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G C Zografos

Publications and source records attributed to G C Zografos.

At least 19 recordsLinked to original sources
PubMed2006

Gastrointestinal stromal tumours: clinical overview, surgery and recent advances in imatinib mesylate therapy.

AIMS: To review the clinical features of gastrointestinal stromal tumours (GISTs), the role of surgery and its principles and molecular targeted therapies. METHODS: A Medline-based literature search on relevant topics was performed in PubMed for key articles concerning the clinical features, biology and the novel strategies in the management, whether surgical and/or pharmaceutical, of gastrointestinal stromal tumours. Some information was obtained from Proceedings of the American Society for Clinical Oncology published recently. RESULTS: Surgical resection, the first-line intervention for operable GISTs, was historically the only effective treatment. For residual, metastatic and/or inoperable disease, treatment options remain under intense and continuous scrutiny. However, their molecular genetics, i.e. the mutations of the genes coding for KIT or platelet-derived growth factor receptor alpha, two receptor tyrosine kinases, have been targeted for therapeutic intervention by imatinib mesylate -- a tyrosine kinase inhibitor. CONCLUSION: Treatment of GISTs with imatinib has led to dramatic improvements in progression-free and overall survival, thereby rendering its use in the preoperative and postoperative treatment under intense investigation. New investigational agents are being developed and participation in promising clinical trials remains a standard of care.

Benzamides↗
PubMed2005

Colonic duplication in adults: report of two cases presenting with rectal bleeding.

Gastrointestinal duplication is an uncommon congenital abnormality in two-thirds of cases manifesting before the age of 2 years. Ileal duplication is common while colonic duplication, either cystic or tubular, is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults only in a few cases. This study reports two cases of colonic duplication in adults. Both cases presented with rectal bleeding on admission. The study was focused on clinical, imaging, histological, and therapeutical aspects of the presenting cases. Gastrografin enema established the diagnosis in both cases. The cystic structure and the adjacent part of the colon were excised en-block. The study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of rectal bleeding.

Age Factors↗
PubMed2005

Extraskeletal myxoid chondrosarcoma metastatic to the pancreas: a case report.

Extraskeletal myxoid chondrosarcoma (EMC) is a low-grade sarcoma characterized by developing metastases and local recurrence in high rate. It is mainly deep seated in the proximal extremities. The most common metastatic sites are the lungs, soft tissues, lymph nodes, bones and the brain. To our knowledge, no case of clearly defined EMC has been reported to date developing a metastasis in the pancreas. We describe a case of a man suffering from EMC who developed a single pancreatic metastasis 20 years after the initial diagnosis. A 49-year-old man was submitted to surgical excision of an EMC, in left thigh, 20 years ago. Fourteen years after the initial diagnosis a local recurrence in left thigh occurred. Multiple lesions of metastatic origin, in both lungs, were excised via thoracotomies until the time being. In 2003, as a part of a periodically performed imaging control, an abdominal CT scan was performed revealing a solid lesion in the pancreas. Distal pancreatectomy was performed. The histopathology of the excised specimen proved to be the one of metastatic lesion of EMC. The above-mentioned case of EMC is, as far as we know, the first one described developing a certain pancreatic metastasis.

Chondrosarcoma↗
PubMed2002

Radiation therapy for high grade soft tissue sarcomas of the extremities treated with limb-preserving surgery.

AIM: It is common to use either pre- or post-operative radiation for high grade sarcomas undergoing limb-conserving surgery. Since 1977, we have adopted a selective policy of post-operative radiation, given only in patients with inadequate surgical margins. METHODS: A retrospective review of 114 patients (1977-1995) with high grade adult soft tissue sarcomas of the extremities was carried out. Amputation was required in 10 (9%). Patients with a minimum surgical margin <2 cm (n=33) received adjuvant radiation (29%). RESULTS: No complications occurred in 81/114. Wound complications were infection (14%), seroma (6%), haematoma (4%), dehiscence (4%) and skin edge necrosis (2%). Remedial operations were required in four (3%). Overall, the local recurrence rate was 23/114. Patients with surgery only (n=57) or surgery plus systemic chemotherapy (n=24) manifested local recurrence in 15/81 (19%) and those with surgery plus radiation (n=21) or surgery and radiation and chemotherapy (n=12) suffered local recurrence in 8/33. The local recurrence rate for tumours < or =5 cm was 6/32 and for those >5 cm 17/82, P=1.0. The 5 year survival rate was 60% for tumours < or =5 cm (n=32) and 46% for tumours > or =5 cm (n=82) (P=0.009). CONCLUSIONS: (1) Limb preservation was feasible in 91% of patients. (2) When the local treatment modality was surgery alone ('wide' margins) the local recurrence rate was 19%, and when it was surgery plus radiation (narrow margins) it was 24%. (3) Selective use of radiation (in patients with narrow margins) and reliance on surgery alone in cases amenable to wide resection may be a legitimate alternative to universal application of radiation with conservative resection.

Adult↗
PubMed1999

Repair after radical groin dissection.

The above-described repair following ilioinguinal dissection with division of the inguinal ligament is essentially a Cooper's ligament repair providing a secure, durable reconstruction. In our experience, there has not been a case of incisional hernia after radical incontinuity groin dissection using the above reconstruction.

Groin↗
PubMed1994

Adrenal adenocarcinoma: a review of 53 cases.

PROBLEM: Fifty-three patients (30 men, 23 women) with histologically proven adrenal carcinoma were reviewed. Nineteen (36%) had endocrine manifestations from functioning tumors. Arteriography was positive in 95% (19/20), CT scan in 94% (17/18), and ultrasound in 92% (12/13). Seventy-six percent of the patients, at the time of diagnosis, were stage III and IV. Most common metastatic sites were the liver, lymph nodes, bone, and lungs. Local recurrence developed in 39% of cases (15/38). METHOD: Forty-one patients underwent an operation. Complete surgical removal of all gross tumor was achieved in 24 patients. RESULT: The overall median survival time was 8 months, and the estimated 5-year survival rate 19%. There were significant differences in survival between the various stages (P = 0.01) and between the group of patients who underwent complete excision of the tumor and those with incomplete resection (P = 0.002). CONCLUSIONS: Complete surgical excision offers the best prospect for long-term survival in localized adrenal carcinoma.

Adrenal Cortex Neoplasms↗
PubMed1994

Regional chemotherapy in the canine liver.

Using a fluorometric assay, mean drug levels of Adriamycin were significantly higher in the normal canine liver following bolus injection of this drug via the hepatic artery or portal vein as compared to hepatic tissue levels following systemic intravenous administration (P < 0.001). However, the variations in tissue levels observed after hepatic artery (+/- 16.8 mcg/gm tissue) or portal vein (+/- 21.1 mcg/gm) infusion were significantly wider than those observed after systemic (+/- 1.3 mcg/gm) administration (P = 0.03). Using C14-labeled drugs, regional infusion of Adriamycin through the hepatic artery or portal vein resulted in significantly higher mean drug levels in the liver than after systemic intravenous administration, but the difference was more pronounced with bolus infusion of the drug than 1-hour infusion. 5-FU bolus or 1-hour infusion in the hepatic artery resulted in significantly higher mean drug levels in the liver compared to peripheral intravenous administration, but this was not so with the 3-hour infusion. The above experiments confirm previous studies that regional chemotherapy results in higher drug levels in the regional tissues compared to systemic administration. They also: (1) demonstrate the spotty drug distribution in the regional tissues after regional administration, a potentially correctable problem, and (2) suggest that the advantage of intra-arterial infusion may be more pronounced within a certain range of infusion times.

Animals↗
PubMed1994

Staging and grading in the survival of adrenal carcinomas.

In 53 patients with histologically proven adrenal cortical carcinomas the most common metastatic sites, at the time of diagnosis, were the liver, lymph nodes, bone and lungs, and during the course of the disease, the lungs. At the time of diagnosis six (11%) of our patients were in Stage S1, seven (13%) in S2, 11 (21%) in S3 and 29 (55%) in S4. Histologic grading (G) in 43 patients showed G1 grade in 11 (26%), G2 in seven (16%) and G3 in 25 patients (58%). Median survival in months (estimated 5-year survival rate) for the various stages were: S1 46 (33%), S2 84 (57%), S3 eight (18%) and S4 seven (7% at 2 years) (P = 0.01). Median survival in months (estimated 5-year survival rate) for the various grades were: G1 46 (46%), G2 24 (43%), G3 five (4% at 2 years) (P = 0.003). In this series, tumor stage (P = 0.01) and grade (P = 0.003) were predictors of survival and the two were closely correlated (P = 0.02).

Adrenal Cortex Neoplasms↗
PubMed1993

Desmoid tumors of the trunk and extremity.

BACKGROUND: Twenty-six patients with desmoid tumors of the extremities (n = 20) or trunk (n = 6) have been treated since 1977. Nine of these were referred with primary tumors and 17 with recurrent tumors. METHODS: The tumor was removed in all patients, and 10 received adjuvant radiation. Five patients (19%) developed local recurrence; one of them was lost to follow-up, and the remaining four patients had the recurrence controlled with surgical resection or resection plus adjuvant radiation. RESULTS: All 25 patients who have been followed are alive and disease-free at a mean follow-up of 84 months (median, 81 months). None with extremity tumors (n = 20) required an amputation. The estimated survival rate for the entire group is 95% at 42 months. CONCLUSIONS: Desmoid tumor of the trunk or extremities treated with surgical resection, supplemented selectively by adjuvant radiation, can be controlled locally in the majority (96%) of patients.

Abdominal Neoplasms↗
PubMed1992

Claviculectomy for the exposure and en bloc resection of adjacent tumors.

Claviculectomy has been described for primary or metastatic tumors of the clavicle. In 11 patients, claviculectomy was used as a technical expedient for the exposure and en bloc resection of large, underlying nodal metastases from melanoma (7 patients) and soft tissue tumors (4 patients). There were no wound complications. Three patients developed moderate edema of the arm. There was little limitation at the shoulder, and the use of the upper extremity has been essentially normal. Claviculectomy is well tolerated, provides good exposure of the underlying neurovascular structures, and, in some patients, provides a method of limb salvage for underlying tumors in preference to forequarter amputation.

Axilla↗