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P P Vassilopoulos

Publications and source records attributed to P P Vassilopoulos.

At least 19 recordsLinked to original sources
PubMed2005

Short-term preoperative radiotherapy is a safe approach for treatment of locally advanced rectal cancer.

BACKGROUND AND AIMS: The Swedish Rectal Cancer Trial (SRCT) demonstrated that a short term regimen of high-dose preoperative radiotherapy (5x5 Gy) not only reduces the risk of local recurrence but also improves overall survival rate. An increase in postoperative mortality and morbidity has also been observed, however. We therefore evaluated early postoperative complications in patients treated with neoadjuvant radiotherapy for locally advanced rectal adenocarcinoma. PATIENTS/METHODS: Between 2000 and 2004, 85 patients with locally advanced rectal tumors were treated in our institution. Preoperative staging was based on CT scan and, in several cases, on endorectal ultrasonography. They were 55 men and 30 women, with a median age of 68 years. They were retrospectively divided into two groups: Group A, which included 40 patients undergoing preoperative radiotherapy (25 Gy in five fractions) followed by surgery within 1 week, and Group B, which included 45 patients with rectal cancer receiving surgery immediately after diagnosis. Both groups were homogeneous regarding age, gender and preoperative stage of the disease. The two groups were compared for both technical difficulties during operation and rate of postoperative complications. RESULTS/FINDINGS: No postoperative deaths were recorded in either group. Low anterior resection with total mesorectal excision was performed in all group A patients, whereas eight patients in group B underwent abdominoperineal resection (P<0.05). Diverting stoma was performed in seven patients of group A and it was closed 3-6 months later on every occasion. Postoperative morbidity was not statistically significant between the two groups (40 vs 39%). The rate of postoperative hemorrhage, pelvic or abdominal wound infection, acute urinary infection, and delayed ileus was similar. The percentage of major anastomotic leak was also equivalent (5 vs 6.6%). INTERPRETATION/CONCLUSION: Short-term preoperative radiotherapy does not increase the rate of postoperative complications and is a safe therapeutic adjunct for the treatment of locally advanced rectal cancer.

Adenocarcinoma↗
PubMed2002

Is gastroscopy still a valid diagnostic tool in detecting gastric MALT lymphomas? A dilemma beyond the eye. Mucosa-associated lymphoid tissue.

BACKGROUND: Primary gastric lymphomas are distinct entities with an indolent clinical course and biologic behavior. They account for 2-8% of all gastric malignancies. We conducted this study to evaluate the role of gastroscopy as the principal diagnostic method in detecting gastric MALT lymphomas. METHODS: Sixty-three consecutive patients with gastric MALT lymphomas, who were evaluated and treated at our institution between January 1978 and December 1997, are retrospectively reviewed. There were 36 males and 27 females, with a mean age of 53 years (range 20-80 years). All patients underwent the standard diagnostic evaluation, including gastroscopy and biopsy. Patients were staged according to revised Musshof modification of the Ann Arbor classification system, whereas histological evaluation was made according to the Isaacson classification system for gastric MALT lymphomas. RESULTS: According to endoscopic findings, the antrum harbored the neoplasm in 31 patients (49%), the body in 38% (24 patients), and the fundus in 4% (3 patients), whereas in 5 patients (8%) the neoplasm occupied the entire stomach. The macroscopic appearance was not in most cases pathognomonic of the disease. Three macroscopic patterns were recognized at endoscopy: (a) the ulcerative in 51% (32 patients), (b) the polypoid in 33% (21 patients) and (c) the diffuse infiltrative in 16% (10 patients). The neoplasm was characterized as a benign disease in 24 patients (38%), with malignancy being suspected in 62% (39 patients). Endoscopy displayed a sensitivity of 61% in detecting malignancy; however, the sensitivity dropped to 27% when endoscopic diagnosis of non-Hodgkin's lymphoma was hypothesized. CONCLUSIONS: Although the impact of gastroscopy as a diagnostic tool in the patients of our study was of limited value, due to the nonspecific gross pattern of gastric MALT lymphomas, it should be maintained in the diagnostic intervention of the upper GI tract pathologies.

Adult↗
PubMed2000

Treatment-related acute gastric bleeding managed successfully with surgical devascularization.

BACKGROUND AND OBJECTIVES: Patients with gastric lymphoma treated by chemotherapy or radiation therapy are at high risk of developing complications, most commonly perforation or bleeding. In any case of upper gastrointestinal tract bleeding during conservative treatment for gastric lymphoma, thorough investigation is required to exclude other causes of hemorrhage which could be managed appropriately. When the source of bleeding is the tumor, the only effective measure is resection of the stomach, a very dangerous operation in these poor-risk patients. METHODS: We treated 3 consecutive patients with life-threatening gastric bleeding from lymphoma treated by chemotherapy. RESULTS: We successfully controlled the hemorrhage by surgical devascularization. CONCLUSION: Devascularization of the involved part of the stomach is safe and effective.

Acute Disease↗
PubMed1998

Competent gastrostomy for patients with head and neck cancer.

This study was performed to evaluate the efficiency and patient satisfaction with a modified Janeway gastrostomy for patients with head and neck cancer and cancer of the upper GI tract and involved 24 consecutive patients with serious malnutrition caused by advanced cancer of these sites. All underwent surgery during which a tube was constructed from the anterior gastric wall with the aid of GIA-75 automatic stapler. The operation was performed under local anaesthesia, with a senior anaesthesiologist, who sedated the patients, in attendance. The operation was successful in all cases. No postoperative mortality could be attributed to the operation. The complications were minor. The patient's close relatives were able to feed them intermittently with home-made formula made according to the instructions of our dietician. No late complications were recorded. Overall, the patients were satisfied with his technique for managing their feeding problem. The modified Janeway gastrostomy is an easy and safe operative procedure; it is an effective way of managing patients with malnutrition as a result of cancer of the head and neck or of the upper GI tract.

Aged↗
PubMed1998

The extent of surgery and prognosis of patients with phyllodes tumor of the breast.

In an attempt to clarify the controversial issues related to prognosis and therapeutic aspects of phyllodes tumors (PT), we retrospectively reviewed all cases of PT treated in our hospital during the last fifteen years. Re-examining the pathology material we found 84 cases, while thirteen more cases which had been initially classified as fibroadenomas with areas of phyllodes tumor were rejected from the analysis because they were classified as fibroadenomas. Based on the criteria proposed by Azzopardi and Salvadori and adopted by WHO, we found 55 benign PT (65.14%), 14 borderline PT (16.6%), and 15 malignant PT (17.8%). The median age of the patients with benign PT was 34 years, compared to 46.5 years for those with borderline tumors and 52 years for those with malignant. The median size of benign tumors was 3 cm, 9.5 cm for borderline, and 7.25 cm for malignant. Out of 55 patients with benign PTs, 37 underwent wide local excision and the remaining 18, with small tumors, underwent enucleation. In this group of patients, there was no recurrence after a median interval of 6.65 years. Eleven patients with borderline PT underwent wide local excision and three mastectomy; one immediately after an incomplete PT excision and the remaining two 8 months and 2 years later due to a locally recurrent PT (the last one proven histologically in the permanent biopsy of the recurrence to be malignant). Twelve patients with malignant PT underwent mastectomy, either during the same operation or following the results of the permanent section biopsy. Three more patients with malignant PT underwent wide local excision. The size of the tumor in these patients was relatively small and the pathology report indicated clear margins with normal breast tissue surrounding the tumor. One patient with 8 cm diameter malignant PT, who underwent mastectomy, passed away sixteen months later from widely spread metastases. Applying the criteria of Azzopardi and Salvadori, each case of PT can be managed successfully avoiding unnecessary mastectomies.

Adult↗
PubMed1995

The prognostic significance of breast tumour microcalcifications.

The prognostic significance of breast tumour microcalcifications has shown, so far, contradictory results. We compared two groups of breast cancer patients: in the first group, the patients showed mammographic and histological microcalcifications, whereas the second group did not. The prognostic indices for both groups included the size of the primary tumour, the number of positive axillary nodes, the histological type, the grade, the hormone-receptor status and the menopausal status. An increased number of cases with both oestrogen and progesterone receptor-positive tumours was found in the group with microcalcifications, which is a favorable prognostic sign for these patients. For the remaining prognostic indices there was no difference between the two groups.

Breast Neoplasms↗
PubMed1995

Subxiphoidal pericardial 'window' in the management of malignant pericardial effusion.

Over the last 5 years, 26 cancer patients developed pericardial effusion and were managed surgically with the creation of a subxiphoidal pericardial 'window'. The operation, in the majority of the cases was performed under local anaesthesia with adequate sedation. It was found to be safe and easy to perform. The operative approach was beneficial to the group of patients without massive involvement by tumour of the thoracic cavity with relief of symptoms. Significant palliation was achieved for the patients with extensive tumour involvement of the mediastinum and thorax, although survival in this group of patients was relatively short.

Adolescent↗
PubMed1992

Pulmonary blastoma presenting with massive hemothorax.

Pulmonary blastoma, a rare primary lung neoplasm occurring in both children and adults, is histologically distinct from other lung tumors. A patient is described who presented with massive and persistent hemothorax. Based on experience, it is possible that in advanced cases of this tumor, more vigorous chemotherapy is needed against both histologic elements.

Adult↗
PubMed1990

Ectopic spleen in the retroperitoneum. Case report.

A 43-year-old man presented with a retroperitoneal mass, the histological examination of which showed well developed spleen parenchyma with a capsule and fibrous tissue in between normal looking splenic cells. Postoperative 99mTc sulphur colloid scans of his liver and spleen were normal. This is, to our knowledge, the first reported case of an ectopic spleen in the left retroperitoneal space.

Adult↗
PubMed1981

Interstitial pneumonitis associated with mitomycin C and DTIC: a case report.

A case of interstitial pneumonitis secondary to mitomycin C and DTIC combination therapy in a 58-year-old male with metastatic adenocarcinoma of the rectum is reported. Dry cough and dyspnea, especially on exertion, were presenting symptoms. Arterial blood gas analysis was compatible with severe impairment in pulmonary diffusion capacity. Chest x-ray showed a diffuse increase in interstitial markings in both lung fields consistent with interstitial pneumonia. Histologically, prominence of type I pneumocytes, focal proliferation of type II pneumocytes, and varying degree of fibroblastic proliferation and collagenization within the alveolar septae were observed. The obliteration of alveolar septal vessels due to endothelial edema and/or proliferation of fibroblast-like mesenchymal cells were also noted. Withdrawal of drugs and institution of high dose corticosteroid therapy were followed in rapid improvement in dyspnea and arterial blood gas findings. If diagnosed early, this potentially life threatening complication may respond to such therapy.

Adenocarcinoma↗
PubMed1981

Treatment of recurrence of adenocarcinoma of the colon and rectum at the anastomotic site.

Resection of recurrent adenocarcinoma of the colon and rectum at the anastomotic site was performed in 30 patients. In the majority of the patients, the recurrence was apparent within two years of the initial operation. In 27 patients, the recurrence was diagnosed based upon persistent signs and symptoms or if the tumor was clinically palpable. In 15 patients, complete resection of the recurrent tumor was feasible, and the median survival time was 59 months, with a five year survival rate of 49 per cent. In ten other patients, minimal tumor was left behind. The median survival time was 17 months and 12 per cent survived five years.

Adenocarcinoma↗
PubMed1980

Surgical resection for metastatic neoplasms of the lung: experience at the University of Minnesota Hospitals.

Pulmonary resection for metastatic disease in 167 patients undergoing 207 thoracotomies resulted in a cumulative survival rate of 29% at five years and 20% at 10 years, with an operative mortality of 0.6%. The most favorable prognosis was associated with testicular and renal cell carcinomas and sarcomas. Less favorable tumors were malignant melanoma, carcinoma of the colon and rectum, and cervix uteri. A significant factor influencing survival was duration of disease-free interval with a 50% five-year survival rate in patients whose primary tumor was treated over five year ago. Patients with multiple pulmonary metastases had a five-year survival rate of 27% vs. 22% of patients with solitary metastases. Of 23 patients with tumor extending to the chest wall, diaphragm, or pleura, only two survived five years. Of 26 patients with mediastinal involvement none survived two years.

Adolescent↗
PubMed1980

Intraarterial infusion chemotherapy for hepatic carcinoma using a totally implantable infusion pump.

Intraarterial infusion chemotherapy has several theoretical advantage over conventional therapy for the treatment of unresectable malignancies. However, the catheter problems and patient restriction to the hospital associated with its use have resulted in infrequent application and a notable lack of progress in this field of oncology. This paper describes the use of a totally implantable, percutaneously refillable infusion pump in 5 patients with primary or metastatic carcinoma of the liver. The infusion cannulae were placed into the hepatic arteries under direct vision at laparotomy, and the pumps were placed in subcutaneous pockets. Four patients received infusions of 5-fluorodeoxyuridine at rates of 0.2-0.5 mg/kg/day for periods of three to 29 weeks; the pump in the fifth patient was defective and was removed. The implanted pumps were well tolerated in these subjects, who received chemotherapy as outpatients; the only adverse effects noted were related to FUDR toxicity. This implantable infusion pump appears to be a practical means of delivering long-term intraarterial infusion chemotherapy to outpatients.

Antineoplastic Agents↗
PubMed1979

Results of a prospective randomized study of hepatic artery infusion with 5-fluorouracil versus intravenous 5-fluorouracil in patients with hepatic metastases from colorectal cancer: A Central Oncology Group study.

In a controlled, prospectively randomized trial, 74 patients with hepatic metastases from colorectal cancer were randomized to either intra-arterial hepatic artery infusion with 5-fluorouracil (5-FU) or systemic chemotherapy with 5-FU. In 61 acceptable patients, there was no significant difference in terms of response rate, time to progression, duration of the response, and survival rate. Though the response rate for the intra-arterial infusion arm was slightly higher than for the systemic arm, the difference was not significant, and the intra-arterial infusion arm was associated with a greater incidence of nausea, vomiting, diarrhea, in addition to complications of femoral-arterial thrombosis, bleeding, and infection at the catheter site not seen in patients treated by systemic chemotherapy. Patients with an objective response to chemotherapy on either treatment arm survived twice as long as the nonresponders. Long-term survival in one patient, 77 months, can occasionally be achieved in patients with hepatic metastases.

Adenocarcinoma↗
PubMedDate not supplied

Surgical treatment of metastatic colorectal adenocarcinoma.

Ninety-one patients with recurrent or metastatic colorectal adenocarcinomas were studied according to the anatomic areas of the recurrent tumor. In Group A, 30 patients with anastomotic recurrence, diagnosis was made in the majority within two years from initial surgery; most of them had specific symptomatology. A significant number of patients had blood in the stools. In half of the patients, complete resection of the recurrent tumor was feasible. In Group B, 47 patients with intra-abdominal recurrence, there was some delay in diagnosis; the symptomatology was less specific, and fewer patients were rendered free of tumor following reresection. The medial survival and estimated five-year survival rate were, in both groups, strongly related to the completeness of the resection. In Group C, with distant metastasis (eight patients with pulmonary and six with liver metastasis), the disease-free interval was longer compared to the previous groups. The metastatic tumor was found in three patients, four or more years after the initial surgery. The medial survival was the same as in the two other subgroups with complete resection of the recurrent tumor.

Adenocarcinoma↗
PubMedDate not supplied

Administration of tamoxifen in the perioperative period to patients with breast carcinoma prolongs axillary fluid drainage.

Compelling evidence points to an estrogen receptor independent mechanism of action of tamoxifen in the extracellular matrix, in addition to its action via the estrogen receptors. We retrospectively studied 380 patients who underwent curative resection for primary breast cancer in our institution from January 1994 to December 1998, of which 227 received tamoxifen in the perioperative period and the remaining 153 never received tamoxifen or delayed the initiation of treatment for at least two weeks following the operation. The administration of tamoxifen in the perioperative period resulted in the prolongation of axillary drainage (mean 10.07 SD 4.18 days vs mean 8.33 SD 2.85 days), which was statistically significant for patients younger than 70 years. There was no difference in the duration of fluid drainage in relation to the number of positive nodes, except in cases of more than 9 nodes involved by the tumor. We assumed that tamoxifen causes a delay in would healing through the secretion of active transforming growth factor beta(TGF-beta), which is the principle negative growth modulator and which can be secreted from epithelial and stromal elements, independently of hormonal receptor status.

Age Factors↗