1. bookTom 12 (2021): Zeszyt 2 (December 2021)
    Supplementary Zeszyt: 27th Hellenic Conference of Clinical Oncology
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27th Hellenic Conference of Clinical Oncology

Data publikacji: 06 Jul 2022
Tom & Zeszyt: Tom 12 (2021) - Zeszyt 2 (December 2021) - Supplementary Zeszyt: 27th Hellenic Conference of Clinical Oncology
Zakres stron: 1 - 50
Informacje o czasopiśmie
License
Format
Czasopismo
eISSN
1792-362X
Pierwsze wydanie
14 Aug 2014
Częstotliwość wydawania
4 razy w roku
Języki
Angielski
BIOMARKERS FOR IMMUNE AND TARGETED THERAPY IN PREOPERATIVE HEAD AND NECK CANCER PATIENTS

Amanda Psyrri, Myrto Moutafi, Georgia-Angeliki Koliou, George Papaxoinis, Niki Gavrielatou, Panagiota Economopoulou, Ioannis Kotsantis, Maria Gkotzamanidou, Maria Anastasiou, Dimitrios G. Pectasides, Aileen Fernandez, Vesal Yaghoobi, Saba Shafi, Ioannis Vathiotis, Thazin Nwe Aung, Stavros Gkolfinopoulos, Periklis Foukas, David L. Rimm, George Fountzilas

National Kapodistrian University of Athens, Attikon Hospital, Athens, Greece; Yale School of Medicine, New Haven, CT; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece; Second Department of Medical Oncology, Agios Savvas Anticancer Hospital, Athens, Greece; Attikon University Hospital, Athens, Greece; Yale University, New Haven, CT; Yale University School of Medicine, New Haven, CT; National and Kapodistrian University of Athens School of Medicine, Athens, Greece; Yale, New Haven, CT; Hellenic Cooperative Oncology Group, Thessaloniki, Greece

Background: Preclinical and clinical models suggest that PARP inhibitor-induced DNA damage regulates immune response and can lead to and effective antitumour response. A range of mechanisms, including STING pathway activation, alter the tumour microenvironment and increase tumour susceptibility. In addition, adaptive upregulation of PD-L1 expression has been reported after PARP blockade. Gene expression profiling and immunohistochemistry (IHC)/fluorescent assessments of PD-L1 expression, CD8 T-cell infiltration and broad immune infiltrate were used to identify immune-related biomarker groups and understand the effects of PARP inhibition-related therapy on HNC tumour immunity.

Aim: To identify the biomarkers of response to olaparib-based treatment in patients with head and neck squamous cell carcinoma (HNSCC).

Methods: Pre- and post-treatment samples were collected form 39 patients enrolled in OPHELIA Phase II trial. In this open-label, non-comparative trial, patients were randomised 3:3:3:1 to cisplatin and olaparib, olaparib alone, no treatment or durvalumab and olaparib. Quantitative immunofluorescence (QIF) assessed PD-L1, STING, Ki67 and γ-H2AX expression. The GeneXpert (GX) closed system real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) quantified CD274 (PD-L1), PDCD1LG2 (PD-L2), CD8A and IRF1 mRNA expression in pre- and post-treatment samples.

Results: Ki67 was decreased after olaparib-based treatment in 23 of 29 (79.3%) available samples when assessed by QIF; 13/23 had a decrease of at least 25%. PD-L1 levels were significantly increased post-durvalumab/olaparib treatment (p = 0.023). An increase in post-treatment CD8A mRNA levels was observed in a majority of samples in the three treatment arms. There were no statistically significant changes in the expression levels of STING and γ-H2AX.

Conclusion: To conclude, in the present study, we showed that brief treatment with olaparib significantly decreased proliferation in HNSCC. We also observed an increase in PD-L1 mRNA levels that could suggest an activated adaptive immunity. Larger cohorts of patients are needed in order to assess the effect of PARP inhibitors on HNSCC immune regulation.

ClinicalTrials.gov Identifier: NCT02882308

CELL-FREE DNA INTEGRITY AND QUANTIFICATION AS PROGNOSTIC INDICATORS IN BREAST CANCER PATIENTS

Balgkouranidou I1, Xenidis N1, Amarantidis K1, Koukaki T1, Karamitrousis E1, Chatzaki E2, Lianidou E3, Kakolyris S1, Biziota Ei1

1Department of Oncology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.

2Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.

3Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Greece

Background: Non-invasive blood-based molecular markers have been investigated for cancer diagnosis and prognosis. Circulating free or cell-free DNA (cfDNA) variables such as ctDNA concentration and ctDNA integrity (cfDI) are two special characteristics of cfDNA. DNA integrity is calculated as the ratio of the concentration of longer DNA fragments to shorter fragments in the plasma.

Aim: In the present study, we aim to correlate important features of ctDNA, such as concentration and integrity, with the clinical outcome of the disease and the potential prognostic ability.

Methods: Two groups of breast cancer patients were examined: group A (n = 65) who received adjuvant treatment and group B (n = 40) patients with metastatic disease who received first-line treatment, and also a control group of healthy blood donors (n = 20). ctDNA quantification and integrity were determined by real-time quantitative polymerase chain reaction (PCR) for the repeating sequences ALU 115 and 247. Integrity was defined as the ratio of ALU247-qPCR to ALU115-qPCR.

Results: ctDNA concentration was significantly higher in the metastatic group of patients compared to the adjuvant group (comparison of mean: 20.8 ng/mL vs. 7.2 ng/mL, respectively), while in the control group, the concentration was extremely low. The mean value of the integrity of DNA (cfDI) in group A was 0.54, while in group B, it was 0.78. In 22.5% of group A patients who relapsed in the first 3 years, a strong statistical correlation was observed between relapse and elevated cfDI (p = 0.001).

Conclusion: Based on these early results, ctDNA concentration and integrity could be innovative prognostic biomarker candidates. This result should be confirmed in a larger number of patients.

PREDICTIVE AND PROGNOSTIC SIGNIFICANCE OF PATRAS IMMUNOTHERAPY SCORE (PIOS SCORE) IN PATIENTS WITH NON-SMAL CELL LUNG CANCER (NSCLC) TREATED WITH NIVOLUMAB OR PEMBROLIZUMAB: RESULTS FROM A MULTICENTER VALIDATION STUDY

Dimitrakopoulos F.-I.1,2, Mountzios G.3, Christopoulos P.4,5, Papastergiou T.6, Elshiaty M.4,5, Daniello L.4,5, Zervas E.7, Agelaki S.8, Samantas E.9, Nikolaidi A.10, Athanasiadis I.10, Baka S.11, Syrigos K.12, Christopoulou A.13, Lianos E.14, Samitas K.7, Tsoukalas N.15, Perdikouri E. I.16, Oikonomopoulos G.17, Kottorou A.1,2, Kalofonou F.18, Makatsoris T.1,2, Koutras A.1,2, Megalooikonomou V.6, Kalofonos H.1,2

1Division of Oncology, Department of Medicine, University Hospital of Patras, Greece

2 Molecular Oncology Laboratory, Medical School, University of Patras, Greece

3 Second Department of Medical Oncology and Clinical trials Unit, Henry Dunant Hospital Center, Athens, Greece

4 Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany

5 Translational Lung Research Center Heidelberg, member of the German Center for Lung Research (DZL)

6 Computer Engineering and Informatics Department, University of Patras, Greece

7 7th Respiratory Medicine Dept and Asthma Center, Athens Chest Hospital Sotiria, Athens, Greece

8 Department of Medical Oncology, University General Hospital, 71110 Heraklion, Greece

9 Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, 14564 Athens, Greece

10 Department of Medical Oncology, Mitera Hospital, Athens, Greece

11 Oncology Department, Interbalkan European Medical Center, Thessaloniki, Greece

12 Oncology Unit, The Third Department of Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece

13 Medical Oncology Unit, S. Andrew Hospital, 26335 Patras, Greece

14 Department of Medicine, Division of Medical Oncology-Hematopoietic Cell Transplant Unit, ‘Metaxa’ Cancer Hospital, Piraeus, Greece

15 Medical Oncology Unit, NIMITS Hospital, Athens, Greece

16 Oncology Department, General Hospital of Volos, Volos, Greece

17 Second Department of Medical Oncology, Metropolitan Hospital, Piraeus, Greece

18 Department of Oncology, Imperial NHS Healthcare Trust, Charing Cross Hospital, London, UK

Background: Daily clinical management of advanced non-small-cell lung cancer (aNSCLC) has tremendously been reformed with the use of immune checkpoint inhibitors (ICIs). Recently, Patras Immunotherapy Score (PIOS) was suggested for this group of patients. PIOS is a baseline formula calculated by a combination of the non-interventional parameters performance status (PS), body mass index (BMI), age and line of treatment (LOT) following the formula PIOS = (PS × BMI)/(LOT × AGE).

Aim: The objective of this study was to validate the clinical value of PIOS in an external cohort of patients with aNSCLC treated with nivolumab or pembrolizumab as monotherapy.

Methods: In the current multicenter study, 626 patients with aNSCLC (stages 3 and 4) who were treated with nivolumab or pembrolizumab as monotherapy in Greek and German cancer centres were retrospectively enrolled. For the patients of the study, clinicopathological and molecular characteristics as well as data regarding response and clinical outcome were collected. Predictive and prognostic value of PIOS, in terms of progression-free survival (PFS) and overall survival (OS), as well as its association with best overall response (BOR) were investigated in the current study.

Results: Patients with PIOS score over median had statistically significant longer PFS compared to patients with lower PIOS score, not only in univariate (hazard ratio [γR] 0.621, 95% confidence interval [CI] 0.470–0.821, p = 0.001), but also in multivariate analysis, adjusted for clinical stage and PD-L1, (HR 0.651, 95% CI 0.492–0.863, p = 0.003). Similarly to PFS, PIOS score was also associated with OS (p < 0.001), with median OS for the favourable group being 778 days compared to 341 days for the patients with low PIOS score (HR = 0.608, 95% CI 0.482–0.766, p < 0.001). This association remained statistically significant (HR 0.620, 95% CI 0.492–0.783, p < 0.001) after adjusting for cofactor (PD-L1). In addition, PIOS was related to response to immunotherapy with patients presenting disease progression (PD) having lower scores compared to those with stable disease (SD), partial response (PR) or complete response (CR) (p < 0.001). Predictive significance of PIOS score was also proved using a binary logistic regression analysis, adjusted for disease stage and PD-L1 status (p = 0.002, OR 0.578, 95% CI 0.408–0.821).

Conclusions: The results from the current study confirm further the clinical value of PIOS biomarker in patients with aNSCLC treated with nivolumab or pembrolizumab.

THE IMPACT OF THE COVID-19 PANDEMIC ON THE FUNCTION OF A LARGE CANCER HOSPITAL

Andreadis Ch., Douganiotis G., Andreadou A., Fotarelli A., Molyva D., Loulias N., Bleka E., Kamargianni M., Laspa Ch., Lalla E.

3rd Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece

Introduction: The recent Covid-19 pandemic created major problems in Cancer Centers.

Purpose: To assess the impact of the pandemic on the access of cancer patients to healthcare, diagnostic examinations and cancer treatments in the largest Cancer Center of Northern Greece.

Methods: Parameters relevant to the function of Theagenio Cancer Hospital were analyzed for the year 2020 and compared with 2019 and 2018.

Results: The most significant results are summarized in the following table

2018 2019 2020 DIFFERENCE (%)

2019/20 2018/20
ENTIRE HOSPITAL
NEW PATIENTS 9563 9254 6932 −25,1 −27,5
OUTPATIENT APPOINTMENTS 136184 128398 100327 −22 −26,3
PATIENT ADMISSIONS 22402 23286 21309 −8,5 −4,9
EVENING OUTPATIENT APPOINTMENTS 17887 14586 9725 −33,3 −45,6
INTERNAL MEDICINE WARD
PATIENT ADMISSIONS 15481 16148 14924 −7,6 −3,6
MEDICAL ONCOLOGY DEPARTMENTS
OUTPATIENT APPOINTMENTS 26996 26380 22851 −13,4 −15,4
PATIENT ADMISSIONS 7323 7016 6593 −6 −10
ONE−DAY CLINIC 32545 32083 29831 −7 −8,3
EVENING OUTPATIENT APPOINTMENTS 4526 3821 2282 −40,3 −49,6
DEPARTMENT OF RADIATION ONCOLOGY
OUTPATIENT APPOINTMENTS 6990 7802 6808 −12,5 −2,6
RADIOTHERAPY SESSIONS 33195 39265 34952 −11 5,3
PATIENT ADMISSIONS 346 335 230 −32,4 −33,5
SURGICAL WARD
PATIENT ADMISSIONS 6921 7138 6385 −11,6 −7,8
OUTPATIENT APPOINTMENTS 36789 36484 32651 −11,5 −11,3
SURGERIES 6318 6173 5287 −14,4 −16,6
DEPARTMENT OF THORACIC SURGERY 1013 984 1040 5,4 2,5
PAIN CENTER 7982 7541 7307 −3,1 −8,5
SCREENING EXAMINATIONS
BREAST CANCER SCREENING 7839 2048 1044 −49,1 −86,7
GYNECOLOGICAL CANCER SCREENING 5435 3190 1446 −54,7 −73.3
DIAGNOSTIC EXAMINATIONS
CT SCANS 8949 9485 8626 −9,1 −3,6
PET SCANS 1027 1853 1883 1,6 83,3
ENDOSCOPIES 3946 4194 3519 −16,1 −10,8
BRONCHOSCOPIES 138 175 144 −17,7 4,3
DEPARTMENT OF CYTOLOGY 10287 10940 7166 −35,5 −30,3
DEPARTMENT OF PATHOLOGY 15856 16775 17700 1,05 11,6
DEPARTMENT OF NUCLEAR MEDICINE 18718 19689 15233 −22,6 −18,6

Conclusions: The Covid-19 pandemic caused a reduction in the entirety of services offered in the only Cancer Hospital in Northern Greece. The greatest reductions were observed in the number of new patients, outpatients examined, screening examinations and some diagnostic examinations. Medium reductions were observed in the number of hospital admissions, surgeries performed, and cancer treatments.

PALLIATIVE CARE FOR CANCER PATIENTS: A SURVEY ON THE OPINIONS AND CONCERNS OF MEDICAL ONCOLOGISTS IN GREECE

Paraskeva M., Agelaki S., Tsoukalas N., Konstantis A., Kiagia M., Arvanitou E., Rovithi M., Alexaki M., Ardavanis A., Boukovinas I.

On behalf of the Hellenic Society of Medical Oncologists (HeSMO, http://www.hesmo.gr), Athens, Greece

Background: Palliative care (PC) improves the quality of life, the levels of satisfaction and survival of cancer patients. The interest of medical oncologists (MO) in Greece in PC is constantly increasing.

Aim: To record the opinions and concerns of Greek MO regarding PC in Greece.

Methods: From 10 February to 1 March 2021, the Hellenic Society of Medical Oncologists (HeSMO) conducted an electronic survey with the registered members of HeSMO and the Greek young oncologists group (ONEO) regarding the delivery of PC to patients with advanced cancer in Greece.

Results: We received 69 answers (89.6% trained, 17.4% in training, 47.8% women) from those working in public (44.1%), university hospitals (25%) and in private practice (27.9%). Among the trained MO, 51.6% have a working experience ≥10 years. MO always/usually assess (42.7%/41.2%) and always/usually (57.1%/31.2%) reassess the PC needs of their patients. Although nearly all MO agree that PC is essential in cancer management, the majority believe that PC needs are met neither on time (89.9%) nor effectively (95.7%) in Greece. Only 36.3% consider themselves efficient to manage common PC needs of their patients, and 82.6% express interest in attending educational programmes in PC. Moreover, 52.2% and 36.2% consider that ≤20% and 20%–50% of cancer patients, respectively, require specialist PC and 95.7% consider that the organisation of multidisciplinary PC teams at cancer centres is a necessity.

Conclusions: MO consider that PC has a fundamental role in the treatment of patients suffering from advanced cancer, and that PC is not effectively provided in Greece. Promoting training and education of MO and organisation of multidisciplinary PC teams in cancer centres could improve the provided services.

THROMBOPROPHYLAXIS IN ACTIVE CANCER PATIENTS. IS IT A CONTROVERSIAL CLINICAL ISSUE OR NOT? PRELIMINARY RESULTS OF ACT4CAT STUDY

Tsoukalas N., Christopoulou A., Papandreou Ch., Athanasiadis I., Koumarianou A., Peroukidis S., Samelis G., Psyrri A., Kapodistrias N., Kalofonos Ch., Andreadis Ch., Tripodaki E-S., Samantas E., Kentepozidis N., Barbounis V., Mavroudis D., Anastopoulou G., Arvanitou E., Timotheadou E., Papadopoulou P., Nikolaidi A., Kampoli A., Katsouli E., Dimitriadou A., Golfinopoulos S., Mouzakiti A., Nikolakopoulos A., Tzimou M., Perdikari K-X., Giannakou M., Bokas A., Litos I., Sofatzis I., Mala A., Thalassinou P., Assi A., Loulias N., Ardavanis-Loukeris G., Volakakis N., Athanasiadis A., Ardavanis A., Papakotoulas P., Boukovinas I.

On behalf of the Hellenic Society of Medical Oncology (HeSMO, http://www.hesmo.gr/en), Athens, Greece

Background: Cancer Associated Thrombosis (CAT) is an increasing challenge for oncology patients since oncologists sometimes are reluctant to mitigate the risk with thromboprophylaxis. Active cancer patients while receiving chemotherapy have a 7fold risk of thrombosis compared with no cancer patients. Anticoagulation holds a prominent place in prevention of CAT usually with Low Molecular Weight Heparins (LMWHs).

Methods: ACT4CAT is prospective observational study conducted by HeSMO across Greece, aiming to record the clinical practice of CAT prophylaxis in patients with solid tumors. Ambulatory, high thrombotic risk, active cancer patients who received thromboprophylaxis enrolled after signing informed consent.

Results: Preliminary results collected from 18 oncology departments. From 431 enrolled patients 322 (65.4%) had completed the study. Tumor types included: lung 28.8%, gastrointestinal 39.8%, gynecological 7.0%, breast 4.4%, urological 7.0% and others 20%. Majority of patients (88.2%) received High-Risk for Thrombosis Chemotherapy Agents (HRTCAs) such as platinum agents (55.9%), antimetabolites (44.7%) and immunotherapy (12.6%). In 1st line were 62.1%, 2nd line 18.4%, adjuvant 8.9% and neoadjuvant 2.4%. The following table depicts: age, gender, metastatic disease, Khorana score ≥2 and HRTCAs.

Neoplasms Proportions (%) Age (>65) Gender (F) Metastases Khorana score (≥2) HRTCAs
Lung 28.8 57.3 22.6 89.6 59.7 88.5
Pancreatic 21.4 56.5 36.7 87.5 100.0 98.9
Colorectal 11.4 55.1 33.3 81.8 18.4 98.0
Gastric 7.0 66.7 16.7 77.8 100.0 90.0
Ovarian 4.7 60.0 100.0 79.0 70.0 89.5
Cervical 1.2 0.0 100.0 80.0 80.0 100.0
Uterine 1.2 40.0 100.0 100.0 80.0 60.0
Breast 4.4 21.1 94.7 76.5 15.8 68.0
Others 20.0 65.1 18.8 69.7 16.3 75.0

All patients received thromboprophylaxis for 5.3±3.6 months with: tinzaparin 90.8%, fondaparinux 5.5%, bemiparin 1.5%, enoxaparin 1.2%, apixaban 0.5% and rivaroxaban 0.5%. Intermediate doses received 70.9% of patients regardless clinical setting (1st, 2nd, adjuvant & neoadjuvant: 70.2%, 79.2%, 51.3% and 70.0% respectively, p=0.0254), although intermediate doses were used more in metastatic stages (OR:2.4 95%CI: 1.4–4.2, p=0.0028). Nine thrombotic events reported (2.1%, 95%CI: 1.1–3.9%), irrespective of clinical setting but with a trend towards prophylactic doses. Eleven grade 1 bleedings reported (2.6%, 95%CI: 1.4–4.5%), despite clinical setting or dose used.

Conclusions: Thromboprophylaxis in ambulatory active cancer patients with high thrombotic risk is safe and effective. Oncologists are alerted about CAT negative influences in cancer patients’ prognosis. Apart from Khorana score, factors such as metastases, use of HRTCAs and drug-drug interactions influence the clinical decision of thromboprophylaxis in active cancer patients mainly with LMWHs and quite often with intermediate doses regardless clinical setting.

SERUM NEUROFILAMENT LIGHT CHAIN AS A BLOOD BIOMARKER OF SEVERITY IN PACLITAXEL-INDUCED PERIPHERAL NEUROTOXICITY

Karteri S.1, Argyriou A.2, Velissaris D.3, Bravou V.4, Kalofonos H.1

1Oncology Unit-Department of Internal Medicine, University Hospital of Patras

2Neurology Department, Saint Andrew’s General Hospital of Patras

3Department of Internal Medicine, University Hospital of Patras

4Department of Anatomy-Histology-Embryology, Medical School, University of Patras

Background: Serum neurofilament light chain (sNF-L) is a neuron-specific cytoskeletal protein important for cell structural stability. There is compelling experimental evidence that neurofilament light chain (NF-L) could sensitively be detected in serum as a biomarker of neuro-axonal damage induced by chemotherapy.

Aim: We sought to assess the significance of measuring sNF-L in the clinical setting of paclitaxel-induced peripheral neurotoxicity (PIPN).

Methods: We longitudinally measured sNF-L in breast cancer patients, scheduled to receive the 12-weekly paclitaxel-based regimen. Patients were clinically examined by means of the Total Neuropathy Score clinical version (TNSc), while sNF-L was quantified using the highly sensitive Simoa technique before the onset of chemotherapy (T0), after commencing two courses (T1), three courses (T2), at the end of chemotherapy (T3) and 3 months post-treatment (T4).

Results: A total of 24 female patients, having a mean age of 56.6 ± 12.6 (33–78) years, were included. Among them, 10 (41.7%) developed grade 0–1 and 14 (58.3%) developed grade 2–3 PIPN at T3. Analysis of variance (ANOVA) of repeated measures disclosed a significant longitudinal increase in sNF-L levels (pg/mL) from T0 to T3 (T0: 15.3 ± 11.9; T1: 30.1 ± 38.5; T2: 51.5 ± 82.1; T3: 134.9 ± 118.6; p < 0.001) and a drop from T3 to T4 (4 ± 11.3). Patients with grade 2–3 PIPN had significantly increased sNF-L levels at T3, compared to those with grade 0–1 (p < 0.001). Mean levels of sNF-L significantly correlated with TNSc scoring. Logistic binary regression analysis revealed that the difference of sNF-L levels between T1 and T0 independently predicted the manifestation of severe grade 3 PIPN at T3. ROC analysis defined that a discriminative increase of >21.5 in sNF-L levels at T1 versus T0 predicted with a sensitivity of 71% and a specificity of 100% the development of grade 3 PIPN at T3.

Conclusion: sNF-L seems to be a strong biomarker of neuro-axonal injury, while its early increase after two chemotherapy courses (T1) possesses a predictive value of final PIPN severity. Our findings could be relevant for future neuroprotection trials.

PROGNOSTIC ROLE OF CIRCULATING MIRNAS IN NON-SMALL CELL LUNG CANCER (NSCLC) PATIENTS TREATED WITH PLATINUM-BASED CHEMOTHERAPY

Monastirioti A.1, Papadaki C.1, Rounis K.2, Kalapanida D.2, Papakosta V.1, Georgiadou M.2, Vardakis N.2, Mavroudis D.1,2, Agelaki S.1,2

1Laboratory of Translational Oncology, School of Medicine, University of Crete, Heraklion, Crete, Greece

2Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece

Background: MicroRNAs (miRNAs) have been reported to modulate the crosstalk between tumour cells and the immune system. Circulating miRNAs may conclude the systemic response to the tumour, providing in parallel the opportunity for repeated monitoring. Let-7c, miR-26a, miR-30d, mir-98, miR-195 and miR-202 are reported to be involved in the polarisation of macrophages.

Aim: To investigate the expression of miRNAs in the plasma of non-small cell lung cancer (NSCLC) patients treated with first-line platinum-based chemotherapy and their association with patients’ outcome.

Methods: Blood samples were obtained from NSCLC patients (N = 125), prior to the initiation of chemotherapy. Plasma miRNA expression levels were analysed by RT-qPCR and classified as high/low based on the median values.

Results: The median age was 65 years (range: 37–88), 86.4% of the patients were male, 68% of the patients had non-squamous (non-SqCC) histological type, and 26.4% of the patients experienced PR, 39.2% SD and 34.4% PD. High miR-202 expression was associated with disease progression (hazard ratio [HR]: 2.335; p = 0.040) and was revealed as an independent prognostic factor for shorter progression-free survival (PFS; HR: 1.564; p = 0.021) and overall survival (OS; HR: 1.558; p = 0.024) in the whole group of patients. In the non-SqCC subgroup, high miR-202 was also revealed as an independent predictor for shorter OS (HR: 1.989; p = 0.008), while in the SqCC subgroup, only high miR-26a expression was correlated with shorter OS (10.07 vs. 13.53 months, p = 0.033).

Conclusions: The present study is the first to demonstrate the potential role of circulating miR-202 in the prediction of outcome in NSCLC patients treated with platinum-based chemotherapy. Additionally, this study further supports the hypothesis that circulating miRNAs involved in the regulation of the immune response may represent promising biomarkers.

CLINICAL SIGNIFICANCE OF GENE EXPRESSION OF EXOSOME BIOGENESIS PATHWAY IN COLORECTAL CANCER

Kottorou A.1, *, Dimitrakopoulos F.-I.1,2,*, Antonacopoulou A.1, Makatsoris T.1,2, Stavropoulos M.3, Koutras A.1,2, Kalofonos H.1,2

1Molecular Oncology Laboratory, Department of Medicine, University of Patras, Greece

2Division of Oncology, University Hospital of Patras, University of Patras, Greece

3Department of Surgery, University Hospital of Patras, University of Patras, Greece

*Equal contribution

Background: In the last decade, a growing number of studies have shed light on the role of extracellular vesicles, mainly of exosomes, in cancer generally as well as in colorectal cancer (CRC) more specifically. The available published data mostly focus on exosome cargo, while data regarding the pathway of exosome biogenesis in CRC are limited.

Aim: The current study aims to investigate the clinical significance of the exosome biogenesis pathway in CRC, evaluating the expression of the most important molecules, which are implicated in the pathway, and associating them with the clinicopathological parameters and the clinical outcome of the patients.

Methods: Based on the data analysis of publicly available datasets, we selected the most promising molecules of the pathway with potential for clinical impact. Totally, 100 cancerous and 60 adjacent non-neoplastic fresh-frozen tissue specimens were used, which were prospectively collected from CRC patients (stages I–IV), who were surgically managed in the University Hospital of Patras, Greece. mRNA expression of RAB27A (Ras-Related Protein Rab-27A), RAB27B (Ras-Related Protein Rab-27γ), RAB2B (Ras-Related Protein Rab-2B), RAB3B (Ras-Related Protein Rab-3B), RAB9A (Ras-Related Protein Rab-9A), RAB11B (Ras-Related Protein Rab-11B), STX1A (syntaxin 1A) and VAMP7 (vesicle-associated membrane protein 7) genes was assessed in the these samples using real-time qPCR and specific primers and probes and was associated with the clinicopathological parameters as well as with the clinical outcome of patients.

Results: Gene expression of the studied molecules differed significantly between cancerous and non-cancerous tissues, with cancer tissues having lower levels of RAB27A (p = 0.003), RAB27B (p = 0.014), VAMP7 (p = 0.017) and RAB3B (p < 0.001) and higher levels of STX1A (p < 0.001), compared to non-neoplastic, tumour-adjacent tissues. In addition, patients with distant metastases at diagnosis had lower mRNA levels of RAB27A (p = 0.049), RAB27B (p = 0.033) and RAB9A (p = 0.034), compared to patients without distant metastases. Furthermore, patients with increased RAB27A (p = 0.008), RAB9A (p = 0.015), RAB11B (p = 0.011) and STX1A (p = 0.011) expression had favourable 3-year survival, while patients with increased VAMP7 expression had unfavourable 5-year survival (p = 0.022).

Conclusions: The results of this study suggest that biogenesis of exosomes is deregulated in CRC and is possibly implicated in metastasis development.

GENETIC PREDISPOSITION IN PAEDIATRIC CANCER PATIENTS USING NEXT-GENERATION SEQUENCING TECHNOLOGY

Glentis S., Katsibardi K., Andritsou A., Roka K., Filippidou M., Kattamis A.

Pediatric Hematology Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece

Background: The genetic variants of intermediate/high risk, as well as genetic counselling and prevention of cancer in other family members are crucial for the diagnosis, treatment and surveillance of paediatric cancer patients.

Aim/Methods: We aimed to investigate the genetic aetiology of cancer in children and teenagers. Our cohort was composed of 81 patients (31 with haematologic cancer and 50 with solid tumours). Inclusion criteria were family history, rare tumour type or site, relapse or refractory disease. Germline genomic DNA was isolated from the peripheral blood of each patient. Two next-generation sequencing (NGS) panels, covering genes associated with solid or haematologic malignancies and consisting of 155 and 160 genes, respectively, were developed. In-solution hybridisation-based probes were designed using appropriate software (Agilent SureDesing, custom-made panel), and they targeted all the exons of the genes of interest. Sequencing was performed with NGS technology in an Illumina Miseq platform. Raw data processing and analysis was performed with standard bioinformatic tools (BWA-MEM, GATK, VCFtools, VEP). Confirmation and family segregation analysis was performed via Sanger sequencing in the identified Pathogenic (P) and Likely Pathogenic (LP) genetic variants.

Results: We captured 859 (range: 750–950) genetic variants per patient. P/LP variants with a direct link to the phenotype were identified in 6/81 (7.4%) patients. Additionally, in 4/81 (4.9%) patients, we identified heterozygous P/LP variants in genes related to cancer predisposition. but not directly linked to their phenotype. Furthermore, five P/LP variants were detected in five patients, but were not linked to the phenotype and were considered incidental findings. Finally, seven variants of unknown significance (VUS) were detected, for which more investigation to assess a possible pathogenic role is required.

Conclusions: NGS contributes to the investigation of germline pathogenicity in paediatric cancer. A significant number of patients carry genetic variants in genes linked to cancer predisposition. VUS investigation is of great importance and requires further research to determine the possible pathogenic role of the variants.

SERUM NEUROFILAMENT LIGHT CHAIN LEVELS AS BIOMARKERS OF PACLITAXEL-INDUCED COGNITIVE IMPAIRMENT IN PATIENTS WITH BREAST CANCER

Argyriou A.1, Karteri S.2, Velissaris D.3, Kalofonos H.2

11Neurology Department, Saint Andrew’s General Hospital of Patras

2Oncology Unit-Department of Internal Medicine, University Hospital of Patras

3Department of Internal Medicine, University Hospital of Patras

Background: Chemotherapy-induced cognitive impairment (CICI), also called ‘chemobrain’, is a well-established clinical syndrome consisting of moderate to subtle cognitive impairment across various domains of gnosia. This syndrome occurs during and after discontinuation of chemotherapy, but its underlying mechanisms remain largely unknown.

Aim: To assess the utility of serum neurofilament light chain (sNfL) levels in identifying the risk to develop CICI in cancer patients. We also examined if sNfL can be identified as an early biomarker of CICI development.

Methods: We longitudinally measured sNfL levels in 20 female patients with breast cancer, scheduled to receive the 12-weekly paclitaxel-based regimen. An equal number of age-matched female heathy subjects were incuded as the control group. CICI was graded by means of the Montreal Cognitive Assessment scale (MOCA); peripheral neurotoxicity (PN) was graded using the neurosensory Common Criteria for Adverse Events (CTCAE) v5.0, while the sNfL levels were quantified using a high-sensitive technique (Quanterix, Simoa) before the administration of chemotherapy (T0), after three courses (T1) and at the end of chemotherapy (T2).

Results: Pre-treatment sNfL levels were comparable in patients and controls (p = 0.103). At T2, 5/20 patients (mean age 61.4 ± 5.0 years) developed CICI. These five patients also had clinically significant PN. Patients with and without CICI had comparable sNfL values at T2 (p = 0.1). In addition, at T2, the sNfL levels did not correlate significantly with MOCA score in CICI patients (p = 0.604). The difference in sNfL levels between T1 and T0 failed to predict independently the occurrence of CICI at T2.

Conclusion: Our findings do not support the utility of measuring sNfL levels as a biomarker of CICI. Grade 2–3 PN most strongly confounded the outcomes of our study.

PROTOCOLS FOR COMMUNICATING BAD NEWS IN ONCOLOGY

Gkoumas G.,1,2 Vlachothanassi E.,3 Simou E4

11Medical Oncologist, MSc, Agios Savvas Anticancer Hospital, Athens, Greece

2Department of Public Health Policy, School of Public Health, University of West Attica

3RN MSc, Laiko General Hospital, Athens, Greece

4Associate Professor, Mass Media and Health Communication, Department of Public Health Policy, School of Public Health, University of West Attica

Background: Communication between doctor and patient and, in particular, breaking bad news in oncology is a key issue in the doctor–patient relationship. Bad news is any information that can negatively affect a person’s expectations for their present, future and, consequently, their quality of life.

Aim: The purpose of this study was to search the available literature regarding the main protocols used in breaking bad news to oncology patients.

Methods: We performed a systematic review of the literature from 1 to 12 April 2019 in search for related articles, studies, reviews of technical manuals and dissertations related to the topic using an appropriate algorithm in PubMed, regardless of the date, based on the following key words: communication, oncology, delivering bad news.

Results: Four main communication protocols for delivering bad news in oncology patients (SPIKES, ABCDE, BREAKES, PEWTER) and their adaptations in different countries according to the culture of each country’s people were identified. The use of an appropriate communication protocol for breaking bad news helps doctors to inform patients, reducing the stress and psychological burden of patients and doctors. Communication becomes more effective, anthropocentric and leads to the development of trust and a strong therapeutic bond between patient and physician, resulting in better treatment plan design and increased patient satisfaction with the medical services provided and respect for its individuality.

Conclusion: Breaking bad news in cancer patients must be done in a specific and structured way based on specific steps that are described in detail in the international protocols for the communication of bad news. There are differences and discrepancies in each protocol of announcing bad news. Most authors emphasise the importance of these protocols as well as the need to integrate them into daily clinical practice.

Keywords: communication, oncology, delivering bad news.

MEDICAL ONCOLOGISTS’ PRACTICES REGARDING PATIENT’S GENDER AS A DIFFERENTIATING FACTOR OF THEIR THERAPEUTIC APPROACH

Levva S.1,2, Sogka H.3, Skolariki A.3, Gkoura S.4, Tripodaki H.S.5, Stafylas P.6, Assi A.7, Goumas G.8, Dimitriadis I.7,9, Stoupis I.10, Loga K.3, Kyriazoglou A.11, Tsironis G.12, Gavriatopoulou M.13, Boukovinas I.1,2

1Department of Medical Oncology, Bioclinic, Thessaloniki

2Department of Medical Oncology, Interbalkan Medical Center, Thessaloniki

3Medical Oncology University Clinic, AUTH, “Papageorgiou” Hospital, Thessaloniki

4Medical Oncology University Clinic, UoI, Ioannina

5“Agios Savvas” Hospital, Athens

6Scientific Director, HealThink, Thessaloniki

7Department of Medical Oncology, Errikos Dynan Hospital, Athens

82nd Internal Medicine Clinic, “Agios Savvas” Hospital, Athens

9Department of Medical Oncology, Hospital Athens

11Department of chemotherapy, General Hospital of Rethymno

122nd Internal Medicine Clinic, Attikon University Hospital, National and Kapodistrian University of Athens

13Department of Medical Oncology, Nicosia General Hospital, Cyprus

14Therapeutic Unit, Hematology / Oncology University Clinic, Alexandra General Hospital, National and Kapodistrian University of Athens

Introduction: The importance of gender as a determinant of disease biology and treatment effectiveness is well known in some fields of medicine, but remains a poorly studied factor in oncology.

Aim: HeGYO created a questionnaire, in order to record whether the patient’s gender is a differentiating factor of Medical Oncologists’ therapeutic approach.

Method: The questionnaire was distributed to the members of HeSMO and HeGYO through an electronic platform and consisted of 22 questions, which concerned physicians’ demographic data and their practices regarding the management of their patients by gender. Statistical analysis was performed using Chi-Square and Fischer’s exact test, using the R programming language.

Results: 105 physicians answered the questionnaire, 79% of whom where specialized and 56% men. The majority of oncologists in a typical week see an equal number of female and male patients (67.9%), do not take gender as a factor in differentiating their therapeutic approach (73%), devote the same time to each patient in the first (83.8%) and in a standard visit for treatment (82.8%), do not modify the medication according to gender (84%) and consider that the occurrence of side effects is gender independent (67%). However, older doctors consider side effects to be more common in women (P = 0.05). 58% consider women patients more anxious, while 50% administer more frequent anxiolytics to them. Oncologists <45 years old discuss fertility and reproduction issues more often with women (P = 0.01). Finally, adherence to medical recommendations (52%) and consistency in follow-up appointments (59%) are gender independent.

Conclusions: Gender as a differentiating factor of cancer patients’ therapeutic approach is a new field of study, promoting personalized medicine and highlighting the peculiarities that arise from the different biology and psychology that accompanies each patient.

THE EFFECT OF ART THERAPY ON ONCOLOGY PATIENTS

Stamatopoulou E.1, Tsilias D.2, Valassi L.3, Valassi S.4, Antonakou A.5, Stamatopoulou A.6

1PhD(c), M.Sc-MPH National School of Public Health, M. Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.

2RN, MSc Clinical Pediatrics & Nursing-Research General Children’s Hospital of Athens P. & A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.

3Graduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.

4Graduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.

5‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.

6PhD(c), Economist, M. Sc. International Business Administration, M. Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica

Background: Research on the effectiveness of artistic therapy has been studied in recent years.

Purpose: To investigate the effect of art therapy on oncology patients.

Methods: The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed in the electronic database PubMed with the following keywords: art therapy oncology patient from 2011 onwards.

Results: Art therapy includes dance, movement, music therapy and art therapy that involves visual art materials and paintings. The creative process of art, as a path of non-verbal expression, enhances life and provides relief. Studies in cancer patients have shown that artistic therapy leads to increased self-awareness, improved ability to cope with symptoms such as stress and traumatic experiences, personal development, social interaction, improvement in mental health and quality of life. Art painting therapy reduces the fatigue levels during radiotherapy in cancer patients. In patients undergoing radiation therapy, participating in art therapy interventions supports the emotional, psychological and spiritual needs of patients. In addition, patients receiving chemotherapy are reported to have reduced anxiety, depression, stress and pain. Existing studies show that art therapy has benefited, and improved, quality of life by reducing stress, depression and anxiety in women with genital cancer. Further qualitative studies should be conducted to investigate the results of art therapy in oncology patients with adequate samples, various art forms and patient biomarker assessment to draw safe conclusions and application.

Conclusions: Art therapy is used as a psychosocial intervention to relieve patients’ symptoms, which can improve the physical, mental and emotional well-being of cancer patients.

THE EFFECT OF MUSIC THERAPY ON PAEDIATRIC PATIENTS

Stamatopoulou E. 1, Tsilias D.2, Valassi L.3, Valassi S.4, Antonakou A.5, Stamatopoulou A.6

1PhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.

2RN, MSc Clinical Pediatrics & Nursing-Research General Children’s Hospital of Athens P. & A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.

Background: Clinical trials recommend music therapy as a complementary, psychosocial intervention to both paediatric oncology patients and caregivers during treatment.

Aim: To investigate the effect of music therapy on paediatric oncology patients.

Methods: The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed in the online PubMed database with the following keywords: oncology pediatric patients effect music therapy from 2008 onwards.

Results: According to the literature review, caregivers of children and adolescents hospitalised in the marrow transplant unit considered music therapy as a positive, beneficial, effective, complementary intervention. The song lyrics, melody listening and music video with preferred photos resulted in a courageous treatment of the disease and increased resilience of hospitalised children and adolescents/young adults with cancer undergoing haematopoietic stem cell transplantation. Rehabilitation in the unit enhanced the understanding of parents’ feelings, social interaction and cooperation of children, helped to minimise the effects of isolation, negative mood, reduced activity and reinforcement and helped in normalisation of negative experiences that the disease imposed in early childhood. Music therapy also supported the improvement of the health-related quality of life of children undergoing allogeneic haematopoietic stem cell transplants in the marrow transplant unit, according to the rating scale. HRQoL and PedsQL pilot study for children aged 3.5–4.5 years, expand the results of music therapy and report the reception of salivary and blood cortisol levels as a biomarker of stress by hospitalised children undergoing haematopoietic cell transplantation and their accompanying parents supported by music therapy for the objective assessment of its results.

Conclusions: The results of the music intervention in paediatric oncology patients show that the documented application proves to enhance their well-being.

EWING’S SARCOMA IN CHILDREN AND ADOLESCENTS: A SINGLE-CENTRE EXPERIENCE

Rigatou E., Tourkantoni N., Tsipou Ch., Roka K., Kattamis A.

University Oncology and Hematology Unit, National and Kapodistrian University of Athens, 1st Department of Pediatrics, ‘Agia Sofia’ Children’s Hospital, Athens

Background: Ewing’s sarcoma (ES) is the second most common bone malignancy in both children and adolescents. Upon diagnosis, 30% of patients already have metastases. In the last three decades, the use of local therapy (surgery ± radiotherapy) and systemic chemotherapy has significantly increased survival.

Aim: In this study, we present the unit’s recent experience in treating children and adolescents with ES.

Methods: Patients with ES treated at the University Oncology Hematology Unit during the years 2012–2020 were retrospectively analysed. A total of 25 patients (M = 16, F = 9) with a mean age at diagnosis of 11 years (1–16) were treated. Three (12%) had multifocal disease, three (12%) had pulmonary metastases and 19 (76%) had localised disease.

Results: All patients (100%) received systemic chemotherapy according to the following protocol: AEWS0031, EUROEWING 99, EUROEWING 2012. Local control of the disease was achieved with surgery (100%) and radiation (80%). Three patients (12%) received megatherapy and autologous stem cell transplantation. With an average follow-up of 4 years, 18 patients are alive (overall survival 72%). Among survivors, 16/18 patients (64%) are in complete remission, 1/18 (4%) has stable disease and 2/18 (8%) have relapse/disease progression. Patients with relapse or disease progression are those with multifocal/metastatic disease at diagnosis. A key survival factor was the presence of metastases at diagnosis, with a survival rate of 33.3% (2/6 patients) versus 84% (16/19 patients). All patients completed treatment without irreversible toxicity.

Conclusions: ES is an aggressive tumour with a high recurrence rate and metastatic potential. Survival ranges from 60% to 80% for patients with localised disease treated with combination therapy. Patients with metastatic disease have a 4-year survival of0 30%. The survival rates in the present study are according to the current literature. This indicates the need for further improved therapeutic approach for patients with metastatic/multifocal disease.

CORRELATION BETWEEN IMMUNE-RELATED TOXICITY AND EFFICACY OF IMMUNOTHERAPY IN SECOND OR LATER LINE TREATMENT OF NSCLC

Stefanou D., Mitsogianni M., Kotteas E., Charpidou A., Gkiozos I., Ntalakou E., Syrigos K.

Oncology Unit, 3rd University Clinic for Internal Medicine, ‘Sotiria’ Hospital, Medical School of the University of Athens

Background: Immunotherapy is an established treatment in the second and later line for patients with non-small cell lung cancer (NSCLC) who did not receive it in the first line. Despite its high efficacy, there are patients who do not respond or achieve only short-term responses. Various efforts have been made to establish the predictive factors of efficacy of immunotherapy.

Aim: Aim of the study is to examine whether there is a connection between immune-related toxicity and efficacy of immunotherapy.

Methods: Patients with NSCLC receiving immunotherapy beyond first line in our clinic over a period of 3 years were included in the analysis. Besides demographics, we collected data concerning efficacy and toxicity of immunotherapy.

Results: One hundred and ninety-six patients were included in the study. Immune-related adverse events occurred in 32.1% of the patients, with skin toxicity (29%) and hypothyroidism (27.4%) occurring more often. Toxicity was grade ≥3 in 9.5% of immune-related adverse events. Treatment with corticosteroids was administered in 31.7% of the patients presenting with toxicity, while discontinuation of immunotherapy was necessary in 14.3% of them. Toxicity of any grade led to longer progression-free survival (13 vs. 3 months, p < 0.001) and duration of response (not reached vs. 8 months, p = 0.003). On the other hand, there was no connection between type and grade of toxicity, hold or discontinuation of immunotherapy or corticosteroid treatment and efficacy of immunotherapy (p > 0.05).

Conclusions: Our study suggests that immune-related toxicity leads to prolongation of progression-free survival and duration of response, while toxicity type and grade, treatment hold or discontinuation and corticosteroids do not have an impact on the therapeutic outcome.

CORRELATION BETWEEN CANCER AND SERIOUS COMPLICATIONS OF SARS-COVID-19

Chatzinikolaou A.1, Lavdaniti M.2

1Postgraduate student, Nursing Department, International Hellenic University, Thessaloniki

2Associate Professor, Nursing Department, International Hellenic University, Thessaloniki

Background: Cancer is a genetic disease in which the characteristics and functions of normal cells have been altered and is considered as one of the leading causes of death worldwide. COVID-19 causes severe acute respiratory syndrome and has emerged as a new infection that has spread rapidly around the world. It poses a serious threat to the health of vulnerable populations, such as patients with malignancies and immunosuppression.

Methods: A literature review was conducted using the electronic databases PubMed and Google Scholar with the keywords ‘cancer’, ‘COVID-19’, ‘patients’, ‘severe implications’ and a combination thereof. Non-English articles were excluded. Twenty-five articles on the subject were used. The review concerned the last 5 years.

Aim: The aim of this review was to investigate the association between cancer and the complications caused by the COVID-19 virus.

Results: Cancer patients are at high risk for SARS-COVID-19 virus disease, as studies have shown that they are more prone and more susceptible. The patient’s age, treatment history and possible underlying diseases play an important role as they are crucial factors in the prognosis of infection in cancer patients. Also, their weakened immune system significantly increases the risk of developing an infection, which may be caused either by the community or by the hospital environment. Finally, the infection of cancer patients with the SARS-COVID-19 virus has been associated with a rapid worsening of symptoms, the occurrence of serious complications, an increase in admissions to intensive care units and a possible deterioration of their condition, which may even lead to death.

Conclusions: COVID-19 virus is a dangerous infection for patients with chronic and serious underlying diseases, such as cancer. Proper information, protection, safety and care of cancer patients during the pandemic should be a priority and the main concern of health professionals.

‘BIG-DATA’ AND MACHINE LEARNING ALGORITHMS TO PREDICT EARLY AND LATE MORTALITY IN CRITICALLY ILL PATIENTS WITH CANCER

Danilatou V.1, Mavroidis D.2, Tzagarakis C.2, Antonakaki D.2, Kanterakis A.2, Kostoulas T.3

1Sphynx Technology Solutions

2Foundation for Research and Technology-Hellas (FORTH)

3University of the Aegean

Background: Patients with cancer hospitalised in Intensive Care Units (ICUs) suffer from high mortality rates. Current prognostic models predict only in-hospital mortality based on first day information, whereas late mortality is hardly predicted. Modern medical databases contain a huge amount of time series data that remain unexploited since classic statistical methods are unable to manage them.

Aim: Exploring the use of automated machine learning algorithms (auto-ML) to predict early and late mortality (months m0, m1, m3, m6, m12, m > 12) in ICU patients with cancer.

Methods: Exactly 5,691 ICU patients (>15 years old) with cancer from MIMIC-III database (median age 67 years old) were studied. Exclusion criteria: do not resuscitate (DNR) code = 358 and pregnancy = 15. Patients were grouped according to their outcome; 902 died early in hospital, 2,659 died later (median time 1.19 years) and 1,757 recorded as survivors in the database. Overall, 1,752 features were collected (including demographic, clinical, laboratory, medications, procedures, known medical scores and free-text medical notes with natural language processing). Prediction models were built based on the web-based platform JADBio. Several different algorithms such as Random Forests, Support Vector Machine and Logistic Regression have been applied with a new protocol called bootstrap bias-corrected cross-validation and hyper-parameter tuning, which is relatively conservative during performance estimation.

Results: Random Forests was the best performing model for mortality prediction (overall area under the curve [γUC] = 0.83). In detail, the AUC for months m0–m > 12 were 0.94, 0.88, 0.84, 0.78, 0.76 and 0.74, respectively. γest-budgeted Statistically Equivalent Signature algorithm revealed the following features with predictive significance: GCS scale, γPSIII score, sepsis, systolic arterial blood pressure, RDW, first day respiratory rate, SpO2, coexistence of metastatic cancer and red cell transfusions.

Conclusion: Prediction of late mortality in ICU patients with cancer is difficult. The use of ‘big-data’ and auto-ML outperforms classic prognostic models. Identification of explainable, clinically meaningful features will help clinicians in decision-making process. RDW could be a rediscovered, easily applied biomarker, since it has been previously shown that it correlates with ICU mortality and cancer stage. Further external validation in other databases is necessary.

THE IMPACT OF THE ADDITION OF CARBOPLATIN TO NEOADJUVANT CHEMOTHERAPY IN TRIPLE NEGATIVE BREAST CANCER

G. Douganiotis1, L. Kontovinis2, A. Pouptsis2, A. Ainali2, I. Natsiopoulos3, K. Papazisis2,3

13rd Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece

2Medical Oncology Department, Euromedica General Clinic, Thessaloniki, Greece

3Breast Cancer Unit, Interbalkan Medical Center, Thessaloniki, Greece

Introduction: Chemotherapy remains the only treatment option for patients with early triple negative breast cancer. One of the combinations that has been suggested in order to improve efficacy is the addition of carboplatin to the standard of care chemotherapy regimen of an anthracycline plus a taxane.

Methods: Data from the medical records of Oncomedicare were retrospectively collected. The analysis included all patients with early triple negative breast cancer who received neoadjuvant chemotherapy in the time period between 2010 and 2020. Pathologic responses following neoadjuvant treatment and patient survival data (disease-free survival, overall survival) were also recorded.

Results: A total of 70 patients were included in the analysis. All patients were included who received neoadjuvant chemotherapy, with or without the addition or carboplatin, for whom histology reports from the final surgery were available. The median age of the patients was 44 years, and the median follow-up was 2.3 years. Testing for the presence of germline mutations was performed in 47 patients, 11 of which had a mutation in BRCA1, BRCA2 and other three genes (PALB2, CHEK2, CDKN2A). A complete pathologic response (pCR) following neoadjuvant chemotherapy was recorded in 39 patients (55.7%). Of the 70 patients, 31 received carboplatin in addition to the standard neoadjuvant chemotherapy regimen, and 39 did not. The rate of pCR was higher in the patients who received carboplatin (21/33 patients, 67.7%) compared to those who did not (17/39 patients, 43.6%). Of the 11 patients with mutations in BRCA1/2, 9 recorded a pCR, one had a micrometastasis in one lymph node, and one had residual disease. The achievement of a pCR was an important favorable prognostic factor of disease-free survival (DFS: HR 0.086, 95% CI 0.025–0.301, p=0.0029) as well as overall survival (OS: HR 0.125, 95% CI 0.028–0.559, p=0.0209).

Conclusions: The addition of carboplatin significantly increased the rate of pathologic complete response following neoadjuvant chemotherapy and constitutes a potential treatment option in patients with early triple negative breast cancer.

There was a greater benefit in patients over 40 years of age (p=0.056) and patients with high Ki-67 (p=0.046)

THYROID ABNORMALITIES IN CHILHDOOD CANCER SURVIVORS

Katsibardi K.1, Vlacou A.1, Nitsa E.1, Avgerinou A.1, Roka K.1, Tourkantoni N.1, Rigatou E.1, Filippidou M.1, Tsipou H1, Bacopoulou F.2, Kanaka-Gantenbein C.3, Kattamis A.1

11Pediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sofia” Children’s Hospital, Athens, Greece.

2Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, Greece.

3Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sofia” Children’s Hospital, Athens, Greece.

Introduction: Thyroid complications in pediatric cancer survivors are common and may present as thyroid dysfunction or thyroid carcinoma.

Aim/Methods: Thyroid function of children treated for pediatric cancer were evaluated retrospectively, within a 6-year period. Therapy was calculated as a category variable; chemotherapy, and or radiation. Hypothyroidism was considered as category value; TSH >5 μIU/mL and TSH<5 μIU/mL. Univariable logistic regression analysis performed to investigate association between hypothyroidism and therapy. Statistical analysis performed with RStudio version 3.6.2. P value <0 .05 was considered statistically significant.

Results: A total of 61 long-term adolescent survivors, 59.0% (N=36) males and 41.0% (N=25) females were longitudinally followed. The follow-up duration was 3.7 years (range 1.7–6.7 years). The median age of treatment was 11.6 years (range 6.6 to 19.2 years). Among them, 28/61 (45.9%) had leukemia, 17/61 (27.8%) lymphoma, 7/61 (11.7%) brain tumor and 9/61 (14.6%) other tumors. Median value of TSH and FT4 was 2.5 μIU/mL (range 0.05–8.2) and 13.4 pmol/L (range 0.35–17.4), respectively. One patient that presented TSH value from 125–147 μIU/mL under relapse treatment for lymphoma was excluded from the present study. Nine patients (15.0%) had hypothyroidism. Minimum/maximum observed time for hypothyroidism was 0.38/5.2 years after treatment completion. Radiation treatment was significantly associated with hypothyroidism (O.R=5.8;95%, C.I (1.3–26.1); p=0.02, 35.71% vs 8.7%). Thyroid lesions, such as cysts-nodules had 6 (10.0%) adolescent survivors. Ten (16.7%) and 4 (6.7%) patients had one and two thyroid parenchymal abnormalities, respectively, while 46 (76.7%) patients had normal thyroid parenchyma. Substitution treatment with levothyroxine was necessary in 10/61 (16.6%) survivors. Most of the patients 60/61 had negative antithyroid antibodies.

Conclusion: Thyroid sequelae resulting from radiation therapy may manifest only after years to decades of follow-up, and their resultant clinical symptoms may be indolent. Life-long monitoring of pediatric cancer survivors for thyroid function is paramount.

CURECANCER DIGITAL PLATFORM IN THE ROUTINE CLINICAL ONCOLOGY PRACTICE FACILITATES PATIENTS’ SELF-DATA RECORDING, COMMUNICATING WITH HEALTHCARE PROFESSIONALS, TREATMENT ADHERENCE AND ‘DISTANCING INTERVENTIONS’ DURING COVID-19 AND REDUCES COSTS – A FEASIBILITY AND SATISFACTION STUDY

Galiti D.1, Agelaki S.2, Karampeazis A.2, Linardou H.2, Tsoukalas N.2, Bamias A.2, Psyrri A.2, Karamouzis M.2, Syrigos K.2, Ardavanis A.2, Athanasiadis I.2, Arvanitou E.2, Sgourou S.2, Kouloulias V.2, Zygogianni A.2, Georgopoulou E.2, Mala A.2, Vallilas C.2, Evangelou G.2, Kokkali S.2, Nikolaidi A.2, Papadopoulou P.2, Nicolatou-Galitis O.1, Boukovinas I.2

1CureCancer, Athens, Greece

2Hellenic Society of Medical Oncology, Athens, Greece

Aim: We assessed CureCancer’s feasibility and patients’ and HCPs’ satisfaction. CureCancer is a patient-centric/driven platform, which enables patients to self-create their profile, report symptoms and communicate with physicians.

Methods: Patients from 18 centres were asked to register at CureCancer, upload their data and complete a questionnaire on demographics, disease and treatment characteristics and their satisfaction.

Results: One hundred and fifty-nine patients were enrolled and 144 (90.6%) registered; 114 of 144 (79.1%), 63 males and 51 females, with a median age 54.5 years, completed the questionnaire. Sixty-four patients were university graduates and 35 were high school graduates. Forty-six patients had metastatic disease, 87 were on active treatment and 51 received supportive care. All patients also visited non-oncology HCPs. Nineteen patients changed their work status and 49 had children below 24 years.

Registration was ‘very/very much’ easy for 98 (86.0%) patients. File uploading was ‘very/very much’ easy for 47 (41.2%) patients. Over 80% of patients and physicians preferred the digital way. Ninety-nine patients and all HCPs will recommend CureCancer to others. Easy data access, improved communication, feeling safe, treatment adherence, interventions from distance, particularly during COVID-19 pandemic, and saving time and money were highly commented by patients and HCPs.

Conclusion: CureCancer was feasible, and patients and HCPs were satisfied. File uploading changed to become more user friendly. Integration of CureCancer in the routine practice is expected to improve cancer care and reduce cancer costs. Patients’ self-reporting, with CureCancer, can increase the accuracy of clinical trial results and map social/work/economic issues following cancer diagnosis to assist healthcare policy.

THE EFFECT OF THE ART THERAPY ON PAEDIATRIC ONCOLOGY PATIENTS

Stamatopoulou E.1, Tsilias D.2, Valassi L.3, Valassi S.4, Antonakou A.5, Stamatopoulou A.6

1PhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.

2RN, MSc Clinical Pediatrics & Nursing-Research General Children’s Hospital of Athens P. & A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.

3Graduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.

4Graduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.

5‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.

6PhD(c), Economist, M.Sc. International Business Administration, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica.

Background: Childhood cancer involves long periods of hospitalisation that cause feelings of fear and sadness, where they have a significant impact on the well-being and quality of life of paediatric oncology patients.

Purpose: To investigate the effect of art therapy on paediatric oncology patients.

Methods: The method followed is secondary as it draws on research and studies by experts. A literature search was performed in the online database PubMed with the following keywords: art therapies effect oncology pediatric cancer patients.

Results: Art therapy includes a set of activities like dance, movement, music, art, laughter therapy, theatre, play and poetry, and studies report a positive effect on the well-being of oncology paediatric patients. Studies on artistic therapeutic intervention with dance/movement, music and graphic arts report positive results in children’s pain, taste and food intake during chemotherapy. Study of oncological children who underwent diagnostic procedures such as bone marrow aspiration, lumbar puncture and treatment participated in art therapies with medical play, free drawing and theatre to reconcile with the change of body image. Children who received a session from the very first hospitalisation showed cooperative behaviour. The parents expressed their ability to better manage the painful processes of caring for their children with art therapy. In paediatric oncology, interactive music therapy reduced stress, anxiety and pain by increasing communication, cooperation, participation in play activities during hospitalisation with a beneficial effect on the well-being of children with cancer. Gaming therapy promotes mental, emotional and social development. A recent study reports that the use of new gaming technologies such as HabitApp increases the levels of affection, love, physical activity and social interaction in the paediatric oncology unit.

Conclusions: In paediatric oncology, art therapy has a significant positive effect on pain, facial expression, nervousness and stress.

ASSESSMENT OF THE CARDIAC SAFETY AND EFFICACY OF NEOADJUVANT CHEMOTHERAPY WITH EPIRUBICIN AND CYCLOPHOSPHAMIDE FOLLOWED BY DOCETAXEL IN COMBINATION WITH DUAL ANTI-HER2 TREATMENT IN WOMEN WITH EARLY HER2-POSITIVE BREAST CANCER

G. Douganiotis1, S. Grigoriadis2, E. Markopoulou2, L. Kontovinis2, A. Pouptsis2, K. Papazisis2

13rd Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece

2Medical Oncology Department, Euromedica General Clinic, Thessaloniki, Greece

Introduction: Dual HER2 targeting (trastuzumab+pertuzumab) has become the standard of care in the neoadjuvant treatment of patients with HER2-positive breast cancer. Given the potential cardiotoxicity of both the chemotherapy used (anthracyclines) and the anti-HER2 monoclonal antibodies, concerns exist regarding the cardiac safety of this combination regimen.

Methods: Data from the medical records of Oncomedicare were retrospectively collected. The analysis included all patients with early HER2-positive breast cancer who received neoajuvant chemotherapy with 4 cycles of epirubicin / cyclophosphamide (90 / 600 mg/m2) and 4 cycles of docetaxel (90mg/m2), trastuzumab and pertuzumab in the time period between 2014 and 2020. Patients additionally received adjuvant anti-HER2 treatment for one year where indicated. Following the regulatory approval of TDM-1, patients with residual disease received TDM-1 as adjuvant anti-HER2 treatment. The evaluation of cardiac function was performed with serial transthoracic ECHO and measurement of the Left Ventricle Ejection Fraction (LVEF). Pathologic responses following neoadjuvant treatment were also recorded.

Results: A total of 55 patients were included in the analysis, with a median age of 50 years at diagnosis and a median cardiological follow-up of 2.61 years following treatment. A total of 283 echocardiograms were performed. There was a consistent drop in LVEF values during treatment, which was not significant enough to necessitate treatment interruption. The values then consistently improved during follow-up. There were no cases of symptomatic heart failure, and there was only one recorded case of asymptomatic LVEF drop > 10%. A complete pathologic response was recorded in 64.8% of patients, with a higher rate for ER-negative patients (90%) than ER-positive ones (50%), a difference which was statistically significant and is consistent with the results from the relevant randomized clinical trials.

Conclusions: This data shows the long-term cardiac safety of this combination regimen in clinical practice and confirms both its safety and efficacy in patients with early HER2-positive breast cancer.

REAL-WORLD DATA: COMPARATIVE EFFICACY OF IMMUNE CHECKPOINT INHIBITORS IN PRETREATED PATIENTS WITH NSCLC

Mitsogianni M., Stefanou D., Charpidou A., Mani M., Gkiozos I., Syrigos N., Kotteas E.

Oncology Unit, 3rd University Clinic for Internal Medicine, ‘Sotiria’ Hospital, Medical School of the University of Athens

Background: Immune checkpoint inhibitors are standard treatment options of patients with non-small cell lung cancer (NSCLC) who did not receive first-line immunotherapy, often leading to long-term responses. Nevertheless, the efficacy of various immunotherapeutic agents has not been directly compared in a randomised clinical trial, while retrospective studies are also limited.

Aim: The aim of the study is to determine possible superiority in the efficacy of pembrolizumab and nivolumab in patients with NSCLC beyond first-line treatment.

Methods: Pretreated patients with NSCLC receiving immunotherapy with pembrolizumab or nivolumab in our clinic in a period of 3 years were retrospectively analysed. We collected demographic data, disease control rate, progression-free survival and duration of response.

Results: One hundred and ninety-six patients were included in the analysis; 46 (23.5%) received pembrolizumab and 150 (76.5%) received nivolumab. Baseline demographic and clinical characteristics did not differ significantly between the two groups (p > 0.05). It has to be noted that there were no patients without PD-L1 expression in the pembrolizumab group. There were no differences in disease control rate (54.3% vs. 49.4%, p = 0.252), progression-free survival (5.0 vs. 4.0 months, p = 0.520) and duration of response (not reached vs. 11.0 months, p = 0.662) between the two groups.

Conclusions: According to our findings, the efficacy of pembrolizumab and nivolumab does not differ significantly in pretreated patients with NSCLC.

THE IMPACT OF ADJUVANT RADIATION THERAPY AND EARLY SALVAGE RADIOTHERAPY AFTER RADICAL PROSTATECTOMY – ONE SINGLE-SITE EXPERIENCE

Fotopoulou E., Plohorou M., Gkirlemis K., Soulimioti G., Maravelis I., Tzorakakis S., Athanasiou E.

“Agioi Anargiroi” General Oncology Hospital, Department of Radiotherapy Oncology

Background: Prostate cancer with adverse pathological features (i.e. pT3 and/or positive margins) after prostatectomy may be treated either with adjuvant radiotherapy (ART) or surveillance followed by early salvage radiotherapy (ESRT) for biochemical recurrence.

Aim: To study the impact of postoperative ART and ESRT administered to patients with prostate cancer with adverse pathological features after radical prostatectomy.

Methods: Forty-seven patients received ART within a year after radical prostatectomy. Three of them with lymph nodes metastasis who received hormone deprivation therapy were excluded. Four patients presented pT2N0M0/R1 disease, 23 patients pT3N0M0/R1 and 17 patients pT3N0M0/R0 excision. All patients, except four at the time of referral for radiotherapy (RT), were already under androgen deprivation therapy. According to postoperative PSA, patients were divided into two groups: a) patients with undetectable postoperative PSA (<0.2 ng/ml) who received adjuvant RT and b) patients who received ESRT and PSA (>0.2 ng/ml). For all patients, RT was performed using three-dimensional conformal RT (3D-CRT) at a dose of 60–64 Gy and a fractional dose of 2 Gy. Surveillance to biochemical recurrence was started from the date of surgery.

Results: From 44 followed patients, 20 had undetectable PSA (median value 0.04 ng/ml) and undergone γRT within 24 weeks from surgery. PSA for 24 of them was between 0.16 and 0.81 ng/ml (median value 0.38 ng/ml) and they were managed with ESRT, with the median time from surgery being 32 weeks (range 28–48 weeks). Median age was 65 years (53–77 years). Median time of follow-up was 48 months (24–84 months). From the ART group, all patients presented no biochemical recurrence until the time of submission. From the ESRT group, three patients (12.5%) presented with progressive increase of PSA.

Conclusions: Results regarding postoperative RT in our department are in agreement with international data. Concerning the second group of patients, the addition of ESRT was also beneficial as in the first group. More clinical data from randomised controlled studies are necessary in order to clarify the optimal postoperative RT approach, ART versus ESRT.

A SYSTEMATIC REVIEW AND META-ANALYSIS OF ADJUVANT THERAPY FOR HIGH-RISK CUTANEOUS MELANOMA IN THE POST INTERFERON-ALPHA ERA

Christofyllakis K1, Pföhler C2, Bewarder M1, Müller C S.L.2, Thurner L1, Rixecker T1, Vogt T2, Stilgenbauer S1, Yordanova K2 and Kaddu-Mulindwa D1

1Department of Hematology, Oncology, Clinical Immunology and Rheumatology Medical School, University of Saarland, Germany

2Department of Dermatology, Venerology and Allergology Medical School, University of Saarland, Germany

Background: Several agents are approved in the adjuvant setting of completely resected high-risk (stage IIC–IV) cutaneous melanoma. Subgroups may benefit differently depending on the agent used. Meta-analyses addressing this question are lacking.

Aim: To evaluate the efficiency and tolerability of available treatment agents in modern adjuvant therapy of cutaneous melanoma in the total population and across the following subgroups: patient age, stage, ulceration status, lymph node involvement, BRAF status.

Methods: We performed a systematic review and meta-analysis of the currently available data. The PubMed and Cochrane Library databases were searched without restriction in year of publication in June and September 2020. Data were extracted according to the PRISMA guidelines from two authors independently and were pooled according to the random-effects model. The predefined primary outcome was recurrence-free survival (RFS).

Results: After quality control, five prospective, randomised, placebo-controlled trials were included in the meta-analysis. The drug regimens included ipilimumab, pembrolizumab, nivolumab, nivolumab/ipilimumab, vemurafenib and dabrafenib/trametinib. Adjuvant treatment was associated with a higher RFS than placebo (hazard ratio [HR] 0.57; 95% confidence interval [CI] = 0.45–0.71). Nivolumab/ipilimumab in stage IV completely resected cutaneous melanoma was associated with the highest RFS benefit (HR 0.23; 97.5% CI = 0.12–0.45), followed by dabrafenib/trametinib in stage III BRAF-mutant melanoma (HR 0.49; 95% CI = 0.40–0.59). The presence of a BRAF mutation was associated with higher RFS rates (HR 0.30; 95% CI = 0.11–0.78), compared to the wildtype group (HR 0.60; 95% CI = 0.44–0.81). Patient age did not influence outcomes (≥65: HR 0.50; 95% CI = 0.36–0.70, <65: HR 0.58; 95% CI = 0.46–0.75). Immune checkpoint inhibitor monotherapy was associated with lower RFS in non-ulcerated melanoma. Patients with stage IIIA benefited equally from adjuvant treatment as those with stage IIIB/C. Nivolumab/ipilimumab and ipilimumab monotherapy were associated with higher toxicity.

Conclusion: Adjuvant therapy should not be withheld on account of advanced age or stage IIIA alone, as treatment benefit is maintained in these subgroups. The presence of a BRAF mutation is prognostically favourable. BRAF/MEK inhibitors should be preferred in the adjuvant treatment of BRAF-mutant non-ulcerated melanoma.

SARCOID-LIKE REACTION: A DIAGNOSIS ATTRIBUTED TO HER2 TREATMENT

Andreadou A.1, Moliva D.2, Bleka Ev.2, Panagiotidis Em3, Andreadis Ch.4

1Consultant, medical Oncologist, 3rd department oncology clinic, Theagenio hospital

2Intern of medical oncology, 3rd department oncology clinic, Theagenio hospital

3Consultant, nuclear medicine, Theagenio hospital

4Chair of the 3rd department oncology clinic, Theagenio

Introduction: Novel targeted treatments have various side effects, some of which are autoimmune. Sarcoidosis is a disease that can be attributed to immunotherapy and there are a few case reports attributed to trastuzumab and none to pertuzumab.

Case: A 45-year-old woman was diagnosed with breast cancer. In Feb 2015, she was diagnosed with locally advanced triple-negative breast cancer. She received neoadjuvant chemotherapy (four cycles EC, four cycles docetaxel) and she had mastectomy ypT1N2/3 and radiotherapy.

In Sept 2017, a metastasis to the liver was present that was confirmed with a PET-CT (SUV: 6.9), which was biopsied. The histology report was different: ER: −, Pr: −, cerbb2: +3, FISH+. She was started on chemotherapy with docetaxel–pertuzumab–trastuzumab. She received six cycles, and then she was continued on maintenance (pertuzumab–trastuzumab) till Sept 2020. The CTs were stable and in Sept 2020, she had a PET-CT that did not show any metastasis, but there were multiple lymph nodes in the mediastinum (SUV: 8.4). The radiologist believed that the diagnosis was immunotherapy-like induced reaction. An EBUS biopsy was conducted. The histopathology report revealed findings of granulomatous reaction pattern, possibly sarcoidosis. The ACE blood exam was normal, although the normal findings did not exclude the diagnosis of sarcoidosis.

Is it a sarcoid-like reaction attributed to the treatment? Or a disease that was already there? Last year, the patient had tingling, palsy in the facial nerves and swelling in joints, but all these symptoms were transient. After a thorough discussion with the patient, we decided to continue only subcutaneous trastuzumab. The stage of the sarcoidosis based on the PET-CT findings was I, which means that the patient should remain on surveillance.

Literature: Trastuzumab has been used since 1998 for treatment of HER2-positive breast cancer. Although adverse effects are not common, some of the pulmonary complications associated with trastuzumab are acute lung injury, acute pneumonitis, organising pneumonia and bronchospasm. There are a few cases worldwide that correlate the use of trastuzumab with sarcoidosis.

Sarcoidosis is considered an adverse effect, but since there are not many cases, there is no guideline for further management. The patient received trastuzumab with pertuzumab; so, it is not certain which drug caused sarcoidosis, if not both. There are no cases reported of sarcoid-like reaction due to pertuzumab.

This young patient was informed about her choices of either stopping the treatment or continuing trastuzumab. She felt uncomfortable of stopping the treatment and decided to continue treatment with trastuzumab.

Conclusions: This is the case of a woman with HER2 metastatic breast cancer, who had complete resolution of her metastasis and was recently diagnosed with sarcoidosis that is likely attributed to anti-HER2 treatment. Each of such rare cases should be discussed individually and the decision should be taken according to the extent of cancer, the stage of sarcoidosis and patient’s wishes.

<ref id="j_fco-2021-0025_ref_001"><label>1</label> <mixed-citation>Rabih Halabi, Trastuzumab induced sarcoidosis mimicking metastatic carcinoma, CHEST 2011; 140:56A.</mixed-citation> <element-citation publication-type="journal" publication-format="print"> <name><surname>Halabi</surname><given-names>Rabih</given-names></name> <article-title>Trastuzumab induced sarcoidosis mimicking metastatic carcinoma</article-title> <source>CHEST</source> <year>2011</year> <volume>140</volume> <fpage>56A</fpage> </element-citation> </ref> <ref id="j_fco-2021-0025_ref_002"><label>2</label> <mixed-citation>Dmitriy Cogan, A case of trastuzumab induced Pulmonary Sarcoidosis, CHEST, <uri>https://doi.org/10.1378/chest.1386625</uri></mixed-citation> <element-citation publication-type="journal" publication-format="print"> <name><surname>Cogan</surname><given-names>Dmitriy</given-names></name> <article-title>A case of trastuzumab induced Pulmonary Sarcoidosis</article-title> <source>CHEST</source> <comment><uri>https://doi.org/10.1378/chest.1386625</uri></comment> </element-citation> </ref> <ref id="j_fco-2021-0025_ref_003"><label>3</label> <mixed-citation>P.T. Nigo, A case of trastuzumab induced sarcoidosis, American Society International Conference abstracts, 2017</mixed-citation> <element-citation publication-type="journal" publication-format="print"> <name><surname>Nigo</surname><given-names>P.T.</given-names></name> <article-title>A case of trastuzumab induced sarcoidosis</article-title> <source>American Society International Conference abstracts</source> <year>2017</year> </element-citation> </ref> </ref-list> </sec> <sec id="j_fco-2021-0025_s_029"><div>NEUROENDOCRINE NEOPLASMS OF RARE PRIMARY SITE: AN ONCOLOGY CENTRE’S 5-YEAR EXPERIENCE</div> <p>Chrysoglou S.I., Veniou E., Fioretzaki R., Georgiadou A., Logothetis M., Charalampakis N., Ntokou A., Kosmas C., Ziras N.</p> <p><italic>Department of Medical Oncology, ‘Metaxa’ Cancer Hospital, Piraeus, Greece</italic></p> <p><bold>Background:</bold> Neuroendocrine neoplasms (NENs) are heterogenous, rare tumours arising from neuroendocrine cells, which are scattered all over the body. They occur more often in the lungs, gastrointestinal tract or pancreas. Their biological behaviour depends on the histopathological characteristics of the tumour (tumour grade, differentiation, number of mitoses, Ki-67) and their localisation.</p> <p><bold>Aim:</bold> To describe the special clinical and histological characteristics of NEN of rare primary site.</p> <p><bold>Methods:</bold> We collected and reviewed all NENs (neuroendocrine tumours [NETs] and neuroendocrine carcinomas [NECs]) of rare primary sites treated in Metaxa Cancer Hospital of Piraeus from 2016 to 2020 and summarised their clinicopathological features.</p> <p><bold>Results:</bold> One hundred and forty-three primary NENs were diagnosed. Among them, we identified 24 (16.8%) of rare primary sites: breast: five (three NECs and two NETs), skin (Merkel): four, thymus: three NETs, larynx: two NECs, bladder: two NECs, prostate: two NECs, liver (paraganglioma): one NET, adrenal gland (pheochromocytoma): one NEC, inguinal area: one NEC, oesophagus: one NEC, kidney: one NEC and ovary: one NEC. The population of the study consisted of 15 men and nine women. Out of the 24 tumours reviewed, 18 were NECs and six were NETs. All NETs were non-functional and their clinical presentation was non-specific. Primary treatment was surgical. Treatment with somatostatin analogues resulted in long-term stabilisation in the case of paraganglioma. The majority of NECs had an aggressive clinical behaviour. Except for breast NECs, which were treated as adenocarcinomas, relapsed or metastatic NECs were treated with first-line cisplatin–etoposide. Immunotherapy was administered in two cases of Merkel carcinoma. Despite their poor clinical outcomes, their prognosis does not seem to differ from other NETs of the same stage.</p> <p><bold>Conclusions:</bold> NENs in rare locations, most frequently NECs, have special characteristics and their management requires multidisciplinary approach offered in highly qualified reference centres. Creation of a national NEN registry and a hospital cooperation network are recommended.</p> </sec> <sec id="j_fco-2021-0025_s_030"><div>ANXIETY AND DEPRESSION IN CANCER PATIENTS RECEIVING ONCOLOGY TREATMENT: ASSOCIATED FACTORS</div> <p>Arvanitou E.<sup>1</sup>, Parpa E.<sup>2</sup>, Tsilika E.<sup>2</sup>, Elmasian T-F<sup>2</sup>, Hatzigeorgiou E.<sup>2</sup>, Tsitsimpis A.<sup>1</sup>, Gkiaouraki M.<sup>1</sup>, Mpallasis K.<sup>1</sup> Chrystofyllakis Ch.<sup>1</sup>, Panagou E.<sup>1</sup>, Tsoukalas N.<sup>1</sup>, Mystakidou K.<sup>2</sup></p> <p><italic><sup>1</sup>Oncology Department, 401 General Military Hospital of Athens, Greece</italic></p> <p><italic><sup>2</sup>Palliative Care Unit, Department of Radiology, University Areteion Hospital School of Medicine, Athens, Greece</italic></p> <p><bold>Background</bold>: Cancer diagnosis is related to fear and is a source of great distress for patients. Anxiety and depression are common in cancer patients and seem to affect quality of life, treatment compliance and even survival. Demoralisation that encompasses feelings of despair, loss of meaning and spiritual distress can occur in patients with cancer. The aim of this study is to investigate the relationship between demoralisation, anxiety and depression and to examine the demographic and clinical factors associated with anxiety and depression.</p> <p><bold>Methods:</bold> A convenience sample of 150 cancer inpatients and outpatients from two oncology centres, with various types of solid tumours, receiving oncology treatment, participated in a prospective cross-sectional observational study. The psychometric tools used were the Greek version of the Hospital Anxiety and Depression Scale (HAD) and the Demoralisation Scale II (DS-II). The study was approved by the ethical committee or related boards of each hospital. Each patient was informed about the aims of the study, and the patient gave his/her written consent to participate.</p> <p><bold>Results:</bold> Patients’ mean age was 62 years (20–85 years) and 89 patients (59.3%) were women. Among patients, 33% had breast, 24% had gastrointestinal and 15% had lung cancer. Eighty-two patients (54.7%) had metastatic disease. Women showed higher rates of anxiety (<italic>p</italic> = 0.054). Anxiety was inversely related to age (<italic>p</italic> = 0.043) and positively correlated with time since diagnosis (<italic>p</italic> = 0.076). Unmarried patients presented higher rates of depression (<italic>p</italic> = 0.026). Multiple linear regression showed a statistically significant impact of demoralisation on anxiety (<italic>p</italic> < 0.001, <italic>R</italic><sup>2</sup> = 36.3%) and depression (<italic>p</italic> < 0.001, <italic>R</italic><sup>2</sup> = 49%).</p> <p><bold>Conclusions:</bold> The results highlight the significant impact of demoralisation on anxiety and depression in cancer patients. This emphasises the need for empathy and understanding of patients’ feelings by healthcare providers to recognise the feelings of despair and distress in a timely manner.</p> </sec> <sec id="j_fco-2021-0025_s_031"><div>METASTATIC PROSTATE CANCER WITH NORMAL LEVEL OF SERUM PROSTATE-SPECIFIC ANTIGEN (PSA)</div> <p>Tsapakidis K., Papadopoulos V., Markou A., Kokkalis A., Chantzara E., Aidarinis C., Saloustros E., Koinis F., Samaras I., Kotsakis A.</p> <p><italic>Department of Medical Oncology, University General Hospital of Larissa, Larissa, Greece</italic></p> <p><bold>Background</bold>: With the use of prostate-specific antigen (PSA), more and more prostate cancer patients are diagnosed at early stages (<a ref-type="bibr" href="#j_fco-2021-0025_ref_004">1</a>). Almost all patients with metastatic prostate cancer have elevated PSA and only a small percentage of patients with metastatic prostate cancer have normal PSA levels (<a ref-type="bibr" href="#j_fco-2021-0025_ref_005">2–3</a>).</p> <p><bold>Aim</bold>: A clinical case of prostate cancer with normal PSA that has been treated successfully with chemotherapy is presented.</p> <p><bold>Case report</bold>: We report a case of an 81-year-old man who presented with haematuria and underwent CT imaging that revealed lymphadenopathy, multiple bones and prostate heterogeneity. He underwent transurethral biopsy, and the histological examination of the specimen showed low-grade invasive carcinoma with the nuclei showing focal neuroendocrine differentiation, synaptophysin 5%–10% and also PSA focally positive, PSAP strongly positive. Laboratory test showed that he had increased NSE (50) and normal PSA (<a ref-type="bibr" href="#j_fco-2021-0025_ref_004">1</a>,<a ref-type="bibr" href="#j_fco-2021-0025_ref_005">2</a>). The patient was started on chemotherapy with carboplatin and docetaxel and has been disease free for 3 years.</p> <p><bold>Conclusions</bold>: In the prostate gland, a number of neuropeptides, such as GRP, chromogranin A and NSE, are found to be present not only in autonomic and sensory nerve terminals, but also in prostatic neuroendocrine cells (<a ref-type="bibr" href="#j_fco-2021-0025_ref_007">4</a>). 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Clin Cancer Res. 2013; 19: 3621–3630</mixed-citation> <element-citation publication-type="journal" publication-format="print"> <name><surname>Aparicio</surname><given-names>A.M.</given-names></name> <name><surname>Harzstark</surname><given-names>A.L.</given-names></name> <name><surname>Corn</surname><given-names>P.G.</given-names></name> <etal/> <article-title>Platinum-based chemotherapy for variant castrate-resistant prostate cancer</article-title> <source>Clin Cancer Res</source> <year>2013</year> <volume>19</volume> <fpage>3621</fpage> <lpage>3630</lpage> </element-citation> </ref> </ref-list> </sec> <sec id="j_fco-2021-0025_s_032"><div>EFFICACY AND SAFETY DATA FOR THROMBOPROPHYLAXIS WITH LOW-MOLECULAR WEIGHT HEPARIN (LMWH) IN LUNG CANCER PATIENTS FROM A SINGLE CENTRE</div> <p>Kouvela M., Stefanou D., Evangelou G., Tourkantonis G., Nasi D., Papafili A., Kotteas H., Syrigos KN</p> <p><italic>3<sup>rd</sup> Department of Internal Medicine, Oncology Unit, ‘Sotiria’ Hospital, Medical School, University of Athens, Athens, Greece</italic></p> <p><bold>Background:</bold> Venus thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and is a very common complication in lung cancer patients. Even though VTE is the second cause of death in cancer patients, there are no guidelines concerning which patients need to receive thromboprophylaxis and in what dosage.</p> <p><bold>Aim:</bold> To assess the efficacy and safety of thromboprophylaxis with low-molecular weight heparin (LMWH) in lung cancer patients.</p> <p><bold>Methods:</bold> This study is a single-centre, prospective, observational study. Lung cancer patients of any histology type were evaluated in the first cycle of treatment for the risk of thrombosis. High-thrombotic risk patients were started on thromboprophylaxis with tinzaparin 0.5 ml, 10.0 Anti-Xa IU, OD, used in current clinical practice, and patients with an indication for therapeutic dosage (atrial fibrillation or pre-existing thrombosis) were started on tinzaparin 175 Anti-Xa IU/kgr, OD.</p> <p><bold>Results:</bold> Preliminary results of 60 patients, five of which were set on therapeutic dosage. The median age was 65 years, and the most common histology was adenocarcinoma (50%). During follow-up (6 months), the compliance of the patients was sufficient. Nine patients died due to disease progression (15%), 10 patients discontinued treatment because of lack of sufficient thrombotic risk factors (17%) and six patients discontinued due to adverse events (10%). The adverse events were mild, without the need for medical intervention or hospitalisation of the patients, and they concerned mainly minor bleeding events (haemoptysis). One case of a minor allergic reaction was recorded. One patient experienced thrombotic event (efficacy 98.3%).</p> <p><bold>Conclusion:</bold> LMWH thromboprophylaxis in active lung cancer patients reduces the risk of potentially deadly thrombotic events and is safe and well tolerated by the patients.</p> </sec> <sec id="j_fco-2021-0025_s_033"><div>THE PSYCHOLOGICAL IMPACTS OF THE COVID-19 PANDEMIC IN CANCER PATIENTS</div> <p>Chatzinikolaou A.<sup>1</sup>, Lavdaniti M.<sup>2</sup></p> <p><italic><sup>1</sup>Postgraduate student, Nursing Department, International Hellenic University, Thessaloniki</italic></p> <p><italic><sup>2</sup>Associate Professor, Nursing Department, International Hellenic University, Thessaloniki</italic></p> <p><bold>Introduction:</bold> People with cancer belong to the high-risk groups, both for infection with the Sars-Covid-19 virus and for psychological transitions due to their state of health.</p> <p><bold>Methods:</bold> A literature review was conducted using the electronic databases PubMed and Google Scholar with the keywords “psychological distress”, “cancer”, “patients”, “Covid-19 pandemic”, and a combination thereof. Exclusion criteria of articles was the language, except English. 15 articles were used on the subject. The review concerned the years 2020–2021.</p> <p><bold>Aim:</bold> The aim of this study was to investigate the psychological effects of a pandemic on cancer patients.</p> <p><bold>Results:</bold> Cancer patients experience high levels of stress. Cancer is a threat to a person’s life and can significantly change their social, emotional and relational world. According to research, women and young people with cancer appeared to be more prone to stress and post-traumatic stress during the pandemic. In addition, the new condition created by the Sars-Covid-19 virus resulted in additional psychological burden during the treatment period due to treatment delays and prohibition on the presence of a caregiver on the hospital premises. Finally, immunosuppression and the treatment given to them make cancer patients more vulnerable due to the weakening of their immune system, which raises additional concerns about the possibility of infection with the Covid-19 virus even in the non-Covid hospital.</p> <p><bold>Conclusions:</bold> The interdisciplinary care team of cancer patients should have a holistic approach to the patient and deal with both his physical-organic rehabilitation and the mental empowerment of the person during the pandemic.</p> </sec> <sec id="j_fco-2021-0025_s_034"><div>ENDOCRINE ADVERSE EFFECTS OF COMBINED IMMUNOTHERAPY ON SOLID CANCER – A SYSTEMATIC REVIEW AND META-ANALYSIS</div> <p>Tsitsimpis A.<sup>1</sup>, Tsoukalas N.<sup>1</sup>, Katsouda A.<sup>2</sup>, Mpagkos P.<sup>3</sup></p> <p><italic><sup>1</sup>Oncology Department of 401GMHA</italic></p> <p><italic><sup>2</sup>5<sup>th</sup> Surgical Department of GH ‘Ippokrateio’</italic></p> <p><italic><sup>3</sup>Computational Medicine and Bioinformatics University of Thessaly</italic></p> <p><bold>Background</bold>: Immunotherapy has created a revolution in oncology in the last decade. Moreover, the combination of immunotherapy takes a great position in the therapy of solid tumours. Many adverse effects (AEs) have been reported, in connection with the stimulation of immune system, and some of them concern the endocrine system.</p> <p><bold>Methods</bold>: We made a systematic review and searched in PubMed, Medline and Clinical trials for the period from 01/2015 to 12/2020, following which we conducted a meta-analysis. Our search was about adult patients with solid tumours who were treated with EMA- or FDA-approved combination immunotherapy treatments and endocrine AEs were observed through phase 2 and 3. Twenty-six randomised clinical trials were included.</p> <p><bold>Results</bold>: We included 21 clinical trials with 3269 patients who were treated with ipilimumab + nivolumab. The percentage of hypophysitis was 6% (95% Cl: 4%–10%) with mild symptoms. The adrenal insufficiency was 2% (95% CI: 1–3). Although the heterogeneity was great, the percentage of hypothyroidism was 15% (95% CI: 13%–18%) and of hyperthyroidism was 14% (95% CI: 11%–18%). We included five clinical trials with 862 patients who were treated with durvalumab + tremelimumab. Hypophysitis was very rare (1%; 95% CI: 0–2%), but was almost always grade III/IV. The same observation was made for adrenal insufficiency, which concerned 2% (95% CI: 1%–5%) of the patients. The most common endocrine AE was hypothyroidism (10%; 95% CI: 8%–13%). The percentage of hyperthyroidism was 4% (95% CI: 1%–17%), but only two clinical trials had data on this AE.</p> <p><bold>Conclusion</bold>: Combination immunotherapy is a promising treatment in oncology. This study provides more accurate data on endocrine AE in patients who were treated with combination immunotherapy. The most common AE was thyroid dysfunction or hypophysitis instead of adrenal insufficiency. Oncologists need to be up-to-date and alerted on these endocrine AEs of immunotherapy in order to diagnose and treat them.</p> </sec> <sec id="j_fco-2021-0025_s_035"><div>PERIPHERAL EOSINOPHILIA IN LONG-TERM SURVIVORS WITH NSCLC UNDER IMMUNOTHERAPY WITH ICIS: PRESENTATION OF TWO CASES AND REVIEW OF LITERATURE</div> <p>Chrysanthidis M., Molfeta A., Chatzichristou E., Bousboukea A., Leon O., Samonis G., Bafaloukos D.</p> <p><italic>1<sup>st</sup> Medical Oncology Department, Metropolitan Hospital – N. Faliro, Pireas, Greece</italic></p> <p><bold>Background:</bold> The potential role of elevated peripheral eosinophils in the response of solid tumours receiving systemic treatments remains ambiguous. The effects of hypereosinophilia in long-term survivors with non-small cell lung cancer (NSCLC) have not been investigated.</p> <p><bold>Aim:</bold> To evaluate whether any associations between hypereosinophilia and response to immunotherapy for NSCLC exist and to review the relevant literature.</p> <p><bold>Methods:</bold> Two cases with high levels of blood eosinophils in patients with NSCLC, showing long-term progression-free survival while in excellent clinical status under treatment with PD-1 and PD-L1 inhibitors, respectively, are presented. The relevant literature has been reviewed.</p> <p><bold>Results:</bold> The first patient, a 61-year-old male, who was a smoker without history of allergies, was diagnosed with NSCLC in October 2018 and initially received six cycles of therapy with paclitaxel and carboplatin. Due to disease progression, his treatment was changed to immunotherapy with nivolumab, and he had already received 43 consecutive doses every 2 weeks. As of June 2020, the mean value of eosinophils in peripheral blood was constantly above 200/<italic>μ</italic>L (217.19/<italic>μ</italic>L).</p> <p>The second patient, a 67-year-old male, who was a smoker with allergy to eggplants, was diagnosed with lung adenocarcinoma in 2014. He then underwent a right bilobectomy followed by two adjuvant cycles of carboplatin and vinorelbine. Due to hydropneumothorax, he was consequently treated with six cycles of pemetrexed. Since September 2019, he has been receiving immunotherapy with pembrolizumab; he has already completed 26 consecutive infusions and is in an excellent condition. As of September 2020, the mean value of blood eosinophils was constantly above 1/<italic>μ</italic>L (1.1125/<italic>μ</italic>L – hypereosinophilic syndrome).</p> <p><bold>Conclusions:</bold> Potential associations between elevated blood eosinophil levels and response to immunotherapy in long–term survivors suffering from NSCLC are worth investigating further.</p> </sec> <sec id="j_fco-2021-0025_s_036"><div>THE EFFECT OF MUSIC THERAPY ON ONCOLOGY PATIENTS</div> <p>Stamatopoulou E.<sup>1</sup>, Tsilias D.<sup>2</sup>, Valassi L.<sup>3</sup>, Valassi S.<sup>4</sup>, Antonakou A.<sup>5</sup>, Stamatopoulou A. <sup>6</sup></p> <p><italic><sup>1</sup>PhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.</italic></p> <p><italic><sup>2</sup>RN, MSc Clinical Pediatrics and Nursing-Research General Children’s Hospital of Athens P. & A. Kyriakou, Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.</italic></p> <p><italic><sup>3</sup>Graduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.</italic></p> <p><italic><sup>4</sup>Graduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.</italic></p> <p><italic><sup>5</sup>‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.</italic></p> <p><italic><sup>6</sup>PhD(c), Economist, M.Sc. International Business Administration, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica.</italic></p> <p><bold>Background:</bold> Music therapy was introduced in the field of palliative care in 1978 by Munro and Mount to relax and encourage the expression of difficult emotions.</p> <p><bold>Purpose:</bold> To determine the effect of music therapy on oncology patients.</p> <p><bold>Methods:</bold> The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed on the online PubMed database with the following keywords: oncology patients effect music therapy from 1978 onwards.</p> <p><bold>Results:</bold> The original 1978 study on music therapy in palliative care reported an improvement in patients’ quality of life. Subsequent meta-analyses, reviews and recent systematic reviews have shown that it plays an important role with short-term positive results such as promoting well-being, elevating mood, causing relaxation and reduction of stress, depression, fatigue and pain, with beneficial effects on heart rate, respiratory rate, arterial pressure, facilitating communication to oncology patients and caregivers, thus improving their quality of life. In women with head and neck cancer or with breast cancer undergoing radiation therapy, chemotherapy significantly reduced stress, anxiety, fatigue, depression and the frequency of vomiting and improved their quality of life. The quality of sleep also improved in patients with osteosarcoma. In patients with gastrointestinal tract cancer who underwent chemotherapy, nausea and vomiting significantly reduced. In women undergoing breast augmentation and cancer surgery, music therapy has helped manage preoperative stress and anaesthesia requirements.</p> <p><bold>Conclusions:</bold> Music therapy is associated with a favourable mood in oncology patients and caregivers. It is used as a psychosocial therapy with the aim of improving psychological, physical well-being, addressing the spiritual needs and relieving stress and existential fears as a way of non-verbal expression and communication to cancer patients and caregivers.</p> </sec> <sec id="j_fco-2021-0025_s_037"><div>A GREEK MULTICENTER, PROSPECTIVE, OBSERVATIONAL STUDY TO ASSESS CLINICAL ACTIVITY, IMPACT ON SYMPTOM BURDEN AND QUALITY OF LIFE OF PATIENTS WITH ADVANCED SOFT TISSUE SARCOMAS TREATED WITH TRABECTEDIN: RESULTS OF THE REAL-WORLD ‘BEYOND-STS’ STUDY</div> <p>Kokkali S.<sup>1</sup>, Boukovinas I.<sup>2</sup>, Samantas E.<sup>3</sup>, Papakotoulas P.<sup>4</sup>, Athanasiadis I.<sup>5</sup>, Andreadis C.<sup>6</sup>, Makrantonakis P.<sup>7</sup>, Samelis G.<sup>8</sup>, Timotheadou E.<sup>9</sup>, Vassilopoulos G.<sup>10</sup>, Papadimitriou C.<sup>11</sup>, Tzanninis D.<sup>12</sup>, Ardavanis A.<sup>1</sup>, Kotsantis I.<sup>13</sup>, Karvounis-Marolachakis K.<sup>14</sup>, Theodoropoulou T.<sup>14</sup>, Psyrri A.<sup>13</sup></p> <p><italic><sup>1</sup>First Department of Medical Oncology, Agios Savvas Athens General Hospital, Athens</italic></p> <p><italic><sup>2</sup>Medical Oncology, Bioclinic of Thessaloniki</italic></p> <p><italic><sup>3</sup>Third Oncology Clinic, AgioiAnargiroi Athens General Hospital, Athens</italic></p> <p><italic><sup>4</sup>First Chemotherapeutic Oncology Department, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki</italic></p> <p><italic><sup>5</sup>Oncology Department, Hygeia Athens Private Hospital, Maroussi, Athens</italic></p> <p><italic><sup>6</sup>Third Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki</italic></p> <p><italic><sup>7</sup>Second Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki</italic></p> <p><italic><sup>8</sup>Oncology Department at Hippocration General Hospital of Athens</italic></p> <p><italic><sup>9</sup>Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloniki</italic></p> <p><italic><sup>10</sup>Department of Hematology, Larissa University Hospital</italic></p> <p><italic><sup>11</sup>Oncology Unit, Aretaieion University Hospital, National and Kapodistrian University of Athens</italic></p> <p><italic><sup>12</sup>Medical Oncology Unit of Athens Medical Center, Maroussi, Athens</italic></p> <p><italic><sup>13</sup>Division Medical Oncology, Attikon University General Hospital of Athens, Haidari</italic></p> <p><italic><sup>14</sup>Medical Department, Genesis Pharma SA, Athens</italic></p> <p><bold>Background:</bold> Advanced soft tissue sarcomas (aSTS) represent a heterogeneous group of neoplasms with limited treatment options. Trabectedin is indicated in the European Union (EU) for the treatment of aSTS patients who have failed or are unfit to receive anthracycline/ifosfamide.</p> <p><bold>Aim</bold>: The study aims to generate real-world evidence on trabectedin effectiveness in aSTS and its impact on symptom burden and quality of life in routine clinical practice in Greece.</p> <p><bold>Methods:</bold> This prospective study consecutively enrolled patients with histologically confirmed aSTS and initiated on trabectedin per local label, who consented to participate in the study. Data were collected through routine assessments and patient-reported outcomes (MD Anderson Symptom Inventory [MDASI] and EuroQol-5 Dimensions-3-Levels [EQ-5D-3L] instrument) at 6-week intervals during the first 24 weeks and every 12 weeks thereafter for a maximum of 182 weeks.</p> <p><bold>Results:</bold> Between 21 Dec 2015 and 06 June 2018, 64 eligible patients (median age: 58.3 years; 62.5% females; median disease duration: 15.3 months; 67.2% metastatic) were enrolled by 13 hospital sites in Greece. At baseline, 93.8% had ECOG performance status ≤1 and 53.1% had ≥1 comorbidity. Disease histological subtypes included leiomyosarcoma (32.8%), pleomorphic undifferentiated sarcoma (15.6%) and liposarcoma (10.9%). Of the patients, 17.2%, 53.1% and 29.7% had received none, 1 and ≥2 prior treatment lines, respectively. A median of 3.0 (interquartile range: 2.0–6.0) trabectedin cycles were received. The median progression-free survival (PFS) and overall survival were 6.6 and 13.1 months, respectively. The 3- and 6-month PFS rates were 67.9% and 51.2%, respectively; the disease control rate was 21.9%. Baseline MDASI and EQ-5D index scores did not significantly change at post-baseline visits. The treatment discontinuation rate due to toxicity was 9.4%. The adverse drug reaction rate was 46.9% (serious: 17.2%; grade 3/4: 31.3%).</p> <p><bold>Conclusions:</bold> In a real-world setting, trabectedin demonstrated clinically meaningful benefits in aSTS patients who had failed or were unfit to receive anthracycline/ifosfamide, with no new emerging safety signals and without imposing additional burden on patients’ quality of life.</p> <p><bold>Acknowledgements:</bold> The authors acknowledge financial support for this study from Genesis pharma SA. The authors acknowledge abstract preparation support from Qualitis Ltd., Athens, Greece.</p> <p><bold>Disclosures:</bold> SK: GENESIS Pharma SA: honoraria, research funding; IB: GENESIS Pharma SA: honoraria, investigator fees, advisory board; ES: GENESIS Pharma SA: honoraria, investigator fees, advisory board; PP: GENESIS Pharma SA: honoraria, investigator fees; IA: GENESIS Pharma SA: advisory board, investigator fees, research funding; ChA: GENESIS Pharma SA: honoraria, investigator fees, advisory board; PM: GENESIS Pharma SA: investigator fees; GS: nothing to disclose; ET: GENESIS Pharma SA: honoraria, research funding, advisory board; GV: GENESIS Pharma SA: honoraria, investigator fees, advisory board, research funding; ChP: NOVARTIS/ASTRA ZENECA, GENESIS, MSD, AMGEN, MERCK AND ROCHE: speaker honoraria and honoraria for consultancy in advisory boards, BMS/ROCHE: research grants; DT: GENESIS Pharma SA: investigator fees; AA: GENESIS Pharma SA: honoraria, investigator fees, advisory board; IK: GENESIS Pharma SA: honoraria; KK-M: GENESIS Pharma SA employee; TT: GENESIS Pharma SA employee; AP: GENESIS Pharma SA: honoraria, investigator fees, advisory board</p> </sec> <sec id="j_fco-2021-0025_s_038"><div>DEVELOPMENT OF A NOVEL HOMECARE UNIT FOR CANCER PATIENTS IN THE PREFECTURE OF AGIOS NIKOLAOS CRETE</div> <p>Rovithi Maria<sup>1</sup>, Alexaki Maria<sup>2</sup>, Patentalaki Krystali<sup>2</sup>, Liodakis George<sup>1</sup></p> <p><italic><sup>1</sup>General Hospital of Agios Nikolaos, Lasithi, Crete</italic></p> <p><italic><sup>2</sup>General Hospital-Rural Health Center Dialynakeio, Neapoli, Lasithi, Crete</italic></p> <p>Quality in oncological care is a multidimensional concept. Palliative care constitutes a pillar of cancer care, unquestionably contributing to life prolongation and improvement of quality of life indexes. The development of the Chemotherapy Unit in Agios Nikolaos General Hospital offered the opportunity, by the cooperation of two integrated hospitals, to simultaneously develop the Cancer Homecare Unit.</p> <p>Agios Nikolaos Cancer Homecare Unit operates once weekly, serving patients with cancer, in the prefecture of Agios Nikolaos, covering a geographically particular area of 511 km<sup>2</sup>. It constitutes the only, to our knowledge, public unit in Greece that includes a general practitioner as a permanent member. This, alongside the nurse care provided by a specialised homecare nurse, allows the upgrade of homecare services to include, indicatively, physical examination and administration of monoclonal antibodies. We present here the cumulative data of the first 2 years of operation.</p> <p>In total, 47 patients have been included thus far (57% women, data cutoff December 2020). Mean age is 68 years (range: 44–90 years). More frequent underlying malignancies were breast, colorectal and lung cancer (24%, 21% and 8%, respectively). In 2019, the team realised in total 56 at-home visits, resulting in 580 healthcare interventions, while in 2020 and amidst the extraordinary, restricted circumstances created in the covid era, the Homecare Unit exponentially increased the actions delivered, totalling 103 visits and 1803 interventions. Average duration of patient inclusion in the unit services is 151 days (range: 7–445 days), and average visits per patient is six (range: 1–14). Also, 44% of the included patients were under active oncological treatment, while the rest were included for end-of-life care.</p> <p>Delivering of palliative care in Greece remains sadly inadequate. There is undoubtedly significant room for improvement, as furthermore highlighted by the Hellenic Society of Medical Oncology, which has included palliative care as a strategic endpoint. Administration of palliative care results in a humane, holistic approach of the cancer patient, while ensuing simultaneously decrease in hospitalisation duration, ultimately leading to relief of hospital workload. Especially in the current pandemic situation, Homecare has the potential to repurpose its role by the inclusion of patients in earlier disease state. We strongly feel that the development of Cancer Homecare should be realised within an extrovert, interdisciplinary context of cooperation of medical oncologists with other specialties, especially with the healthcare professionals of primary care, to maximise its potential.</p> </sec> <sec id="j_fco-2021-0025_s_039"><div>CASE REPORT: SARCOIDOSIS RELATED TO BRAF/MEK INHIBITION IN A PATIENT WITH METASTATIC MELANOMA</div> <p>Mitsogianni M, Bala VM, Laschos K, Pliakou E, Lazaridi E, Lampropoulou DI, Aravantinos G</p> <p><italic>2<sup>nd</sup> Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargyroi’</italic></p> <p><bold>Background:</bold> BRAF/MEK inhibitors are widely used for the treatment of metastatic melanoma. While granulomatous sarcoidosis-like reactions have been reported in numerous cases of melanoma patients receiving immunotherapy, they are extremely uncommon under BRAF/MEK inhibition.</p> <p><bold>Aim:</bold> The aim of this report is to present a case of clinical interest regarding a granulomatous reaction in a patient under treatment with BRAF/MEK inhibitors for metastatic melanoma.</p> <p><bold>Method:</bold> Review of the clinical case.</p> <p><bold>Case report:</bold> A 55-year-old woman was submitted to wide excision due to melanoma of the left scapula (pT2b [1.5 mm], N0 [SLNB], cM0, Clark level 3). Fifteen months later, she presented with metastatic lymphadenopathy of the left axilla and mediastinum. Due to the presence of BRAF V600E mutation, she was treated with dabrafenib and trametinib and she achieved complete response. CT staging 16 months later showed enlarged mediastinal lymph nodes as possible manifestations of progressive disease. EBUS-TBNA was carried out and histopathology revealed the existence of sarcoidosis-like granulomatous lymphadenopathy. The patient was asymptomatic and received no treatment for sarcoidosis, while targeted therapy was continued. The lymphadenopathy regressed spontaneously in the next 5 months.</p> <p><bold>Conclusion:</bold> Mediastinal sarcoidosis-like lymphadenopathy is possible under treatment with BRAF/MEK inhibitors and should be included in differential diagnosis from disease progression.</p> </sec> <sec id="j_fco-2021-0025_s_040"><div>DURATION OF TRASTUZUMAB IN METASTATIC BREAST CANCER AFTER COMPLETE RESPONSE</div> <p>Oikonomopoulos G, Galani E, Klouvas G, Agrogianni A, Rapti A, Nikolakopoulou A, Maria, Batziou A, Tsakalos G, Christodoulou C</p> <p><italic>2nd Oncology Department, Metropolitan Hospital, Pireus, Greece</italic></p> <p><bold>Background:</bold> Trastuzumab is the cornerstone of treatment of Her-2 (+) breast cancer, turning a highly lethal disease into a chronic one. In the metastatic setting, after combination with chemotherapy, there is evidence proving that continuation of trastuzumab monotherapy as maintenance offers a significant benefit.</p> <p><bold>Aim:</bold> We present the experience of our centre with patients achieving complete response on trastuzumab-based treatment.</p> <p><bold>Methods:</bold> We evaluated retrospectively eight patients with Her-2 (+) metastatic breast cancer, who achieved complete response on treatment with trastuzumab-containing regimen and continued with monotherapy. Concurrent hormonal therapy was applied accordingly. We included patients with complete remission of visceral disease and at least stable bone disease.</p> <p><bold>Results:</bold> Median time on trastuzumab-based treatment was 93 months (54–111 months). Six patients had discontinued trastuzumab, whereas two still received it until December 2016. Only one patient had stopped treatment due to decrease in cardiac ejection fraction. After discontinuation of trastuzumab, five out of the six patients showed progression of disease (84%) with a mean time to progression of 20.2 months. Of the two patients on trastuzumab, one had recurrence of disease (50%). All patients with recurrence received trastuzumab-based treatment.</p> <p><bold>Conclusions:</bold> There is little evidence to define the duration of trastuzumab after complete response. Our study revealed that discontinuation of trastuzumab increases the risk of recurrence. There is definite need for larger trials to establish the optimal duration of trastuzumab after complete response.</p> </sec> <sec id="j_fco-2021-0025_s_041"><div>THE ROLE OF NEOADJUVANT CHEMORADIOTHERAPY NEL TUMOUR RESPONSE FOR THE LOCALLY ADVANCED RECTUM TUMOURS – OUR EXPERIENCE</div> <p>G. Soulimioti, A. Fotopoulou, M. Ploxorou, I. Maravelis, S. Tzorakakis, K. Girlemis, E. Athanasiou</p> <p><italic>Radiotherapy Department of G.O.N.K <<Oi Agioi Anargiroi>></italic></p> <p><bold>Background:</bold> The standard of therapy for locally advanced rectum tumour is neoadjuvant chemo-radiotherapy followed by surgery.</p> <p><bold>Aim:</bold> The aim of our study is to determine the tumour response to surgery after neoadjuvant chemo-radiotherapy.</p> <p><bold>Methods:</bold> Thirty-three patients with locally advanced rectum tumours received neoadjuvant chemo-radiotherapy in our department from 2013 to 2020. Of these, 21 were males (68%) and 12 were females (32%). The median age was 67 years (range 35–89). Of these, seven had stage II tumour (35%) and 26 had stage IIγ tumour (65%). The clinical stage of the tumour was identified with colonoscopy and magnetic resonance imaging (MRI). The histology of all tumours was adenocarcinoma. Thirteen patients had tumours in the upper part of rectum (38%) and 20 patients had them in the lower part of rectum (62%). All the patients received 3D conformal RT with 45 Gy/1.8 Gy/day. Thirty-one patients (93%) received concomitant chemotherapy with capecitabine (850 mg/m<sup>2</sup> twice a day for 25 days). The surgery was done 4–8 weeks after the end of neoadjuvant chemo-radiotherapy.</p> <p><bold>Results:</bold> The results after the surgery were as follows: eight patients (24.4%) had complete response (ypT0) and 23 patients (72.6%) had partial response. Also, two patients died before the surgery due to other medical reasons (4%). In our study, it seems that of the eight patients who had complete response, six had tumours in the upper segments of rectum and two had them in the lower part of rectum (75% vs. 25%). So, it seems that the patients with tumours in the upper segments of rectum had better response to surgery after neoadjuvant chemo-radiotherapy.</p> <p><bold>Conclusions:</bold> Neoadjuvant chemo-radiotherapy shows very good results in tumour response of the locally advanced rectums tumours. Our results are similar of those of international studies.</p> </sec> <sec id="j_fco-2021-0025_s_042"><div>MESONEPHRIC-LIKE MULLERIAN ADENOCARCINOMA OF THE OVARY</div> <p><sup>1</sup>Michas Athanasios MD MSc, <sup>2</sup>Akrivos Thomas MD, <sup>2</sup>Giannakas Panagiotis MD, <sup>1</sup>Arvanitou Eleni MD MSc, <sup>1</sup>Gkikas Konstantinos MD, <sup>1</sup>Kolomitrousi Andria MD, <sup>1</sup>Kagkaras Christos MD, <sup>1</sup>Gkiaouraki Marina MD, <sup>1</sup>Mpalasis Konstantinos MD, <sup>1</sup>Christofilakis Charalampos MD, <sup>1</sup>Tsoukalas Nikolaos MD MSc PhD</p> <p><italic><sup>1</sup>Oncology department of 401General Military Hospital of Athens (401GMHA)</italic></p> <p><italic><sup>2</sup>Gynecologic department of 401General Military Hospital of Athens (401GMHA)</italic></p> <p><bold>Background:</bold> Mesonephric-like Mullerian adenocarcinomas of the ovaries are extremely rare gynaecological malignancies. Their embryological and histological origin remains debatable. The more prevalent tumorigenic theories support either development from mesonephric duct remnants of the female genital tract or development from Mullerian lesions that undergo mesonephric differentiation.</p> <p><bold>Case Report:</bold> This report concerns a 64-year-old female patient with medical history of hypothyroidism and dyslipidaemia. During annual gynaecological US screening examination, a solid formation (approximately 4 cm diameter) was found on the left ovary. An ensuing abdominal MRI tomography revealed a solid ovarian mass. Further staging with CTs and PET-CT scan excluded distant neoplasmatic dissemination. Subsequently, a surgical total hysterectomy was performed. After histological evaluation, the analysis concluded low-grade mesonephric-like Mullerian adenocarcinoma of the left ovary, adjacent to multiple foci of endometriosis. Due to the tumour rarity, the histological results were rechecked and verified by multiple histology experts. The patient received adjuvant chemotherapy with six cycles of carboplatin/paclitaxel. Treatment was completed without significant side effects, except for mild nausea and hand–foot syndrome. Follow-up examinations showed complete disease remission. Currently, the patient is regularly monitored with scheduled periodic assessments, without any sign of recurrence. Moreover, molecular analysis revealed heterozygous somatic <italic>KRAS</italic> mutation NM_033360.4:c.35G>A:p.(Gly12Asp) and heterozygous genomic <italic>PMS2</italic> mutation NM_000535.7:c.2559C>G p.(Ile853Met).</p> <p><bold>Conclusion:</bold> Mesonephric-like Mullerian adenocarcinomas of ovaries are extremely rare tumours (<15 literature reports in PubMed, Scopus). The most prevalent theory of tumorigenesis involves cancer development from Mullerian lesions (e.g. foci of endometriosis) that undergo mesonephric differentiation. Further research is necessary for a deep understanding of the neoplastic nature of these lesions.</p> </sec> <sec id="j_fco-2021-0025_s_043"><div>MULTIPLE ENDOCRINE NEOPLASIA TYPE 1</div> <p>Gkikas K.<sup>1</sup>, Malliopoulos D.<sup>2</sup>, Pappas D.<sup>3</sup>, Kolomitrousi A.<sup>1</sup>, Arvanitou E.<sup>1</sup>, Tsitsibis A.<sup>1</sup>, Michas A.<sup>1</sup>, Chatzelis E.<sup>4</sup>, Gkiaouraki M.<sup>1</sup>, Ballasis K.<sup>1</sup>, Christofyllakis Ch.<sup>1</sup>, Tsoukalas N.<sup>1</sup></p> <p><italic><sup>1</sup>Oncology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>2</sup>Endocrinology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>3</sup>Pathological Laboratory, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>4</sup>Endocrinology Department, 251 Air Force General Hospital of Athens</italic></p> <p><bold>Background:</bold> Multiple endocrine neoplasia (MEN) syndromes are rare endocrine cancer syndromes, inherited as an autosomal dominant disorder. The most common tumours seen in MEN1 involve the parathyroid gland, islet cells of the pancreas and the pituitary gland.</p> <p><bold>Aim:</bold> To present a case of MEN type 1 in an adult patient.</p> <p><bold>Case report:</bold> In March 2020, a 37-year-old male was diagnosed with MEN type 1 syndrome after his family members’ (mother/brother) positive diagnosis as well, through molecular genetic testing. Several diagnostic imaging and laboratory tests subsequently performed revealed the following disorders: 1) primary hyperparathyroidism with hypercalcaemia and hypophosphataemia, combined with two hypoechoic solid masses on the thyroid, and 2) abdominal magnetic resonance imaging (MRI) findings including two abnormal masses of tissue placed on the pancreas (1.7 and 2 cm), as well as two suspicious-appearing masses (1.3 and 1.9 cm) within the liver. Molecular testing on <italic>MEN1</italic> gene showed an NM_000244.3:c.1126dup p.(Val376Glyfs<sup>*</sup>38) heterozygous mutation. Further diagnostic imaging tests depicted nodular swelling on both the adrenal glands, such as a tiny pituitary lesion, which looked like a microadenoma. The 68-Ga-DOTATATE PET-CT scan showed an increased radiopharmaceutical uptake in the region of pancreas head, pancreas neck and liver part II. After finishing all necessary tests, the patient underwent an EUS-guided pancreas biopsy. Both cytological and histological examination results showed the existence of a high-grade neuroendocrine neoplasm. Therefore, after multidisciplinary oncology approach, the patient was suggested to perform a total parathyroidectomy to restore the insisting primary hyperparathyroidism. Furthermore, he was asked to perform a repetition of certain imaging tests 3 months later as a means to determinate the most suitable treatment option.</p> <p><bold>Conclusion:</bold> Clinical suspicion of MEN syndromes often results from family medical history, while molecular testing confirms the final diagnosis. Undoubtedly, treatment requires multidisciplinary oncology approach among many different medical specialties, not to mention the ultimate need for patients’ psychological support.</p> </sec> <sec id="j_fco-2021-0025_s_044"><div>RENAL HEMANGIOBLASTOMA IN AN ADULT WOMAN</div> <p>Kolomitrousi A<sup>1</sup>, Gikas K.<sup>1</sup>, Chrystofyllakis Ch.<sup>1</sup>, Mpallasis K.<sup>1</sup>, Gkiaouraki M.<sup>1</sup>, Psarogiorgou S.<sup>2</sup>, Zarogiannos A.<sup>3</sup>, Tsitsimpis A.<sup>4</sup>, Arvanitou E.<sup>4</sup>, Tsoukalas N.<sup>1</sup></p> <p><italic><sup>1</sup>Oncology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>2</sup>Pathology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>3</sup>Urology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>4</sup>1<sup>st</sup> Internal Medicine Department, 401 General Military Hospital of Athens</italic></p> <p><bold>Introduction</bold>: Hemangioblastoma is a benign tumor of the central nervus system (CNS). Occurrence of hemangioblastoma in other sites, outside the CNS, is extremely rare and is worth mentioned.</p> <p><bold>Case report:</bold> A 49-year-old female with a past medical history of breast cancer (pT2N(sn)γi invasive lobular breast carcinoma, which was diagnosed 2 years ago and treated with lumpectomy, sentinel lymph node biopsy and resection of two lymph nodes, adjuvant chemotherapy, radiotherapy, and hormonal therapy) presented with a 2,3cm solid mass in the lower pole of the right kidney, as detected in the imaging exams. No other pathological features were found. Patient denied further work up and a close follow-up performed. The next imaging assessment, 6 months later, showed an increase of the mass size and subsequently a mass resection was planned. Due to perioperative complications a total nephrectomy was performed, and histological examination of the specimen showed a tumor mass within the renal parenchyma, composed of a rich capillary vessels and stromal cells with foamy clear or eosinophilic cytoplasm, with PAS positivity in cytoplasmic vacuoles. Moreover, several peripheral deformed, irregular, thick-walled vessels were found, Congo red stain was negative, and no necrosis or mitosis was seen. Furthermore, was observed hemosiderin deposits and mild inflammatory infiltration, while mast cells were easily observed. Tumor cells were negative for AE1/3, PAX8, HMB45, Melan A, HHV-8, CD10, GFPA and CD117. CD31 and CD34 included vessels and a small number of stromal cells was positive for CD34. Finally, was observed positivity for S100, NSE and inhibin. These results were compatible with the diagnosis of hemangioblastoma.</p> <p><bold>Conclusion:</bold> Hemangioblastoma is a benign tumor of the central nervus system (CNS) and less often could be observed elsewhere. They can also rarely be associated with other conditions such as polyarthritis and pancreatic cysts and may occur in the context of Von Hippel-Lindau syndrome, which is why molecular testing is considered appropriate. Our case is presented due to the rarity of the presence of renal hemangioblastoma as an extensive review in the medical literature has so far highlighted 14 cases of renal hemangioblastoma.</p> </sec> <sec id="j_fco-2021-0025_s_045"><div>POSTERIOR FOSSA MEDULLOBLASTOMA IN AN ADULT PATIENT</div> <p>Arvanitou E.<sup>1</sup>, Plakas S.<sup>2</sup>, Giannakouras G.<sup>3</sup>, Rigakos G.<sup>4</sup>, Pappas D.<sup>5</sup>, Tsitsimpis A.<sup>1</sup>, Gikas K.<sup>1</sup>, Kolomitrousi A.<sup>1</sup>, Michas A.<sup>1</sup>, Gkiaouraki M.<sup>1</sup>, Mpallasis K.<sup>1</sup>, Chrystofyllakis Ch.<sup>1</sup>, Tsoukalas N.<sup>1</sup></p> <p><italic><sup>1</sup>Oncology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>2</sup>Neurosurgery Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>3</sup>Radiotherapy Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>4</sup>3rd Medical Oncology Department, Hygeia Hospital Athens</italic></p> <p><italic><sup>5</sup>Pathological Laboratory, 401 General Military Hospital of Athens</italic></p> <p><bold>Background</bold>: Medulloblastoma is an embryonic type of tumour, mainly located in the cerebellum, which unlike children rarely occurs in adults, with an annual incidence of 0.05–0.1 cases per 100,000. Medulloblastoma shows heterogeneity and is distinguished according to the World Health Organisation (WHO) into four subtypes, based on histological and molecular characteristics: a) WNT activated, b) SHH activated and TP53 wildtype, c) SHH activated and TP53 mutant and d) non-WNT/non-SHH. The prognosis of each subtype depends on age and differs in adults and children. Treatment includes gross total resection, adjuvant chemotherapy and craniospinal irradiation.</p> <p><bold>Aim:</bold> To present a case of posterior fossa medulloblastoma in an adult patient.</p> <p><bold>Case report:</bold> In January 2020, a 39-year-old male presented with persistent headache and progressively increasing vomiting. Brain magnetic resonance imaging (MRI) depicted a space-occupying lesion of 37 × 39 × 44 mm in the right cerebellum, without contrast enhancement, causing intense pressing phenomena, displacement of structures and increased dimensions of the ventricles. Due to the oedema, corticosteroids were started, and the patient showed clinical improvement. At the same time, due to manifestations from the psychic sphere, he was evaluated by a psychiatrist. The initial staging with craniospinal MRI, chest and abdominal computed tomography (CT) was normal. A surgical removal of more than 50% of the tumour mass was performed. The histological examination showed a grade IV cerebellum medulloblastoma of nodular/desmoplastic type. Further examination revealed tumour with ki-67 = 40%, without pathological IDH 1,2, without MYC amplification, and with <italic>YAP1</italic> overexpression, most likely of the SHH-activated molecular subtype (group 2). Postoperative MRI showed a large reduction in the size of the lesion. Subsequently, an assessment from a specialised central nervous system (CNS) tumour treatment centre was requested. Patient underwent craniospinal irradiation, and at present, receives chemotherapy with the lomustine/cisplatin/vincristine regimen, with adequate response according to the first follow-up. The molecular test that was performed revealed a TP53 heterozygous mutation of unknown clinical significance.</p> <p><bold>Conclusions:</bold> The management of rare tumours such as cerebellum medulloblastoma requires collaboration with specialised cancer treatment centres. The importance of an interdisciplinary team for the optimal management of patient care is also highlighted.</p> </sec> <sec id="j_fco-2021-0025_s_046"><div>PROSTATE EMBRYONAL RHABDOMYOSARCOMA IN A YOUNG ADULT PATIENT</div> <p>Arvanitou E.<sup>1</sup>, Papandropoulos I.<sup>2</sup>, Giannakouras G.<sup>3</sup>, Psarogiwrgou S.<sup>4</sup>, Tsitsimpis A.<sup>1</sup>, Gikas K.<sup>1</sup>, Kolomitrousi A.<sup>1</sup>, Michas A.<sup>1</sup>, Gkiaouraki M.<sup>1</sup>, Mpallasis K.<sup>1</sup>, Chrystofyllakis Ch.<sup>1</sup>, Tsoukalas N.<sup>1</sup></p> <p><italic><sup>1</sup>Oncology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>2</sup>Urology Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>3</sup>Radiotherapy Department, 401 General Military Hospital of Athens</italic></p> <p><italic><sup>4</sup>Pathological Laboratory, 401 General Military Hospital of Athens</italic></p> <p><bold>Background</bold>: Rhabdomyosarcoma represents an aggressive tumour which originates from the embryonal mesenchyme. It is the most common soft tissue sarcoma in children. But it is extremely rare in adults, as it accounts for 2%–5% of the soft tissue sarcomas. Prostate rhabdomyosarcoma is an aggressive tumour characterised by rapid tissue infiltration and poor prognosis. Immunohistochemistry and molecular testing are useful for diagnosis and classification. Treatment involves surgery, irradiation and chemotherapy.</p> <p><bold>Aim:</bold> To present a case of prostate embryonal rhabdomyosarcoma in a young adult patient.</p> <p><bold>Case report</bold>: In June 2019, a 24-year-old male presented with acute urinary retention and was diagnosed with a locally extended prostate mass and secondary pulmonary and bone lesions. The histological examination showed sheets of spindle or round cells with moderate pleomorphism and plenty of mitoses. The tumour cells demonstrated immunohistochemical positivity for vimentin, desmin and myogenin. Proliferation index, Ki-67, was rather high (70%). These findings were referable to embryonal rhabdomyosarcoma. An assessment from a centre specialising in paediatric and adolescent oncology was requested, and first-line treatment with IVADo regimen (d-actinomycin, doxorubicin, ifofosfamide, vincristine) with mesna administration was initiated. After chemotherapy completion, restaging computed tomography (CTs) and magnetic resonance imaging (MRIs) showed significant response of the prostate mass and bone disease and partial response of the pulmonary lesions. Subsequently, patient underwent a course of radiotherapy with volumetric modulated arc therapy (VMAT)/image-guided radiation therapy (IGRT) technique to the primary and metastatic bone lesions. Due to disease progression, second-line treatment with irinotecan/vincristine/temozolamide was selected. Despite the initial response, patient developed clinical deterioration with local recurrence and new metastatic bone lesions. Palliative radiotherapy (RT) followed, and third-line chemotherapy with cisplatin/adriblastina was initiated. Molecular testing showed no findings compatible with hereditary cancer syndrome.</p> <p><bold>Conclusion</bold>: Rhabdomyosarcoma is rare in adults and its treatment requires cooperation with specialised cancer centres. The importance of palliative care for the optimal patient care is also highlighted.</p> </sec> <sec id="j_fco-2021-0025_s_047"><div>PRIMARY SQUAMOUS NON-SMALL CELL LUNG CANCER WITH GASTROINTESTINAL METASTASES AT DIAGNOSIS</div> <p>Papadopoulos V., Tsapakidis K., Xantzara E., Markou A., Kokkalis A., Aidarinis X., Saloustros E., Koinis F., Samaras I., Kotsakis A.</p> <p><italic>Department of Clinical Oncology, University Hospital of Larissa, Greece</italic></p> <p><bold>Background:</bold> About half of the patients diagnosed with non-small cell lung cancer have distant metastases. The liver, bones, brain and adrenal glands are the most common anatomical sites of metastasis. Multiple metastatic lesions in the gastrointestinal tract from primary lung carcinoma are very rare.</p> <p><bold>Aim:</bold> To describe a case of extremely rare synchronous metastases in the gastrointestinal tract from squamous non-small cell lung carcinoma, although their incidence in autopsies is described to be about 14%.</p> <p><bold>Case report:</bold> A 71-year-old patient was diagnosed with squamous cell carcinoma of the lung due to cough and shortness of breath (IHC: p40+, TTF1−, synaptophysin−). During the initial staging of the disease with positron emission tomography/computed tomography (PET/CT) 18F-FDG, a hypermetabolic lesion was found in the left pulmonary portal (SUVmax: 11.2) and increased intake of 18F-FDG was observed in thickening of the stomach wall (SUVmax: 15.6) and in caecum (SUVmax: 12.9). The patient underwent gastroscopy and colonoscopy, which showed squamous cell carcinoma immunohistochemically similar to the primary lung. The patient received first-line chemotherapy with gemcitabine and carboplatin. The treatment failed after three cycles of chemotherapy as a result of tumour progression to the liver, and the patient was switched to second-line treatment with nivolumab. In the third cycle of treatment, melena occurred and a new gastroscopy was performed that revealed bleeding from the known metastatic lesion of the stomach. The patient underwent gastric haemostatic radiotherapy and while initially he was stabilised haemodynamically, he relapsed with haemorrhagic brain metastases and eventually passed away.</p> <p><bold>Conclusions:</bold> Gastrointestinal metastases from lung cancers are very rare and occur more frequently in older smokers with squamous cell carcinoma. The sputum seeding metastasis hypothesis is referred as a possible explanation, but needs investigation. However, the small number of patients in the literature makes it difficult to interpret this rare disease entity.</p> <p><bold>References:</bold> 1. Xinyu Li, Songhe Li, Zhiming Ma, Shutao Zhao, Xudong Wang, Dacheng Wen. Multiple gastrointestinal metastases of squamous-cell lung cancer. A case report. Medicine (Baltimore).2018 Jun; 97(24): e11027</p> <p>2. Ibrahim Azar, Efstratios Koutroumpakis, Raina Patel, Syed Mehdi. Squamous cell lung carcinoma presenting as melena: a case report and review of the literature. Rare Tumors. 2017 Oct 4;9(3):7164</p> <p>3. Ying He, Yong Cui, Xinchun Duan, Chunquan Liu, and Xianqi Cai. Primary lung squamous cell carcinoma with gastric metastasis: A case report. Thorac Cancer.2019 Feb; 10(2): 373–377.</p> <p>4. Mariko Nemoto, Pankaj Prasoon, Hiroshi Ichikawa, Takaaki Hanyu, Yosuke Kano, Yusuke Muneoka, Kenji Usui, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Ishikawa, Masanori Tsuchida, Toshifumi Wakai. Primary lung squamous cell carcinoma and its association with gastric metastasis: A case report and literature review. Thorac Cancer. 2020 Jun;11(6):1708–1711</p> </sec> <sec id="j_fco-2021-0025_s_048"><div>SIMULTANEOUS DIAGNOSIS OF PULMONARY ADENOCARCENOMA AND MYELODYSPLASTIC SYNDROME. CASE REPORT</div> <p>E. Chrysoulidou, E. Panori</p> <p><italic>Blood donation Dep. G. H. KAVALA</italic></p> <p><bold>Background:</bold> During the last years, there have been great leaps regarding the diagnosis and treatment of cancer. This is attributed to the development of technology which allows scientists to isolate and observe the activities of specific genes that have undergone mutations and are responsible for tumour growth. Genes with specific mutations are observed in different neoplacies, regardless of their origin. This means that the same medication can be used in different kinds of cancer.</p> <p>The term myelodysplastic syndrome (MDS) refers to a heterogenic group of acquired clonal neoplasmatic disorders of the bone marrow at the level of a polyvalent haematopoietic cell. It is characterised by a non-effective hematopoiesis cytarropenia, morphological disorders of haematopoietic cells and could evolve into an acute myelogenic leukaemia. It usually affects people over 60 years old. Pulmonary adenocarcinoma constitutes the most common type of cancer. It belongs to the category of the non-microcellular lung cancer. It is asymptomatic and in most cases, before it is clinically perceived, it would have already become metastatic. It affects mostly middle-aged men aged 60–70.</p> <p><bold>Aim:</bold> Description of a case diagnosed with two different types of neoplacies simultaneously in the same biopathological material.</p> <p><bold>Methods:</bold> A male, 69 years old, presented with weakness, fatigue and shortness of breath in the course of 3 days and he had free individual background. During his clinical evaluation, a pulmonary murmur reduction was established, SpO<sub>2</sub>- 85%. He was haemodynamically stable without fever. According to his lab results, he presented with respiratory acidosis, pancytopenia, elevated CRP, LDH, ALP and cancer indicators. His chest X-ray showed ozomorphic shading bilaterally, left semi-diaphragm fuzzification and atypical bone imaging. In his CT scan, leukoencephalopathy was observed. Image of a blurred glass in the lung parenchyma was seen bilaterally. Image of a lower left lung lobe percolation with a positive aerobronchgramme. Swollen lymph nodes were found in the mesothorax. Pleural effusion collection bilaterally. Multiple liver metastatic focus. At least one metastatic focus on the splene. Multiple bone metastases. During the examination, both on osteomyelic biopsy and a myelogram were conducted which present: elevated cytarobrithia with hyperplacia of granulomatous and red line cell, dysplastic lesions of all 3 hemopoitic series. CD34 and CD 117 coloring showed positive blast-cells at a >10% and <20%. Accumulation of neoplasmatic cells s obserued which exhibit immunohistochemically the phenotype of a pulmonary andenocarcinoma : AE1/AE3(+),CK7(+),NapsinA(+),TTF1(+),CK20(-),CK5/6(-), synaptophysyne(-), chromogranine().</p> <p><bold>Result:</bold> The patient was diagnosed with two different malignancies simultaneously: pulmonary adenocarcinoma with multiple metastatic focuses and myelodysplastic syndrome with excess blasts (EB-2).</p> <p><bold>Conclusions:</bold> The investigation of pancytopenia contributed to the diagnosis of pulmonary adenocarcinoma in conjunction with blood neoplasia. Similar cases of adenocarcinoma co-existing with other haemopoietic system malignancies have been reported. This co-existence is rare and is probably due to a common pathophysiological mechanism. Further study could help in its treatment.</p> <p>Mutations in isocitrate dehydrogenase genes <italic>IDH1</italic> and <italic>IDH2</italic> were found in acute myelogenic leukaemia and the selective inhibitors <italic>IDH1</italic> and <italic>IDH2</italic> have been approved for the targeted treatment of acute myelogenic leukaemia. Studies have revealed <italic>IDH1</italic> mutations in many malignancies, with the most frequent being IDH1 R132H. It has been proved that the expression IDH1/2 in non-small cell lung cancer (NSCLC) appears in pulmonary adenocarcinomas as an indication of sub-clonal evolution.</p> </sec> <sec id="j_fco-2021-0025_s_049"><div>ACUTE RESPIRATORY FAILURE AFTER THORACHOTOMY – THE ROLE OF THE NURSERY USE OF NON-INVASIVE MECHANICAL VENTILATION: A CASE STUDY</div> <p>Papastergiou K.<sup>1</sup>, Karantsiri M.<sup>2</sup>, Lavdaniti M.<sup>3</sup></p> <p><italic><sup>1</sup>RN, MSc, ‘Theageneio’ Hospital, Thessaloniki</italic></p> <p><italic><sup>2</sup>RN, School Nurse, Thessaloniki</italic></p> <p><italic><sup>3</sup>Associate Professor, Department of Nursing, International University of Greece, Thessaloniki</italic></p> <p><bold>Background</bold>: Acute respiratory failure is a pathological condition in which the body is unable to perform gas exchange satisfactorily. Thoracic surgeries have a high risk of postoperative respiratory complications, especially in patients with risk factors (such as COPD) associated with anaesthesia. Non-invasive mechanical ventilation is a method of intervening in a patient’s breathing by supporting it mechanically, without the act of intubation.</p> <p><bold>Aim</bold>: The aim of the study was to describe an incident with the occurrence of acute postoperative respiratory failure in a patient undergoing thoracotomy and the use of non-invasive mechanical ventilation.</p> <p><bold>Method</bold>: This is a case study of a 77-year-old male patient who underwent right rear thoracotomy in a large hospital in Northern Greece.</p> <p><bold>Results</bold>: A 77-year-old male patient with right upper lung adenocarcinoma arrived in November 2020 for surgery. The patient underwent right posterior thoracotomy, wedge resection of the right upper lobe and mediastinal lymph node biopsies. He had chronic respiratory pulmonary disease, arterial hypertension, hepatitis C as special problems, along with being a former smoker 30 years ago. Forced vital capacity (FCV) was 2.02%–65% and forced expiratory volume (FEV1) was 1.90%–81%. There were no intraoperative complications, and the intubation was performed in the resuscitation room, while later, he was transferred to the ICU. During the first 6 h of hospitalisation in the ICU, there were symptoms of respiratory distress with SpO2 >85% and shortness of breath, while he had a good level of consciousness and communication. The difficulty was addressed with the placement of a NIV mask and regular monitoring of SpO2 and reduction of speed. Nursing care consisted of the timely recognition of shortness of breath, dyspnoea, sweating and decreased SpO2, in order to apply the NIV mask in a timely manner and to regularly monitor the vital signs hourly.</p> <p><bold>Conclusions</bold>: Acute respiratory failure is life-threatening to the patient. Non-invasive mechanical ventilation improves the efficiency of the lung in gas exchange in a short time and should be applied for the best outcome of the patient.</p> </sec> </div></div></div></div><div id="pane-3" class="SeriesTab_card__26XnC SeriesTab_tab-pane__3pc7y card tab-pane" role="tabpanel" aria-labelledby="tab-3"><div class="SeriesTab_card-header__1DTAS card-header d-md-none pl-0" role="tab" id="heading-3"><h4 class="mb-0"><a data-toggle="collapse" href="#collapse-3" data-parent="#content" aria-expanded="false" aria-controls="collapse-3" style="padding:24px 0">Ilustracje i tabele<svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="chevron-down" class="svg-inline--fa fa-chevron-down fa-w-14 " role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"><path fill="currentColor" d="M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 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mt-4">j.fco-2021-0025.tab.001</h4><table frame="hsides" rules="groups"> <thead> <tr> <th align="left" valign="middle" rowspan="3"/> <th align="center" valign="middle" rowspan="3"><bold>2018</bold></th> <th align="center" valign="middle" rowspan="3"><bold>2019</bold></th> <th align="center" valign="middle" rowspan="3"><bold>2020</bold></th> <th align="center" valign="middle" colspan="2"><bold>DIFFERENCE (%)</bold></th> </tr> <tr> <th align="center" valign="middle" colspan="2"><hr/></th> </tr> <tr> <th align="center" valign="middle"><bold>2019/20</bold></th> <th align="center" valign="middle"><bold>2018/20</bold></th> </tr> </thead> <tbody> <tr> <td colspan="6" align="left" valign="top"><bold>ENTIRE HOSPITAL</bold></td> </tr> <tr> <td align="left" valign="top"><bold>NEW PATIENTS</bold></td> <td align="center" valign="top">9563</td> <td align="center" valign="top">9254</td> <td align="center" valign="top">6932</td> <td align="center" valign="top">−25,1</td> <td align="center" valign="top">−27,5</td> </tr> <tr> <td align="left" valign="top"><bold>OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">136184</td> <td align="center" valign="top">128398</td> <td align="center" valign="top">100327</td> <td align="center" valign="top">−22</td> <td align="center" valign="top">−26,3</td> </tr> <tr> <td align="left" valign="top"><bold>PATIENT ADMISSIONS</bold></td> <td align="center" valign="top">22402</td> <td align="center" valign="top">23286</td> <td align="center" valign="top">21309</td> <td align="center" valign="top">−8,5</td> <td align="center" valign="top">−4,9</td> </tr> <tr> <td align="left" valign="top"><bold>EVENING OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">17887</td> <td align="center" valign="top">14586</td> <td align="center" valign="top">9725</td> <td align="center" valign="top">−33,3</td> <td align="center" valign="top">−45,6</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>INTERNAL MEDICINE WARD</bold></td> </tr> <tr> <td align="left" valign="top"><bold>PATIENT ADMISSIONS</bold></td> <td align="center" valign="top">15481</td> <td align="center" valign="top">16148</td> <td align="center" valign="top">14924</td> <td align="center" valign="top">−7,6</td> <td align="center" valign="top">−3,6</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>MEDICAL ONCOLOGY DEPARTMENTS</bold></td> </tr> <tr> <td align="left" valign="top"><bold>OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">26996</td> <td align="center" valign="top">26380</td> <td align="center" valign="top">22851</td> <td align="center" valign="top">−13,4</td> <td align="center" valign="top">−15,4</td> </tr> <tr> <td align="left" valign="top"><bold>PATIENT ADMISSIONS</bold></td> <td align="center" valign="top">7323</td> <td align="center" valign="top">7016</td> <td align="center" valign="top">6593</td> <td align="center" valign="top">−6</td> <td align="center" valign="top">−10</td> </tr> <tr> <td align="left" valign="top"><bold>ONE−DAY CLINIC</bold></td> <td align="center" valign="top">32545</td> <td align="center" valign="top">32083</td> <td align="center" valign="top">29831</td> <td align="center" valign="top">−7</td> <td align="center" valign="top">−8,3</td> </tr> <tr> <td align="left" valign="top"><bold>EVENING OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">4526</td> <td align="center" valign="top">3821</td> <td align="center" valign="top">2282</td> <td align="center" valign="top">−40,3</td> <td align="center" valign="top">−49,6</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>DEPARTMENT OF RADIATION ONCOLOGY</bold></td> </tr> <tr> <td align="left" valign="top"><bold>OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">6990</td> <td align="center" valign="top">7802</td> <td align="center" valign="top">6808</td> <td align="center" valign="top">−12,5</td> <td align="center" valign="top">−2,6</td> </tr> <tr> <td align="left" valign="top"><bold>RADIOTHERAPY SESSIONS</bold></td> <td align="center" valign="top">33195</td> <td align="center" valign="top">39265</td> <td align="center" valign="top">34952</td> <td align="center" valign="top">−11</td> <td align="center" valign="top">5,3</td> </tr> <tr> <td align="left" valign="top"><bold>PATIENT ADMISSIONS</bold></td> <td align="center" valign="top">346</td> <td align="center" valign="top">335</td> <td align="center" valign="top">230</td> <td align="center" valign="top">−32,4</td> <td align="center" valign="top">−33,5</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>SURGICAL WARD</bold></td> </tr> <tr> <td align="left" valign="top"><bold>PATIENT ADMISSIONS</bold></td> <td align="center" valign="top">6921</td> <td align="center" valign="top">7138</td> <td align="center" valign="top">6385</td> <td align="center" valign="top">−11,6</td> <td align="center" valign="top">−7,8</td> </tr> <tr> <td align="left" valign="top"><bold>OUTPATIENT APPOINTMENTS</bold></td> <td align="center" valign="top">36789</td> <td align="center" valign="top">36484</td> <td align="center" valign="top">32651</td> <td align="center" valign="top">−11,5</td> <td align="center" valign="top">−11,3</td> </tr> <tr> <td align="left" valign="top"><bold>SURGERIES</bold></td> <td align="center" valign="top">6318</td> <td align="center" valign="top">6173</td> <td align="center" valign="top">5287</td> <td align="center" valign="top">−14,4</td> <td align="center" valign="top">−16,6</td> </tr> <tr> <td align="left" valign="top"><bold>DEPARTMENT OF THORACIC SURGERY</bold></td> <td align="center" valign="top">1013</td> <td align="center" valign="top">984</td> <td align="center" valign="top">1040</td> <td align="center" valign="top">5,4</td> <td align="center" valign="top">2,5</td> </tr> <tr> <td align="left" valign="top"><bold>PAIN CENTER</bold></td> <td align="center" valign="top">7982</td> <td align="center" valign="top">7541</td> <td align="center" valign="top">7307</td> <td align="center" valign="top">−3,1</td> <td align="center" valign="top">−8,5</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>SCREENING EXAMINATIONS</bold></td> </tr> <tr> <td align="left" valign="top"><bold>BREAST CANCER SCREENING</bold></td> <td align="center" valign="top">7839</td> <td align="center" valign="top">2048</td> <td align="center" valign="top">1044</td> <td align="center" valign="top">−49,1</td> <td align="center" valign="top">−86,7</td> </tr> <tr> <td align="left" valign="top"><bold>GYNECOLOGICAL CANCER SCREENING</bold></td> <td align="center" valign="top">5435</td> <td align="center" valign="top">3190</td> <td align="center" valign="top">1446</td> <td align="center" valign="top">−54,7</td> <td align="center" valign="top">−73.3</td> </tr> <tr> <td colspan="6" align="left" valign="top"><bold>DIAGNOSTIC EXAMINATIONS</bold></td> </tr> <tr> <td align="left" valign="top"><bold>CT SCANS</bold></td> <td align="center" valign="top">8949</td> <td align="center" valign="top">9485</td> <td align="center" valign="top">8626</td> <td align="center" valign="top">−9,1</td> <td align="center" valign="top">−3,6</td> </tr> <tr> <td align="left" valign="top"><bold>PET SCANS</bold></td> <td align="center" valign="top">1027</td> <td align="center" valign="top">1853</td> <td align="center" valign="top">1883</td> <td align="center" valign="top">1,6</td> <td align="center" valign="top">83,3</td> </tr> <tr> <td align="left" valign="top"><bold>ENDOSCOPIES</bold></td> <td align="center" valign="top">3946</td> <td align="center" valign="top">4194</td> <td align="center" valign="top">3519</td> <td align="center" valign="top">−16,1</td> <td align="center" valign="top">−10,8</td> </tr> <tr> <td align="left" valign="top"><bold>BRONCHOSCOPIES</bold></td> <td align="center" valign="top">138</td> <td align="center" valign="top">175</td> <td align="center" valign="top">144</td> <td align="center" valign="top">−17,7</td> <td align="center" valign="top">4,3</td> </tr> <tr> <td align="left" valign="top"><bold>DEPARTMENT OF CYTOLOGY</bold></td> <td align="center" valign="top">10287</td> <td align="center" valign="top">10940</td> <td align="center" valign="top">7166</td> <td align="center" valign="top">−35,5</td> <td align="center" valign="top">−30,3</td> </tr> <tr> <td align="left" valign="top"><bold>DEPARTMENT OF PATHOLOGY</bold></td> <td align="center" valign="top">15856</td> <td align="center" valign="top">16775</td> <td align="center" valign="top">17700</td> <td align="center" valign="top">1,05</td> <td align="center" valign="top">11,6</td> </tr> <tr> <td align="left" valign="top"><bold>DEPARTMENT OF NUCLEAR MEDICINE</bold></td> <td align="center" valign="top">18718</td> <td align="center" valign="top">19689</td> <td align="center" valign="top">15233</td> <td align="center" valign="top">−22,6</td> <td align="center" valign="top">−18,6</td> </tr> </tbody> </table><h4 class="mb-4 mt-4">j.fco-2021-0025.tab.002</h4><table frame="hsides" rules="groups"> <thead> <tr> <th align="left" valign="middle"><bold>Neoplasms</bold></th> <th align="center" valign="middle"><bold>Proportions (%)</bold></th> <th align="center" valign="middle"><bold>Age (>65)</bold></th> <th align="center" valign="middle"><bold>Gender (F)</bold></th> <th align="center" valign="middle"><bold>Metastases</bold></th> <th align="center" valign="middle"><bold>Khorana score (≥2)</bold></th> <th align="center" valign="middle"><bold>HRTCAs</bold></th> </tr> </thead> <tbody> <tr> <td align="left" valign="top"><bold>Lung</bold></td> <td align="center" valign="top">28.8</td> <td align="center" valign="top">57.3</td> <td align="center" valign="top">22.6</td> <td align="center" valign="top">89.6</td> <td align="center" valign="top">59.7</td> <td align="center" valign="top">88.5</td> </tr> <tr> <td align="left" valign="top"><bold>Pancreatic</bold></td> <td align="center" valign="top">21.4</td> <td align="center" valign="top">56.5</td> <td align="center" valign="top">36.7</td> <td align="center" valign="top">87.5</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">98.9</td> </tr> <tr> <td align="left" valign="top"><bold>Colorectal</bold></td> <td align="center" valign="top">11.4</td> <td align="center" valign="top">55.1</td> <td align="center" valign="top">33.3</td> <td align="center" valign="top">81.8</td> <td align="center" valign="top">18.4</td> <td align="center" valign="top">98.0</td> </tr> <tr> <td align="left" valign="top"><bold>Gastric</bold></td> <td align="center" valign="top">7.0</td> <td align="center" valign="top">66.7</td> <td align="center" valign="top">16.7</td> <td align="center" valign="top">77.8</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">90.0</td> </tr> <tr> <td align="left" valign="top"><bold>Ovarian</bold></td> <td align="center" valign="top">4.7</td> <td align="center" valign="top">60.0</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">79.0</td> <td align="center" valign="top">70.0</td> <td align="center" valign="top">89.5</td> </tr> <tr> <td align="left" valign="top"><bold>Cervical</bold></td> <td align="center" valign="top">1.2</td> <td align="center" valign="top">0.0</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">80.0</td> <td align="center" valign="top">80.0</td> <td align="center" valign="top">100.0</td> </tr> <tr> <td align="left" valign="top"><bold>Uterine</bold></td> <td align="center" valign="top">1.2</td> <td align="center" valign="top">40.0</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">100.0</td> <td align="center" valign="top">80.0</td> <td align="center" valign="top">60.0</td> </tr> <tr> <td align="left" valign="top"><bold>Breast</bold></td> <td align="center" valign="top">4.4</td> <td align="center" valign="top">21.1</td> <td align="center" valign="top">94.7</td> 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want \u003cSTRONG\u003eFCO\u003c/STRONG\u003e to serve as a forum, for us all, to communicate clinical and research achievements in English; to share thoughts, opinions, facts, problems and solutions.\u003cBR\u003eWe envision the journal to be the means, by which our efforts in the fight against cancer will become known to a wider audience, thus establishing our presence in the global setting. \u003cSTRONG\u003eFCO\u003c/STRONG\u003e publishes original and translational research articles relevant to diagnosis and treatment of cancer, state-of-the-art reviews, case reports, research articles, statements of opinion and comments, all related to clinical practice and basic research. A large number of eminent Greek and Foreign colleagues who participate in the National and International Editorial Boards, with their continuum direction and support, guarantee the high quality of the work published in \u003cSTRONG\u003eFCO\u003c/STRONG\u003e. In every issue published there will be something new, enjoyable and exciting to be read. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eWhy submit\u003c/STRONG\u003e \u003c/P\u003e \u003cP\u003eWe would like to welcome you to the \u003cSTRONG\u003eForum of Clinical Oncology (FCO),\u003c/STRONG\u003e the official scientific journal of the \u003cSTRONG\u003eHellenic Society of Medical Oncology\u003c/STRONG\u003e.\u003cBR\u003eIn the \u003cSTRONG\u003eHellenic Society of Medical Oncology\u003c/STRONG\u003e we share the view that there are many issues we deal with in our everyday clinical and research practice that are common to our colleagues geographically closer to us, in the Balkans and the Mediterranean basin, but also to those in other parts of the world. That led us to dare \"the great leap forward\": to broaden the scope of our Greek scientific journal for oncology, published in Greek for the last 10 years, and develop \u003cSTRONG\u003eForum of Clinical Oncology\u003c/STRONG\u003e a web based open access journal in English. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eFCO\u003c/STRONG\u003e will serve as a forum for us all to communicate clinical and research achievements. One of the innovations of the journal is its online management from submission of an article to its publication. Online is more efficient: submitting, reviewing, proofreading, filing and indexing. However, the most important benefit of all is easy universal access. \u003c/P\u003e \u003cP\u003eEnglish has become the common language amongst scientists from around the globe. This is the reason why we chose English as the official language of the journal. Many Greek colleagues have already published work in English in distinguished journals or have studied or worked abroad. We believe that the language change will not be an impediment for our Greek colleagues to present their work in \u003cSTRONG\u003eFCO\u003c/STRONG\u003e, whereas on the other hand it will allow our colleagues from other countries to participate. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eThe Forum of Clinical Oncology\u003c/STRONG\u003e publishes original and translational research articles relevant to diagnosis and treatment of cancer, state-of-the-art reviews, case reports, research articles, statements of opinion and comments, all related to clinical practice and basic research. \u003c/P\u003e \u003cP\u003eWe share the view that there should be no barriers to knowledge and thus, we decided \u003cSTRONG\u003eForum of Clinical Oncology\u003c/STRONG\u003e to be an open-access journal, i.e., any work submitted to the journal and accepted for publication shall be made immediately available to the scientific community and the general public, via the journal's website and printed version. Authors are requested to adjust accordingly the information regarding their work they wish to make public. It is the desire of the editorial team to make this journal an interactive educational tool to acquire knowledge and it is addressed to scientists working with oncology. \u003c/P\u003e \u003cP\u003ePlease join us in our effort and submit your work to the \u003cSTRONG\u003eFCO\u003c/STRONG\u003e. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eArchiving \u003c/STRONG\u003e\u003c/P\u003e \u003cP\u003eSciendo archives the contents of this journal in \u003cA href=\"https://www.portico.org/\"\u003ePortico\u003c/A\u003e - digital long-term preservation service of scholarly books, journals and collections. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003ePlagiarism Policy\u003c/STRONG\u003e \u003c/P\u003e \u003cP\u003eThe editorial board is participating in a growing community of \u003cA href=\"https://www.crossref.org/services/similarity-check/\"\u003eSimilarity Check System's\u003c/A\u003e users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. \u003c/P\u003e\u003c/DIV\u003e"},{"type":"submission","language":"English","textformat":null,"content":"\u003cP\u003eAll submissions must be made via online submission system Editorial Manager: \u003cA href=\"http://www.editorialmanager.com/fco\"\u003ewww.editorialmanager.com/fco\u003c/A\u003e \u003c/P\u003e \u003cP\u003eIn case of any technical problems, please contact the Journal Office at: \u003cA href=\"mailto:hesmo@otenet.gr\"\u003ehesmo@otenet.gr\u003c/A\u003e \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eOpen Access Statement\u003c/STRONG\u003e \u003c/P\u003e \u003cP\u003eThe journal is an Open Access journal that allows a free unlimited access to all its contents without any restrictions upon publication to all users. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003e\u003cA href=\"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/FCO/Open_Access_License.pdf\"\u003eOpen Access License\u003c/A\u003e\u003c/STRONG\u003e \u003c/P\u003e \u003cP\u003e\u003cU\u003eCopyright License\u003c/U\u003e \u003c/P\u003e \u003cP\u003eForum of Clinical Oncology is an open journal, available online on, among others, \u003cA href=\"http://www.jultrason.pl//t_blank\"\u003e\u003cU\u003ewww.jultrason.pl\u003c/U\u003e\u003c/A\u003e. It can be accessed free of charge and with no other barriers on the basis of the Creative Commons Attribution-Non Commercial-No Derivatives License (\u003cA href=\"http://creativecommons.org/licenses/by-nc-nd/4.0/\"\u003e\u003cU\u003ehttp://creativecommons.org/licenses/by-nc-nd/4.0/\u003c/U\u003e\u003c/A\u003e) – CC-BY-NC-ND (certain rights reserved for the publisher and authors). The license allows for redistribution, presentation and preparation of the material for non-commercial purposes only, as long as it remains in its original form (without creating derivative works). The journal allows the author(s) to hold the copyright and retain publishing rights without restrictions. When deciding to publish an article in “Forum of Clinical Oncology” the author consents to its redistribution on the aforementioned terms and guarantees that the article does not infringe the rights of the third party. \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eArticle Processing Charge (APC)\u003c/STRONG\u003e \u003c/P\u003eThe journal does not have article processing charges (APCs) nor article submission charges."},{"type":"editorial","language":"English","textformat":null,"content":"\u003cP\u003e\u003cSTRONG\u003eManaging Editors\u003cBR\u003e\u003c/STRONG\u003e\u003cA href=\"mailto:tsoukn@yahoo.gr\"\u003eNikolaos Tsoukalas\u003c/A\u003e, MD, MSc, PhD, Medical Oncologist, MSc in Bioinformatics, Deputy Director, Oncology Department,\u003cBR\u003e401 General Military Hospital, Consultant, Henry Dunant Hospital Center, Athens, Greece, HeSMO \u003c/P\u003e \u003cP\u003e\u003c/P\u003e \u003cP\u003e\u003cA href=\"mailto:mliontos@gmail.com\"\u003eMichael Liontos\u003c/A\u003e, Medical Oncologist, Associate Professor of Therapeutics-Oncology, National and Kapodistrian University of Athens, Dept of Clinical Therapeutics, Alexandra Hospital, Athens, Greece, HeSMO \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eAssociated Editor\u003c/STRONG\u003e\u003cBR\u003e\u003cA href=\"mailto:v-a-g-@hotmail.com\"\u003eEvangelos Karamitrousis\u003c/A\u003e, MD, PhD, MSc, BSc, Medical Oncology Consultant, University Medical Oncology Department, Papageorgiou General Hospital, Thessaloniki, Greece, HeSMO \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eAdvisory Editorial Board\u003cBR\u003e\u003c/STRONG\u003eRene Adam, Paul Brousse Hospital, France\u003cBR\u003eAthanassios Argiris, University of Pittsburgh School of Medicine, United States\u003cBR\u003eVassileios Avramis, Children's Hospital Los Angeles, United States\u003cBR\u003eLodovico Balducci, Lee Moffitt Cancer Center and Research Institute, United States\u003cBR\u003eGeorge Peter Canellos, Harvard Medical School, United States\u003cBR\u003eJ.Y. Douillard, Medical Oncology Branch, Centre R. Gauducheau, France\u003cBR\u003eGeorge Demetri, Dana-Farber Cancer Institute, United States\u003cBR\u003eSpyros Linardopoulos, Cancer Research UK Centre for Cancer Therapeutics, Chester Beatty Laboratories, United Kingdom\u003cBR\u003eTerry Mamounas, Cancer Center, Aultman Health Foundation, United States\u003cBR\u003eAnthony Maraveyas, Castle Hill Hospital, United Kingdom\u003cBR\u003eVassiliki Papadimitrakopoulou, UT/MD Anderson Cancer Center, United States\u003cBR\u003eGeorge Pavlakis, NCI at Frederick, United States\u003cBR\u003eSpyros Retsas, Cromwell Hospital, United Kingdom\u003cBR\u003ePhilippe Rougier, Department of Gastroenterology, Hospital Ambroise Paris, France\u003cBR\u003eGiorgio Scaglioti, University of Torino, San Luigi Hospital, Italy\u003cBR\u003eT.C. Theoharides, Tufts University School of Medicine, Tufts Medical Center, United States \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eEditors\u003cBR\u003e\u003c/STRONG\u003eAthanassios Anagnostopoulos, Henry Dunant Hospital, Greece\u003cBR\u003eGerasimos Aravantinos, \"Agioi Anargyroi\" Hospital, Greece\u003cBR\u003eAthanassios Athanassiadis, General Hospital of Larissa \"Koutlimpaneio \u0026amp; Triantafylleio\", Greece\u003cBR\u003eDimitrios Bafaloukos, Metropolitan Hospital, Greece\u003cBR\u003eAristotelis Bamias, University General Hospital of Athens \"Alexandra\", Greece\u003cBR\u003eIoannis Boukovinas, Theageneio Anticancer Hospital, Greece\u003cBR\u003eChristos Emmanouilides, Interbalkan Medical Center, Greece\u003cBR\u003eHelen Gogas, University General Hospital of Athens \"Laiko\", Greece\u003cBR\u003eStylianos Kakolyris, University General Hospital of Alexandroupoli, Greece\u003cBR\u003eAthanasios Karampeazis, 401 General Military Hospital of Athens, Greece\u003cBR\u003eMichael Karamouzis, Medical School, University of Athens, Greece\u003cBR\u003eOurania Katopodi, Bioclinic of Athens, Greece\u003cBR\u003eGeorgios Klouvas, Metropolitan Hospital, Greece\u003cBR\u003eChristos Kosmas, General Anticancer Hospital \"Metaxa\", Greece\u003cBR\u003eGeorgios Koumakis, \"Agios Savvas\" Anticancer Hospital, Greece\u003cBR\u003eThomas Makatsoris, University General Hospital of Patra - Rio, Greece\u003cBR\u003eDimitris Mavroudis, University General Hospital of Heraklion, Greece\u003cBR\u003eMichael Nikolaou, \"Ippokrateion\" University Hospital of Athens, Greece\u003cBR\u003eChristos Panopoulos, \"Agios Savvas\" Anticancer Hospital, Greece\u003cBR\u003eChristos Papadimitriou, University General Hospital of Athens \"Alexandra\", Greece\u003cBR\u003eChristos Papandreou, University General Hospital of Larissa, Greece\u003cBR\u003eKonstantinos Papazissis, Theageneio Anticancer Hospital, Greece\u003cBR\u003eDimitrios Pectasides, General Hospital of Athens \"Ippokratio\", Greece\u003cBR\u003eGeorgios Pentheroudakis, University General Hospital of Ioannina, Greece\u003cBR\u003eAmanda Psyrri, University General Hospital of Athens \"Attikon\", Greece\u003cBR\u003eEvangelia Razis, Hygeia Hospital, Greece\u003cBR\u003eGeorgios Samonis, University General Hospital of Heraklion, Greece\u003cBR\u003eIoannis Souglakos, University General Hospital of Heraklion, Greece\u003cBR\u003eKyriakos Souliotis, Associate Professor, University of Peloponnese, Greece\u003cBR\u003eKostas Syrigos, \"Sotiria\" Regional Chest Diseases Hospital of Athens, Greece\u003cBR\u003eDimitrios Tryfonopoulos, \"Agios Savvas\" Anticancer Hospital, Greece\u003cBR\u003eLambros Vamvakas, University General Hospital of Heraklion, Greece\u003cBR\u003eMichael Vaslamatzis, General Hospital of Athens \"Evaggelismos\", Greece\u003cBR\u003eSpyridon Xynogalos, General Hospital of Athens \"Evaggelismos\", Greece\u003cBR\u003eNikolaos Ziras, General Anticancer Hospital \"Metaxa\", Greece \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eSection Editors\u003cBR\u003e\u003c/STRONG\u003e\u003cEM\u003eGenetics\u003c/EM\u003e\u003cBR\u003eKoulis Giannoukakos, NSCR Demokritos, Greece\u003cBR\u003eEmmanouil Saloustros, General Hospital of Heraklion \"Venizeleio- Pananeio\", Greece \u003c/P\u003e \u003cP\u003e\u003cEM\u003eMedical Oncology\u003cBR\u003e\u003c/EM\u003eCharalambos Andreadis, Theageneio Anticancer Hospital, Greece\u003cBR\u003eDimitrios Mavroudis, University of Crete, Greece\u003cBR\u003eEvaggelos Briasoulis, University of Ioannina, Greece \u003c/P\u003e \u003cP\u003e\u003cEM\u003eMolecular Biology\u003cBR\u003e\u003c/EM\u003eSam Murray, Genekor SA, Greece\u003cBR\u003eVasiliki Kotoula, University of Thessaloniki, Greece \u003c/P\u003e \u003cP\u003e\u003cEM\u003ePathology\u003cBR\u003e\u003c/EM\u003ePetroula Arapantoni-Dadioti, Metropolitan Hospital General Anticancer Hospital \"Metaxa\", Greece\u003cBR\u003eSavvas Papadopoulos, Hygeia Hospital, Greece \u003c/P\u003e \u003cP\u003e\u003cEM\u003eRadiation Oncology\u003cBR\u003e\u003c/EM\u003eDimitris Kardamakis, University of Patras, Greece\u003cBR\u003eDespoina Misailidou, Interbalkan Medical Centre, Greece \u003c/P\u003e \u003cP\u003e\u003cEM\u003eSurgical Oncology\u003cBR\u003e\u003c/EM\u003eOdysseas Zoras, Medical School University General Hospital of Heraklion, Greece\u003cBR\u003eEvaggelos Xynos, University Hospital of Herakleion, Greece \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003eContact\u003cBR\u003e\u003c/STRONG\u003e\u003cA href=\"mailto:fco@hesmo.gr\"\u003efco@hesmo.gr\u003c/A\u003e / \u003cA href=\"mailto:hesmo@otenet.gr\"\u003ehesmo@otenet.gr\u003c/A\u003e \u003c/P\u003e \u003cP\u003e\u003cSTRONG\u003ePublisher\u003cBR\u003e\u003c/STRONG\u003eDe Gruyter Poland\u003cBR\u003eBogumiła Zuga 32A Str.\u003cBR\u003e01-811 Warsaw, Poland \u003c/P\u003e"}]}],"metrics":{"metric":[{"name":"Cite Score","value":0.5},{"name":"SCImago Journal Rank","value":0.134},{"name":"Source Normalized Impact per Paper","value":0.027}]},"pricing":null,"publicationFrequency":{"frequency":"4","period":"YEAR"},"permissions":null,"contributors":"","serial":null,"publishMonth":"12","publishYear":"2021","tableCount":null,"figureCount":null,"refCount":null,"keywords":[],"figures":null,"tables":null,"planPubDates":[],"epubLink":null,"pdfLink":null,"coverImage":"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/62c5b94cca8f8703463bdb5a/cover-image.jpg","coverImageOriginal":"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/62c5b94cca8f8703463bdb5a/cover-image-original.jpg","pdfFiles":[],"parentObjectId":"62c5b94cca8f8703463bdb5a","isParentConference":false,"relatedTitles":null,"forAuthors":null,"nextPackageId":null,"prevPackageId":null,"parentName":"Volume 12 (2021): Issue 2 (December 2021)\u003cbr/\u003eSupplementary Issue: 27th Hellenic Conference of Clinical Oncology","grandParentId":"6005b041e797941b18f23c56","grandParentName":"Forum of Clinical Oncology","isGrandParentConference":false,"publisherName":"Sciendo","publisherLocation":null,"nextMap":{"doi":null},"prevMap":{"doi":null},"counter":0,"apaString":"(2021).\u003carticle-title\u003e27\u003csup\u003eth\u003c/sup\u003e Hellenic Conference of Clinical Oncology\u003c/article-title\u003e. Forum of Clinical Oncology,12(2) 1-50. \u003ca href='https://doi.org/10.2478/fco-2021-0025'\u003ehttps://doi.org/10.2478/fco-2021-0025\u003c/a\u003e","mlaString":"\"\u003carticle-title\u003e27\u003csup\u003eth\u003c/sup\u003e Hellenic Conference of Clinical Oncology\u003c/article-title\u003e\" Forum of Clinical Oncology, vol.12, no.2, 2021, pp.1-50. \u003ca href='https://doi.org/10.2478/fco-2021-0025'\u003ehttps://doi.org/10.2478/fco-2021-0025\u003c/a\u003e","harvardString":" (2021) \u003carticle-title\u003e27\u003csup\u003eth\u003c/sup\u003e Hellenic Conference of Clinical Oncology\u003c/article-title\u003e. 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J Urol 1990; 143: 1146.","doi":null,"mixed-citation":"\u003cref id=\"j_fco-2021-0025_ref_004\"\u003e\u003clabel\u003e1\u003c/label\u003e\n\u003cmixed-citation\u003eCooner WH, Mosley BR, Rutherford CL, Beard JH, Pond HS, Bass RB, Terry WJ, Igel TC, Kidd DD. Prostate cancer detection in a clonical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. 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Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients. J Urol 1989; 141: 1070.","doi":null,"mixed-citation":"\u003cref id=\"j_fco-2021-0025_ref_005\"\u003e\u003clabel\u003e2\u003c/label\u003e\n\u003cmixed-citation\u003eStamey TA, Kabalin JN. Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients. J Urol 1989; 141: 1070.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eStamey\u003c/surname\u003e\u003cgiven-names\u003eTA\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eKabalin\u003c/surname\u003e\u003cgiven-names\u003eJN\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eProstate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. 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J Urol 1997; 157: 565.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eKimura\u003c/surname\u003e\u003cgiven-names\u003eN\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eHoshi\u003c/surname\u003e\u003cgiven-names\u003eS\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eTakahashi\u003c/surname\u003e\u003cgiven-names\u003eM\u003c/given-names\u003e\u003c/name\u003e\n\u003cetal/\u003e\n\u003carticle-title\u003ePlasma chromogranin A in prostatic carcinoma and neuroendocrine tumors\u003c/article-title\u003e\n\u003csource\u003eJ Urol\u003c/source\u003e\n\u003cyear\u003e1997\u003c/year\u003e\n\u003cvolume\u003e157\u003c/volume\u003e\n\u003cfpage\u003e565\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e"},{"refId":"j_fco-2021-0025_ref_009","citeString":"Aparicio A.M. Harzstark A.L. Corn P.G. et al. Platinum-based chemotherapy for variant castrate-resistant prostate cancer. Clin Cancer Res. 2013; 19: 3621–3630","doi":null,"mixed-citation":"\u003cref id=\"j_fco-2021-0025_ref_009\"\u003e\u003clabel\u003e6\u003c/label\u003e\n\u003cmixed-citation\u003eAparicio A.M. Harzstark A.L. Corn P.G. et al. Platinum-based chemotherapy for variant castrate-resistant prostate cancer. 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valign=\"top\"\u003e128398\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100327\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−22\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−26,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22402\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e23286\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21309\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−4,9\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eEVENING OUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e17887\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e14586\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9725\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−33,3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−45,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eINTERNAL MEDICINE WARD\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15481\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16148\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e14924\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eMEDICAL ONCOLOGY DEPARTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e26996\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e26380\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22851\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−13,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−15,4\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7323\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7016\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6593\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−10\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eONE−DAY CLINIC\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32545\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32083\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e29831\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eEVENING OUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4526\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3821\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2282\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−40,3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−49,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF RADIATION ONCOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6990\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7802\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6808\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−12,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−2,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eRADIOTHERAPY SESSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e33195\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e39265\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e34952\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e346\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e335\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e230\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−32,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−33,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSURGICAL WARD\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6921\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7138\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6385\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7,8\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36789\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36484\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32651\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSURGERIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6318\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6173\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5287\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−14,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−16,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF THORACIC SURGERY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1013\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e984\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1040\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePAIN CENTER\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7982\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7541\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7307\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSCREENING EXAMINATIONS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBREAST CANCER SCREENING\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7839\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2048\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1044\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−49,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−86,7\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eGYNECOLOGICAL CANCER SCREENING\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5435\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3190\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1446\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−54,7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−73.3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDIAGNOSTIC EXAMINATIONS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eCT SCANS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e8949\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9485\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e8626\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−9,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePET SCANS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1027\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1853\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1883\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e83,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eENDOSCOPIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3946\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4194\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3519\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−16,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−10,8\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBRONCHOSCOPIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e138\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e175\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e144\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−17,7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF CYTOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e10287\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e10940\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7166\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−35,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−30,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF PATHOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15856\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16775\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e17700\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1,05\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e11,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF NUCLEAR MEDICINE\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18718\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e19689\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15233\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−22,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−18,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e","j.fco-2021-0025.tab.002":"\u003ctable frame=\"hsides\" rules=\"groups\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\" valign=\"middle\"\u003e\u003cbold\u003eNeoplasms\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eProportions (%)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eAge (\u0026gt;65)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eGender (F)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eMetastases\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eKhorana score (≥2)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eHRTCAs\u003c/bold\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eLung\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e28.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e57.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22.6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e89.6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e59.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e88.5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePancreatic\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e56.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e87.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e98.9\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eColorectal\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e11.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e55.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e33.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e81.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e98.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eGastric\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e66.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e77.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e90.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOvarian\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e60.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e79.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e70.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e89.5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eCervical\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1.2\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e0.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eUterine\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1.2\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e40.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e60.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBreast\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e94.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e76.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e68.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOthers\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e20.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e65.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e69.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e75.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e"},"tables":null,"articleContent":"\n\u003cdiv\u003e\n\u003csec id=\"j_fco-2021-0025_s_001\"\u003e\u003cdiv\u003eBIOMARKERS FOR IMMUNE AND TARGETED THERAPY IN PREOPERATIVE HEAD AND NECK CANCER PATIENTS\u003c/div\u003e\n\u003cp\u003eAmanda Psyrri, Myrto Moutafi, Georgia-Angeliki Koliou, George Papaxoinis, Niki Gavrielatou, Panagiota Economopoulou, Ioannis Kotsantis, Maria Gkotzamanidou, Maria Anastasiou, Dimitrios G. Pectasides, Aileen Fernandez, Vesal Yaghoobi, Saba Shafi, Ioannis Vathiotis, Thazin Nwe Aung, Stavros Gkolfinopoulos, Periklis Foukas, David L. Rimm, George Fountzilas\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eNational Kapodistrian University of Athens, Attikon Hospital, Athens, Greece; Yale School of Medicine, New Haven, CT; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece; Second Department of Medical Oncology, Agios Savvas Anticancer Hospital, Athens, Greece; Attikon University Hospital, Athens, Greece; Yale University, New Haven, CT; Yale University School of Medicine, New Haven, CT; National and Kapodistrian University of Athens School of Medicine, Athens, Greece; Yale, New Haven, CT; Hellenic Cooperative Oncology Group, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Preclinical and clinical models suggest that PARP inhibitor-induced DNA damage regulates immune response and can lead to and effective antitumour response. A range of mechanisms, including STING pathway activation, alter the tumour microenvironment and increase tumour susceptibility. In addition, adaptive upregulation of PD-L1 expression has been reported after PARP blockade. Gene expression profiling and immunohistochemistry (IHC)/fluorescent assessments of PD-L1 expression, CD8 T-cell infiltration and broad immune infiltrate were used to identify immune-related biomarker groups and understand the effects of PARP inhibition-related therapy on HNC tumour immunity.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To identify the biomarkers of response to olaparib-based treatment in patients with head and neck squamous cell carcinoma (HNSCC).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Pre- and post-treatment samples were collected form 39 patients enrolled in OPHELIA Phase II trial. In this open-label, non-comparative trial, patients were randomised 3:3:3:1 to cisplatin and olaparib, olaparib alone, no treatment or durvalumab and olaparib. Quantitative immunofluorescence (QIF) assessed PD-L1, STING, Ki67 and γ-H2AX expression. The GeneXpert (GX) closed system real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) quantified CD274 (PD-L1), PDCD1LG2 (PD-L2), CD8A and IRF1 mRNA expression in pre- and post-treatment samples.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Ki67 was decreased after olaparib-based treatment in 23 of 29 (79.3%) available samples when assessed by QIF; 13/23 had a decrease of at least 25%. \u003citalic\u003ePD-L1\u003c/italic\u003e levels were significantly increased post-durvalumab/olaparib treatment (\u003citalic\u003ep\u003c/italic\u003e = 0.023). An increase in post-treatment \u003citalic\u003eCD8A\u003c/italic\u003e mRNA levels was observed in a majority of samples in the three treatment arms. There were no statistically significant changes in the expression levels of STING and γ-H2AX.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e To conclude, in the present study, we showed that brief treatment with olaparib significantly decreased proliferation in HNSCC. We also observed an increase in \u003citalic\u003ePD-L1\u003c/italic\u003e mRNA levels that could suggest an activated adaptive immunity. Larger cohorts of patients are needed in order to assess the effect of PARP inhibitors on HNSCC immune regulation.\u003c/p\u003e\n\u003cp\u003eClinicalTrials.gov Identifier: NCT02882308\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_002\"\u003e\u003cdiv\u003eCELL-FREE DNA INTEGRITY AND QUANTIFICATION AS PROGNOSTIC INDICATORS IN BREAST CANCER PATIENTS\u003c/div\u003e\n\u003cp\u003eBalgkouranidou I\u003csup\u003e1\u003c/sup\u003e, Xenidis N\u003csup\u003e1\u003c/sup\u003e, Amarantidis K\u003csup\u003e1\u003c/sup\u003e, Koukaki T\u003csup\u003e1\u003c/sup\u003e, Karamitrousis E\u003csup\u003e1\u003c/sup\u003e, Chatzaki E\u003csup\u003e2\u003c/sup\u003e, Lianidou E\u003csup\u003e3\u003c/sup\u003e, Kakolyris S\u003csup\u003e1\u003c/sup\u003e, Biziota Ei\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Oncology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eLaboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eLaboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Non-invasive blood-based molecular markers have been investigated for cancer diagnosis and prognosis. Circulating free or cell-free DNA (cfDNA) variables such as ctDNA concentration and ctDNA integrity (cfDI) are two special characteristics of cfDNA. DNA integrity is calculated as the ratio of the concentration of longer DNA fragments to shorter fragments in the plasma.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e In the present study, we aim to correlate important features of ctDNA, such as concentration and integrity, with the clinical outcome of the disease and the potential prognostic ability.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Two groups of breast cancer patients were examined: group A (\u003citalic\u003en\u003c/italic\u003e = 65) who received adjuvant treatment and group B (\u003citalic\u003en\u003c/italic\u003e = 40) patients with metastatic disease who received first-line treatment, and also a control group of healthy blood donors (\u003citalic\u003en\u003c/italic\u003e = 20). ctDNA quantification and integrity were determined by real-time quantitative polymerase chain reaction (PCR) for the repeating sequences ALU 115 and 247. Integrity was defined as the ratio of ALU247-qPCR to ALU115-qPCR.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e ctDNA concentration was significantly higher in the metastatic group of patients compared to the adjuvant group (comparison of mean: 20.8 ng/mL vs. 7.2 ng/mL, respectively), while in the control group, the concentration was extremely low. The mean value of the integrity of DNA (cfDI) in group A was 0.54, while in group B, it was 0.78. In 22.5% of group A patients who relapsed in the first 3 years, a strong statistical correlation was observed between relapse and elevated cfDI (\u003citalic\u003ep\u003c/italic\u003e = 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Based on these early results, ctDNA concentration and integrity could be innovative prognostic biomarker candidates. This result should be confirmed in a larger number of patients.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_003\"\u003e\u003cdiv\u003ePREDICTIVE AND PROGNOSTIC SIGNIFICANCE OF PATRAS IMMUNOTHERAPY SCORE (PIOS SCORE) IN PATIENTS WITH NON-SMAL CELL LUNG CANCER (NSCLC) TREATED WITH NIVOLUMAB OR PEMBROLIZUMAB: RESULTS FROM A MULTICENTER VALIDATION STUDY\u003c/div\u003e\n\u003cp\u003eDimitrakopoulos F.-I.\u003csup\u003e1,2\u003c/sup\u003e, Mountzios G.\u003csup\u003e3\u003c/sup\u003e, Christopoulos P.\u003csup\u003e4,5\u003c/sup\u003e, Papastergiou T.\u003csup\u003e6\u003c/sup\u003e, Elshiaty M.\u003csup\u003e4,5\u003c/sup\u003e, Daniello L.\u003csup\u003e4,5\u003c/sup\u003e, Zervas E.\u003csup\u003e7\u003c/sup\u003e, Agelaki S.\u003csup\u003e8\u003c/sup\u003e, Samantas E.\u003csup\u003e9\u003c/sup\u003e, Nikolaidi A.\u003csup\u003e10\u003c/sup\u003e, Athanasiadis I.\u003csup\u003e10\u003c/sup\u003e, Baka S.\u003csup\u003e11\u003c/sup\u003e, Syrigos K.\u003csup\u003e12\u003c/sup\u003e, Christopoulou A.\u003csup\u003e13\u003c/sup\u003e, Lianos E.\u003csup\u003e14\u003c/sup\u003e, Samitas K.\u003csup\u003e7\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e15\u003c/sup\u003e, Perdikouri E. I.\u003csup\u003e16\u003c/sup\u003e, Oikonomopoulos G.\u003csup\u003e17\u003c/sup\u003e, Kottorou A.\u003csup\u003e1,2\u003c/sup\u003e, Kalofonou F.\u003csup\u003e18\u003c/sup\u003e, Makatsoris T.\u003csup\u003e1,2\u003c/sup\u003e, Koutras A.\u003csup\u003e1,2\u003c/sup\u003e, Megalooikonomou V.\u003csup\u003e6\u003c/sup\u003e, Kalofonos H.\u003csup\u003e1,2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eDivision of Oncology, Department of Medicine, University Hospital of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003e Molecular Oncology Laboratory, Medical School, University of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003e Second Department of Medical Oncology and Clinical trials Unit, Henry Dunant Hospital Center, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003e Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003e Translational Lung Research Center Heidelberg, member of the German Center for Lung Research (DZL)\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003e Computer Engineering and Informatics Department, University of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e7\u003c/sup\u003e 7th Respiratory Medicine Dept and Asthma Center, Athens Chest Hospital Sotiria, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e8\u003c/sup\u003e Department of Medical Oncology, University General Hospital, 71110 Heraklion, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e9\u003c/sup\u003e Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, 14564 Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e10\u003c/sup\u003e Department of Medical Oncology, Mitera Hospital, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003e Oncology Department, Interbalkan European Medical Center, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e12\u003c/sup\u003e Oncology Unit, The Third Department of Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e13\u003c/sup\u003e Medical Oncology Unit, S. Andrew Hospital, 26335 Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e14\u003c/sup\u003e Department of Medicine, Division of Medical Oncology-Hematopoietic Cell Transplant Unit, ‘Metaxa’ Cancer Hospital, Piraeus, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e15\u003c/sup\u003e Medical Oncology Unit, NIMITS Hospital, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e16\u003c/sup\u003e Oncology Department, General Hospital of Volos, Volos, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e17\u003c/sup\u003e Second Department of Medical Oncology, Metropolitan Hospital, Piraeus, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e18\u003c/sup\u003e Department of Oncology, Imperial NHS Healthcare Trust, Charing Cross Hospital, London, UK\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Daily clinical management of advanced non-small-cell lung cancer (aNSCLC) has tremendously been reformed with the use of immune checkpoint inhibitors (ICIs). Recently, Patras Immunotherapy Score (PIOS) was suggested for this group of patients. PIOS is a baseline formula calculated by a combination of the non-interventional parameters performance status (PS), body mass index (BMI), age and line of treatment (LOT) following the formula PIOS = (PS × BMI)/(LOT × AGE).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The objective of this study was to validate the clinical value of PIOS in an external cohort of patients with aNSCLC treated with nivolumab or pembrolizumab as monotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e In the current multicenter study, 626 patients with aNSCLC (stages 3 and 4) who were treated with nivolumab or pembrolizumab as monotherapy in Greek and German cancer centres were retrospectively enrolled. For the patients of the study, clinicopathological and molecular characteristics as well as data regarding response and clinical outcome were collected. Predictive and prognostic value of PIOS, in terms of progression-free survival (PFS) and overall survival (OS), as well as its association with best overall response (BOR) were investigated in the current study.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Patients with PIOS score over median had statistically significant longer PFS compared to patients with lower PIOS score, not only in univariate (hazard ratio [γR] 0.621, 95% confidence interval [CI] 0.470–0.821, \u003citalic\u003ep\u003c/italic\u003e = 0.001), but also in multivariate analysis, adjusted for clinical stage and PD-L1, (HR 0.651, 95% CI 0.492–0.863, \u003citalic\u003ep\u003c/italic\u003e = 0.003). Similarly to PFS, PIOS score was also associated with OS (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001), with median OS for the favourable group being 778 days compared to 341 days for the patients with low PIOS score (HR = 0.608, 95% CI 0.482–0.766, \u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001). This association remained statistically significant (HR 0.620, 95% CI 0.492–0.783, \u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001) after adjusting for cofactor (PD-L1). In addition, PIOS was related to response to immunotherapy with patients presenting disease progression (PD) having lower scores compared to those with stable disease (SD), partial response (PR) or complete response (CR) (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001). Predictive significance of PIOS score was also proved using a binary logistic regression analysis, adjusted for disease stage and PD-L1 status (\u003citalic\u003ep\u003c/italic\u003e = 0.002, OR 0.578, 95% CI 0.408–0.821).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The results from the current study confirm further the clinical value of PIOS biomarker in patients with aNSCLC treated with nivolumab or pembrolizumab.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_004\"\u003e\u003cdiv\u003eTHE IMPACT OF THE COVID-19 PANDEMIC ON THE FUNCTION OF A LARGE CANCER HOSPITAL\u003c/div\u003e\n\u003cp\u003eAndreadis Ch., Douganiotis G., Andreadou A., Fotarelli A., Molyva D., Loulias N., Bleka E., Kamargianni M., Laspa Ch., Lalla E.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e3\u003csup\u003erd\u003c/sup\u003e Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction\u003c/bold\u003e: The recent Covid-19 pandemic created major problems in Cancer Centers.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003ePurpose\u003c/bold\u003e: To assess the impact of the pandemic on the access of cancer patients to healthcare, diagnostic examinations and cancer treatments in the largest Cancer Center of Northern Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: Parameters relevant to the function of Theagenio Cancer Hospital were analyzed for the year 2020 and compared with 2019 and 2018.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e The most significant results are summarized in the following table\n\u003ctable-wrap id=\"j_fco-2021-0025_tab_001\" position=\"anchor\"\u003e\n\u003ctable frame=\"hsides\" rules=\"groups\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\" valign=\"middle\" rowspan=\"3\"/\u003e\n\u003cth align=\"center\" valign=\"middle\" rowspan=\"3\"\u003e\u003cbold\u003e2018\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\" rowspan=\"3\"\u003e\u003cbold\u003e2019\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\" rowspan=\"3\"\u003e\u003cbold\u003e2020\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\" colspan=\"2\"\u003e\u003cbold\u003eDIFFERENCE (%)\u003c/bold\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"center\" valign=\"middle\" colspan=\"2\"\u003e\u003chr/\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003e2019/20\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003e2018/20\u003c/bold\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eENTIRE HOSPITAL\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eNEW PATIENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9563\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9254\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6932\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−25,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−27,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e136184\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e128398\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100327\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−22\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−26,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22402\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e23286\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21309\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−4,9\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eEVENING OUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e17887\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e14586\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9725\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−33,3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−45,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eINTERNAL MEDICINE WARD\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15481\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16148\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e14924\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eMEDICAL ONCOLOGY DEPARTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e26996\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e26380\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22851\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−13,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−15,4\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7323\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7016\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6593\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−10\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eONE−DAY CLINIC\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32545\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32083\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e29831\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eEVENING OUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4526\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3821\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2282\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−40,3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−49,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF RADIATION ONCOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6990\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7802\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6808\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−12,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−2,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eRADIOTHERAPY SESSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e33195\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e39265\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e34952\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e346\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e335\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e230\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−32,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−33,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSURGICAL WARD\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePATIENT ADMISSIONS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6921\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7138\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6385\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−7,8\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOUTPATIENT APPOINTMENTS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36789\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36484\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e32651\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−11,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSURGERIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6318\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e6173\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5287\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−14,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−16,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF THORACIC SURGERY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1013\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e984\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1040\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5,4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePAIN CENTER\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7982\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7541\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7307\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−8,5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eSCREENING EXAMINATIONS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBREAST CANCER SCREENING\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7839\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e2048\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1044\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−49,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−86,7\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eGYNECOLOGICAL CANCER SCREENING\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e5435\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3190\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1446\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−54,7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−73.3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\" align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDIAGNOSTIC EXAMINATIONS\u003c/bold\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eCT SCANS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e8949\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e9485\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e8626\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−9,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−3,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePET SCANS\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1027\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1853\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1883\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e83,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eENDOSCOPIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3946\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4194\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e3519\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−16,1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−10,8\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBRONCHOSCOPIES\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e138\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e175\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e144\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−17,7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF CYTOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e10287\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e10940\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7166\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−35,5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−30,3\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF PATHOLOGY\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15856\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16775\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e17700\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1,05\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e11,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eDEPARTMENT OF NUCLEAR MEDICINE\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18718\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e19689\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15233\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−22,6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e−18,6\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/table-wrap\u003e\n\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions\u003c/bold\u003e: The Covid-19 pandemic caused a reduction in the entirety of services offered in the only Cancer Hospital in Northern Greece. The greatest reductions were observed in the number of new patients, outpatients examined, screening examinations and some diagnostic examinations. Medium reductions were observed in the number of hospital admissions, surgeries performed, and cancer treatments.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_005\"\u003e\u003cdiv\u003ePALLIATIVE CARE FOR CANCER PATIENTS: A SURVEY ON THE OPINIONS AND CONCERNS OF MEDICAL ONCOLOGISTS IN GREECE\u003c/div\u003e\n\u003cp\u003eParaskeva M., Agelaki S., Tsoukalas N., Konstantis A., Kiagia M., Arvanitou E., Rovithi M., Alexaki M., Ardavanis A., Boukovinas I.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eOn behalf of the Hellenic Society of Medical Oncologists (HeSMO, \u003cext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"http://www.hesmo.gr\"\u003ehttp://www.hesmo.gr\u003c/ext-link\u003e), Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Palliative care (PC) improves the quality of life, the levels of satisfaction and survival of cancer patients. The interest of medical oncologists (MO) in Greece in PC is constantly increasing.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To record the opinions and concerns of Greek MO regarding PC in Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e From 10 February to 1 March 2021, the Hellenic Society of Medical Oncologists (HeSMO) conducted an electronic survey with the registered members of HeSMO and the Greek young oncologists group (ONEO) regarding the delivery of PC to patients with advanced cancer in Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e We received 69 answers (89.6% trained, 17.4% in training, 47.8% women) from those working in public (44.1%), university hospitals (25%) and in private practice (27.9%). Among the trained MO, 51.6% have a working experience ≥10 years. MO always/usually assess (42.7%/41.2%) and always/usually (57.1%/31.2%) reassess the PC needs of their patients. Although nearly all MO agree that PC is essential in cancer management, the majority believe that PC needs are met neither on time (89.9%) nor effectively (95.7%) in Greece. Only 36.3% consider themselves efficient to manage common PC needs of their patients, and 82.6% express interest in attending educational programmes in PC. Moreover, 52.2% and 36.2% consider that ≤20% and 20%–50% of cancer patients, respectively, require specialist PC and 95.7% consider that the organisation of multidisciplinary PC teams at cancer centres is a necessity.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e MO consider that PC has a fundamental role in the treatment of patients suffering from advanced cancer, and that PC is not effectively provided in Greece. Promoting training and education of MO and organisation of multidisciplinary PC teams in cancer centres could improve the provided services.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_006\"\u003e\u003cdiv\u003eTHROMBOPROPHYLAXIS IN ACTIVE CANCER PATIENTS. IS IT A CONTROVERSIAL CLINICAL ISSUE OR NOT? PRELIMINARY RESULTS OF ACT4CAT STUDY\u003c/div\u003e\n\u003cp\u003eTsoukalas N., Christopoulou A., Papandreou Ch., Athanasiadis I., Koumarianou A., Peroukidis S., Samelis G., Psyrri A., Kapodistrias N., Kalofonos Ch., Andreadis Ch., Tripodaki E-S., Samantas E., Kentepozidis N., Barbounis V., Mavroudis D., Anastopoulou G., Arvanitou E., Timotheadou E., Papadopoulou P., Nikolaidi A., Kampoli A., Katsouli E., Dimitriadou A., Golfinopoulos S., Mouzakiti A., Nikolakopoulos A., Tzimou M., Perdikari K-X., Giannakou M., Bokas A., Litos I., Sofatzis I., Mala A., Thalassinou P., Assi A., Loulias N., Ardavanis-Loukeris G., Volakakis N., Athanasiadis A., Ardavanis A., Papakotoulas P., Boukovinas I.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eOn behalf of the Hellenic Society of Medical Oncology (HeSMO, \u003cext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"http://www.hesmo.gr/en\"\u003ehttp://www.hesmo.gr/en\u003c/ext-link\u003e), Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Cancer Associated Thrombosis (CAT) is an increasing challenge for oncology patients since oncologists sometimes are reluctant to mitigate the risk with thromboprophylaxis. Active cancer patients while receiving chemotherapy have a 7fold risk of thrombosis compared with no cancer patients. Anticoagulation holds a prominent place in prevention of CAT usually with Low Molecular Weight Heparins (LMWHs).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e ACT4CAT is prospective observational study conducted by HeSMO across Greece, aiming to record the clinical practice of CAT prophylaxis in patients with solid tumors. Ambulatory, high thrombotic risk, active cancer patients who received thromboprophylaxis enrolled after signing informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: Preliminary results collected from 18 oncology departments. From 431 enrolled patients 322 (65.4%) had completed the study. Tumor types included: lung 28.8%, gastrointestinal 39.8%, gynecological 7.0%, breast 4.4%, urological 7.0% and others 20%. Majority of patients (88.2%) received High-Risk for Thrombosis Chemotherapy Agents (HRTCAs) such as platinum agents (55.9%), antimetabolites (44.7%) and immunotherapy (12.6%). In 1\u003csup\u003est\u003c/sup\u003e line were 62.1%, 2nd line 18.4%, adjuvant 8.9% and neoadjuvant 2.4%. The following table depicts: age, gender, metastatic disease, Khorana score ≥2 and HRTCAs.\u003c/p\u003e\n\u003cp\u003e\n\u003ctable-wrap id=\"j_fco-2021-0025_tab_002\" position=\"anchor\"\u003e\n\u003ctable frame=\"hsides\" rules=\"groups\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\" valign=\"middle\"\u003e\u003cbold\u003eNeoplasms\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eProportions (%)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eAge (\u0026gt;65)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eGender (F)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eMetastases\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eKhorana score (≥2)\u003c/bold\u003e\u003c/th\u003e\n\u003cth align=\"center\" valign=\"middle\"\u003e\u003cbold\u003eHRTCAs\u003c/bold\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eLung\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e28.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e57.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e22.6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e89.6\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e59.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e88.5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003ePancreatic\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e56.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e36.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e87.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e98.9\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eColorectal\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e11.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e55.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e33.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e81.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e98.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eGastric\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e7.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e66.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e77.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e90.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOvarian\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e60.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e79.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e70.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e89.5\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eCervical\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1.2\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e0.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eUterine\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e1.2\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e40.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e100.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e80.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e60.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eBreast\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e4.4\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e21.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e94.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e76.5\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e15.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e68.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\" valign=\"top\"\u003e\u003cbold\u003eOthers\u003c/bold\u003e\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e20.0\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e65.1\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e18.8\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e69.7\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e16.3\u003c/td\u003e\n\u003ctd align=\"center\" valign=\"top\"\u003e75.0\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/table-wrap\u003e\n\u003c/p\u003e\n\u003cp\u003eAll patients received thromboprophylaxis for 5.3±3.6 months with: tinzaparin 90.8%, fondaparinux 5.5%, bemiparin 1.5%, enoxaparin 1.2%, apixaban 0.5% and rivaroxaban 0.5%. Intermediate doses received 70.9% of patients regardless clinical setting (1\u003csup\u003est\u003c/sup\u003e, 2\u003csup\u003end\u003c/sup\u003e, adjuvant \u0026amp; neoadjuvant: 70.2%, 79.2%, 51.3% and 70.0% respectively, p=0.0254), although intermediate doses were used more in metastatic stages (OR:2.4 95%CI: 1.4–4.2, p=0.0028). Nine thrombotic events reported (2.1%, 95%CI: 1.1–3.9%), irrespective of clinical setting but with a trend towards prophylactic doses. Eleven grade 1 bleedings reported (2.6%, 95%CI: 1.4–4.5%), despite clinical setting or dose used.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Thromboprophylaxis in ambulatory active cancer patients with high thrombotic risk is safe and effective. Oncologists are alerted about CAT negative influences in cancer patients’ prognosis. Apart from Khorana score, factors such as metastases, use of HRTCAs and drug-drug interactions influence the clinical decision of thromboprophylaxis in active cancer patients mainly with LMWHs and quite often with intermediate doses regardless clinical setting.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_007\"\u003e\u003cdiv\u003eSERUM NEUROFILAMENT LIGHT CHAIN AS A BLOOD BIOMARKER OF SEVERITY IN PACLITAXEL-INDUCED PERIPHERAL NEUROTOXICITY\u003c/div\u003e\n\u003cp\u003eKarteri S.\u003csup\u003e1\u003c/sup\u003e, Argyriou A.\u003csup\u003e2\u003c/sup\u003e, Velissaris D.\u003csup\u003e3\u003c/sup\u003e, Bravou V.\u003csup\u003e4\u003c/sup\u003e, Kalofonos H.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Unit-Department of Internal Medicine, University Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eNeurology Department, Saint Andrew’s General Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eDepartment of Internal Medicine, University Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eDepartment of Anatomy-Histology-Embryology, Medical School, University of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Serum neurofilament light chain (sNF-L) is a neuron-specific cytoskeletal protein important for cell structural stability. There is compelling experimental evidence that neurofilament light chain (NF-L) could sensitively be detected in serum as a biomarker of neuro-axonal damage induced by chemotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim\u003c/bold\u003e: We sought to assess the significance of measuring sNF-L in the clinical setting of paclitaxel-induced peripheral neurotoxicity (PIPN).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: We longitudinally measured sNF-L in breast cancer patients, scheduled to receive the 12-weekly paclitaxel-based regimen. Patients were clinically examined by means of the Total Neuropathy Score clinical version (TNSc), while sNF-L was quantified using the highly sensitive Simoa technique before the onset of chemotherapy (T0), after commencing two courses (T1), three courses (T2), at the end of chemotherapy (T3) and 3 months post-treatment (T4).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: A total of 24 female patients, having a mean age of 56.6 ± 12.6 (33–78) years, were included. Among them, 10 (41.7%) developed grade 0–1 and 14 (58.3%) developed grade 2–3 PIPN at T3. Analysis of variance (ANOVA) of repeated measures disclosed a significant longitudinal increase in sNF-L levels (pg/mL) from T0 to T3 (T0: 15.3 ± 11.9; T1: 30.1 ± 38.5; T2: 51.5 ± 82.1; T3: 134.9 ± 118.6; \u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001) and a drop from T3 to T4 (4 ± 11.3). Patients with grade 2–3 PIPN had significantly increased sNF-L levels at T3, compared to those with grade 0–1 (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001). Mean levels of sNF-L significantly correlated with TNSc scoring. Logistic binary regression analysis revealed that the difference of sNF-L levels between T1 and T0 independently predicted the manifestation of severe grade 3 PIPN at T3. ROC analysis defined that a discriminative increase of \u0026gt;21.5 in sNF-L levels at T1 versus T0 predicted with a sensitivity of 71% and a specificity of 100% the development of grade 3 PIPN at T3.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion\u003c/bold\u003e: sNF-L seems to be a strong biomarker of neuro-axonal injury, while its early increase after two chemotherapy courses (T1) possesses a predictive value of final PIPN severity. Our findings could be relevant for future neuroprotection trials.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_008\"\u003e\u003cdiv\u003ePROGNOSTIC ROLE OF CIRCULATING MIRNAS IN NON-SMALL CELL LUNG CANCER (NSCLC) PATIENTS TREATED WITH PLATINUM-BASED CHEMOTHERAPY\u003c/div\u003e\n\u003cp\u003eMonastirioti A.\u003csup\u003e1\u003c/sup\u003e, Papadaki C.\u003csup\u003e1\u003c/sup\u003e, Rounis K.\u003csup\u003e2\u003c/sup\u003e, Kalapanida D.\u003csup\u003e2\u003c/sup\u003e, Papakosta V.\u003csup\u003e1\u003c/sup\u003e, Georgiadou M.\u003csup\u003e2\u003c/sup\u003e, Vardakis N.\u003csup\u003e2\u003c/sup\u003e, Mavroudis D.\u003csup\u003e1,2\u003c/sup\u003e, Agelaki S.\u003csup\u003e1,2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eLaboratory of Translational Oncology, School of Medicine, University of Crete, Heraklion, Crete, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e MicroRNAs (miRNAs) have been reported to modulate the crosstalk between tumour cells and the immune system. Circulating miRNAs may conclude the systemic response to the tumour, providing in parallel the opportunity for repeated monitoring. Let-7c, miR-26a, miR-30d, mir-98, miR-195 and miR-202 are reported to be involved in the polarisation of macrophages.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To investigate the expression of miRNAs in the plasma of non-small cell lung cancer (NSCLC) patients treated with first-line platinum-based chemotherapy and their association with patients’ outcome.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Blood samples were obtained from NSCLC patients (\u003citalic\u003eN\u003c/italic\u003e = 125), prior to the initiation of chemotherapy. Plasma miRNA expression levels were analysed by RT-qPCR and classified as high/low based on the median values.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e The median age was 65 years (range: 37–88), 86.4% of the patients were male, 68% of the patients had non-squamous (non-SqCC) histological type, and 26.4% of the patients experienced PR, 39.2% SD and 34.4% PD. High miR-202 expression was associated with disease progression (hazard ratio [HR]: 2.335; \u003citalic\u003ep\u003c/italic\u003e = 0.040) and was revealed as an independent prognostic factor for shorter progression-free survival (PFS; HR: 1.564; \u003citalic\u003ep\u003c/italic\u003e = 0.021) and overall survival (OS; HR: 1.558; \u003citalic\u003ep\u003c/italic\u003e = 0.024) in the whole group of patients. In the non-SqCC subgroup, high miR-202 was also revealed as an independent predictor for shorter OS (HR: 1.989; \u003citalic\u003ep\u003c/italic\u003e = 0.008), while in the SqCC subgroup, only high miR-26a expression was correlated with shorter OS (10.07 vs. 13.53 months, \u003citalic\u003ep\u003c/italic\u003e = 0.033).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The present study is the first to demonstrate the potential role of circulating miR-202 in the prediction of outcome in NSCLC patients treated with platinum-based chemotherapy. Additionally, this study further supports the hypothesis that circulating miRNAs involved in the regulation of the immune response may represent promising biomarkers.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_009\"\u003e\u003cdiv\u003eCLINICAL SIGNIFICANCE OF GENE EXPRESSION OF EXOSOME BIOGENESIS PATHWAY IN COLORECTAL CANCER\u003c/div\u003e\n\u003cp\u003eKottorou A.\u003csup\u003e1\u003c/sup\u003e, \u003csup\u003e*\u003c/sup\u003e, Dimitrakopoulos F.-I.\u003csup\u003e1,2,*\u003c/sup\u003e, Antonacopoulou A.\u003csup\u003e1\u003c/sup\u003e, Makatsoris T.\u003csup\u003e1,2\u003c/sup\u003e, Stavropoulos M.\u003csup\u003e3\u003c/sup\u003e, Koutras A.\u003csup\u003e1,2\u003c/sup\u003e, Kalofonos H.\u003csup\u003e1,2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eMolecular Oncology Laboratory, Department of Medicine, University of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eDivision of Oncology, University Hospital of Patras, University of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eDepartment of Surgery, University Hospital of Patras, University of Patras, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e*\u003c/sup\u003eEqual contribution\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e In the last decade, a growing number of studies have shed light on the role of extracellular vesicles, mainly of exosomes, in cancer generally as well as in colorectal cancer (CRC) more specifically. The available published data mostly focus on exosome cargo, while data regarding the pathway of exosome biogenesis in CRC are limited.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The current study aims to investigate the clinical significance of the exosome biogenesis pathway in CRC, evaluating the expression of the most important molecules, which are implicated in the pathway, and associating them with the clinicopathological parameters and the clinical outcome of the patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Based on the data analysis of publicly available datasets, we selected the most promising molecules of the pathway with potential for clinical impact. Totally, 100 cancerous and 60 adjacent non-neoplastic fresh-frozen tissue specimens were used, which were prospectively collected from CRC patients (stages I–IV), who were surgically managed in the University Hospital of Patras, Greece. mRNA expression of \u003citalic\u003eRAB27A\u003c/italic\u003e (Ras-Related Protein Rab-27A), \u003citalic\u003eRAB27B\u003c/italic\u003e (Ras-Related Protein Rab-27γ), \u003citalic\u003eRAB2B\u003c/italic\u003e (Ras-Related Protein Rab-2B), \u003citalic\u003eRAB3B\u003c/italic\u003e (Ras-Related Protein Rab-3B), \u003citalic\u003eRAB9A\u003c/italic\u003e (Ras-Related Protein Rab-9A), \u003citalic\u003eRAB11B\u003c/italic\u003e (Ras-Related Protein Rab-11B), \u003citalic\u003eSTX1A\u003c/italic\u003e (syntaxin 1A) and \u003citalic\u003eVAMP7\u003c/italic\u003e (vesicle-associated membrane protein 7) genes was assessed in the these samples using real-time qPCR and specific primers and probes and was associated with the clinicopathological parameters as well as with the clinical outcome of patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Gene expression of the studied molecules differed significantly between cancerous and non-cancerous tissues, with cancer tissues having lower levels of \u003citalic\u003eRAB27A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.003), \u003citalic\u003eRAB27B (p\u003c/italic\u003e = 0.014), \u003citalic\u003eVAMP7\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.017) and \u003citalic\u003eRAB3B\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001) and higher levels of \u003citalic\u003eSTX1A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001), compared to non-neoplastic, tumour-adjacent tissues. In addition, patients with distant metastases at diagnosis had lower mRNA levels of \u003citalic\u003eRAB27A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.049), \u003citalic\u003eRAB27B\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.033) and \u003citalic\u003eRAB9A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.034), compared to patients without distant metastases. Furthermore, patients with increased \u003citalic\u003eRAB27A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.008), \u003citalic\u003eRAB9A (p\u003c/italic\u003e = 0.015), \u003citalic\u003eRAB11B\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.011) and \u003citalic\u003eSTX1A\u003c/italic\u003e (\u003citalic\u003ep\u003c/italic\u003e = 0.011) expression had favourable 3-year survival, while patients with increased \u003citalic\u003eVAMP7\u003c/italic\u003e expression had unfavourable 5-year survival (\u003citalic\u003ep\u003c/italic\u003e = 0.022).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The results of this study suggest that biogenesis of exosomes is deregulated in CRC and is possibly implicated in metastasis development.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_010\"\u003e\u003cdiv\u003eGENETIC PREDISPOSITION IN PAEDIATRIC CANCER PATIENTS USING NEXT-GENERATION SEQUENCING TECHNOLOGY\u003c/div\u003e\n\u003cp\u003eGlentis S., Katsibardi K., Andritsou A., Roka K., Filippidou M., Kattamis A.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003ePediatric Hematology Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: The genetic variants of intermediate/high risk, as well as genetic counselling and prevention of cancer in other family members are crucial for the diagnosis, treatment and surveillance of paediatric cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim/Methods\u003c/bold\u003e: We aimed to investigate the genetic aetiology of cancer in children and teenagers. Our cohort was composed of 81 patients (31 with haematologic cancer and 50 with solid tumours). Inclusion criteria were family history, rare tumour type or site, relapse or refractory disease. Germline genomic DNA was isolated from the peripheral blood of each patient. Two next-generation sequencing (NGS) panels, covering genes associated with solid or haematologic malignancies and consisting of 155 and 160 genes, respectively, were developed. In-solution hybridisation-based probes were designed using appropriate software (Agilent SureDesing, custom-made panel), and they targeted all the exons of the genes of interest. Sequencing was performed with NGS technology in an Illumina Miseq platform. Raw data processing and analysis was performed with standard bioinformatic tools (BWA-MEM, GATK, VCFtools, VEP). Confirmation and family segregation analysis was performed via Sanger sequencing in the identified Pathogenic (P) and Likely Pathogenic (LP) genetic variants.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e We captured 859 (range: 750–950) genetic variants per patient. P/LP variants with a direct link to the phenotype were identified in 6/81 (7.4%) patients. Additionally, in 4/81 (4.9%) patients, we identified heterozygous P/LP variants in genes related to cancer predisposition. but not directly linked to their phenotype. Furthermore, five P/LP variants were detected in five patients, but were not linked to the phenotype and were considered incidental findings. Finally, seven variants of unknown significance (VUS) were detected, for which more investigation to assess a possible pathogenic role is required.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e NGS contributes to the investigation of germline pathogenicity in paediatric cancer. A significant number of patients carry genetic variants in genes linked to cancer predisposition. VUS investigation is of great importance and requires further research to determine the possible pathogenic role of the variants.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_011\"\u003e\u003cdiv\u003eSERUM NEUROFILAMENT LIGHT CHAIN LEVELS AS BIOMARKERS OF PACLITAXEL-INDUCED COGNITIVE IMPAIRMENT IN PATIENTS WITH BREAST CANCER\u003c/div\u003e\n\u003cp\u003eArgyriou A.\u003csup\u003e1\u003c/sup\u003e, Karteri S.\u003csup\u003e2\u003c/sup\u003e, Velissaris D.\u003csup\u003e3\u003c/sup\u003e, Kalofonos H.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003eNeurology Department, Saint Andrew’s General Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eOncology Unit-Department of Internal Medicine, University Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eDepartment of Internal Medicine, University Hospital of Patras\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Chemotherapy-induced cognitive impairment (CICI), also called ‘chemobrain’, is a well-established clinical syndrome consisting of moderate to subtle cognitive impairment across various domains of gnosia. This syndrome occurs during and after discontinuation of chemotherapy, but its underlying mechanisms remain largely unknown.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To assess the utility of serum neurofilament light chain (sNfL) levels in identifying the risk to develop CICI in cancer patients. We also examined if sNfL can be identified as an early biomarker of CICI development.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e We longitudinally measured sNfL levels in 20 female patients with breast cancer, scheduled to receive the 12-weekly paclitaxel-based regimen. An equal number of age-matched female heathy subjects were incuded as the control group. CICI was graded by means of the Montreal Cognitive Assessment scale (MOCA); peripheral neurotoxicity (PN) was graded using the neurosensory Common Criteria for Adverse Events (CTCAE) v5.0, while the sNfL levels were quantified using a high-sensitive technique (Quanterix, Simoa) before the administration of chemotherapy (T0), after three courses (T1) and at the end of chemotherapy (T2).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Pre-treatment sNfL levels were comparable in patients and controls (\u003citalic\u003ep\u003c/italic\u003e = 0.103). At T2, 5/20 patients (mean age 61.4 ± 5.0 years) developed CICI. These five patients also had clinically significant PN. Patients with and without CICI had comparable sNfL values at T2 (\u003citalic\u003ep\u003c/italic\u003e = 0.1). In addition, at T2, the sNfL levels did not correlate significantly with MOCA score in CICI patients (\u003citalic\u003ep\u003c/italic\u003e = 0.604). The difference in sNfL levels between T1 and T0 failed to predict independently the occurrence of CICI at T2.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion\u003c/bold\u003e: Our findings do not support the utility of measuring sNfL levels as a biomarker of CICI. Grade 2–3 PN most strongly confounded the outcomes of our study.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_012\"\u003e\u003cdiv\u003ePROTOCOLS FOR COMMUNICATING BAD NEWS IN ONCOLOGY\u003c/div\u003e\n\u003cp\u003eGkoumas G.,\u003csup\u003e1,2\u003c/sup\u003e Vlachothanassi E.,\u003csup\u003e3\u003c/sup\u003e Simou E\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003eMedical Oncologist, MSc, Agios Savvas Anticancer Hospital, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Public Health Policy, School of Public Health, University of West Attica\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eRN MSc, Laiko General Hospital, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eAssociate Professor, Mass Media and Health Communication, Department of Public Health Policy, School of Public Health, University of West Attica\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Communication between doctor and patient and, in particular, breaking bad news in oncology is a key issue in the doctor–patient relationship. Bad news is any information that can negatively affect a person’s expectations for their present, future and, consequently, their quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The purpose of this study was to search the available literature regarding the main protocols used in breaking bad news to oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e We performed a systematic review of the literature from 1 to 12 April 2019 in search for related articles, studies, reviews of technical manuals and dissertations related to the topic using an appropriate algorithm in PubMed, regardless of the date, based on the following key words: communication, oncology, delivering bad news.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Four main communication protocols for delivering bad news in oncology patients (SPIKES, ABCDE, BREAKES, PEWTER) and their adaptations in different countries according to the culture of each country’s people were identified. The use of an appropriate communication protocol for breaking bad news helps doctors to inform patients, reducing the stress and psychological burden of patients and doctors. Communication becomes more effective, anthropocentric and leads to the development of trust and a strong therapeutic bond between patient and physician, resulting in better treatment plan design and increased patient satisfaction with the medical services provided and respect for its individuality.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Breaking bad news in cancer patients must be done in a specific and structured way based on specific steps that are described in detail in the international protocols for the communication of bad news. There are differences and discrepancies in each protocol of announcing bad news. Most authors emphasise the importance of these protocols as well as the need to integrate them into daily clinical practice.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eKeywords:\u003c/bold\u003e communication, oncology, delivering bad news.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_013\"\u003e\u003cdiv\u003eMEDICAL ONCOLOGISTS’ PRACTICES REGARDING PATIENT’S GENDER AS A DIFFERENTIATING FACTOR OF THEIR THERAPEUTIC APPROACH\u003c/div\u003e\n\u003cp\u003eLevva S.\u003csup\u003e1,2\u003c/sup\u003e, Sogka H.\u003csup\u003e3\u003c/sup\u003e, Skolariki A.\u003csup\u003e3\u003c/sup\u003e, Gkoura S.\u003csup\u003e4\u003c/sup\u003e, Tripodaki H.S.\u003csup\u003e5\u003c/sup\u003e, Stafylas P.\u003csup\u003e6\u003c/sup\u003e, Assi A.\u003csup\u003e7\u003c/sup\u003e, Goumas G.\u003csup\u003e8\u003c/sup\u003e, Dimitriadis I.\u003csup\u003e7,9\u003c/sup\u003e, Stoupis I.\u003csup\u003e10\u003c/sup\u003e, Loga K.\u003csup\u003e3\u003c/sup\u003e, Kyriazoglou A.\u003csup\u003e11\u003c/sup\u003e, Tsironis G.\u003csup\u003e12\u003c/sup\u003e, Gavriatopoulou M.\u003csup\u003e13\u003c/sup\u003e, Boukovinas I.\u003csup\u003e1,2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Medical Oncology, Bioclinic, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Medical Oncology, Interbalkan Medical Center, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eMedical Oncology University Clinic, AUTH, “Papageorgiou” Hospital, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eMedical Oncology University Clinic, UoI, Ioannina\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003e“Agios Savvas” Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003eScientific Director, HealThink, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e7\u003c/sup\u003eDepartment of Medical Oncology, Errikos Dynan Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e8\u003c/sup\u003e2nd Internal Medicine Clinic, “Agios Savvas” Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e9\u003c/sup\u003eDepartment of Medical Oncology, Hospital Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003eDepartment of chemotherapy, General Hospital of Rethymno\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e12\u003c/sup\u003e2nd Internal Medicine Clinic, Attikon University Hospital, National and Kapodistrian University of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e13\u003c/sup\u003eDepartment of Medical Oncology, Nicosia General Hospital, Cyprus\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e14\u003c/sup\u003eTherapeutic Unit, Hematology / Oncology University Clinic, Alexandra General Hospital, National and Kapodistrian University of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction:\u003c/bold\u003e The importance of gender as a determinant of disease biology and treatment effectiveness is well known in some fields of medicine, but remains a poorly studied factor in oncology.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e HeGYO created a questionnaire, in order to record whether the patient’s gender is a differentiating factor of Medical Oncologists’ therapeutic approach.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethod:\u003c/bold\u003e The questionnaire was distributed to the members of HeSMO and HeGYO through an electronic platform and consisted of 22 questions, which concerned physicians’ demographic data and their practices regarding the management of their patients by gender. Statistical analysis was performed using Chi-Square and Fischer’s exact test, using the R programming language.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e 105 physicians answered the questionnaire, 79% of whom where specialized and 56% men. The majority of oncologists in a typical week see an equal number of female and male patients (67.9%), do not take gender as a factor in differentiating their therapeutic approach (73%), devote the same time to each patient in the first (83.8%) and in a standard visit for treatment (82.8%), do not modify the medication according to gender (84%) and consider that the occurrence of side effects is gender independent (67%). However, older doctors consider side effects to be more common in women (P = 0.05). 58% consider women patients more anxious, while 50% administer more frequent anxiolytics to them. Oncologists \u0026lt;45 years old discuss fertility and reproduction issues more often with women (P = 0.01). Finally, adherence to medical recommendations (52%) and consistency in follow-up appointments (59%) are gender independent.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Gender as a differentiating factor of cancer patients’ therapeutic approach is a new field of study, promoting personalized medicine and highlighting the peculiarities that arise from the different biology and psychology that accompanies each patient.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_014\"\u003e\u003cdiv\u003eTHE EFFECT OF ART THERAPY ON ONCOLOGY PATIENTS\u003c/div\u003e\n\u003cp\u003eStamatopoulou E.\u003csup\u003e1\u003c/sup\u003e, Tsilias D.\u003csup\u003e2\u003c/sup\u003e, Valassi L.\u003csup\u003e3\u003c/sup\u003e, Valassi S.\u003csup\u003e4\u003c/sup\u003e, Antonakou A.\u003csup\u003e5\u003c/sup\u003e, Stamatopoulou A.\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePhD(c), M.Sc-MPH National School of Public Health, M. Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eRN, MSc Clinical Pediatrics \u0026amp; Nursing-Research General Children’s Hospital of Athens P. \u0026amp; A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eGraduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eGraduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003e‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003ePhD(c), Economist, M. Sc. International Business Administration, M. Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Research on the effectiveness of artistic therapy has been studied in recent years.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003ePurpose:\u003c/bold\u003e To investigate the effect of art therapy on oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed in the electronic database PubMed with the following keywords: art therapy oncology patient from 2011 onwards.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Art therapy includes dance, movement, music therapy and art therapy that involves visual art materials and paintings. The creative process of art, as a path of non-verbal expression, enhances life and provides relief. Studies in cancer patients have shown that artistic therapy leads to increased self-awareness, improved ability to cope with symptoms such as stress and traumatic experiences, personal development, social interaction, improvement in mental health and quality of life. Art painting therapy reduces the fatigue levels during radiotherapy in cancer patients. In patients undergoing radiation therapy, participating in art therapy interventions supports the emotional, psychological and spiritual needs of patients. In addition, patients receiving chemotherapy are reported to have reduced anxiety, depression, stress and pain. Existing studies show that art therapy has benefited, and improved, quality of life by reducing stress, depression and anxiety in women with genital cancer. Further qualitative studies should be conducted to investigate the results of art therapy in oncology patients with adequate samples, various art forms and patient biomarker assessment to draw safe conclusions and application.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Art therapy is used as a psychosocial intervention to relieve patients’ symptoms, which can improve the physical, mental and emotional well-being of cancer patients.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_015\"\u003e\u003cdiv\u003eTHE EFFECT OF MUSIC THERAPY ON PAEDIATRIC PATIENTS\u003c/div\u003e\n\u003cp\u003eStamatopoulou E. \u003csup\u003e1\u003c/sup\u003e, Tsilias D.\u003csup\u003e2\u003c/sup\u003e, Valassi L.\u003csup\u003e3\u003c/sup\u003e, Valassi S.\u003csup\u003e4\u003c/sup\u003e, Antonakou A.\u003csup\u003e5\u003c/sup\u003e, Stamatopoulou A.\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eRN, MSc Clinical Pediatrics \u0026amp; Nursing-Research General Children’s Hospital of Athens P. \u0026amp; A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Clinical trials recommend music therapy as a complementary, psychosocial intervention to both paediatric oncology patients and caregivers during treatment.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To investigate the effect of music therapy on paediatric oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed in the online PubMed database with the following keywords: oncology pediatric patients effect music therapy from 2008 onwards.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e According to the literature review, caregivers of children and adolescents hospitalised in the marrow transplant unit considered music therapy as a positive, beneficial, effective, complementary intervention. The song lyrics, melody listening and music video with preferred photos resulted in a courageous treatment of the disease and increased resilience of hospitalised children and adolescents/young adults with cancer undergoing haematopoietic stem cell transplantation. Rehabilitation in the unit enhanced the understanding of parents’ feelings, social interaction and cooperation of children, helped to minimise the effects of isolation, negative mood, reduced activity and reinforcement and helped in normalisation of negative experiences that the disease imposed in early childhood. Music therapy also supported the improvement of the health-related quality of life of children undergoing allogeneic haematopoietic stem cell transplants in the marrow transplant unit, according to the rating scale. HRQoL and PedsQL pilot study for children aged 3.5–4.5 years, expand the results of music therapy and report the reception of salivary and blood cortisol levels as a biomarker of stress by hospitalised children undergoing haematopoietic cell transplantation and their accompanying parents supported by music therapy for the objective assessment of its results.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The results of the music intervention in paediatric oncology patients show that the documented application proves to enhance their well-being.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_016\"\u003e\u003cdiv\u003eEWING’S SARCOMA IN CHILDREN AND ADOLESCENTS: A SINGLE-CENTRE EXPERIENCE\u003c/div\u003e\n\u003cp\u003eRigatou E., Tourkantoni N., Tsipou Ch., Roka K., Kattamis A.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eUniversity Oncology and Hematology Unit, National and Kapodistrian University of Athens, 1\u003csup\u003est\u003c/sup\u003e Department of Pediatrics, ‘Agia Sofia’ Children’s Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Ewing’s sarcoma (ES) is the second most common bone malignancy in both children and adolescents. Upon diagnosis, 30% of patients already have metastases. In the last three decades, the use of local therapy (surgery ± radiotherapy) and systemic chemotherapy has significantly increased survival.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e In this study, we present the unit’s recent experience in treating children and adolescents with ES.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Patients with ES treated at the University Oncology Hematology Unit during the years 2012–2020 were retrospectively analysed. A total of 25 patients (M = 16, F = 9) with a mean age at diagnosis of 11 years (1–16) were treated. Three (12%) had multifocal disease, three (12%) had pulmonary metastases and 19 (76%) had localised disease.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e All patients (100%) received systemic chemotherapy according to the following protocol: AEWS0031, EUROEWING 99, EUROEWING 2012. Local control of the disease was achieved with surgery (100%) and radiation (80%). Three patients (12%) received megatherapy and autologous stem cell transplantation. With an average follow-up of 4 years, 18 patients are alive (overall survival 72%). Among survivors, 16/18 patients (64%) are in complete remission, 1/18 (4%) has stable disease and 2/18 (8%) have relapse/disease progression. Patients with relapse or disease progression are those with multifocal/metastatic disease at diagnosis. A key survival factor was the presence of metastases at diagnosis, with a survival rate of 33.3% (2/6 patients) versus 84% (16/19 patients). All patients completed treatment without irreversible toxicity.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e ES is an aggressive tumour with a high recurrence rate and metastatic potential. Survival ranges from 60% to 80% for patients with localised disease treated with combination therapy. Patients with metastatic disease have a 4-year survival of0 30%. The survival rates in the present study are according to the current literature. This indicates the need for further improved therapeutic approach for patients with metastatic/multifocal disease.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_017\"\u003e\u003cdiv\u003eCORRELATION BETWEEN IMMUNE-RELATED TOXICITY AND EFFICACY OF IMMUNOTHERAPY IN SECOND OR LATER LINE TREATMENT OF NSCLC\u003c/div\u003e\n\u003cp\u003eStefanou D., Mitsogianni M., Kotteas E., Charpidou A., Gkiozos I., Ntalakou E., Syrigos K.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eOncology Unit, 3\u003csup\u003erd\u003c/sup\u003e University Clinic for Internal Medicine, ‘Sotiria’ Hospital, Medical School of the University of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Immunotherapy is an established treatment in the second and later line for patients with non-small cell lung cancer (NSCLC) who did not receive it in the first line. Despite its high efficacy, there are patients who do not respond or achieve only short-term responses. Various efforts have been made to establish the predictive factors of efficacy of immunotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e Aim of the study is to examine whether there is a connection between immune-related toxicity and efficacy of immunotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Patients with NSCLC receiving immunotherapy beyond first line in our clinic over a period of 3 years were included in the analysis. Besides demographics, we collected data concerning efficacy and toxicity of immunotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e One hundred and ninety-six patients were included in the study. Immune-related adverse events occurred in 32.1% of the patients, with skin toxicity (29%) and hypothyroidism (27.4%) occurring more often. Toxicity was grade ≥3 in 9.5% of immune-related adverse events. Treatment with corticosteroids was administered in 31.7% of the patients presenting with toxicity, while discontinuation of immunotherapy was necessary in 14.3% of them. Toxicity of any grade led to longer progression-free survival (13 vs. 3 months, \u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001) and duration of response (not reached vs. 8 months, \u003citalic\u003ep\u003c/italic\u003e = 0.003). On the other hand, there was no connection between type and grade of toxicity, hold or discontinuation of immunotherapy or corticosteroid treatment and efficacy of immunotherapy (\u003citalic\u003ep\u003c/italic\u003e \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Our study suggests that immune-related toxicity leads to prolongation of progression-free survival and duration of response, while toxicity type and grade, treatment hold or discontinuation and corticosteroids do not have an impact on the therapeutic outcome.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_018\"\u003e\u003cdiv\u003eCORRELATION BETWEEN CANCER AND SERIOUS COMPLICATIONS OF SARS-COVID-19\u003c/div\u003e\n\u003cp\u003eChatzinikolaou A.\u003csup\u003e1\u003c/sup\u003e, Lavdaniti M.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePostgraduate student, Nursing Department, International Hellenic University, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eAssociate Professor, Nursing Department, International Hellenic University, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Cancer is a genetic disease in which the characteristics and functions of normal cells have been altered and is considered as one of the leading causes of death worldwide. COVID-19 causes severe acute respiratory syndrome and has emerged as a new infection that has spread rapidly around the world. It poses a serious threat to the health of vulnerable populations, such as patients with malignancies and immunosuppression.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e A literature review was conducted using the electronic databases PubMed and Google Scholar with the keywords ‘cancer’, ‘COVID-19’, ‘patients’, ‘severe implications’ and a combination thereof. Non-English articles were excluded. Twenty-five articles on the subject were used. The review concerned the last 5 years.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The aim of this review was to investigate the association between cancer and the complications caused by the COVID-19 virus.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Cancer patients are at high risk for SARS-COVID-19 virus disease, as studies have shown that they are more prone and more susceptible. The patient’s age, treatment history and possible underlying diseases play an important role as they are crucial factors in the prognosis of infection in cancer patients. Also, their weakened immune system significantly increases the risk of developing an infection, which may be caused either by the community or by the hospital environment. Finally, the infection of cancer patients with the SARS-COVID-19 virus has been associated with a rapid worsening of symptoms, the occurrence of serious complications, an increase in admissions to intensive care units and a possible deterioration of their condition, which may even lead to death.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e COVID-19 virus is a dangerous infection for patients with chronic and serious underlying diseases, such as cancer. Proper information, protection, safety and care of cancer patients during the pandemic should be a priority and the main concern of health professionals.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_019\"\u003e\u003cdiv\u003e‘BIG-DATA’ AND MACHINE LEARNING ALGORITHMS TO PREDICT EARLY AND LATE MORTALITY IN CRITICALLY ILL PATIENTS WITH CANCER\u003c/div\u003e\n\u003cp\u003eDanilatou V.\u003csup\u003e1\u003c/sup\u003e, Mavroidis D.\u003csup\u003e2\u003c/sup\u003e, Tzagarakis C.\u003csup\u003e2\u003c/sup\u003e, Antonakaki D.\u003csup\u003e2\u003c/sup\u003e, Kanterakis A.\u003csup\u003e2\u003c/sup\u003e, Kostoulas T.\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eSphynx Technology Solutions\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eFoundation for Research and Technology-Hellas (FORTH)\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eUniversity of the Aegean\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Patients with cancer hospitalised in Intensive Care Units (ICUs) suffer from high mortality rates. Current prognostic models predict only in-hospital mortality based on first day information, whereas late mortality is hardly predicted. Modern medical databases contain a huge amount of time series data that remain unexploited since classic statistical methods are unable to manage them.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e Exploring the use of automated machine learning algorithms (auto-ML) to predict early and late mortality (months m0, m1, m3, m6, m12, m \u0026gt; 12) in ICU patients with cancer.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Exactly 5,691 ICU patients (\u0026gt;15 years old) with cancer from MIMIC-III database (median age 67 years old) were studied. Exclusion criteria: do not resuscitate (DNR) code = 358 and pregnancy = 15. Patients were grouped according to their outcome; 902 died early in hospital, 2,659 died later (median time 1.19 years) and 1,757 recorded as survivors in the database. Overall, 1,752 features were collected (including demographic, clinical, laboratory, medications, procedures, known medical scores and free-text medical notes with natural language processing). Prediction models were built based on the web-based platform JADBio. Several different algorithms such as Random Forests, Support Vector Machine and Logistic Regression have been applied with a new protocol called bootstrap bias-corrected cross-validation and hyper-parameter tuning, which is relatively conservative during performance estimation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Random Forests was the best performing model for mortality prediction (overall area under the curve [γUC] = 0.83). In detail, the AUC for months m0–m \u0026gt; 12 were 0.94, 0.88, 0.84, 0.78, 0.76 and 0.74, respectively. γest-budgeted Statistically Equivalent Signature algorithm revealed the following features with predictive significance: GCS scale, γPSIII score, sepsis, systolic arterial blood pressure, RDW, first day respiratory rate, SpO\u003csub\u003e2\u003c/sub\u003e, coexistence of metastatic cancer and red cell transfusions.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Prediction of late mortality in ICU patients with cancer is difficult. The use of ‘big-data’ and auto-ML outperforms classic prognostic models. Identification of explainable, clinically meaningful features will help clinicians in decision-making process. RDW could be a rediscovered, easily applied biomarker, since it has been previously shown that it correlates with ICU mortality and cancer stage. Further external validation in other databases is necessary.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_020\"\u003e\u003cdiv\u003eTHE IMPACT OF THE ADDITION OF CARBOPLATIN TO NEOADJUVANT CHEMOTHERAPY IN TRIPLE NEGATIVE BREAST CANCER\u003c/div\u003e\n\u003cp\u003eG. Douganiotis\u003csup\u003e1\u003c/sup\u003e, L. Kontovinis\u003csup\u003e2\u003c/sup\u003e, A. Pouptsis\u003csup\u003e2\u003c/sup\u003e, A. Ainali\u003csup\u003e2\u003c/sup\u003e, I. Natsiopoulos\u003csup\u003e3\u003c/sup\u003e, K. Papazisis\u003csup\u003e2,3\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003e3rd Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eMedical Oncology Department, Euromedica General Clinic, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eBreast Cancer Unit, Interbalkan Medical Center, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction\u003c/bold\u003e: Chemotherapy remains the only treatment option for patients with early triple negative breast cancer. One of the combinations that has been suggested in order to improve efficacy is the addition of carboplatin to the standard of care chemotherapy regimen of an anthracycline plus a taxane.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: Data from the medical records of Oncomedicare were retrospectively collected. The analysis included all patients with early triple negative breast cancer who received neoadjuvant chemotherapy in the time period between 2010 and 2020. Pathologic responses following neoadjuvant treatment and patient survival data (disease-free survival, overall survival) were also recorded.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e A total of 70 patients were included in the analysis. All patients were included who received neoadjuvant chemotherapy, with or without the addition or carboplatin, for whom histology reports from the final surgery were available. The median age of the patients was 44 years, and the median follow-up was 2.3 years. Testing for the presence of germline mutations was performed in 47 patients, 11 of which had a mutation in BRCA1, BRCA2 and other three genes (PALB2, CHEK2, CDKN2A). A complete pathologic response (pCR) following neoadjuvant chemotherapy was recorded in 39 patients (55.7%). Of the 70 patients, 31 received carboplatin in addition to the standard neoadjuvant chemotherapy regimen, and 39 did not. The rate of pCR was higher in the patients who received carboplatin (21/33 patients, 67.7%) compared to those who did not (17/39 patients, 43.6%). Of the 11 patients with mutations in BRCA1/2, 9 recorded a pCR, one had a micrometastasis in one lymph node, and one had residual disease. The achievement of a pCR was an important favorable prognostic factor of disease-free survival (DFS: HR 0.086, 95% CI 0.025–0.301, p=0.0029) as well as overall survival (OS: HR 0.125, 95% CI 0.028–0.559, p=0.0209).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions\u003c/bold\u003e: The addition of carboplatin significantly increased the rate of pathologic complete response following neoadjuvant chemotherapy and constitutes a potential treatment option in patients with early triple negative breast cancer.\u003c/p\u003e\n\u003cp\u003e\u003cfigure id=\"j_fco-2021-0025_fig_001\" position=\"anchor\" fig-type=\"figure\"\u003e\u003cimg xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"graphic/j_fco-2021-0025_fig_001.jpg\" src=\"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/62c5b94cca8f8703463bdb5a/j_fco-2021-0025_fig_001.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256\u0026amp;X-Amz-Date=20230205T205312Z\u0026amp;X-Amz-SignedHeaders=host\u0026amp;X-Amz-Expires=18000\u0026amp;X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20230205%2Feu-central-1%2Fs3%2Faws4_request\u0026amp;X-Amz-Signature=6f6e4b7d7f2c6d94d7960496fb8a12ce1424bfd6b9411a28af1fa0364e8515be\" class=\"mw-100\"\u003e\u003c/img\u003e\u003c/figure\u003e\u003c/p\u003e\n\u003cp\u003eThere was a greater benefit in patients over 40 years of age (p=0.056) and patients with high Ki-67 (p=0.046)\u003c/p\u003e\n\u003cp\u003e\u003cfigure id=\"j_fco-2021-0025_fig_002\" position=\"anchor\" fig-type=\"figure\"\u003e\u003cimg xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"graphic/j_fco-2021-0025_fig_002.jpg\" src=\"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/62c5b94cca8f8703463bdb5a/j_fco-2021-0025_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256\u0026amp;X-Amz-Date=20230205T205312Z\u0026amp;X-Amz-SignedHeaders=host\u0026amp;X-Amz-Expires=18000\u0026amp;X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20230205%2Feu-central-1%2Fs3%2Faws4_request\u0026amp;X-Amz-Signature=34309b79e266b93ba8f90efd2ee1269fa8973a2d38a5eaa1bce8200d486d1e83\" class=\"mw-100\"\u003e\u003c/img\u003e\u003c/figure\u003e\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_021\"\u003e\u003cdiv\u003eTHYROID ABNORMALITIES IN CHILHDOOD CANCER SURVIVORS\u003c/div\u003e\n\u003cp\u003eKatsibardi K.\u003csup\u003e1\u003c/sup\u003e, Vlacou A.\u003csup\u003e1\u003c/sup\u003e, Nitsa E.\u003csup\u003e1\u003c/sup\u003e, Avgerinou A.\u003csup\u003e1\u003c/sup\u003e, Roka K.\u003csup\u003e1\u003c/sup\u003e, Tourkantoni N.\u003csup\u003e1\u003c/sup\u003e, Rigatou E.\u003csup\u003e1\u003c/sup\u003e, Filippidou M.\u003csup\u003e1\u003c/sup\u003e, Tsipou H\u003csup\u003e1\u003c/sup\u003e, Bacopoulou F.\u003csup\u003e2\u003c/sup\u003e, Kanaka-Gantenbein C.\u003csup\u003e3\u003c/sup\u003e, Kattamis A.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003ePediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sofia” Children’s Hospital, Athens, Greece.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eCenter for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, Greece.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eDivision of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sofia” Children’s Hospital, Athens, Greece.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction:\u003c/bold\u003e Thyroid complications in pediatric cancer survivors are common and may present as thyroid dysfunction or thyroid carcinoma.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim/Methods:\u003c/bold\u003e Thyroid function of children treated for pediatric cancer were evaluated retrospectively, within a 6-year period. Therapy was calculated as a category variable; chemotherapy, and or radiation. Hypothyroidism was considered as category value; TSH \u0026gt;5 \u003citalic\u003eμ\u003c/italic\u003eIU/mL and TSH\u0026lt;5 \u003citalic\u003eμ\u003c/italic\u003eIU/mL. Univariable logistic regression analysis performed to investigate association between hypothyroidism and therapy. Statistical analysis performed with RStudio version 3.6.2. P value \u0026lt;0 .05 was considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e A total of 61 long-term adolescent survivors, 59.0% (N=36) males and 41.0% (N=25) females were longitudinally followed. The follow-up duration was 3.7 years (range 1.7–6.7 years). The median age of treatment was 11.6 years (range 6.6 to 19.2 years). Among them, 28/61 (45.9%) had leukemia, 17/61 (27.8%) lymphoma, 7/61 (11.7%) brain tumor and 9/61 (14.6%) other tumors. Median value of TSH and FT4 was 2.5 \u003citalic\u003eμ\u003c/italic\u003eIU/mL (range 0.05–8.2) and 13.4 pmol/L (range 0.35–17.4), respectively. One patient that presented TSH value from 125–147 \u003citalic\u003eμ\u003c/italic\u003eIU/mL under relapse treatment for lymphoma was excluded from the present study. Nine patients (15.0%) had hypothyroidism. Minimum/maximum observed time for hypothyroidism was 0.38/5.2 years after treatment completion. Radiation treatment was significantly associated with hypothyroidism (O.R=5.8;95%, C.I (1.3–26.1); p=0.02, 35.71% vs 8.7%). Thyroid lesions, such as cysts-nodules had 6 (10.0%) adolescent survivors. Ten (16.7%) and 4 (6.7%) patients had one and two thyroid parenchymal abnormalities, respectively, while 46 (76.7%) patients had normal thyroid parenchyma. Substitution treatment with levothyroxine was necessary in 10/61 (16.6%) survivors. Most of the patients 60/61 had negative antithyroid antibodies.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Thyroid sequelae resulting from radiation therapy may manifest only after years to decades of follow-up, and their resultant clinical symptoms may be indolent. Life-long monitoring of pediatric cancer survivors for thyroid function is paramount.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_022\"\u003e\u003cdiv\u003eCURECANCER DIGITAL PLATFORM IN THE ROUTINE CLINICAL ONCOLOGY PRACTICE FACILITATES PATIENTS’ SELF-DATA RECORDING, COMMUNICATING WITH HEALTHCARE PROFESSIONALS, TREATMENT ADHERENCE AND ‘DISTANCING INTERVENTIONS’ DURING COVID-19 AND REDUCES COSTS – A FEASIBILITY AND SATISFACTION STUDY\u003c/div\u003e\n\u003cp\u003eGaliti D.\u003csup\u003e1\u003c/sup\u003e, Agelaki S.\u003csup\u003e2\u003c/sup\u003e, Karampeazis A.\u003csup\u003e2\u003c/sup\u003e, Linardou H.\u003csup\u003e2\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e2\u003c/sup\u003e, Bamias A.\u003csup\u003e2\u003c/sup\u003e, Psyrri A.\u003csup\u003e2\u003c/sup\u003e, Karamouzis M.\u003csup\u003e2\u003c/sup\u003e, Syrigos K.\u003csup\u003e2\u003c/sup\u003e, Ardavanis A.\u003csup\u003e2\u003c/sup\u003e, Athanasiadis I.\u003csup\u003e2\u003c/sup\u003e, Arvanitou E.\u003csup\u003e2\u003c/sup\u003e, Sgourou S.\u003csup\u003e2\u003c/sup\u003e, Kouloulias V.\u003csup\u003e2\u003c/sup\u003e, Zygogianni A.\u003csup\u003e2\u003c/sup\u003e, Georgopoulou E.\u003csup\u003e2\u003c/sup\u003e, Mala A.\u003csup\u003e2\u003c/sup\u003e, Vallilas C.\u003csup\u003e2\u003c/sup\u003e, Evangelou G.\u003csup\u003e2\u003c/sup\u003e, Kokkali S.\u003csup\u003e2\u003c/sup\u003e, Nikolaidi A.\u003csup\u003e2\u003c/sup\u003e, Papadopoulou P.\u003csup\u003e2\u003c/sup\u003e, Nicolatou-Galitis O.\u003csup\u003e1\u003c/sup\u003e, Boukovinas I.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eCureCancer, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eHellenic Society of Medical Oncology, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e We assessed CureCancer’s feasibility and patients’ and HCPs’ satisfaction. CureCancer is a patient-centric/driven platform, which enables patients to self-create their profile, report symptoms and communicate with physicians.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: Patients from 18 centres were asked to register at CureCancer, upload their data and complete a questionnaire on demographics, disease and treatment characteristics and their satisfaction.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: One hundred and fifty-nine patients were enrolled and 144 (90.6%) registered; 114 of 144 (79.1%), 63 males and 51 females, with a median age 54.5 years, completed the questionnaire. Sixty-four patients were university graduates and 35 were high school graduates. Forty-six patients had metastatic disease, 87 were on active treatment and 51 received supportive care. All patients also visited non-oncology HCPs. Nineteen patients changed their work status and 49 had children below 24 years.\u003c/p\u003e\n\u003cp\u003eRegistration was ‘very/very much’ easy for 98 (86.0%) patients. File uploading was ‘very/very much’ easy for 47 (41.2%) patients. Over 80% of patients and physicians preferred the digital way. Ninety-nine patients and all HCPs will recommend CureCancer to others. Easy data access, improved communication, feeling safe, treatment adherence, interventions from distance, particularly during COVID-19 pandemic, and saving time and money were highly commented by patients and HCPs.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion\u003c/bold\u003e: CureCancer was feasible, and patients and HCPs were satisfied. File uploading changed to become more user friendly. Integration of CureCancer in the routine practice is expected to improve cancer care and reduce cancer costs. Patients’ self-reporting, with CureCancer, can increase the accuracy of clinical trial results and map social/work/economic issues following cancer diagnosis to assist healthcare policy.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_023\"\u003e\u003cdiv\u003eTHE EFFECT OF THE ART THERAPY ON PAEDIATRIC ONCOLOGY PATIENTS\u003c/div\u003e\n\u003cp\u003eStamatopoulou E.\u003csup\u003e1\u003c/sup\u003e, Tsilias D.\u003csup\u003e2\u003c/sup\u003e, Valassi L.\u003csup\u003e3\u003c/sup\u003e, Valassi S.\u003csup\u003e4\u003c/sup\u003e, Antonakou A.\u003csup\u003e5\u003c/sup\u003e, Stamatopoulou A.\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eRN, MSc Clinical Pediatrics \u0026amp; Nursing-Research General Children’s Hospital of Athens P. \u0026amp; A. Kyriakou. Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eGraduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eGraduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003e‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003ePhD(c), Economist, M.Sc. International Business Administration, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Childhood cancer involves long periods of hospitalisation that cause feelings of fear and sadness, where they have a significant impact on the well-being and quality of life of paediatric oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003ePurpose:\u003c/bold\u003e To investigate the effect of art therapy on paediatric oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e The method followed is secondary as it draws on research and studies by experts. A literature search was performed in the online database PubMed with the following keywords: art therapies effect oncology pediatric cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Art therapy includes a set of activities like dance, movement, music, art, laughter therapy, theatre, play and poetry, and studies report a positive effect on the well-being of oncology paediatric patients. Studies on artistic therapeutic intervention with dance/movement, music and graphic arts report positive results in children’s pain, taste and food intake during chemotherapy. Study of oncological children who underwent diagnostic procedures such as bone marrow aspiration, lumbar puncture and treatment participated in art therapies with medical play, free drawing and theatre to reconcile with the change of body image. Children who received a session from the very first hospitalisation showed cooperative behaviour. The parents expressed their ability to better manage the painful processes of caring for their children with art therapy. In paediatric oncology, interactive music therapy reduced stress, anxiety and pain by increasing communication, cooperation, participation in play activities during hospitalisation with a beneficial effect on the well-being of children with cancer. Gaming therapy promotes mental, emotional and social development. A recent study reports that the use of new gaming technologies such as HabitApp increases the levels of affection, love, physical activity and social interaction in the paediatric oncology unit.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e In paediatric oncology, art therapy has a significant positive effect on pain, facial expression, nervousness and stress.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_024\"\u003e\u003cdiv\u003eASSESSMENT OF THE CARDIAC SAFETY AND EFFICACY OF NEOADJUVANT CHEMOTHERAPY WITH EPIRUBICIN AND CYCLOPHOSPHAMIDE FOLLOWED BY DOCETAXEL IN COMBINATION WITH DUAL ANTI-HER2 TREATMENT IN WOMEN WITH EARLY HER2-POSITIVE BREAST CANCER\u003c/div\u003e\n\u003cp\u003eG. Douganiotis\u003csup\u003e1\u003c/sup\u003e, S. Grigoriadis\u003csup\u003e2\u003c/sup\u003e, E. Markopoulou\u003csup\u003e2\u003c/sup\u003e, L. Kontovinis\u003csup\u003e2\u003c/sup\u003e, A. Pouptsis\u003csup\u003e2\u003c/sup\u003e, K. Papazisis\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003e3rd Department of Medical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eMedical Oncology Department, Euromedica General Clinic, Thessaloniki, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction:\u003c/bold\u003e Dual HER2 targeting (trastuzumab+pertuzumab) has become the standard of care in the neoadjuvant treatment of patients with HER2-positive breast cancer. Given the potential cardiotoxicity of both the chemotherapy used (anthracyclines) and the anti-HER2 monoclonal antibodies, concerns exist regarding the cardiac safety of this combination regimen.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: Data from the medical records of Oncomedicare were retrospectively collected. The analysis included all patients with early HER2-positive breast cancer who received neoajuvant chemotherapy with 4 cycles of epirubicin / cyclophosphamide (90 / 600 mg/m\u003csup\u003e2\u003c/sup\u003e) and 4 cycles of docetaxel (90mg/m\u003csup\u003e2\u003c/sup\u003e), trastuzumab and pertuzumab in the time period between 2014 and 2020. Patients additionally received adjuvant anti-HER2 treatment for one year where indicated. Following the regulatory approval of TDM-1, patients with residual disease received TDM-1 as adjuvant anti-HER2 treatment. The evaluation of cardiac function was performed with serial transthoracic ECHO and measurement of the Left Ventricle Ejection Fraction (LVEF). Pathologic responses following neoadjuvant treatment were also recorded.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: A total of 55 patients were included in the analysis, with a median age of 50 years at diagnosis and a median cardiological follow-up of 2.61 years following treatment. A total of 283 echocardiograms were performed. There was a consistent drop in LVEF values during treatment, which was not significant enough to necessitate treatment interruption. The values then consistently improved during follow-up. There were no cases of symptomatic heart failure, and there was only one recorded case of asymptomatic LVEF drop \u0026gt; 10%. A complete pathologic response was recorded in 64.8% of patients, with a higher rate for ER-negative patients (90%) than ER-positive ones (50%), a difference which was statistically significant and is consistent with the results from the relevant randomized clinical trials.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions\u003c/bold\u003e: This data shows the long-term cardiac safety of this combination regimen in clinical practice and confirms both its safety and efficacy in patients with early HER2-positive breast cancer.\u003c/p\u003e\n\u003cp\u003e\u003cfigure id=\"j_fco-2021-0025_fig_003\" position=\"anchor\" fig-type=\"figure\"\u003e\u003cimg xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"graphic/j_fco-2021-0025_fig_003.jpg\" src=\"https://sciendo-parsed-data-feed.s3.eu-central-1.amazonaws.com/62c5b94cca8f8703463bdb5a/j_fco-2021-0025_fig_003.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256\u0026amp;X-Amz-Date=20230205T205312Z\u0026amp;X-Amz-SignedHeaders=host\u0026amp;X-Amz-Expires=18000\u0026amp;X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20230205%2Feu-central-1%2Fs3%2Faws4_request\u0026amp;X-Amz-Signature=b7d8f44bb0cac03a8f866441f74865c0b3fe5cf3aeb73cc2c96d85bdc521929e\" class=\"mw-100\"\u003e\u003c/img\u003e\u003c/figure\u003e\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_025\"\u003e\u003cdiv\u003eREAL-WORLD DATA: COMPARATIVE EFFICACY OF IMMUNE CHECKPOINT INHIBITORS IN PRETREATED PATIENTS WITH NSCLC\u003c/div\u003e\n\u003cp\u003eMitsogianni M., Stefanou D., Charpidou A., Mani M., Gkiozos I., Syrigos N., Kotteas E.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eOncology Unit, 3\u003csup\u003erd\u003c/sup\u003e University Clinic for Internal Medicine, ‘Sotiria’ Hospital, Medical School of the University of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Immune checkpoint inhibitors are standard treatment options of patients with non-small cell lung cancer (NSCLC) who did not receive first-line immunotherapy, often leading to long-term responses. Nevertheless, the efficacy of various immunotherapeutic agents has not been directly compared in a randomised clinical trial, while retrospective studies are also limited.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The aim of the study is to determine possible superiority in the efficacy of pembrolizumab and nivolumab in patients with NSCLC beyond first-line treatment.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Pretreated patients with NSCLC receiving immunotherapy with pembrolizumab or nivolumab in our clinic in a period of 3 years were retrospectively analysed. We collected demographic data, disease control rate, progression-free survival and duration of response.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e One hundred and ninety-six patients were included in the analysis; 46 (23.5%) received pembrolizumab and 150 (76.5%) received nivolumab. Baseline demographic and clinical characteristics did not differ significantly between the two groups (\u003citalic\u003ep\u003c/italic\u003e \u0026gt; 0.05). It has to be noted that there were no patients without PD-L1 expression in the pembrolizumab group. There were no differences in disease control rate (54.3% vs. 49.4%, \u003citalic\u003ep\u003c/italic\u003e = 0.252), progression-free survival (5.0 vs. 4.0 months, \u003citalic\u003ep\u003c/italic\u003e = 0.520) and duration of response (not reached vs. 11.0 months, \u003citalic\u003ep\u003c/italic\u003e = 0.662) between the two groups.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e According to our findings, the efficacy of pembrolizumab and nivolumab does not differ significantly in pretreated patients with NSCLC.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_026\"\u003e\u003cdiv\u003eTHE IMPACT OF ADJUVANT RADIATION THERAPY AND EARLY SALVAGE RADIOTHERAPY AFTER RADICAL PROSTATECTOMY – ONE SINGLE-SITE EXPERIENCE\u003c/div\u003e\n\u003cp\u003eFotopoulou E., Plohorou M., Gkirlemis K., Soulimioti G., Maravelis I., Tzorakakis S., Athanasiou E.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e“Agioi Anargiroi” General Oncology Hospital, Department of Radiotherapy Oncology\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Prostate cancer with adverse pathological features (i.e. pT3 and/or positive margins) after prostatectomy may be treated either with adjuvant radiotherapy (ART) or surveillance followed by early salvage radiotherapy (ESRT) for biochemical recurrence.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To study the impact of postoperative ART and ESRT administered to patients with prostate cancer with adverse pathological features after radical prostatectomy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Forty-seven patients received ART within a year after radical prostatectomy. Three of them with lymph nodes metastasis who received hormone deprivation therapy were excluded. Four patients presented pT2N0M0/R1 disease, 23 patients pT3N0M0/R1 and 17 patients pT3N0M0/R0 excision. All patients, except four at the time of referral for radiotherapy (RT), were already under androgen deprivation therapy. According to postoperative PSA, patients were divided into two groups: a) patients with undetectable postoperative PSA (\u0026lt;0.2 ng/ml) who received adjuvant RT and b) patients who received ESRT and PSA (\u0026gt;0.2 ng/ml). For all patients, RT was performed using three-dimensional conformal RT (3D-CRT) at a dose of 60–64 Gy and a fractional dose of 2 Gy. Surveillance to biochemical recurrence was started from the date of surgery.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e From 44 followed patients, 20 had undetectable PSA (median value 0.04 ng/ml) and undergone γRT within 24 weeks from surgery. PSA for 24 of them was between 0.16 and 0.81 ng/ml (median value 0.38 ng/ml) and they were managed with ESRT, with the median time from surgery being 32 weeks (range 28–48 weeks). Median age was 65 years (53–77 years). Median time of follow-up was 48 months (24–84 months). From the ART group, all patients presented no biochemical recurrence until the time of submission. From the ESRT group, three patients (12.5%) presented with progressive increase of PSA.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Results regarding postoperative RT in our department are in agreement with international data. Concerning the second group of patients, the addition of ESRT was also beneficial as in the first group. More clinical data from randomised controlled studies are necessary in order to clarify the optimal postoperative RT approach, ART versus ESRT.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_027\"\u003e\u003cdiv\u003eA SYSTEMATIC REVIEW AND META-ANALYSIS OF ADJUVANT THERAPY FOR HIGH-RISK CUTANEOUS MELANOMA IN THE POST INTERFERON-ALPHA ERA\u003c/div\u003e\n\u003cp\u003eChristofyllakis K\u003csup\u003e1\u003c/sup\u003e, Pföhler C\u003csup\u003e2\u003c/sup\u003e, Bewarder M\u003csup\u003e1\u003c/sup\u003e, Müller C S.L.\u003csup\u003e2\u003c/sup\u003e, Thurner L\u003csup\u003e1\u003c/sup\u003e, Rixecker T\u003csup\u003e1\u003c/sup\u003e, Vogt T\u003csup\u003e2\u003c/sup\u003e, Stilgenbauer S\u003csup\u003e1\u003c/sup\u003e, Yordanova K\u003csup\u003e2\u003c/sup\u003e and Kaddu-Mulindwa D\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology Medical School, University of Saarland, Germany\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Dermatology, Venerology and Allergology Medical School, University of Saarland, Germany\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Several agents are approved in the adjuvant setting of completely resected high-risk (stage IIC–IV) cutaneous melanoma. Subgroups may benefit differently depending on the agent used. Meta-analyses addressing this question are lacking.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To evaluate the efficiency and tolerability of available treatment agents in modern adjuvant therapy of cutaneous melanoma in the total population and across the following subgroups: patient age, stage, ulceration status, lymph node involvement, BRAF status.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e We performed a systematic review and meta-analysis of the currently available data. The PubMed and Cochrane Library databases were searched without restriction in year of publication in June and September 2020. Data were extracted according to the PRISMA guidelines from two authors independently and were pooled according to the random-effects model. The predefined primary outcome was recurrence-free survival (RFS).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e After quality control, five prospective, randomised, placebo-controlled trials were included in the meta-analysis. The drug regimens included ipilimumab, pembrolizumab, nivolumab, nivolumab/ipilimumab, vemurafenib and dabrafenib/trametinib. Adjuvant treatment was associated with a higher RFS than placebo (hazard ratio [HR] 0.57; 95% confidence interval [CI] = 0.45–0.71). Nivolumab/ipilimumab in stage IV completely resected cutaneous melanoma was associated with the highest RFS benefit (HR 0.23; 97.5% CI = 0.12–0.45), followed by dabrafenib/trametinib in stage III BRAF-mutant melanoma (HR 0.49; 95% CI = 0.40–0.59). The presence of a BRAF mutation was associated with higher RFS rates (HR 0.30; 95% CI = 0.11–0.78), compared to the wildtype group (HR 0.60; 95% CI = 0.44–0.81). Patient age did not influence outcomes (≥65: HR 0.50; 95% CI = 0.36–0.70, \u0026lt;65: HR 0.58; 95% CI = 0.46–0.75). Immune checkpoint inhibitor monotherapy was associated with lower RFS in non-ulcerated melanoma. Patients with stage IIIA benefited equally from adjuvant treatment as those with stage IIIB/C. Nivolumab/ipilimumab and ipilimumab monotherapy were associated with higher toxicity.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Adjuvant therapy should not be withheld on account of advanced age or stage IIIA alone, as treatment benefit is maintained in these subgroups. The presence of a BRAF mutation is prognostically favourable. BRAF/MEK inhibitors should be preferred in the adjuvant treatment of BRAF-mutant non-ulcerated melanoma.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_028\"\u003e\u003cdiv\u003eSARCOID-LIKE REACTION: A DIAGNOSIS ATTRIBUTED TO HER2 TREATMENT\u003c/div\u003e\n\u003cp\u003eAndreadou A.\u003csup\u003e1\u003c/sup\u003e, Moliva D.\u003csup\u003e2\u003c/sup\u003e, Bleka Ev.\u003csup\u003e2\u003c/sup\u003e, Panagiotidis Em\u003csup\u003e3\u003c/sup\u003e, Andreadis Ch.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eConsultant, medical Oncologist, 3rd department oncology clinic, Theagenio hospital\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eIntern of medical oncology, 3rd department oncology clinic, Theagenio hospital\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eConsultant, nuclear medicine, Theagenio hospital\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eChair of the 3rd department oncology clinic, Theagenio\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction:\u003c/bold\u003e Novel targeted treatments have various side effects, some of which are autoimmune. Sarcoidosis is a disease that can be attributed to immunotherapy and there are a few case reports attributed to trastuzumab and none to pertuzumab.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase:\u003c/bold\u003e A 45-year-old woman was diagnosed with breast cancer. In Feb 2015, she was diagnosed with locally advanced triple-negative breast cancer. She received neoadjuvant chemotherapy (four cycles EC, four cycles docetaxel) and she had mastectomy ypT1N2/3 and radiotherapy.\u003c/p\u003e\n\u003cp\u003eIn Sept 2017, a metastasis to the liver was present that was confirmed with a PET-CT (SUV: 6.9), which was biopsied. The histology report was different: ER: −, Pr: −, cerbb2: +3, FISH+. She was started on chemotherapy with docetaxel–pertuzumab–trastuzumab. She received six cycles, and then she was continued on maintenance (pertuzumab–trastuzumab) till Sept 2020. The CTs were stable and in Sept 2020, she had a PET-CT that did not show any metastasis, but there were multiple lymph nodes in the mediastinum (SUV: 8.4). The radiologist believed that the diagnosis was immunotherapy-like induced reaction. An EBUS biopsy was conducted. The histopathology report revealed findings of granulomatous reaction pattern, possibly sarcoidosis. The ACE blood exam was normal, although the normal findings did not exclude the diagnosis of sarcoidosis.\u003c/p\u003e\n\u003cp\u003eIs it a sarcoid-like reaction attributed to the treatment? Or a disease that was already there? Last year, the patient had tingling, palsy in the facial nerves and swelling in joints, but all these symptoms were transient. After a thorough discussion with the patient, we decided to continue only subcutaneous trastuzumab. The stage of the sarcoidosis based on the PET-CT findings was I, which means that the patient should remain on surveillance.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eLiterature:\u003c/bold\u003e Trastuzumab has been used since 1998 for treatment of HER2-positive breast cancer. Although adverse effects are not common, some of the pulmonary complications associated with trastuzumab are acute lung injury, acute pneumonitis, organising pneumonia and bronchospasm. There are a few cases worldwide that correlate the use of trastuzumab with sarcoidosis.\u003c/p\u003e\n\u003cp\u003eSarcoidosis is considered an adverse effect, but since there are not many cases, there is no guideline for further management. The patient received trastuzumab with pertuzumab; so, it is not certain which drug caused sarcoidosis, if not both. There are no cases reported of sarcoid-like reaction due to pertuzumab.\u003c/p\u003e\n\u003cp\u003eThis young patient was informed about her choices of either stopping the treatment or continuing trastuzumab. She felt uncomfortable of stopping the treatment and decided to continue treatment with trastuzumab.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e This is the case of a woman with HER2 metastatic breast cancer, who had complete resolution of her metastasis and was recently diagnosed with sarcoidosis that is likely attributed to anti-HER2 treatment. Each of such rare cases should be discussed individually and the decision should be taken according to the extent of cancer, the stage of sarcoidosis and patient’s wishes.\u003c/p\u003e\n\u003cref-list\u003e\u003ctitle/\u003e\n\u003cref id=\"j_fco-2021-0025_ref_001\"\u003e\u003clabel\u003e1\u003c/label\u003e\n\u003cmixed-citation\u003eRabih Halabi, Trastuzumab induced sarcoidosis mimicking metastatic carcinoma, CHEST 2011; 140:56A.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eHalabi\u003c/surname\u003e\u003cgiven-names\u003eRabih\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eTrastuzumab induced sarcoidosis mimicking metastatic carcinoma\u003c/article-title\u003e\n\u003csource\u003eCHEST\u003c/source\u003e\n\u003cyear\u003e2011\u003c/year\u003e\n\u003cvolume\u003e140\u003c/volume\u003e\n\u003cfpage\u003e56A\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_002\"\u003e\u003clabel\u003e2\u003c/label\u003e\n\u003cmixed-citation\u003eDmitriy Cogan, A case of trastuzumab induced Pulmonary Sarcoidosis, CHEST, \u003curi\u003ehttps://doi.org/10.1378/chest.1386625\u003c/uri\u003e\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eCogan\u003c/surname\u003e\u003cgiven-names\u003eDmitriy\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eA case of trastuzumab induced Pulmonary Sarcoidosis\u003c/article-title\u003e\n\u003csource\u003eCHEST\u003c/source\u003e\n\u003ccomment\u003e\u003curi\u003ehttps://doi.org/10.1378/chest.1386625\u003c/uri\u003e\u003c/comment\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_003\"\u003e\u003clabel\u003e3\u003c/label\u003e\n\u003cmixed-citation\u003eP.T. Nigo, A case of trastuzumab induced sarcoidosis, American Society International Conference abstracts, 2017\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eNigo\u003c/surname\u003e\u003cgiven-names\u003eP.T.\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eA case of trastuzumab induced sarcoidosis\u003c/article-title\u003e\n\u003csource\u003eAmerican Society International Conference abstracts\u003c/source\u003e\n\u003cyear\u003e2017\u003c/year\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003c/ref-list\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_029\"\u003e\u003cdiv\u003eNEUROENDOCRINE NEOPLASMS OF RARE PRIMARY SITE: AN ONCOLOGY CENTRE’S 5-YEAR EXPERIENCE\u003c/div\u003e\n\u003cp\u003eChrysoglou S.I., Veniou E., Fioretzaki R., Georgiadou A., Logothetis M., Charalampakis N., Ntokou A., Kosmas C., Ziras N.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eDepartment of Medical Oncology, ‘Metaxa’ Cancer Hospital, Piraeus, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Neuroendocrine neoplasms (NENs) are heterogenous, rare tumours arising from neuroendocrine cells, which are scattered all over the body. They occur more often in the lungs, gastrointestinal tract or pancreas. Their biological behaviour depends on the histopathological characteristics of the tumour (tumour grade, differentiation, number of mitoses, Ki-67) and their localisation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To describe the special clinical and histological characteristics of NEN of rare primary site.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e We collected and reviewed all NENs (neuroendocrine tumours [NETs] and neuroendocrine carcinomas [NECs]) of rare primary sites treated in Metaxa Cancer Hospital of Piraeus from 2016 to 2020 and summarised their clinicopathological features.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e One hundred and forty-three primary NENs were diagnosed. Among them, we identified 24 (16.8%) of rare primary sites: breast: five (three NECs and two NETs), skin (Merkel): four, thymus: three NETs, larynx: two NECs, bladder: two NECs, prostate: two NECs, liver (paraganglioma): one NET, adrenal gland (pheochromocytoma): one NEC, inguinal area: one NEC, oesophagus: one NEC, kidney: one NEC and ovary: one NEC. The population of the study consisted of 15 men and nine women. Out of the 24 tumours reviewed, 18 were NECs and six were NETs. All NETs were non-functional and their clinical presentation was non-specific. Primary treatment was surgical. Treatment with somatostatin analogues resulted in long-term stabilisation in the case of paraganglioma. The majority of NECs had an aggressive clinical behaviour. Except for breast NECs, which were treated as adenocarcinomas, relapsed or metastatic NECs were treated with first-line cisplatin–etoposide. Immunotherapy was administered in two cases of Merkel carcinoma. Despite their poor clinical outcomes, their prognosis does not seem to differ from other NETs of the same stage.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e NENs in rare locations, most frequently NECs, have special characteristics and their management requires multidisciplinary approach offered in highly qualified reference centres. Creation of a national NEN registry and a hospital cooperation network are recommended.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_030\"\u003e\u003cdiv\u003eANXIETY AND DEPRESSION IN CANCER PATIENTS RECEIVING ONCOLOGY TREATMENT: ASSOCIATED FACTORS\u003c/div\u003e\n\u003cp\u003eArvanitou E.\u003csup\u003e1\u003c/sup\u003e, Parpa E.\u003csup\u003e2\u003c/sup\u003e, Tsilika E.\u003csup\u003e2\u003c/sup\u003e, Elmasian T-F\u003csup\u003e2\u003c/sup\u003e, Hatzigeorgiou E.\u003csup\u003e2\u003c/sup\u003e, Tsitsimpis A.\u003csup\u003e1\u003c/sup\u003e, Gkiaouraki M.\u003csup\u003e1\u003c/sup\u003e, Mpallasis K.\u003csup\u003e1\u003c/sup\u003e Chrystofyllakis Ch.\u003csup\u003e1\u003c/sup\u003e, Panagou E.\u003csup\u003e1\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e, Mystakidou K.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department, 401 General Military Hospital of Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003ePalliative Care Unit, Department of Radiology, University Areteion Hospital School of Medicine, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: Cancer diagnosis is related to fear and is a source of great distress for patients. Anxiety and depression are common in cancer patients and seem to affect quality of life, treatment compliance and even survival. Demoralisation that encompasses feelings of despair, loss of meaning and spiritual distress can occur in patients with cancer. The aim of this study is to investigate the relationship between demoralisation, anxiety and depression and to examine the demographic and clinical factors associated with anxiety and depression.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e A convenience sample of 150 cancer inpatients and outpatients from two oncology centres, with various types of solid tumours, receiving oncology treatment, participated in a prospective cross-sectional observational study. The psychometric tools used were the Greek version of the Hospital Anxiety and Depression Scale (HAD) and the Demoralisation Scale II (DS-II). The study was approved by the ethical committee or related boards of each hospital. Each patient was informed about the aims of the study, and the patient gave his/her written consent to participate.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Patients’ mean age was 62 years (20–85 years) and 89 patients (59.3%) were women. Among patients, 33% had breast, 24% had gastrointestinal and 15% had lung cancer. Eighty-two patients (54.7%) had metastatic disease. Women showed higher rates of anxiety (\u003citalic\u003ep\u003c/italic\u003e = 0.054). Anxiety was inversely related to age (\u003citalic\u003ep\u003c/italic\u003e = 0.043) and positively correlated with time since diagnosis (\u003citalic\u003ep\u003c/italic\u003e = 0.076). Unmarried patients presented higher rates of depression (\u003citalic\u003ep\u003c/italic\u003e = 0.026). Multiple linear regression showed a statistically significant impact of demoralisation on anxiety (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001, \u003citalic\u003eR\u003c/italic\u003e\u003csup\u003e2\u003c/sup\u003e = 36.3%) and depression (\u003citalic\u003ep\u003c/italic\u003e \u0026lt; 0.001, \u003citalic\u003eR\u003c/italic\u003e\u003csup\u003e2\u003c/sup\u003e = 49%).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The results highlight the significant impact of demoralisation on anxiety and depression in cancer patients. This emphasises the need for empathy and understanding of patients’ feelings by healthcare providers to recognise the feelings of despair and distress in a timely manner.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_031\"\u003e\u003cdiv\u003eMETASTATIC PROSTATE CANCER WITH NORMAL LEVEL OF SERUM PROSTATE-SPECIFIC ANTIGEN (PSA)\u003c/div\u003e\n\u003cp\u003eTsapakidis K., Papadopoulos V., Markou A., Kokkalis A., Chantzara E., Aidarinis C., Saloustros E., Koinis F., Samaras I., Kotsakis A.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eDepartment of Medical Oncology, University General Hospital of Larissa, Larissa, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: With the use of prostate-specific antigen (PSA), more and more prostate cancer patients are diagnosed at early stages (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_004\"\u003e1\u003c/a\u003e). Almost all patients with metastatic prostate cancer have elevated PSA and only a small percentage of patients with metastatic prostate cancer have normal PSA levels (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_005\"\u003e2–3\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim\u003c/bold\u003e: A clinical case of prostate cancer with normal PSA that has been treated successfully with chemotherapy is presented.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report\u003c/bold\u003e: We report a case of an 81-year-old man who presented with haematuria and underwent CT imaging that revealed lymphadenopathy, multiple bones and prostate heterogeneity. He underwent transurethral biopsy, and the histological examination of the specimen showed low-grade invasive carcinoma with the nuclei showing focal neuroendocrine differentiation, synaptophysin 5%–10% and also PSA focally positive, PSAP strongly positive. Laboratory test showed that he had increased NSE (50) and normal PSA (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_004\"\u003e1\u003c/a\u003e,\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_005\"\u003e2\u003c/a\u003e). The patient was started on chemotherapy with carboplatin and docetaxel and has been disease free for 3 years.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions\u003c/bold\u003e: In the prostate gland, a number of neuropeptides, such as GRP, chromogranin A and NSE, are found to be present not only in autonomic and sensory nerve terminals, but also in prostatic neuroendocrine cells (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_007\"\u003e4\u003c/a\u003e). Their biological role is not fully understood, but their levels in patients who do not express PSA are elevated (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_008\"\u003e5\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIt is now accepted that besides prostate adenocarcinoma, there are cases that display clinical features associated with small-cell carcinoma and are very sensitive to the combination of carboplatin chemotherapy with docetaxel (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_009\"\u003e6\u003c/a\u003e). These patients should receive chemotherapy, but the prognosis remains extremely poor (\u003ca ref-type=\"bibr\" href=\"#j_fco-2021-0025_ref_006\"\u003e3\u003c/a\u003e).\u003c/p\u003e\n\u003cref-list\u003e\u003ctitle/\u003e\n\u003cref id=\"j_fco-2021-0025_ref_004\"\u003e\u003clabel\u003e1\u003c/label\u003e\n\u003cmixed-citation\u003eCooner WH, Mosley BR, Rutherford CL, Beard JH, Pond HS, Bass RB, Terry WJ, Igel TC, Kidd DD. Prostate cancer detection in a clonical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. J Urol 1990; 143: 1146.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eCooner\u003c/surname\u003e\u003cgiven-names\u003eWH\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eMosley\u003c/surname\u003e\u003cgiven-names\u003eBR\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eRutherford\u003c/surname\u003e\u003cgiven-names\u003eCL\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eBeard\u003c/surname\u003e\u003cgiven-names\u003eJH\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003ePond\u003c/surname\u003e\u003cgiven-names\u003eHS\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eBass\u003c/surname\u003e\u003cgiven-names\u003eRB\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eTerry\u003c/surname\u003e\u003cgiven-names\u003eWJ\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eIgel\u003c/surname\u003e\u003cgiven-names\u003eTC\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eKidd\u003c/surname\u003e\u003cgiven-names\u003eDD\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eProstate cancer detection in a clonical urological practice by ultrasonography, digital rectal examination and prostate specific antigen\u003c/article-title\u003e\n\u003csource\u003eJ Urol\u003c/source\u003e\n\u003cyear\u003e1990\u003c/year\u003e\n\u003cvolume\u003e143\u003c/volume\u003e\n\u003cfpage\u003e1146\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_005\"\u003e\u003clabel\u003e2\u003c/label\u003e\n\u003cmixed-citation\u003eStamey TA, Kabalin JN. Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients. J Urol 1989; 141: 1070.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eStamey\u003c/surname\u003e\u003cgiven-names\u003eTA\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eKabalin\u003c/surname\u003e\u003cgiven-names\u003eJN\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eProstate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients\u003c/article-title\u003e\n\u003csource\u003eJ Urol\u003c/source\u003e\n\u003cyear\u003e1989\u003c/year\u003e\n\u003cvolume\u003e141\u003c/volume\u003e\n\u003cfpage\u003e1070\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_006\"\u003e\u003clabel\u003e3\u003c/label\u003e\n\u003cmixed-citation\u003eYamamoto S, Ito T, Akiyama A, Aizawa T, Miki M, Tachibana M. M1 prostate cancer with a serum level of prostate-specific antigen less than 10 ng/ml. Int J Urol 2001; 8: 374.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eYamamoto\u003c/surname\u003e\u003cgiven-names\u003eS\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eIto\u003c/surname\u003e\u003cgiven-names\u003eT\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eAkiyama\u003c/surname\u003e\u003cgiven-names\u003eA\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eAizawa\u003c/surname\u003e\u003cgiven-names\u003eT\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eMiki\u003c/surname\u003e\u003cgiven-names\u003eM\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eTachibana\u003c/surname\u003e\u003cgiven-names\u003eM\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eM1 prostate cancer with a serum level of prostate-specific antigen less than 10 ng/ml\u003c/article-title\u003e\n\u003csource\u003eInt J Urol\u003c/source\u003e\n\u003cyear\u003e2001\u003c/year\u003e\n\u003cvolume\u003e8\u003c/volume\u003e\n\u003cfpage\u003e374\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_007\"\u003e\u003clabel\u003e4\u003c/label\u003e\n\u003cmixed-citation\u003eGkonos PJ, Krongrad A, Roos BA. Neuroendocrine peptides in the prostate. Urol Res 1995; 23: 81.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eGkonos\u003c/surname\u003e\u003cgiven-names\u003ePJ\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eKrongrad\u003c/surname\u003e\u003cgiven-names\u003eA\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eRoos\u003c/surname\u003e\u003cgiven-names\u003eBA\u003c/given-names\u003e\u003c/name\u003e\n\u003carticle-title\u003eNeuroendocrine peptides in the prostate\u003c/article-title\u003e\n\u003csource\u003eUrol Res\u003c/source\u003e\n\u003cyear\u003e1995\u003c/year\u003e\n\u003cvolume\u003e23\u003c/volume\u003e\n\u003cfpage\u003e81\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_008\"\u003e\u003clabel\u003e5\u003c/label\u003e\n\u003cmixed-citation\u003eKimura N, Hoshi S, Takahashi M et al. Plasma chromogranin A in prostatic carcinoma and neuroendocrine tumors. J Urol 1997; 157: 565.\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eKimura\u003c/surname\u003e\u003cgiven-names\u003eN\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eHoshi\u003c/surname\u003e\u003cgiven-names\u003eS\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eTakahashi\u003c/surname\u003e\u003cgiven-names\u003eM\u003c/given-names\u003e\u003c/name\u003e\n\u003cetal/\u003e\n\u003carticle-title\u003ePlasma chromogranin A in prostatic carcinoma and neuroendocrine tumors\u003c/article-title\u003e\n\u003csource\u003eJ Urol\u003c/source\u003e\n\u003cyear\u003e1997\u003c/year\u003e\n\u003cvolume\u003e157\u003c/volume\u003e\n\u003cfpage\u003e565\u003c/fpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003cref id=\"j_fco-2021-0025_ref_009\"\u003e\u003clabel\u003e6\u003c/label\u003e\n\u003cmixed-citation\u003eAparicio A.M. Harzstark A.L. Corn P.G. et al. Platinum-based chemotherapy for variant castrate-resistant prostate cancer. Clin Cancer Res. 2013; 19: 3621–3630\u003c/mixed-citation\u003e\n\u003celement-citation publication-type=\"journal\" publication-format=\"print\"\u003e\n\u003cname\u003e\u003csurname\u003eAparicio\u003c/surname\u003e\u003cgiven-names\u003eA.M.\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eHarzstark\u003c/surname\u003e\u003cgiven-names\u003eA.L.\u003c/given-names\u003e\u003c/name\u003e\n\u003cname\u003e\u003csurname\u003eCorn\u003c/surname\u003e\u003cgiven-names\u003eP.G.\u003c/given-names\u003e\u003c/name\u003e\n\u003cetal/\u003e\n\u003carticle-title\u003ePlatinum-based chemotherapy for variant castrate-resistant prostate cancer\u003c/article-title\u003e\n\u003csource\u003eClin Cancer Res\u003c/source\u003e\n\u003cyear\u003e2013\u003c/year\u003e\n\u003cvolume\u003e19\u003c/volume\u003e\n\u003cfpage\u003e3621\u003c/fpage\u003e\n\u003clpage\u003e3630\u003c/lpage\u003e\n\u003c/element-citation\u003e\n\u003c/ref\u003e\n\u003c/ref-list\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_032\"\u003e\u003cdiv\u003eEFFICACY AND SAFETY DATA FOR THROMBOPROPHYLAXIS WITH LOW-MOLECULAR WEIGHT HEPARIN (LMWH) IN LUNG CANCER PATIENTS FROM A SINGLE CENTRE\u003c/div\u003e\n\u003cp\u003eKouvela M., Stefanou D., Evangelou G., Tourkantonis G., Nasi D., Papafili A., Kotteas H., Syrigos KN\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e3\u003csup\u003erd\u003c/sup\u003e Department of Internal Medicine, Oncology Unit, ‘Sotiria’ Hospital, Medical School, University of Athens, Athens, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Venus thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and is a very common complication in lung cancer patients. Even though VTE is the second cause of death in cancer patients, there are no guidelines concerning which patients need to receive thromboprophylaxis and in what dosage.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To assess the efficacy and safety of thromboprophylaxis with low-molecular weight heparin (LMWH) in lung cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e This study is a single-centre, prospective, observational study. Lung cancer patients of any histology type were evaluated in the first cycle of treatment for the risk of thrombosis. High-thrombotic risk patients were started on thromboprophylaxis with tinzaparin 0.5 ml, 10.0 Anti-Xa IU, OD, used in current clinical practice, and patients with an indication for therapeutic dosage (atrial fibrillation or pre-existing thrombosis) were started on tinzaparin 175 Anti-Xa IU/kgr, OD.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Preliminary results of 60 patients, five of which were set on therapeutic dosage. The median age was 65 years, and the most common histology was adenocarcinoma (50%). During follow-up (6 months), the compliance of the patients was sufficient. Nine patients died due to disease progression (15%), 10 patients discontinued treatment because of lack of sufficient thrombotic risk factors (17%) and six patients discontinued due to adverse events (10%). The adverse events were mild, without the need for medical intervention or hospitalisation of the patients, and they concerned mainly minor bleeding events (haemoptysis). One case of a minor allergic reaction was recorded. One patient experienced thrombotic event (efficacy 98.3%).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e LMWH thromboprophylaxis in active lung cancer patients reduces the risk of potentially deadly thrombotic events and is safe and well tolerated by the patients.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_033\"\u003e\u003cdiv\u003eTHE PSYCHOLOGICAL IMPACTS OF THE COVID-19 PANDEMIC IN CANCER PATIENTS\u003c/div\u003e\n\u003cp\u003eChatzinikolaou A.\u003csup\u003e1\u003c/sup\u003e, Lavdaniti M.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePostgraduate student, Nursing Department, International Hellenic University, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eAssociate Professor, Nursing Department, International Hellenic University, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction:\u003c/bold\u003e People with cancer belong to the high-risk groups, both for infection with the Sars-Covid-19 virus and for psychological transitions due to their state of health.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e A literature review was conducted using the electronic databases PubMed and Google Scholar with the keywords “psychological distress”, “cancer”, “patients”, “Covid-19 pandemic”, and a combination thereof. Exclusion criteria of articles was the language, except English. 15 articles were used on the subject. The review concerned the years 2020–2021.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The aim of this study was to investigate the psychological effects of a pandemic on cancer patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Cancer patients experience high levels of stress. Cancer is a threat to a person’s life and can significantly change their social, emotional and relational world. According to research, women and young people with cancer appeared to be more prone to stress and post-traumatic stress during the pandemic. In addition, the new condition created by the Sars-Covid-19 virus resulted in additional psychological burden during the treatment period due to treatment delays and prohibition on the presence of a caregiver on the hospital premises. Finally, immunosuppression and the treatment given to them make cancer patients more vulnerable due to the weakening of their immune system, which raises additional concerns about the possibility of infection with the Covid-19 virus even in the non-Covid hospital.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The interdisciplinary care team of cancer patients should have a holistic approach to the patient and deal with both his physical-organic rehabilitation and the mental empowerment of the person during the pandemic.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_034\"\u003e\u003cdiv\u003eENDOCRINE ADVERSE EFFECTS OF COMBINED IMMUNOTHERAPY ON SOLID CANCER – A SYSTEMATIC REVIEW AND META-ANALYSIS\u003c/div\u003e\n\u003cp\u003eTsitsimpis A.\u003csup\u003e1\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e, Katsouda A.\u003csup\u003e2\u003c/sup\u003e, Mpagkos P.\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department of 401GMHA\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003e5\u003csup\u003eth\u003c/sup\u003e Surgical Department of GH ‘Ippokrateio’\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eComputational Medicine and Bioinformatics University of Thessaly\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: Immunotherapy has created a revolution in oncology in the last decade. Moreover, the combination of immunotherapy takes a great position in the therapy of solid tumours. Many adverse effects (AEs) have been reported, in connection with the stimulation of immune system, and some of them concern the endocrine system.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods\u003c/bold\u003e: We made a systematic review and searched in PubMed, Medline and Clinical trials for the period from 01/2015 to 12/2020, following which we conducted a meta-analysis. Our search was about adult patients with solid tumours who were treated with EMA- or FDA-approved combination immunotherapy treatments and endocrine AEs were observed through phase 2 and 3. Twenty-six randomised clinical trials were included.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: We included 21 clinical trials with 3269 patients who were treated with ipilimumab + nivolumab. The percentage of hypophysitis was 6% (95% Cl: 4%–10%) with mild symptoms. The adrenal insufficiency was 2% (95% CI: 1–3). Although the heterogeneity was great, the percentage of hypothyroidism was 15% (95% CI: 13%–18%) and of hyperthyroidism was 14% (95% CI: 11%–18%). We included five clinical trials with 862 patients who were treated with durvalumab + tremelimumab. Hypophysitis was very rare (1%; 95% CI: 0–2%), but was almost always grade III/IV. The same observation was made for adrenal insufficiency, which concerned 2% (95% CI: 1%–5%) of the patients. The most common endocrine AE was hypothyroidism (10%; 95% CI: 8%–13%). The percentage of hyperthyroidism was 4% (95% CI: 1%–17%), but only two clinical trials had data on this AE.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion\u003c/bold\u003e: Combination immunotherapy is a promising treatment in oncology. This study provides more accurate data on endocrine AE in patients who were treated with combination immunotherapy. The most common AE was thyroid dysfunction or hypophysitis instead of adrenal insufficiency. Oncologists need to be up-to-date and alerted on these endocrine AEs of immunotherapy in order to diagnose and treat them.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_035\"\u003e\u003cdiv\u003ePERIPHERAL EOSINOPHILIA IN LONG-TERM SURVIVORS WITH NSCLC UNDER IMMUNOTHERAPY WITH ICIS: PRESENTATION OF TWO CASES AND REVIEW OF LITERATURE\u003c/div\u003e\n\u003cp\u003eChrysanthidis M., Molfeta A., Chatzichristou E., Bousboukea A., Leon O., Samonis G., Bafaloukos D.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e1\u003csup\u003est\u003c/sup\u003e Medical Oncology Department, Metropolitan Hospital – N. Faliro, Pireas, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e The potential role of elevated peripheral eosinophils in the response of solid tumours receiving systemic treatments remains ambiguous. The effects of hypereosinophilia in long-term survivors with non-small cell lung cancer (NSCLC) have not been investigated.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To evaluate whether any associations between hypereosinophilia and response to immunotherapy for NSCLC exist and to review the relevant literature.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Two cases with high levels of blood eosinophils in patients with NSCLC, showing long-term progression-free survival while in excellent clinical status under treatment with PD-1 and PD-L1 inhibitors, respectively, are presented. The relevant literature has been reviewed.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e The first patient, a 61-year-old male, who was a smoker without history of allergies, was diagnosed with NSCLC in October 2018 and initially received six cycles of therapy with paclitaxel and carboplatin. Due to disease progression, his treatment was changed to immunotherapy with nivolumab, and he had already received 43 consecutive doses every 2 weeks. As of June 2020, the mean value of eosinophils in peripheral blood was constantly above 200/\u003citalic\u003eμ\u003c/italic\u003eL (217.19/\u003citalic\u003eμ\u003c/italic\u003eL).\u003c/p\u003e\n\u003cp\u003eThe second patient, a 67-year-old male, who was a smoker with allergy to eggplants, was diagnosed with lung adenocarcinoma in 2014. He then underwent a right bilobectomy followed by two adjuvant cycles of carboplatin and vinorelbine. Due to hydropneumothorax, he was consequently treated with six cycles of pemetrexed. Since September 2019, he has been receiving immunotherapy with pembrolizumab; he has already completed 26 consecutive infusions and is in an excellent condition. As of September 2020, the mean value of blood eosinophils was constantly above 1/\u003citalic\u003eμ\u003c/italic\u003eL (1.1125/\u003citalic\u003eμ\u003c/italic\u003eL – hypereosinophilic syndrome).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Potential associations between elevated blood eosinophil levels and response to immunotherapy in long–term survivors suffering from NSCLC are worth investigating further.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_036\"\u003e\u003cdiv\u003eTHE EFFECT OF MUSIC THERAPY ON ONCOLOGY PATIENTS\u003c/div\u003e\n\u003cp\u003eStamatopoulou E.\u003csup\u003e1\u003c/sup\u003e, Tsilias D.\u003csup\u003e2\u003c/sup\u003e, Valassi L.\u003csup\u003e3\u003c/sup\u003e, Valassi S.\u003csup\u003e4\u003c/sup\u003e, Antonakou A.\u003csup\u003e5\u003c/sup\u003e, Stamatopoulou A. \u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003ePhD(c), M.Sc-MPH National School of Public Health, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Public Health Officer, R. N. General Hospital of Attica KAT, Teacher, Member Hellenic Society of Internal Medicine, Member PCRS UK.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eRN, MSc Clinical Pediatrics and Nursing-Research General Children’s Hospital of Athens P. \u0026amp; A. Kyriakou, Cross-sectoral Department of Pediatric Clinics: Pathology, Maxillofacial Surgery, Otolaryngology and Ophthalmology.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eGraduate of the University of Macedonia School of Social Humanities and Arts, Master of Special Pedagogy, University ‘Neofit Rilski’, MSc in music therapy Diploma in Byzantine Music, Academic Scholar.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eGraduate of E.K.Π.A. Diploma in Byzantine Music, MSc Special Education, MS (c) Management of Cultural Units.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003e‘Senior Nurse Manager’, MSc General Hospital of Nikaia ‘Agios Panteleimon’.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003ePhD(c), Economist, M.Sc. International Business Administration, M.Sc. in Management of Health and Social Welfare Services University of West Attica and European University Cyprus, Teacher, Academic fellow in University of West Attica.\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Music therapy was introduced in the field of palliative care in 1978 by Munro and Mount to relax and encourage the expression of difficult emotions.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003ePurpose:\u003c/bold\u003e To determine the effect of music therapy on oncology patients.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e The method followed is secondary, as it draws on research and studies by experts. A bibliographic search was performed on the online PubMed database with the following keywords: oncology patients effect music therapy from 1978 onwards.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e The original 1978 study on music therapy in palliative care reported an improvement in patients’ quality of life. Subsequent meta-analyses, reviews and recent systematic reviews have shown that it plays an important role with short-term positive results such as promoting well-being, elevating mood, causing relaxation and reduction of stress, depression, fatigue and pain, with beneficial effects on heart rate, respiratory rate, arterial pressure, facilitating communication to oncology patients and caregivers, thus improving their quality of life. In women with head and neck cancer or with breast cancer undergoing radiation therapy, chemotherapy significantly reduced stress, anxiety, fatigue, depression and the frequency of vomiting and improved their quality of life. The quality of sleep also improved in patients with osteosarcoma. In patients with gastrointestinal tract cancer who underwent chemotherapy, nausea and vomiting significantly reduced. In women undergoing breast augmentation and cancer surgery, music therapy has helped manage preoperative stress and anaesthesia requirements.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Music therapy is associated with a favourable mood in oncology patients and caregivers. It is used as a psychosocial therapy with the aim of improving psychological, physical well-being, addressing the spiritual needs and relieving stress and existential fears as a way of non-verbal expression and communication to cancer patients and caregivers.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_037\"\u003e\u003cdiv\u003eA GREEK MULTICENTER, PROSPECTIVE, OBSERVATIONAL STUDY TO ASSESS CLINICAL ACTIVITY, IMPACT ON SYMPTOM BURDEN AND QUALITY OF LIFE OF PATIENTS WITH ADVANCED SOFT TISSUE SARCOMAS TREATED WITH TRABECTEDIN: RESULTS OF THE REAL-WORLD ‘BEYOND-STS’ STUDY\u003c/div\u003e\n\u003cp\u003eKokkali S.\u003csup\u003e1\u003c/sup\u003e, Boukovinas I.\u003csup\u003e2\u003c/sup\u003e, Samantas E.\u003csup\u003e3\u003c/sup\u003e, Papakotoulas P.\u003csup\u003e4\u003c/sup\u003e, Athanasiadis I.\u003csup\u003e5\u003c/sup\u003e, Andreadis C.\u003csup\u003e6\u003c/sup\u003e, Makrantonakis P.\u003csup\u003e7\u003c/sup\u003e, Samelis G.\u003csup\u003e8\u003c/sup\u003e, Timotheadou E.\u003csup\u003e9\u003c/sup\u003e, Vassilopoulos G.\u003csup\u003e10\u003c/sup\u003e, Papadimitriou C.\u003csup\u003e11\u003c/sup\u003e, Tzanninis D.\u003csup\u003e12\u003c/sup\u003e, Ardavanis A.\u003csup\u003e1\u003c/sup\u003e, Kotsantis I.\u003csup\u003e13\u003c/sup\u003e, Karvounis-Marolachakis K.\u003csup\u003e14\u003c/sup\u003e, Theodoropoulou T.\u003csup\u003e14\u003c/sup\u003e, Psyrri A.\u003csup\u003e13\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eFirst Department of Medical Oncology, Agios Savvas Athens General Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eMedical Oncology, Bioclinic of Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eThird Oncology Clinic, AgioiAnargiroi Athens General Hospital, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eFirst Chemotherapeutic Oncology Department, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003eOncology Department, Hygeia Athens Private Hospital, Maroussi, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e6\u003c/sup\u003eThird Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e7\u003c/sup\u003eSecond Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e8\u003c/sup\u003eOncology Department at Hippocration General Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e9\u003c/sup\u003eDepartment of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e10\u003c/sup\u003eDepartment of Hematology, Larissa University Hospital\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e11\u003c/sup\u003eOncology Unit, Aretaieion University Hospital, National and Kapodistrian University of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e12\u003c/sup\u003eMedical Oncology Unit of Athens Medical Center, Maroussi, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e13\u003c/sup\u003eDivision Medical Oncology, Attikon University General Hospital of Athens, Haidari\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e14\u003c/sup\u003eMedical Department, Genesis Pharma SA, Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Advanced soft tissue sarcomas (aSTS) represent a heterogeneous group of neoplasms with limited treatment options. Trabectedin is indicated in the European Union (EU) for the treatment of aSTS patients who have failed or are unfit to receive anthracycline/ifosfamide.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim\u003c/bold\u003e: The study aims to generate real-world evidence on trabectedin effectiveness in aSTS and its impact on symptom burden and quality of life in routine clinical practice in Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e This prospective study consecutively enrolled patients with histologically confirmed aSTS and initiated on trabectedin per local label, who consented to participate in the study. Data were collected through routine assessments and patient-reported outcomes (MD Anderson Symptom Inventory [MDASI] and EuroQol-5 Dimensions-3-Levels [EQ-5D-3L] instrument) at 6-week intervals during the first 24 weeks and every 12 weeks thereafter for a maximum of 182 weeks.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Between 21 Dec 2015 and 06 June 2018, 64 eligible patients (median age: 58.3 years; 62.5% females; median disease duration: 15.3 months; 67.2% metastatic) were enrolled by 13 hospital sites in Greece. At baseline, 93.8% had ECOG performance status ≤1 and 53.1% had ≥1 comorbidity. Disease histological subtypes included leiomyosarcoma (32.8%), pleomorphic undifferentiated sarcoma (15.6%) and liposarcoma (10.9%). Of the patients, 17.2%, 53.1% and 29.7% had received none, 1 and ≥2 prior treatment lines, respectively. A median of 3.0 (interquartile range: 2.0–6.0) trabectedin cycles were received. The median progression-free survival (PFS) and overall survival were 6.6 and 13.1 months, respectively. The 3- and 6-month PFS rates were 67.9% and 51.2%, respectively; the disease control rate was 21.9%. Baseline MDASI and EQ-5D index scores did not significantly change at post-baseline visits. The treatment discontinuation rate due to toxicity was 9.4%. The adverse drug reaction rate was 46.9% (serious: 17.2%; grade 3/4: 31.3%).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e In a real-world setting, trabectedin demonstrated clinically meaningful benefits in aSTS patients who had failed or were unfit to receive anthracycline/ifosfamide, with no new emerging safety signals and without imposing additional burden on patients’ quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAcknowledgements:\u003c/bold\u003e The authors acknowledge financial support for this study from Genesis pharma SA. The authors acknowledge abstract preparation support from Qualitis Ltd., Athens, Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eDisclosures:\u003c/bold\u003e SK: GENESIS Pharma SA: honoraria, research funding; IB: GENESIS Pharma SA: honoraria, investigator fees, advisory board; ES: GENESIS Pharma SA: honoraria, investigator fees, advisory board; PP: GENESIS Pharma SA: honoraria, investigator fees; IA: GENESIS Pharma SA: advisory board, investigator fees, research funding; ChA: GENESIS Pharma SA: honoraria, investigator fees, advisory board; PM: GENESIS Pharma SA: investigator fees; GS: nothing to disclose; ET: GENESIS Pharma SA: honoraria, research funding, advisory board; GV: GENESIS Pharma SA: honoraria, investigator fees, advisory board, research funding; ChP: NOVARTIS/ASTRA ZENECA, GENESIS, MSD, AMGEN, MERCK AND ROCHE: speaker honoraria and honoraria for consultancy in advisory boards, BMS/ROCHE: research grants; DT: GENESIS Pharma SA: investigator fees; AA: GENESIS Pharma SA: honoraria, investigator fees, advisory board; IK: GENESIS Pharma SA: honoraria; KK-M: GENESIS Pharma SA employee; TT: GENESIS Pharma SA employee; AP: GENESIS Pharma SA: honoraria, investigator fees, advisory board\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_038\"\u003e\u003cdiv\u003eDEVELOPMENT OF A NOVEL HOMECARE UNIT FOR CANCER PATIENTS IN THE PREFECTURE OF AGIOS NIKOLAOS CRETE\u003c/div\u003e\n\u003cp\u003eRovithi Maria\u003csup\u003e1\u003c/sup\u003e, Alexaki Maria\u003csup\u003e2\u003c/sup\u003e, Patentalaki Krystali\u003csup\u003e2\u003c/sup\u003e, Liodakis George\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eGeneral Hospital of Agios Nikolaos, Lasithi, Crete\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eGeneral Hospital-Rural Health Center Dialynakeio, Neapoli, Lasithi, Crete\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003eQuality in oncological care is a multidimensional concept. Palliative care constitutes a pillar of cancer care, unquestionably contributing to life prolongation and improvement of quality of life indexes. The development of the Chemotherapy Unit in Agios Nikolaos General Hospital offered the opportunity, by the cooperation of two integrated hospitals, to simultaneously develop the Cancer Homecare Unit.\u003c/p\u003e\n\u003cp\u003eAgios Nikolaos Cancer Homecare Unit operates once weekly, serving patients with cancer, in the prefecture of Agios Nikolaos, covering a geographically particular area of 511 km\u003csup\u003e2\u003c/sup\u003e. It constitutes the only, to our knowledge, public unit in Greece that includes a general practitioner as a permanent member. This, alongside the nurse care provided by a specialised homecare nurse, allows the upgrade of homecare services to include, indicatively, physical examination and administration of monoclonal antibodies. We present here the cumulative data of the first 2 years of operation.\u003c/p\u003e\n\u003cp\u003eIn total, 47 patients have been included thus far (57% women, data cutoff December 2020). Mean age is 68 years (range: 44–90 years). More frequent underlying malignancies were breast, colorectal and lung cancer (24%, 21% and 8%, respectively). In 2019, the team realised in total 56 at-home visits, resulting in 580 healthcare interventions, while in 2020 and amidst the extraordinary, restricted circumstances created in the covid era, the Homecare Unit exponentially increased the actions delivered, totalling 103 visits and 1803 interventions. Average duration of patient inclusion in the unit services is 151 days (range: 7–445 days), and average visits per patient is six (range: 1–14). Also, 44% of the included patients were under active oncological treatment, while the rest were included for end-of-life care.\u003c/p\u003e\n\u003cp\u003eDelivering of palliative care in Greece remains sadly inadequate. There is undoubtedly significant room for improvement, as furthermore highlighted by the Hellenic Society of Medical Oncology, which has included palliative care as a strategic endpoint. Administration of palliative care results in a humane, holistic approach of the cancer patient, while ensuing simultaneously decrease in hospitalisation duration, ultimately leading to relief of hospital workload. Especially in the current pandemic situation, Homecare has the potential to repurpose its role by the inclusion of patients in earlier disease state. We strongly feel that the development of Cancer Homecare should be realised within an extrovert, interdisciplinary context of cooperation of medical oncologists with other specialties, especially with the healthcare professionals of primary care, to maximise its potential.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_039\"\u003e\u003cdiv\u003eCASE REPORT: SARCOIDOSIS RELATED TO BRAF/MEK INHIBITION IN A PATIENT WITH METASTATIC MELANOMA\u003c/div\u003e\n\u003cp\u003eMitsogianni M, Bala VM, Laschos K, Pliakou E, Lazaridi E, Lampropoulou DI, Aravantinos G\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e2\u003csup\u003end\u003c/sup\u003e Department of Medical Oncology, General Oncology Hospital of Kifissia ‘Agioi Anargyroi’\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e BRAF/MEK inhibitors are widely used for the treatment of metastatic melanoma. While granulomatous sarcoidosis-like reactions have been reported in numerous cases of melanoma patients receiving immunotherapy, they are extremely uncommon under BRAF/MEK inhibition.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The aim of this report is to present a case of clinical interest regarding a granulomatous reaction in a patient under treatment with BRAF/MEK inhibitors for metastatic melanoma.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethod:\u003c/bold\u003e Review of the clinical case.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report:\u003c/bold\u003e A 55-year-old woman was submitted to wide excision due to melanoma of the left scapula (pT2b [1.5 mm], N0 [SLNB], cM0, Clark level 3). Fifteen months later, she presented with metastatic lymphadenopathy of the left axilla and mediastinum. Due to the presence of BRAF V600E mutation, she was treated with dabrafenib and trametinib and she achieved complete response. CT staging 16 months later showed enlarged mediastinal lymph nodes as possible manifestations of progressive disease. EBUS-TBNA was carried out and histopathology revealed the existence of sarcoidosis-like granulomatous lymphadenopathy. The patient was asymptomatic and received no treatment for sarcoidosis, while targeted therapy was continued. The lymphadenopathy regressed spontaneously in the next 5 months.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Mediastinal sarcoidosis-like lymphadenopathy is possible under treatment with BRAF/MEK inhibitors and should be included in differential diagnosis from disease progression.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_040\"\u003e\u003cdiv\u003eDURATION OF TRASTUZUMAB IN METASTATIC BREAST CANCER AFTER COMPLETE RESPONSE\u003c/div\u003e\n\u003cp\u003eOikonomopoulos G, Galani E, Klouvas G, Agrogianni A, Rapti A, Nikolakopoulou A, Maria, Batziou A, Tsakalos G, Christodoulou C\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e2nd Oncology Department, Metropolitan Hospital, Pireus, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Trastuzumab is the cornerstone of treatment of Her-2 (+) breast cancer, turning a highly lethal disease into a chronic one. In the metastatic setting, after combination with chemotherapy, there is evidence proving that continuation of trastuzumab monotherapy as maintenance offers a significant benefit.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e We present the experience of our centre with patients achieving complete response on trastuzumab-based treatment.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e We evaluated retrospectively eight patients with Her-2 (+) metastatic breast cancer, who achieved complete response on treatment with trastuzumab-containing regimen and continued with monotherapy. Concurrent hormonal therapy was applied accordingly. We included patients with complete remission of visceral disease and at least stable bone disease.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e Median time on trastuzumab-based treatment was 93 months (54–111 months). Six patients had discontinued trastuzumab, whereas two still received it until December 2016. Only one patient had stopped treatment due to decrease in cardiac ejection fraction. After discontinuation of trastuzumab, five out of the six patients showed progression of disease (84%) with a mean time to progression of 20.2 months. Of the two patients on trastuzumab, one had recurrence of disease (50%). All patients with recurrence received trastuzumab-based treatment.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e There is little evidence to define the duration of trastuzumab after complete response. Our study revealed that discontinuation of trastuzumab increases the risk of recurrence. There is definite need for larger trials to establish the optimal duration of trastuzumab after complete response.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_041\"\u003e\u003cdiv\u003eTHE ROLE OF NEOADJUVANT CHEMORADIOTHERAPY NEL TUMOUR RESPONSE FOR THE LOCALLY ADVANCED RECTUM TUMOURS – OUR EXPERIENCE\u003c/div\u003e\n\u003cp\u003eG. Soulimioti, A. Fotopoulou, M. Ploxorou, I. Maravelis, S. Tzorakakis, K. Girlemis, E. Athanasiou\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eRadiotherapy Department of G.O.N.K \u0026lt;\u0026lt;Oi Agioi Anargiroi\u0026gt;\u0026gt;\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e The standard of therapy for locally advanced rectum tumour is neoadjuvant chemo-radiotherapy followed by surgery.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e The aim of our study is to determine the tumour response to surgery after neoadjuvant chemo-radiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e Thirty-three patients with locally advanced rectum tumours received neoadjuvant chemo-radiotherapy in our department from 2013 to 2020. Of these, 21 were males (68%) and 12 were females (32%). The median age was 67 years (range 35–89). Of these, seven had stage II tumour (35%) and 26 had stage IIγ tumour (65%). The clinical stage of the tumour was identified with colonoscopy and magnetic resonance imaging (MRI). The histology of all tumours was adenocarcinoma. Thirteen patients had tumours in the upper part of rectum (38%) and 20 patients had them in the lower part of rectum (62%). All the patients received 3D conformal RT with 45 Gy/1.8 Gy/day. Thirty-one patients (93%) received concomitant chemotherapy with capecitabine (850 mg/m\u003csup\u003e2\u003c/sup\u003e twice a day for 25 days). The surgery was done 4–8 weeks after the end of neoadjuvant chemo-radiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults:\u003c/bold\u003e The results after the surgery were as follows: eight patients (24.4%) had complete response (ypT0) and 23 patients (72.6%) had partial response. Also, two patients died before the surgery due to other medical reasons (4%). In our study, it seems that of the eight patients who had complete response, six had tumours in the upper segments of rectum and two had them in the lower part of rectum (75% vs. 25%). So, it seems that the patients with tumours in the upper segments of rectum had better response to surgery after neoadjuvant chemo-radiotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Neoadjuvant chemo-radiotherapy shows very good results in tumour response of the locally advanced rectums tumours. Our results are similar of those of international studies.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_042\"\u003e\u003cdiv\u003eMESONEPHRIC-LIKE MULLERIAN ADENOCARCINOMA OF THE OVARY\u003c/div\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eMichas Athanasios MD MSc, \u003csup\u003e2\u003c/sup\u003eAkrivos Thomas MD, \u003csup\u003e2\u003c/sup\u003eGiannakas Panagiotis MD, \u003csup\u003e1\u003c/sup\u003eArvanitou Eleni MD MSc, \u003csup\u003e1\u003c/sup\u003eGkikas Konstantinos MD, \u003csup\u003e1\u003c/sup\u003eKolomitrousi Andria MD, \u003csup\u003e1\u003c/sup\u003eKagkaras Christos MD, \u003csup\u003e1\u003c/sup\u003eGkiaouraki Marina MD, \u003csup\u003e1\u003c/sup\u003eMpalasis Konstantinos MD, \u003csup\u003e1\u003c/sup\u003eChristofilakis Charalampos MD, \u003csup\u003e1\u003c/sup\u003eTsoukalas Nikolaos MD MSc PhD\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology department of 401General Military Hospital of Athens (401GMHA)\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eGynecologic department of 401General Military Hospital of Athens (401GMHA)\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Mesonephric-like Mullerian adenocarcinomas of the ovaries are extremely rare gynaecological malignancies. Their embryological and histological origin remains debatable. The more prevalent tumorigenic theories support either development from mesonephric duct remnants of the female genital tract or development from Mullerian lesions that undergo mesonephric differentiation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase Report:\u003c/bold\u003e This report concerns a 64-year-old female patient with medical history of hypothyroidism and dyslipidaemia. During annual gynaecological US screening examination, a solid formation (approximately 4 cm diameter) was found on the left ovary. An ensuing abdominal MRI tomography revealed a solid ovarian mass. Further staging with CTs and PET-CT scan excluded distant neoplasmatic dissemination. Subsequently, a surgical total hysterectomy was performed. After histological evaluation, the analysis concluded low-grade mesonephric-like Mullerian adenocarcinoma of the left ovary, adjacent to multiple foci of endometriosis. Due to the tumour rarity, the histological results were rechecked and verified by multiple histology experts. The patient received adjuvant chemotherapy with six cycles of carboplatin/paclitaxel. Treatment was completed without significant side effects, except for mild nausea and hand–foot syndrome. Follow-up examinations showed complete disease remission. Currently, the patient is regularly monitored with scheduled periodic assessments, without any sign of recurrence. Moreover, molecular analysis revealed heterozygous somatic \u003citalic\u003eKRAS\u003c/italic\u003e mutation NM_033360.4:c.35G\u0026gt;A:p.(Gly12Asp) and heterozygous genomic \u003citalic\u003ePMS2\u003c/italic\u003e mutation NM_000535.7:c.2559C\u0026gt;G p.(Ile853Met).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Mesonephric-like Mullerian adenocarcinomas of ovaries are extremely rare tumours (\u0026lt;15 literature reports in PubMed, Scopus). The most prevalent theory of tumorigenesis involves cancer development from Mullerian lesions (e.g. foci of endometriosis) that undergo mesonephric differentiation. Further research is necessary for a deep understanding of the neoplastic nature of these lesions.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_043\"\u003e\u003cdiv\u003eMULTIPLE ENDOCRINE NEOPLASIA TYPE 1\u003c/div\u003e\n\u003cp\u003eGkikas K.\u003csup\u003e1\u003c/sup\u003e, Malliopoulos D.\u003csup\u003e2\u003c/sup\u003e, Pappas D.\u003csup\u003e3\u003c/sup\u003e, Kolomitrousi A.\u003csup\u003e1\u003c/sup\u003e, Arvanitou E.\u003csup\u003e1\u003c/sup\u003e, Tsitsibis A.\u003csup\u003e1\u003c/sup\u003e, Michas A.\u003csup\u003e1\u003c/sup\u003e, Chatzelis E.\u003csup\u003e4\u003c/sup\u003e, Gkiaouraki M.\u003csup\u003e1\u003c/sup\u003e, Ballasis K.\u003csup\u003e1\u003c/sup\u003e, Christofyllakis Ch.\u003csup\u003e1\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eEndocrinology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003ePathological Laboratory, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003eEndocrinology Department, 251 Air Force General Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e Multiple endocrine neoplasia (MEN) syndromes are rare endocrine cancer syndromes, inherited as an autosomal dominant disorder. The most common tumours seen in MEN1 involve the parathyroid gland, islet cells of the pancreas and the pituitary gland.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To present a case of MEN type 1 in an adult patient.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report:\u003c/bold\u003e In March 2020, a 37-year-old male was diagnosed with MEN type 1 syndrome after his family members’ (mother/brother) positive diagnosis as well, through molecular genetic testing. Several diagnostic imaging and laboratory tests subsequently performed revealed the following disorders: 1) primary hyperparathyroidism with hypercalcaemia and hypophosphataemia, combined with two hypoechoic solid masses on the thyroid, and 2) abdominal magnetic resonance imaging (MRI) findings including two abnormal masses of tissue placed on the pancreas (1.7 and 2 cm), as well as two suspicious-appearing masses (1.3 and 1.9 cm) within the liver. Molecular testing on \u003citalic\u003eMEN1\u003c/italic\u003e gene showed an NM_000244.3:c.1126dup p.(Val376Glyfs\u003csup\u003e*\u003c/sup\u003e38) heterozygous mutation. Further diagnostic imaging tests depicted nodular swelling on both the adrenal glands, such as a tiny pituitary lesion, which looked like a microadenoma. The 68-Ga-DOTATATE PET-CT scan showed an increased radiopharmaceutical uptake in the region of pancreas head, pancreas neck and liver part II. After finishing all necessary tests, the patient underwent an EUS-guided pancreas biopsy. Both cytological and histological examination results showed the existence of a high-grade neuroendocrine neoplasm. Therefore, after multidisciplinary oncology approach, the patient was suggested to perform a total parathyroidectomy to restore the insisting primary hyperparathyroidism. Furthermore, he was asked to perform a repetition of certain imaging tests 3 months later as a means to determinate the most suitable treatment option.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Clinical suspicion of MEN syndromes often results from family medical history, while molecular testing confirms the final diagnosis. Undoubtedly, treatment requires multidisciplinary oncology approach among many different medical specialties, not to mention the ultimate need for patients’ psychological support.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_044\"\u003e\u003cdiv\u003eRENAL HEMANGIOBLASTOMA IN AN ADULT WOMAN\u003c/div\u003e\n\u003cp\u003eKolomitrousi A\u003csup\u003e1\u003c/sup\u003e, Gikas K.\u003csup\u003e1\u003c/sup\u003e, Chrystofyllakis Ch.\u003csup\u003e1\u003c/sup\u003e, Mpallasis K.\u003csup\u003e1\u003c/sup\u003e, Gkiaouraki M.\u003csup\u003e1\u003c/sup\u003e, Psarogiorgou S.\u003csup\u003e2\u003c/sup\u003e, Zarogiannos A.\u003csup\u003e3\u003c/sup\u003e, Tsitsimpis A.\u003csup\u003e4\u003c/sup\u003e, Arvanitou E.\u003csup\u003e4\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003ePathology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eUrology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003e1\u003csup\u003est\u003c/sup\u003e Internal Medicine Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eIntroduction\u003c/bold\u003e: Hemangioblastoma is a benign tumor of the central nervus system (CNS). Occurrence of hemangioblastoma in other sites, outside the CNS, is extremely rare and is worth mentioned.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report:\u003c/bold\u003e A 49-year-old female with a past medical history of breast cancer (pT2N(sn)γi invasive lobular breast carcinoma, which was diagnosed 2 years ago and treated with lumpectomy, sentinel lymph node biopsy and resection of two lymph nodes, adjuvant chemotherapy, radiotherapy, and hormonal therapy) presented with a 2,3cm solid mass in the lower pole of the right kidney, as detected in the imaging exams. No other pathological features were found. Patient denied further work up and a close follow-up performed. The next imaging assessment, 6 months later, showed an increase of the mass size and subsequently a mass resection was planned. Due to perioperative complications a total nephrectomy was performed, and histological examination of the specimen showed a tumor mass within the renal parenchyma, composed of a rich capillary vessels and stromal cells with foamy clear or eosinophilic cytoplasm, with PAS positivity in cytoplasmic vacuoles. Moreover, several peripheral deformed, irregular, thick-walled vessels were found, Congo red stain was negative, and no necrosis or mitosis was seen. Furthermore, was observed hemosiderin deposits and mild inflammatory infiltration, while mast cells were easily observed. Tumor cells were negative for AE1/3, PAX8, HMB45, Melan A, HHV-8, CD10, GFPA and CD117. CD31 and CD34 included vessels and a small number of stromal cells was positive for CD34. Finally, was observed positivity for S100, NSE and inhibin. These results were compatible with the diagnosis of hemangioblastoma.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion:\u003c/bold\u003e Hemangioblastoma is a benign tumor of the central nervus system (CNS) and less often could be observed elsewhere. They can also rarely be associated with other conditions such as polyarthritis and pancreatic cysts and may occur in the context of Von Hippel-Lindau syndrome, which is why molecular testing is considered appropriate. Our case is presented due to the rarity of the presence of renal hemangioblastoma as an extensive review in the medical literature has so far highlighted 14 cases of renal hemangioblastoma.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_045\"\u003e\u003cdiv\u003ePOSTERIOR FOSSA MEDULLOBLASTOMA IN AN ADULT PATIENT\u003c/div\u003e\n\u003cp\u003eArvanitou E.\u003csup\u003e1\u003c/sup\u003e, Plakas S.\u003csup\u003e2\u003c/sup\u003e, Giannakouras G.\u003csup\u003e3\u003c/sup\u003e, Rigakos G.\u003csup\u003e4\u003c/sup\u003e, Pappas D.\u003csup\u003e5\u003c/sup\u003e, Tsitsimpis A.\u003csup\u003e1\u003c/sup\u003e, Gikas K.\u003csup\u003e1\u003c/sup\u003e, Kolomitrousi A.\u003csup\u003e1\u003c/sup\u003e, Michas A.\u003csup\u003e1\u003c/sup\u003e, Gkiaouraki M.\u003csup\u003e1\u003c/sup\u003e, Mpallasis K.\u003csup\u003e1\u003c/sup\u003e, Chrystofyllakis Ch.\u003csup\u003e1\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eNeurosurgery Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eRadiotherapy Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003e3rd Medical Oncology Department, Hygeia Hospital Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e5\u003c/sup\u003ePathological Laboratory, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: Medulloblastoma is an embryonic type of tumour, mainly located in the cerebellum, which unlike children rarely occurs in adults, with an annual incidence of 0.05–0.1 cases per 100,000. Medulloblastoma shows heterogeneity and is distinguished according to the World Health Organisation (WHO) into four subtypes, based on histological and molecular characteristics: a) WNT activated, b) SHH activated and TP53 wildtype, c) SHH activated and TP53 mutant and d) non-WNT/non-SHH. The prognosis of each subtype depends on age and differs in adults and children. Treatment includes gross total resection, adjuvant chemotherapy and craniospinal irradiation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To present a case of posterior fossa medulloblastoma in an adult patient.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report:\u003c/bold\u003e In January 2020, a 39-year-old male presented with persistent headache and progressively increasing vomiting. Brain magnetic resonance imaging (MRI) depicted a space-occupying lesion of 37 × 39 × 44 mm in the right cerebellum, without contrast enhancement, causing intense pressing phenomena, displacement of structures and increased dimensions of the ventricles. Due to the oedema, corticosteroids were started, and the patient showed clinical improvement. At the same time, due to manifestations from the psychic sphere, he was evaluated by a psychiatrist. The initial staging with craniospinal MRI, chest and abdominal computed tomography (CT) was normal. A surgical removal of more than 50% of the tumour mass was performed. The histological examination showed a grade IV cerebellum medulloblastoma of nodular/desmoplastic type. Further examination revealed tumour with ki-67 = 40%, without pathological IDH 1,2, without MYC amplification, and with \u003citalic\u003eYAP1\u003c/italic\u003e overexpression, most likely of the SHH-activated molecular subtype (group 2). Postoperative MRI showed a large reduction in the size of the lesion. Subsequently, an assessment from a specialised central nervous system (CNS) tumour treatment centre was requested. Patient underwent craniospinal irradiation, and at present, receives chemotherapy with the lomustine/cisplatin/vincristine regimen, with adequate response according to the first follow-up. The molecular test that was performed revealed a TP53 heterozygous mutation of unknown clinical significance.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The management of rare tumours such as cerebellum medulloblastoma requires collaboration with specialised cancer treatment centres. The importance of an interdisciplinary team for the optimal management of patient care is also highlighted.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_046\"\u003e\u003cdiv\u003ePROSTATE EMBRYONAL RHABDOMYOSARCOMA IN A YOUNG ADULT PATIENT\u003c/div\u003e\n\u003cp\u003eArvanitou E.\u003csup\u003e1\u003c/sup\u003e, Papandropoulos I.\u003csup\u003e2\u003c/sup\u003e, Giannakouras G.\u003csup\u003e3\u003c/sup\u003e, Psarogiwrgou S.\u003csup\u003e4\u003c/sup\u003e, Tsitsimpis A.\u003csup\u003e1\u003c/sup\u003e, Gikas K.\u003csup\u003e1\u003c/sup\u003e, Kolomitrousi A.\u003csup\u003e1\u003c/sup\u003e, Michas A.\u003csup\u003e1\u003c/sup\u003e, Gkiaouraki M.\u003csup\u003e1\u003c/sup\u003e, Mpallasis K.\u003csup\u003e1\u003c/sup\u003e, Chrystofyllakis Ch.\u003csup\u003e1\u003c/sup\u003e, Tsoukalas N.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eOncology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eUrology Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eRadiotherapy Department, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e4\u003c/sup\u003ePathological Laboratory, 401 General Military Hospital of Athens\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: Rhabdomyosarcoma represents an aggressive tumour which originates from the embryonal mesenchyme. It is the most common soft tissue sarcoma in children. But it is extremely rare in adults, as it accounts for 2%–5% of the soft tissue sarcomas. Prostate rhabdomyosarcoma is an aggressive tumour characterised by rapid tissue infiltration and poor prognosis. Immunohistochemistry and molecular testing are useful for diagnosis and classification. Treatment involves surgery, irradiation and chemotherapy.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To present a case of prostate embryonal rhabdomyosarcoma in a young adult patient.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report\u003c/bold\u003e: In June 2019, a 24-year-old male presented with acute urinary retention and was diagnosed with a locally extended prostate mass and secondary pulmonary and bone lesions. The histological examination showed sheets of spindle or round cells with moderate pleomorphism and plenty of mitoses. The tumour cells demonstrated immunohistochemical positivity for vimentin, desmin and myogenin. Proliferation index, Ki-67, was rather high (70%). These findings were referable to embryonal rhabdomyosarcoma. An assessment from a centre specialising in paediatric and adolescent oncology was requested, and first-line treatment with IVADo regimen (d-actinomycin, doxorubicin, ifofosfamide, vincristine) with mesna administration was initiated. After chemotherapy completion, restaging computed tomography (CTs) and magnetic resonance imaging (MRIs) showed significant response of the prostate mass and bone disease and partial response of the pulmonary lesions. Subsequently, patient underwent a course of radiotherapy with volumetric modulated arc therapy (VMAT)/image-guided radiation therapy (IGRT) technique to the primary and metastatic bone lesions. Due to disease progression, second-line treatment with irinotecan/vincristine/temozolamide was selected. Despite the initial response, patient developed clinical deterioration with local recurrence and new metastatic bone lesions. Palliative radiotherapy (RT) followed, and third-line chemotherapy with cisplatin/adriblastina was initiated. Molecular testing showed no findings compatible with hereditary cancer syndrome.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusion\u003c/bold\u003e: Rhabdomyosarcoma is rare in adults and its treatment requires cooperation with specialised cancer centres. The importance of palliative care for the optimal patient care is also highlighted.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_047\"\u003e\u003cdiv\u003ePRIMARY SQUAMOUS NON-SMALL CELL LUNG CANCER WITH GASTROINTESTINAL METASTASES AT DIAGNOSIS\u003c/div\u003e\n\u003cp\u003ePapadopoulos V., Tsapakidis K., Xantzara E., Markou A., Kokkalis A., Aidarinis X., Saloustros E., Koinis F., Samaras I., Kotsakis A.\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eDepartment of Clinical Oncology, University Hospital of Larissa, Greece\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e About half of the patients diagnosed with non-small cell lung cancer have distant metastases. The liver, bones, brain and adrenal glands are the most common anatomical sites of metastasis. Multiple metastatic lesions in the gastrointestinal tract from primary lung carcinoma are very rare.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e To describe a case of extremely rare synchronous metastases in the gastrointestinal tract from squamous non-small cell lung carcinoma, although their incidence in autopsies is described to be about 14%.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eCase report:\u003c/bold\u003e A 71-year-old patient was diagnosed with squamous cell carcinoma of the lung due to cough and shortness of breath (IHC: p40+, TTF1−, synaptophysin−). During the initial staging of the disease with positron emission tomography/computed tomography (PET/CT) 18F-FDG, a hypermetabolic lesion was found in the left pulmonary portal (SUVmax: 11.2) and increased intake of 18F-FDG was observed in thickening of the stomach wall (SUVmax: 15.6) and in caecum (SUVmax: 12.9). The patient underwent gastroscopy and colonoscopy, which showed squamous cell carcinoma immunohistochemically similar to the primary lung. The patient received first-line chemotherapy with gemcitabine and carboplatin. The treatment failed after three cycles of chemotherapy as a result of tumour progression to the liver, and the patient was switched to second-line treatment with nivolumab. In the third cycle of treatment, melena occurred and a new gastroscopy was performed that revealed bleeding from the known metastatic lesion of the stomach. The patient underwent gastric haemostatic radiotherapy and while initially he was stabilised haemodynamically, he relapsed with haemorrhagic brain metastases and eventually passed away.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e Gastrointestinal metastases from lung cancers are very rare and occur more frequently in older smokers with squamous cell carcinoma. The sputum seeding metastasis hypothesis is referred as a possible explanation, but needs investigation. However, the small number of patients in the literature makes it difficult to interpret this rare disease entity.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eReferences:\u003c/bold\u003e 1. Xinyu Li, Songhe Li, Zhiming Ma, Shutao Zhao, Xudong Wang, Dacheng Wen. Multiple gastrointestinal metastases of squamous-cell lung cancer. A case report. Medicine (Baltimore).2018 Jun; 97(24): e11027\u003c/p\u003e\n\u003cp\u003e2. Ibrahim Azar, Efstratios Koutroumpakis, Raina Patel, Syed Mehdi. Squamous cell lung carcinoma presenting as melena: a case report and review of the literature. Rare Tumors. 2017 Oct 4;9(3):7164\u003c/p\u003e\n\u003cp\u003e3. Ying He, Yong Cui, Xinchun Duan, Chunquan Liu, and Xianqi Cai. Primary lung squamous cell carcinoma with gastric metastasis: A case report. Thorac Cancer.2019 Feb; 10(2): 373–377.\u003c/p\u003e\n\u003cp\u003e4. Mariko Nemoto, Pankaj Prasoon, Hiroshi Ichikawa, Takaaki Hanyu, Yosuke Kano, Yusuke Muneoka, Kenji Usui, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Ishikawa, Masanori Tsuchida, Toshifumi Wakai. Primary lung squamous cell carcinoma and its association with gastric metastasis: A case report and literature review. Thorac Cancer. 2020 Jun;11(6):1708–1711\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_048\"\u003e\u003cdiv\u003eSIMULTANEOUS DIAGNOSIS OF PULMONARY ADENOCARCENOMA AND MYELODYSPLASTIC SYNDROME. CASE REPORT\u003c/div\u003e\n\u003cp\u003eE. Chrysoulidou, E. Panori\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003eBlood donation Dep. G. H. KAVALA\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground:\u003c/bold\u003e During the last years, there have been great leaps regarding the diagnosis and treatment of cancer. This is attributed to the development of technology which allows scientists to isolate and observe the activities of specific genes that have undergone mutations and are responsible for tumour growth. Genes with specific mutations are observed in different neoplacies, regardless of their origin. This means that the same medication can be used in different kinds of cancer.\u003c/p\u003e\n\u003cp\u003eThe term myelodysplastic syndrome (MDS) refers to a heterogenic group of acquired clonal neoplasmatic disorders of the bone marrow at the level of a polyvalent haematopoietic cell. It is characterised by a non-effective hematopoiesis cytarropenia, morphological disorders of haematopoietic cells and could evolve into an acute myelogenic leukaemia. It usually affects people over 60 years old. Pulmonary adenocarcinoma constitutes the most common type of cancer. It belongs to the category of the non-microcellular lung cancer. It is asymptomatic and in most cases, before it is clinically perceived, it would have already become metastatic. It affects mostly middle-aged men aged 60–70.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim:\u003c/bold\u003e Description of a case diagnosed with two different types of neoplacies simultaneously in the same biopathological material.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethods:\u003c/bold\u003e A male, 69 years old, presented with weakness, fatigue and shortness of breath in the course of 3 days and he had free individual background. During his clinical evaluation, a pulmonary murmur reduction was established, SpO\u003csub\u003e2\u003c/sub\u003e- 85%. He was haemodynamically stable without fever. According to his lab results, he presented with respiratory acidosis, pancytopenia, elevated CRP, LDH, ALP and cancer indicators. His chest X-ray showed ozomorphic shading bilaterally, left semi-diaphragm fuzzification and atypical bone imaging. In his CT scan, leukoencephalopathy was observed. Image of a blurred glass in the lung parenchyma was seen bilaterally. Image of a lower left lung lobe percolation with a positive aerobronchgramme. Swollen lymph nodes were found in the mesothorax. Pleural effusion collection bilaterally. Multiple liver metastatic focus. At least one metastatic focus on the splene. Multiple bone metastases. During the examination, both on osteomyelic biopsy and a myelogram were conducted which present: elevated cytarobrithia with hyperplacia of granulomatous and red line cell, dysplastic lesions of all 3 hemopoitic series. CD34 and CD 117 coloring showed positive blast-cells at a \u0026gt;10% and \u0026lt;20%. Accumulation of neoplasmatic cells s obserued which exhibit immunohistochemically the phenotype of a pulmonary andenocarcinoma : AE1/AE3(+),CK7(+),NapsinA(+),TTF1(+),CK20(-),CK5/6(-), synaptophysyne(-), chromogranine().\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResult:\u003c/bold\u003e The patient was diagnosed with two different malignancies simultaneously: pulmonary adenocarcinoma with multiple metastatic focuses and myelodysplastic syndrome with excess blasts (EB-2).\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions:\u003c/bold\u003e The investigation of pancytopenia contributed to the diagnosis of pulmonary adenocarcinoma in conjunction with blood neoplasia. Similar cases of adenocarcinoma co-existing with other haemopoietic system malignancies have been reported. This co-existence is rare and is probably due to a common pathophysiological mechanism. Further study could help in its treatment.\u003c/p\u003e\n\u003cp\u003eMutations in isocitrate dehydrogenase genes \u003citalic\u003eIDH1\u003c/italic\u003e and \u003citalic\u003eIDH2\u003c/italic\u003e were found in acute myelogenic leukaemia and the selective inhibitors \u003citalic\u003eIDH1\u003c/italic\u003e and \u003citalic\u003eIDH2\u003c/italic\u003e have been approved for the targeted treatment of acute myelogenic leukaemia. Studies have revealed \u003citalic\u003eIDH1\u003c/italic\u003e mutations in many malignancies, with the most frequent being IDH1 R132H. It has been proved that the expression IDH1/2 in non-small cell lung cancer (NSCLC) appears in pulmonary adenocarcinomas as an indication of sub-clonal evolution.\u003c/p\u003e\n\u003c/sec\u003e\n\u003csec id=\"j_fco-2021-0025_s_049\"\u003e\u003cdiv\u003eACUTE RESPIRATORY FAILURE AFTER THORACHOTOMY – THE ROLE OF THE NURSERY USE OF NON-INVASIVE MECHANICAL VENTILATION: A CASE STUDY\u003c/div\u003e\n\u003cp\u003ePapastergiou K.\u003csup\u003e1\u003c/sup\u003e, Karantsiri M.\u003csup\u003e2\u003c/sup\u003e, Lavdaniti M.\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e1\u003c/sup\u003eRN, MSc, ‘Theageneio’ Hospital, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e2\u003c/sup\u003eRN, School Nurse, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003citalic\u003e\u003csup\u003e3\u003c/sup\u003eAssociate Professor, Department of Nursing, International University of Greece, Thessaloniki\u003c/italic\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eBackground\u003c/bold\u003e: Acute respiratory failure is a pathological condition in which the body is unable to perform gas exchange satisfactorily. Thoracic surgeries have a high risk of postoperative respiratory complications, especially in patients with risk factors (such as COPD) associated with anaesthesia. Non-invasive mechanical ventilation is a method of intervening in a patient’s breathing by supporting it mechanically, without the act of intubation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eAim\u003c/bold\u003e: The aim of the study was to describe an incident with the occurrence of acute postoperative respiratory failure in a patient undergoing thoracotomy and the use of non-invasive mechanical ventilation.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eMethod\u003c/bold\u003e: This is a case study of a 77-year-old male patient who underwent right rear thoracotomy in a large hospital in Northern Greece.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eResults\u003c/bold\u003e: A 77-year-old male patient with right upper lung adenocarcinoma arrived in November 2020 for surgery. The patient underwent right posterior thoracotomy, wedge resection of the right upper lobe and mediastinal lymph node biopsies. He had chronic respiratory pulmonary disease, arterial hypertension, hepatitis C as special problems, along with being a former smoker 30 years ago. Forced vital capacity (FCV) was 2.02%–65% and forced expiratory volume (FEV1) was 1.90%–81%. There were no intraoperative complications, and the intubation was performed in the resuscitation room, while later, he was transferred to the ICU. During the first 6 h of hospitalisation in the ICU, there were symptoms of respiratory distress with SpO2 \u0026gt;85% and shortness of breath, while he had a good level of consciousness and communication. The difficulty was addressed with the placement of a NIV mask and regular monitoring of SpO2 and reduction of speed. Nursing care consisted of the timely recognition of shortness of breath, dyspnoea, sweating and decreased SpO2, in order to apply the NIV mask in a timely manner and to regularly monitor the vital signs hourly.\u003c/p\u003e\n\u003cp\u003e\u003cbold\u003eConclusions\u003c/bold\u003e: Acute respiratory failure is life-threatening to the patient. Non-invasive mechanical ventilation improves the efficiency of the lung in gas exchange in a short time and should be applied for the best outcome of the patient.\u003c/p\u003e\n\u003c/sec\u003e\n\u003c/div\u003e","keywords":[],"recentIssues":{"10.2478/fco-2021-0016":"\u003carticle-title\u003eTwo Distinct Nutritional Assessment Tools Have Dissimilar Outcomes in a Sample of Older Adult Patients With Cancer\u003c/article-title\u003e","10.2478/fco-2021-0013":"\u003carticle-title\u003eSurvival rate and prognostic factors of oral squamous cell carcinoma in Indonesia: A single-center retrospective study\u003c/article-title\u003e","10.2478/fco-2022-0005":"\u003carticle-title\u003eEvaluation of lymph node adequacy in patients with colorectal cancer: Results from a referral center in Iran\u003c/article-title\u003e","10.2478/fco-2022-0001":"\u003carticle-title\u003e\u003citalic\u003eTumor Biology's\u003c/italic\u003e struggle to survive: A tough lesson for cancer and oncology research 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w zasięgu ręki","home.info1":"Sciendo jest wiodącym dostawcą rozwiązań wydawniczych dla czasopism naukowych, książek oraz materiałów konferencyjnych.","home.info2":"Wydajemy ponad 500 tytułów, obsługując 300 instytucji naukowych i branżowch w 40 różnych krajach.","Publish with us":"Publikuj z nami","View Publications":"PRZEGLĄDAJ PUBLIKACJE","publishingServices":"Poznaj nasze usługi wydawnicze","academicJournals":"Usługi dla czasopism naukowych","selfPublishing":"Samodzielne wydanie książki oraz pena obsługa wydawnicza","conferenceServices":"Usługi dla organizatorów konferencji i redaktorów materiałów konferencyjnych","wePublishFor":"Dla kogo publikujemy?","Academic Institutions":"Instytucje akademickie","Professional Organizations":"Organizacje profesjonalne","Individual Authors":"Autorzy indywidualni","WhatMakesUsDistinct":"CO NAS WYRÓŻNIA","WhyPublishWithSciendo":"Dlaczego warto publikować ze Sciendo?","GlobalDistributionImpact":"Globalna dystrybucja i zasięg","ContentDeliveryToLibraries":"Dostarczanie treści do bibliotek, serwisów indeksujących i typu discovery na całym świecie","ComprehensiveSolutions":"Kompleksowe rozwiązania wydawnicze","EditingTools":"Narzędzia redakcyjne, projektowanie, systemy produkcyjne, druk i nie tylko","WorldClassPublishingTechnology":"Światowej klasy technologia wydawnicza","DoiNumbersRegistration":"Rejestracja numerów DOI, narzędzia do eksportowania cytowań, udostępnianie treści i więcej","Available access models":"Modele wydawnicze","Open Access":"Otwarty dostęp","Paid Access":"Paid Access","Hybrid Access":"Model hybrydowy","DistributeOnlineToAllReaders":"Udostępniaj treści bez opłat dla czytelników","PaywallArticles":"Zarządzanie subskrypcją artykułów i rozdziałów książek","SubscriptionContent":"Treści subskrypcyjne połączone z artykułami dostępnymi dla wszystkich","Learn more about our publishing services":"Dowiedz się więcej o naszych usługach wydawniczych","Latest in our blog":"Najnowsze na naszym blogu","See all blog articles":"ZOBACZ WSZYSTKIE ARTYKUŁY NA BLOGU","Books":"Książki","ScholarlyBooks":"Sciendo realizuje potrzeby różnych typów książek naukowych, w tym monografii, podręczników oraz tomów pod redakcją. Dostarczamy szeroki wachlarz profesjonalnych usług począwszy od edycji tekstu po marketing, indeksowanie i PR.","HowWePublish":"W jaki sposób publikujemy?","SelfPublishingServices":"Samodzielne wydanie książki","PublishAnAcademicBookOnYourOwnTerms":"Jeśli chcesz opublikować książkę naukową na własnych zasadach, wybierz naszą ofertę self-publishing. Przekaż nam gotowy do wydania plik, a my opublikujemy go online, rozpowszechnimy i udostępnimy do sprzedaży.","Profit from Sales":"Zysk ze sprzedaży","AuthorBenefitrevenuesSales":"Jako autor otrzymasz od nas 70% przychodów netto od zakupionych książek.","Scope of the offer":"Zakres oferty","IncludeAnIndividualWebsiteForTheTitle":"Obejmują wykonanie indywidualnej strony internetowej dla publikacji, rejestrację numeru ISBN oraz dystrybucję do sprzedawców detalicznych na całym świecie. Wybierz tę opcję, jeśli Twoja książka naukowa jest odpowiednio sformatowana i gotowa do publikacji","Additional services":"Rozwiązania dodatkowe","SupplementaryOfferIfYouNeedOurAssistance":"Wybierz usługi z oferty uzupełniającej, jeśli potrzebujesz naszego wsparcia. Dopracujemy i zredagujemy tekst, zaprojektujemy profesjonalną okładkę oraz układ książki, a także zapewnimy zaawansowane usługi marketingowe i indeksacyjne","Full-publishing offer":"Pełna obsługa wydawnicza","FullCareOfYourManuscript":"Jeśli poszukujesz kompleksowych rozwiązań wydawniczych i chciałbyś, abyśmy w pełni zajęli się Twoją publikacją, zapraszamy do zapoznania się z ofertą pełnej obsługi wydawniczej.","ToReleaseBookYourself":"Wybierz ten model, jeśli chciałbyś opublikować książkę we własnym zakresie","FullPublishingServices":"Pełna obsługa wydawnicza","LeadingAcademicBookPublishers":"Sciendo jest jednym z wiodących wydawców książek naukowych, posiadającym wieloletnie doświadczenie w produkcji i promocji książek. Wybierz naszą pełną obsługę wydawniczą, jeżeli chcesz oddać swój manuskrypt w profesjonalistom.","ChooseThePackage":"Wybierz pakiet odpowiadający Twoim potrzebom","ThreePackagesServices":"Nasze rozwiązania wydawnicze dostępne są w trzech pakietach","Standard":"Standard","Basic services":"Podstawowe usługi wspierające publikację książki, rejestracja ISBN","Classic":"Classic","Standard package":"Pakiet Standard, wersja elektroniczna, usługi produkcyjne","Premier":"Premier","Classic package":"Pakiet Classic","HostingDstributionPlatform":"Platforma hostingowa i dystrybucyjna","WideElectronicDistribution":"Szeroka dystrybucja wersji elektronicznej","ContentIndexing":"Indeksowanie treści","ISBNRegistration":"Rejestracja ISBN","Print on demand":"Druk i wysyłka na życzenie","TypesettingAndProofreading":"Skład oraz korekta","Copyediting":"Adiustacja (poziom zaawansowany)","ePub version":"Wersja ePub","ProfessionalContentMarketing":"Profesjonalny marketing","Ppt-in services":"Zmodyfikuj swój pakiet uzupełniając go o rozwiązania opcjonalne","SEE OPT-IN":"SPRAWDŹ USŁUGI DODATKOWE","Self-publishing offer":"Samodzielne wydanie książki","MinimalInvolvement":"Jeżeli preferujesz wydać książkę na swoich własnych zasadach,","VisitSelf-publishingOffer":"zapoznaj się z naszą ofertą self-publishing.","LEARN MORE":"DOWIEDZ SIĘ WIĘCEJ","Brochure":"Broszura","DownloadOurBrochure":"Pobierz broszurę, aby uzyskać szczegółowy opis usług","ReceiveMonthlyNews":"Chciałbyś otrzymywać comiesięczne aktualizacje?","SUBSCRIBE TO OUR NEWSLETTER":"ZAPISZ SIĘ DO NASZEGO NEWSLETTERA","Discover aur publishing services":"Poznaj nasze rozwiązania wydawnicze","Journals":"Czasopisma","Services for academic journals":"Usługi dla czasopism naukowych","Self-publishingFull-publishing":"Samodzielne wydanie książki lub pełna obsługa wydawnicza","Proceedings":"Materiały konferencyjne","ConferenceOrganizersProceedingsEditors":"Usługi dla organizatorów konferencji i redaktorów materiałów konferencyjnych","SponsoringInstitution":"Wybierz tę opcję, jeżeli Twoja instytucja sponsorująca będzie finansować publikację","Access types":"Rodzaje dostępu do treści","FreeAccesstoAcademicBook":"Stały, bezpłatny dostęp do książki z możliwością zakupu wersji drukowanej","SoldDirectlyFromPlatform":"Książki sprzedawane są bezpośrednio z naszej platformy oraz poprzez globalne kanały dystrybucji","Testimonials":"Rekomendacje","GetInouchWithUs":"Aby uzyskać dodatkowe informacje oraz profesjonalną konsultację, skontaktuj się z nami","DownloadBrochure":"Pobierz broszurę, aby uzyskać szczegółowy opis usług","MonthlyNews":"Chciałbyś otrzymywać comiesięczne aktualizacje?","Discover our other publishing services":"Poznaj nasze rozwiązania wydawnicze","ServicesAcademicJournals":"Usługi dla czasopism naukowych","WePublishYourConferenceProceedings":"Sciendo jako jedyna firma na świecie spełnia dwie najważniejsze potrzeby organizatorów konferencji akademickich i branżowych. Możemy zarówno opublikować materiały konferencyjne, jak i udostępnić jeden z najlepszych na świecie systemów do zarządzania wydarzeniami.","ServicesForconferenceOrganizers":"Jaki usługi oferujemy organizatorom konferencji?","OpenAccessToConferencePapers":"Artykuły publikujemy w modelu Open Access","AssistanceInEditingAndMarketing":"Rozwiązania redakcyjne i marketingowe","AbstractingAndIndexingSupport":"Wsparcie w indeksacji treści","EventAndAbstractManagementSystem":"System do zarządzania wydarzeniami oraz abstraktami","Print-on-demand":"Druk na życzenie","PublishingPackage":"Wybierz pakiet odpowiadający Twoim potrzebom","BundledThreePackages":"Nasze rozwiązania wydawnicze dostępne są w trzech pakietach","BasicServices":"Podstawowe usługi wspierające publikację treści, rejestracja ISBN","StandardPackage":"Podstawowe usługi wspierające publikację czasopisma","ClassicPackage":"system do przeprowadzania procesu recenzji","CustomizeYourPackage":"Zmodyfikuj swój pakiet uzupełniając go o rozwiązania opcjonalne","ConferencePlanning,Budgeting,AndMarketing":"Sciendo może wspomóc planowanie konferencji, budżetowanie oraz marketing. Nasz system do zarządzania wydarzeniami zapewnia łatwe administrowanie programem konferencji, rejestrację i śledzenie uczestników, a także bezpieczny proces płatności. Ponadto, posiada on osobny moduł do zbierania, edycji i obsługi przesłanych prac.","GetInTouchWithUs":"Aby uzyskać dodatkowe informacje oraz profesjonalną konsultację, skontaktuj się z nami","ServicesConferenceProceedingsEditors":"Usługi dla organizatorów konferencji i redaktorów materiałów konferencyjnych","CONTACT FORM":"CONTACT FORM","Let's work together":"Let's work together","First and last name":"Imię i nazwisko*","Enter first name":"Wprowadź swoje imię","Institution":"Nazwa instytucji/firmy","Enter company name":"Wprowadź nazwę firmy","Country":"Kraj*","Enter country":"Wprowadź kraj","E-mail Address":"Adres e-mail*","Enter email address":"Wprowadź adres e-mail","Telephone number":"Numer telefonu","Enter telephone number":"Wprowadź numer telefonu","Which services are you looking for":"Jakimi usługami jesteś zainteresowany?","Additional Comments":"Dodatkowe komentarze","SUBMIT":"WYŚLIJ","Thank you for getting in touch":"Dziękujemy za kontakt!","ReceivedInquiry":"Otrzymaliśmy Twoje zapytanie","OurTeamWillContactYou":"Nasz zespół wkrótce się z Tobą skontaktuje","CLOSE":"ZAMKNIJ","HowItWorks":"Jak to działa?","ArticleProcessingCharge":"Model opłat autorskich {APC)","SufficientlmpactFactor":"Model stworzony został dla publikacji o odpowiednim wskaźniku lmpact Factor oraz indeksacji.","AvailablePackages":"Dostępne pakiety","TwoPackages":"Nasze usługi wydawnicze dostępne są w dwóch pakietach:","OnlineSubmissionAndPeerReview":"System do składania prac i przeprowadzania procesu recenzji, moduł do pobierania opłat autorskich","SeeOptInServices":"SPRAWDŹ USŁUGI DODATKOWE ➔","GetInTouch":"Aby uzyskać dodatkowe informacje oraz profesjonalną konsultację, skontaktuj się z nami","DiscoverPublishingServices":"Poznaj nasze rozwiązania wydawnicze","ScholarlyJournal":"Sciendo jest jednym z wiodących wydawców czasopism naukowych z wieloletnim doświadczeniem. Oferujemy obszerną listę rozwiązań, które z łatwością dostosujesz do swoich indywidualnych potrzeb.","Publishing models":"Modele wydawnicze","PermanentAccessToArticles":"Czytelnicy otrzymują stały dostęp do artykułów bez ponoszenia opłat, koszty publikacji ponosi instytucja sponsorująca","RetainSubscriptionRevenues":"Czasopisma pokrywają opłaty wydawnicze i zatrzymują przychody z subskrypcji","CombineSubscriptionAndOpenaccess":"Model dla tytułów łączących subskrypcję z treściami dostępnymi dla wszystkich","OpenAccessJournaIs":"Rozwiązanie dla czasopism Open Access, które chciałyby publikować ze Sciendo nie martwiąc się o opłaty wydawnicze","Available Packages":"Dostępne pakiety","ThreeDifferentPackages":"Nasze rozwiązania wydawnicze dostępne są w trzech pakietach","Standard Package":"Pakiet Standard","PremierPackage":"usługi produkcyjne i redakcyjne, XML dla pełnych wersji tekstów, usługi marketingowe","Hosting and distribution platform":"Platforma hostingowa i dystrybucyjna","Content delivery to libraries":"Szeroka dystrybucja treści do bibliotek, serwisów typu discovery oraz baz indeksujących","Online submission system":"System do przeprowadzania procesu recenzji","Language editing":"Korekta językowa i adiustacja","Typesetting proofreading":"Skład oraz korekta","Full-text XML publication":"XML dla pełnych wersji tekstów","Professional content marketing":"Profesjonalny marketing","CustomizePackage":"Zmodyfikuj swój pakiet uzupełniając go o rozwiązania opcjonalne","SEE OPT-IN SERVICES":"SPRAWDŹ USŁUGI DODATKOWE","White Label Publishing House":"Wydawnictwo White Label","WhiteLabelPublishingHouseServices":"Jeśli reprezentujesz wydawnictwo uniwersyteckie lub inną organizację poszukującą partnera do wydania wszystkich lub tylko niektórych z Twoich czasopism naukowych, książek i innych publikacji, zachęcamy do zapoznania się z naszą ofertą Wydawnictwa White Label.","AdditionalInformationContactUs":"Aby uzyskać dodatkowe informacje oraz profesjonalną konsultację, skontaktuj się z nami","Self-publishingAndFull-publishing":"Samodzielne wydanie książki lub pełna obsługa wydawnicza","Services for conference":"Usługi dla organizatorów konferencji i redaktorów materiałów konferencyjnych","ServicesAcademicJournaIs":"Usługi dla czasopism naukowych","SelfPublishingFullServices":"Samodzielne wydanie książki lub pełna obsługa wydawnicza","ServicesForConference":"Usługi dla organizatorów konferencji i redaktorów materiałów konferencyjnych","SubscribeNewsletter":"ZAPISZ SIĘ DO NASZEGO NEWSLETTERA","BOOKSHELF":"BOOKSHELF","SEE ALL PUBLICATIONS":"ZOBACZ WSZYSTKIE PUBLIKACJE","PublishingSolutions":"Rozwiązania wydawnicze dla Ciebie i Twojej organizacji","SearchByTitleAuthorKeywordSubject":"Wyszukiwanie według tytułu, autora, słowa kluczowego, tematu, numeru ISBN...","SearchFor":"Wyszukaj czasopismo, książkę, materiały konferencyjny lub autora...","ADVANCED SEARCH":"WYSZUKIWANIE ZAAWANSOWANE","Search by…":"Szukaj według …","Search publications":"Wyszukaj publikacje …","Access Type":"Typ dostępu","Publication Type":"Typ publikacji","Add date range":"Zakres dat","Languages":"Języki","Subjects":"Kategorie","SEARCH":"SZUKAJ","WideArrayOfPublishing":"Sciendo oferuje szeroką gamę rozwiązań wydawniczych dla wielu typów publikacji","SelfPublishing":"Samodzielne wydanie książki lub pełna obsługa wydawnicza","WhiteLabel":"Wydawnictwo White Label","OfferForUniversity":"Przygotowaliśmy specjalną ofertę dla wydawnictw uniwersyteckich oraz innych organizacji poszukujących partnera do wydania wszystkich lub niektórych ze swoich czasopism, książek i innych publikacji.","LearnMore":"( DOWIEDZ SIĘ WIĘCEJ )","Overview of Services":"Lista usług","Standard Services":"Usługi standardowe","EssentialServices":"Podstawowe rozwiązania wydawnicze dostępne dla wszystkich typów publikacji bez dodatkowych kosztów","Solutions for Electronic Content":"Rozwiązania dla treści elektronicznych","WeAssignDoiNumbers":"Nadajemy Twojej publikacji numery DOI, wspieramy w rejestracji numerów ISSN i ​​ISBN oraz przygotowujemy metadane w formacie XML","GlobalDistribution":"Globalna dystrybucja","DeliverTheContentToLibraries":"Nasza platforma dostarcza treści do bibliotek i serwisów typu discovery na całym świecie","Abstractinglndexing":"Indeksacja treści","CooperateWithIndexingServices":"Sciendo współpracuje z międzynarodowymi serwisami abstraktowymi i indeksowymi, aby zwiększyć widoczność Twojej publikacji","Long-Term Preservation":"Archiwizacja","BackUpAndStare":"Tworzymy kopie zapasowe i zabezpieczamy je na zewnętrznych serwerach, aby zapewnić długoterminowy dostęp do treści","PlagiarismCheck":"Wykrywanie plagiatów","ProfessionalPlagiarismScreeningTool":"Sciendo zapewnia profesjonalne narzędzie do wykrywania plagiatów, aby zapewnić autentyczność przesłanych manuskryptów","Opt-In Services":"Usługi opcjonalne","AccelerateYourEditorial":"Szukasz sposobu na efektywniejsze zarządzanie procesami redakcyjnymi?","ProductionSolutionsCanAssist":"Sprawdź, jak nasze rozwiązania redakcyjne i produkcyjne mogą pomóc Ci osiągnąć te cele","Editorial services":"Usługi redakcyjne","WePrepareTheManuscripts":"Przygotowujemy manuskrypty do publikacji online nanosząc korekty językowe, formatując dokumenty i realizując skład","Online Systems":"Systemy online","SciendoProvidesOnlinePlatforms":"Sciendo dostarcza systemy przeznaczone do zarządzania manuskryptami, procesami produkcyjnymi, bibliografią, opłatami autorskimi i nie tylko","GraphicDesignServices":"Usługi projektowania graficznego","OurDesignersCanHelp":"Nasi projektanci pomogą ulepszyć wygląd Twoich treści, przygotowując projekty schematów i okładek, odzwierciedlając niepowtarzalny styl Twojej publikacji","Professional Marketing":"Profesjonalny marketing","MarketingActivities":"Dzięki naszym działaniom marketingowym docieramy do potencjalnych autorów i czytelników, promując publikacje w Internecie i zwiększając ich widoczność","Printing Services":"Druk","PrintOnDemand":"Sciendo świadczy usługę druku na życzenie dla wszystkich publikacji dostępnych na platformie. Dodatkowo możemy stworzyć także pliki do druku","ForAdditionalInformation":"Aby uzyskać dodatkowe informacje oraz profesjonalną konsultację,","get in touch with us":"skontaktuj się z nami","Redirecting":"Przeadresować","aboutSciendo":"Informacje o Sciendo","cookiePolicy":"Polityka cookie","about.first":"Sciendo jest nie tylko dostawcą usług i technologii. Sciendo należy do De Gruyter, renomowanego wydawcy akademickiego.","about.second":"Oferujemy światowej klasy rozwiązania i usługi wydawnicze, sprawdzone i przetestowane na naszych własnych czasopismach oraz książkach.","about.third":"Sciendo zapewnia usługi i rozwiązania wydawnicze instytucjom oraz autorom indywidualnym. Publikujemy czasopisma, książki oraz materiały konferencyjne.","about.fourth":"Publikujemy zarówno nowe treści, jak również wcześniej wydane tomy czasopism i książek. Nasi klienci mogą zadecydować, czy ich publikacja powinna zostać udostępniona w modelu Open Access czy paid access.","about.fifth":"Sciendo publikuje obecnie około 500 czasopism należących do uniwersytetów i innych instytucji. 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Please Wait.":"Pobieranie... 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your search":"","Search in Google Scholar":"Szukaj w Google Scholar","Supplement":"Suplement","Supplementary Material Details":"Dodatkowe informacje o materiałach","Recent Articles":"Najnowsze artykuły","Recieved":"Otrzymano","Accepted":"Przyjęty","Recommended articles from Trend MD":"Polecane artykuły z Trend MD","Pages":"Ilość stron","Illustration":"Ilustracje","PaperBack":"Okładka miękka","Authors":"Autorzy","Table of Contents":"Spis treści","People Also Read":"Polecane publikacje","Download Chapter PDF":"Pobierz rozdział PDF","Download Book PDF":"Pobierz książkę PDF","Download ePub":"Pobierz ePub","Chapter":"Rozdział","Requires Authentication":"Wymagane uwierzytelnienie","Published Online on":"Data publikacji w dniu","How can we help you?":"Co możemy dla Ciebie zrobić?","Publication timeframe":"Częstotliwość wydawania","Search Within The Issue":"Szukaj w tym wydaniu","Top Articles":"Najczęściej czytane","Articles":"Artykułów","Sort By":"Sortuj według","Download Cover":"Pobierz okładkę","Issues":"Zeszyty","Details, Metrics \u0026 Owners":"Szczegóły, dane i właściciele","Aims \u0026 Scope":"Opis","Editorial Board":"Rada redakcyjna","Abstracting \u0026 Indexing":"Lista baz indeksujących","Submit":"Zgłaszanie prac","Impact Factor":"Czynnik uderzenia","Five Year Impact Factor":"Pięcioletni współczynnik wpływu","Cite Score":"Punktacja cytowania","Journal RSS Feed":"Kanał RSS czasopisma","Editor-in-Chief":"Redaktor naczelny","Other news articles":"Inne artykuły z wiadomościami","No Result Found!":"Nie znaleziono żadnych wyników!","News":"Blog","Load More":"Załaduj więcej","Privacy Policy":"Polityka Prywatności","publish_solution":"Rozwiązania wydawnicze dla czasopism,\u003c1\u003e\u003c/1\u003eksiążek oraz materiałów konferencyjnych","Publishing and Ethical Policies":"Polityka wydawnicza i etyczna","of":"z","results":"wyników","Clear":"Jasne","Apply":"Zastosować","All":"Wszystkie","New Titles":"Nowe tytuły","Browse all":"Przeglądaj 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ogólne","Geosciences":"Nauki o Ziemi","History":"Historia","Industrial Chemistry":"Chemia przemysłowa","Jewish Studies":"Studia judaistyczne","Law":"Prawo","Library and Information Science, Book Studies":"Bibliotekoznawstwo i bibliologia","Life Sciences":"Nauki o organizmach żywych","Linguistics and Semiotics":"Językoznawstwo i semiotyka","Literary Studies":"Literatura","Materials Sciences":"Inżynieria materiałowa","Mathematics":"Matematyka","Medicine":"Medycyna","Music":"Muzyka","Pharmacy":"Nauki farmaceutyczne","Philosophy":"Filozofia","Physics":"Fizyka","Business and Economics":"Biznes i ekonomia","Social Sciences":"Nauki społeczne","Sports and Recreation":"Sport i rekreacja","Theology and Religion":"Teologia i religia","Journal Subjects":"Dziedziny czasopisma","Keywords":"Słowa kluczowe","Management":"Zarząd","Sales":"Sprzedaż","Customer Service":"Obsługa Klienta","Marketing":"Marketing","Production":"Produkcja","Administration":"Administracja","Journal Details":"Informacje o 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needs of various scholarly books, including monographs, textbooks and edited volumes. We provide a wide array of professional services ranging from text editing to marketing, indexing and PR.","HowWePublish":"How do we publish?","SelfPublishingServices":"Self-Publishing Services","PublishAnAcademicBookOnYourOwnTerms":"lf you want to publish an academic book on your own terms, choose our self­publishing offer. Simply provide us with the ready-made publishable e-book file, and we will launch it online, advertise, distribute and sell it.","Profit from Sales":"Profit from Sales","AuthorBenefitrevenuesSales":"As the author you will benefit from 70% of the net revenues from sales.","Scope of the offer":"Scope of the offer","IncludeAnIndividualWebsiteForTheTitle":"Include an individual website for the title, ISBN registration and distribution to retailers worldwide. 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\u003c1\u003econtact our representative\u003c/1\u003e for your territory to meet and discuss the terms of the White Label Publishing House offer.","whiteLabelContent.first":"Sciendo has a special offer for universities and other organizations that are seeking a partner to publish all or some of their English, German, French, Spanish, Italian and Polish languages journals, books and other publications. This applies to new publications and to previously published books and back journal volumes. We publish monographs, textbooks, edited volumes, and other categories.","whiteLabelContent.fourth":"The university can decide which package of services applies to each journal and book. Such packages are described in the pages for \u003c1\u003ejournals\u003c/1\u003e and \u003c3\u003ebooks\u003c/3\u003e. \u003c5\u003eIf the value of the contract exceeds an agreed amount, the university can enjoy discounts up to 60% on standard fees.\u003c/5\u003e","whiteLabelContent.second":"The university can decide if a given journal or book is published using the Open Access or paid access model. All books and journal articles bear both the university and the Sciendo logos.","whiteLabelContent.third":"At no cost to the university, Sciendo will design, produce and manage the website of this publishing house. The role of the university is to select and channel books and book proposals for this publishing co-operation, as well as to promote this publishing opportunity to its faculty.","conferenceServices.first":"If you would like to learn more about these services, please contact Sales \u0026 Publishing Specialist — Services for conference organizers: \u003c1\u003ealexandru.vlad@sciendo.com\u003c/1\u003e or call directly \u003c3\u003e+44 2086388130\u003c/3\u003e.","conferenceServices.second":"Sciendo is the only company in the world that meets the two most important needs of an academic conference organizer. As well as publishing conference proceedings, we can also provide the organizer with one of the world's best event management systems. We have partnered with Cvent and Converia.","conferenceServices.third":"We can publish your conference proceedings and optionally provide you with the event management systems. We publish conference proceedings online using theOpen Access model. Printed copies can be bought online. We currently publish proceedings in English language only.","conferenceServices.fourth":"The services and solutions that we offer for conference proceedings are bundled into three packages: \u003c1\u003eStandard\u003c/1\u003e, \u003c3\u003eClassic\u003c/3\u003e and \u003c5\u003ePremier\u003c/5\u003e. We charge for each paper published and the charge depends on the package and any additional services and solutions you choose.","conferenceServices.fifth":"The diagram shows the key components of each package.","conferenceServices.sixth":"Sciendo would be delighted to publish your conference proceedings and provide event management systems for your conference. Please refer to the services shown in the chart above and \u003c1\u003edownload the brochure\u003c/1\u003e for more information.","fullPublishingContent.first":"Sciendo publishes books from universities, research institutes, academies of sciences, learned societies and other organizations. We offer both the Open Access and traditional (paid access) models. The following rules also apply to individual authors whose institutions are willing to pay the publishing fees for the publication of their books.","fullPublishingContent.second":"\u003c0\u003eWe have a special offer for universities and other organizations to publish all or some of their English language journals, books and other publications. \u003c1\u003eSee more here.\u003c/1\u003e\u003c/0\u003e","fullPublishingContent.third":"The services and solutions that we offer are bundled into three packages: Standard, Classic and Premier. These packages range from standard components required for publication to a full-service package and a hybrid between “basic” and “full-service”. We charge for each book published, the charge is dependent on the package and any additional services and solutions are chosen.","fullPublishingContent.fourth":"The table shows the key components of each package. Sciendo would be delighted to offer the services shown in the chart below to books whose publication is financed by institutions.","fullPublishingContent.fifth":"Institutions and authorsinterested in learning more about the services and relevant charges should \u003c1\u003econtact our representative\u003c/1\u003e for their territory, to meet and discuss the terms.","journals.first":"Sciendo publishes academic journals that belong to universities, research institutes, academies of sciences, learned societies and other organizations. We can publish them both in the Open Access and in traditional ( paid access) models. 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