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1. 77P The impact of COVID-19 on gynecological cancer diagnoses in Greece

Author

Fiste, O., primary, Iliopoulou, P., additional, Tzannis, K., additional, Theofanakis, C., additional, Rouvali, A., additional, Markellos, C., additional, Kunadis, E., additional, Potiri, E., additional, Papanota, A-M., additional, Papatheodoridi, A., additional, Andrikopoulou, A., additional, Svarna, A., additional, Kaparelou, M., additional, Koutsoukos, K., additional, Thomakos, N., additional, Haidopoulos, D., additional, Rodolakis, A., additional, Zagouri, F., additional, Dimopoulos, M., additional, and Liontos, M., additional

Published
2023
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2. Quality of training in cervical cancer radical surgery: a survey from the European Network of Young Gynaecologic Oncologists (ENYGO)

Author

Bizzarri, Nicolo', Pletnev, A., Razumova, Z., Zalewski, K., Theofanakis, C., Selcuk, I., Nikolova, T., Lanner, M., Gomez-Hidalgo, N. R., Kacperczyk-Bartnik, J., Querleu, D., Cibula, D., Verheijen, R. H. M., Fagotti, Anna, Bizzarri N., Fagotti A. (ORCID:0000-0001-5579-335X), Bizzarri, Nicolo', Pletnev, A., Razumova, Z., Zalewski, K., Theofanakis, C., Selcuk, I., Nikolova, T., Lanner, M., Gomez-Hidalgo, N. R., Kacperczyk-Bartnik, J., Querleu, D., Cibula, D., Verheijen, R. H. M., Fagotti, Anna, Bizzarri N., and Fagotti A. (ORCID:0000-0001-5579-335X)

Abstract

BACKGROUND: The European Society of Gynaecological Oncology (ESGO) and partners are committed to improving the training for gynecologic oncology fellows. The aim of this survey was to assess the type and level of training in cervical cancer surgery and to investigate whether the Laparoscopic Approach to Cervical Cancer (LACC) trial results impacted training in radical surgery for gynecologic oncology fellows. METHODS: In June 2020, a 47-question electronic survey was shared with European Network of Young Gynaecologic Oncologists (ENYGO) members. Specialist fellows in obstetrics and gynecology, and gynecologic oncology, from high- and low-volume centers, who started training between January 1, 2017 and January 1, 2020 or started before January 1, 2017 but finished their training at least 6 months after the LACC trial publication (October 2018), were included. RESULTS: 81 of 125 (64.8%) respondents were included. The median time from the start of the fellowship to completion of the survey was 28 months (range 6-48). 56 (69.1%) respondents were still fellows-in-training. 6 of 56 (10.7%) and 14 of 25 (56.0%) respondents who were still in training and completed the fellowship, respectively, performed ≥10 radical hysterectomies during their training. Fellows trained in an ESGO accredited center had a higher chance to perform sentinel lymph node biopsy (60.4% vs 30.3%; p=0.027). There was no difference in the mean number of radical hysterectomies performed by fellows during fellowship before and after the LACC trial publication (8±12.0 vs 7±8.4, respectively; p=0.46). A significant reduction in number of minimally invasive radical hysterectomies was noted when comparing the period before and after the LACC trial (38.5% vs 13.8%, respectively; p<0.001). CONCLUSION: Exposure to radical surgery for cervical cancer among gynecologic oncology fellows is low. Centralization of cervical cancer cases to high-volume centers may provide an increase in fellows' exposure to radical

Published
2022

3. Subspecialty training in Europe: A report by the European Network of Young Gynaecological Oncologists

Author

Lanner, M. Nikolova, T. Gutic, B. Nikolova, N. Pletnev, A. Selcuk, I. Vlachos, D.-E. Razumova, Z. Bizzarri, N. Theofanakis, C. Lepka, P. Kahramanoglu, I. Han, S. Nasser, S. Molnar, S. Hudry, D. Montero-Macías, R. De Lange, N. MacUks, R. Hasanov, M.F. Karimbayli, R. Gagua, I. Andrade, C. Pardal, C. Dotlic, J. Alvarez, R.M. Hruda, M. Fruhauf, F. Ekdahl, L. Antonsen, S.L. Sukhin, V. Eriksson, A.G.Z. Gliozheni, E. Delic, R. Satanova, A. Kovacevic, N. Gristsenko, L. Babloyan, S. Zalewski, K. Bharathan, R.

Subjects
education
Abstract

Background ESGO (European Society of Gynaecological Oncology) and partners are continually improving the developmental opportunities for gynaecological oncology fellows. The objectives of this survey were to evaluate the progress in the infrastructure of the training systems in Europe over the past decade. We also evaluated training and assessment techniques, the perceived relevance of ENYGO (European Network of Young Gynaecological Oncologists) initiatives, and unmet needs of trainees. Methodology National representatives of ENYGO from 39 countries were contacted with an electronic survey. A graduation in well/moderately/loosely-structured training systems was performed. Descriptive statistical analysis and frequency tables, as well as two-sided Fisher's exact test, were used. Results National representatives from 33 countries answered our survey questionnaire, yielding a response rate of 85%. A national fellowship is offered in 22 countries (66.7%). A logbook to document progress during training is mandatory in 24 (72.7%) countries. A logbook of experience is only utilized in a minority of nations (18%) for assessment purposes. In 42.4% of countries, objective assessments are recognized. Trainees in most countries (22 (66.7%)) requested additional training in advanced laparoscopic surgery. 13 (39.4%) countries have a loosely-structured training system, 11 (33.3%) a moderately-structured training system, and 9 (27.3%) a well-structured training system. Conclusion Since the last publication in 2011, ENYGO was able to implement new activities, workshops, and online education to support training of gynaecological oncology fellows, which were all rated by the respondents as highly useful. This survey also reveals the limitations in establishing more accredited centers, centralized cancer care, and the lack of laparoscopic training. © 2021 BMJ Publishing Group. All rights reserved.

Published
2021

4. Fertility sparing surgery for early-stage clear cell carcinoma of the ovary; A systematic review and analysis of obstetric outcomes

Author

Prodromidou, A. Theofanakis, C. Thomakos, N. Haidopoulos, D. Rodolakis, A.

Abstract

Clear cell carcinoma of the ovary (CCOC), accounts for 5–25% of epithelial ovarian cancer (EOC) cases. A significant proportion of patients with CCOC are of reproductive age, wishing to preserve their fertility. The application of fertility sparing surgery (FSS) in those patients has been extensively criticized, due to the high reported recurrence rates and chemotherapy resistance. The aim of the present study was to accumulate the current knowledge on obstetric and fertility outcomes of patients with early stage CCOC who underwent fertility sparing surgery. A meticulous search of 3 electronic databases was conducted for articles published up to June 2020 relevant in the field using the terms “ovarian cancer”, “clear cell”, “fertility sparing”, “conservative treatment”. Studies that reported pregnancy and maternal outcomes after fertility sparing surgery for the management of early stage CCOC were considered eligible. A total of 5 studies which comprised of 60 patients with early stage CCOC, who underwent fertility-sparing surgery, were reviewed. Ten patients (16.6%) had disease recurrence. The total clinical pregnancy rate of 32% with a proportion of 24% of live birth rates in 12 of the included patients. The median interval from surgery to pregnancy was 41.5 months, while no evidence of disease was recorded among the patients who achieved pregnancy. No difference in survival and recurrence rates among patients who underwent fertility-sparing surgery and those who had radical surgical procedures. Fertility-sparing treatment for International Federation of Gynaecology and Obstetrics (FIGO) Stage IA/IC CCOC seems to be an acceptable treatment option for selected premenopausal women who strongly wish to preserve their childbearing potential. However, larger studies are needed to validate the safety of the procedure. © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology

Published
2021

5. Minimizing fertility-sparing treatment for low volume early stage cervical cancer; Is less the (R)evolution?

Author

Theofanakis, C. Haidopoulos, D. Thomakos, N. Rodolakis, A. Fotopoulou, C.

Abstract

Background/Aim: The aim of this study was to conduct a review on less radical fertility-sparing surgical treatment for early-stage cervical cancer. Materials and Methods: We conducted a Medline search from 2014 to 2018 regarding less radical fertility-sparing techniques, such as simple trachelectomy or cervical conization, with pelvic lymphadenectomy. We also assessed the impact of the removal of the parametrium on the obstetric and oncologic outcome, in women who desire to preserve their fertility. Results: We analyzed studies about cervical conization and simple trachelectomy, together with pelvic lymphadenectomy in early-stage cervical cancer. We also assessed the importance of parametrial involvement in reducing morbidity, without jeopardizing the oncologic outcome of these patients. Studies demonstrate that in tumors ≤2 cm, without lymphovascular Space Invasion and without evidence of parametrial involvement, a less radical fertilitysparing surgical approach could increase pregnancy rates and have a positive effect on the quality of life of these patients. Conclusion: Standard fertility-sparing treatment for early-stage cervical cancer is still radical trachelectomy with pelvic lymphadenectomy. However, studies suggest that the omission of parametrectomy is a feasible and safe option. Simple trachelectomy or cervical conization, both combined with pelvic lymphadenectomy are acceptable approaches in a selected group of patients with early-stage cervical cancer. © 2020 International Institute of Anticancer Research. All rights reserved.

Published
2020

9. The impact of HCG in IVF Treatment: Does it depend on age or on protocol?

Author

Theofanakis, C. Athanasiou, V. Liokari, E. Stavrou, S. Sakellariou, M. Athanassiou, A.-I. Athanassiou, A. Drakakis, P. Loutradis, D.

Subjects
endocrine system, hormones, hormone substitutes, and hormone antagonists
Abstract

Objective: to evaluate the effect of the addition of low dose human chorionic gonadotropin (hCG) to human menopausal gonadotropin (HMG) throughout the early follicular phase in controlled ovarian stimulation (COS) conducted with two difference regimens. Gonadotropin-releasing hormone (GnRH) antagonist and short GnRH-agonist protocol were applied in two in vitro fertilization (IVF) clinics. Methods: Clinical study conducted during the period 2014–2016 in two IVF clinics in a cohort of 240 women. In the first group 1 (124 women), a GnRH antagonist protocol with HMG and addition of low dose (100IU/day) h CG was applied. The other group 2 consisted of 116 women who underwent a short GnRH- agonist protocol with HMG and addition of low dose (100 IU/day) h CG. Results: Multiple logistic regression analysis was performed. The group 2 found to be associated with greater number of follicles and oocytes. The pregnancy rates were 12.1% and 26.7% in group 1 and group 2, respectively (p = 0.004). For patients over 40 years, the number of follicles and oocytes retrieved were significant higher in group 2.The pregnancy rate in group 2 was higher than in group 1 (21, 6% vs 5%, p = 0.017). Conclusions: Advanced age women are likely to achievepregnancy using the GnRH Short than GnRH antagonist, when HMG/hCG is used, while HMG–hCG gonadotropins have the same potentialas Recombinant follicle stimulating hormone (rFSH)–hCG used in GnRH short protocol. © 2019 Elsevier Masson SAS

Published
2019

11. Local analgesic effect of pethidine infiltrated intrafascially after total abdominal hysterectomy: A randomized, double-blind study

Author

Stamatakis, E. Kalopita, K. Hadzilia, S. Theofanakis, C. Valsamidis, D.

Abstract

Objective: Surgical-site infiltration with local anesthetics is a key component of multimodal analgesia regimen for adequate postoperative pain management. This randomized, double-blind study was designed to evaluate the local analgesic efficacy of pethidine in patients undergoing total abdominal hysterectomy (TAH) through a Pfannenstiel incision. Materials and Methods: Patients were randomized into two groups. The first group received wound infiltration (WI) with 0.5 mg/kg pethidine, diluted in 15 ml normal saline, and injected in the fascial layer at the end of surgery, combined with a simultaneous intramuscular (IM) injection of 2.5 ml normal saline (WI group). The second group received WI with 15 ml normal saline combined with an IM injection of 0.5 mg/kg pethidine and diluted in 2.5 ml normal saline (IM group). All patients received general anesthesia following a standardized anesthetic protocol. Study end points were 24-h total morphine consumption and pain scores based on a visual analog scale (VAS) at rest and on coughing at 1, 3, 6, and 24 postoperative h, as well as sedation scores observed using a 0-10 numeric rating scale. Adverse effects from morphine uptake, such as nausea, vomiting, and the need for rescue antiemetics, were recorded as well. Results: Postoperative VAS assessments showed no statistically significant advantage between WI and IM method, while the total (24h) consumption of morphine was lower in the IM, compared to the WI group (27.2%). The latter demonstrated a consistently higher median sedation score at all assessed time points after the operation (P < 0.05); however, it was significantly different only at the 6 h time point. Conclusions: Local WI with pethidine after TAH did not reduce the total morphine consumption for the first 24 h postoperatively. Morphine consumption was lower in the IM group, compared to the WI group. Further studies are needed to assess the effectiveness of pethidine as a local anesthetic agent. © 2018 Journal of Natural Science, Biology and Medicine | Published by Wolters Kluwer - Medknow.

Published
2018

12. Anesthetic management of mosaic Turner's syndrome posted for elective cesarean delivery after spontaneous pregnancy

Author

Kalopita, K. Michala, L. Theofanakis, C. Valsamidis, D.

Abstract

Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal-epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases. The patient was managed successfully under regional anesthesia, which is generally a preferred technique to general anesthesia, to avoid sympathetic stimulation during intubation and emergence. Further, this technique may avoid potential complications associated with difficult airway management. © 2017 Elsevier Ltd

Published
2018

13. Second trimester uterine rupture in a septated unscarred uterus: A case report study

Author

Theofanakis, C. Michala, L. Karampelas, A. Al-Achmar, S.N. Daskalakis, G.

Abstract

Introduction: Uterine rupture in the second trimester before the onset of labor is a rare condition that can lead to high maternal morbidity and fatal fetal outcome. Case Report: The authors report a case of spontaneous uterine rupture in a 35-year-old woman at the 16th week of a twin gestation, after IVF. She presented with intraperitoneal haemorrhage, maternal collapse, fetal demise, and required immediate surgical management. Conclusions: Uterine rupture in a primigravid uterus is a rare but life-threatening situation. Studies have shown that the unscarred uterus is not immune to such an event. Even though it is not a common complication, it should always be considered in primigravid women presenting with abdominal pain, hemodynamic instability, and indications of fetal demise. © 2018 S.O.G. Canada Inc. All rights reserved.

Published
2018

14. Prenatal diagnosis of sirenomelia with anencephaly and craniorachischisis totalis: A case report study

Author

Theofanakis, C. Theodora, M. Sindos, M. Daskalakis, G.

Abstract

Rationale:Sirenomelia and anencephaly are well-defined congenital malformations that usually occur independently.Patient concerns:We report a case of combined sirenomelia, anencephaly and complete rachischisis, diagnosed in the 16th week of gestation.Diagnoses:To our knowledge, this is the 7th case in the literature and the first that is diagnosed so early in pregnancy.Interventions:The final diagnosis is confirmed with radiological examination after the termination of pregnancy.Outcomes:Prenatal diagnosis of sirenomelia is difficult due to the presence of kidney agenesis and severe oligohydramnios.Lessons:The combination of sirenomelia and craniorachischisis totalis is extremely rare and prenatal ultrasound scan are a challenge, even for experts in the field. Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

Published
2017

15. Human chorionic gonadotropin: The pregnancy hormone and more

Author

Theofanakis, C. Drakakis, P. Besharat, A. Loutradis, D.

Subjects
endocrine system, urogenital system, hormones, hormone substitutes, and hormone antagonists
Abstract

To thoroughly review the uses of human chorionic gonadotropin (hCG) related to the process of reproduction and also assess new, non-traditional theories. Review of the international literature and research studies. hCG and its receptor, LH/CGR, are expressed in numerous sites of the reproductive tract, both in gonadal and extra-goanadal tissues, promoting oocyte maturation, fertilization, implantation and early embryo development. Moreover, hCG seems to have a potential role as an anti-rejection agent in solid organ transplantation. Future research needs to focus extensively on the functions of hCG and its receptor LH/CGR, in an effort to reveal known, as well as unknown clinical potentials. © 2017 by the authors. Licensee MDPI, Basel, Switzerland.

Published
2017

16. Perivascular epithelioid cell tumor of the uterus: Report of two cases and mini-review of the literature

Author

Theofanakis, C. Thomakos, N. Sotiropoulou, M. Rodolakis, A.

Abstract

Introduction Perivascular Epithelioid Cell tumor (PEComa) is a rare neoplasm of mesenchymal origin, with the uterus being the most common site of appearance, regarding the female genital tract. Case report We present two cases of PEComas of the uterus in patients aged 57 and 42-years-old, presented to our department with palpable abdominal masses and abnormal vaginal bleeding. During follow up period, both patients are free of recurrent disease one and two years after surgery, respectively, without receiving any adjuvant treatment. Conclusions PEComa of the female gynecological tract is a rare entity presenting with variable symptoms and different prognosis for each individual case. The diagnosis is based on histopathology and immunohistochemistry reports and the optimal treatment is the surgical resection of the tumor. © 2016

Published
2016

17. Session 66: Embryo quality: does it predict pregnancy?

Author

Ferreira, Y. J., primary, Gardiner, C., additional, Poli, M., additional, Turner, K., additional, Child, T., additional, Sargent, I. L., additional, Theofanakis, C., additional, Dinopoulou, V., additional, Mavrogianni, D., additional, Anagnostou, E., additional, Bletsa, R., additional, Kallianidis, K., additional, Loutradis, D., additional, Kiessling, A. A., additional, Azzarello, A., additional, Hoest, T., additional, Mikkelsen, A. L., additional, Ohgi, S., additional, Hagiwara, C., additional, Nakamura, C., additional, Anakubo, H., additional, Yanaihara, A., additional, Morbeck, D., additional, Bauman, N., additional, Fredrickson, J., additional, Moyer, T., additional, and Matern, D., additional

Published
2013
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18. FEMALE (IN)FERTILITY

Author

Kanta Goswami, S., primary, Banerjee, S., additional, Saha, P., additional, Chakraborty, P., additional, Kabir, S. N., additional, Karimzadeh, M. A., additional, Mohammadian, F., additional, Mashayekhy, M., additional, Saldeen, P., additional, Kallen, K., additional, Karlstrom, P. O., additional, Rodrigues-Wallberg, K. A., additional, Salerno, A., additional, Nazzaro, A., additional, Di Iorio, L., additional, Marino, S., additional, Granato, C., additional, Landino, G., additional, Pastore, E., additional, Ghoshdastidar, B., additional, Chakraborty, C., additional, Ghoshdastidar, B. N., additional, Ghoshdastidar, S., additional, Partsinevelos, G. A., additional, Papamentzelopoulou, M., additional, Mavrogianni, D., additional, Marinopoulos, S., additional, Dinopoulou, V., additional, Theofanakis, C., additional, Anagnostou, E., additional, Loutradis, D., additional, Franz, C., additional, Nieuwland, R., additional, Montag, M., additional, Boing, A., additional, Rosner, S., additional, Germeyer, A., additional, Strowitzki, T., additional, Toth, B., additional, Mohamed, M., additional, Vlismas, A., additional, Sabatini, L., additional, Caragia, A., additional, Collins, B., additional, Leach, A., additional, Zosmer, A., additional, Al-Shawaf, T., additional, Beyhan, Z., additional, Fisch, J. D., additional, Danner, C., additional, Keskintepe, L., additional, Aydin, Y., additional, Ayca, P., additional, Oge, T., additional, Hassa, H., additional, Papanikolaou, E., additional, Pados, G., additional, Grimbizis, G., additional, Bili, H., additional, Karastefanou, K., additional, Fatemi, H., additional, Kyrou, D., additional, Humaidan, P., additional, Tarlatzis, B., additional, Gungor, F., additional, Karamustafaoglu, B., additional, Iyibozkurt, A. C., additional, Ozsurmeli, M., additional, Bastu, E., additional, Buyru, F., additional, Di Emidio, G., additional, Vitti, M., additional, Mancini, A., additional, Baldassarra, T., additional, D'Alessandro, A. M., additional, Polsinelli, F., additional, Tatone, C., additional, Leperlier, F., additional, Lammers, J., additional, Dessolle, L., additional, Lattes, S., additional, Barriere, P., additional, Freour, T., additional, Elodie, P., additional, Assou, S., additional, Van den Abbeel, E., additional, Arce, J. C., additional, Hamamah, S., additional, Dechaud, H., additional, Haouzi, D., additional, Tiplady, S., additional, Johnson, S., additional, Jones, G., additional, Ledger, W., additional, Eizadyar, N., additional, Ahmad Nia, S., additional, Seyed Mirzaie, M., additional, Azin, S. A., additional, Yazdani Safa, M., additional, Onaran, Y., additional, Iltemir Duvan, C., additional, Keskin, E., additional, Ayrim, A., additional, Kafali, H., additional, Kadioglu, N., additional, Guler, B., additional, Var, T., additional, Cicek, M. N., additional, Batioglu, A. S., additional, Lichtblau, I., additional, Olivennes, F., additional, de Mouzon, J., additional, Dumont, M., additional, Junca, A. M., additional, Cohen-Bacrie, M., additional, Hazout, A., additional, Belloc, S., additional, Cohen-Bacrie, P., additional, Allegra, A., additional, Marino, A., additional, Sammartano, F., additional, Coffaro, F., additional, Scaglione, P., additional, Gullo, S., additional, Volpes, A., additional, Prisant, N., additional, Saare, M., additional, Vaidla, K., additional, Salumets, A., additional, Peters, M., additional, Jindal, U. N., additional, Thakur, M., additional, Shvell, V., additional, Diamond, M. P., additional, Awonuga, A. O., additional, Veljkovic, M., additional, Macanovic, B., additional, Milacic, I., additional, Borogovac, D., additional, Arsic, B., additional, Pavlovic, D., additional, Lekic, D., additional, Bojovic Jovic, D., additional, Garalejic, E., additional, Jayaprakasan, K., additional, Eljabu, H., additional, Hopkisson, J., additional, Campbell, B., additional, Raine-Fenning, N., additional, Kop, P., additional, van Wely, M., additional, Mol, B. W., additional, Melker, A. A., additional, Janssens, P. M. W., additional, Nap, A., additional, Arends, B., additional, Roovers, J. P. W. R., additional, Ruis, H., additional, Repping, S., additional, van der Veen, F., additional, Mochtar, M. H., additional, Sargin, A., additional, Yilmaz, N., additional, Gulerman, C., additional, Guven, A., additional, Polat, B., additional, Ozel, M., additional, Bardakci, Y., additional, Vidal, C., additional, Giles, J., additional, Remohi, J., additional, Pellicer, A., additional, Garrido, N., additional, Javdani, M., additional, Fallahzadeh, H., additional, Davar, R., additional, Sheibani, H., additional, Leary, C., additional, Killick, S., additional, Sturmey, R. G., additional, Kim, S. G., additional, Lee, K. H., additional, Park, I. H., additional, Sun, H. G., additional, Lee, J. H., additional, Kim, Y. Y., additional, Choi, E. M., additional, Van Loendersloot, L. L., additional, Van Wely, M., additional, Bossuyt, P. M. M., additional, Van Der Veen, F., additional, Roychoudhury Sarkar, M., additional, Roy, D., additional, Sahu, R., additional, Bhattacharya, J., additional, Eguiluz Gutierrez- Barquin, I., additional, Sanchez Sanchez, V., additional, Torres Afonso, A., additional, Alvarez Sanchez, M., additional, De Leon Socorro, S., additional, Molina Cabrillana, J., additional, Seara Fernandez, S., additional, Garcia Hernandez, J. A., additional, Ozkan, Z. S., additional, Simsek, M., additional, Kumbak, B., additional, Atilgan, R., additional, Sapmaz, E., additional, Agirregoikoa, J. A., additional, DePablo, J. L., additional, Abanto, E., additional, Gonzalez, M., additional, Anarte, C., additional, Barrenetxea, G., additional, Aleyasin, A., additional, Mahdavi, A., additional, Agha Hosseini, M., additional, Safdarian, L., additional, Fallahi, P., additional, Bahmaee, F., additional, Sarikaya, E., additional, Segawa, T., additional, Teramoto, S., additional, Tsuchiyama, S., additional, Miyauchi, O., additional, Watanabe, Y., additional, Ohkubo, T., additional, Shozu, M., additional, Ishikawa, H., additional, Yelian, F., additional, Papaioannou, S., additional, Knowles, T., additional, Aslam, M., additional, Milnes, R., additional, Takashima, A., additional, Takeshita, N., additional, Kinoshita, T., additional, Chapman, M. G., additional, Kilani, S., additional, Dadras, N., additional, Parsanezhad, M. E., additional, Zolghadri, J., additional, Younesi, M., additional, Floehr, J., additional, Dietzel, E., additional, Wessling, J., additional, Neulen, J., additional, Rosing, B., additional, Tan, S., additional, Jahnen-Dechent, W., additional, Lee, K. S., additional, Joo, J. K., additional, Son, J. B., additional, Joo, B. S., additional, Risquez, F., additional, Confino, E., additional, Llavaneras, F., additional, Marval, I., additional, D'Ommar, G., additional, Gil, M., additional, Risquez, M., additional, Lozano, L., additional, Paublini, A., additional, Piras, M., additional, Risquez, A., additional, Prochazka, R., additional, Blaha, M., additional, Nemcova, L., additional, Weghofer, A., additional, Kim, A., additional, Barad, D. H., additional, Gleicher, N., additional, Kilic, Y., additional, Ergun, B., additional, Howard, B., additional, Weiss, H., additional, Doody, K., additional, Schafer, C., additional, Ensslen, S., additional, Denecke, B., additional, Veitinger, T., additional, Spehr, M., additional, Tropartz, T., additional, Tolba, R., additional, Egert, A., additional, Schorle, H., additional, Alanya, S., additional, and Yumru, H., additional

Published
2012
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19. SESSION 30: EMBRYOLOGY - EARLY EVENTS

Author

Nikiforaki, D., primary, Vanden Meerschaut, F., additional, Qian, C., additional, Van den Abbeel, E., additional, Heindryckx, B., additional, De Sutter, P., additional, Serdarogullari, M., additional, Ciray, H. N., additional, Yayla, S., additional, Bayram, A., additional, Bahceci, M., additional, Dalati, S., additional, Day, M. L., additional, Trapphoff, T., additional, Demant, M., additional, Staubach, N., additional, Frohlich, T., additional, Arnold, G. J., additional, Eichenlaub-Ritter, U., additional, Dinopoulou, V., additional, Theofanakis, C., additional, Mavrogianni, D., additional, Partsinevelos, G. A., additional, Kiapekou, E., additional, Bletsa, A., additional, Loutradis, D., additional, Asgari, L., additional, Williamson, S., additional, Maalouf, W., additional, Jayaprakasan, K., additional, Marsters, P., additional, and Campbell, B. K., additional

Published
2012
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20. POSTER VIEWING SESSION - EMBRYOLOGY

Author

Fourati Ben Mustapha, S., primary, Khrouf, M., additional, Kacem Ben Rejeb, K., additional, Elloumi Chaabene, H., additional, Merdassi, G., additional, Wahbi, D., additional, Ben Meftah, M., additional, Zhioua, F., additional, Zhioua, A., additional, Azzarello, A., additional, Host, T., additional, Mikkelsen, A. L., additional, Theofanakis, C. P., additional, Dinopoulou, V., additional, Mavrogianni, D., additional, Partsinevelos, G. A., additional, Drakakis, P., additional, Stefanidis, K., additional, Bletsa, A., additional, Loutradis, D., additional, Rienzi, L., additional, Cobo, A., additional, Paffoni, A., additional, Scarduelli, C., additional, Capalbo, A., additional, Garrido, N., additional, Remohi, J., additional, Ragni, G., additional, Ubaldi, F. M., additional, Herrer, R., additional, Quera, M., additional, GIL, E., additional, Serna, J., additional, Grondahl, M. L., additional, Bogstad, J., additional, Agerholm, I. E., additional, Lemmen, J. G., additional, Bentin-Ley, U., additional, Lundstrom, P., additional, Kesmodel, U. S., additional, Raaschou-Jensen, M., additional, Ladelund, S., additional, Guzman, L., additional, Ortega, C., additional, Albuz, F. K., additional, Gilchrist, R. B., additional, Devroey, P., additional, Smitz, J., additional, De Vos, M., additional, Bielanska, M., additional, Leveille, M. C., additional, Borghi, E., additional, Magli, M. C., additional, Figueroa, M. J., additional, Mascaretti, G., additional, Ferraretti, A. P., additional, Gianaroli, L., additional, Szlit, E., additional, Leocata Nieto, F., additional, Maggiotto, G., additional, Arenas, G., additional, Tarducci Bonfiglio, N., additional, Ahumada, A., additional, Asch, R., additional, Sciorio, R., additional, Dayoub, N., additional, Thong, J., additional, Pickering, S., additional, Ten, J., additional, Carracedo, M. A., additional, Guerrero, J., additional, Rodriguez-Arnedo, A., additional, Llacer, J., additional, Bernabeu, R., additional, Tatone, C., additional, Heizenrieder, T., additional, Di Emidio, G., additional, Treffon, P., additional, Seidel, T., additional, Eichenlaub-Ritter, U., additional, Cortezzi, S. S., additional, Cabral, E. C., additional, Ferreira, C. R., additional, Trevisan, M. G., additional, Figueira, R. C. S., additional, Braga, D. P. A. F., additional, Eberlin, M. N., additional, Iaconelli Jr., A., additional, Borges Jr., E., additional, Zabala, A., additional, Pessino, T., additional, Blanco, L., additional, Rey Valzacchi, G., additional, Leocata, F., additional, Vanden Meerschaut, F., additional, Heindryckx, B., additional, Qian, C., additional, Deforce, D., additional, Leybaert, L., additional, De Sutter, P., additional, De las Heras, M., additional, De Pablo, J. L., additional, Navarro, B., additional, Agirregoikoa, J. A., additional, Barrenetxea, G., additional, Cruz, M., additional, Perez-Cano, I., additional, Gadea, B., additional, Herrero, J., additional, Martinez, M., additional, Roldan, M., additional, Munoz, M., additional, Pellicer, A., additional, Meseguer, M., additional, Galindo, N., additional, Scarselli, F., additional, Alviggi, E., additional, Colasante, A., additional, Minasi, M. G., additional, Rubino, P., additional, Lobascio, M., additional, Ferrero, S., additional, Litwicka, K., additional, Varricchio, M. T., additional, Giannini, P., additional, Piscitelli, P., additional, Franco, G., additional, Zavaglia, D., additional, Nagy, Z. P., additional, Greco, E., additional, Urner, F., additional, Wirthner, D., additional, Murisier, F., additional, Mock, P., additional, Germond, M., additional, Amorocho Llanos, B., additional, Calderon, G., additional, Lopez, D., additional, Fernandez, L., additional, Nicolas, M., additional, Landeras, J., additional, Finn-Sell, S. L., additional, Leandri, R., additional, Fleming, T. P., additional, Macklon, N. S., additional, Cheong, Y. C., additional, Eckert, J. J., additional, Lee, J. H., additional, Jung, Y. J., additional, Hwang, H. K., additional, Kang, A., additional, An, S. J., additional, Jung, J. Y., additional, Kwon, H. C., additional, Lee, S. J., additional, Palini, S., additional, Zolla, L., additional, De Stefani, S., additional, Scala, V., additional, D'Alessandro, A., additional, Polli, V., additional, Rocchi, P., additional, Tiezzi, A., additional, Pelosi, E., additional, Dusi, L., additional, Bulletti, C., additional, Fadini, R., additional, Lain, M., additional, Mignini Renzini, M., additional, Brambillasca, F., additional, Coticchio, G., additional, Merola, M., additional, Guglielmo, M. C., additional, Dal Canto, M., additional, Figueira, R., additional, Setti, A. S., additional, Worrilow, K. C., additional, Uzochukwu, C. D., additional, Eid, S., additional, Le Gac, S., additional, Esteves, T. C., additional, van Rossem, F., additional, van den Berg, A., additional, Boiani, M., additional, Kasapi, E., additional, Panagiotidis, Y., additional, Goudakou, M., additional, Papatheodorou, A., additional, Pasadaki, T., additional, Prapas, N., additional, Prapas, Y., additional, Vanderzwalmen, P., additional, Norasing, S., additional, Atchajaroensatit, P., additional, Tawiwong, W., additional, Thepmanee, O., additional, Saenlao, S., additional, Aojanepong, J., additional, Hunsajarupan, P., additional, Sajjachareonpong, K., additional, Punyatanasakchai, P., additional, Maneepalviratn, S., additional, Jetsawangsri, U., additional, Tejera, A., additional, Rubio, I., additional, Romero, J. L., additional, Nordhoff, V., additional, Schlatt, S., additional, Schuring, A. N., additional, Kiesel, L., additional, Kliesch, S., additional, Azambuja, R., additional, Okada, L., additional, Lazzari, V., additional, Dorfman, L., additional, Michelon, J., additional, Badalotti, M., additional, Badalotti, F., additional, Petracco, A., additional, Schwarzer, C., additional, Versieren, K., additional, De Croo, I., additional, Lierman, S., additional, De Vos, W., additional, Van den Abbeel, E., additional, Gerris, J., additional, Milacic, I., additional, Borogovac, D., additional, Veljkovic, M., additional, Arsic, B., additional, Jovic Bojovic, D., additional, Lekic, D., additional, Pavlovic, D., additional, Garalejic, E., additional, Albertini, D. F., additional, De Ponti, E., additional, Sanges, F., additional, Talevi, R., additional, Papini, L., additional, Mollo, V., additional, Rienzi, L. F., additional, Gualtieri, R., additional, Orteg, C., additional, Choi, J., additional, Lee, H., additional, Ku, S., additional, Kim, S., additional, Choi, Y., additional, Kim, J., additional, Moon, S., additional, Demilly, E., additional, Assou, S., additional, Moussaddykine, S., additional, Dechaud, H., additional, Hamamah, S., additional, Takisawa, T., additional, Doshida, M., additional, Hattori, H., additional, Nakamura, Y., additional, Kyoya, T., additional, Shibuya, Y., additional, Nakajo, Y., additional, Tasaka, A., additional, Toya, M., additional, Kyono, K., additional, Novo, S., additional, Penon, O., additional, Gomez, R., additional, Barrios, L., additional, Duch, M., additional, Santalo, J., additional, Esteve, J., additional, Nogues, C., additional, Plaza, J. A., additional, Perez-Garcia, L., additional, Ibanez, E., additional, Chavez, S., additional, Loewke, K., additional, Behr, B., additional, Reijo Pera, R., additional, Huang, S., additional, Wang, H., additional, Soong, Y., additional, Chang, C., additional, Okimura, T., additional, Kuwayama, M., additional, Mori, C., additional, Morita, M., additional, Uchiyama, K., additional, Aono, F., additional, Kato, K., additional, Takehara, Y., additional, Kato, O., additional, Minasi, M., additional, Casciani, V., additional, Arizzi, L., additional, Mencacci, C., additional, Piscitelli, C., additional, Cucinelli, F., additional, Tocci, A., additional, Wydooghe, E., additional, Vandaele, L., additional, Dewulf, J., additional, Van Soom, A., additional, Moon, J. H., additional, Son, W. Y., additional, Mahfoudh, A., additional, Henderson, S., additional, Jin, S. G., additional, Shalom-Paz, E., additional, Dahan, M., additional, Holzer, H., additional, Mahmoud, K., additional, Triki-Hmam, C., additional, Terras, K., additional, Hfaiedh, T., additional, Ben Aribia, M. H., additional, Otsubo, H., additional, Egashira, A., additional, Tanaka, K., additional, Matsuguma, T., additional, Murakami, M., additional, Murakami, K., additional, Otsuka, M., additional, Yoshioka, N., additional, Araki, Y., additional, Kuramoto, T., additional, Smit, J. G., additional, Sterrenburg, M. D., additional, Eijkemans, M. J. C., additional, Al-Inany, H. G., additional, Youssef, M. A. F. M., additional, Broekmans, F. J. M., additional, Willoughby, K., additional, DiPaolo, L., additional, Deys, L., additional, Lagunov, A., additional, Amin, S., additional, Faghih, M., additional, Hughes, E., additional, Karnis, M., additional, Ashkar, F., additional, King, W. A., additional, Neal, M. S., additional, Antonova, I., additional, Veleva, L., additional, Petkova, L., additional, Shterev, A., additional, Nogales, C., additional, Martinez, E., additional, Ariza, M., additional, Cernuda, D., additional, Gaytan, M., additional, Linan, A., additional, Guillen, A., additional, Bronet, F., additional, Cottin, V., additional, Fabian, D., additional, Allemann, F., additional, Koller, A., additional, Spira, J. C., additional, Agudo, D., additional, Martinez-Burgos, M., additional, Arnanz, A., additional, Basile, N., additional, Rodriguez, A., additional, Cho, Y. S., additional, Filioli Uranio, M., additional, Ambruosi, B., additional, Paternoster, M. S., additional, Totaro, P., additional, Sardanelli, A. M., additional, Dell'Aquila, M. E., additional, Zollner, U., additional, Hofmann, T., additional, Zollner, K. P., additional, Kovacic, B., additional, Roglic, P., additional, Vlaisavljevic, V., additional, Sole, M., additional, Boada, M., additional, Coroleu, B., additional, Veiga, A., additional, Martiny, G., additional, Molinari, M., additional, Revelli, A., additional, Chimote, N. M., additional, Chimote, M., additional, Mehta, B., additional, Chimote, N. N., additional, Sheikh, N., additional, Nath, N., additional, Mukherjee, A., additional, Rakic, K., additional, Reljic, M., additional, Ingerslev, H. J., additional, Kirkegaard, K., additional, Hindkjaer, J., additional, Agerholm, I., additional, Kitasaka, H., additional, Fukunaga, N., additional, Nagai, R., additional, Yoshimura, T., additional, Tamura, F., additional, Kitamura, K., additional, Hasegawa, N., additional, Nakayama, K., additional, Katou, M., additional, Itoi, F., additional, Asano, E., additional, Deguchi, N., additional, Ooyama, K., additional, Hashiba, Y., additional, Asada, Y., additional, Michaeli, M., additional, Rotfarb, N., additional, Karchovsky, E., additional, Ruzov, O., additional, Atamny, R., additional, Slush, K., additional, Fainaru, O., additional, Ellenbogen, A., additional, Chekuri, S., additional, Chaisrisawatsuk, T., additional, Chen, P., additional, Pangestu, M., additional, Jansen, S., additional, Catt, S., additional, Molinari, E., additional, Racca, C., additional, Ryu, C., additional, Kang, S., additional, Lee, J., additional, Chung, D., additional, Roh, S., additional, Chi, H., additional, Yokota, Y., additional, Yokota, M., additional, Yokota, H., additional, Sato, S., additional, Nakagawa, M., additional, Komatsubara, M., additional, Makita, M., additional, Oyama, K., additional, Naruse, K., additional, Kilani, S., additional, Chapman, M. G., additional, Kwik, M., additional, Chapman, M., additional, Guven, S., additional, Odaci, E., additional, Yildirim, O., additional, Kart, C., additional, Unsal, M. A., additional, Yulug, E., additional, Isachenko, E., additional, Maettner, R., additional, Strehler, E., additional, Isachenko, V., additional, Hancke, K., additional, Kreienberg, R., additional, Sterzik, K., additional, Zheng, X. Y., additional, Wang, L. N., additional, Liu, P., additional, Qiao, J., additional, Inoue, F., additional, Dashtizad, M., additional, Wahid, H., additional, Rosnina, Y., additional, Daliri, M., additional, Hajarian, H., additional, Akbarpour, M., additional, Abbas Mazni, O., additional, Knez, K., additional, Tomaevic, T., additional, Vrtacnik Bokal, E., additional, Zorn, B., additional, Virant Klun, I., additional, Koster, M., additional, Liebenthron, J., additional, Nicolov, A., additional, van der Ven, K., additional, van der Ven, H., additional, Montag, M., additional, Fayazi, M., additional, Salehnia, M., additional, Beigi Boroujeni, M., additional, Khansarinejad, B., additional, Deignan, K., additional, Emerson, G., additional, Mocanu, E., additional, Wang, J. J., additional, Andonov, M., additional, Linara, E., additional, Ahuja, K. K., additional, Nachef, S., additional, Pasqualotto, F. F., additional, Pasqualotto, E., additional, Chang, C. C., additional, Bernal, D. P., additional, Elliott, T. A., additional, Shapiro, D. B., additional, Toledo, A. A., additional, Economou, K., additional, Davies, S., additional, Argyrou, M., additional, Doriza, S., additional, Sisi, P., additional, Moschopoulou, M., additional, Karagianni, A., additional, Mendorou, C., additional, Polidoropoulos, N., additional, Papanicopoulos, C., additional, Stefanis, P., additional, Karamalegos, C., additional, Cazlaris, H., additional, Koutsilieris, M., additional, Mastrominas, M., additional, Gotts, S., additional, Doshi, A., additional, Harper, J., additional, Serhal, P., additional, Borini, A., additional, Guzeloglu-Kayisli, O., additional, Bianchi, V., additional, Seli, E., additional, Lappi, M., additional, Bonu, M. A., additional, Mizuta, S., additional, Hashimoto, H., additional, Kuroda, Y., additional, Matsumoto, Y., additional, Mizusawa, Y., additional, Ogata, S., additional, Yamada, S., additional, Kokeguchi, S., additional, Noda, Y., additional, Shiotani, M., additional, Stojkovic, M., additional, Ilic, M., additional, Markovic, N., additional, Stojkovic, P., additional, Feng, G., additional, Zhang, B., additional, Zhou, H., additional, Zhou, L., additional, Gan, X., additional, Qin, X., additional, Shu, J., additional, Wu, F., additional, Molina Botella, I., additional, Lazaro Ibanez, E., additional, Debon Aucejo, A., additional, Pertusa, J., additional, Fernandez Colom, P. J., additional, Li, C., additional, Zhang, Y., additional, Cui, Y., additional, Zhao, H., additional, Liu, J., additional, Oliveira, J. B. A., additional, Petersen, C. G., additional, Mauri, A. L., additional, Massaro, F. C., additional, Silva, L. F. I., additional, Ricci, J., additional, Cavagna, M., additional, Pontes, A., additional, Vagnini, L. D., additional, Baruffi, R. L. R., additional, Franco Jr., J. G., additional, Felipe, V., additional, Vilela, M., additional, Tiveron, M., additional, Lombardi, C., additional, Viglierchio, M. I., additional, Marconi, G., additional, Rawe, V., additional, Wale, P. L., additional, Gardner, D. K., additional, Nakagawa, K., additional, Sugiyama, R., additional, Nishi, Y., additional, Kuribayashi, Y., additional, Jyuen, H., additional, Yamashiro, E., additional, Shirai, A., additional, Inoue, M., additional, Hovatta, O., additional, Tohonen, V., additional, Inzunza, J., additional, Parmegiani, L., additional, Cognigni, G. E., additional, Bernardi, S., additional, Ciampaglia, W., additional, Infante, F. E., additional, Tabarelli de Fatis, C., additional, Pocognoli, P., additional, Arnone, A., additional, Maccarini, A. M., additional, Troilo, E., additional, Filicori, M., additional, Radwan, P., additional, Polac, I., additional, Borowiecka, M., additional, Bijak, M., additional, and Radwan, M., additional

Published
2011
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21. A Narrative Review on the Clinical Utility of Electrical Impedance Spectroscopy for Diagnosing High-Grade Cervical Intraepithelial Neoplasia.

Author

Panagakis GP, Machairiotis N, Tsiriva M, Theofanakis C, Tsetsa P, Pantelis AG, Thomakos N, Rodolakis A, and Haidopoulos D

Abstract

Colposcopy constitutes a pivotal step in the diagnosis and management of cervical intraepithelial neoplasia; nevertheless, the method has several inherent and external limitations. Electrical impedance spectroscopic (EIS) has been among the adjuncts that have been developed to increase the diagnostic accuracy of colposcopy. EIS is based on the principle that the trajectory of electrical current alters depending on the consistency of the tissues. In the present study, we investigate the diagnostic accuracy and clinical utility of EIS by means of searching the available evidence. Our search yielded 17 articles during the period 2005-2023. Subsequently, we focused on the performance metrics of the included studies. The general concept is that EIS, in combination with colposcopy, is a method with increased sensitivity and specificity in detecting high-grade cervical intraepithelial neoplasia as compared to colposcopy alone. However, we documented a heterogeneous distribution of these and other metrics, including the positive predictive value, the negative predictive value, and the area under the receiver operating characteristic curve (AUC). Additionally, we located potential confounders that might hamper the measurements of EIS and, as such, warrant further investigation in future research. We conclude that future studies should be directed towards randomized multicentric trials, whereas the advent of artificial intelligence might improve the diagnostic accuracy of the method by helping incorporate a large amount of data., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Panagakis et al.)

Published
2024
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22. Management of Patients with Hypersensitivity to Platinum Salts and Taxane in Gynecological Cancers: A Cross-Sectional Study by the European Network of Young Gynaecologic Oncologists (ENYGO).

Author

Zwimpfer TA, Bilir E, Gasimli K, Cokan A, Bizzarri N, Razumova Z, Kacperczyk-Bartnik J, Nikolova T, Pletnev A, Kahramanoglu I, Shushkevich A, Strojna A, Theofanakis C, Cicakova T, Vetter M, Montavon C, Morgan G, and Heinzelmann-Schwarz V

Abstract

Platinum and taxane chemotherapy is associated with the risk of hypersensitivity reactions (HSRs), which may require switching to less effective treatments. Desensitization to platinum and taxane HSRs can be used to complete chemotherapy according to the standard regimen. Therefore, we aimed to investigate the current management of HSRs to platinum and/or taxane chemotherapy in patients with gynecologic cancers. We conducted an online cross-sectional survey among gynecological and medical oncologists consisting of 33 questions. A total of 144 respondents completed the survey, and 133 respondents were included in the final analysis. Most participants were gynecologic oncologists (43.6%) and medical oncologists (33.8%), and 77.4% ( n = 103) were involved in chemotherapy treatment. More than 73% of participants experienced >5 HSRs to platinum and taxane per year. Premedication and a new attempt with platinum or taxane chemotherapy were used in 84.8% and 92.5% of Grade 1-2 HSRs to platinum and taxane, respectively. In contrast, desensitization was used in 49.4% and 41.8% of Grade 3-4 HSRs to platinum and taxane, respectively. Most participants strongly emphasized the need to standardize the management of platinum and taxane HSRs in gynecologic cancer. Our study showed that HSRs in gynecologic cancer are common, but management is variable and the use of desensitization is low. In addition, the need for guidance on the management of platinum- and taxane-induced HSRs in gynecologic cancer was highlighted.

Published
2024
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23. Detection of High-Grade Cervical Intraepithelial Neoplasia by Electrical Impedance Spectroscopy in Women Diagnosed with Low-Grade Cervical Intraepithelial Neoplasia in Cytology.

Author

Panagakis G, Papapanagiotou IK, Theofanakis C, Tsetsa P, Kontogeorgi A, Thomakos N, Rodolakis A, and Haidopoulos D

Abstract

The authors attempt to address the importance of timely detection and management of cervical intraepithelial neoplasia (CIN) to prevent cervical cancer. The study focused on the potential of electrical impedance spectroscopy (EIS) as an adjunct to colposcopy, aiming to enhance the accuracy of identifying high-grade cervical lesions. Colposcopy, a widely used technique, exhibited variable sensitivity in detecting high-grade lesions, which relies on the expertise of the operator. The study's primary objective is to evaluate the effectiveness of combining colposcopy with EIS in detecting high-grade cervical lesions among patients initially diagnosed with low-grade CIN based on cytology. We employed a cross-sectional observational design, recruiting 101 women with abnormal cervical cytology results. The participants underwent colposcopy with acetic acid and subsequent EIS using the ZedScan device. The ZedScan results are categorized into color-coded probability levels, with red indicating the highest likelihood of high-grade squamous intraepithelial lesions (HSIL) occurrence. Results revealed that ZedScan exhibits a sensitivity rate of 89.5% and a specificity rate of 84% for detecting high-grade lesions. Colposcopy, on the other hand, recorded a sensitivity rate of 85.5% and a specificity rate of 92%. The agreement rate between ZedScan and biopsy is 79.2%, as indicated by a kappa coefficient of 0.71, while the agreement rate between colposcopy and biopsy is 74.3%, with a kappa coefficient of 0.71.

Published
2023
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24. Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer.

Author

Andrikopoulou A, Theofanakis C, Markellos C, Kaparelou M, Koutsoukos K, Apostolidou K, Thomakos N, Haidopoulos D, Rodolakis A, Dimopoulos MA, Zagouri F, and Liontos M

Abstract

Background: There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC)., Methods: We retrospectively identified patients with stage IIIC/IV HGSC who received NACT followed by IDS during a 15-year period (January 2003-December 2018) in our Institution., Results: Overall, 115 patients with stage IIIC/IV HGSC were included. The median age of diagnosis was 62.7 years (IQR: 14.0). A total of 76.5% (88/115) of patients were diagnosed with IIIC HGSC and 23.5% (27/115) with IV HGSC. Median PFS was 15.7 months (95% CI: 13.0-18.5), and median OS was 44.7 months (95% CI: 38.8-50.5). Patients were categorized in groups according to the time interval from NACT to IDS: <4 weeks (group A); 4-5 weeks (group B); 5-6 weeks (group C); >6 weeks (group D). Patients with a time interval IDS to NACT ≥4 weeks had significantly shorter PFS ( p = 0.004) and OS ( p = 0.002). Median PFS was 26.6 months (95% CI: 24-29.2) for patients undergoing IDS <4 weeks after NACT vs. 14.4 months (95% CI: 12.6-16.2) for those undergoing IDS later ( p = 0.004). Accordingly, median OS was 66.3 months (95% CI: 39.1-93.4) vs. 39.4 months (95% CI: 31.8-47.0) in the <4 week vs. >4 week time interval NACT to IDS groups ( p = 0.002). On multivariate analysis, the short time interval (<4 weeks) from NACT to IDS was an independent factor of PFS ( p = 0.004) and OS ( p = 0.003)., Conclusion: We have demonstrated that performing IDS within four weeks after NACT may be associated with better survival outcomes. Multidisciplinary coordination among ovarian cancer patients is required to avoid any unnecessary delays.

Published
2023
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25. Gender-related differences in career development among gynecologic oncology surgeons in Europe. European Network of Young Gynecologic Oncologists' Survey based data.

Author

Nikolova T, Bossart M, Kacperczyk-Bartnik J, Razumova Z, Strojna A, Bizzarri N, Pletnev A, Gómez-Hidalgo NR, Theofanakis C, Lanner M, Selcuk I, Shushkevich A, Anca CR, Nikolova N, Concin N, and Zalewski K

Abstract

Introduction: Gender-related differences in career development are well known issues in various professions. An international survey on gender-related differences was performed among young gynecologic oncology surgeons in Europe to identify potential gender inequalities in career development., Material and Methods: A survey on demographics, clinical and academic working environment, family/parenting, career development, salary and leadership was sent to all members of the European Network of Young Gynecologic Oncologists (ENYGO), which is a network within the European Society of Gynecologic Oncology (ESGO). Gynecologic oncology surgeons and obstetricians/gynecologists who actively work in this field in Europe were included in the study., Results: Responses were analyzed from 192 gynecologic oncology surgeons of whom 65.1% (125/192) were female (median age 37, IQR: 34 - 42) and 34.9% (67/192) were male (median age 38, IQR: 36 - 41). Male reported to perform a median of 15 and female a median of 10 operations per month (p = . 007). Among female, 24.8% had a leadership position vs. 44.8% among male, crude OR = 2.46, 95% CI 1.31-4.62, p< .01. When stratifying for age under 41 and having children, 36.7% of male and 5.6% of female had a leadership position, adjusted OR 10.8, 95% CI 3.28-35.64, p <.001. A significantly higher proportion of female compared to male believed they earned less than their gender counterparts at the same clinical position and with same qualifications (30.4% vs. 2.5%, p< .001). There was not a statistically significant gender difference in the academic qualification PhD degree or professorship ( p = .92 and p = .64, respectively). In the previous year, male published more peer-reviewed articles than female (median 3 vs. median 2; p = .017)., Conclusion: This first comprehensive survey on gender-differences in gynecologic oncology in Europe revealed that there are gender gaps concerning several aspects during the critical time of career development in the young generation of gynecologic oncology surgeons. These gender gaps are particularly reflected by a lower rate of female leadership positions. ENYGO and ESGO are dedicated to work on solution to overcome the identified obstacles and to support closing gender gaps., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nikolova, Bossart, Kacperczyk-Bartnik, Razumova, Strojna, Bizzarri, Pletnev, Gómez-Hidalgo, Theofanakis, Lanner, Selcuk, Shushkevich, Anca, Nikolova, Concin and Zalewski.)

Published
2022
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27. What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience.

Author

Liontos M, Svarna A, Theofanakis C, Fiste O, Andrikopoulou A, Kaparelou M, Koutsoukos K, Thomakos N, Haidopoulos D, Rodolakis A, Dimopoulos MA, and Zagouri F

Subjects
Disease-Free Survival, Female, Humans, Retrospective Studies, Cystadenocarcinoma, Serous pathology, Cystadenocarcinoma, Serous therapy, Endometrial Neoplasms pathology, Endometrial Neoplasms therapy, Uterine Neoplasms pathology, Uterine Neoplasms therapy
Abstract

Uterine serous carcinoma accounts for 3-10% of endometrial cancers, but it is the most lethal histopathological subtype. The molecular characterization of endometrial carcinomas has allowed novel therapeutic approaches for these patients. We undertook a retrospective analysis of patients with uterine serous carcinomas treated in our hospital within the last two decades to identify possible changes in their management. The patients and their characteristics were evenly distributed across the two decades. Treatment modalities did not change significantly throughout this period. After adjuvant treatment, patients' median disease-free survival was 42.07 months (95% CI: 20.28-63.85), and it did not differ significantly between the two decades ( p = 0.059). The median overall survival was 47.51 months (95% Cl: 32.18-62.83), and it significantly favored the first decade's patients ( p = 0.024). In patients with de novo metastatic or recurrent disease, median progression-free survival was 7.8 months (95% Cl: 5.81-9.93), whereas both the median progression-free survival and the median overall survival of these patients did not show any significant improvement during the examined time period. Overall, the results of our study explore the minor changes in respect of uterine serous carcinoma's treatment over the last two decades, which are reflected in the survival outcomes of these patients and consequently underline the critical need for therapeutic advances in the near future.

Published
2021
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28. Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution?

Author

Theofanakis C, Haidopoulos D, Thomakos N, Rodolakis A, and Fotopoulou C

Subjects
Female, Fertility Preservation methods, Humans, Lymph Node Excision methods, Neoplasm Staging methods, Quality of Life, Trachelectomy methods, Uterine Cervical Neoplasms surgery, Uterine Cervical Neoplasms therapy
Abstract

Background/aim: The aim of this study was to conduct a review on less radical fertility-sparing surgical treatment for early-stage cervical cancer., Materials and Methods: We conducted a Medline search from 2014 to 2018 regarding less radical fertility-sparing techniques, such as simple trachelectomy or cervical conization, with pelvic lymphadenectomy. We also assessed the impact of the removal of the parametrium on the obstetric and oncologic outcome, in women who desire to preserve their fertility., Results: We analyzed studies about cervical conization and simple trachelectomy, together with pelvic lymphadenectomy in early-stage cervical cancer. We also assessed the importance of parametrial involvement in reducing morbidity, without jeopardizing the oncologic outcome of these patients. Studies demonstrate that in tumors ≤2 cm, without lymphovascular Space Invasion and without evidence of parametrial involvement, a less radical fertility-sparing surgical approach could increase pregnancy rates and have a positive effect on the quality of life of these patients., Conclusion: Standard fertility-sparing treatment for early-stage cervical cancer is still radical trachelectomy with pelvic lymphadenectomy. However, studies suggest that the omission of parametrectomy is a feasible and safe option. Simple trachelectomy or cervical conization, both combined with pelvic lymphadenectomy are acceptable approaches in a selected group of patients with early-stage cervical cancer., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Published
2020
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29. Prenatal diagnosis of sirenomelia with anencephaly and craniorachischisis totalis: A case report study.

Author

Theofanakis C, Theodora M, Sindos M, and Daskalakis G

Subjects
Abortion, Eugenic, Female, Humans, Pregnancy, Young Adult, Anencephaly diagnostic imaging, Ectromelia diagnostic imaging, Neural Tube Defects diagnostic imaging, Ultrasonography, Prenatal
Abstract

Rationale: Sirenomelia and anencephaly are well-defined congenital malformations that usually occur independently., Patient Concerns: We report a case of combined sirenomelia, anencephaly and complete rachischisis, diagnosed in the 16th week of gestation., Diagnoses: To our knowledge, this is the 7th case in the literature and the first that is diagnosed so early in pregnancy., Interventions: The final diagnosis is confirmed with radiological examination after the termination of pregnancy., Outcomes: Prenatal diagnosis of sirenomelia is difficult due to the presence of kidney agenesis and severe oligohydramnios., Lessons: The combination of sirenomelia and craniorachischisis totalis is extremely rare and prenatal ultrasound scan are a challenge, even for experts in the field., (Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Published
2017
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30. Human Chorionic Gonadotropin: The Pregnancy Hormone and More.

Author

Theofanakis C, Drakakis P, Besharat A, and Loutradis D

Subjects
Female, Fertilization in Vitro, Gonadotropin-Releasing Hormone genetics, Humans, Oocytes metabolism, Pregnancy, Pregnancy Rate, Chorionic Gonadotropin genetics, Embryonic Development genetics, Oocytes growth & development, Receptors, LH genetics
Abstract

To thoroughly review the uses of human chorionic gonadotropin (hCG) related to the process of reproduction and also assess new, non-traditional theories. Review of the international literature and research studies. hCG and its receptor, LH/CGR, are expressed in numerous sites of the reproductive tract, both in gonadal and extra-goanadal tissues, promoting oocyte maturation, fertilization, implantation and early embryo development. Moreover, hCG seems to have a potential role as an anti-rejection agent in solid organ transplantation. Future research needs to focus extensively on the functions of hCG and its receptor LH/CGR, in an effort to reveal known, as well as unknown clinical potentials.

Published
2017
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31. Pyoderma Gangrenosum of the breast: A case report study.

Author

Marinopoulos S, Theofanakis C, Zacharouli T, Sotiropoulou M, and Dimitrakakis C

Abstract

Introduction: Pyoderma gangrenosum (PG) of the breast is a rare and rapidly spreading disease, which usually co-exists with severe underlying systemic conditions. PG often presents secondary to breast surgery with skin lesions and signs of infection, even though it is a non-infectious, necrotizing dermatological entity., Presentation of Case: We present a case of de novo unilateral breast PG in 37-year-old woman, with a clear medical history whatsoever. The patient was treated with corticosteroids and, in a two-month follow up, presents with nearly no signs of PG., Discussion: PG of the breast presents with atypical clinical signs and is characterized by an exclusion-based diagnosis. It often mimics inflammation but is resistant to antibiotics., Conclusion: The optimal treatment for PG is systemic use of corticosteroids and surgical debridement of the necrotic tissue, while the timely onset of the therapeutic approach is of outmost importance., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2017
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32. Perivascular epithelioid cell tumor of the uterus: Report of two cases and mini-review of the literature.

Author

Theofanakis C, Thomakos N, Sotiropoulou M, and Rodolakis A

Abstract

Introduction: Perivascular Epithelioid Cell tumor (PEComa) is a rare neoplasm of mesenchymal origin, with the uterus being the most common site of appearance, regarding the female genital tract., Case Report: We present two cases of PEComas of the uterus in patients aged 57 and 42-years-old, presented to our department with palpable abdominal masses and abnormal vaginal bleeding. During follow up period, both patients are free of recurrent disease one and two years after surgery, respectively, without receiving any adjuvant treatment., Conclusions: PEComa of the female gynecological tract is a rare entity presenting with variable symptoms and different prognosis for each individual case. The diagnosis is based on histopathology and immunohistochemistry reports and the optimal treatment is the surgical resection of the tumor., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2016
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33. LH receptor gene expression in cumulus cells in women entering an ART program.

Author

Papamentzelopoulou M, Mavrogianni D, Partsinevelos GA, Marinopoulos S, Dinopoulou V, Theofanakis C, Anagnostou E, and Loutradis D

Subjects
Adult, Chorionic Gonadotropin administration & dosage, Cumulus Cells drug effects, Cumulus Cells metabolism, Down-Regulation, Female, Follicle Stimulating Hormone genetics, Follicle Stimulating Hormone metabolism, Gene Expression drug effects, Gonadotropin-Releasing Hormone agonists, Gonadotropin-Releasing Hormone genetics, Gonadotropin-Releasing Hormone metabolism, Humans, Infertility genetics, Infertility metabolism, Luteinizing Hormone genetics, Luteinizing Hormone metabolism, Male, Ovary metabolism, Ovulation Induction methods, Pregnancy, Protein Isoforms genetics, Protein Isoforms metabolism, Receptors, LH metabolism, Sperm Injections, Intracytoplasmic methods, Cumulus Cells physiology, Receptors, LH biosynthesis, Receptors, LH genetics, Reproductive Techniques, Assisted
Abstract

Purpose: Luteinizing hormone (LH) exerts its actions through its receptor (LHR), which is mainly expressed in theca cells and to a lesser extent in oocytes, granulosa and cumulus cells. The aim of the present study was the investigation of a possible correlation between LHR gene and LHR splice variants expression in cumulus cells and ovarian response as well as ART outcome., Methods: Forty patients undergoing ICSI treatment for male factor infertility underwent a long luteal GnRH-agonist downregulation protocol with a fixed 5-day rLH pre-treatment prior to rFSH stimulation and samples of cumulus cells were collected on the day of egg collection. RNA extraction and cDNA preparation was followed by LHR gene expression investigation through real-time PCR. Furthermore, cumulus cells were investigated for the detection of LHR splice variants using reverse transcription PCR., Results: Concerning LHR expression in cumulus cells, a statistically significant negative association was observed with the duration of ovarian stimulation (odds ratio = 0.23, p = 0.012). Interestingly, 6 over 7 women who fell pregnant expressed at least two specific types of LHR splice variants (735 bp, 621 bp), while only 1 out of 19 women that did not express any splice variant achieved a pregnancy., Conclusions: Consequently, the present study provide a step towards a new role of LHR gene expression profiling as a biomarker in the prediction of ovarian response at least in terms of duration of stimulation and also a tentative role of LHR splice variants expression in the prediction of pregnancy success.

Published
2012
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