2) below 68 Gy.

Fusaroli P.,University of Bologna | Kypreos D.,Saint Savvas Hospital | Alma Petrini C.A.,University of Bologna | Caletti G.,University of Bologna
Journal of Clinical Gastroenterology | Year: 2011

The literature about endoscopic ultrasonography (EUS) is still very prolific although it was introduced in the early 1980s. We aimed to review last decade's scientific production and to compare it with our earlier data about the period from 1980 to 2000. EUS publications of the period January 2001 to January 2010 were retrieved. Reviews, prospective, and retrospective studies, randomized controlled trials, meta-analyses, surveys, guidelines, and case-series were assessed. Data were collected on the subject-matter, type of publication, number of patients included, publishing journal, most recent impact factor, year of publication, and country accredited for publication. A total of 1763 relevant papers were published in more than 250 journals. The main areas of research were pancreatic disorders, tumors of the gastrointestinal wall, the extrahepatic biliary tree, submucosal lesions, lung cancer, and mediastinal masses. It is interesting to note that the therapeutic applications of EUS accounted for a new field of investigation. The majority of articles comprised retrospective trials and reviews, followed by prospective studies and case series. However, a considerable number of randomized controlled trials and meta-analyses was retrieved, which were absent in the earlier survey. United States, Europe, and Japan still possessed a pivotal role on EUS research, but an increasing number of publications has also emerged from other countries. The available literature on EUS keeps expanding, encompassing not only its well-established diagnostic role, but also novel indications and therapeutic interventions. EUS has evolved into a valuable implement of modern clinical practice, with a critical effect on patients' management. A trend toward well-structured studies is evident. Copyright © 2011 by Lippincott Williams & Wilkins.

Dimitriadis E.,Saint Savvas Hospital | Alexiou G.A.,Childrens Hospital Agia Sofia | Tsotsou P.,Saint Savvas Hospital | Simeonidi E.,Saint Savvas Hospital | And 4 more authors.
Journal of Neuro-Oncology | Year: 2013

Low grade astrocytomas are the most common brain tumor in children. Recent studies have identified alterations in the BRAF serine/threonine kinase gene that result in mitogen activated protein kinase pathway activation. Herewith, we investigated the genetic changes of BRAF in pediatric low grade gliomas and their relation to pathological findings and Ki-67 proliferation index. The results showed gene fusions between KIAA1549 and BRAF in 66.7 % of tumors. The majority involved the KIAA1549-BRAF exon 16-exon 9 variant. Fusion junction between KIAA1549 exon 15 and BRAF exon 9 was found in five tumors, in which the myxoid component was the predominant. This has not been previously reported. No significant correlation was found between specific KIAA1549 and BRAF fusion junctions and Ki-67 index. All of the samples included in this study were tested for the presence of the BRAFV600E mutation, and no positive sample was found. © 2013 Springer Science+Business Media New York.

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