A. Deodhar, D. Kulkarni, Kishor D. Kharche, T. George
Primary neuroendocrine tumors of the thymus (NETTs) are rare neoplasms and are biologically aggressive. These are more frequently seen in the third to fifth decade of life. Endocrinopathies such as Cushing's syndrome, acromegaly, or multiple endocrine neoplasia-1 are associated in 50% of cases. These tumors usually present with the invasion of surrounding mediastinal structures. The long-term outcome of NETT is poor due to high risk of recurrence or metastasis. Prognosis depends on the stage, invasion, resection, and possible association of endocrinopathies. We present this case of a 17-year-old male clinically diagnosed as Cushing's syndrome with hypothyroidism, without adrenal mass but with anterior mediastinal mass, and it histologically turned out to be carcinoid of the thymus. Although thymic carcinoids are known to present with Cushing's syndrome, we have not come across with its association of hypothyroidism. Total thymectomy was performed for the case. The patient is on regular follow-up for the past 3 years, he is totally asymptomatic and not on any medication.
{"title":"Thymic carcinoid presenting as cushing's syndrome","authors":"A. Deodhar, D. Kulkarni, Kishor D. Kharche, T. George","doi":"10.4103/oji.oji_37_21","DOIUrl":"https://doi.org/10.4103/oji.oji_37_21","url":null,"abstract":"Primary neuroendocrine tumors of the thymus (NETTs) are rare neoplasms and are biologically aggressive. These are more frequently seen in the third to fifth decade of life. Endocrinopathies such as Cushing's syndrome, acromegaly, or multiple endocrine neoplasia-1 are associated in 50% of cases. These tumors usually present with the invasion of surrounding mediastinal structures. The long-term outcome of NETT is poor due to high risk of recurrence or metastasis. Prognosis depends on the stage, invasion, resection, and possible association of endocrinopathies. We present this case of a 17-year-old male clinically diagnosed as Cushing's syndrome with hypothyroidism, without adrenal mass but with anterior mediastinal mass, and it histologically turned out to be carcinoid of the thymus. Although thymic carcinoids are known to present with Cushing's syndrome, we have not come across with its association of hypothyroidism. Total thymectomy was performed for the case. The patient is on regular follow-up for the past 3 years, he is totally asymptomatic and not on any medication.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129728381","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}
M. Salvi, B. Bharadwaj, Muktanjalee Deka, Mridul Sharma, B. Goswami
Background: Lymph node yield (LNY), number of lymph nodes recovered after neck dissection has been identified as a prognostic indicator for several cancers of non-head and neck sites as well as head-and-neck squamous cell carcinoma (HNSCC). Accurate estimation of LNY has been less evaluated in Indian settings. The purpose of this study was to estimate LNY in HNSCC patients, and to find out their association with clinicopathological factors. Materials and Methods: This was a single-center prospective study conducted on patients diagnosed with HNSCC who had undergone neck dissection with or without primary surgery. Grossing of all surgical specimens was done by guidelines under the College of American Pathologists (November 2021). LNY with their association with other clinic-pathological parameters were analyzed using SPSS software version 21.0. Results: A total of 2692 lymph nodes yielded from 112 samples of neck dissection with the mean LNY of 24.02 ± 9.69. A total of 192 lymph nodes were found to be positive with the mean lymph node ratio of 0.07 ± 2.96. Modified radical neck dissection versus selective node dissection performed cases, poor differentiation of tumor, higher tumor stage, more tumor thickness, and positive nodes for metastasis of squamous cell carcinoma were factors that contributed to higher mean LNY over 24. Conclusions: In an Indian setting, the mean LNY for HNSCC patients undergoing lymph node dissection is 24.02 and the factors such as node positivity, tumor differentiation, tumor stage, and higher tumor thickness affect the estimation of LNY.
{"title":"Clinicopathological factors affecting lymph node yield in patients undergoing surgery in head-and-neck squamous cell carcinoma in a tertiary care center of North East India","authors":"M. Salvi, B. Bharadwaj, Muktanjalee Deka, Mridul Sharma, B. Goswami","doi":"10.4103/oji.oji_2_22","DOIUrl":"https://doi.org/10.4103/oji.oji_2_22","url":null,"abstract":"Background: Lymph node yield (LNY), number of lymph nodes recovered after neck dissection has been identified as a prognostic indicator for several cancers of non-head and neck sites as well as head-and-neck squamous cell carcinoma (HNSCC). Accurate estimation of LNY has been less evaluated in Indian settings. The purpose of this study was to estimate LNY in HNSCC patients, and to find out their association with clinicopathological factors. Materials and Methods: This was a single-center prospective study conducted on patients diagnosed with HNSCC who had undergone neck dissection with or without primary surgery. Grossing of all surgical specimens was done by guidelines under the College of American Pathologists (November 2021). LNY with their association with other clinic-pathological parameters were analyzed using SPSS software version 21.0. Results: A total of 2692 lymph nodes yielded from 112 samples of neck dissection with the mean LNY of 24.02 ± 9.69. A total of 192 lymph nodes were found to be positive with the mean lymph node ratio of 0.07 ± 2.96. Modified radical neck dissection versus selective node dissection performed cases, poor differentiation of tumor, higher tumor stage, more tumor thickness, and positive nodes for metastasis of squamous cell carcinoma were factors that contributed to higher mean LNY over 24. Conclusions: In an Indian setting, the mean LNY for HNSCC patients undergoing lymph node dissection is 24.02 and the factors such as node positivity, tumor differentiation, tumor stage, and higher tumor thickness affect the estimation of LNY.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129838581","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}
A. Abrari, Durre Shehwar, Bilal Hussain, K. Akhtar
Primary pancreatic lymphoma is an extremely rare entity presenting 2.0% of extranodal malignant lymphomas and 0.5% of all pancreatic masses. We present the case of primary pancreatic Hodgkin's lymphoma in a 62-year-old male, who presented with right hypochondrial pain, nausea, vomiting, yellowish discoloration of skin and sclera, accompanied by generalized itching for 3 weeks without any significant loss of appetite and weight loss. Endoscopic ultrasound (EUS) showed a reddish bulge in the head of the pancreas due to the growth. EUS-guided biopsy revealed extensive infiltration by dyscohesive lymphoid cells with classic morphology of mononuclear Reed–Sternberg cells, in a background of lymphocytes and eosinophils. This rare report will be of significant diagnostic help to clinicians and pathologists in accurately diagnosing such cases as there is a high likelihood of misinterpreting these as pancreatic adenocarcinoma, which may impact patient management and survival.
{"title":"A rare case of primary Hodgkin's lymphoma of the pancreas","authors":"A. Abrari, Durre Shehwar, Bilal Hussain, K. Akhtar","doi":"10.4103/oji.oji_19_22","DOIUrl":"https://doi.org/10.4103/oji.oji_19_22","url":null,"abstract":"Primary pancreatic lymphoma is an extremely rare entity presenting 2.0% of extranodal malignant lymphomas and 0.5% of all pancreatic masses. We present the case of primary pancreatic Hodgkin's lymphoma in a 62-year-old male, who presented with right hypochondrial pain, nausea, vomiting, yellowish discoloration of skin and sclera, accompanied by generalized itching for 3 weeks without any significant loss of appetite and weight loss. Endoscopic ultrasound (EUS) showed a reddish bulge in the head of the pancreas due to the growth. EUS-guided biopsy revealed extensive infiltration by dyscohesive lymphoid cells with classic morphology of mononuclear Reed–Sternberg cells, in a background of lymphocytes and eosinophils. This rare report will be of significant diagnostic help to clinicians and pathologists in accurately diagnosing such cases as there is a high likelihood of misinterpreting these as pancreatic adenocarcinoma, which may impact patient management and survival.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127118184","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}
Pub Date : 2022-01-01DOI: 10.4103/2589-1871.343576
{"title":"Erratum: Bacterial vaginosis and its association with human papilloma virus and increased risk of cervical intraepithelial lesions: An experience from Eastern India","authors":"","doi":"10.4103/2589-1871.343576","DOIUrl":"https://doi.org/10.4103/2589-1871.343576","url":null,"abstract":"","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"2 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123808472","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. Kumar, D. Gupta, Parveen Kumar, Somesh Janoria, Pranjal Prem
Renal cell carcinoma is the most common renal cancer occurring in the sixth and seventh decades of life. Most of the renal cell carcinomas are detected incidentally at an early stage. It is rare to find a giant renal cell carcinoma. Most of the giant renal cell carcinomas reported were of chromophobe or sarcomatoid variety. Giant renal clear cell carcinoma is extremely rare. In this case report, we are presenting the largest giant renal clear cell carcinoma ever reported from the Indian subcontinent.
{"title":"Giant clear cell renal cell carcinoma: An extremely rare and surgically challenging tumor","authors":"P. Kumar, D. Gupta, Parveen Kumar, Somesh Janoria, Pranjal Prem","doi":"10.4103/oji.oji_2_21","DOIUrl":"https://doi.org/10.4103/oji.oji_2_21","url":null,"abstract":"Renal cell carcinoma is the most common renal cancer occurring in the sixth and seventh decades of life. Most of the renal cell carcinomas are detected incidentally at an early stage. It is rare to find a giant renal cell carcinoma. Most of the giant renal cell carcinomas reported were of chromophobe or sarcomatoid variety. Giant renal clear cell carcinoma is extremely rare. In this case report, we are presenting the largest giant renal clear cell carcinoma ever reported from the Indian subcontinent.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130668374","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}
Pulmonary sarcomatoid carcinoma (PSC) is a rare type of non-small cell lung cancer which contains poorly differentiated cells and sarcoma or sarcomatoid components (spindle and/or giant cells). Most of the cases are peripherally located and usually present as a large lung mass. We report a case of PSC in a 42-year-old male with massive pleural effusion as initial presentation. Therapeutic pleurocentesis showed exudative lymphocyte predominant pleural fluid. The diagnosis of PSC could be arrived at with medical thoracoscopy, biopsy and immunohistochemical staining. The next generation sequencing assay of gene panel revealed ROS1 positive status. The patient responded well to crizotinib, till the last follow-up of 21 months from the start of treatment.
{"title":"ROS1 rearranged pulmonary sarcomatoid carcinoma: A rare clinical presentation","authors":"H. Devi, A. Arjun, V. Maka","doi":"10.4103/oji.oji_13_21","DOIUrl":"https://doi.org/10.4103/oji.oji_13_21","url":null,"abstract":"Pulmonary sarcomatoid carcinoma (PSC) is a rare type of non-small cell lung cancer which contains poorly differentiated cells and sarcoma or sarcomatoid components (spindle and/or giant cells). Most of the cases are peripherally located and usually present as a large lung mass. We report a case of PSC in a 42-year-old male with massive pleural effusion as initial presentation. Therapeutic pleurocentesis showed exudative lymphocyte predominant pleural fluid. The diagnosis of PSC could be arrived at with medical thoracoscopy, biopsy and immunohistochemical staining. The next generation sequencing assay of gene panel revealed ROS1 positive status. The patient responded well to crizotinib, till the last follow-up of 21 months from the start of treatment.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129854486","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. Bhagat, Amit Y Jadhav, Saiprasad Patil, Hanmant Barkate
Background: Renal cell carcinoma (RCC) is the most common type of kidney cancer. Despite the availability of several tyrosine kinase inhibitors (TKI) and immunotherapies in India, the placing and sequencing of molecules in the management of RCC remains a source of dispute. The purpose of this qualitative survey was to get insight on the positioning of TKIs, specifically Axitinib, in the treatment of RCC. Methodology: This was a cross-sectional, questionnaire-based survey conducted across India among Medical Oncologist involved in the management of metastatic RCC. The questionnaire consists of 15 questions that were validated by a senior oncologist. The responses to the question were compiled in Microsoft Excel version 2018 and analyzed. Results: Total 51 oncologists completed this questionnaire. Majority preferred the International Metastatic RCC Database consortium risk stratification criteria. In favourable risk category sunitinib was preferred while in intermediate/poor risk patient's axitinib plus pembrolizumab was preferred by majority. Pazopanib and axitinib was favoured in patients with advanced age and comorbidities. Axitinib was the choice in patients who had good response to 1st line therapy and who have visceral metastasis. Majority of oncologists endorsed the use of axitinib in elderly with comorbid patients because of its favourable efficacy and tolerability. Conclusion: Axitinib is preferred choice in metastatic RCC patients who have responded well to TKIs in the first line, in elderly patients with associated comorbidities, in patients with renal impairment and in patients with poor performance status. It is a well-tolerated drug with minimal adverse effects which are transient in nature.
{"title":"Axitinib in management of renal cell carcinoma: Indian perspective","authors":"S. Bhagat, Amit Y Jadhav, Saiprasad Patil, Hanmant Barkate","doi":"10.4103/oji.oji_42_21","DOIUrl":"https://doi.org/10.4103/oji.oji_42_21","url":null,"abstract":"Background: Renal cell carcinoma (RCC) is the most common type of kidney cancer. Despite the availability of several tyrosine kinase inhibitors (TKI) and immunotherapies in India, the placing and sequencing of molecules in the management of RCC remains a source of dispute. The purpose of this qualitative survey was to get insight on the positioning of TKIs, specifically Axitinib, in the treatment of RCC. Methodology: This was a cross-sectional, questionnaire-based survey conducted across India among Medical Oncologist involved in the management of metastatic RCC. The questionnaire consists of 15 questions that were validated by a senior oncologist. The responses to the question were compiled in Microsoft Excel version 2018 and analyzed. Results: Total 51 oncologists completed this questionnaire. Majority preferred the International Metastatic RCC Database consortium risk stratification criteria. In favourable risk category sunitinib was preferred while in intermediate/poor risk patient's axitinib plus pembrolizumab was preferred by majority. Pazopanib and axitinib was favoured in patients with advanced age and comorbidities. Axitinib was the choice in patients who had good response to 1st line therapy and who have visceral metastasis. Majority of oncologists endorsed the use of axitinib in elderly with comorbid patients because of its favourable efficacy and tolerability. Conclusion: Axitinib is preferred choice in metastatic RCC patients who have responded well to TKIs in the first line, in elderly patients with associated comorbidities, in patients with renal impairment and in patients with poor performance status. It is a well-tolerated drug with minimal adverse effects which are transient in nature.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116139063","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}
Primary small-cell neuroendocrine carcinomas (NEC) of the gallbladder (GB) are rare with aggressive behavior. It has high malignancy potential with a low survival rate. In this case report, we present a case of primary small-cell NEC of GB in a 43-year-old female who presented with complaints of constipation, upper abdominal pain, and poor oral intake which was identified as a GB mass with liver nodularity on ultrasonography. It was subsequently diagnosed as a case of primary small-cell NEC of GB with liver and bone metastasis on contrast-enhanced computed tomography and core needle biopsy obtained from the left iliac bone. In view of severe jaundice, endoscopic retrograde cholangiopancreatography dilatation and stenting was done followed by palliative chemotherapy and radiotherapy. This case is unique in presenting with liver and bone metastases both instead of only liver metastasis as is commonly seen. Moreover, a sample for histopathological diagnosis was also obtained from a bony site rather than the liver as is the norm.
{"title":"Primary small-cell neuroendocrine carcinoma of the gallbladder with bone metastasis: A rare presentation","authors":"A. Anand, M. Ali, S. Qayoom, Geeta Singh","doi":"10.4103/oji.oji_24_21","DOIUrl":"https://doi.org/10.4103/oji.oji_24_21","url":null,"abstract":"Primary small-cell neuroendocrine carcinomas (NEC) of the gallbladder (GB) are rare with aggressive behavior. It has high malignancy potential with a low survival rate. In this case report, we present a case of primary small-cell NEC of GB in a 43-year-old female who presented with complaints of constipation, upper abdominal pain, and poor oral intake which was identified as a GB mass with liver nodularity on ultrasonography. It was subsequently diagnosed as a case of primary small-cell NEC of GB with liver and bone metastasis on contrast-enhanced computed tomography and core needle biopsy obtained from the left iliac bone. In view of severe jaundice, endoscopic retrograde cholangiopancreatography dilatation and stenting was done followed by palliative chemotherapy and radiotherapy. This case is unique in presenting with liver and bone metastases both instead of only liver metastasis as is commonly seen. Moreover, a sample for histopathological diagnosis was also obtained from a bony site rather than the liver as is the norm.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"290 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133522684","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}
LinuA Jacob, RamKrishna Sai, K. Lokesh, L. Dasappa, M. Babu, L. Rajeev
Background: Extraosseous Ewing sarcoma (EOES) is the rare soft-tissue counterpart of Ewing sarcoma (ES) of bone. However, studies on clinical behavior and outcome of EOES are scarce. In this retrospective study, we described the pattern of clinicodemographic characteristics, treatment, and outcomes of EOES and explored predictors of outcomes. Materials and Methods: A total of 46 diagnosed EOES patients were treated at our institute from September 2017 to January 2020. The detailed data were retrieved from hospital records and were analyzed. Progression-free survival (PFS) was estimated by the method of Kaplan and Meier curve. Comparison of different parameters for PFS was calculated by using log-rank test. Results: The mean age at diagnosis was 29.6 years with a male-to-female ratio of 1.4:1. The most common primary site of location for EOES was lower limb (n = 14), followed by retroperitoneum (n = 13) and trunk (n = 10). Seven (15.2%) patients presented with upfront metastasis and the rest 39 cases were nonmetastatic. Treatment outcome was evaluated in 43 patients (38 nonmetastatic and 5 metastatic) in terms of median PFS (mPFS). Extremity EOES in comparison to nonextremity (axial) EOES (P = 0.030) and localized versus upfront metastatic EOES (P = 0.001) had better mPFS. The localized EOES patients who received surgical treatment approach had higher mPFS than those who received nonsurgical treatment (18 months versus 14 months; P = 0.009). EOES patients with subcutaneous (SC) lesions had a trend of higher mPFS than other patients (19 months versus 15 months; P = 0.055). We did not find any difference in mPFS for gender and size of the tumor at presentation. Conclusions: Lower limb and retroperitoneum are the common primary sites of presentation for EOES. EOES patients with extremity location, SC lesion in comparison to deeper presentation, upfront nonmetastatic, and those receiving surgical treatment approach performed better.
{"title":"Extraosseous ewing sarcoma: Experience from a tertiary cancer institute in South India","authors":"LinuA Jacob, RamKrishna Sai, K. Lokesh, L. Dasappa, M. Babu, L. Rajeev","doi":"10.4103/oji.oji_23_21","DOIUrl":"https://doi.org/10.4103/oji.oji_23_21","url":null,"abstract":"Background: Extraosseous Ewing sarcoma (EOES) is the rare soft-tissue counterpart of Ewing sarcoma (ES) of bone. However, studies on clinical behavior and outcome of EOES are scarce. In this retrospective study, we described the pattern of clinicodemographic characteristics, treatment, and outcomes of EOES and explored predictors of outcomes. Materials and Methods: A total of 46 diagnosed EOES patients were treated at our institute from September 2017 to January 2020. The detailed data were retrieved from hospital records and were analyzed. Progression-free survival (PFS) was estimated by the method of Kaplan and Meier curve. Comparison of different parameters for PFS was calculated by using log-rank test. Results: The mean age at diagnosis was 29.6 years with a male-to-female ratio of 1.4:1. The most common primary site of location for EOES was lower limb (n = 14), followed by retroperitoneum (n = 13) and trunk (n = 10). Seven (15.2%) patients presented with upfront metastasis and the rest 39 cases were nonmetastatic. Treatment outcome was evaluated in 43 patients (38 nonmetastatic and 5 metastatic) in terms of median PFS (mPFS). Extremity EOES in comparison to nonextremity (axial) EOES (P = 0.030) and localized versus upfront metastatic EOES (P = 0.001) had better mPFS. The localized EOES patients who received surgical treatment approach had higher mPFS than those who received nonsurgical treatment (18 months versus 14 months; P = 0.009). EOES patients with subcutaneous (SC) lesions had a trend of higher mPFS than other patients (19 months versus 15 months; P = 0.055). We did not find any difference in mPFS for gender and size of the tumor at presentation. Conclusions: Lower limb and retroperitoneum are the common primary sites of presentation for EOES. EOES patients with extremity location, SC lesion in comparison to deeper presentation, upfront nonmetastatic, and those receiving surgical treatment approach performed better.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127784446","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. Babbar, A. Rudresha, L. Dasappa, LinuJacob Abraham, M. Babu, K. Lokesh, L. Rajeev, S. Saldanha, GH Abhilash, Amit Pandey
Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been used as prognostic markers in several tumors particularly more studied in gastrointestinal cancers. Impact of these markers on breast cancer is less studied. We evaluated the correlation of pretreatment NLR and PLR with pathological complete response (pCR) rate to neoadjuvant chemotherapy (NACT) treatment in triple-negative breast cancer (TNBC) patients in addition to analyze the association of these parameters with other clinicopathological parameters. Materials and Methods: Seventy-four early or locally advanced TNBC patients who received NACT and subsequent breast surgery from January 2018 to December 2020 were analyzed. Complete blood profiles done within 1 week of start of NACT were recorded and NLR and PLR were calculated. Pathological responses to NACT after surgery were recorded. The correlation of NLR and PLR with pCR rate and other clinicopathological parameters were evaluated. Results: The median age of presentation was 47 years. Eighteen patients (24.3%) had achieved pCR in this study. The pCR rate was higher in patients with low pre-treatment NLR (≤2.2) versus high NLR (>2.2) (P = 0.038) and low pre-treatment PLR (≤195.8) versus high PLR (>195.8) (P = 0.039). Both the pretreatment NLR and PLR values had no significant association with other clinicopathological profiles such as age, menopausal status, histopathological types and grade of differentiation, and initial clinical stage whereas there is an increase trend of ≤50 years of age group presentation in low NLR/PLR patients. On multivariate analysis, pre-NACT NLR and PLR were found to be independent predictive biomarker for pCR in TNBC patients. Conclusion: The study observed that the pre-NACT NLR and PLR are an indicator of pCR to NACT in TNBC unfolding its potential in future as a cost-effective prognostic and predictive biomarker.
{"title":"Combined peripheral neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as a predictive biomarker for pathological complete response after neoadjuvant chemotherapy in triple-negative breast cancer patients","authors":"P. Babbar, A. Rudresha, L. Dasappa, LinuJacob Abraham, M. Babu, K. Lokesh, L. Rajeev, S. Saldanha, GH Abhilash, Amit Pandey","doi":"10.4103/oji.oji_27_21","DOIUrl":"https://doi.org/10.4103/oji.oji_27_21","url":null,"abstract":"Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been used as prognostic markers in several tumors particularly more studied in gastrointestinal cancers. Impact of these markers on breast cancer is less studied. We evaluated the correlation of pretreatment NLR and PLR with pathological complete response (pCR) rate to neoadjuvant chemotherapy (NACT) treatment in triple-negative breast cancer (TNBC) patients in addition to analyze the association of these parameters with other clinicopathological parameters. Materials and Methods: Seventy-four early or locally advanced TNBC patients who received NACT and subsequent breast surgery from January 2018 to December 2020 were analyzed. Complete blood profiles done within 1 week of start of NACT were recorded and NLR and PLR were calculated. Pathological responses to NACT after surgery were recorded. The correlation of NLR and PLR with pCR rate and other clinicopathological parameters were evaluated. Results: The median age of presentation was 47 years. Eighteen patients (24.3%) had achieved pCR in this study. The pCR rate was higher in patients with low pre-treatment NLR (≤2.2) versus high NLR (>2.2) (P = 0.038) and low pre-treatment PLR (≤195.8) versus high PLR (>195.8) (P = 0.039). Both the pretreatment NLR and PLR values had no significant association with other clinicopathological profiles such as age, menopausal status, histopathological types and grade of differentiation, and initial clinical stage whereas there is an increase trend of ≤50 years of age group presentation in low NLR/PLR patients. On multivariate analysis, pre-NACT NLR and PLR were found to be independent predictive biomarker for pCR in TNBC patients. Conclusion: The study observed that the pre-NACT NLR and PLR are an indicator of pCR to NACT in TNBC unfolding its potential in future as a cost-effective prognostic and predictive biomarker.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125383555","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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