No abstract

The impact of cytoreductive surgery with standard peritonectomy procedures has not been extensively assessed in the treatment of advanced ovarian cancer. The aims of the study are to report the long-term results of patients with advanced ovarian cancer undergoing cytoreductive surgery with standard peritonectomy procedures and to identify the prognostic indicators that may affect outcome. The records of 74 women with advanced ovarian cancer were retrospectively reviewed. Clinical indicators were correlated to survival. The hospital mortality and morbidity rates were 13.5% and 28.4%, respectively. Complete or near-complete cytoreduction was possible in 78.4% of the patients. Overall 10-year survival rate was 52.5%. Complete cytoreductive surgery, small-volume tumor, low-grade tumor, the absence of distant metastases, the use of systemic adjuvant chemotherapy, performance status >70%, and limited extent of peritoneal carcinomatosis were favorable indicators of survival. Complete cytoreduction (P= 0.000) and treatment with systemic chemotherapy (P= 0.001) independently influenced survival. Recurrence was recorded in 37.8% of the patients and was independently influenced by the tumor grade (P= 0.037). Cytoreductive surgery with standard peritonectomy procedures followed by adjuvant chemotherapy offers long-term survival in women with advanced ovarian cancer who have limited peritoneal carcinomatosis and no distant and irresectable metastases.

Intratumoral hemorrhage is a rare but life threatening complication of adrenal metastases and should be treated as soon as it has been diagnosed. If adrenalectomy is not feasible, combination chemotherapy should be applied as in metastatic disease. For choosing the appropriate chemotherapeutic regimen it is important to accurately achieve the diagnosis.

Introduction:The purpose of this study is to report the incidence of landmine injuries during peacetime in a European country.Methods:Forty victims of landmine explosions were admitted to Didimoticho General Hospital in Greece, from December 1988 to March 2003. A total of 19 people survived (47.5%) these events; all of the others were dead upon admission to the hospital. All of the victims were men, either suspected smugglers or migrants entering the country illegally, with an aver- age of 30 years (range: 15–56 years).Results:Most victims presented in groups, with multiple traumatic injuries, including lower extremity wounds. The mortality rate in the minefield prior to hospital admission was 52.5%, and the amputation rate for the survivors was 37%. There were no deaths of the patients admitted to the hospital.Conclusions:Landmines cause highenergy injuries with high mortality and amputation rates. Illegal migrants are the main victims of landmine explosions in Greece.

The purpose of this retrospective study was to investigate the incidence of bone metastases as the first sign of metastatic spread in patients with primary solid malignant tumours. Between January 1987 and December 1998, we treated 867 patients suffering from primary solid malignant tumours. Their average age was 67 (range: 30-96) years and all were thoroughly investigated with a complete physical examination and laboratory tests as well as imaging studies and bone scans. No bone metastases were found at the time of the initial diagnosis, and the patients were then re-assessed every 6 months for the first 5 years and then once a year. We found that, regardless of treatment, bone metastases appeared in a certain number of patients and that after excluding patients with prostate cancer a bone metastasis was the first sign of "recurrence" in 1.3% of the patients with a known primary solid malignant tumour.RØsumØ Le but de cette Ø tude r Ø trospective Ø tait de rapporter la fr Ø quence des m Ø tastases osseuses comme premier signe m Ø tastatique, chez des patients ayant une tumeur solide primitive connue. De janvier 1987 à dØcembre 1998 nous avons traitØ 867 malades souffrant de tumeurs solides primitives. Leur âge moyen Øtait de 67 (30-96) ans. Tous les malades ont eu un examen complet y compris les Øtudes d'imagerie et la scintigraphie osseuse. Aucune mØtastase osseuse n'a ØtØ trouvØ au diagnostic initial. Les malades ont ØtØ ØvaluØs tous les 6 mois pendant les 5 premi res annØes et ensuite une fois par an. Sans tenir compte du traitement, nous avons constatØ que les mØtastases osseuses apparaissaient chez un certain nombre de malades. En excluant les malades avec un cancer prostatique, les mØtastases osseuses Øtaient le premier signe de rØcidive chez 1,3% des malades avec une tumeur solide primitive connue.