Indian Journal of Cancer
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   2005| October-December  | Volume 42 | Issue 4  
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Pattern of metastases in renal cell carcinoma: A single institution study
B Sivaramakrishna, Narmada P Gupta, Pankaj Wadhwa, Ashok K Hemal, Prem N Dogra, Amlesh Seth, Monish Aron, Rajeev Kumar
October-December 2005, 42(4):173-177
Background: Increasing numbers of patients with renal cell carcinoma (RCC) are incidentally detected and can be potentially cured by surgery alone. In treating metastatic RCC, worthwhile survival rates are achieved in cases of low burden recurrences. This necessitates a rational follow up protocol, which picks up early recurrences and avoids costly surveillance for those with a favorable prognosis. Aims: We studied the patterns of metastases occurring in patients operated for localized or locally advanced renal cell carcinoma in the Indian setting and try to evolve a suitable follow up protocol. Setting and Design: Institution based, retrospective data. Method and Materials: Records of patients from January 1988 to December 2003, operated for initially localized RCC were reviewed. Follow up was performed using an established protocol. Occurrence of metastases and their patterns were studied. Statistical analysis used: Comparison of the different survival times was performed using the one-way analysis method. Multiple comparisons (post hoc test) were performed using the Bonferroni method. Result: Follow up was available on 209 patients. Mean survival was 43.75 months (SD ? 28.72). Thirty-nine patients developed 59 metastases. Lungs were the commonest site of metastases (37%), followed by bone (22%), liver (19%) and brain (8%). Relapse and survival showed significant correlation with pathological stage (p < 0.001), with higher stage being associated with greater relapses and lesser survival. There was no correlation between site of recurrence and stage of disease. Conclusions: Occurrence of metastases correlate with the pathological stage of the disease at primary presentation. Tailored, stage-based follow up protocols allow adequate surveillance for disease activity and progression without escalating the overall costs.
  14 5,769 619
Quality of life of head and neck cancer patient: Validation of the European organization for research and treatment of cancer QLQ-C30 and European organization for research and treatment of cancer QLQ-H&N35 in Indian patients
DA Chaukar, AK Das, MS Deshpande, PS Pai, KA Pathak, P Chaturvedi, AC Kakade, RW Hawaldar, AK DCruz
October-December 2005, 42(4):178-184
Aims: To present the first cross-culture validation of the European organization for research and treatment of cancer (EORTC) quality of life questionnaires, the EORTC-QLQ-C30, and the QLQ-H&N35 in India. Settings and Design: These questionnaires were translated into two vernacular languages and pilot test was done on 15 patients. Two hundred head and neck cancer patients completed the QLQ-C30 and the QLQ-H&N35 at two time points during their treatment. Psychometric evaluation of the structure, reliability, and validity of the questionnaire was undertaken. Results: The data supports the reliability of the scales. Validity was tested by item-scale, scale--scale correlation and by performing known group comparisons. The results demonstrated that the items correlated with their respective scale and no significant correlation was found between scales. The questionnaire was responsive to change over a period of time. Summary: This data suggests that the EORTC QLO-C30 and the QLQ-H&N35 are reliable and valid questionnaires when applied to a sample of head and neck cancer patients in India.
  12 4,883 726
Primary malignant melanoma of cervix - a case report
R Gupta, S Singh, AK Mandal
October-December 2005, 42(4):201-204
Primary malignant melanoma is a rare neoplasm involving the uterine cervix. It may be misdiagnosed especially when amelanotic, in which case immunohistochemistry is useful in reaching the diagnosis. Though its staging and treatment are not yet well codified, prognosis is generally poor and unpredictable and hence early diagnosis is needed. We present the case of a 39-year-old female patient presenting with bleeding per vaginum. Speculum examination revealed an ulcero-proliferative growth involving the cervix. Microscopic examination of the tumor showed sheets of predominantly monomorphic cells, with few cells showing dark-brown pigment. The cells were positive for S-100 and HMB-45. In view of presence of subtle epitheliotropism, diagnosis of primary melanoma was entertained. Primary cervical melanoma should be considered while diagnosing cervical neoplasms, especially those displaying prominent eosinophilic nucleoli, even though this feature may be present only focally. Special staining and immunohistochemistry should be resorted to, whenever needed, to reach the diagnosis as early as possible. This is essential since cervical melanoma is incurable with the currently available therapies.
  8 6,585 359
Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule
S Basu, N Nair, AM Borges
October-December 2005, 42(4):205-207
Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule), who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.
  5 4,282 320
Serum ferritin in renal cell carcinoma: Effect of tumor size, volume grade, and stage
Kamal Jeet Singh, SK Singh, Amit Suri, Vivek Vijjan, AK Goswami, Madhu Khullar
October-December 2005, 42(4):197-200
Aim: To study the levels of serum ferritin in patients of renal cell carcinoma (RCC). Patients and methods: Serum ferritin levels were measured preoperatively in 32 patients with radiological evidence of RCC using an enzyme immunoassay. The largest diameter of the primary tumor was measured in the pathological specimens in patients undergoing radical nephrectomy while in patients with nonoperable tumor maximum tumor dimension was taken from CT scan. Pathological staging was done according TNM-1997. Results: Mean serum ferritin value in patients of RCC was 283.23 77.38 ng/ml while in controls the mean value was 79.98 32.96 ng/ml (P < 0.001) which was statistically significant. The sensitivity, specificity, and positive predictive value of serum ferritin in RCC observed was 92.6, 73.86, and 81.85%, respectively. Conclusions: Serum ferritin levels are elevated in patients with RCC although its actual source is unclear. Further studies are needed to establish the role of ferritin in RCC.
  5 4,135 368
Follicular dendritic cell tumour of tonsil - Is it an under-diagnosed entity?
R Bothra, PS Pai, P Chaturvedi, TA Majeed, C Singh, S Gujral, SV Kane
October-December 2005, 42(4):211-214
Neoplasms of follicular dendritic cells are uncommon and while majority of them occur in lymph nodes, they are increasingly recognized at varied sites such as abdominal viscera. Tonsil is the most common extra nodal site for occurrence of FDCT in the head and neck region. We describe three cases of follicular dendritic cell tumour occurring in the tonsil.
  4 3,954 302
Effect of preoperative short - course famotidine on TILs and survival in breast cancer
R Parshad, P Hazrah, S Kumar, S Datta Gupta, R Ray, S Bal
October-December 2005, 42(4):185-190
Background: Histamine receptor antagonists have been shown to induce tumor-infiltrating lymphocytes (TILs) in colonic cancers and improve survival. The role of histamine receptor anatagonists in breast cancer is unclarified. Aim: To evaluate the role of histamine receptor antagonists in inducing (TILs) in breast cancer. Method: Forty-five patients with operable breast cancers (25 cases who received preoperative famotidine and 20 controls) were studied for the effect of famotidine in inducing TILs and survival in breast cancer. Results: Significant TILs were seen in 75% (18/24) of cases as opposed to 35% (7/20) controls. In logistic regression analysis the only variable found to be predictive of TILs was famotidine, odds ratio 7.324 (1.693-31.686) P = 0.008. In Cox's regression presence of TILs was favorably associated with improved disease free survival at a median follow up of 35.56 months. The hazard ratio for disease relapse was 3.327 (1.174-9.426) P = 0.024 in TIL negative as compared to TIL positive patients. Famotidine use alone was not significant in the original model, however, on incorporation of quadrant of involvement in addition to other established prognostic factors in the above multivariate model, it assumed borderline significance with a hazard ratio for disease free survival 3.404 (1.005-11.531, P = 0.049). Conclusions: Preoperative short course famotidine induces TILs in breast cancer. Patients with TILs demonstrable in tumor specimens had an improved disease free survival. Famotidine may improve disease free survival in breast cancer and these findings need validation in larger population subsets.
  4 4,990 420
High resolution computed tomography findings on the lung of early breast-cancer patients treated by postoperative breast irradiation with a hypofractionated radiotherapy schedule
GA Plataniotis, ME Theofanopoulou, K Sotiriadou, M Vlychou, GA Fountoulis, J Fezoulidis
October-December 2005, 42(4):191-196
Context: Hypofractionated breast radiotherapy (RT), although convenient for patients and health care systems, could have a negative impact on normal tissues such as lung. Aims: To evaluate radiation-induced lung toxicity in early breast-cancer patients treated by hypofractionated RT. Settings and Design: We have been using the 42.5 Gy/16 fractions RT schedule since May 2003. As large fraction size is related to increased normal tissue toxicity we intended to investigate the possible radiation-induced lung toxicity to these patients, by performing high-resolution computed tomography (HRCT) 6 months after the completion of the treatment. Methods and Material: A group of 30 consecutive early breast cancer patients (T1-2N0M0) have been treated by the above-mentioned RT schedule, using a pair of opposing tangential fields. The impact of chemotherapy and hormonotherapy and various breast size-related parameters on HRCT lung changes were investigated. Acute skin and breast tissue reactions were also recorded. Statistical analysis: used Correlation of numerical variables was investigated by Pearson correlation coefficient. Logistic regression analysis was used to investigate correlation between HRCT findings (present vs absent) with other variables. Results: Minimal HRCT findings were evident in 15/30 patients. These included small septal lines, linear and subpleural opacities and to a lesser extend, focal-ground glass opacification. The HRCT findings were positively correlated only to field separation (distance between the entrance points of the tangential beams on the breast) (H.R.=1.33, 95% CI: 1.013-1.75). Conclusions: The short 16-fraction RT schedule for early breast-cancer patients appears to have a minor effect on the underlying lung parenchyma.
  4 3,792 331
Familial testicular tumour in two brothers- a case report
MK Gupta, RK Seam, DS Gurung, S Kanika
October-December 2005, 42(4):208-210
Testicular tumors account for 1% of all cancers in men and it occurs in 1 in 500 men. Incidence of familial testicular tumours is rare. Total number of cases till the year 1992 in identical twins is 21, in brothers 82 and father-son both affected in 31 pairs. We report a case of two brothers presenting simultaneously with testicular tumours. Both were subjected to retrograde orchidectomy. Histopathologic examination of one revealed embryonal cell carcinoma and other mature teratoma of the testis. Patient with embryonal carcinoma was given adjuvant chemotherapy based on Bleomycin, Etoposide and cisplatinum (BEP) and one with mature teratoma was put on a follow up.
  1 3,440 257
Role of soluble transferrin receptors study in hepatocellular carcinoma with underlying cirrhosis
R Mehta, D Suvarna, CP Mustafa, S Sadasivan
October-December 2005, 42(4):215-215
  1 2,429 226
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  2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow