South Asian Journal of Cancer最新文献

Shamaila ShamaunBackground  Cervical cancer is the third most prevalent female cancer in Pakistan; nearly 70% present at a very advanced stage of malignancy due to lack of awareness, proper screening, and vaccination. Therefore, we aimed to assess the knowledge and attitude toward screening, vaccination, and risk factors of cervical cancer in sexually active women of Pakistan. Methods  This cross-sectional study was conducted at the gynecology outpatient clinic of a public sector hospital in Karachi, Pakistan, from December 2021 to March 2022. We included sexually active women with exception of diagnosed cases of cervical cancer, pregnancy, vaginal bleeding, and psychological disorder. Collected data were regarding demographic characteristics, awareness regarding cervical cancer, screening, human papillomavirus (HPV) vaccine, and risk factors, history of cervical screening, and wiliness to opt-in for cervical screening. Results  We included 226 women with a mean age of 41.25 ± 10.54 years. The mean parity level was observed to be 3.8 ± 1.95. A majority of women were housewives by profession (88.9%) and uneducated (61.9%). Only 41.2% (93) of women were aware of cervical cancer, 33.6% (76) were aware of cervical screening, and only 15.9% (36) had a history of cervical screening. Only four women (1.8%) were aware of the HPV vaccine and 31% (70) showed intention to opt-in for cervical screening. A vast majority of women (96.9%) were not aware of the risk factors of cervical cancer. Conclusion(s)  We have observed poor awareness regarding cervical cancer, HPV vaccination, and cervical screening among women in our population. Lack of awareness was not restricted to a certain segment but it prevails all across the demographic in our population.

Nursel Alp DalObjective  This study was conducted to determine the relationship between gynecological cancer awareness and self-care agency among married women. Materials and Methods  This descriptive and cross-sectional study was performed with 819 women who presented to the obstetrics polyclinic of a hospital located in the west of Turkey between December 15, 2020 and April 15, 2021. The data of the study were collected by using the Exercise of Self-Care Agency Scale (ESCA) and the Gynecological Cancers Awareness Scale (GCAS). Results  The mean age of the participants was 37.62 ± 9.181 years. The mean ESCA score of the women who participated in this study was 95.89 ± 25.060, which indicated moderate levels of self-care agency. The mean total GCAS score of the participants of this study was 156.57 ± 32.930, which indicated high levels of gynecological cancer awareness among the women. As the self-care agency of the women increased, their awareness of gynecological cancers also increased. Conclusion  Midwives and nurses who provide preventive and supportive healthcare services may affect the self-care agency of women positively by gynecological cancer awareness they will raise in these women.

K. MuthulingeshkumarObjectives  This article reports the clinical outcomes of uterine body cancers in South Indian population. The primary outcome of our study was overall survival (OS). The secondary outcomes were disease-free survival (DFS), patterns of recurrence, toxicities of radiation treatment, and the association of patient, disease, and treatment characteristics with survival and recurrence. Materials and Methods  Records of the patients diagnosed as malignancy in uterus and treated with surgery alone or with adjuvant treatment from January 2013 to December 2017 were retrieved after Institute Ethics Committee approval. Demographic, surgical, histopathology, and adjuvant treatment details were retrieved. Patients of endometrial adenocarcinoma were stratified according to the European Society of Medical Oncology/European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology consensus for analysis and overall outcomes irrespective of histology were also analyzed. Statistical Analysis  For the survival analysis, Kaplan-Meier survival estimator was used. Cox regression was used to test the significance of association of factors with outcomes in terms of hazard ratio (HR). Results  A total of 178 patient records were retrieved. The median follow-up of all patients was 30 months (0.5-81 months). The median age of the population was 55 years. Most common histology was endometrioid type of adenocarcinoma (89%), sarcomas comprised only 4%. The mean OS of all patients was 68 months ( n  = 178), median was not reached. Five-year OS was 79 %. Five-year OS rates observed in low, intermediate, high-intermediate, and high-risk were 91, 88, 75, and 81.5%, respectively. The mean DFS was 65 months, median not reached. The 5-year DFS was 76%. The 5-year DFS rates observed were 82, 95, 80, and 81.5% for low, intermediate, high-intermediate, and high-risk, respectively. Univariate analysis using Cox regression showed increase in hazard for death in case of node positivity, HR 3.96 ( p 0.033). The HR for disease recurrence was 0.35 ( p  = 0.042) in patients who had received adjuvant radiation therapy. No other factors had any significant impact on death or disease recurrence. Conclusion  The survival outcomes in terms of DFS and OS were comparable with other Indian and Western data reported in the published literature.

Biplab SarkarObjectives  This editorial describes the growth pattern of female radiation oncologists (FRO) in India and the prediction of gender equality through a mathematical formulation. Materials and Methods  Among the countries in South Asia, India has the largest population of radiation oncologists (RO), a total of 3,763: 1,286 female and 2,477 male radiation oncologists (MROs), and they are registered with the Association of Radiation Oncologists of India (AROI). The data were analyzed to find the differential and cumulative growth pattern of the FROs and MROs and predict gender equality in radiation oncology. The cumulative growth rate indicates the total number of FROs and MROs by end of every year. Differential growth rate indicates the differential increase in the number of FROs and MROs for a particular year. Annual cumulative and differential growth patterns were plotted as a function of the time, and an analytical functional form was fitted to predict the future growth pattern and achievement of gender equality. Results  AROI registration of FROs and MROs for 2013-2020 were as follows: FRO: MRO 2013-54: 102, 2014-99: 162, 2015-77: 148; 2016-86: 143, 2017-110: 110, 2018-116: 151, 2019-121: 152, 2020 (October)-129: 110. Differential growth pattern between 2013 and 2020 with the average incremental growth rate for FROs and MROs were 12.7 ± 14.8% and 2.1 ± 32.0%. Differential growth rate FRO fits in a power-law exponent 58.6 ×(Power0.3695), where MRO growth pattern showed a saturation [4.7ln(×) + 128.5] . Gender parity among Indian radiation oncologists is likely to be achieved by end of 2027. Conclusions  The present density of FRO in India 34.1% is high compared to developed countries such as the United States (≈26%). It is a big leap for the Indian radiation oncology society tending toward gender parity.

Pravesh Dhiman, DNB (Medical Oncology).Background  Epithelial ovarian cancer (EOC) is one of the leading causes of cancer-related death in women. Approximately 70% of patients with EOC are diagnosed in advanced stage [The International Federation of Gynecology and Obstetrics(FIGO stage III and IV)] with an expected 5-year survival rate of 30%. Numerous studies have shown that survival with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is noninferior to primary debulking surgery followed by chemotherapy. Materials and Methods  In this retroprospective observational study, 50 patients with advanced ovarian cancer, diagnosed from January 2012 to January 2015, were included and followed-up till January 2017. Correlation of NACT with patient profile, CA125 levels, clinicopathologic parameters, progression-free survival (PFS), and treatment response was studied. Statistical analysis was performed using log-rank test and Kaplan-Meir survival plots. Results  The extent of cytoreduction significantly correlated with PFS. The PFS was maximum in patients who had optimal cytoreduction (19 months) and 10 months in patients with suboptimal cytoreduction with p -value < 0.05. The survival was not significantly correlated with other parameters such as age, stage, preoperative CA125 levels, and ascites. Conclusions  The extent of cytoreduction following NACT in this study was associated with statistically significant PFS advantage in patients who were able to undergo optimal cytoreduction, but not significantly correlated to other factors such as age, stage, preoperative CA125 levels, and ascites. NACT followed by interval cytoreduction is an important modality affecting survival in advanced EOC. Further studies and longer follow-up are needed to demonstrate survival advantage over standard treatment.

Gauri KapoorBackground  The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods  A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results  Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays ( p , 0.01) and interval admissions ( p , 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC ( R ²  = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion  Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.