Indian Journal of Cancer
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   2009| January-March  | Volume 46 | Issue 1  
    Online since March 6, 2009

 
 
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LETTERS TO EDITOR
Changing trends in incidence of breast cancer: Indian scenario
NS Murthy, K Chaudhry, D Nadayil, UK Agarwal, S Saxena
January-March 2009, 46(1):73-74
DOI:10.4103/0019-509X.48603  PMID:19282574
  17,229 1,612 38
ORIGINAL ARTICLES
Study of 'patterns of care' of ovarian cancer patients in a specialized cancer institute in Kolkata, eastern India
P Basu, P De, S Mandal, K Ray, J Biswas
January-March 2009, 46(1):28-33
DOI:10.4103/0019-509X.48592  PMID:19282563
Background Ovarian cancer is one of the leading cancers in Indian women. The current standard of care is a combination of surgical staging, maximal surgical effort to achieve cytoreduction, and judicious use of chemotherapy. Multimodality therapy can reduce mortality, but the practice and uptake of such therapy in Indian Institutions are not up to the desired level. Objectives To study the protocol adherence for ovarian cancer management along with patient compliance and evaluate their effects on survival. Materials and Methods: The retrospective study obtained and analyzed data from records of patients operated for ovarian cancer at a Regional Cancer Center in eastern India between January 2002 and December 2006. Results: The records of 202 patients were evaluable. None of the patients who had primary surgery outside the institute had staging information. A substantial number of patients operated at the institute had incomplete surgical staging, inadequate information on residual disease after surgery, and incomplete histology report. Only 20.3% patients could have optimal cytoreduction after surgery. Compliance to chemotherapy was poor. The median overall survival time and disease-free survival time were 24 months and 5 months, respectively. The residual disease after surgery significantly affected the overall survival, but not the disease-free survival. Incomplete chemotherapy was found to adversely affect survival after adjusting for advanced stage and bulky residual disease. Conclusion: Management of ovarian cancer is suboptimal even in the specialized cancer institute. Poor patient compliance to chemotherapy is one of the major factors adversely affecting survival from advanced ovarian cancer.
  10,184 705 15
Prognostic significance of bone marrow histology in multiple myeloma
R Subramanian, D Basu, TK Dutta
January-March 2009, 46(1):40-45
DOI:10.4103/0019-509X.48594  PMID:19282565
Background: Bone marrow examination continues to be the cornerstone for establishing the diagnosis of multiple myeloma in association with other clinical and laboratory parameters. Plasma cell morphology has significant correlation with clinical stage and survival. Aims: To note the bone marrow histology in detail in multiple myeloma and to correlate it with clinical stage and survival. Methods and Material: Fifty-five cases of multiple myeloma diagnosed between January 2001 and December 2006, who had a bone marrow aspiration and biopsy done at the time of diagnosis were included in the present study. Statistical Analysis: SPSS software version 13.0 was used. Clinical stage and plasma cell morphology were correlated using chi square test and Spearman's correlation coefficient. Survival analysis was done using the Kaplan-Meier method. Results: Seventy-six percent patients were in clinical stage III, 17% and 7% were in stage II and I respectively. The clinical stage correlated significantly with plasma cell morphology, percentage of plasma cell infiltration and pattern of infiltration. Plasma cell morphology correlated significantly with bone marrow parameters like percentage infiltrate, pattern of infiltration, degree of fibrosis and mitotic activity. Patients in advanced clinical stage, >50% plasma cells in the marrow, diffuse pattern of infiltration, high mitosis and increased fibrosis had a shorter median survival than patients with favorable features. Conclusions: It is recommended that the bone marrow histology be studied in detail in multiple myeloma at diagnosis since it correlates well with the clinical stage and offers useful prognostic information.
  8,790 829 11
Desmoid tumors: Experience of 32 cases and review of the literature
V Kumar, S Khanna, AK Khanna, R Khanna
January-March 2009, 46(1):34-39
DOI:10.4103/0019-509X.48593  PMID:19282564
Background: Desmoids are infiltrative, locally destructive, soft tissue tumors. Although they do not metastasize, the incidence of local recurrence is quite high. Aim : Present study aimed at reporting the 10-year experience of 32 desmoid cases and reviewing some facts with symptoms, investigation, and treatment of the disease. Materials and Methods : Thirty two cases of desmoid tumors were reviewed over a 10-year span. Surgical resection and adjuvant radiotherapy were the treatments of choice whenever histological margins were positive . Results : Multiparous women in reproductive age were the most commonly afflicted. The commonest site of presentation was the abdominal wall. Ninety one percent (20/22) were infraumbilical. The tumors were found in the rectus sheath in 14 patients (64%) and were laterally situated in 8 patients (36%). Local infiltration was found in six patients and the urinary bladder was most commonly involved (3/6). Locally recurrent desmoids were seen in eight patients (25%). Conclusions : In our experience, 25% of the desmoid tumors (8/32) were recurrent and postoperative radiotherapy did not seem to influence the local recurrence rate. The most important predictor for recurrence was tumors of >5 cm.
  8,872 719 17
REVIEW ARTICLES
Cell phones and tumor: Still in no man's land
DR Kohli, A Sachdev, HS Vats
January-March 2009, 46(1):5-12
DOI:10.4103/0019-509X.48589  PMID:19282560
The use of cell phones is increasing worldwide at a phenomenal pace. While cellular communication has dramatically influenced our lifestyle, its impact on human health has not been completely assessed. Widespread concern continues in the community about the deleterious effects of radiofrequency radiations (with which cell phones operate) on human tissues and the subsequent potential for carcinogenesis. A detailed survey of published studies researching this question was done in preparation of this manuscript. Included in the survey were case reports, in vitro studies, population based retrospective studies and other investigations. The database of indexed journals was searched for key words like 'cell phone', 'radiation', 'cancer' and 'radio waves'. Guidelines issued by the World Health Organization, federal and technical authorities, Institute of Electrical and Electronic Engineers and the International Commission for Non-Ionizing Radiation Protection were reviewed. The evaluation of current evidence provided by various studies to suggest the possible carcinogenic potential of radiofrequency radiation is inconclusive. This risk assumes significance in light of the burgeoning number of people who are continually exposed to the high frequency radiation from cell phones and towers that serve as receiving and transmitting stations. The aim of this review is to identify limitations in past studies, present available data for consideration, and identify gaps in the current knowledge base. This will provide impetus and direction for further research and allow informed decisions pertaining to cell phone use to be made.
  8,577 908 6
CASE REPORTS
Mucosal malignant melanoma of the nasal cavity
KA Bothale, SA Maimoon, AD Patrikar, SD Mahore
January-March 2009, 46(1):67-70
DOI:10.4103/0019-509X.48600  PMID:19282571
Mucosal malignant melanoma (MMM) of the nose is extremely rare. We report a case of MMM of the nasal cavity in a 60-year-old male patient presenting with a polypoidal mass in the right nasal cavity. It was increasing gradually and obstructing breathing. A biopsy of the lesion was done with a clinical suspicion of inverted papilloma/carcinoma. Microscopy revealed features suggestive of malignant melanoma with minimal melanin pigmentation. Subsequently wide local excision was done. Diagnosis of malignant melanoma was facilitated by histochemistry and immunohistochemistry.
  7,281 551 6
ORIGINAL ARTICLES
Primary testicular non-Hodgkin lymphoma: A single institution experience from India
D Gupta, A Sharma, V Raina, S Bakhshi, BK Mohanti
January-March 2009, 46(1):46-49
DOI:10.4103/0019-509X.48595  PMID:19282566
Background: Primary testicular non-Hodgkin lymphoma (NHL) is an uncommon extra nodal presentation, constituting 1% of all NHL. Median age at time of presentation is 60 years. Anthracycline based chemotherapies are most frequently used. There is not enough data on use of monoclonal antibody (Rituximab) in testicular NHL. Methods: We screened approximately eight hundred and fifty NHL cases registered from January 2002 to May 2008 and found six primary testicular NHL patients. These six cases were analyzed for baseline clinical features, investigations, staging, treatment and outcome variables. Results: Median age was 55 years (range 7-72 years) and median duration of symptoms was 3.5 months (range 1-8 months). All patients had testicular swelling and abdominal lymphadenopathy. Five patients (83%) had stage IV and one had stage IE disease. Majority had diffuse large B-cell histology (83%). All patients were treated with anthracycline based combination chemotherapy and CNS prophylaxis after local therapy except one pediatric patient who did not receive any local therapy. Four patients completed therapy and are on follow up while two patients having extensive disease with poor performance status died of neutropenic sepsis after 1-2 cycles of chemotherapy. The surviving four patients achieved complete remission and are without any recurrence with a median follow up of 26 months (1-78 months). Conclusion: Primary testicular NHL is an uncommon entity and with current combined modality treatment and CNS prophylaxis, the outcome may be as good as nodal NHL.
  5,049 574 2
CASE REPORTS
Recurrent alpha-fetoprotein secreting Sertoli-Leydig cell tumor of ovary with an unusual presentation
UR Poli, G Swarnalata, R Maturi, ST Rao
January-March 2009, 46(1):64-66
DOI:10.4103/0019-509X.48599  PMID:19282570
Alpha-fetoprotein secreting (AFP) Sertoli-Leydig cell tumors of ovary (SLCT) are now identified as a distinct entity among the uncommon group of sex cord tumors of ovary. We report an unusual case of recurrent AFP secreting ovarian tumors and as ileocecal mesenteric cyst in a 25-year-old patient resulting in difficulty in initial diagnosis of AFP producing SLCT. Although six recurrent cases were described out of the 25 reported cases of AFP secreting SLCTs, this patient with an unusual presentation of recurrence is the second case in the literature to the best of our knowledge.
  4,410 420 7
EDITORIAL
Tackling the cancer Tsunami
P Kumar, GS Bhattacharyya, S Dattatreya, H Malhotra
January-March 2009, 46(1):1-4
DOI:10.4103/0019-509X.48588  PMID:19282559
  4,340 437 3
LETTERS TO EDITOR
Refractory hypokalemia due to conventional amphotericin B in patients with leukemia
AV Bamba, MP Jadhav, R Prabhu, S Ray, NJ Gogtay, FF Jijina, NA Kshirsagar
January-March 2009, 46(1):76-76
DOI:10.4103/0019-509X.48605  PMID:19282576
  4,411 334 1
ORIGINAL ARTICLES
A comparative study of low dose weekly paclitaxel versus cisplatin with concurrent radiation in the treatment of locally advanced head and neck cancers
RK Jain, P Kirar, G Gupta, S Dubey, SK Gupta, J Goyal
January-March 2009, 46(1):50-53
DOI:10.4103/0019-509X.48596  PMID:19282567
Purpose: The purpose of this study was to compare low dose weekly paclitaxel versus cisplatin with concurrent radiation in locally advanced head and neck cancers. Materials and Methods: From August 2005 to July 2006, a total of 100 biopsy proven, locally advanced head and neck cancers were enrolled for the study. All the patients were stratified in two groups, study group A and control group B. Study group patients received injection Paclitaxel 20 mg/m 2 , I/V 1 hr infusion weekly for 6 weeks and control group patients received injection Cisplatin 30 mg/m 2 , I/V 2 hrs infusion weekly for 6 weeks. All patients received 66-70 Gy concurrent radiation at the rate of 2 Gy/day, 5 #/week, in 6-7 weeks by cobalt theratron phoenix - 80 teletherapy units. Result: Complete response achieved in 73% of patients in study group and 64% of patients in control group. There was no statistically significant difference observed between the study group and the control group (χ2 = 1.167, df = 1, level of significance 0.05). On 3-10 months of follow-up 59% of patients in the study group and 42% of patients in the control group are alive and disease free. Local toxicities including mucositis, dysphasia and skin reactions were more in the study group but tolerable. Conclusion: Efficacy of paclitaxel in low dose weekly schedule is comparable to cisplatin in locally advanced head and neck squamous cell carcinoma. Further analysis and follow-up are needed to evaluate if this benefit will translate into prolonged survival.
  4,229 501 8
Survival effects of cyclooxygenase-2 and 12-lipooxygenase in Egyptian women with operable breast cancer
AA Zeeneldin, AM Mohamed, HA Abdel, FM Taha, IA Goda, WT AboDeef
January-March 2009, 46(1):54-60
DOI:10.4103/0019-509X.48597  PMID:19282568
Background: Breast cancer (BC) is the commonest among women in Egypt as well as in many other countries. Cyclo-oxygenase-2 (COX-2) and 12-lipo-oxygenase (12-LOX) are over-expressed in 30-40% of patients and carry a poor prognosis. The objectives of this study were to correlate COX-2 and 12-LOX expression with various clinico-pathologic patients' characteristics and their impact on overall survival (OS) and disease free survival (DFS) in Egyptian women with operable BC. Materials and Methods: This prospective study included 57 consecutive BC cases presenting to the Egyptian National Cancer Institute. Sections from BC and nearby normal tissues were examined for expression of COX-2 and 12-LOX using reverse transcriptase polymerase chain reaction. Results: The patients' median age was 45 years. Fifty-three percent were premenopausal. Stage II and III disease represented 25 and 75% respectively. Adjuvant chemotherapy, radiotherapy and tamoxifen were used in 90, 75 and 60% respectively. Sixty percent had hormone-receptor positive tumors and 28% over-expressed HER2/neu. Forty-nine and sixty-five percent showed over-expression of COX-2 and 12-LOX respectively. Patients with higher TNM stage or who developed visceral metastases had significantly higher COX-2 expression. For the whole group of patients, the median DFS was 37 months, while the median OS was not reached. OS or DFS did not differ significantly between patients with normal and over-expression of COX-2. DFS but not OS was significantly higher in 12-LOX over-expression compared to normal expression. Conclusion: COX-2 over-expression was associated with poor prognostic criteria in BC, but did not affect DFS or OS. 12-LOX over-expression was associated with better DFS, but not OS.
  4,022 467 12
CASE REPORTS
Coexistent hepatic and pulmonary epitheloid hemangioendothelioma
N Kalra, R Kochhar, K Vaiphei, V Virmani, TD Yadav, N Khandelwal
January-March 2009, 46(1):61-63
DOI:10.4103/0019-509X.48598  PMID:19282569
Epitheloid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin known to arise in soft tissue, liver and lung. We describe a case of coexistent hepatic and pulmonary epitheloid hemangioendothelioma, proven on autopsy, and review the histological and radiological features of epitheloid hemangioendothelioma. The coexistence of hepatic with pulmonary EHE has been reported in only a few cases. Large confluent masses, peripheral location with capsular retraction, hypertrophy of uninvolved liver, invasion of portal and hepatic veins, enhancing margins and delayed enhancement and dense calcification are the typical features which provide a clue to diagnosis of hepatic EHE. In patients with both hepatic and pulmonary EHE it is difficult to say whether the tumor arose primarily in the lung or liver, or began simultaneously in both organs.
  3,720 377 1
REVIEW ARTICLES
Endocrinological cancers and the internet
HK Bid, R Konwar, S Kumar
January-March 2009, 46(1):17-27
DOI:10.4103/0019-509X.48591  PMID:19282562
Endocrine cancers are some of the commonest forms of cancer getting mention as early as in old papyruses of Egypt. Our current knowledge about this cluster of cancer has grown immensely with improved survival rates. In the era of specialization and super specialization, we started peeking into these conditions more elaborately and beyond microscopically. The growing awareness demanded categorization of information into disease basics like molecular pathology of initiation and progression; advanced diagnostics; new therapeutic options; patient awareness and involvement in clinical trials. Recent advances in genomics and hereditary counseling have delineated pre-disease forecasting possibilities. With advanced diagnostics and therapeutic modalities, we saw an increase in cancer survivors demanding extra care and moral support. Throughout these developments, we went through a boost in global information communications, the main thrust being the Internet. Networking of computers globally generated a platform that created a ripple of knowledge far and wide. The purpose of this review is to investigate how the Internet is supporting the growth and development of the field of endocrine cancer, and present and future scope of the Internet as a tool for professionals involved in this area. The information furnished here were collected from cited references as well as all websites mentioned in the tables.
  3,341 395 -
Oncologists should measure life, not death: A newer perspective of cancer statistics
A Srivastava, A Sood
January-March 2009, 46(1):13-16
DOI:10.4103/0019-509X.48590  PMID:19282561
We discuss why we should measure parameters of 'life' and not 'death' in choosing a therapy for cancer and what are the flaws and difficulties in measuring cancer specific deaths. We then submit those parameters which can be measured with high precision and validity in cancer patients and so should be recorded to guide us in deciding the best therapy.
  3,078 481 1
LETTERS TO EDITOR
Castleman's disease: A rare diagnosis in retroperitoneum
KS Shahi, G Bhandari, PK Hota
January-March 2009, 46(1):75-76
DOI:10.4103/0019-509X.48604  PMID:19282575
  2,994 329 1
Rare occurrence of carcinoma esophagus in a case of epidermolysis bullosa
A Ray, S Bhattacharya, A Kumar, K Bhattacharya
January-March 2009, 46(1):72-73
DOI:10.4103/0019-509X.48602  PMID:19282573
  2,458 455 2
Transitional cell carcinoma urinary bladder manifesting as second malignancy following radiotherapy for carcinoma cervix
Subhajeet Dey, Joseph Sebestian Philipraj, Shankarnarayanan
January-March 2009, 46(1):71-72
DOI:10.4103/0019-509X.48601  PMID:19282572
  2,414 292 -
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