{"title":"High Fluorescent Cells on Automated Body Fluid Analysis as Discriminator for Malignant Cell Detection","authors":"Ankita Saini, Rateesh Sareen, G. N. Gupta","doi":"10.1055/s-0043-1776287","DOIUrl":"https://doi.org/10.1055/s-0043-1776287","url":null,"abstract":"The automated examination of body fluids (BF) serves as a valuable screening tool for the presence of malignant cells in such samples. Malignant cells are identified as high fluorescence cells (HFC) when analyzed using the Sysmex XN-1000 automated analyzer. This study aimed to assess the correlation between HFC cell counts generated by the automated analyzer and manual cytological examination for detecting malignant cells. Additionally, it sought to establish reliable cutoff values for malignant cells since there is a lack of literature on this subject. Conducted at the department of pathology hematology and cytology laboratory in a tertiary care hospital in India from January 2019 to May 2020, this hospital-based comparative study analyzed 120 BF samples, each subjected to cytological evaluation. The mean age of the study population was 52 years, with 70 male and 50 female patients (male-to-female ratio of 1.4:1). The samples consisted of 53 ascitic fluids (44.17%), 46 pleural fluids (38.33%), and 21 cerebrospinal fluids (CSF; 17.50%). Cytopathological examination revealed malignant cells in 50 (41.67%) of the BF samples, with 70 (58.33%) samples classified as nonmalignant. Specifically, among the ascitic fluids, 24 (48%) were malignant, while 29 (41.43%) were nonmalignant. For pleural fluids, 24 (48%) were malignant, and 22 (31.43%) were nonmalignant. In CSF, 2 (4%) samples were malignant, and 19 (27.14%) were nonmalignant. The total white blood cell counts provided by automated hematology analyzers were significantly higher in malignant samples, ranging from a minimum of 100 cells to a maximum of 60,000, with a median count of 800. Nonmalignant samples had white blood cell counts ranging from 2 to 12,000, with a median count of 100. Subgroup analysis for ascitic, pleural, and CSF samples revealed significantly higher median HFC counts in malignant samples. Receiver operating characteristic curve analysis indicated that the HF-BF parameter could effectively distinguish between benign and malignant fluids. For HF#, the area under the curve (AUC) was 0.844, with a sensitivity of 82% and specificity of 81%, while HF% had an AUC of 0.706, with sensitivity and specificity values of 72% and 72.9%, respectively. This study highlights that the HFC count in the BF mode of Sysmex XN-1000 can be a valuable tool for predicting the presence of malignant cells in serous fluids and for selecting samples for further microscopic examination. Based on this study, cutoff values of 15.70/µL for absolute HFC count and 5.05% for relative HFC count can be applied to screen BF samples for malignancy, offering good sensitivity and specificity.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"5 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136317761","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}
{"title":"Initial Experiences in Adolescents and Young Adults with T-Cell Acute Lymphoblastic Leukemia/Lymphoma Treated with the Modified BFM 2002 Protocol in a Resource-Constrained Setting","authors":"Prutha Jinwala, Rajesh Patidar, Shashank Bansal, Vikas Asati, S.P. Shrivastava, Aditya Elhence, Swati Patel, P.G. Chitalkar","doi":"10.1055/s-0043-1776040","DOIUrl":"https://doi.org/10.1055/s-0043-1776040","url":null,"abstract":"T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/LBL) in adolescents and young adults (AYAs) is a clinically aggressive malignancy and life-threatening at diagnosis. Intensive chemotherapy protocols, inspired by the Berlin-Frankfurt-Münster (BFM) regimen, along with central nervous system (CNS) prophylaxis, have achieved a 75 to 85% 5-year disease-free survival rate. However, in cases of marrow and CNS relapses, second-line chemotherapy is usually ineffective. This study aimed to assess the safety and efficacy of the BFM 2002 protocol and to correlate clinical profiles and prognostic factors with survival outcomes in AYA T-ALL/LBL patients. We retrospectively analyzed data from T-ALL/LBL patients treated at the Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences (SAIMS), Indore, between 2018 and 2021. Twenty-one patients aged 15 to 29 years were studied for their clinical course and laboratory parameters over 36 months. Diagnosis and risk stratification were performed following the guidelines of the BFM 2002 protocol. All patients received treatment and monitoring according to this pediatric-inspired protocol. The median age of the patients was 17 years (range: 15–28 years). Eleven patients presented with mediastinal lymph node enlargement, 10% exhibited CNS involvement, and none had testicular involvement. Eleven patients had marrow blasts greater than 25%, indicative of acute lymphoblastic leukemia. All 21 patients were treated according to the intensive modified BFM 2002 protocol and achieved morphological remission after a median follow-up of 24 months (range: 18–36 months). Seventeen patients achieved minimal residual disease (MRD) negativity post-induction. MRD at day 33 showed a significant association with the probability of disease relapse (p = 0.0015). There were five deaths (24%), one due to toxicity and four due to relapse. The study recorded an 18-month overall survival of 76%. These results were achieved despite financial constraints. Data were entered into a spreadsheet, and statistical analysis was performed using IBM SPSS version 23. Continuous data are presented as ranges and medians, while categorical variables are shown as percentages and numbers. A chi-squared test for association, with a significance level set at p < 0.05, was conducted as indicated. AYA T-ALL/LBL requires intensive treatment regimens. With biological characterization of LBL/ALL and close therapy monitoring, encouraging outcomes can be achieved even in resource-limited settings.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136033628","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}
{"title":"A Prospective Randomized Controlled Trial to Study the Role of Sulfasalazine in the Prevention of Acute Gastrointestinal Toxicities in Patients of Carcinoma of the Cervix Receiving Concurrent Chemoradiation","authors":"Vasireddy Abhinav, Naga Chandra Sekhar Darisi, Amrutha Iyyapu, V.L Anusha Konakalla","doi":"10.1055/s-0043-1776041","DOIUrl":"https://doi.org/10.1055/s-0043-1776041","url":null,"abstract":"The present study aimed to evaluate the effectiveness of sulfasalazine in preventing acute gastrointestinal (GI) toxicities in patients with cervical carcinoma receiving concurrent chemoradiation. This prospective randomized controlled study was conducted at the Department of Radiotherapy from November 2016 to April 2018. A total of 60 eligible patients (30 in arm A and 30 in arm B) were enrolled in the study. Patients in arm A received 5,000 cGy of external beam radiotherapy (EBRT) in 25 fractions concurrently with chemotherapy using cisplatin (40 mg/m2 weekly) and tablet sulfasalazine (1 g twice a day). Patients in arm B received 5,000 cGy of EBRT in 25 fractions concurrently with chemotherapy using cisplatin (40 mg/m2 weekly) without any prophylactic medication. The acute GI toxicities assessed in this study included diarrhea, abdominal pain, tenesmus, and rectal bleeding. The chi-squared test was employed to compare the toxicity grades in the two arms. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 21, with statistical significance considered at p < 0.05. The results showed a significant decrease in the incidence of grade 2 or higher diarrhea in the study arm compared to the control arm. Additionally, there was a decrease in the incidence of grade 1 or higher abdominal pain in the study arm. A decrease in the incidence of grade 1 or higher tenesmus was also observed, although the difference was not statistically significant. Rectal bleeding decreased significantly. Sulfasalazine was found to be a cost-effective and safe method for reducing the incidence of radiation-induced acute GI toxicities in cervical carcinoma patients undergoing radiotherapy.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136142324","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}
Mir Sadaqat Hassan Zafar, Sajad Ahmad Geelani, Javid Rasool Bhat
{"title":"Analysis of Treatment Outcome in Large Granular Lymphocytic Leukemia: A Retrospective Study from India","authors":"Mir Sadaqat Hassan Zafar, Sajad Ahmad Geelani, Javid Rasool Bhat","doi":"10.1055/s-0043-1773806","DOIUrl":"https://doi.org/10.1055/s-0043-1773806","url":null,"abstract":"Large granular lymphocytic (LGL) leukemia is a rare and indolent lymphoproliferative disorder that belongs to mature T and natural killer (NK) cell neoplasms, as per the World Health Organization classification. This article assesses the response to immunosuppressive therapy. In this retrospective study, various cases of chronic lymphoproliferative disorders (CLPDs) evaluated and treated in two tertiary care settings were screened and taken for subanalyses. After fulfilling the criteria for LGL leukemia, cases were further assessed for presenting features and response to treatment. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 23. Out of 384 cases of CLPDs analyzed, 14 cases of LGL leukemia were identified (3.64%) and subjected to further analysis. There were six males (42.85%) and eight females (57.14%) (M: F = 1:1.33) with an age group ranging from 42 to 82 years. Thirteen cases (92.85%) were T-LGL type, and one case belonged to NK-LGL type (7.14%). Anemia was the most common presentation (92.85% of cases), followed by lymphocytosis (85.71% of cases) and neutropenia (78.57% of cases). Four patients (28.57%) presented with thrombocytopenia, and two patients presented with pancytopenia (14.28%). Splenomegaly was seen in two patients (14.28%), and lymphadenopathy in one patient (7.14%). One patient (7.14%) had rheumatoid arthritis, and one (7.14%) had recurrent chest infections. Out of the 14 cases, 5 (35.71%) attained complete remission, 5 (35.71%) attained partial remission, 2 patients were resistant to first-line treatment, and 2 patients were closely followed with observation only. The overall treatment response rate was 83.33%. This study highlights the excellent response rates with immunosuppressive therapy in a rare lymphoproliferative disorder.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853883","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}
Shalu Kasliwal, Ranjith K., Pramod Reddy, Narendra Maharaj, Gopichand M., Aditya Adhav, Kamlesh Harsh, Nagesh Madnoorkar, Ashok Diwan, Mamraj Gupta, Ghanshyam Patel, Srinivas B. J., Mikhail Vladimirovich Dvorkin
{"title":"Comparison of Efficacy and Safety of a Bevacizumab Biosimilar, in Combination with Chemotherapies, in Nonresectable Metastatic Colorectal Cancer and in Advanced Nonsquamous Non–Small Cell Lung Cancer: A Randomized, Double-Blind, Phase III Study","authors":"Shalu Kasliwal, Ranjith K., Pramod Reddy, Narendra Maharaj, Gopichand M., Aditya Adhav, Kamlesh Harsh, Nagesh Madnoorkar, Ashok Diwan, Mamraj Gupta, Ghanshyam Patel, Srinivas B. J., Mikhail Vladimirovich Dvorkin","doi":"10.1055/s-0043-1774403","DOIUrl":"https://doi.org/10.1055/s-0043-1774403","url":null,"abstract":"The objective of this study was to compare the efficacy, safety, pharmacokinetics, and immunogenicity of a proposed bevacizumab biosimilar (DRL_BZ) with the innovator Avastin (reference medicinal product [RMP]) in patients with nonresectable metastatic colorectal cancer (mCRC) over a period of 9 months and advanced nonsquamous non–small cell lung cancer (NSCLC) over 6 months. The study was planned as a randomized, double-blind trial. In part A, a total of 117 mCRC patients were intended to receive 5 mg/kg of bevacizumab every 2 weeks along with mFOLFOX6 chemotherapy for a maximum of 18 cycles. In part B, 60 NSCLC patients were to receive 15 mg/kg of bevacizumab every 3 weeks along with pemetrexed and carboplatin for the initial four cycles, followed by pemetrexed for another four cycles. The primary endpoint was the progression-free survival rate at 6 months (PFS6) in both subparts. The anticipated sample size was 106 evaluable mCRC patients to achieve 85% statistical power for concluding noninferiority with a margin of half the difference (18.8%) between DRL_BZ and Avastin, along with a pilot study involving 60 evaluable NSCLC patients. Safety comparison included assessing adverse events (AEs), infusion reactions, and lab abnormalities. Immunogenicity comparison involved the incidence of antidrug antibodies (ADAs) and neutralizing antibodies (NAbs). Pharmacokinetic comparison was planned after the first and fourth dosing cycles of treatment in 24 NSCLC patients. The PFS6 for mCRC patients treated with DRL_BZ and RMP was 57.8% and 50% respectively, with a difference in efficacy of 7.8 (–8.7, 23.7). The PFS9 was 31.1% and 22.9%, with a difference of 8.2% (–6.9%, 22.9%). The objective response rate (ORR) for DRL_BZ and RMP was 28.8% and 22.4%, while the disease control rate (DCR) was 44.2% and 37.9% respectively. For NSCLC patients, the PFS6 was 44% and 45%, showing a difference of –1.0 (–4.2, 22.1). The ORR was 41.4% and 48.1%, and the DCR was 62.1% and 63%. The frequency, type, and severity of AEs were similar in both indications. Blood levels during the first and fourth dosing cycles exhibited comparable values. All NSCLC patients tested negative for ADA, while no mCRC patients on DRL_BZ tested positive for ADA. Low incidences of ADA (8%) and NAbs (4.0%) were reported in patients on RMP. Overall, the efficacy, safety, immunogenicity, and pharmacokinetic parameters of DRL_BZ and RMP were found to be comparable. Clinical Trial Registration For BZ-01-002: CTRI/2016/01/006481","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853729","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}
{"title":"Prevalence and Pattern of Nodal Metastases in Ovarian Malignancy: A Perioperative Audit","authors":"Ashok Padhy, Sony Nanda, Bhagyalaxmi Nayak","doi":"10.1055/s-0043-1775818","DOIUrl":"https://doi.org/10.1055/s-0043-1775818","url":null,"abstract":"It is still unclear whether or not full nodal dissection and detailed staging offer any benefits. Little is known regarding the degree of nodal involvement based on histotype. We aimed to assess the lymphatic dissemination patterns and prevalence in early-stage epithelial ovarian cancer and identify the underlying risk factors for nodal metastases. This is a prospective study conducted over a period of three years. Institutional ethics committee approval has been obtained. A total of 157 consecutive patients with apparently early-stage ovarian cancer, who were treated at the Department of Gynecologic Oncology, Acharya Harihar Post Graduate Institute of Cancer (AHPGIC) from January 2020 to January 2023, were included. The most frequent grade was 3 (66.8%), and the most common histotype was high-grade serous ovarian cancer (HGSOC; 55.4%), followed by mucinous (16.5%) and endometrioid (14.01%) varieties. Seromucinous and clear cell ovarian cancers were found infrequently. The most common pattern was isolated pelvic nodal involvement in 48.9% of patients, followed by both para-aortic and pelvic nodal involvement in 25.5% of patients; 13 patients had isolated para-aortic nodal involvement. HGSOC was most commonly associated with isolated metastasis to the pelvic lymph nodes alone, while the endometrioid variety was prone to both pelvic and para-aortic spread. Out of the 55 patients with nonserous tumors, 12.72% exhibited nodal involvement. Most nonserous tumors showed affinity for both pelvic and para-aortic (42.85%) nodal metastases. Only grade 3 and serous histology showed a positive association with nodal metastasis. Approximately 45.2% of cases showed upstaging after surgical staging procedures. Multicentric studies are essential to analyze the prognostic impact of systematic lymphadenectomy in ovarian carcinoma patients, depending on the histotype and distribution pattern of nodal metastases.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853730","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}
{"title":"Usefulness of Indian Diabetes Risk Score in Predicting Treatment-Induced Hyperglycemia in Women Undergoing Adjuvant Chemotherapy for Breast Cancer","authors":"Krishna Prasad, Sanath Hegde, Suresh Rao, Rhea Katherine D'souza, Thomas George, Manjeshwar Shrinath Baliga, Sucharitha Suresh","doi":"10.1055/s-0043-1775805","DOIUrl":"https://doi.org/10.1055/s-0043-1775805","url":null,"abstract":"In the curative treatment of cancer with adjuvant chemotherapy, antineoplastic drugs, along with glucocorticoids, can induce hyperglycemia. The objective of this study was to assess the utility of the Indian Diabetes Risk Score (IDRS) in predicting treatment-induced hyperglycemia in women who were nondiabetic and normoglycemic at the start of chemotherapy. This prospective study was conducted with nondiabetic women who required adjuvant chemotherapy. Participants voluntarily completed the IDRS, providing information on age, waist circumference, family history of diabetes, and physical activity. Chemotherapy-induced hyperglycemia was defined as fasting blood glucose levels ≥100 mg/dL or random blood glucose levels ≥140 mg/dL during treatment. Data were categorized into women who developed hyperglycemia and those who remained normoglycemic during treatment and were analyzed using Fisher's exact test. A significance level of p < 0.05 was applied. Receiver operating characteristic (ROC) curves were constructed to validate the IDRS for predicting hyperglycemia. A total of 208 women met the inclusion criteria and participated in the study. The results revealed that 38.93% (81/208) developed hyperglycemia by the end of chemotherapy, as observed during their first follow-up after treatment. Fisher's exact test demonstrated a significant difference in the total IDRS score and its domains, including family history, physical activity, and waist circumference (p = 0.017–< 0.001), but not age. ROC analysis indicated that an IDRS score above 60 increased the likelihood of developing hyperglycemia, with a sensitivity of 81.3%, specificity of 54.7%, and an area under the curve of 0.727. These findings suggest that the IDRS is a sensitive tool for predicting adjuvant chemotherapy-induced hyperglycemia in breast cancer patients without diabetes. To the best of the authors' knowledge, this is the first study to evaluate the utility of the IDRS in predicting treatment-induced hyperglycemia in women undergoing adjuvant chemotherapy for breast cancer. Ongoing efforts are focused on understanding the underlying mechanisms and strategies for mitigation.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853885","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}
{"title":"The Islanded Nasolabial Flap: A Versatile and Reliable Flap for Reconstruction in Cancers of the Oral Cavity","authors":"Amar Jain, Sandeep Ghosh, Deepak Bhojwani, Abhishek Sharma","doi":"10.1055/s-0043-1775846","DOIUrl":"https://doi.org/10.1055/s-0043-1775846","url":null,"abstract":"Abstract Sandeep Ghosh On the Indian subcontinent, oral cancer represents a significant health burden. Local flaps offer a viable alternative to free flaps in specific reconstructive scenarios where free flaps may not be feasible. The islanded nasolabial flap, based on the facial artery, proves to be a robust and versatile option for single-stage reconstructions of oral cavity defects. In this study, we share our experience employing the islanded nasolabial flap at a high-volume cancer center in Central India for reconstructing buccal mucosa and tongue defects. This prospective observational study focused on approximately 76 patients diagnosed with squamous cell carcinoma of the oral cavity (specifically, the anterior 2/3rd of the tongue and buccal mucosa) at our cancer hospital between August 2021 and January 2023. Initially, 76 patients were included; however, four patients were subsequently excluded due to inadvertent facial vein injury during neck dissection caused by level IB node invasion. Consequently, 72 patients underwent islanded nasolabial flap reconstruction and were monitored for postoperative complications and functional outcomes. Our study's patients fell within the age range of 24 to 81 years, with the majority between 40 and 50 years old. Most of our patients had carcinoma affecting the anterior two-thirds of the tongue (61.11%), followed by carcinoma of the buccal mucosa (38.88%). Surgical site infection occurred in four patients (5.55%) at the donor site, and one patient (1.38%) experienced flap necrosis after tongue carcinoma surgery. However, the majority of our patients (93.05%) experienced no postoperative complications. Speech intelligibility was good for all patients (100%) with buccal mucosa cancer. A significant portion of patients (78.57%) could tolerate a normal diet, while 21.42% required a soft diet. Among patients with tongue carcinoma, 56.81% had good speech intelligibility, and 43.18% had acceptable speech intelligibility. Regarding swallowing capacity assessment, 65.90% of patients tolerated a normal diet, and 34.09% could manage a soft diet. None of our patients had poor speech intelligibility, and none depended on a liquid diet or tube feeding. This study underscores the versatility of the islanded nasolabial flap in oral cancer resection reconstruction. The islanded nasolabial flap proves to be a straightforward, effective, and reliable technique with a low incidence of complications and exceptional functional outcomes, establishing it as a valuable reconstructive option for small-to-medium-sized oral defects. This is particularly noteworthy for high-volume centers and regions with limited resources.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134944443","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}
{"title":"Evaluation and Clinicopathological Correlation of ALDH1 in Colorectal Adenoma with Low-/High-Grade Dysplasia and Carcinoma.","authors":"Himanshi Bhanu, Ruchi Mittal, Urmila Senapati","doi":"10.1055/s-0043-1774402","DOIUrl":"https://doi.org/10.1055/s-0043-1774402","url":null,"abstract":"Colorectal carcinoma (CRC) stands as one of the most prevalent malignant neoplasms, carrying significant morbidity and mortality implications. Within colorectal carcinogenesis, cancer stem cells are recognized as key contributors, infusing tumors with aggressive traits, including chemoresistance. A group of enzymes known as ALDH1 exhibits stem cell properties, potentially playing a role in colorectal neoplasms. This study aims to evaluate ALDH1 expression in colonic neoplasms and its correlation with clinicopathological parameters. The research encompasses 50 consecutive cases, involving CRC (30) and colorectal adenoma (20), gathered prospectively from September 2019 to August 2021, as well as archived cases from January 2018 to August 2019. Histological examination was conducted on CRC cases to assess tumor type, grade, lymphovascular invasion, perineural invasion, mitosis, and necrosis, while colorectal adenomas were subjected to histological grading. ALDH1 immunohistochemistry was performed on both CRC and adenoma specimens. Statistical analysis utilized SPSS 20 software, employing the chi-squared test and Fischer's exact test. A higher count of adenoma cases displayed positive staining (p = 0.0005) and greater expression (p = 0.036) in comparison to carcinoma cases. The other clinicopathological parameters didn't demonstrate notable associations. Adenomas with low-grade dysplasia exhibited a higher frequency of positive ALDH1 staining and expression than those with high-grade dysplasia. In malignant cases, a higher proportion of positive staining was observed in lower-stage disease compared to higher-stage disease. The heightened staining and expression outcomes of ALDH1 in adenomas versus carcinomas, as well as their presence in lower-stage carcinomas, suggest the potential acquisition of novel mutations and the proliferation of distinct clonal stem cell subsets during disease progression. The absence of ALDH1 in adenoma/carcinoma could indicate a poorer prognosis and an increased likelihood of disease progression to a higher stage. Comprehensive multi-institutional and validation studies are needed to enhance our understanding of ALDH1's role in colorectal oncogenesis, as well as its viability as a targeted or personalized therapy option.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135478793","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}
Sarita Shrivastva, Stalin Chowdary Bala, Rachana Chennamaneni, Meher Lakshmi Konatam, Venkateswara Rao Pydi, Kuruva Siva Prasad, Sadashivudu Gundeti
{"title":"Trastuzumab-Related Cardiotoxicity in Adjuvant Setting: A Real-World Scenario","authors":"Sarita Shrivastva, Stalin Chowdary Bala, Rachana Chennamaneni, Meher Lakshmi Konatam, Venkateswara Rao Pydi, Kuruva Siva Prasad, Sadashivudu Gundeti","doi":"10.1055/s-0043-1768039","DOIUrl":"https://doi.org/10.1055/s-0043-1768039","url":null,"abstract":"Trastuzumab, a humanized monoclonal antibody, significantly improves outcomes in HER2-neu positive breast cancer. The incidence of cardiotoxicity with trastuzumab is approximately 8 to 10%. This study was designed to analyze the incidence and risk factors associated with trastuzumab-related cardiotoxicity in real-world settings. This was a single institutional retrospective analysis of the incidence of trastuzumab-related cardiotoxicity in nonmetastatic HER2-positive, invasive breast cancer from January 2013 to December 2018. Trastuzumab-related cardiotoxicity was defined as symptomatic heart failure or asymptomatic decline in left ventricular ejection fraction (LVEF) by more than or equal to 10% or LVEF less than 50%. Risk factors analyzed were higher body mass index (≥30 kg/m2), history of diabetes, hypertension, cardiac disease, left-sided radiotherapy (RT), and prior exposure to anthracyclines. Out of the 246 patients diagnosed with early stage HER2-positive breast cancer, 117 (47.5%) received trastuzumab and constituted the study population. Trastuzumab-related cardiotoxicity was seen in a total of 16 (13.6%) patients. Eleven (9.4%) patients had an asymptomatic decline, while symptomatic LV dysfunction was seen in five (4.2%) patients. The median baseline ejection fraction was 65% (range, 56–72). The median time to development of cardiotoxicity was 18.5 weeks (range, 3–52) and the median trastuzumab cycle for cardiotoxicity was 6 (range, 2–16). Ten (62.5%) patients were rechallenged with trastuzumab following which one patient developed an asymptomatic decline in ejection fraction and one patient developed symptomatic heart failure. Cardiac-related mortality was seen in one (0.85%) patient. Left-sided RT to chest (p = 0.012) and presence of more than or equal to two risk factors (p = 0.01) had significant impact on incidence of cardiotoxicity. Approximately 14% developed trastuzumab-related cardiotoxicity that was slightly higher compared with that seen in clinical trials. Left-sided RT to chest and presence of two or more risk factors had significant impact on development of cardiotoxicity.","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135534904","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}