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Gauthier Mcclure posted an update a month ago
Squamous cell carcinoma oral tongue (SCCOT) in patients below 45 years is relatively uncommon in literature; however, there have been increasing trends in incidence. Previous studies showed conflicting data, with no conclusive evidence of differences in outcome compared with older patients. The aim of our study was to determine if younger patients with tongue cancer in India had different clinico-pathological characteristics, prognostic determinants or survival than their older counterparts. Retrospective analysis of 425 adult patients of SCCOT, with 114 patients less then 45 years of age (younger group) and 311 patients ≥ 45 years of age (older group), treated with surgery and adjuvant as indicated. Clinical and pathological features were described. Survival analysis was performed using Kaplan Meier’s method and multivariate analysis was performed for recurrence and survival using Cox proportional hazards ratio. Younger patients had a higher incidence of adverse pathological features (APFs) like lymphovascular invasion (p = 0.01), perineural invasion (p = 0.009), poorer differentiation (p = 0.044), nodal involvement (p = 0.021), extranodal extension (p = 0.003) and local recurrence (p = 0.008). All of these factors were noted to impact survival. However, on multivariate analysis for APFs, age was not an independent predictor of recurrence or survival. Younger patients with squamous cell carcinoma of tongue have an increased risk of APFs and local recurrence. The clinical observation that young patients have a worse outcome is likely due to the association of APFs rather than age being an independent prognostic factor. Further study is required to show if tumour biology in this cohort is distinct.Fine-needle aspiration biopsy (FNAB) is the first-line modality in the evaluation of thyroid nodules. However, the results of indeterminate pathology place the thyroid surgeon in difficult management situations. This study evaluates McGill Thyroid Nodule Score (MTNS) to identify thyroid nodules that harbor malignancy in cases of indeterminate FNABs and to guide surgeon about the need and extent of surgery. We conducted a retrospective chart review of 344 patients who underwent total thyroidectomy between January 2013 and January 2018. Patients with FNAB of indeterminate nodules (Bethesda types III, IV, and V) and calculated MTNS were included in the study. Postoperative histopathology was divided into benign and malignant groups. The median and the mean MTNS, the malignancy rate, and the standard deviations were calculated for each subgroup. Of the 344 patient charts reviewed, 106 (30.8%) had an indeterminate FNA biopsy. Eighty-one (76.4%) patients were females and 25 (23.6%) were males. Final pathology revealed malignancy in 69 patients (65.1%). The mean MTNS of patients with malignant pathology (12.81 ± 3.55) was higher than the mean in the benign group (8.32 ± 2.32). 82.4% of thyroid nodules with median MTNS of less than 8 had a benign pathology, and 91.4% of thyroid nodules with median MTNS equal or more than 11 had a malignant pathology (p = 0.002). The rate of malignancy in our series of indeterminate FNABs was 65.1%. The MTNS can be of value to thyroid surgeons in preoperative decision-making when dealing with an indeterminate thyroid nodule.A combination of cytoreductive intervention with the intrahepatic hyperthermic chemotherapy is a well-established treatment of peritoneal carcinomatosis. There are many challenges in establishing a new peritoneal surface malignancy program in a low-income country regarding perioperative safety and resource allocation. We analyzed the retrospective database to determine the immediate surgical outcomes of the first 28 patients with peritoneal carcinomatosis and the impact of the program on allocation of general hospital and human resources. During the preparatory stage, web conferences with international experts established the goals and general requirements of the program, formalized in a written document; and a peritoneal surface malignancy multidisciplinary team was established. The team created the patient selection criteria, perioperative management checklists, and suggested material and staff requirements for surgical and anesthesia services. Twenty-nine cytoreduction were carried out, of which 18 were followed by HIPEC. The average operative time was 6.2 h. The median blood loss was 350 mL, which did not result in additional blood transfusion requirements for the blood bank. No additional nursing and supportive staff were provided for the ICU and the surgical unit. The average postoperative stay was 8.7 days. One patient died with 30-day mortality rate of 3%. Proteinase K datasheet Ten patients (34.5%) developed postoperative complications, of which 6 (20.6%) had grade III and higher Clavien-Dindo complications. Establishing a peritoneal surface malignancy program is possible via staged planning, liberal use of international mentors, and thoughtful resource allocation. This new program did not result in a significant redistribution of resources among other service lines of cancer care within the same institution.Context The therapeutic role of D2 lymphadenectomy in the management of gastric cancer is an ongoing controversy. Aims To examine the morbidity and oncological outcomes of D2 lymph node dissection for gastric cancer patients treated in a stand-alone cancer center in rural India and to compare it with international data. Settings and design Retrospective study on patients treated for gastric cancer from June 2009 to December 2014. Methods and material All patients underwent subtotal or total gastrectomy with modified D2 lymph node dissection preserving spleen and pancreas. The Clavien-Dindo model was used to stratify the severity of morbidity. Statistical analysis Descriptive statistics was used for data exploration. Chi-square test was used to compare the association of various factors with survival. Kaplan-Meier method was used to calculate the survival rates (RFS and DFS). Log-rank test was used to compare the survival of different subgroups. Results Fifty-four patients (41 males and 13 females) were included in the study.