Open Access Original Research Article

Granulosa Cell Tumour of Ovary: Review of Cases at Tertiary Care Centre

Geeta Acharya, T. S. Premalatha, Kiran A. Kulkarni, G. Sumangala, B. Vishakha

Journal of Cancer and Tumor International, Page 1-7
DOI: 10.9734/JCTI/2018/47008

Introduction: Granulosa cell tumours of the ovary are rare malignancies representing 2-3% of all malignant ovarian tumours.

Objective: To review the clinical characteristics and management of granulosa cell tumour of ovary.

Materials and Methods: The medical records of nine women diagnosed with granulosa cell tumour of ovary from June 2005 to October 2015 in the Department of Gynecologic Oncology of our institution were retrospectively reviewed.

Results: The mean age of the women was 42 years. They presented with various symptoms: menorrhagia, post-menoausal bleeding, abdominal distension and pain abdomen. In one patient who presented with abdominal pain and distension with breathlessness, chest X-ray showed? metastatic lesions and received neoadjuvant chemotherapy. Eight patients underwent primary surgery with complete staging in six patients. Two patients presented with haemoperitoneum and underwent emergency laparotomy. Four patients had ascites. Mean ovarian tumour size was 14 cms (range 4-30 cms). Fertility sparing surgery was done in one patient. The number of patients in various stages were I - 4(IA-3, IC2-1); IIA-1; IIIC-1; IVB-1 and unknown - 2 accord­ing to the International Federation of Gynecology and Obstetrics (FIGO) 2014 criteria. The maximum follow up duration was 65 months. Recurrence was observed after 3 years in two patients (one stage IA and other stage IIIC).

Conclusion: Granulosa cell tumours are classified into two types by juvenile and adult variant. GCT has low malignant potential and known to recur after many years of apparent clinical cure. Therefore, long term follow up with clinical examination and tumour marker is recommended.

Open Access Original Research Article

Comparative Analysis between an Anthracycline Based Regimen and a Platin Based Regimen in Neoadjuvant Setting for Triple-negative Breast Cancer: A Single Institutional Retrospective Study

Satadru Biswas, Ritam Joarder, Krishnangshu Bhanja Choudhury, Shilpi Adhikary, Santanu Acharyya, Chandan Dasgupta

Journal of Cancer and Tumor International, Page 1-7
DOI: 10.9734/JCTI/2018/46585

Objective: This study was designed to comparatively analyse the response and survival between Carboplatin plus Paclitaxel (TP) vs. 5FU plus Epirubicin plus Cyclophosphamide (FEC) in ER, PR and HER-2 neu negative Breast Cancer patients of locally advanced breast cancer (LABC), large operable breast cancer (LOBC) and selected early breast cancer (EBC) patients as Neoadjuvant Chemotherapy (NACT).

Methods: In this single institutional retrospective study total 73, AJCC 7th Stage group IIB ∼ IIIB, TNBC patients were included. Patients received 6 cycles of either Inj. Paclitaxel 175 mg/m2 IV plus Inj. Carboplatin at an AUC 5 IV on day1, every 21 days or Inj. 5FU 500 mg/m2 IV plus Inj. Epirubicin100 mg/m2 IV plus Inj. Cyclophosphamide 500 mg/m2 IV on day1, every 21 days. Response was assessed after 6 cycles using RECIST v1.1. Modified Radical Mastectomy (MRM) and adjuvant Post Mastectomy Radiation Therapy (PMRT) were done as and when indicated. Survival benefit was comparatively analysed in terms of median progression free survival (mPFS) and Overall Survival (OS).

Results: Out of total 73 Triple-negative Breast Cancer(TNBC) patients 37 (3 EBC, 11 LOBC and 23 LABC) received FEC and 36 (2 EBC, 13 LOBC and 21 LABC) received TP. Age, menopausal status and number of first/second degree relatives affected, Nottingham Prognostic Index (NPI) were closely comparable for both arms. MRM could be done in 62.2% (FEC) and 86.1% (TP) patients (p value 0.020). Post- NACT pathological T0 (ypT0) was achieved in 13.5% & 41.7% patients of FEC and TP arms, respectively (p value 0.007). Complete response (CR) and partial response (PR) were achieved in 13.5% and 43.2% (FEC arm) vs. 33.3% and 63.9% (TP arm); p value 0.001. mPFS was 13 months(FEC) vs. 17 months(TP) (p value 0.001). No significant difference in terms of severe hematological toxicities was found (21.6% Vs 22.2%, p=0.61) though neurological toxicities were slightly more common in TP arm.

Conclusion: Platin-taxane combination chemotherapy was proven promising over anthracycline-based combination chemotherapy in neo-adjuvant setting while treating TNBC of various stages in terms of efficacy considering tolerable toxicity profile.

Open Access Original Research Article

Retinoblastoma – Lessons Learned about Patterns of Care and Contributory Factors from 5 Years’ Experience in a Tertiary Care Center in Eastern India

Debjit Ghosh, Bidyut Mondal, Abhishek Basu, Janmenjoy Mondal, Shubhendu Gangopadhyay

Journal of Cancer and Tumor International, Page 1-11
DOI: 10.9734/jcti/2018/v8i230093

Objectives: Retinoblastoma is the most common intraocular malignancy afflicting children worldwide. Even though there are enough data about the epidemiology of retinoblastoma in western population, there are only few reports from developing countries like India. In this retrospective study, we aimed to describe the epidemiological patterns, survival characteristics and prognostic factors of retinoblastoma.

Materials and Methods: From medical records, we retrospectively analyzed the data of 68 children diagnosed in our hospital between January 2013 and December 2017 as having retinoblastoma. Data on sex, religion, laterality, age at diagnosis, presenting signs, family history, lag time for treatment, cause of such lag time and spread of tumor, treatment mode, and survival time were collected.

Results: The median age of onset was 22 ± 19.73 months (range 2-92 months).The median  patient age of onset of  the unilateral cases was 23 ± 20.6 months, and that of the bilateral cases was 21 ±16.2 months. The median overall survival was 28.1±2.2 months. For unilateral cases, it was 30.1±2.5 months and for bilateral cases it was 19.7±2.9 months. The overall progression free survival (PFS) was 22.2±2.3 months. For unilateral cases, it was 24.18±2.7 months and for bilateral cases it was 13.9±2.9 months.

4 cases of familial retinoblastoma were reported. Among the 13 bilateral cases, 3 were found to have pinealoblastoma too. On Cox regression analysis, age of onset below 36 months, diagnostic delay of less than 5 months and delay of treatment initiation (after diagnosis) less than 2 months were found to have significant effect on OS. The former two were found to have significant effect on PFS but not the latter (p<0.05 and HR>1).

Conclusions: Almost 81% of patients presented at an advanced stage of the disease, the reason being accounted by diagnostic and therapeutic delay by virtue of a number of causes, the major one being eluded by apparently nonviolent yet ineffective alternative medicine practices. In spite of following the institutional protocols which are at par to the international guidelines, analysis shows much poorer survival in this study compared to those of developed countries. The cause might be such late presentation of the cases in already advanced stages of the disease.

Open Access Original Research Article

Autoimmune Haemolytic Anaemia in Patients with Cancer Diagnoses

Kaladada Ibitrokoemi Korubo, Oseikheumen Adebayo Ejele, Chijioke Adonye Nwauche

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/jcti/2018/v8i230095

Aims: To determine if AIHA plays a role in anaemia associated with malignancies, and ascertain the cancers in which AIHA occurs.

Study Design: This was a cross-sectional case-control study.

Place and Duration of Study: Department of Haematology and Blood Transfusion, University of Port Harcourt Teaching Hospital, Rivers, Nigeria.

Methodology: We conducted the study on patients with malignancies either on admission in the wards or attending follow up clinics. Healthy age/sex-matched subjects were used as controls. Cases with and without chemotherapy were analyzed as subgroups. Three hundred and seventy-six (376) participants (188 cancer patients and 188 controls) were enrolled in the study. Full blood count, reticulocyte count, blood film, direct antiglobulin test (DAT), indirect antiglobulin test (IAT) and bilirubin assays were conducted on anticoagulated blood samples of all the patients and controls. The DAT was performed on a fresh sample not more than 6 hours after collection using polyspecific anti-human globulin.

Results: Three (1.6%) of the 188 patients with malignancies were found to have a positive DAT of which 2 (1.1%) had strongly positive DAT with features of haemolysis and therefore had AIHA. The two patients with AIHA had chronic lymphocytic leukaemia. The third case was a weak positive DAT with malignant teratoma but did not have features of haemolysis. The cases of both AIHA and DAT were found in the group without chemotherapy. AIHA was the aetiology of anaemia in 2 (2%) of the 98 cases who had anaemia and were chemotherapy naive.

Conclusion: AIHA plays a minor role in the aetiology of anaemia in cancer and is more common in lymphoid malignancies. A positive DAT may occur without features of haemolysis.

Open Access Review Article

Technological Applications in Skin Cancer Prevention

Jennings Hernandez, Anjali Kumar

Journal of Cancer and Tumor International, Page 1-7
DOI: 10.9734/jcti/2018/v8i230096

In the United States, skin cancer is the most common cancer diagnosed. The three types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Of those, basal and squamous cell carcinomas are the most diagnosed skin cancer types. Both of which are curable, however they can mar skin in addition to being expensive to fight. Melanoma places in third for being diagnosed. All three types of skin cancer are linked to ultraviolet light rays which come from the sun, tanning beds and sunlamps. The checklist for early detection includes being aware of changes to your skin, visiting a licensed dermatologist or primary care physician to receive a body scan and assess for any skin concerns. By the same token, phone apps, recognition technologies, and devices for early detection have become a few of the forward-thinking prevention techniques for the future because of the knowledge that early detection leads to a better survival outcome. These phone apps analyzing digital images of moles and lesions for instance and determining the risk of cancer. This paper will delve into several apps that are on the market for smartphones that can be used for prevention of skin cancer. For example, Nevisense is a device used in office that's FDA-approved, painless and there's no downtime. In minutes, a doctor can use it on sunspots and moles that look suspicious or concerning. The device sends an electrical frequency into the skin and depending on the way the current travels, the device will notify the doctor whether a biopsy is recommended.