Khurshida Rahman, Nageswar Sahu, U. Senapati, S. Sahu
Background: Lymphovascular invasion (LVI) is one of the important prognostic factors in carcinoma breast and its accurate diagnosis is important, particularly in node-negative cases for making the decision regarding aggressive adjuvant chemotherapy. Sometimes, it becomes very difficult to diagnose LVI on routine hematoxylin and eosin (H and E) stained tissue sections. Staining with endothelial immunomarkers makes the identification easy. Aim of the Study: This study aims to compare LVI detection on H and E and immunohistochemistry (IHC) stained sections and its correlation with axillary lymph node metastasis. Materials and Methods: A total of 45 cases of invasive breast carcinoma were studied. LVI was evaluated in routine H and E and IHC stained sections. The results were compared. The LVI status on IHC was correlated with axillary lymph node status. Results: The accuracy of H and E stained sections in detection of LVI was 75.6% with a false-positive and false-negative rate of 20% and 4.4%, respectively. There was no significant association between LVI on IHC and axillary lymph node status. Conclusions: The detection of LVI on routine H and E sections can be erroneous. IHC should be done in cases with confusing focus on routine H and E stained sections, particularly in node-negative cases.
{"title":"Importance of endothelial markers in detection of lymphovascular invasion in carcinoma breast and its correlation with axillary lymph node metastasis","authors":"Khurshida Rahman, Nageswar Sahu, U. Senapati, S. Sahu","doi":"10.4103/oji.oji_52_19","DOIUrl":"https://doi.org/10.4103/oji.oji_52_19","url":null,"abstract":"Background: Lymphovascular invasion (LVI) is one of the important prognostic factors in carcinoma breast and its accurate diagnosis is important, particularly in node-negative cases for making the decision regarding aggressive adjuvant chemotherapy. Sometimes, it becomes very difficult to diagnose LVI on routine hematoxylin and eosin (H and E) stained tissue sections. Staining with endothelial immunomarkers makes the identification easy. Aim of the Study: This study aims to compare LVI detection on H and E and immunohistochemistry (IHC) stained sections and its correlation with axillary lymph node metastasis. Materials and Methods: A total of 45 cases of invasive breast carcinoma were studied. LVI was evaluated in routine H and E and IHC stained sections. The results were compared. The LVI status on IHC was correlated with axillary lymph node status. Results: The accuracy of H and E stained sections in detection of LVI was 75.6% with a false-positive and false-negative rate of 20% and 4.4%, respectively. There was no significant association between LVI on IHC and axillary lymph node status. Conclusions: The detection of LVI on routine H and E sections can be erroneous. IHC should be done in cases with confusing focus on routine H and E stained sections, particularly in node-negative cases.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129592948","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}
Background: Cancers of cervix, breast, and oral cavity claim millions of deaths each year globally and are the three most common cancers in India. There is a need to develop and test models for organizing integrated cancer screening camps in low-resource settings with intersectoral coordination between different stakeholders. Aim: To test a model of community based integrated screening camp for it's feasibility and to early detect these three common cancers in low-resource rural settings. Materials and Methods: A community-based integrated cancer screening camp was organized in a rural setting of North India in coordination with district health administration and local governing body (Panchayati Raj Institution). Screening methods included clinical breast examination for breast cancer, visual inspection under 5% acetic acid (VIA) for cervical cancer, and oral visual examination (OVE) for oral cavity cancer. Men and women found to be screen positive in the camp were referred to the district hospital and a tertiary care center for further diagnostic tests and were followed up. Results: A total of ninety individuals (forty men and fifty women) above 30 years of age attended the screening camp were included in the study. One (2.5%) out of these forty males was screened positive for precancerous lesion of the oral cavity. Out of the fifty women attending the camp, two were detected with suspected breast lumps, which on further diagnostic tests at district hospital were diagnosed as benign tumors. About half (52.0%) of the women consented for cervical cancer screening, out of which one (3.9%) was screened positive on VIA, which on colposcopy examination and biopsy at a referral center was confirmed as early-stage cancerous lesion of the cervix and was instituted on treatment. Conclusion: The screening camp sets a successful example of community-based cancer control activity for the early detection and management of three common cancers through intersectoral coordination in low-resource settings.
{"title":"A successful model of cancer screening in low-resource settings: Findings of an integrated cancer screening camp from a rural setting of North India","authors":"M. Bashar, A. Aggarwal, D. Valecha","doi":"10.4103/oji.oji_31_19","DOIUrl":"https://doi.org/10.4103/oji.oji_31_19","url":null,"abstract":"Background: Cancers of cervix, breast, and oral cavity claim millions of deaths each year globally and are the three most common cancers in India. There is a need to develop and test models for organizing integrated cancer screening camps in low-resource settings with intersectoral coordination between different stakeholders. Aim: To test a model of community based integrated screening camp for it's feasibility and to early detect these three common cancers in low-resource rural settings. Materials and Methods: A community-based integrated cancer screening camp was organized in a rural setting of North India in coordination with district health administration and local governing body (Panchayati Raj Institution). Screening methods included clinical breast examination for breast cancer, visual inspection under 5% acetic acid (VIA) for cervical cancer, and oral visual examination (OVE) for oral cavity cancer. Men and women found to be screen positive in the camp were referred to the district hospital and a tertiary care center for further diagnostic tests and were followed up. Results: A total of ninety individuals (forty men and fifty women) above 30 years of age attended the screening camp were included in the study. One (2.5%) out of these forty males was screened positive for precancerous lesion of the oral cavity. Out of the fifty women attending the camp, two were detected with suspected breast lumps, which on further diagnostic tests at district hospital were diagnosed as benign tumors. About half (52.0%) of the women consented for cervical cancer screening, out of which one (3.9%) was screened positive on VIA, which on colposcopy examination and biopsy at a referral center was confirmed as early-stage cancerous lesion of the cervix and was instituted on treatment. Conclusion: The screening camp sets a successful example of community-based cancer control activity for the early detection and management of three common cancers through intersectoral coordination in low-resource settings.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"424 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123585125","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}
Background: Undocumented observations suggest a rising incidence of gastrointestinal tract cancers (GITc) among urban dwellers in Nigeria. Aim: The aim is to report on the incidence and clinic-pathological characteristics of GITc in Port Harcourt and its environs. Materials and Methods: Clinical, pathological, and demographic information on cancer patients obtained from various hospitals, radiology centers, and pathology laboratories within Port Harcourt and Obio-Akpor local government areas of Rivers state between 2008 and 2017 were reviewed. The information was coded using the International Classification of Diseases for Oncology, 3rd Edition and stored in Canreg 4 software in the Port Harcourt cancer registry. Results: GITc constituted the third-most common systemic cancers consisting of 12.2% (328 cases) with a male-to-female ratio of 1.05:1. The annual age-standardized rate ranged between 1.1–21.6/100,000 for females and 1.8–15.9/100,000 for males, with the highest rate recorded in 2017. The mean age was 51.2 ± 15.8 years with bimodal peak age groups of 50–54 and 55–59 years. The most common sites for GITc were colorectal followed by the liver and stomach consisting of 44.5%, 16.5%, and 15.2% of cases, respectively. Epithelial malignancies, i.e., carcinomas markedly predominated over malignancies of other cell types such as mesenchymal cell malignancies, lymphoreticular cell malignancies, and germ cell malignancies and constituted 92.4% of total GITc. Conclusion: GITc is posing a public health challenge in Port Harcourt and environs. A government-sponsored health plan on cancer control, including awareness campaigns on the adoption of more healthy lifestyles, hepatitis B vaccination, colonoscopy screening with prompt treatment, is advocated.
{"title":"Epidemiology of Gastrointestinal Malignancies in Nigeria:Port Harcourt Cancer Registry Study","authors":"C. Obiorah, E. Ray-Offor","doi":"10.4103/oji.oji_30_19","DOIUrl":"https://doi.org/10.4103/oji.oji_30_19","url":null,"abstract":"Background: Undocumented observations suggest a rising incidence of gastrointestinal tract cancers (GITc) among urban dwellers in Nigeria. Aim: The aim is to report on the incidence and clinic-pathological characteristics of GITc in Port Harcourt and its environs. Materials and Methods: Clinical, pathological, and demographic information on cancer patients obtained from various hospitals, radiology centers, and pathology laboratories within Port Harcourt and Obio-Akpor local government areas of Rivers state between 2008 and 2017 were reviewed. The information was coded using the International Classification of Diseases for Oncology, 3rd Edition and stored in Canreg 4 software in the Port Harcourt cancer registry. Results: GITc constituted the third-most common systemic cancers consisting of 12.2% (328 cases) with a male-to-female ratio of 1.05:1. The annual age-standardized rate ranged between 1.1–21.6/100,000 for females and 1.8–15.9/100,000 for males, with the highest rate recorded in 2017. The mean age was 51.2 ± 15.8 years with bimodal peak age groups of 50–54 and 55–59 years. The most common sites for GITc were colorectal followed by the liver and stomach consisting of 44.5%, 16.5%, and 15.2% of cases, respectively. Epithelial malignancies, i.e., carcinomas markedly predominated over malignancies of other cell types such as mesenchymal cell malignancies, lymphoreticular cell malignancies, and germ cell malignancies and constituted 92.4% of total GITc. Conclusion: GITc is posing a public health challenge in Port Harcourt and environs. A government-sponsored health plan on cancer control, including awareness campaigns on the adoption of more healthy lifestyles, hepatitis B vaccination, colonoscopy screening with prompt treatment, is advocated.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123898678","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}
Clear cell odontogenic carcinoma (CCOC) is an extremely rare odontogenic carcinoma with few cases reported in literature. In 2005, the WHO reclassified CCOC as a malignant odontogenic neoplasm, exhibiting an aggressive growth pattern with a propensity for regional, nodal, and distant metastasis. Being characterized histopathologically by sheets and islands of clear and vacuolated cells, it poses a diagnostic challenge to the clinician and pathologist to distinguish CCOC from other perplexing clear cell entities and requires immunohistochemical analysis. Here, we report a case of CCOC in a 50-year-old woman who presented with a solitary, diffuse, and tender swelling in the posterior aspect of the mandible for 1½ months. Wide local excision was performed for the case. The present case may aid to delineate its biological behavior along with shedding light on its histopathological and immunohistochemical character, thus contributing to the literature.
{"title":"Clear cell odontogenic carcinoma an enigmatic diagnostic challenge","authors":"S. Sahu, S. Das, Rachna Rath","doi":"10.4103/oji.oji_10_20","DOIUrl":"https://doi.org/10.4103/oji.oji_10_20","url":null,"abstract":"Clear cell odontogenic carcinoma (CCOC) is an extremely rare odontogenic carcinoma with few cases reported in literature. In 2005, the WHO reclassified CCOC as a malignant odontogenic neoplasm, exhibiting an aggressive growth pattern with a propensity for regional, nodal, and distant metastasis. Being characterized histopathologically by sheets and islands of clear and vacuolated cells, it poses a diagnostic challenge to the clinician and pathologist to distinguish CCOC from other perplexing clear cell entities and requires immunohistochemical analysis. Here, we report a case of CCOC in a 50-year-old woman who presented with a solitary, diffuse, and tender swelling in the posterior aspect of the mandible for 1½ months. Wide local excision was performed for the case. The present case may aid to delineate its biological behavior along with shedding light on its histopathological and immunohistochemical character, thus contributing to the literature.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116074299","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. Palled, Nadiah Aldaleeli, K. Ganesh, M. Vadivel, S. Alsalhi
Background: The pre- and post-treatment evaluation of cervical cancer is usually done by clinical examination and radiological imaging depending on the facility available. The biochemistry of tumor tissues gets dramatically altered after chemoradiation, and such changes could be monitored by the spectral analysis of blood and urine for biochemical component. Aim: This study aims to evaluate the pre- and post-treatment biochemical changes through spectral analysis of blood and urine samples. Materials and Methods: Sixty-nine diagnosed cases of cervical carcinoma were taken for the study. The pre- and post-treatment evaluation of disease was done by clinical examination and radiological imaging. The biochemical component of blood and urine samples of all patients was analyzed spectroscopically before and after radiotherapy by exciting at 400 nm and capturing the emission spectrum over the range of 425 nm–675 nm. Results: The majority of cervical carcinoma patients were clinical International Federation of Gynecology and Obstetrics Stage IIIB followed by Stage IIB and Stage IB consisting of 49.28%, 33.33%, and 8.70% of cases, respectively. Rest of 8.70% of patients were postoperative. The initial results were found to be encouraging with good correlation (up to 66.67%) between spectral biomarker measurement, and the clinical and abdominal ultrasound scan monitoring. Conclusion: This proof of concept study with a limited number of patients, there was good clinical correlation and supplementary information for monitoring the patients. Spectral biomarker analysis could become a reliable, inexpensive tool complementing or supplementing expensive techniques like computed tomography scan.
{"title":"Spectral technique for monitoring cervical cancer treatment following radiotherapy","authors":"S. Palled, Nadiah Aldaleeli, K. Ganesh, M. Vadivel, S. Alsalhi","doi":"10.4103/oji.oji_43_19","DOIUrl":"https://doi.org/10.4103/oji.oji_43_19","url":null,"abstract":"Background: The pre- and post-treatment evaluation of cervical cancer is usually done by clinical examination and radiological imaging depending on the facility available. The biochemistry of tumor tissues gets dramatically altered after chemoradiation, and such changes could be monitored by the spectral analysis of blood and urine for biochemical component. Aim: This study aims to evaluate the pre- and post-treatment biochemical changes through spectral analysis of blood and urine samples. Materials and Methods: Sixty-nine diagnosed cases of cervical carcinoma were taken for the study. The pre- and post-treatment evaluation of disease was done by clinical examination and radiological imaging. The biochemical component of blood and urine samples of all patients was analyzed spectroscopically before and after radiotherapy by exciting at 400 nm and capturing the emission spectrum over the range of 425 nm–675 nm. Results: The majority of cervical carcinoma patients were clinical International Federation of Gynecology and Obstetrics Stage IIIB followed by Stage IIB and Stage IB consisting of 49.28%, 33.33%, and 8.70% of cases, respectively. Rest of 8.70% of patients were postoperative. The initial results were found to be encouraging with good correlation (up to 66.67%) between spectral biomarker measurement, and the clinical and abdominal ultrasound scan monitoring. Conclusion: This proof of concept study with a limited number of patients, there was good clinical correlation and supplementary information for monitoring the patients. Spectral biomarker analysis could become a reliable, inexpensive tool complementing or supplementing expensive techniques like computed tomography scan.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127277027","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. Sahoo, D. Sahu, Madhur Verma, P. Parija, U. Panda
India is going through a significant epidemiological transition with the rising of chronic diseases such as cancer. An accompanying aspect is social stigma and negative perceptions regarding cancer. This not only affects cancer care and treatment but also puts a strain on prevention efforts. It is particularly worrisome in a low- and middle-income country like India with low levels of health literacy and the lack of access to cancer care. There have been attempts by the government and positive changes toward mitigating stigma, but a lot needs to be done to address this issue. The family and the community need to be significant players in synergy with the health system in the efforts to minimize the stigma in cancer.
{"title":"Cancer and stigma: Present situation and challenges in India","authors":"S. Sahoo, D. Sahu, Madhur Verma, P. Parija, U. Panda","doi":"10.4103/oji.oji_51_19","DOIUrl":"https://doi.org/10.4103/oji.oji_51_19","url":null,"abstract":"India is going through a significant epidemiological transition with the rising of chronic diseases such as cancer. An accompanying aspect is social stigma and negative perceptions regarding cancer. This not only affects cancer care and treatment but also puts a strain on prevention efforts. It is particularly worrisome in a low- and middle-income country like India with low levels of health literacy and the lack of access to cancer care. There have been attempts by the government and positive changes toward mitigating stigma, but a lot needs to be done to address this issue. The family and the community need to be significant players in synergy with the health system in the efforts to minimize the stigma in cancer.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130751805","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}
Gorham–Stout disease (GSD) is a very rare disorder of unknown etiology, characterized by the abnormal proliferation of lymphatic endothelial cells, and also called “vanishing bone disease,” “phantom bone disease,” and “massive osteolysis,” as osteolysis is a characteristic feature. Patients present with a variety of symptoms such as swelling, pain, physical disability and deformity, shortness of breath, and neurological symptoms. It is a progressive disease, and owing to its rarity, the research and treatment options are limited. Our patient is a 15-year-old male, who presented with large mass over abdomen and chest, chylothorax, and osteolysis. This patient was initially treated with chest drains, subcutaneous drains, and sclerotherapy. Eventually, symptoms were worsened. After literature search, the patient was diagnosed with GSD, and sirolimus therapy was started. After 2 months of sirolimus therapy, the lesions subsided and well controlled.
{"title":"Management of Gorham–Stout disease presenting as intractable pleural effusion in an adolescent: A case report and review of literature","authors":"T. Jayakumar, D. Khera, V. Manchanda, K. Rathod","doi":"10.4103/oji.oji_20_19","DOIUrl":"https://doi.org/10.4103/oji.oji_20_19","url":null,"abstract":"Gorham–Stout disease (GSD) is a very rare disorder of unknown etiology, characterized by the abnormal proliferation of lymphatic endothelial cells, and also called “vanishing bone disease,” “phantom bone disease,” and “massive osteolysis,” as osteolysis is a characteristic feature. Patients present with a variety of symptoms such as swelling, pain, physical disability and deformity, shortness of breath, and neurological symptoms. It is a progressive disease, and owing to its rarity, the research and treatment options are limited. Our patient is a 15-year-old male, who presented with large mass over abdomen and chest, chylothorax, and osteolysis. This patient was initially treated with chest drains, subcutaneous drains, and sclerotherapy. Eventually, symptoms were worsened. After literature search, the patient was diagnosed with GSD, and sirolimus therapy was started. After 2 months of sirolimus therapy, the lesions subsided and well controlled.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128776919","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}
Kaalindi Singh, S. Backianathan, A. Jennifer, DN Susitra, R. George
A woman with postmastectomy lymphedema presented with a progressive nodular swelling on the affected limb. The biopsy was reported as dermatofibrosarcoma protuberans (DFSP). There is only one other case in literature, where a truncal dermatofibrosarcoma was reported in association with breast cancer. Both tumors had the P53 mutation. In our patient, the breast cancer and the DFSP were both negative for the P53 mutation and it is possible that chronic lymphedema was causative in the formation of the DFSP. More evidence is needed to understand the etiopathogenesis of DFSP occurring in breast cancer patients.
{"title":"Dermatofibrosarcoma protuberans, lymphedema, and breast cancer: A rare association","authors":"Kaalindi Singh, S. Backianathan, A. Jennifer, DN Susitra, R. George","doi":"10.4103/oji.oji_26_19","DOIUrl":"https://doi.org/10.4103/oji.oji_26_19","url":null,"abstract":"A woman with postmastectomy lymphedema presented with a progressive nodular swelling on the affected limb. The biopsy was reported as dermatofibrosarcoma protuberans (DFSP). There is only one other case in literature, where a truncal dermatofibrosarcoma was reported in association with breast cancer. Both tumors had the P53 mutation. In our patient, the breast cancer and the DFSP were both negative for the P53 mutation and it is possible that chronic lymphedema was causative in the formation of the DFSP. More evidence is needed to understand the etiopathogenesis of DFSP occurring in breast cancer patients.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131387825","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}
H. Singh, R. Khurana, M. Rastogi, S. Nanda, S. Rath, A. Mishra
Background: Patients of head-and-neck cancer (HANC) undergoing chemoradiotherapy (CRT) are at high risk of malnutrition due to acute effects of radiotherapy (RT). This study was intended to assess weight loss and change in body mass index (BMI) during CRT with active diet counseling and nutritional supplementation. Aims and Objective: The primary end point was to assess loss of weight and BMI during treatment. The secondary end point is assessment of compliance to stipulated treatment time, frequency of nasogastric tube feeding, intravenous support, and duration of hospital admission. Materials and Methods: This was a prospective observational study performed in Radiation Oncology department of a tertiary care center. Consecutive patients of HANC requiring definitive or adjuvant RT (±chemotherapy) were included. Nutritional status assessment and diet counseling were done before start of RT, and further weekly assessment of body weight and BMI was done. Results: Between December 2017 and December 2018, 128 patients were included in this study. Sitewise distribution were oral cavity, oropharynx, hypopharynx, and larynx in 69, 33, 9, and 17 patients, respectively. Weight loss and BMI comparison were done at the start and end of RT (mean weight: 53.86 kg; 95% confidence interval [CI]: ± 1.71, mean BMI: 21.52; 95% CI: ± 0.95 [at the start of RT] and mean weight: 48.30 kg; 95% CI: ± 1.58, mean BMI: 19.18; 95% CI: ± 0.88 [at the end of RT]).There was a significant reduction in weight (P < 0.0001, S) and BMI (P = 0.00034, S), respectively. During the treatment, a total of 14 patients were put on nasogastric tube feeding, and 23 patients were admitted for parenteral nutrition with median hospital stay of 3 days (range: 1–5 days). Conclusions: There is a significant weight loss and change in BMI during CRT in HANC patients. Regular assessment and active nutritional intervention are required in all patients to improve compliance.
{"title":"Assessment and results of early active nutritional interventions during radiotherapy with or without chemotherapy of head-and-neck cancer","authors":"H. Singh, R. Khurana, M. Rastogi, S. Nanda, S. Rath, A. Mishra","doi":"10.4103/oji.oji_29_19","DOIUrl":"https://doi.org/10.4103/oji.oji_29_19","url":null,"abstract":"Background: Patients of head-and-neck cancer (HANC) undergoing chemoradiotherapy (CRT) are at high risk of malnutrition due to acute effects of radiotherapy (RT). This study was intended to assess weight loss and change in body mass index (BMI) during CRT with active diet counseling and nutritional supplementation. Aims and Objective: The primary end point was to assess loss of weight and BMI during treatment. The secondary end point is assessment of compliance to stipulated treatment time, frequency of nasogastric tube feeding, intravenous support, and duration of hospital admission. Materials and Methods: This was a prospective observational study performed in Radiation Oncology department of a tertiary care center. Consecutive patients of HANC requiring definitive or adjuvant RT (±chemotherapy) were included. Nutritional status assessment and diet counseling were done before start of RT, and further weekly assessment of body weight and BMI was done. Results: Between December 2017 and December 2018, 128 patients were included in this study. Sitewise distribution were oral cavity, oropharynx, hypopharynx, and larynx in 69, 33, 9, and 17 patients, respectively. Weight loss and BMI comparison were done at the start and end of RT (mean weight: 53.86 kg; 95% confidence interval [CI]: ± 1.71, mean BMI: 21.52; 95% CI: ± 0.95 [at the start of RT] and mean weight: 48.30 kg; 95% CI: ± 1.58, mean BMI: 19.18; 95% CI: ± 0.88 [at the end of RT]).There was a significant reduction in weight (P < 0.0001, S) and BMI (P = 0.00034, S), respectively. During the treatment, a total of 14 patients were put on nasogastric tube feeding, and 23 patients were admitted for parenteral nutrition with median hospital stay of 3 days (range: 1–5 days). Conclusions: There is a significant weight loss and change in BMI during CRT in HANC patients. Regular assessment and active nutritional intervention are required in all patients to improve compliance.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125562805","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}
Pradosh Kumar Sarangi, Nachiketa Mangaraj, Keshaba Panigrahy, A. Jajodia
The Torricelli-Bernoulli sign is a useful computed tomographic sign seen in ulcerated/necrotic gastrointestinal stromal tumor (GIST) or leiomyosarcoma characterized by the collection of air in the nondependent aspect of larger gastrointestinal cavitating tumors. This sign is based on the physical principle of the law of Torricelli's and Bernoulli's principle. Herein, we describe this interesting imaging sign in an adult male with malignant duodenal GIST with extensive hepatic, peritoneal, omental, and lymph nodes (though rare in GIST) metastasis. The patient succumbed few days after admission.
{"title":"Ulcerated duodenal gastrointestinal stromal tumor – Demonstration of an interesting radiological sign (the Torricelli-Bernoulli sign)","authors":"Pradosh Kumar Sarangi, Nachiketa Mangaraj, Keshaba Panigrahy, A. Jajodia","doi":"10.4103/oji.oji_33_19","DOIUrl":"https://doi.org/10.4103/oji.oji_33_19","url":null,"abstract":"The Torricelli-Bernoulli sign is a useful computed tomographic sign seen in ulcerated/necrotic gastrointestinal stromal tumor (GIST) or leiomyosarcoma characterized by the collection of air in the nondependent aspect of larger gastrointestinal cavitating tumors. This sign is based on the physical principle of the law of Torricelli's and Bernoulli's principle. Herein, we describe this interesting imaging sign in an adult male with malignant duodenal GIST with extensive hepatic, peritoneal, omental, and lymph nodes (though rare in GIST) metastasis. The patient succumbed few days after admission.","PeriodicalId":431823,"journal":{"name":"Oncology Journal of India","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130311603","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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