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Derdelis G, Pergialiotis V, Terzakis E, Koufopoulos N, Martzoukou I, Gakiopoulou C, Lazaris A, Patsouris E. The impact of inguinal lymph node micrometastases in patients with vulvar cancer. Arch Gynecol Obstet 2016; 295:435-438. [PMID: 27832348 DOI: 10.1007/s00404-016-4233-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Inguinofemoral metastases are a major determinant of vulvar cancer relapse. Until today, the impact of micrometastases of inguinal nodes on local recurrence rates of patients with vulvar cancer remains unknown. The purpose of this retrospective study is to evaluate the rates of micrometastases in a series of patients with vulvar cancer treated with radical vulvectomy and inguinofemoral LND and to assess the probability of cancer relapse among this specific category. METHODS We conducted a retrospective observational study on patients with vulvar cancer who attended the gynaecological department of Anticancer Hospital of St. Savvas between January 1989 and January 2007. Ultra-staging of lymph nodes for micrometastases was performed after cutting the remaining specimens with a microtome in multiple slices of 3 μm. Subsequently they were stained with traditional hematoxylin and eosin and CK AE1/AE3 antibodies for immunohistochemichal analysis. RESULTS Ninety-two patients with primary vulvar malignancies were included in the present retrospective study. Ultrastaging of the lymph nodes revealed micrometastases in five patients (5.4%). Neither the duration of the procedure, nor the number of retrieved lymph nodes was directly associated with the presence of micrometastases. The patients were followed up for more than 5 years. Sixteen recurrences (17.4%) occurred during this period. The presence of micrometastases did not influence the recurrence rate (OR 3.57, 95% CI 0.55-23.36, p = 0.184). CONCLUSION Ultrastaging of inguinal nodes does not seem to add any benefit in the prediction of local recurrence rates. Future multicenter studies are needed in the field to corroborate our findings.
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Affiliation(s)
- Grigoris Derdelis
- Third Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 66, Dimitriou Gounari Str., 15124, Marousi, Greece.
| | - Vasilios Pergialiotis
- Third Department of Ob/Gyn, Attikon University Hospital, National and Kapodistrian University of Athens, 66, Dimitriou Gounari Str., 15124, Marousi, Greece
| | - Emmanouil Terzakis
- Second Department of Gynaecology, St. Savas Anticancer Hospital, 171 Alexandras Avenue, 11522, Athens, Greece
| | - Nektarios Koufopoulos
- First Histopathology Department, Athens Medical School, Laiko Hospital, Athens, Greece
| | - Ioanna Martzoukou
- First Histopathology Department, Athens Medical School, Laiko Hospital, Athens, Greece
| | - Chara Gakiopoulou
- First Histopathology Department, Athens Medical School, Laiko Hospital, Athens, Greece
| | - Andreas Lazaris
- First Histopathology Department, Athens Medical School, Laiko Hospital, Athens, Greece
| | - Efstratios Patsouris
- First Histopathology Department, Athens Medical School, Laiko Hospital, Athens, Greece
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Pateman K, Holland T, Knez J, Derdelis G, Cutner A, Saridogan E, Jurkovic D. Should a detailed ultrasound examination of the complete urinary tract be routinely performed in women with suspected pelvic endometriosis? Hum Reprod 2015; 30:2802-7. [DOI: 10.1093/humrep/dev246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/08/2015] [Indexed: 11/12/2022] Open
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Mavrelos D, Memtsa M, Helmy S, Derdelis G, Jauniaux E, Jurkovic D. β-hCG resolution times during expectant management of tubal ectopic pregnancies. BMC Womens Health 2015; 15:43. [PMID: 25994203 PMCID: PMC4443555 DOI: 10.1186/s12905-015-0200-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/08/2015] [Indexed: 11/16/2022]
Abstract
Background A subset of women with a tubal ectopic pregnancy can be safely managed expectantly. Expectant management involves a degree of disruption with hospital visits to determine serum β-hCG (β-human chorionic gonadotrophin) concentration until the pregnancy test becomes negative and expectant management is considered complete. The length of time required for the pregnancy test to become negative and the parameters that influence this interval have not been described. Information on the likely length of follow up would be useful for women considering expectant management of their tubal ectopic pregnancy. Methods This was a retrospective study at a tertiary referral center in an inner city London Hospital. We included women who were diagnosed with a tubal ectopic pregnancy by transvaginal ultrasound between March 2009 and March 2014. During the study period 474 women were diagnosed with a tubal ectopic pregnancy and 256 (54 %) of them fulfilled our management criteria for expectant management. A total of 158 (33 %) women had successful expectant management and in those cases we recorded the diameter of the ectopic pregnancy (mm), the maximum serum β-hCG (IU/L) and levels during follow up until resolution as well as the interval to resolution (days). Results The median interval from maximum serum β-hCG concentration to resolution was 18.0 days (IQR 11.0–28.0). The maximum serum β-hCG concentration and the rate of decline of β-hCG were independently associated with the length of follow up. Women’s age and size of ectopic pregnancy did not have significant effects on the length of follow up. Conclusion Women undergoing expectant management of ectopic pregnancy can be informed that the likely length of follow up is under 3 weeks and that it positively correlates with initial β-hCG level at the time of diagnosis.
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Affiliation(s)
- D Mavrelos
- Institute of Women's Health, University College London, London, UK.
| | - M Memtsa
- Gynaecological Diagnostic and Outpatient Treatment Unit, University College London Hospital, Lower Ground Floor, Elizabeth Garrett Anderson Wing, 250 Euston Road, London, NW1 6BU, UK.
| | - S Helmy
- University Hospital, Vienna, Austria.
| | - G Derdelis
- Gynaecological Diagnostic and Outpatient Treatment Unit, University College London Hospital, Lower Ground Floor, Elizabeth Garrett Anderson Wing, 250 Euston Road, London, NW1 6BU, UK.
| | - E Jauniaux
- Institute of Women's Health, University College London, London, UK.
| | - D Jurkovic
- Gynaecological Diagnostic and Outpatient Treatment Unit, University College London Hospital, Lower Ground Floor, Elizabeth Garrett Anderson Wing, 250 Euston Road, London, NW1 6BU, UK.
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Arnogiannaki N, Grigoriadis C, Zygouris D, Androutsopoulos G, Derdelis G, Terzakis E. Primary ovarian non-Hodgkin's lymphoma. EUR J GYNAECOL ONCOL 2011; 32:441-442. [PMID: 21941973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Primary ovarian non Hodgkin's lymphoma (PONHL) is a very rare disease. We present a case of PONHL and review the literature. CASE The patient, a 24-year-old nulliparous Greek woman, presented with the complaint of abdominal pain. She underwent left salpingo-oophorectomy, multiple biopsies from the right ovary, total omentectomy, pelvic and paraortic lymphadenectomy, appendectomy and curettage. The histopathology revealed diffuse large B-cell non-Hodgkin's lymphoma of the left ovary. She underwent postoperative chemotherapy. She remains well without evidence of disease, 15 months after initial surgery. CONCLUSION The use of chemotherapy is based on the principle that PONHL must be considered a localized manifestation of systemic disease. Patients with PONHL have a similar outcome compared to patients with other NHL.
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Affiliation(s)
- N Arnogiannaki
- Department of Pathology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece
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Terzakis E, Androutsopoulos G, Zygouris D, Grigoriadis C, Derdelis G, Arnogiannaki N. Angiokeratoma of the vulva. EUR J GYNAECOL ONCOL 2011; 32:597-598. [PMID: 22053688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Angiokeratoma of the vulva is relatively uncommon in the general population. We present two cases of angiokeratoma of the vulva and review the literature. The two patients presented with the complaint of vulvar pruritus. They underwent wide local excision of the lesions. Histopathology revealed angiokeratoma of the vulva. The women remain well with no evidence of recurrence 48 and 32 months after initial surgery. Although it is a rare disease, angiokeratoma of the vulva should be included in the differential diagnosis of a vulvar tumor.
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Affiliation(s)
- E Terzakis
- 2nd Department of Gynaecology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece
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Terzakis E, Androutsopoulos G, Derdelis G, Zygouris D, Grigoriadis C, Apostolikas N. Loop electrosurgical excision procedure in Greek patients with vulvar intraepithelial neoplasia. EUR J GYNAECOL ONCOL 2010; 31:191-193. [PMID: 20527238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The aim of our study was to evaluate the therapeutic effectiveness of loop electrosurgical excision procedure (LEEP) in Greek patients with vulvar intraepithelial neoplasia (VIN). MATERIALS AND METHODS Between January 2002 and January 2009, 55 women with histologically confirmed VIN usual type were included in our study. For the LEEP procedure we used a high frequency electrosurgical unit with at least 80 W output. The tissue was removed to the second surgical plane. Statistical analyses were performed using the SPSS-13 for Windows. RESULTS Complete response rate at 12-month follow-up was 100%. Complete response rate at 48 months of follow-up was 80%. Recurrence rate at 48 months of follow-up was 20%. CONCLUSION LEEP may constitute a valuable excisional method for the treatment of VIN. It provides an interpretable specimen of the whole lesion within a few minutes. It needs a short period of training and has low cost.
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Affiliation(s)
- E Terzakis
- 2nd Department of Gynaecology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece
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Terzakis E, Androutsopoulos G, Zygouris D, Grigoriadis C, Derdelis G, Arnogiannaki N. Loop electrosurgical excision procedure in Greek patients with vaginal intraepithelial neoplasia. EUR J GYNAECOL ONCOL 2010; 31:392-394. [PMID: 20882879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The aim of our study was to evaluate the therapeutic effectiveness of the loop electrosurgical excision procedure (LEEP) in Greek patients with vaginal intraepithelial neoplasia (VAIN). MATERIALS AND METHODS Between January 2002 and January 2009, 23 women with histologically confirmed VAIN were included in our study. For the LEEP procedure we used a high frequency electrosurgery unit with at least 80 W output. RESULTS Complete response rate at 12 months of follow-up was 86.96%. Recurrence rate at 12 months of follow-up was 13.04%. Complete response rate at 24 months of follow-up was 75%. Recurrence rate at 24 months of follow-up was 25%. CONCLUSION LEEP may constitute a valuable excisional method for the treatment of VAIN. It provides an interpretable specimen of the whole lesion within a few minutes. It needs a short period of training and has low cost.
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Affiliation(s)
- E Terzakis
- 2nd Department of Gynaecology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece
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Terzakis E, Androutsopoulos G, Grigoriadis C, Zygouris D, Derdelis G, Arnogiannaki N, Fragkakis G. Synchronous primary endometrial and fallopian tube cancers. EUR J GYNAECOL ONCOL 2010; 31:467-468. [PMID: 20882898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Synchronous primary cancers are relatively uncommon in the general population. We present a case of synchronous primary endometrial and fallopian tube cancers and review the literature. CASE The patient, a 54-year-old, gravida 2, para 2 postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and total omentectomy. The histopathology revealed synchronous primary cancers of the endometrium and right fallopian tube. The patient underwent postoperative chemotherapy and postoperative radiotherapy. She remains well without evidence of disease, 65 months after initial surgery. CONCLUSION The reason for the better median overall survival of patients with synchronous primary endometrial and fallopian tube cancers is not intuitively obvious. Perhaps it is due to the detection of patients at earlier clinical stage and lower grade disease state.
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Affiliation(s)
- E Terzakis
- 2nd Department of Gynecology, St. Savvas Anticancer-Oncologic Hospital, Athens, Greece
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