Abstract The NIC defines hematological cancers as those that begin in blood forming tissues such as bone marrow or cells of the immune system and these broadly include three groups: leukemias, lymphomas, and myelomas. The role of imaging is also fundamentally different between the three main groups of hematological malignancies. While imaging is the main tool for staging as well as treatment response assessment in lymphoma, it represents one of several key criteria for the diagnosis and follow-up of myeloma; whereas in leukemia, imaging has a role to play in the detection and management of treatment-related complications which is a crucial part of post-transplant treatment.
{"title":"Imaging Recommendations for Diagnosis, Staging, and Management of Hematological Malignancies","authors":"A. Guha","doi":"10.1055/s-0042-1760327","DOIUrl":"https://doi.org/10.1055/s-0042-1760327","url":null,"abstract":"Abstract The NIC defines hematological cancers as those that begin in blood forming tissues such as bone marrow or cells of the immune system and these broadly include three groups: leukemias, lymphomas, and myelomas. The role of imaging is also fundamentally different between the three main groups of hematological malignancies. While imaging is the main tool for staging as well as treatment response assessment in lymphoma, it represents one of several key criteria for the diagnosis and follow-up of myeloma; whereas in leukemia, imaging has a role to play in the detection and management of treatment-related complications which is a crucial part of post-transplant treatment.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"302 - 307"},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43769181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Gala, Daksh Chandra, N. Shetty, Ujjwal Agarwal, Harshita Bansal, Md Shariq, H. Pendse, A. Janu, R. Mandava, S. Kulkarni
Abstract The percutaneous needle biopsy (PNB) is the initial step for obtaining the diagnosis and it helps in treatment. It aids in primary diagnosis, tumor staging, or ruling out infective etiology. It is a safe and successful minimally invasive method compared to open biopsies. PNB is defined as the placement and insertion of a needle into a suspected lesion or organ with the intent of retrieving tissue or cells for diagnosis. It can fine needle aspiration cytology or core needle biopsy. The patient needs to be counseled regarding the procedure and detailed history, including anticoagulant history needs to be taken. The SIR consensus guidelines have divided biopsies into low-risk procedures with a bleeding risk of < 1.5% and high-risk procedures > 1.5%. There are advancements in needle design (e.g., echogenic tip while performing ultrasound-guided needle biopsy) and image-guidance technology (ultrasound quality, multi-slice CT scan) that improved these procedures safety and efficacy. There are different types of needles available such as coaxial, aspiration needles, Murphy's bone biopsy needle, which depends on the tissue which needs to be sampled or the organ to be biopsied. Various different types of biopsy guns, such as semi-automatic, automatic, or manual are available. The newer technology such as fusion and navigation biopsies helps in better characterizing and localization of the lesion, improving the yield of the biopsy. Open and excisional biopsies have a higher mortality and morbidity rate than percutaneous biopsies, they are reserved for cases where the image-guided method has failed to provide the diagnostic yield. Sample collection must be done under a sterile container in formaline or microbiological examination. Regular analysis and rad-path correlation are key to success and improving diagnostic yield. This abstract provides an overview of the existing biopsy literature.
{"title":"Imaging Recommendations for Image-Guided Biopsy in Oncology","authors":"K. Gala, Daksh Chandra, N. Shetty, Ujjwal Agarwal, Harshita Bansal, Md Shariq, H. Pendse, A. Janu, R. Mandava, S. Kulkarni","doi":"10.1055/s-0043-1761265","DOIUrl":"https://doi.org/10.1055/s-0043-1761265","url":null,"abstract":"Abstract The percutaneous needle biopsy (PNB) is the initial step for obtaining the diagnosis and it helps in treatment. It aids in primary diagnosis, tumor staging, or ruling out infective etiology. It is a safe and successful minimally invasive method compared to open biopsies. PNB is defined as the placement and insertion of a needle into a suspected lesion or organ with the intent of retrieving tissue or cells for diagnosis. It can fine needle aspiration cytology or core needle biopsy. The patient needs to be counseled regarding the procedure and detailed history, including anticoagulant history needs to be taken. The SIR consensus guidelines have divided biopsies into low-risk procedures with a bleeding risk of < 1.5% and high-risk procedures > 1.5%. There are advancements in needle design (e.g., echogenic tip while performing ultrasound-guided needle biopsy) and image-guidance technology (ultrasound quality, multi-slice CT scan) that improved these procedures safety and efficacy. There are different types of needles available such as coaxial, aspiration needles, Murphy's bone biopsy needle, which depends on the tissue which needs to be sampled or the organ to be biopsied. Various different types of biopsy guns, such as semi-automatic, automatic, or manual are available. The newer technology such as fusion and navigation biopsies helps in better characterizing and localization of the lesion, improving the yield of the biopsy. Open and excisional biopsies have a higher mortality and morbidity rate than percutaneous biopsies, they are reserved for cases where the image-guided method has failed to provide the diagnostic yield. Sample collection must be done under a sterile container in formaline or microbiological examination. Regular analysis and rad-path correlation are key to success and improving diagnostic yield. This abstract provides an overview of the existing biopsy literature.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"334 - 342"},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44163749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Varsha Rana, S. Joshi, Ajita Kendre, Prasant Chandra, Dishitha Shetty, Mansi Munshi, S. Deshmukh, Sujai Hegde, G. Kanitkar, A. Mane, Minish Jain, Chakor Vora
Abstract
摘要
{"title":"Abstract","authors":"Varsha Rana, S. Joshi, Ajita Kendre, Prasant Chandra, Dishitha Shetty, Mansi Munshi, S. Deshmukh, Sujai Hegde, G. Kanitkar, A. Mane, Minish Jain, Chakor Vora","doi":"10.1055/s-0043-1761164","DOIUrl":"https://doi.org/10.1055/s-0043-1761164","url":null,"abstract":"Abstract","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"371 - 376"},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48195785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Pramanik, Shubhra Vats, Sanchita Mitra, S. Deo, L. Kumar, A. Gogia, S. Khurana, A. Batra
Abstract Introduction Hereditary breast and ovarian cancer (HBOC) syndrome affects a significant proportion of our breast and ovarian cancer patients. Mutations in genes, for example, BRCA1 and 2, confer a high risk of acquiring certain malignancies, including breast cancer in both men and women, and ovarian cancer in women. Mutation carriers provide a unique opportunity for healthcare professionals to intensively screen and detect malignancy at an early and curable stage. But, patient awareness and acceptance are the keys to the success of these strategies. Objective There is a need to assess the awareness of the patients in this field as the patients come from varied backgrounds, and differ in their socioeconomic profiles, educational backdrop, and cultures. In this study, done prior to establishing our cancer genetics clinic, we evaluated the knowledge and attitude toward HBOC in patients with breast cancer and ovarian cancer. Materials and Methods This cross-sectional observational study was conducted on patients registered in IRCH-AIIMS, who has a diagnosis of breast cancer or ovarian cancer using a self-administered questionnaire based on knowledge and attitude. The sample population included 84 women aged between 25 and 80 years. A binary response was given to knowledge questions, whereas a categorical response was given to attitude questions. The overall data was computed using STATA v13 software. Results According to the findings of the study, 39.3% (5.11/13) of the patients were aware of hereditary cancer. Knowledge among the targeted population was poor, but 72.1% (37.5/52) of the population had a neutral attitude toward learning more about hereditary cancer tests. Only 23/84 (27%) people had heard of genetic counseling. Seventy of eighty-four (83%) patients agreed that they would opt for a genetic test if indicated. While 60/84 (72%) of the population wanted to interact with a counselor over a telephonic call, only 41/84 (49%) wanted to interact in person. Conclusion We concluded from the study that breast and ovarian cancer patients in our clinic have little understanding of HBOC syndrome but have a neutral attitude toward learning more about it.
{"title":"Assessment of Knowledge and Attitude of Breast and Ovarian Cancer Patients Regarding Hereditary Breast-Ovarian Cancer Syndrome at a Tertiary Cancer Institute: A Cross-Sectional Observational Study","authors":"R. Pramanik, Shubhra Vats, Sanchita Mitra, S. Deo, L. Kumar, A. Gogia, S. Khurana, A. Batra","doi":"10.1055/s-0043-1768178","DOIUrl":"https://doi.org/10.1055/s-0043-1768178","url":null,"abstract":"Abstract Introduction Hereditary breast and ovarian cancer (HBOC) syndrome affects a significant proportion of our breast and ovarian cancer patients. Mutations in genes, for example, BRCA1 and 2, confer a high risk of acquiring certain malignancies, including breast cancer in both men and women, and ovarian cancer in women. Mutation carriers provide a unique opportunity for healthcare professionals to intensively screen and detect malignancy at an early and curable stage. But, patient awareness and acceptance are the keys to the success of these strategies. Objective There is a need to assess the awareness of the patients in this field as the patients come from varied backgrounds, and differ in their socioeconomic profiles, educational backdrop, and cultures. In this study, done prior to establishing our cancer genetics clinic, we evaluated the knowledge and attitude toward HBOC in patients with breast cancer and ovarian cancer. Materials and Methods This cross-sectional observational study was conducted on patients registered in IRCH-AIIMS, who has a diagnosis of breast cancer or ovarian cancer using a self-administered questionnaire based on knowledge and attitude. The sample population included 84 women aged between 25 and 80 years. A binary response was given to knowledge questions, whereas a categorical response was given to attitude questions. The overall data was computed using STATA v13 software. Results According to the findings of the study, 39.3% (5.11/13) of the patients were aware of hereditary cancer. Knowledge among the targeted population was poor, but 72.1% (37.5/52) of the population had a neutral attitude toward learning more about hereditary cancer tests. Only 23/84 (27%) people had heard of genetic counseling. Seventy of eighty-four (83%) patients agreed that they would opt for a genetic test if indicated. While 60/84 (72%) of the population wanted to interact with a counselor over a telephonic call, only 41/84 (49%) wanted to interact in person. Conclusion We concluded from the study that breast and ovarian cancer patients in our clinic have little understanding of HBOC syndrome but have a neutral attitude toward learning more about it.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43703484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ayesha, Monalisa Hui, S. Uppin, M. Uppin, S. Jena, Rajsekhar Patil, Ranganath Ratnagiri, T. Paul
Abstract Introduction A specific subset of papillary microcarcinoma of thyroid (PMC) can metastasize regionally and to distant organs, and thus, have a significant effect on the overall survival of the patient cohort. Objectives We aim to analyze the prognostic significance of various clinicopathologic parameters including BRAF V600E mutation by immunohistochemistry in PMC, in order to identify the subset of cases with aggressive behavior. Materials and Methods Data regarding the PMC cases was retrieved retrospectively from medical records. The clinicopathologic factors like age, tumor size, focality, capsular invasion, histologic subtype, lymphovascular invasion, perithyroidal fat invasion (PTFI), lymph node (LN) metastasis, and distant metastasis were studied in depth. Tissue microarray was constructed to perform immunohistochemistry with CK19 and BRAF V600E . Information regarding overall survival (OS) and development of metastasis, if any, was noted. Chi-squared test was performed to know the association between various factors. To determine odds ratio, logistic regression was done. Survival analysis was done using Kaplan–Meier and Cox-regression analysis. Results PMC was diagnosed in 48 patients (M:F = 1:2.4), between 22 and 70 years of age (median = 46.5 years). Chi-squared test showed significant association of fibrosis with tumor size more than or equal to 0.5 cm, infiltrative borders, PTFI, and LN metastasis. Tumor size was also associated with infiltrative borders; and LN metastasis with PTFI. BRAF V600E positivity showed significant association with histologic pattern, PTFI and distant metastasis. On logistic regression, tumor size showed significantly increased odds ratio with presence of fibrosis and infiltrative borders. Presence of fibrosis also showed significant association with infiltrative borders and LN metastasis. BRAF V600E had significantly increased odds ratio with histologic pattern, both on univariate and multivariate logistic regression. Kaplan–Meier analysis revealed significantly reduced OS with presence of LN metastases ( p -value = 0.050, log-rank test). Cox-regression did not yield a significant hazard ratio for the various factors studied. Conclusion This study shows association of LN metastasis with intratumoral fibrosis, PTFI and reduced OS. Intratumoral fibrosis was also associated with tumor size more than 5mm, infiltrative borders and PTFI. Increasing tumor size and infiltrative borders also showed an association. In addition, BRAF V600E positivity was found to be associated with histologic pattern, PTFI and distant metastasis.
{"title":"Prognostic Significance of Various Clinicopathologic Parameters and BRAF V600E Mutation in Papillary Thyroid Microcarcinoma—An Observational Study","authors":"S. Ayesha, Monalisa Hui, S. Uppin, M. Uppin, S. Jena, Rajsekhar Patil, Ranganath Ratnagiri, T. Paul","doi":"10.1055/s-0043-1761412","DOIUrl":"https://doi.org/10.1055/s-0043-1761412","url":null,"abstract":"Abstract Introduction A specific subset of papillary microcarcinoma of thyroid (PMC) can metastasize regionally and to distant organs, and thus, have a significant effect on the overall survival of the patient cohort. Objectives We aim to analyze the prognostic significance of various clinicopathologic parameters including BRAF V600E mutation by immunohistochemistry in PMC, in order to identify the subset of cases with aggressive behavior. Materials and Methods Data regarding the PMC cases was retrieved retrospectively from medical records. The clinicopathologic factors like age, tumor size, focality, capsular invasion, histologic subtype, lymphovascular invasion, perithyroidal fat invasion (PTFI), lymph node (LN) metastasis, and distant metastasis were studied in depth. Tissue microarray was constructed to perform immunohistochemistry with CK19 and BRAF V600E . Information regarding overall survival (OS) and development of metastasis, if any, was noted. Chi-squared test was performed to know the association between various factors. To determine odds ratio, logistic regression was done. Survival analysis was done using Kaplan–Meier and Cox-regression analysis. Results PMC was diagnosed in 48 patients (M:F = 1:2.4), between 22 and 70 years of age (median = 46.5 years). Chi-squared test showed significant association of fibrosis with tumor size more than or equal to 0.5 cm, infiltrative borders, PTFI, and LN metastasis. Tumor size was also associated with infiltrative borders; and LN metastasis with PTFI. BRAF V600E positivity showed significant association with histologic pattern, PTFI and distant metastasis. On logistic regression, tumor size showed significantly increased odds ratio with presence of fibrosis and infiltrative borders. Presence of fibrosis also showed significant association with infiltrative borders and LN metastasis. BRAF V600E had significantly increased odds ratio with histologic pattern, both on univariate and multivariate logistic regression. Kaplan–Meier analysis revealed significantly reduced OS with presence of LN metastases ( p -value = 0.050, log-rank test). Cox-regression did not yield a significant hazard ratio for the various factors studied. Conclusion This study shows association of LN metastasis with intratumoral fibrosis, PTFI and reduced OS. Intratumoral fibrosis was also associated with tumor size more than 5mm, infiltrative borders and PTFI. Increasing tumor size and infiltrative borders also showed an association. In addition, BRAF V600E positivity was found to be associated with histologic pattern, PTFI and distant metastasis.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"345 - 352"},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48848557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md Fahim Ahmad, P. Menon, S. Solanki, A. Trehan, Parikshaa Gupta
Abstract A 4-month-old infant presented with an enlarging large vascular presternal swelling noticed for the past 2 months. Clinical examination revealed a left renal mass in this otherwise asymptomatic child. She underwent left nephroureterectomy and excision of the skin metastasis following a course of chemotherapy. Preoperative cytology and postoperative histopathological examination confirmed Wilms' tumor with a single skin metastasis. We report this case for its rarity.
{"title":"Unusual Presentation of Wilms' Tumor in a 4-Month-Old Infant as Presternal Metastatic Swelling—A Case Report with Review of Literature","authors":"Md Fahim Ahmad, P. Menon, S. Solanki, A. Trehan, Parikshaa Gupta","doi":"10.1055/s-0043-1766131","DOIUrl":"https://doi.org/10.1055/s-0043-1766131","url":null,"abstract":"Abstract A 4-month-old infant presented with an enlarging large vascular presternal swelling noticed for the past 2 months. Clinical examination revealed a left renal mass in this otherwise asymptomatic child. She underwent left nephroureterectomy and excision of the skin metastasis following a course of chemotherapy. Preoperative cytology and postoperative histopathological examination confirmed Wilms' tumor with a single skin metastasis. We report this case for its rarity.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44034402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Radiation recall dermatitis (RRD) is an extremely rare phenomenon. A variety of factors such as antineoplastic agents, pharmaceutical agents, physical and environmental factors have been proposed to be the underlying cause of RRD. Only a handful cases have been reported till date, where trastuzumab is sought to be the triggering agent. The presentation of RRD varies from mild erythematous to extensive confluent dermatitis, resolving over a period of 1 to 2 weeks with conservative management. Most of the patients tend to tolerate rechallenge well without showing reappearance. We hereby describe a lady with breast cancer having RRD following administration of trastuzumab. She developed reaction 28 days post-radiotherapy and managed conservatively. Furthermore, she was rechallenged with the same dose, that she tolerated very well, without any reappearance. Hence, an acquaintance of the clinicians to this rare entity is essential for timely diagnosis and appropriate management.
{"title":"Radiation Recall Dermatitis in Breast Cancer Patient after Trastuzumab: A Case Report with Review of Literature","authors":"Rohit Avinash Vadgaonkar, Pradeep Ventrapati, Ankita Mehta, Anupurva Dutta","doi":"10.1055/s-0043-1761263","DOIUrl":"https://doi.org/10.1055/s-0043-1761263","url":null,"abstract":"Abstract Radiation recall dermatitis (RRD) is an extremely rare phenomenon. A variety of factors such as antineoplastic agents, pharmaceutical agents, physical and environmental factors have been proposed to be the underlying cause of RRD. Only a handful cases have been reported till date, where trastuzumab is sought to be the triggering agent. The presentation of RRD varies from mild erythematous to extensive confluent dermatitis, resolving over a period of 1 to 2 weeks with conservative management. Most of the patients tend to tolerate rechallenge well without showing reappearance. We hereby describe a lady with breast cancer having RRD following administration of trastuzumab. She developed reaction 28 days post-radiotherapy and managed conservatively. Furthermore, she was rechallenged with the same dose, that she tolerated very well, without any reappearance. Hence, an acquaintance of the clinicians to this rare entity is essential for timely diagnosis and appropriate management.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"365 - 370"},"PeriodicalIF":0.2,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41702935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balateja Kantamani, Manasi Bavaskar, Rathan Shetty, H. Singhavi
Abstract The overall outcome of head and neck cancer (HNC) patients undergoing any treatment modality may significantly depend upon their general nutritional condition. Poor nutritional status leading to sarcopenia may be a negative prognostic factor in determining the outcome of HNC patients. PubMed database was searched to identify studies published between 2015 and 2022. All studies reporting the index for sarcopenia as well as its effect on HNC were included. This narrative review was conducted to specifically evaluate the impact of sarcopenia on HNC patients undergoing surgery/ free flap reconstruction/ adjuvant treatment. In oncology, computed tomography assessment of skeletal mass at C3 and L3 is the most suitable index to detect sarcopenia. From the articles yielded, the prevalence rate of sarcopenia ranges from 6 to 70% worldwide. Indian population presents with a significantly higher rate of 31.5% sarcopenia HNC patients. Sarcopenic patients have an increased propensity for surgical site infections, as high as 24.6% owing to the reduced skeletal muscle mass. These patients are also prone to have frequent breaks during radiation treatment of more than 1 week and increased chemotherapy-related toxicities. Further, sarcopenic individuals tend to have higher Ryle's tube dependency of more than 90 days. Sarcopenic patients undergoing surgery have a poor overall survival (OS) and disease-free survival (DFS). In terms of hazards ratio, sarcopenic patients have 1.96 times poor OS and 2.00 times poor DFS when compared to normal individuals who undergo HNC surgery. Sarcopenia is an indispensable part of cancer ailment and it is an independent factor negatively influencing DFS and OS. Thus, nutritional strategy needs to be developed to mitigate sarcopenic effects, especially in the Indian population in preoperative setting.
{"title":"Impact of Sarcopenia on Head and Neck Cancer Treatment: A Review of Literature","authors":"Balateja Kantamani, Manasi Bavaskar, Rathan Shetty, H. Singhavi","doi":"10.1055/s-0043-1768690","DOIUrl":"https://doi.org/10.1055/s-0043-1768690","url":null,"abstract":"Abstract The overall outcome of head and neck cancer (HNC) patients undergoing any treatment modality may significantly depend upon their general nutritional condition. Poor nutritional status leading to sarcopenia may be a negative prognostic factor in determining the outcome of HNC patients. PubMed database was searched to identify studies published between 2015 and 2022. All studies reporting the index for sarcopenia as well as its effect on HNC were included. This narrative review was conducted to specifically evaluate the impact of sarcopenia on HNC patients undergoing surgery/ free flap reconstruction/ adjuvant treatment. In oncology, computed tomography assessment of skeletal mass at C3 and L3 is the most suitable index to detect sarcopenia. From the articles yielded, the prevalence rate of sarcopenia ranges from 6 to 70% worldwide. Indian population presents with a significantly higher rate of 31.5% sarcopenia HNC patients. Sarcopenic patients have an increased propensity for surgical site infections, as high as 24.6% owing to the reduced skeletal muscle mass. These patients are also prone to have frequent breaks during radiation treatment of more than 1 week and increased chemotherapy-related toxicities. Further, sarcopenic individuals tend to have higher Ryle's tube dependency of more than 90 days. Sarcopenic patients undergoing surgery have a poor overall survival (OS) and disease-free survival (DFS). In terms of hazards ratio, sarcopenic patients have 1.96 times poor OS and 2.00 times poor DFS when compared to normal individuals who undergo HNC surgery. Sarcopenia is an indispensable part of cancer ailment and it is an independent factor negatively influencing DFS and OS. Thus, nutritional strategy needs to be developed to mitigate sarcopenic effects, especially in the Indian population in preoperative setting.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"391 - 397"},"PeriodicalIF":0.2,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42363148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Tamoxifen is a selective estrogen receptor modulator and forms the mainstay of endocrine therapy in premenopausal women with breast cancer in both adjuvant and metastatic setting. Common adverse effects are menopausal symptoms with venous thrombosis and endometrial carcinoma being rarer but more sinister complications. Vasculitis is a rarely reported reaction to tamoxifen. We report a case of a 38-year-old woman with locally advanced breast cancer, who received neoadjuvant chemotherapy followed by modified radical mastectomy and adjuvant paclitaxel. She was on maintenance tamoxifen and leuprolide for 3 months, when she presented with pruritic bilateral maculopapular rash over all her limbs, legs more than hands. A skin biopsy from the left lower limb confirmed the diagnosis of vasculitis. Tamoxifen was stopped, and patient was switched to letrozole and leuprolide. She was given antihistamines, antibiotics, fusidic acid, vitamin C, and topical steroids. The lesions resolved completely in 1 month after stoppage of tamoxifen. We report this rare side effect of tamoxifen so that oncologists can effectively diagnose and treat this distressing but reversible condition.
{"title":"Tamoxifen-Induced Cutaneous Vasculitis—A Rare Case Report with Review of Literature","authors":"A. Das, A. Sahay, S. Joshi","doi":"10.1055/s-0043-1768181","DOIUrl":"https://doi.org/10.1055/s-0043-1768181","url":null,"abstract":"Abstract Tamoxifen is a selective estrogen receptor modulator and forms the mainstay of endocrine therapy in premenopausal women with breast cancer in both adjuvant and metastatic setting. Common adverse effects are menopausal symptoms with venous thrombosis and endometrial carcinoma being rarer but more sinister complications. Vasculitis is a rarely reported reaction to tamoxifen. We report a case of a 38-year-old woman with locally advanced breast cancer, who received neoadjuvant chemotherapy followed by modified radical mastectomy and adjuvant paclitaxel. She was on maintenance tamoxifen and leuprolide for 3 months, when she presented with pruritic bilateral maculopapular rash over all her limbs, legs more than hands. A skin biopsy from the left lower limb confirmed the diagnosis of vasculitis. Tamoxifen was stopped, and patient was switched to letrozole and leuprolide. She was given antihistamines, antibiotics, fusidic acid, vitamin C, and topical steroids. The lesions resolved completely in 1 month after stoppage of tamoxifen. We report this rare side effect of tamoxifen so that oncologists can effectively diagnose and treat this distressing but reversible condition.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42550670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Vias, S. Goyal, R. Madan, N. Kakkar, R. Sood, K. Periasamy, Rajender Kumar
Abstract Patients with autosomal dominant polycystic kidney disease (ADPKD), especially those with renal failure, carry a higher risk of developing renal cell carcinoma (RCC) compared to the general population. Genetic mutations associated with ADPKD are known but a direct link associated with RCC is still controversial. We discuss the clinical course of two such patients. The first patient was diagnosed with ADPKD at the age of 10 years with an unreported tubulocystic RCC focus on his renal biopsy that was picked up on review 16 years later when he presented with vertebral metastases determined to have originated from the RCC. He was doing well on multikinase inhibitors till 4 years of diagnosis with metastatic disease when he succumbed to progressive disease after 3 lines of systemic therapy. The second patient was diagnosed with ADPKD in middle age and papillary RCC 3 years later. Within 3 months of cancer diagnosis, there was progression to metastatic disease and rapid decline despite systemic therapies. We surmise that the diagnosis of RCC may be missed in ADPKD till the advanced stages. Patients with ADPKD should be monitored regularly with imaging and biopsy if needed. Histology may be varied but once diagnosed, systemic therapies may help disease control.
{"title":"Renal Cell Carcinoma in the Background of Autosomal Dominant Polycystic Kidney Disease: Report of Two Cases and Review of Literature","authors":"P. Vias, S. Goyal, R. Madan, N. Kakkar, R. Sood, K. Periasamy, Rajender Kumar","doi":"10.1055/s-0043-57268","DOIUrl":"https://doi.org/10.1055/s-0043-57268","url":null,"abstract":"Abstract Patients with autosomal dominant polycystic kidney disease (ADPKD), especially those with renal failure, carry a higher risk of developing renal cell carcinoma (RCC) compared to the general population. Genetic mutations associated with ADPKD are known but a direct link associated with RCC is still controversial. We discuss the clinical course of two such patients. The first patient was diagnosed with ADPKD at the age of 10 years with an unreported tubulocystic RCC focus on his renal biopsy that was picked up on review 16 years later when he presented with vertebral metastases determined to have originated from the RCC. He was doing well on multikinase inhibitors till 4 years of diagnosis with metastatic disease when he succumbed to progressive disease after 3 lines of systemic therapy. The second patient was diagnosed with ADPKD in middle age and papillary RCC 3 years later. Within 3 months of cancer diagnosis, there was progression to metastatic disease and rapid decline despite systemic therapies. We surmise that the diagnosis of RCC may be missed in ADPKD till the advanced stages. Patients with ADPKD should be monitored regularly with imaging and biopsy if needed. Histology may be varied but once diagnosed, systemic therapies may help disease control.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44631444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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