Sakina Mankada, M. Mehta, J. Poddar, A. Kichloo, Akash Pandya, U. Suryanarayana
Primary osteosarcoma of breast is an extremely rare entity with a poor prognosis. Although resection is the main treatment, the optimal treatment remains uncertain. It has early tumor recurrence with a propensity for hematogenous spread, most commonly to the lungs rather than lymphatic spread. Herein, we report a case of primary osteosarcoma of the left breast in a 50-year-old female. Her metastatic workup did not show any evidence of regional or distant metastasis. The patient was treated by simple mastectomy with axillary lymph node dissection followed by adjuvant chemotherapy. The patient is disease free at a follow-up of 11 months.
{"title":"Primary osteosarcoma of breast","authors":"Sakina Mankada, M. Mehta, J. Poddar, A. Kichloo, Akash Pandya, U. Suryanarayana","doi":"10.4103/oji.oji_38_19","DOIUrl":"https://doi.org/10.4103/oji.oji_38_19","url":null,"abstract":"Primary osteosarcoma of breast is an extremely rare entity with a poor prognosis. Although resection is the main treatment, the optimal treatment remains uncertain. It has early tumor recurrence with a propensity for hematogenous spread, most commonly to the lungs rather than lymphatic spread. Herein, we report a case of primary osteosarcoma of the left breast in a 50-year-old female. Her metastatic workup did not show any evidence of regional or distant metastasis. The patient was treated by simple mastectomy with axillary lymph node dissection followed by adjuvant chemotherapy. The patient is disease free at a follow-up of 11 months.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115209686","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. Vyas, R. Kantharia, Shehnaz R. Kantharia, Z. Teli, Y. Mistry
Objectives: To analyze the incidence of cervical lymph node metastasis in cT1/T2 buccal mucosa cancers, correlate it with the depth of invasion and study the percentage of occult metastasis. Through this study, we also attempt to look into subsite-specific buccal mucosa data which are lacking in literature and will help us improve the understanding of the disease. Materials and Methods: Retrospective analysis of the prospectively collected data of 109 patients with cT1/T2 buccal mucosa cancer operated from January 2018 to August 2019 was done. Information regarding the pathological T stage, depth of invasion, presence or absence of cervical node metastasis, occult metastasis, size of the metastatic lymph nodes, and the presence of extracapsular extension was collected from the final histopathology reports. Results: Twenty-five out of 109 (22.94%) patients had cervical node metastasis. Nine out of 93 (9.68%) clinically N0 patients had occult metastasis. No metastasis was observed for the patients with depth of invasion <4 mm. Of these 25 patients, 17 were pathologically staged T2 (68%), whereas 8 were staged T1 (32%). P value obtained by the Fisher's exact test was 0.003 and validated the hypothesis generated by our results. Conclusion: Through this study, we can conclude that the possibility of cervical node metastasis in cT1/T2 buccal mucosa cancers with depth of invasion <4 mm is negligible and the percentage of occult metastasis stands low. Our study also reflects the lack of robust data in context to early-stage buccal mucosa cancers and offers an insight on the importance of subsite specific research.
{"title":"Lymph node metastasis in cT1/T2 buccal mucosa squamous cell carcinoma: A subsite-specific study","authors":"S. Vyas, R. Kantharia, Shehnaz R. Kantharia, Z. Teli, Y. Mistry","doi":"10.4103/oji.oji_54_20","DOIUrl":"https://doi.org/10.4103/oji.oji_54_20","url":null,"abstract":"Objectives: To analyze the incidence of cervical lymph node metastasis in cT1/T2 buccal mucosa cancers, correlate it with the depth of invasion and study the percentage of occult metastasis. Through this study, we also attempt to look into subsite-specific buccal mucosa data which are lacking in literature and will help us improve the understanding of the disease. Materials and Methods: Retrospective analysis of the prospectively collected data of 109 patients with cT1/T2 buccal mucosa cancer operated from January 2018 to August 2019 was done. Information regarding the pathological T stage, depth of invasion, presence or absence of cervical node metastasis, occult metastasis, size of the metastatic lymph nodes, and the presence of extracapsular extension was collected from the final histopathology reports. Results: Twenty-five out of 109 (22.94%) patients had cervical node metastasis. Nine out of 93 (9.68%) clinically N0 patients had occult metastasis. No metastasis was observed for the patients with depth of invasion <4 mm. Of these 25 patients, 17 were pathologically staged T2 (68%), whereas 8 were staged T1 (32%). P value obtained by the Fisher's exact test was 0.003 and validated the hypothesis generated by our results. Conclusion: Through this study, we can conclude that the possibility of cervical node metastasis in cT1/T2 buccal mucosa cancers with depth of invasion <4 mm is negligible and the percentage of occult metastasis stands low. Our study also reflects the lack of robust data in context to early-stage buccal mucosa cancers and offers an insight on the importance of subsite specific research.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129468977","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}
Introduction: Breast cancer being a multifactorial disorder outcome depends on various clinicopathological and molecular factors. Neoadjuvant chemotherapy (NACT) is increasingly used before surgery to obtain pathological complete response (pCR) as it is associated with increase event-free survival and overall survival. Aim: The aim of this study is to evaluate the response to NACT in locally advanced breast cancer (LABC) in association with various clinicopathological factors in a tertiary care setting. Materials and Methods: LABC patients (clinical Stage IIB and III) who underwent either modified radical mastectomy or breast conservative surgery after NACT treatment in a 1-year period were retrospectively reviewed for the clinical and pathological response. Effect of clinicopathological and molecular factors on treatment response were evaluated. pCR was evaluated on final histopathology. Results: Fifty LABC patients fulfilled the study criteria and were reviewed. pCR was present in 6 (12%) cases. All the pCR cases were invasive ductal carcinoma. A statistically significant association between the presence of tumor necrosis in initial biopsy and pCR to NACT was observed (P = 0.024) with a high negative predictive value of 94%. All the 11 patients (100%) with positive lymphovascular emboli (LVE) on initial biopsy did not show pCR. Four out of 6 pCR cases had preclinical tumor size ≤5 cm. Ductal carcinoma in situ (DCIS) was present in 15 cases and only 1 pCR patient had the presence of DCIS. Conclusion: Preclinical tumor size, histopathological tumor type, DCIS, and presence of tumor necrosis and LVE on initial core biopsy are some of the notable factors for pCR among LABC patients who received NACT.
简介:乳腺癌是一种多因素的疾病，其结果取决于各种临床病理和分子因素。新辅助化疗(NACT)越来越多地用于术前获得病理完全缓解(pCR)，因为它与无事件生存期和总生存期的增加有关。目的:本研究的目的是评估与三级护理环境中各种临床病理因素相关的局部晚期乳腺癌(LABC) NACT的疗效。材料和方法:回顾性分析NACT治疗后1年内行改良根治性乳房切除术或乳房保守手术的LABC患者(临床分期IIB和III期)的临床和病理反应。观察临床病理及分子因素对治疗效果的影响。最终组织病理学评价pCR。结果:50例LABC患者符合研究标准并进行了回顾。6例(12%)存在pCR。所有pCR病例均为浸润性导管癌。初步活检中肿瘤坏死的存在与pCR到NACT之间存在统计学意义上的相关性(P = 0.024)，阴性预测值高达94%。所有11例(100%)初始活检淋巴血管栓塞(LVE)阳性的患者均未显示pCR。6例pCR病例中有4例临床前肿瘤大小≤5 cm。导管原位癌(Ductal carcinoma in situ, DCIS) 15例，只有1例pCR患者存在DCIS。结论:临床前肿瘤大小、肿瘤组织病理类型、DCIS、初始核心活检是否存在肿瘤坏死和LVE是应用NACT的LABC患者进行pCR的重要因素。
{"title":"Response to neoadjuvant chemotherapy in locally advanced breast cancers in association with different clinicopathological parameters","authors":"B. Bharadwaj, N. Mahanta, B. Goswami, K. Bhuyan","doi":"10.4103/oji.oji_26_20","DOIUrl":"https://doi.org/10.4103/oji.oji_26_20","url":null,"abstract":"Introduction: Breast cancer being a multifactorial disorder outcome depends on various clinicopathological and molecular factors. Neoadjuvant chemotherapy (NACT) is increasingly used before surgery to obtain pathological complete response (pCR) as it is associated with increase event-free survival and overall survival. Aim: The aim of this study is to evaluate the response to NACT in locally advanced breast cancer (LABC) in association with various clinicopathological factors in a tertiary care setting. Materials and Methods: LABC patients (clinical Stage IIB and III) who underwent either modified radical mastectomy or breast conservative surgery after NACT treatment in a 1-year period were retrospectively reviewed for the clinical and pathological response. Effect of clinicopathological and molecular factors on treatment response were evaluated. pCR was evaluated on final histopathology. Results: Fifty LABC patients fulfilled the study criteria and were reviewed. pCR was present in 6 (12%) cases. All the pCR cases were invasive ductal carcinoma. A statistically significant association between the presence of tumor necrosis in initial biopsy and pCR to NACT was observed (P = 0.024) with a high negative predictive value of 94%. All the 11 patients (100%) with positive lymphovascular emboli (LVE) on initial biopsy did not show pCR. Four out of 6 pCR cases had preclinical tumor size ≤5 cm. Ductal carcinoma in situ (DCIS) was present in 15 cases and only 1 pCR patient had the presence of DCIS. Conclusion: Preclinical tumor size, histopathological tumor type, DCIS, and presence of tumor necrosis and LVE on initial core biopsy are some of the notable factors for pCR among LABC patients who received NACT.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123944206","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}
F. Lalfamkima, S. Bommaji, K. Reddy, K. Chalapathi, Manisha B. Patil, Tejal R. Patil, A. Nayyar
Context: Oral submucous fibrosis (OSMF) has infested the oral cavities of “betel nut” and “gutkha” chewers in a pandemic manner. It has one of the highest rates of malignant transformation among the various oral potentially malignant epithelial lesions. Chewing of gutkha alters the salivary parameters including salivary flow rate (SFR) as well as salivary pH. Aim: The present study intended to assess and compare the SFR between betel nut/gutkha chewers with and without OSMF and healthy controls. Materials and Methods: We conducted a prospective case–control study comprising 90 individuals within an age range of 15–50 years who were divided into three groups with Group A consisting of 30 patients who were betel nut/gutkha chewers with OSMF, Group B consisting of 30 individuals who were betel nut/gutkha chewers but without OSMF and Group C consisting of 30 healthy controls who were included as normal controls. The assessment of the SFR was done and the results obtained were subjected to statistical analysis. Results: The mean SFR in Group B patients was significantly more than Group A and Group C individuals. Moreover, the mean SFR in patients with OSMF Stage I was significantly more as compared to patients in Stage II and Stage III OSMF. Conclusion: We concluded that reduced SFR could be an initial subjective sign of OSMF. An early diagnosis and management of these changes can help such patients to improve their quality of life significantly and decreases the chance of the ongoing malignant transformation with early intervention.
{"title":"Comparative evaluation of alteration in salivary flow rate between betal Nut/Gutkha chewers with and without OSMF, and healthy subjects: A prospective case-control study","authors":"F. Lalfamkima, S. Bommaji, K. Reddy, K. Chalapathi, Manisha B. Patil, Tejal R. Patil, A. Nayyar","doi":"10.4103/oji.oji_22_20","DOIUrl":"https://doi.org/10.4103/oji.oji_22_20","url":null,"abstract":"Context: Oral submucous fibrosis (OSMF) has infested the oral cavities of “betel nut” and “gutkha” chewers in a pandemic manner. It has one of the highest rates of malignant transformation among the various oral potentially malignant epithelial lesions. Chewing of gutkha alters the salivary parameters including salivary flow rate (SFR) as well as salivary pH. Aim: The present study intended to assess and compare the SFR between betel nut/gutkha chewers with and without OSMF and healthy controls. Materials and Methods: We conducted a prospective case–control study comprising 90 individuals within an age range of 15–50 years who were divided into three groups with Group A consisting of 30 patients who were betel nut/gutkha chewers with OSMF, Group B consisting of 30 individuals who were betel nut/gutkha chewers but without OSMF and Group C consisting of 30 healthy controls who were included as normal controls. The assessment of the SFR was done and the results obtained were subjected to statistical analysis. Results: The mean SFR in Group B patients was significantly more than Group A and Group C individuals. Moreover, the mean SFR in patients with OSMF Stage I was significantly more as compared to patients in Stage II and Stage III OSMF. Conclusion: We concluded that reduced SFR could be an initial subjective sign of OSMF. An early diagnosis and management of these changes can help such patients to improve their quality of life significantly and decreases the chance of the ongoing malignant transformation with early intervention.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114294797","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}
L. Moharana, L. Dasappa, M. Babu, K. Lokesh, A. Rudresha, L. Rajeev, S. Saldanha, L. Jacob
Background: Surgery is the primary modality of treatment for Stage II colon cancer, and the role of adjuvant chemotherapy is not well defined. Attempts have been made to find out various high-risk sub-groups within Stage II colon cancer, who might benefit from the adjuvant chemotherapy. Most of these studies do not quantify the risks associated with each of the high-risk factors and the survival benefits conferred by adjuvant chemotherapy based on them. Aim: This study aimed to analyze the prognostic and predictive significance of various high-risk factors among patients with Stage II colon cancer and to define the role of adjuvant chemotherapy among these if any with respect to various high-risk factors. Materials and Methods: An audit on postoperative Stage II colon carcinoma patients was performed retrospectively from the patient database of our hospital, registered over the period from January 2010 to August 2017. Results: A total of 41 pathological Stage II colon carcinoma patients were reviewed. Twelve (29.3%) patients without any high-risk features were spared of adjuvant chemotherapy. Twenty-nine (70.7%) patients had at least one high-risk feature and received adjuvant chemotherapy. Mean disease-free survival (DFS) after a minimum 20-month follow-up period was 26.8 months. On univariate analysis, there was a statistically significant difference in mean DFS according to the T stage (T3 vs. T4; P = 0.04), lympho-vascular invasion (LVI) status (absent vs. present; P < 0.01), perineural invasion status (absent vs. present; P = 0.03) and number of lymph nodes in the histopathology specimen (≥12 vs. <12; P < 0.01). On multivariate analysis, LVI positivity and inadequate lymph node dissection (<12 lymph nodes in the specimen) were independent high-risk factors for recurrence. Conclusion: The presence of LVI, inadequate lymph node dissection, or presence of multiple high-risk factors are associated with higher risks of recurrence even with adjuvant 5-flourouracil-based chemotherapy.
背景:手术是II期结肠癌的主要治疗方式，辅助化疗的作用尚未明确。人们试图找出可能从辅助化疗中受益的II期结肠癌的各种高危亚群。这些研究大多没有量化与每个高危因素相关的风险以及基于这些因素的辅助化疗所带来的生存益处。目的:本研究旨在分析各种高危因素对II期结肠癌患者预后的预测意义，并明确其中辅助化疗在各种高危因素中的作用。材料与方法:对我院2010年1月至2017年8月登记的二期结肠癌术后患者进行回顾性审计。结果:本组共41例病理性II期结肠癌患者。无高危特征的12例(29.3%)患者未行辅助化疗。29例(70.7%)患者至少有一项高危特征并接受了辅助化疗。至少20个月的随访期后，平均无病生存期(DFS)为26.8个月。单因素分析显示，按T分期(T3 vs. T4;P = 0.04)，淋巴血管浸润(LVI)状态(无vs有;P < 0.01)，周围神经浸润情况(无vs有;P = 0.03)和组织病理标本中淋巴结数目(≥12 vs <12;P < 0.01)。在多因素分析中，LVI阳性和淋巴结清扫不充分(标本中淋巴结<12)是复发的独立高危因素。结论:LVI的存在，淋巴结清扫不充分，或存在多种高危因素，即使是辅助5-氟尿嘧啶化疗，复发风险也较高。
{"title":"Quantification of risk of recurrence associated with high risk factors in Stage II colon cancer: A retrospective study from a tertiary cancer institute in India","authors":"L. Moharana, L. Dasappa, M. Babu, K. Lokesh, A. Rudresha, L. Rajeev, S. Saldanha, L. Jacob","doi":"10.4103/oji.oji_4_21","DOIUrl":"https://doi.org/10.4103/oji.oji_4_21","url":null,"abstract":"Background: Surgery is the primary modality of treatment for Stage II colon cancer, and the role of adjuvant chemotherapy is not well defined. Attempts have been made to find out various high-risk sub-groups within Stage II colon cancer, who might benefit from the adjuvant chemotherapy. Most of these studies do not quantify the risks associated with each of the high-risk factors and the survival benefits conferred by adjuvant chemotherapy based on them. Aim: This study aimed to analyze the prognostic and predictive significance of various high-risk factors among patients with Stage II colon cancer and to define the role of adjuvant chemotherapy among these if any with respect to various high-risk factors. Materials and Methods: An audit on postoperative Stage II colon carcinoma patients was performed retrospectively from the patient database of our hospital, registered over the period from January 2010 to August 2017. Results: A total of 41 pathological Stage II colon carcinoma patients were reviewed. Twelve (29.3%) patients without any high-risk features were spared of adjuvant chemotherapy. Twenty-nine (70.7%) patients had at least one high-risk feature and received adjuvant chemotherapy. Mean disease-free survival (DFS) after a minimum 20-month follow-up period was 26.8 months. On univariate analysis, there was a statistically significant difference in mean DFS according to the T stage (T3 vs. T4; P = 0.04), lympho-vascular invasion (LVI) status (absent vs. present; P < 0.01), perineural invasion status (absent vs. present; P = 0.03) and number of lymph nodes in the histopathology specimen (≥12 vs. <12; P < 0.01). On multivariate analysis, LVI positivity and inadequate lymph node dissection (<12 lymph nodes in the specimen) were independent high-risk factors for recurrence. Conclusion: The presence of LVI, inadequate lymph node dissection, or presence of multiple high-risk factors are associated with higher risks of recurrence even with adjuvant 5-flourouracil-based chemotherapy.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114803526","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}
The occurrence of pelvic malignancies along with an ectopic kidney is a rare finding. In the patients of early stage carcinoma of cervix presenting with pelvic kidney, surgery is preferred to radiation to avoid irradiating the kidney. However, advanced stage carcinoma of cervix in such scenario poses a therapeutic dilemma and conformal radiotherapy in the form of intensity-modulated radiotherapy (IMRT) is preferred option. This helps to achieve the desired dose to the target while reducing the dose to the surrounding organs at risk particularly to the pelvic kidney. Herein, we present a case of International Federation of Gynecology and Obstetrics Stage IIB carcinoma of cervix having ectopic right pelvic kidney in a 40-year-old female, and the patient was successfully treated with chemoradiotherapy in IMRT technique. The patient is disease free with normal renal function at 2-year follow-up. The previously reported cases of pelvic malignancies with ectopic kidney in the literature are discussed here briefly.
{"title":"Carcinoma cervix with ectopic kidney, its treatment and outcome","authors":"M. Anand, Ankita Parikh, S. Shah","doi":"10.4103/oji.oji_28_19","DOIUrl":"https://doi.org/10.4103/oji.oji_28_19","url":null,"abstract":"The occurrence of pelvic malignancies along with an ectopic kidney is a rare finding. In the patients of early stage carcinoma of cervix presenting with pelvic kidney, surgery is preferred to radiation to avoid irradiating the kidney. However, advanced stage carcinoma of cervix in such scenario poses a therapeutic dilemma and conformal radiotherapy in the form of intensity-modulated radiotherapy (IMRT) is preferred option. This helps to achieve the desired dose to the target while reducing the dose to the surrounding organs at risk particularly to the pelvic kidney. Herein, we present a case of International Federation of Gynecology and Obstetrics Stage IIB carcinoma of cervix having ectopic right pelvic kidney in a 40-year-old female, and the patient was successfully treated with chemoradiotherapy in IMRT technique. The patient is disease free with normal renal function at 2-year follow-up. The previously reported cases of pelvic malignancies with ectopic kidney in the literature are discussed here briefly.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117106711","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. Patil, V. Gupta, R. Rangaraju, Waseem Abbas, R. Acharya, Archit Pandit
Background: Patients with metastatic gastric adenocarcinoma have a relatively poor prognosis with a median survival of 6 months. The three-drug regimen of docetaxel, oxaliplatin, and fluorouracil (DOF) has been shown to improve survival compared to the two-drug regimen of docetaxel and oxaliplatin with similar toxicity. However, there is no published Indian experience with this regimen. Aim: The aim of this study was to evaluate the efficacy in terms of progression-free survival (PFS) and overall survival (OS) of DOF regimen for metastatic gastric adenocarcinoma patients in Indian settings. Materials and Methods: All patients with metastatic gastric adenocarcinoma who were treated with DOF regimen chemotherapy at our tertiary care center in North India from 2014 to 2018 were retrospectively reviewed. The DOF regimen consisted of docetaxel 50 mg/m2 on day 1, followed by oxaliplatin 85 mg/m2 on day 1, and 5-FU 2400 mg/m2 continuous intravenous infusion over 46 h; (cycle repeated at two weekly intervals until progression or unacceptable toxicity). The endpoints were overall response rate (ORR), PFS, and OS, which were evaluated using Kaplan–Meier analysis. Results: Fifteen patients with a median age of 52 years were identified; 73% were male. ORR was seen in 86.7% of patients (complete response: 20%, partial response: 60%, and stable disease: 6.7%) and progressive disease was seen in 13.3% of patients. With a median follow-up of 14 months, the median PFS was 7 months and the median OS was 16 months from the start of therapy. One-year PFS was 22% and 1- and 2-year OS was 79% and 26%, respectively. The most frequent Grades 3–4 adverse events in our patients being mucositis (33.3%), neutropenia (26.7%), and diarrhea (20%). Conclusion: DOF regimen is an effective and feasible regimen in patients with metastatic gastric cancer.
{"title":"Survival outcomes with docetaxel, oxaliplatin, and fluorouracil regimen for the treatment of metastatic gastric adenocarcinoma: A single-center experience","authors":"P. Patil, V. Gupta, R. Rangaraju, Waseem Abbas, R. Acharya, Archit Pandit","doi":"10.4103/oji.oji_8_20","DOIUrl":"https://doi.org/10.4103/oji.oji_8_20","url":null,"abstract":"Background: Patients with metastatic gastric adenocarcinoma have a relatively poor prognosis with a median survival of 6 months. The three-drug regimen of docetaxel, oxaliplatin, and fluorouracil (DOF) has been shown to improve survival compared to the two-drug regimen of docetaxel and oxaliplatin with similar toxicity. However, there is no published Indian experience with this regimen. Aim: The aim of this study was to evaluate the efficacy in terms of progression-free survival (PFS) and overall survival (OS) of DOF regimen for metastatic gastric adenocarcinoma patients in Indian settings. Materials and Methods: All patients with metastatic gastric adenocarcinoma who were treated with DOF regimen chemotherapy at our tertiary care center in North India from 2014 to 2018 were retrospectively reviewed. The DOF regimen consisted of docetaxel 50 mg/m2 on day 1, followed by oxaliplatin 85 mg/m2 on day 1, and 5-FU 2400 mg/m2 continuous intravenous infusion over 46 h; (cycle repeated at two weekly intervals until progression or unacceptable toxicity). The endpoints were overall response rate (ORR), PFS, and OS, which were evaluated using Kaplan–Meier analysis. Results: Fifteen patients with a median age of 52 years were identified; 73% were male. ORR was seen in 86.7% of patients (complete response: 20%, partial response: 60%, and stable disease: 6.7%) and progressive disease was seen in 13.3% of patients. With a median follow-up of 14 months, the median PFS was 7 months and the median OS was 16 months from the start of therapy. One-year PFS was 22% and 1- and 2-year OS was 79% and 26%, respectively. The most frequent Grades 3–4 adverse events in our patients being mucositis (33.3%), neutropenia (26.7%), and diarrhea (20%). Conclusion: DOF regimen is an effective and feasible regimen in patients with metastatic gastric cancer.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115121052","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}
Context: Gastric cancer is the fifth most common malignancy, with a high incidence in Eastern Asian countries. Diet is an important risk factor in the genesis of gastric cancer, and the fact that it is modifiable warrants it to be studied extensively in relation to various clinicopathological parameters of gastric cancer. Aims: The present study was undertaken to study the dietary habits (vegetarian/nonvegetarian) among gastric carcinoma patients in the Indian context. Materials and Methods: We studied 100 consecutive cases of gastric carcinoma excluding tumors at gastroesophageal junction. Clinical data regarding food habits in the patients were collected by personal enquiry. Pathological characteristics including size, site, gross appearance, Lauren's histological type, and the World Health Organization (WHO) histological type were noted. Data analysis was done using Chi-square test. Results: Sixty-nine percent of gastric cancer patients were vegetarians and 31% were nonvegetarians. Statistically significant association between nonvegetarian diet and gastric cancer location at the lesser curvature was found (P ≤ 0.001). No statistically significant association between diet and gross appearance, Lauren's, and WHO histological type of gastric cancer was found. Conclusions: For anatomical locations, most gastric cancers located at lesser curvature had been developed among nonvegetarian patients, whereas we did not observe diet to be related to gross appearance and histological type of gastric carcinoma.
{"title":"Diet and gastric cancer","authors":"K. Dewan, R. Madan, P. Sengupta, A. Mandal","doi":"10.4103/oji.oji_47_19","DOIUrl":"https://doi.org/10.4103/oji.oji_47_19","url":null,"abstract":"Context: Gastric cancer is the fifth most common malignancy, with a high incidence in Eastern Asian countries. Diet is an important risk factor in the genesis of gastric cancer, and the fact that it is modifiable warrants it to be studied extensively in relation to various clinicopathological parameters of gastric cancer. Aims: The present study was undertaken to study the dietary habits (vegetarian/nonvegetarian) among gastric carcinoma patients in the Indian context. Materials and Methods: We studied 100 consecutive cases of gastric carcinoma excluding tumors at gastroesophageal junction. Clinical data regarding food habits in the patients were collected by personal enquiry. Pathological characteristics including size, site, gross appearance, Lauren's histological type, and the World Health Organization (WHO) histological type were noted. Data analysis was done using Chi-square test. Results: Sixty-nine percent of gastric cancer patients were vegetarians and 31% were nonvegetarians. Statistically significant association between nonvegetarian diet and gastric cancer location at the lesser curvature was found (P ≤ 0.001). No statistically significant association between diet and gross appearance, Lauren's, and WHO histological type of gastric cancer was found. Conclusions: For anatomical locations, most gastric cancers located at lesser curvature had been developed among nonvegetarian patients, whereas we did not observe diet to be related to gross appearance and histological type of gastric carcinoma.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114456339","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}
Vijay Gnanaguru, M. Dhanushkodi, V. Radhakrishnan, J. Kalaiarasi, A. Rajan, G. Selvarajan, Sivasree Kesana, Srikamakshi Kothandaraman, S. Sekhar, Venktesh Vaidhyalingam, Arvind Krishnamurthi, Aswin Nagarajan, Kuluvoya Ramanaiah, H. Kumar, Arun Kumar, R. Madhavan, A. John, R. Ranganathan, T. Ganesan, T. Sagar
Introduction: Patients with locally advanced head-and-neck squamous cell carcinoma (LAHNSCC) have a poor prognosis despite multimodality treatment. Aim: This study was done to assess the efficacy and toxicity of induction chemotherapy (IC) in patients with LAHNSCC. Materials and Methods: This was a retrospective study of patients with LAHNSCC who were treated with IC from May 2016 to July 2019 from a tertiary care cancer center in India. Results: A total of 26 patients were included in this analysis, with a median follow-up of 9.5 months. The majority of the patients had carcinoma of the oral cavity (96.2%, n = 25) and 1 (3.8%) had oropharyngeal cancer. The most common oral cavity subsites were buccal mucosa (65.4%) and gingivum (11.5%). Fifteen patients received a triplet regimen of IC and 11 patients received a doublet IC regimen. Among patients with an evaluable disease for response assessment (n = 21), complete response, partial response, stable disease, and progressive disease were seen in 9.5%, 66.7%, 19%, and 4.8%, respectively. Among patients with unresectable (Stage IVB) Oral squamous cell cancer (OSCCs), 40% underwent surgery. The median progression-free survival (PFS) was 8 months. Patients who underwent surgery after IC had a better PFS as compared to those who underwent nonoperative local therapy (12 months vs. 8 months). IC-induced Grade 3 or more toxicity occurred in 45% of the patients and mortality occurred in 2 patients (7.7%) due to neutropenic sepsis. Conclusion: IC is feasible in patients with inoperable LAHNSCC. Patients who underwent surgery after IC had a trend towards better PFS as compared to those who underwent nonsurgical local therapy after IC.
{"title":"Induction chemotherapy in locally advanced head-and-neck squamous cell carcinoma: Real-world outcome","authors":"Vijay Gnanaguru, M. Dhanushkodi, V. Radhakrishnan, J. Kalaiarasi, A. Rajan, G. Selvarajan, Sivasree Kesana, Srikamakshi Kothandaraman, S. Sekhar, Venktesh Vaidhyalingam, Arvind Krishnamurthi, Aswin Nagarajan, Kuluvoya Ramanaiah, H. Kumar, Arun Kumar, R. Madhavan, A. John, R. Ranganathan, T. Ganesan, T. Sagar","doi":"10.4103/oji.oji_21_20","DOIUrl":"https://doi.org/10.4103/oji.oji_21_20","url":null,"abstract":"Introduction: Patients with locally advanced head-and-neck squamous cell carcinoma (LAHNSCC) have a poor prognosis despite multimodality treatment. Aim: This study was done to assess the efficacy and toxicity of induction chemotherapy (IC) in patients with LAHNSCC. Materials and Methods: This was a retrospective study of patients with LAHNSCC who were treated with IC from May 2016 to July 2019 from a tertiary care cancer center in India. Results: A total of 26 patients were included in this analysis, with a median follow-up of 9.5 months. The majority of the patients had carcinoma of the oral cavity (96.2%, n = 25) and 1 (3.8%) had oropharyngeal cancer. The most common oral cavity subsites were buccal mucosa (65.4%) and gingivum (11.5%). Fifteen patients received a triplet regimen of IC and 11 patients received a doublet IC regimen. Among patients with an evaluable disease for response assessment (n = 21), complete response, partial response, stable disease, and progressive disease were seen in 9.5%, 66.7%, 19%, and 4.8%, respectively. Among patients with unresectable (Stage IVB) Oral squamous cell cancer (OSCCs), 40% underwent surgery. The median progression-free survival (PFS) was 8 months. Patients who underwent surgery after IC had a better PFS as compared to those who underwent nonoperative local therapy (12 months vs. 8 months). IC-induced Grade 3 or more toxicity occurred in 45% of the patients and mortality occurred in 2 patients (7.7%) due to neutropenic sepsis. Conclusion: IC is feasible in patients with inoperable LAHNSCC. Patients who underwent surgery after IC had a trend towards better PFS as compared to those who underwent nonsurgical local therapy after IC.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127097258","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}
Supratim Bhattacharyya, P. Devi, Subrat Samantara, K. Mohammed
Primary pancreatic malignancy with pure squamous cell histology is extremely rare and has aggressive behavior with poor prognosis. The management of primary squamous cell carcinoma of the pancreas (SCCP) is poorly defined due to the paucity of data. Preoperative histological diagnosis is difficult in the majority of cases. Curative resection is the main stay of treatment, but most of the cases were found inoperable due to delayed diagnosis and dissemination of the disease at the time of initial diagnosis. Herein, we report a case of primary SCCP in a 44-year-old female located at the head of the pancreas. Her contrast-enhanced computed tomography (CECT) scan image had the findings of pancreatic head mass along with the features of atrophic pancreatitis. Whipple's procedure was performed successfully for the case with the postoperative pathological staging of PT2N0CM0 and chronic pancreatitis. However, the patient died due to sepsis on the 32nd postoperative day. The presence of atrophic pancreatitis on CECT scan and postoperative pathological findings of chronic pancreatitis suggested the development of squamous metaplasia followed by subsequent development of SCCP.
{"title":"Primary squamous cell carcinoma of head of the pancreas","authors":"Supratim Bhattacharyya, P. Devi, Subrat Samantara, K. Mohammed","doi":"10.4103/oji.oji_43_20","DOIUrl":"https://doi.org/10.4103/oji.oji_43_20","url":null,"abstract":"Primary pancreatic malignancy with pure squamous cell histology is extremely rare and has aggressive behavior with poor prognosis. The management of primary squamous cell carcinoma of the pancreas (SCCP) is poorly defined due to the paucity of data. Preoperative histological diagnosis is difficult in the majority of cases. Curative resection is the main stay of treatment, but most of the cases were found inoperable due to delayed diagnosis and dissemination of the disease at the time of initial diagnosis. Herein, we report a case of primary SCCP in a 44-year-old female located at the head of the pancreas. Her contrast-enhanced computed tomography (CECT) scan image had the findings of pancreatic head mass along with the features of atrophic pancreatitis. Whipple's procedure was performed successfully for the case with the postoperative pathological staging of PT2N0CM0 and chronic pancreatitis. However, the patient died due to sepsis on the 32nd postoperative day. The presence of atrophic pancreatitis on CECT scan and postoperative pathological findings of chronic pancreatitis suggested the development of squamous metaplasia followed by subsequent development of SCCP.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132976495","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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