Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a su... more Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a surgeon in the emergency department. It accounts for 6.3% of all intestinal obstructions. In the acute setting, it often presents with abdominal distention, vomiting and constipation. This study aims to analyse clinical and aetiopathological features associated with large bowel obstruction and the outcome of various modalities of managing LBO. Patients and Methods: In this prospective study, patients above 18 years of age presenting to the emergency department of our hospital with features suggestive of dynamic intestinal obstruction were selected. After confirmation of the diagnosis and its underlying aetiology, they were managed either surgically or conservatively. The patient outcome in terms of complications and mortality were evaluated. Results: Out of 53 patients, 29 were males and 24 were females. The most common cause of large bowel obstruction was colonic malignancy in 27 patients (50.94%) followed by colonic volvulus in 15 patients (28.30%). Majority of patients (45) underwent surgery. The most common procedure done in our study was resection and anastomosis in 29 patients. 20% of the cases suffered from wound infection. Out of 53 cases in our study 27 patients had an uneventful post-operative period and 13 patients had delayed recovery. The total number of deaths in the study was 5 (12.5%). Conclusion: Prompt diagnosis and timely appropriate surgery in large bowel obstruction with available modern equipment and anaesthesia reduces morbidity, mortality, hospital stay and gives a satisfactory outcome.
reached (NE) for PCO and was 43.2 months for PC (p = 0.043, HR 0.35). Methods This Phase 3, doubl... more reached (NE) for PCO and was 43.2 months for PC (p = 0.043, HR 0.35). Methods This Phase 3, double-blind, placebo-controlled, multicenter trial, has enrolled patients from 14 countries. Patients with optimally debulked with FIGO III/IV EOC and serum CA125 ! 50 U/ml receiving adjuvant (Cohort 1) or neoadjuvant (Cohort 2) chemotherapy were randomized post-surgery to PCO or PCP. Patients with germline BRCA1/ 2 mutations were excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with an additional dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with an additional dose at 6-and 18-weeks following cycle 6. The primary objective is PFS determined by RECIST 1.1 criteria. Current Trial Status At the time of abstract submission, 618 patients were enrolled and target enrolment Cohort 1 (378) and Cohort 2 (240) was achieved.
Purpose or Objective Even if evidence of post-mastectomy radiotherapy (PMRT) in patients with T1-... more Purpose or Objective Even if evidence of post-mastectomy radiotherapy (PMRT) in patients with T1-2 and 1 to 3 positive nodes breast cancer is increasing, controversies still exist, especially in elderly patients because the risk of treatment-related toxicity. The aim of this study is to evaluate the efficacy and toxicity of PMRT in elderly as well as the place and use of systemic treatment in this population of patients. Material and Methods We retrospectively reviewed records of consecutive patients with T1-2 and 1 to 3 positive nodes treated with mastectomy at our institution between June 2009 and June 2014. Elderly patients were defined as 65 years or above. Patients who had received neoadjuvant treatment were excluded from the analysis. In total, we analyzed 73 patients, of them only 23 received PMRT. Locoregional recurrence (LRR) was defined as any recurrence within the ipsilateral chest wall, ipsilateral axillary, internal mammary, infraclavicular or supraclavicular lymph nodes. All recurrences at other sites were recorded as distant disease recurrence (DDR). Disease-free survival (DFS) was defined as the time from start of PMRT until recurrence of tumor or death from any cause. Overall survival (OS) is defined as the time from start of PMRT until death from any cause. Results The median age was 72 years (range, 65-91 years). There were 10 patients with HER2 positive tumors, of them100% (n=4) received trastuzumab in the PMRT group and 2 of 6 patients in non-PMRT group. All patients with HR positive tumor received endocrine therapy. The patients in the PMRT group were younger (69 years vs. 75 years, P=0.005). Higher number of patients in the PMRT group received adjuvant chemotherapy (82.6 % vs 48 %, P=0.006). At a median follow-up of 48 months (range, 25-85 months), there were 2 LRR diagnosed concurrently with distant metastasis, one in each group respectively. We observed six distant metastases and 5 deaths. In the whole cohort,
Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the ci... more Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the circulating tumor associated antigen cancer antigen 125 (CA125), expressed on the surface of more than 80% of the epithelial ovarian cancer (EOC) cells. Oregovomab acts as a therapeutic vaccine inducing indirect immunization by cellular and humoral immune responses directed against CA125. This phenomenon is hypothesized to bypass tumor-associated immune suppression when administered in combination with chemotherapy. In a randomized phase II study in patients with previously untreated EOC, immunization with oregovomab in a schedule-dependent combination with paclitaxel and carboplatin (PC) demonstrated significant improvement in median progression-free survival (PFS) of 41.8 months (95% confidence interval [CI]=21.8-not estimable [NE]) for paclitaxel-carboplatin-oregovomab (PCO) and 12.2 months (10.4-18.6) for PC (p=0.0027; hazard ratio [HR]=0.46; 95% CI=0.28-0.7) and median overall survival has NE (45.2-NE) for PCO and was 43.2 months (31.8-NE) for PC (p=0.043; HR=0.35; 95% CI=0.16-0.74). Methods: This is a phase 3, double-blind, placebo-controlled, multi centered clinical trial. Patients with optimally debulked with International Federation of Gynecology and Obstetrics III/ IV EOC and serum CA125 ≥50 U/mL receiving adjuvant (cohort 1) or neoadjuvant (cohort 2) chemotherapy will be randomized postsurgery to PCO or paclitaxel-carboplatin-placebo. Patients with germline BRCA1/2 mutations will be excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with a single maintenance dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with maintenance doses at 6-and 18-week following cycle 6. No maintenance therapy is not permitted. The primary objective is PFS determined by RECIST 1.1 criteria. Cohort 1 will recruit 372 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.65) when 252 PFS events have been observed. Cohort 2 will be analyzed separately recruiting 232 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.60) when 165 PFS events have been observed. The study is being planned to enroll patients from 16 countries and 507 patients randomized at time of submission.
Introduction: Renal cell carcinoma presents with metastatic disease in approximately 30% of cases... more Introduction: Renal cell carcinoma presents with metastatic disease in approximately 30% of cases. Since the introduction of targeted therapies, they have demonstrated impressive gains in overall survival, progression-free survival and response rates over the previously utilized immunotherapies in cases with mRCC. The rates of cytoreductive nephrectomy have declined since the introduction of targeted therapy. We report our experience with cytoreductive nephrectomy plus targeted therapy. Materials & Methods: We retrospectively collected the hospital inpatient and outpatient records of mRCC who had undergone cytoreductive nephrectomy trailed by targeted treatment. Data included demographic, clinical, imaging and laboratory data and those that were found to have prognostic value. Measured outcomes included OS. Results: 78 patients (61 males and 17 females) 60.17± 8.76 years was mean age who underwent cytoreductive nephrectomy for mRCC of clear cell type. 43 (55.1%) patients had comorbidity. 78 patients had huge renal masses (mean 10.167±2.756 cms) on CT imaging. All patients were introduced on target therapy four to eight weeks after surgery. The mean overall survival of the patients was 27.98±1.47 months. Conclusions: Presently the important role of cytoreductive nephrectomy is not well defined in the ear of targeted therapy. However, in our study patient with good performance statuses do better than patients with existing health risks.
Introduction: Oral cancer is a major health problem. The study of exfoliative cytology material h... more Introduction: Oral cancer is a major health problem. The study of exfoliative cytology material helps in the differentiation of premalignant and malignant alterations of oral lesions. The objective of this study was to assess the feasibility of detecting oral cancer by targeting genomic VPAC (combined vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide) receptors expressed on malignant oral cancer cells. Patients & Methods: All patients with suspected oral cavity cancers/lesions formed the study group. The samples from the oral cavity lesion or suspicious area were collected with a cytology brush. The harvested material was examined for malignant cells by 1. the standard PAP stain and 2. targeting the VPAC receptors on the cell surface using a fluorescent microscope. Similarly, malignant cells were identified from cells shed in oral gargles. Results: A total of 60 patients with oral lesions were included in the study. The histopathological diagnosis was squamous cell carcinoma in 30 of these. The VPAC receptor positivity both on the brush cytology staining as well oral gargle staining was more sensitive than the brush cytology PAP staining. The accuracy of the various techniques was as follows, brush cytology PAP staining at 86.67%, brush cytology VPAC staining at 91.67% and oral gargle VPAC staining at 95%. Conclusions: This preliminary study validates our belief that malignant cells in the saliva can be identified by targeting the VPAC receptors. The test is simple, easy, non-invasive and reliable in the detection of oral cancers.
Proceedings of the 38th Annual Meeting of Korean Society of Gynecologic Oncology
Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the ci... more Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the circulating tumor associated antigen cancer antigen 125 (CA125), expressed on the surface of more than 80% of the epithelial ovarian cancer (EOC) cells. Oregovomab acts as a therapeutic vaccine inducing indirect immunization by cellular and humoral immune responses directed against CA125. This phenomenon is hypothesized to bypass tumor-associated immune suppression when administered in combination with chemotherapy. In a randomized phase II study in patients with previously untreated EOC, immunization with oregovomab in a schedule-dependent combination with paclitaxel and carboplatin (PC) demonstrated significant improvement in median progression-free survival (PFS) of 41.8 months (95% confidence interval [CI]=21.8-not estimable [NE]) for paclitaxel-carboplatin-oregovomab (PCO) and 12.2 months (10.4-18.6) for PC (p=0.0027; hazard ratio [HR]=0.46; 95% CI=0.28-0.7) and median overall survival has NE (45.2-NE) for PCO and was 43.2 months (31.8-NE) for PC (p=0.043; HR=0.35; 95% CI=0.16-0.74). Methods: This is a phase 3, double-blind, placebo-controlled, multi centered clinical trial. Patients with optimally debulked with International Federation of Gynecology and Obstetrics III/ IV EOC and serum CA125 ≥50 U/mL receiving adjuvant (cohort 1) or neoadjuvant (cohort 2) chemotherapy will be randomized postsurgery to PCO or paclitaxel-carboplatin-placebo. Patients with germline BRCA1/2 mutations will be excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with a single maintenance dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with maintenance doses at 6-and 18-week following cycle 6. No maintenance therapy is not permitted. The primary objective is PFS determined by RECIST 1.1 criteria. Cohort 1 will recruit 372 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.65) when 252 PFS events have been observed. Cohort 2 will be analyzed separately recruiting 232 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.60) when 165 PFS events have been observed. The study is being planned to enroll patients from 16 countries and 507 patients randomized at time of submission.
Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a su... more Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a surgeon in the emergency department. It accounts for 6.3% of all intestinal obstructions. In the acute setting, it often presents with abdominal distention, vomiting and constipation. This study aims to analyse clinical and aetiopathological features associated with large bowel obstruction and the outcome of various modalities of managing LBO. Patients and Methods: In this prospective study, patients above 18 years of age presenting to the emergency department of our hospital with features suggestive of dynamic intestinal obstruction were selected. After confirmation of the diagnosis and its underlying aetiology, they were managed either surgically or conservatively. The patient outcome in terms of complications and mortality were evaluated. Results: Out of 53 patients, 29 were males and 24 were females. The most common cause of large bowel obstruction was colonic malignancy in 27 patients (50.94%) followed by colonic volvulus in 15 patients (28.30%). Majority of patients (45) underwent surgery. The most common procedure done in our study was resection and anastomosis in 29 patients. 20% of the cases suffered from wound infection. Out of 53 cases in our study 27 patients had an uneventful post-operative period and 13 patients had delayed recovery. The total number of deaths in the study was 5 (12.5%). Conclusion: Prompt diagnosis and timely appropriate surgery in large bowel obstruction with available modern equipment and anaesthesia reduces morbidity, mortality, hospital stay and gives a satisfactory outcome.
Recently developing countries showing growing trend in hepatocellular carcinoma cases. Hepatocell... more Recently developing countries showing growing trend in hepatocellular carcinoma cases. Hepatocellular carcinoma metastasis to oral cavity is uncommon finding. Most common site for mets is lung, breast, kidney. Data on HCC metastasis to oral cavity is limited. We present here one such rare case of HCC metastasis to oral cavity. Awareness about the entity helps in early diagnosis and management that leads to better prognosis and good quality of life to patient.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Thyroid gland (TG) metastasis by laryngeal cancer is uncommon. However, now a days following conc... more Thyroid gland (TG) metastasis by laryngeal cancer is uncommon. However, now a days following concept of ‘organ preservation’, so ipsilateral hemithyroidectomy is not required in every case with total laryngectomy (TL) for laryngeal cancer. Studies for T3 and T4 laryngeal cancer having, anterior commissure involvement, transglottic growth or subglottic extension indicates thyroidectomy in the majority of cases. Hemithyroidectomies are linked to hypothyroidism in 23–63% of cases and hypoparathyroidism in 25–52% of cases. There is no recognized link between tumour differentiation and TG involvement. According to reports, the prognosis in cases of TG involvement is poor. The tumour differentiation determines whether the spread is contiguous or noncontiguous. Contiguous spread is more likely in well-differentiated carcinomas, while non-contiguous spread is more likely in poorly or moderately differentiated carcinomas. Anatomically, direct TG invasion is only possible through extralarynge...
The Journal of Obstetrics and Gynecology of India, 2022
Global incidence of non-Hodgkin’s lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma.... more Global incidence of non-Hodgkin’s lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma. Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B-cell lymphoma (DLBCL). It is usually seen in human immunodeficiency virus (HIV) infected patients. PBL occurring in extranodal site, particularly female genital tract, is very rare, and only few case reports have been reported. Here, we report a unique rare case of uterine PBL in an HIV/Epstein–Barr virus-negative patient that was initially diagnosed as endometrioid carcinoma.
Abstract: Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is de... more Abstract: Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous oophoritis have been reported to date. We describe a rare case of xanthogranulomatous oophoritis with involvement of omentum.
Abstract: Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior me... more Abstract: Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually, thymomas can also be found in other locations. Surgical excision, when feasible, appears to provide good results. We encountered a rare case of a thymoma that developed in the right thoracic cavity, and originating from the pleura in posterior mediastinum. We describe the clinical scenario, investigations, and our management of the patient.
Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a su... more Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a surgeon in the emergency department. It accounts for 6.3% of all intestinal obstructions. In the acute setting, it often presents with abdominal distention, vomiting and constipation. This study aims to analyse clinical and aetiopathological features associated with large bowel obstruction and the outcome of various modalities of managing LBO. Patients and Methods: In this prospective study, patients above 18 years of age presenting to the emergency department of our hospital with features suggestive of dynamic intestinal obstruction were selected. After confirmation of the diagnosis and its underlying aetiology, they were managed either surgically or conservatively. The patient outcome in terms of complications and mortality were evaluated. Results: Out of 53 patients, 29 were males and 24 were females. The most common cause of large bowel obstruction was colonic malignancy in 27 patients (50.94%) followed by colonic volvulus in 15 patients (28.30%). Majority of patients (45) underwent surgery. The most common procedure done in our study was resection and anastomosis in 29 patients. 20% of the cases suffered from wound infection. Out of 53 cases in our study 27 patients had an uneventful post-operative period and 13 patients had delayed recovery. The total number of deaths in the study was 5 (12.5%). Conclusion: Prompt diagnosis and timely appropriate surgery in large bowel obstruction with available modern equipment and anaesthesia reduces morbidity, mortality, hospital stay and gives a satisfactory outcome.
reached (NE) for PCO and was 43.2 months for PC (p = 0.043, HR 0.35). Methods This Phase 3, doubl... more reached (NE) for PCO and was 43.2 months for PC (p = 0.043, HR 0.35). Methods This Phase 3, double-blind, placebo-controlled, multicenter trial, has enrolled patients from 14 countries. Patients with optimally debulked with FIGO III/IV EOC and serum CA125 ! 50 U/ml receiving adjuvant (Cohort 1) or neoadjuvant (Cohort 2) chemotherapy were randomized post-surgery to PCO or PCP. Patients with germline BRCA1/ 2 mutations were excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with an additional dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with an additional dose at 6-and 18-weeks following cycle 6. The primary objective is PFS determined by RECIST 1.1 criteria. Current Trial Status At the time of abstract submission, 618 patients were enrolled and target enrolment Cohort 1 (378) and Cohort 2 (240) was achieved.
Purpose or Objective Even if evidence of post-mastectomy radiotherapy (PMRT) in patients with T1-... more Purpose or Objective Even if evidence of post-mastectomy radiotherapy (PMRT) in patients with T1-2 and 1 to 3 positive nodes breast cancer is increasing, controversies still exist, especially in elderly patients because the risk of treatment-related toxicity. The aim of this study is to evaluate the efficacy and toxicity of PMRT in elderly as well as the place and use of systemic treatment in this population of patients. Material and Methods We retrospectively reviewed records of consecutive patients with T1-2 and 1 to 3 positive nodes treated with mastectomy at our institution between June 2009 and June 2014. Elderly patients were defined as 65 years or above. Patients who had received neoadjuvant treatment were excluded from the analysis. In total, we analyzed 73 patients, of them only 23 received PMRT. Locoregional recurrence (LRR) was defined as any recurrence within the ipsilateral chest wall, ipsilateral axillary, internal mammary, infraclavicular or supraclavicular lymph nodes. All recurrences at other sites were recorded as distant disease recurrence (DDR). Disease-free survival (DFS) was defined as the time from start of PMRT until recurrence of tumor or death from any cause. Overall survival (OS) is defined as the time from start of PMRT until death from any cause. Results The median age was 72 years (range, 65-91 years). There were 10 patients with HER2 positive tumors, of them100% (n=4) received trastuzumab in the PMRT group and 2 of 6 patients in non-PMRT group. All patients with HR positive tumor received endocrine therapy. The patients in the PMRT group were younger (69 years vs. 75 years, P=0.005). Higher number of patients in the PMRT group received adjuvant chemotherapy (82.6 % vs 48 %, P=0.006). At a median follow-up of 48 months (range, 25-85 months), there were 2 LRR diagnosed concurrently with distant metastasis, one in each group respectively. We observed six distant metastases and 5 deaths. In the whole cohort,
Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the ci... more Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the circulating tumor associated antigen cancer antigen 125 (CA125), expressed on the surface of more than 80% of the epithelial ovarian cancer (EOC) cells. Oregovomab acts as a therapeutic vaccine inducing indirect immunization by cellular and humoral immune responses directed against CA125. This phenomenon is hypothesized to bypass tumor-associated immune suppression when administered in combination with chemotherapy. In a randomized phase II study in patients with previously untreated EOC, immunization with oregovomab in a schedule-dependent combination with paclitaxel and carboplatin (PC) demonstrated significant improvement in median progression-free survival (PFS) of 41.8 months (95% confidence interval [CI]=21.8-not estimable [NE]) for paclitaxel-carboplatin-oregovomab (PCO) and 12.2 months (10.4-18.6) for PC (p=0.0027; hazard ratio [HR]=0.46; 95% CI=0.28-0.7) and median overall survival has NE (45.2-NE) for PCO and was 43.2 months (31.8-NE) for PC (p=0.043; HR=0.35; 95% CI=0.16-0.74). Methods: This is a phase 3, double-blind, placebo-controlled, multi centered clinical trial. Patients with optimally debulked with International Federation of Gynecology and Obstetrics III/ IV EOC and serum CA125 ≥50 U/mL receiving adjuvant (cohort 1) or neoadjuvant (cohort 2) chemotherapy will be randomized postsurgery to PCO or paclitaxel-carboplatin-placebo. Patients with germline BRCA1/2 mutations will be excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with a single maintenance dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with maintenance doses at 6-and 18-week following cycle 6. No maintenance therapy is not permitted. The primary objective is PFS determined by RECIST 1.1 criteria. Cohort 1 will recruit 372 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.65) when 252 PFS events have been observed. Cohort 2 will be analyzed separately recruiting 232 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.60) when 165 PFS events have been observed. The study is being planned to enroll patients from 16 countries and 507 patients randomized at time of submission.
Introduction: Renal cell carcinoma presents with metastatic disease in approximately 30% of cases... more Introduction: Renal cell carcinoma presents with metastatic disease in approximately 30% of cases. Since the introduction of targeted therapies, they have demonstrated impressive gains in overall survival, progression-free survival and response rates over the previously utilized immunotherapies in cases with mRCC. The rates of cytoreductive nephrectomy have declined since the introduction of targeted therapy. We report our experience with cytoreductive nephrectomy plus targeted therapy. Materials & Methods: We retrospectively collected the hospital inpatient and outpatient records of mRCC who had undergone cytoreductive nephrectomy trailed by targeted treatment. Data included demographic, clinical, imaging and laboratory data and those that were found to have prognostic value. Measured outcomes included OS. Results: 78 patients (61 males and 17 females) 60.17± 8.76 years was mean age who underwent cytoreductive nephrectomy for mRCC of clear cell type. 43 (55.1%) patients had comorbidity. 78 patients had huge renal masses (mean 10.167±2.756 cms) on CT imaging. All patients were introduced on target therapy four to eight weeks after surgery. The mean overall survival of the patients was 27.98±1.47 months. Conclusions: Presently the important role of cytoreductive nephrectomy is not well defined in the ear of targeted therapy. However, in our study patient with good performance statuses do better than patients with existing health risks.
Introduction: Oral cancer is a major health problem. The study of exfoliative cytology material h... more Introduction: Oral cancer is a major health problem. The study of exfoliative cytology material helps in the differentiation of premalignant and malignant alterations of oral lesions. The objective of this study was to assess the feasibility of detecting oral cancer by targeting genomic VPAC (combined vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide) receptors expressed on malignant oral cancer cells. Patients & Methods: All patients with suspected oral cavity cancers/lesions formed the study group. The samples from the oral cavity lesion or suspicious area were collected with a cytology brush. The harvested material was examined for malignant cells by 1. the standard PAP stain and 2. targeting the VPAC receptors on the cell surface using a fluorescent microscope. Similarly, malignant cells were identified from cells shed in oral gargles. Results: A total of 60 patients with oral lesions were included in the study. The histopathological diagnosis was squamous cell carcinoma in 30 of these. The VPAC receptor positivity both on the brush cytology staining as well oral gargle staining was more sensitive than the brush cytology PAP staining. The accuracy of the various techniques was as follows, brush cytology PAP staining at 86.67%, brush cytology VPAC staining at 91.67% and oral gargle VPAC staining at 95%. Conclusions: This preliminary study validates our belief that malignant cells in the saliva can be identified by targeting the VPAC receptors. The test is simple, easy, non-invasive and reliable in the detection of oral cancers.
Proceedings of the 38th Annual Meeting of Korean Society of Gynecologic Oncology
Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the ci... more Objective: Oregovomab, a murine IgGκ1 MAb, has high affinity binding (1.16×10 10 /M −1) to the circulating tumor associated antigen cancer antigen 125 (CA125), expressed on the surface of more than 80% of the epithelial ovarian cancer (EOC) cells. Oregovomab acts as a therapeutic vaccine inducing indirect immunization by cellular and humoral immune responses directed against CA125. This phenomenon is hypothesized to bypass tumor-associated immune suppression when administered in combination with chemotherapy. In a randomized phase II study in patients with previously untreated EOC, immunization with oregovomab in a schedule-dependent combination with paclitaxel and carboplatin (PC) demonstrated significant improvement in median progression-free survival (PFS) of 41.8 months (95% confidence interval [CI]=21.8-not estimable [NE]) for paclitaxel-carboplatin-oregovomab (PCO) and 12.2 months (10.4-18.6) for PC (p=0.0027; hazard ratio [HR]=0.46; 95% CI=0.28-0.7) and median overall survival has NE (45.2-NE) for PCO and was 43.2 months (31.8-NE) for PC (p=0.043; HR=0.35; 95% CI=0.16-0.74). Methods: This is a phase 3, double-blind, placebo-controlled, multi centered clinical trial. Patients with optimally debulked with International Federation of Gynecology and Obstetrics III/ IV EOC and serum CA125 ≥50 U/mL receiving adjuvant (cohort 1) or neoadjuvant (cohort 2) chemotherapy will be randomized postsurgery to PCO or paclitaxel-carboplatin-placebo. Patients with germline BRCA1/2 mutations will be excluded. Chemotherapy will be administered every 3 weeks in both cohorts. In cohort 1, oregovomab/placebo is administered simultaneously at cycles 1, 3, and 5 of chemotherapy with a single maintenance dose at 12 weeks following cycle 5. In cohort 2, oregovomab/placebo is administered post interval debulking surgery at cycles 4 and 6 with maintenance doses at 6-and 18-week following cycle 6. No maintenance therapy is not permitted. The primary objective is PFS determined by RECIST 1.1 criteria. Cohort 1 will recruit 372 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.65) when 252 PFS events have been observed. Cohort 2 will be analyzed separately recruiting 232 patients with a 90% power to detect a difference with an alpha of 0.025 (HR of 0.60) when 165 PFS events have been observed. The study is being planned to enroll patients from 16 countries and 507 patients randomized at time of submission.
Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a su... more Introduction: Large bowel obstruction (LBO) is one of the most frequent cases encountered by a surgeon in the emergency department. It accounts for 6.3% of all intestinal obstructions. In the acute setting, it often presents with abdominal distention, vomiting and constipation. This study aims to analyse clinical and aetiopathological features associated with large bowel obstruction and the outcome of various modalities of managing LBO. Patients and Methods: In this prospective study, patients above 18 years of age presenting to the emergency department of our hospital with features suggestive of dynamic intestinal obstruction were selected. After confirmation of the diagnosis and its underlying aetiology, they were managed either surgically or conservatively. The patient outcome in terms of complications and mortality were evaluated. Results: Out of 53 patients, 29 were males and 24 were females. The most common cause of large bowel obstruction was colonic malignancy in 27 patients (50.94%) followed by colonic volvulus in 15 patients (28.30%). Majority of patients (45) underwent surgery. The most common procedure done in our study was resection and anastomosis in 29 patients. 20% of the cases suffered from wound infection. Out of 53 cases in our study 27 patients had an uneventful post-operative period and 13 patients had delayed recovery. The total number of deaths in the study was 5 (12.5%). Conclusion: Prompt diagnosis and timely appropriate surgery in large bowel obstruction with available modern equipment and anaesthesia reduces morbidity, mortality, hospital stay and gives a satisfactory outcome.
Recently developing countries showing growing trend in hepatocellular carcinoma cases. Hepatocell... more Recently developing countries showing growing trend in hepatocellular carcinoma cases. Hepatocellular carcinoma metastasis to oral cavity is uncommon finding. Most common site for mets is lung, breast, kidney. Data on HCC metastasis to oral cavity is limited. We present here one such rare case of HCC metastasis to oral cavity. Awareness about the entity helps in early diagnosis and management that leads to better prognosis and good quality of life to patient.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Thyroid gland (TG) metastasis by laryngeal cancer is uncommon. However, now a days following conc... more Thyroid gland (TG) metastasis by laryngeal cancer is uncommon. However, now a days following concept of ‘organ preservation’, so ipsilateral hemithyroidectomy is not required in every case with total laryngectomy (TL) for laryngeal cancer. Studies for T3 and T4 laryngeal cancer having, anterior commissure involvement, transglottic growth or subglottic extension indicates thyroidectomy in the majority of cases. Hemithyroidectomies are linked to hypothyroidism in 23–63% of cases and hypoparathyroidism in 25–52% of cases. There is no recognized link between tumour differentiation and TG involvement. According to reports, the prognosis in cases of TG involvement is poor. The tumour differentiation determines whether the spread is contiguous or noncontiguous. Contiguous spread is more likely in well-differentiated carcinomas, while non-contiguous spread is more likely in poorly or moderately differentiated carcinomas. Anatomically, direct TG invasion is only possible through extralarynge...
The Journal of Obstetrics and Gynecology of India, 2022
Global incidence of non-Hodgkin’s lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma.... more Global incidence of non-Hodgkin’s lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma. Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B-cell lymphoma (DLBCL). It is usually seen in human immunodeficiency virus (HIV) infected patients. PBL occurring in extranodal site, particularly female genital tract, is very rare, and only few case reports have been reported. Here, we report a unique rare case of uterine PBL in an HIV/Epstein–Barr virus-negative patient that was initially diagnosed as endometrioid carcinoma.
Abstract: Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is de... more Abstract: Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous oophoritis have been reported to date. We describe a rare case of xanthogranulomatous oophoritis with involvement of omentum.
Abstract: Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior me... more Abstract: Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually, thymomas can also be found in other locations. Surgical excision, when feasible, appears to provide good results. We encountered a rare case of a thymoma that developed in the right thoracic cavity, and originating from the pleura in posterior mediastinum. We describe the clinical scenario, investigations, and our management of the patient.
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Papers by Mahesh Kalloli