Theagenio Cancer Hospital

Thessaloníki, Greece

Theagenio Cancer Hospital

Thessaloníki, Greece
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Papadiochos I.,Theagenio Cancer Hospital | Mangoudi D.,Theagenio Cancer Hospital
Journal of Cutaneous and Aesthetic Surgery | Year: 2017

Background: Postauricular flaps have proved very effective in the reconstruction of most types of partial auricular defects. However, few reports exist regarding the reconstruction of centrally located perforating defects of the auricle. Objectives: This paper aimed to describe a onestage technique including a post-Auricular folded flap (PAFF) for reconstruction of fullthickness defects of central auricular sites. Patients and Methods: Between March 2010 and November 2014, five male patients were treated with this reconstructive technique under local anaesthesia. At the time of surgery, patients' age ranged from 76 to 86 years (mean age, 79.8). The patients suffered from a central and fullthickness defect owing to surgical excision of a skin malignancy or failed reconstruction procedures secondary to surgical excision of a skin malignancy. Results: Healing was uneventful for all the included patients, without signs of dehiscence, necrosis, hematoma and infection. The defects were completely repaired, without the need of further operations. During the followup period, all the patients remained satisfied with the aesthetic outcome. Conclusions: This technique constitutes an immediate, effective and lowmorbidity procedure to repair fullthickness central defects of the auricle. Since PAFF requires only one surgical operation under local anaesthesia, patients with burdened medical history may profit from this technique. © 2017 Journal of Cutaneous and Aesthetic Surgery.


Chaidos A.,Imperial College London | Barnes C.P.,University College London | Cowan G.,Imperial College London | May P.C.,Imperial College London | And 18 more authors.
Blood | Year: 2013

The phenotype and function of cells enriched in tumor-propagating activity and their relationship to the phenotypic architecture in multiple myeloma (MM) are controversial. Here, in a cohort of 30 patients, we show that MM composes 4 hierarchically organized, clonally related subpopulations, which, although phenotypically distinct, share the same oncogenic chromosomal abnormalities as well as immunoglobulin heavy chain complementarity region 3 area sequence. Assessed in xenograft assays, myeloma-propagating activity is the exclusive property of a population characterized by its ability for bidirectional transition between the dominant CD19-CD138+ plasma cell (PC) and a low frequency CD19-CD138- subpopulation (termed Pre-PC); in addition, Pre-PCs are more quiescent and unlike PCs, are primarily localized at extramedullary sites. As shown by gene expression profiling, compared with PCs, Pre-PCs are enriched in epigenetic regulators, suggesting that epigenetic plasticity underpins the phenotypic diversification of myeloma-propagating cells. Prospective assessment in paired, pretreatment, and posttreatment bone marrow samples shows that Pre-PCs are up to 300-fold more drug-resistant than PCs. Thus, clinical drug resistance in MM is linked to reversible, bidirectional phenotypic transition of myeloma-propagating cells. These novel biologic insights have important clinical implications in relation to assessment of minimal residual disease and development of alternative therapeutic strategies in MM. © 2013 by The American Society of Hematology.


Asteriou C.,Theagenio Cancer Hospital | Barbetakis N.,Theagenio Cancer Hospital | Lalountas M.,Aristotle University of Thessaloniki | Kleontas A.,Theagenio Cancer Hospital | Tsilikas C.,Theagenio Cancer Hospital
Annals of Surgical Oncology | Year: 2011

Background: The most dangerous complication following esophagogastrectomy for esophageal cancer is anastomotic leakage. Surgical interventions described did not have a major impact in reducing the risk of occurrence. On the other hand, pleural tenting has been used for more than a decade by thoracic surgeons to prevent prolonged air leak after formal upper lobectomy with excellent results. Methods: A retrospective analysis of 114 cases of esophagogastrectomy for cancer of esophagus or cardioesophageal junction is presented. Patients have been divided in 2 groups. In group B modified pleural tenting was used to prevent a potential anastomotic leak, while in group A, the control group, pleural tenting was not used. Evaluation of modified pleural tenting in preventing anastomotic leakage was the aim of the study. Results: The pleural tenting group showed a significant decrease in anastomotic leak. In 1 patient versus 8 in group without pleural tenting the complication appeared (P = .032). The risk for an anastomotic leakage in group without pleural tenting was almost 9 times greater (odds ratio: 9.143, 95% confidence interval: lower bound 1.104, upper bound 75.708). The 30-day mortality, although lower in pleural tenting group, was not statistically significant. Conclusions: Pleural tenting is a safe, fast, and effective technique for prevention of anastomotic leakage after Ivor Lewis esophagogastrectomy. Subpleural blanketing of intrathoracic anastomosis could diminish the consequences of a possible anastomotic leak. © 2011 Society of Surgical Oncology.


Kyrgidis A.,Theagenio Cancer Hospital | Tzellos T.G.,Aristotle University of Thessaloniki | Vahtsevanos K.,Theagenio Cancer Hospital | Triaridis S.,Aristotle University of Thessaloniki
Journal of Surgical Research | Year: 2010

Basal cell carcinoma (BCC) is the commonest cancer in Caucasians and its incidence is increasing. Whilst ultraviolet radiation (UVR) is recognized as the main etiological factor, the relationship between exposure and host phenotype is still unclear. We systematically searched Medline, Embase, and the Cochrane databases for studies assessing the genetic basis of host response to UVR DNA damage, the effect of UVR on generation of reactive oxygen species (ROS), and their detoxification, UVR induced skin immunity modifications, and the role of genomic instability with a focus on the potential use of these biomarkers to the surgical treatment planning and prognosis of BCC patients. Data suggest that risk for BCC development is likely to result from the combined effect of many genes, each with a relatively weak individual contribution. Certain genomic alterations have been associated with increased or reduced risk for BCC development, with a second primary BCC or with recurrence of BCC. However, use of these biomarkers in everyday practice should be supported by further studies, mainly for its cost-effectiveness. In addition, not enough information exists on the prognostic value of existing demographic and clinical risk predictors for BCC regarding development of second primary or recurrent tumors. Information reviewed suggests that these predictors are of higher predictive value compared with biomarkers whilst they are indisputably cheaper and easier to monitor even in developing countries. Conclusively, we suggest that further studies aimed in investigating second primary or recurrent BCC are needed to provide better information on the predictive value of certain demographic, clinical and histological factors. © 2010 Elsevier Inc. All rights reserved.


Lalountas M.,Aristotle University of Thessaloniki | Ballas K.D.,Aristotle University of Thessaloniki | Michalakis A.,National Technical University of Athens | Psarras K.,Aristotle University of Thessaloniki | And 6 more authors.
British Journal of Surgery | Year: 2012

Background: Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm®) in the prevention of postoperative intraperitoneal adhesions in rats. Methods: One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm® group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation. Results: All antiadhesive film groups (Seprafilm®, placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm® in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm® group, but only one-quarter in the low-dose Statofilm group. Conclusion: The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm® in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.


PURPOSE: The aims of this study were to assess the accuracy of the presurgical TNM staging of patients with oral squamous cell carcinoma who underwent neck dissection, to explore the relation between the site of the primary tumor and the histopathologically determined neck metastasis, and to perform survival analysis in relation to the histopathologic neck status.PATIENTS AND METHODS: A retrospective chart review with prospective follow-up of oral squamous cell carcinoma patients who underwent neck dissection was performed. Presurgical clinical neck status (cN) and postsurgical histopathologic neck status (pN) were recorded. Sensitivity, specificity, and likelihood ratios were calculated. Kaplan-Meier survival analysis was performed.RESULTS: The patients clinically staged as cN+ have more than 2-fold odds of having a pN+ neck. Those staged as cN0 have 4 times less odds of a pN+ neck. The mean follow-up was 45.8 months. The median overall survival was 27 months (41 mo in the patients with pN0 and 19.5 mo in the patients with pN+). For the patients with pN0, the 1-year overall survival probability was 95%, falling to 90% at 2 years and 81.8% at 5 years. In the patients with pN+, the 1-year overall survival probability was 72.2%, falling to 44.4% at 2 years and 26.7% at 5 years. Disease-specific and disease-free survival exhibited similar trends.CONCLUSIONS: No means of presurgical assessment either clinical or imaging was sufficiently sensitive and specific enough to predict the metastatic status of the neck. An approximately 50% decrease in the 5-year overall survival rate may be expected when regional metastasis is confirmed. © 2014 by Mutaz B. Habal, MD.


Polychronidou G.,Theagenio Cancer Hospital | Papakotoulas P.,Theagenio Cancer Hospital
Case Reports in Oncology | Year: 2013

The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib are known to have greater efficacy in EGFR mutation-positive non-small cell lung cancer (NSCLC), although erlotinib also has activity in wild-type disease. We report the successful long-term maintenance treatment of a patient with EGFR wild-type NSCLC with gefitinib and later erlotinib. The patient (male; 44 years old; smoker) was diagnosed with EGFR wild-type NSCLC after computer tomography had revealed a mediastinal mass, and histology and mutation testing had identified the tumor as an EGFR wild-type grade 3 adenocarcinoma. The patient received multiple rounds of chemotherapy, followed by gefitinib maintenance (3 years). Later on, he received erlotinib maintenance and developed a persistent rash (grade 1/2) that lasted throughout the treatment. The patient's condition has remained stable on erlotinib for more than 5 years, with no evidence of progression. We describe the patient's disease course and treatment in the context of EGFR TKI therapy and the prognostic factors for long-term clinical outcomes of NSCLC, including the development of erlotinib-induced rash. © 2013 S. Karger AG, Basel.


Barbetakis N.,Theagenio Cancer Hospital | Asteriou C.,Theagenio Cancer Hospital | Kleontas A.,Theagenio Cancer Hospital | Tsilikas C.,Theagenio Cancer Hospital
Journal of Surgical Oncology | Year: 2011

Background and Objectives: Vascular access has great importance in the treatment of patients submitted to prolonged chemotherapy. Purpose of this study is to assess the efficacy and safety of the percutaneous insertion and use of totally implantable central venous access ports (TICVAP). Methods: During a 10-year period, 700 TICVAP were inserted into cancer patients for chemotherapy. Early and late complications and their management were recorded and analyzed. Results: Of the 700 catheters implanted, 126 (18%) presented one or more types of early and late complication. Removal of 262 catheters was performed, of which 216 (82.4%) were elective indications due to the termination of the treatment and 46 (17.6%) resulted from complications that could not be controlled using clinical measures. In 280 patients (40%), the catheter remained functional until the patient's death, and 158 patients (22.5%) are still making use of their catheters for clinical treatment. Conclusions: The low rate of complications according to this study confirms the safety and convenience of the percutaneous insertion and use of TICVAP in patients undergoing prolonged chemotherapy regimens and explains the increasing use of these devices in current medical oncology practice. © 2011 Wiley Periodicals, Inc.


Barbetakis N.,Theagenio Cancer Hospital
Interactive cardiovascular and thoracic surgery | Year: 2011

Hibernoma is an unusual benign soft tissue tumor derived from a specialized form of brown fat. A case of a 52-year-old female who was admitted with a slowly worsening hoarseness is presented. Further investigation revealed a left upper mediastinal mass next to the aortic arch. Upon surgical exploration a soft encapsulated mass was identified. Pathology was consistent with hibernoma. Despite their benign behavior, some variants of hibernoma can be confused histologically with liposarcoma. Therefore, long-term follow-up is advisable.


Asteriou C.,Theagenio Cancer Hospital | Barbetakis N.,Theagenio Cancer Hospital | Kleontas A.,Theagenio Cancer Hospital | Konstantinou D.,University Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2011

Mediastinum is a common site where benign tumors, like teratomas, can develop. Usually, these lesions do not cause any symptoms and the diagnosis is reached accidentally. As they enlarge they may cause symptoms by compressing the nearby structures of the thorax, mostly the trachea and the bronchi. Extrinsic compression of the heart or the great vessels appears to be a very rare occurrence. Atrial fibrillation as the first clinical presentation of left atrial compression by a giant mediastinal teratoma is extremely uncommon and very few cases have been described in the English literature. © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

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