Background: Disease Management (DM) is an approach to health care that coordinates resources across the entire health care delivery system and throughout the course of a disease. Objectives: The purpose of the present study was to evaluate the DM implementation in a country like Greece, with distinct geographical characteristics and non-symmetrical distribution of health care services.

Primary spindle cell rhabdomyosarcoma of the prostate is an uncommon variant of embryonal rhabdomyosarcoma seen in pediatric age group mostly during infancy and childhood. Rhabdomyosarcoma (RMS) arising from prostate predominantly presents obstructive urinary symptoms. To date, only one case of the spindle cell variant of embryonal rhabdomyosarcoma of the prostate have been described in literature. The delay in diagnosis and a more aggressive behavior of this malignancy contributed to an eventually unfavorable outcome. Early diagnosis and complete surgical resection offering patients for the best possibility of survival.

The rectum is considered the straight part of the bowel although it’s not straight with at least three folds. Sometimes defi ned as the last 12 cm of the large bowel other consider it as the last 15 cm. Surgeons mark it starting at the anorectal ring, anatomist use the dentate line, more consensus and agreements is needed for the rectum as a structure. Also there is a lot of difference between the upper and lower part of the rectum, anatomically and embryologically. Differences between both can be easily recognized in treatment options, treatment results, and consequences of treatment as regard permanent colostomy and sphincter control. With the growing evidence of the watch and wait policy it may be worthy to start separating the upper rectum from its lower part, which may help to direct us to different treatment approaches and the introduction of colostomy free survival as one of the end treatment results. Hence our suggestion of the separation between the upper and lower rectum.

Oral cavity squamous cell cancer (OSCC) and Oropharynx squamous cell carcinoma (OPSCC) are the most frequent forms of Head and Neck Cancers (HNCs) [1]. About 300,000 new cases of oral cancers are being counted yearly worldwide, having registered an increase of incidence of 225% in U.S.A. in the last 20 years, with about 50% of related deaths [2,3]. The relevant advances in treatments of OSCC during the last decades, allowed updated surgery techniques, robotic surgery, intensive induction chemotherapy and hyperfractionated radiotherapy to be currently applied to the advanced cases. Unfortunately, most of these therapies often carry severe acute and chronic side effects, heavily impacting on patients’ quality of life.

Decavanadate compounds were described to be involved in a variety of biological activities and responses such as anti-virus, anti-bacterial and anticancer. While the mechanisms of action of the antiviral and anti-bacterial activities are better understood, the same does not go for the anti-tumour activity. Nevertheless, the inhibition of tumour proliferation seems to impact certain enzymes such as alkaline phosphatase, ecto-nucleotidases or P-type ATPases. In the present report, several studies are described, in a way to explain the increasing interest of these polyoxometalate in cancer therapy. The detailed knowledge of the molecular basis of decavanadate–proteins and cellular interactions allows to better understand the processes associated with the anticancer applications, not only for decavanadate but as well for other polyoxometalates (POMs).

In the past few years, immunotherapy, particularly immune checkpoint inhibitors, have redefi ned standard of care cancer treatment for numerous malignancies. However, despite the wealth of promising data and great enthusiasm, the vast majority of cancer patients still fail to respond to these therapies as single agents. In tumors which are thought of as immunogenic (e.g. renal cell, urothelial, non-small cell lung cancer (NSCLC)) the response rate to single agent immune checkpoint inhibition seems to be around 20% [1], but in still other tumors generally thought of as non-immunogenic the response rate seems to be far less. In these non-immunogenic tumor types much focus has been given to the subset of patients with high microsatellite instability (MSI-H) or mismatch repair defi cient tumors which have been shown to have relatively high response rates to single agent PD-1 therapy [2]. But patients with MSI tumors often make up only a tiny fraction of patients with these non-immunogenic tumors. One clear example of this is colorectal cancer (CRC) where only 15% of patients have MSI-H disease and only 4% of patients with metastatic disease have MSI-H tumors [3]. Therefore, hundreds of trials are currently underway evaluating the combination of immune checkpoint inhibition with other treatment options in an effort to increase the percentage of patients both with immunogenic and non-immunogenic tumors who will respond to immune checkpoint inhibition. One such trial was recently conducted in CRC patients with microsatellite stable (MSS) disease.

Cancer is a leading cause of death in men worldwide and the major cause of cancer related death is drug resistance [1,2]. In past few years, scientists have established tumor heterogeneity as a phenomenon of critical importance in the natural history of individual neoplasms and drug resistance [3-5]. The concept of tumor heterogeneity has a major impact on therapeutic approaches [6-9]. Drug resistance creates difficulty in cancer treatment and is directly linked to the tumor progression and poorer prognosis. As tumor heterogeneity is very common in almost all solid tumors, cancer therapy needs to become more personalized, selective, and specific [10-13]. Understanding the mechanisms of tumor heterogeneity and drug resistance will provide sustenance for the future development of personalized cancer medicine.

Cutaneous angiosarcoma is a rare and aggressive malignant tumor of vascular origin. Multimodality treatment including surgery, radiotherapy and chemotherapy should be used according to age and local spread. Prognosis is poor with a 5-year survival of 10-15%. We report the case of an angiosarcoma of the scalp and face treated with sequential contact radiotherapy and chemotherapy. After local response, the patient progressed in non-irradiated zone then had liver metastasis.

Introduction: Granular cell tumours (GCT), also known as Abrikossoff’s tumours, are rare, and occur in the breast in approximately 5-6% of the cases these tumours are usually benign with only 1% of malignancy.

Penile carcinoma is a rare malignant disease with a significantly higher incidence in some areas of underdeveloped countries [1]. Inguinal nodal involvement is found in 20% to 40% of cases at diagnosis and nodal metastasis is an important predictive factor for survival [2,3]. Metastatic penile carcinoma has an extremely poor prognosis, since reported results of systemic therapy have been disappointing, even when improvement is achieved [4-12].