No. 1

Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery

Pages: 16-32
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Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery

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DOI: 10.18488/journal.95/2014.1.1/95.1.16.32

Valentina Krstevska , Snezhana Smichkoska , Beti Zafirova-Ivanovska

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Valentina Krstevska , Snezhana Smichkoska , Beti Zafirova-Ivanovska (2014). Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery. Cancers Review, 1(1): 16-32. DOI: 10.18488/journal.95/2014.1.1/95.1.16.32
Background. There is limited data on adjuvant treatment following surgery in patients with squamous cell carcinoma of the oral tongue. 
Aims. This retrospective study investigates prognostic value of different factors for local relapse-free survival (LRFS), regional relapse-free survival (RRFS), disease-free survival (DFS), and overall survival (OS) in patients with oral tongue cancer treated with adjuvant therapy following surgery. 
Materials and methods. Forty six patients with surgically treated oral tongue cancer were enrolled in the analysis. Adjuvant therapy consisted of postoperative radiotherapy (PO-RT) or postoperative concurrent chemoradiotherapy (PO-CCRT). All patients received three dimensional conformal radiotherapy. Weekly cisplatin was given as concurrent chemotherapy. Identification of prognostic factors for survival was done with univariate analysis. Multivariate analysis was used for factors confirmed as significant on univariate analysis. 
Results. Independent prognostic factors negatively influencing LRFS, DFS, and OS were ECOG performance status (p = 0.002, p = 0.013 and p = 0.022, respectively), overall stage (p = 0.011, p = 0.010 and p = 0.009, respectively), and pathologic nodal classification (p = 0.016, p = 0.011 and p = 0.015, respectively). Surgical margin status was an independent prognostic factor for RRFS, DFS, and OS (p = 0.032, p = 0.027 and p = 0.028, respectively). The type of adjuvant treatment used was independently prognostic for lower rates of LRFS and DFS (p = 0.029 and p = 0.010, respectively).
Conclusions. Positive postoperative nodal status and close or positive resection margins had the most prominent negative prognostic influence on patients’ survival.  

Contribution/ Originality
This study is one of very few studies which have investigated potential prognostic factors that might influence treatment outcome exclusively in patients with squamous cell carcinoma originating from the oral tongue whose adjuvant therapy following surgery consisted of postoperative radiotherapy or postoperative concurrent chemoradiotherapy. 

Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study

Pages: 5-15
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Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study

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DOI: 10.18488/journal.95/2014.1.1/95.1.5.15

Navneet Kaur , Akhil Garg , Anupama Tandon , Usha Rani Singh

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Navneet Kaur , Akhil Garg , Anupama Tandon , Usha Rani Singh (2014). Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study. Cancers Review, 1(1): 5-15. DOI: 10.18488/journal.95/2014.1.1/95.1.5.15
Background: The current recommendation for evaluation of axilla in patients with early breast cancers is Sentinel Lymph Node Dissection. Axilllary node sampling (ANS) has been validated as an alternative, but its reliance on palpation for localization of axillary nodes limits its precision. Pre-operative ultrasound guided localization can be combined with ANS to overcome this limitation. We conducted this study to find the accuracy of Ultrasound Guided Axillary Node Sampling (UGANS) in predicting the status of the axilla in patients with  breast cancer.
Methods: Forty patients of carcinoma breast with clinically negative axilla underwent pre-operative ultrasonography to identify  axillary nodes with suspicion of metastatic involvement. Identified nodes were marked on the skin by a permanent marker and depth from the  surface was recorded. The patients underwent mastectomy/breast conservation surgery with axillary dissection. The pre-operatively marked  nodes were first dissected out under guidance of the skin markings and  subsequently complete axillary lymph node dissection (ALND) was  performed. Based on histopathological correlation, accuracy of UGANS was calculated taking ALND as the gold standard.
Results: Thirty eight (95%) patients had successful marking of axillary nodes by ultrasonography (USG) (Mean 3.89 nodes). Thirty four (85%) patients had successful sampling of marked nodes (Mean-3.76 nodes). There was a higher rate of sampling failure in patients with negative axilla ( 3/17, 17.6%) than those with axillary metastasis ( 1/21,  4 .76% ).  Patients in whom marked nodes could not be localized were mostly young (mean age 39 years), had significantly higher body mass index (BMI) score   ( mean 31.38 Kg/m2  versus 24.84 kg/m2 , p = 0.006), and smaller size of marked nodes ( mean 0.99 cm in failure group versus 1.03 cm in successful group). The nodes sampled with USG guidance reflected the status of axilla with accuracy of 100%
Conclusion: The present study establishes the feasibility and accuracy of UGANS as a potential cost effective axillary staging modality in low resource settings. However, more studies with a larger sample size are required to validate these initial results.

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A Systematic Review to Explore the Scope of Global Interventions to Reduce the Incidence of Gastric Cancer

Pages: 1-4
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A Systematic Review to Explore the Scope of Global Interventions to Reduce the Incidence of Gastric Cancer

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DOI: 10.18488/journal.95/2014.1.1/95.1.1.4

Saurabh Ram Bihari Lal Shrivastava , Prateek Saurabh Shrivastava , Jegadeesh Ramasamy

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Saurabh Ram Bihari Lal Shrivastava , Prateek Saurabh Shrivastava , Jegadeesh Ramasamy (2014). A Systematic Review to Explore the Scope of Global Interventions to Reduce the Incidence of Gastric Cancer. Cancers Review, 1(1): 1-4. DOI: 10.18488/journal.95/2014.1.1/95.1.1.4
Globally, gastric cancer has been acknowledged as a disease of public health concern because of its related morbidity, deaths and influence on multiple dimensions of the quality of life of the patient and their family members. The objective of this article is to systematically review the published literature on the potential risk factors of gastric cancer, and eventually suggest range of interventions to eventually minimize the prevalence of gastric cancer. An extensive search of all materials related to the topic was made using library sources including Pubmed, Medline, World Health Organization website and Google scholar searches for one month. Keywords used in the search include Gastric cancer, health, and Helicobacter pylori. Multiple ranges of factors have been attributed to the causation of gastric cancer in heterogeneous settings. To counter the consequences of gastric cancer, there is a crucial need to develop and implement a public health strategy to enable early detection of the cancer. In conclusion, in the global aim to reduce the burden of gastric cancer, the need of the hour is to formulate comprehensive & cost-effective strategies well supported by intensified awareness campaigns and strengthening of the health care delivery system.
Contribution/ Originality
This study explores the potential risk factors of gastric cancer, and suggests multiple interventions to minimize the prevalence of gastric cancer on a global scale.