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Mittal A, Deo SVS, Gogia A, Batra A, Kumar A, Bhoriwal S, Deb KS, Dhamija E, Thulkar S, Ramprasad VL, Olopade O, Pramanik R. Profile of Pathogenic Mutations and Evaluation of Germline Genetic Testing Criteria in Consecutive Breast Cancer Patients Treated at a North Indian Tertiary Care Center. Ann Surg Oncol 2021; 29:1423-1432. [PMID: 34601666 PMCID: PMC8487333 DOI: 10.1245/s10434-021-10870-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/16/2021] [Indexed: 01/14/2023]
Abstract
Background The burden of hereditary breast cancer in India is not well defined. Moreover, genetic testing criteria (National Comprehensive Cancer Network [NCCN] and Mainstreaming Cancer Genetics [MCG] Plus) have never been validated in the Indian population. Methods All new female breast cancer patients from 1st March 2019 to 28th February 2020 were screened. Those providing informed consent and without previous genetic testing were recruited. Multigene panel testing (107 genes) by next-generation sequencing was performed for all patients. The frequency of pathogenic/likely pathogenic (P/LP) mutations between patients qualifying and not qualifying the testing criteria was compared and their sensitivity was computed. Results Overall, 275 breast cancer patients were screened and 236 patients were included (median age 45 years); 30 patients did not consent and 9 patients previously underwent genetic testing. Thirty-four (14%) women had a positive family history and 35% had triple-negative breast cancer. P/LP mutations were found in 44/236 (18.64%) women; mutations in BRCA1 (22/47, 46.8%) and BRCA2 (9/47, 19.1%) were the most common, with 34% of mutations present in non-BRCA genes. Patients qualifying the testing criteria had a higher risk of having a P/LP mutation (NCCN: 23.6% vs. 7.04%, p = 0.03; MCG plus: 24.8% vs. 7.2%, p = 0.01). The sensitivity of the NCCN criteria was 88.6% (75.4–96.2) and 86.36% (72.65–94.83) for MCG plus. More than 95% sensitivity was achieved if all women up to 60 years of age were tested. Cascade testing was performed in 31 previous (16/44 families), with 23 testing positive. Conclusions The frequency of P/LP mutations in India is high, with significant contribution of non-BRCA genes. Testing criteria need modification to expand access to testing. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-10870-w.
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Deo SVS, Kumar S, Bhoriwal S, Shukla NK, Sharma A, Thulkar S, Das P, Bhagat P, Dhall K, Pathy S, Mohanti BK. Colorectal Cancers in Low- and Middle-Income Countries-Demographic Pattern and Clinical Profile of 970 Patients Treated at a Tertiary Care Cancer Center in India. JCO Glob Oncol 2021; 7:1110-1115. [PMID: 34236917 PMCID: PMC8457848 DOI: 10.1200/go.21.00111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Globally, colorectal cancer (CRC) ranks third in terms of incidence and second in terms of mortality. A relatively low burden of CRC has been reported from low- and middle-income countries (LMIC), and there is a paucity of publications related to CRC from LMIC. PATIENTS AND METHODS A computerized comprehensive structured CRC clinical database was developed. All the patients with histopathologically proven CRC undergoing either curative and palliative multimodality management or surgical interventions between 2000 and 2019 were included in the study. A descriptive analysis of the demographic profile and clinical spectrum was performed. RESULTS A total of 970 patients of CRC were treated between 2000 and 2019. Of these, 401 patients (41.3%) had colon cancer and 569 (58.7%) had rectal cancer. The male-to-female ratio was 1.79:1. The mean age at presentation was 47.7 years. A total of 337 (34.7%) patients qualified as young CRC (≤ 40 years of age at diagnosis). The commonest symptom among patients with colon cancer was abdominal pain; 55.6% of patients had a right-sided primary tumor as compared with 42.2% with left-sided tumors. The commonest symptom among patients with rectal cancer was bleeding per rectum. The predominant location of the tumor was in the lower rectum (58%). Majority of patients with CRC presented with locally advanced stage II and III disease. The most common histologic subtype encountered for both colon and rectal cancers was adenocarcinoma (84.8% and 81.2%, respectively). CONCLUSION This study has revealed certain important findings related to CRC in LMIC including a higher burden of young colorectal cancer, a relatively higher proportion of rectal cancers in comparison with colon cancer, a high percentage of patients with low-rectal cancer, and advanced stage at presentation.
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Sharma A, Pramanik R, Kumar A, Pathy S, Kumar S, Bhoriwal S, Thulkar S, Dash NR, Pal S, Choudhary P, Pawar S, Kumar R, Gupta G. Safety and Efficacy of Modified FOLFIRINOX in Unresectable or Metastatic Gallbladder Cancer: A Phase II Pilot Study. JCO Glob Oncol 2021; 7:820-826. [PMID: 34086477 PMCID: PMC8457810 DOI: 10.1200/go.20.00657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE For unresectable gallbladder cancer (GBC), gemcitabine and platinum is standard combination; however, outcome is poor. We conducted this study to find feasibility of modified flourouracil, oxaliplatin, and irinotecan in this group. MATERIALS AND METHODS We conducted a prospective, phase II single-arm pilot study. Inclusion criteria were histologically proven GBC and Eastern Cooperative Oncology Group 0-1. Primary end points were overall response rates and overall survival. The following treatment was given: oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, and irinotecan 150 mg/m2, all once on day 1, fluorouracil 2,400 mg/m2 continuous intra-venous infusion over 46 hours repeated every 2 weeks, and maximum 12 doses, with primary granulocyte colony-stimulating factor prophylaxis. RESULTS Between February 2019 and July 2020, 29 patients with unresectable GBC were enrolled. The median age was 52 years, and 18 were females. The Eastern Cooperative Oncology Group was 0 in 4. Five had bilirubin > normal, and 15 each had high serum alkaline phosphatase and carbohydrate antigen 19-9. Twenty-five patients had stage IV disease, and remaining unresectable locally advanced disease. A median of 8.5 cycles was given, and 11 completed treatment. Nine stopped chemotherapy because of progression, and one because of toxicity, and treatment is ongoing in three. Twenty-two required dose reduction. A treatment delay of 1-2 weeks was seen in 25 patients. Best response was complete response 1, partial response 13 (overall response rate 48.2%), and stable disease 9. Four patients with metastatic disease underwent R0 resection. As on cutoff date, nine are surviving (three without disease). Eighteen died of PD, and in two, cause was unknown. There was no toxic death. The median overall survival and progression-free survival were 309 and 252 days, respectively. Twenty-three patients experienced grade III or IV toxicity, and common were diarrhea (13), vomiting (12), and anemia (7). CONCLUSION First-line modified flourouracil, oxaliplatin, and irinotecan is feasible in unresectable GBC with encouraging responses. Toxicities are higher but manageable. Higher response rates make this an option to explore in borderline resectable cases.
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Kumar N, Deo S, Bhoriwal S, Sharma A, Pramanik R, Kumar R, Das P, Arora S, Kumar S. Comparison of treatment response assessed by 18F-FDG PET/CT with the histopathological response using tumor regression grading on surgically resected specimen following neoadjuvant chemotherapy in squamous cell carcinoma of esophagus. Nucl Med Commun 2021; 42:928-934. [PMID: 33795613 DOI: 10.1097/mnm.0000000000001413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND For the response assessment after chemotherapy, gold standard is always the histopathological response. However, metabolic response can also guide further treatment. Herein, this study aimed to evaluate metabolic response assessment to neoadjuvant chemotherapy in squamous cell carcinoma esophagus using PET response criteria in solid tumors (PERCIST) criteria with taking histopathological response by tumor regression grading as the standard method. METHODS Total fifty-seven patients with squamous cell carcinoma esophagus were enrolled between April 2017 to December 2018 for this prospective study. All patients were undergone for baseline PET scan before going for neoadjuvant chemotherapy. Repeat PET scan was done after neoadjuvant chemotherapy. Operable patients were taken for surgery. Final histological response was assessed by Mandard grading. Three metabolic tools [maximum standardized uptake value (SUVmax), tumor regression grading, PERCIST] were compared. RESULTS The mean SULpeak of the primary lesion was 11.7 ± 5.5 (median, 10.2, range 5.5-31.8). The average percentage change (%Δ) in SUVmax was 42.9 ± 26.3. On histopathology, 5 (13.1%) patients showed complete pathological response, whereas grade II, III, IV and V in 8 (21.1%), 12 (31.6%), 10 (26.3%) and 3 (7.8%) respectively. On comparison of PERCIST with Mandard grading, agreement analysis showed that there was moderate agreement (k, 0.48). %ΔSUV peak change showed a strong correlation with %ΔSUVmax (P = 0.01) and percentage tumor to liver ratio change (P = 0.01). On comparison, these metabolic response tools showed a weak agreement (k, 0.28 with tumor to liver ratio, k, 0.38 with SUVmax). CONCLUSION After neoadjuvant chemotherapy, 18F-fluorodeoxyglucose PET/CT can help to assess the response and guide the treatment. However, a larger study is warranted to evaluate their correlation with pathological response.
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Kumar N, Deo S, Bhoriwal S, Pramanik R, Sharma A, Kumar R, Das P, Kumar S. MO20-6 A prospective study comparing metabolic tools on PET scan with Mandard grading following NACT in SCC of esophagus. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Deo S, Ray M, Bansal B, Bhoriwal S, Bhatnagar S, Garg R, Gupta N, Sharma A, Kumar L, Thulkar S, Dhamija E, Mathur S, Das P. Feasibility and outcomes of cytoreductive surgery and HIPEC for peritoneal surface malignancies in low- and middle-income countries: a single-center experience of 232 cases. World J Surg Oncol 2021; 19:164. [PMID: 34090452 PMCID: PMC8180169 DOI: 10.1186/s12957-021-02276-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has recently emerged as a viable management option for peritoneal surface malignancy (PSM). CRS and HIPEC is a complex, multidisciplinary and resource-intensive surgical procedure. It has a steep learning curve and is associated with significant morbidity and mortality. The expertise is mostly limited to few dedicated high-volume centers located in developed countries. We present a single institutional experience of 232 cases of CRS and HIPEC performed at a tertiary care cancer center in a low- and middle-income country (LMIC). METHODS A multidisciplinary PSM program was initiated in 2015 at a high-volume public-sector tertiary care cancer center in North India catering largely to patients belonging to low- and middle-income groups. Perioperative protocols were developed, and a prospective structured database was created to capture data. All patients undergoing CRS and HIPEC between January 2015 and December 2020 were identified, and the data was retrospectively analyzed for clinical spectrum, surgical details, and perioperative morbidity and mortality. RESULTS Two hundred and thirty-two patients underwent CRS and HIPEC during the study period. Epithelial ovarian carcinoma (56.5%) was the most common malignancy treated, followed by pseudomyxoma peritonei (18.5%), colorectal carcinoma (13.4%), and malignant mesothelioma (5.6%). Optimal CRS could be achieved in 94.4% of patients. Cisplatin and mitomycin were the most common drugs used for HIPEC. A total of 28.0% of patients had morbidity including deep vein thrombosis, subacute intestinal obstruction, sepsis, burst abdomen, lymphocele, urinoma, acute renal failure, and enterocutaneous fistula. The overall treatment-related mortality was 3.5%. CONCLUSIONS Results of the current study indicate that it is feasible to establish a successful CRS and HIPEC program for PSM in government-funded hospitals in LMIC facing resource constraints. The most common indication for CRS and HIPEC were carcinoma of the ovary followed by pseudomyxoma peritonei and colorectal carcinoma. Overall morbidity and mortality in the current series are comparable to global standards, reported from high-income countries. A protocol-based multidisciplinary team approach, optimal patient selection, and surgical expertise can help achieve optimal outcomes in government-funded hospitals in LMIC.
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Mittal A, Pramanik R, Gogia A, Batra A, Jha A, Kumar L, Deo S, Bhoriwal S, Deb K, Dhamija E, Ramprasad V, Olopade O. 155P Profile of pathogenic mutations and evaluation of germline genetic testing criteria in consecutive breast cancer patients treated at a North Indian tertiary care center. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kumar N, Bhoriwal S, Yadav R, Deo SVS. Clear Cell Sarcoma of Sigmoid Colon: a Rare Malignancy with Common Clinical Manifestations. J Gastrointest Cancer 2021; 51:1070-1073. [PMID: 32385725 DOI: 10.1007/s12029-020-00413-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
MESH Headings
- Adult
- Anemia/etiology
- Anemia/therapy
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biopsy
- Colectomy
- Colon, Sigmoid/diagnostic imaging
- Colon, Sigmoid/pathology
- Colon, Sigmoid/surgery
- Colonoscopy
- Cytogenetic Analysis
- Diagnosis, Differential
- Erythrocyte Transfusion
- Gastrointestinal Hemorrhage/etiology
- Gastrointestinal Hemorrhage/therapy
- Humans
- Ileostomy
- Immunohistochemistry
- Intestinal Mucosa/diagnostic imaging
- Intestinal Mucosa/pathology
- Intestinal Mucosa/surgery
- Male
- Rectum
- Sarcoma, Clear Cell/complications
- Sarcoma, Clear Cell/diagnosis
- Sarcoma, Clear Cell/genetics
- Sarcoma, Clear Cell/surgery
- Sigmoid Neoplasms/complications
- Sigmoid Neoplasms/diagnosis
- Sigmoid Neoplasms/genetics
- Sigmoid Neoplasms/surgery
- Tomography, X-Ray Computed
- Treatment Outcome
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Kumar N, Bhoriwal S, Das P, Deo SVS. A Rare Case of Paraneoplastic Hypoglycemia Induced by Abdominopelvic Gastrointestinal Stromal Tumor. J Gastrointest Cancer 2021; 51:1065-1069. [PMID: 32367463 DOI: 10.1007/s12029-020-00406-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bhoriwal S, Deo SVS, Kumar R, Thulkar S, Gogia A, Sharma DN, Mathur S. A Prospective Study Comparing the Role of 18 FDG PET-CT with Contrast-Enhanced Computed Tomography and Tc99m Bone Scan for Staging Locally Advanced Breast Cancer. Indian J Surg Oncol 2021; 12:266-271. [PMID: 34295069 DOI: 10.1007/s13193-021-01299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/24/2021] [Indexed: 11/27/2022] Open
Abstract
Locally advanced breast cancer (LABC) patients require an accurate staging of the disease to rule out distant metastases. Various imaging investigations are used to stage LABC patients. The present study is a prospective comparison of conventional imaging (CI) with fusion positron-emission tomography and computed tomography (PET-CT) scans in the staging of LABC patients. Seventy-three consecutive LABC patients presenting to the breast cancer clinic of the tertiary care cancer institute were included in the study. All patients underwent contrast-enhanced computed tomography, Tv99m bone scintigraphy, and fusion PET-CT. Histology of the metastatic site was confirmed wherever possible. The disparity between the two imaging findings was compared. Doubtful lesions were observed clinically for at least 2 years to confirm their nature. PET-CT detected a higher number of lymph nodes in the axilla, internal mammary, and supraclavicular region as compared to CI. PET-CT upstaged 36.98% and downstaged 5.4% of the patients respectively leading to a change in the management in 30.13% of the patients. Sensitivity, specificity, positive predictive value, and negative predictive value of CI and PET-CT were 71.87%, 87.80%, 82.14%, and 80%, and 90.90%, 90%, 88.23%, and 92.30% respectively. PET-CT was more accurate in staging the LABC patients as compared to CI. PET-CT is more accurate then contrast-enhanced CT and bone scintigraphy for staging locally advanced breast carcinoma patients. It can replace multiple organ-directed imaging in staging breast cancer. It can provide accurate staging of the disease so that patients can be prognosticated and can be directed to the most appropriate treatment plans.
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Bhoriwal S, Dhall K, Yadav M, Deo SVS. Cavernous sinus thrombosis: a late complication of head and neck surgery. BMJ Case Rep 2021; 14:14/2/e240269. [PMID: 33541954 PMCID: PMC7868265 DOI: 10.1136/bcr-2020-240269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cavernous sinus thrombosis is a rare but fatal condition arising due to various infectious and noninfectious causes. Although its incidence is very low in the setting of head and neck surgery, including radical neck dissection, a high index of suspicion with prompt treatment is the key to a successful outcome. We report a case of a 50-year-old woman with a chondrosarcoma of left lower alveolobuccal complex who underwent en bloc tumour resection with infratemporal fossa clearance and left modified radical neck dissection. Subsequently, she developed cavernous sinus thrombosis, which was successfully managed with a multidisciplinary approach. This case highlights the importance of high clinical suspicion in the postoperative setting to diagnose this potentially lethal complication.
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Bhoriwal S, Kumar S, Mishra A, Kumar N. Comment on: Randomized clinical trial of pancreaticogastrostomy versus pancreaticojejunostomy on the rate and severity of pancreatic fistula after pancreaticoduodenectomy. Br J Surg 2020; 107:e665. [PMID: 33038265 DOI: 10.1002/bjs.12045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
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Bhoriwal S, Dhall K, Gamit PK, Deo S. Acute arterial thrombosis in a breast cancer survivor with coronavirus disease 2019 (COVID-19). Surgery 2020. [PMCID: PMC7340034 DOI: 10.1016/j.surg.2020.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kumar N, Bhoriwal S, Kumar S. Letter to the Editor of Annals of Surgical Oncology Concerning "The Landmark Series: Multimodality Therapy for Stage 3A Non-small Cell Lung Cancer". Ann Surg Oncol 2020; 28:3432. [PMID: 33090286 DOI: 10.1245/s10434-020-09249-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 11/18/2022]
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Bhoriwal S, Sharma J, Dhall K, Mandal A, Chhebbi M, Surya TSHV. Duplication of the internal jugular vein - A rare anatomical variation. Oral Oncol 2020; 112:104985. [PMID: 32888818 DOI: 10.1016/j.oraloncology.2020.104985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
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K R, Kumar S, Bhoriwal S, Deo S, Sharma A, R. Kumar. P-174 When to do PET-CT and diagnostic laparoscopy in gall bladder cancer? A prospective study to assess the role of PET-CT and diagnostic laparoscopy in the staging of gall bladder cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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K R, Deo S, Kumar S, Bhoriwal S, Sharma A, Pathy S. P-287 Does endemic gallbladder cancer behave differently? Data of clinical spectrum, management and outcome of gallbladder cancer patients from a north Indian tertiary cancer centre. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gupta R, Karthik AR, Rustagi K, Gupta N, Bhoriwal S, Kumar V, Garg R, Mishra S. Unraveling the Role of Palliative Surgery in the Era of COVID-19 Pandemic. Indian J Palliat Care 2020; 26:S153-S155. [PMID: 33088108 PMCID: PMC7535011 DOI: 10.4103/ijpc.ijpc_158_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 02/07/2023] Open
Abstract
Palliative surgery forms an important pillar of palliative treatment to provide holistic care to cancer patients in the form of providing relief from pain, local control of disease, hemorrhage, and for the purpose of rehabilitation. During the COVID-19 pandemic, we report the successful management of two cases of colorectal cancer which came under the category of high priority and underwent palliative surgery to provide relief from pain.
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Deo S, Garg P, Bhoriwal S, Kumar R, Thulkar S, Mathur S, K R. P031: PET - CT - SUV correlation with molecular subtypes of breast cancer - Results of a prospective study. Eur J Surg Oncol 2020. [DOI: 10.1016/j.ejso.2020.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Deo SVS, Kumar S, Kumar N, Saikia J, Bhoriwal S, Bhatnagar S, Sharma A. Guiding Principles for Cancer Surgery during the COVID-19 Pandemic. Indian J Surg Oncol 2020; 11:3-10. [PMID: 32382219 PMCID: PMC7201913 DOI: 10.1007/s13193-020-01082-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Saikia J, Deo SVS, Bhoriwal S, Bharati SJ, Kumar S. Video assisted thoracoscopic surgery in paediatric mediastinal tumors. MEDIASTINUM 2020; 4:2. [PMID: 35118270 PMCID: PMC8794293 DOI: 10.21037/med.2019.09.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/12/2019] [Indexed: 12/02/2022]
Abstract
Video assisted thoracoscopic surgery (VATS) is an emerging tool for approaching childhood mediastinal tumors in a minimally invasive way. The magnified visibility and availability of smaller instruments has allowed to explore even areas close to the great vessels and other vital structures. The safety and feasibility of this technique has been described for a wide range of these tumors. In spite of that the literature is deficient in use of this modality in paediatric mediastinal tumors. Although widely practiced in adults, various controversies have been set forward in application of this technique in children. This article aims to explore reasons for the underutilisation of VATS in these patients and tries to explain the areas of controversy with this technique. Various ways of comparison have been attempted for a broad understanding of the finer details (comparisons between open and VATS in children, VATS in children and adults, VATS in mediastinal tumors and lung surgeries).
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Mishra A, Ray MD, Bhoriwal S, Sharma J, Kumar C, Dhall K, Gowda M, Kumar A. Management options for gynecological cancers in low- to middle-income countries amidst COVID-19 pandemic. JOURNAL OF CANCER RESEARCH AND PRACTICE 2020. [DOI: 10.4103/jcrp.jcrp_14_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Kumar N, Bhoriwal S. Kimura's disease: A diagnostic dilemma. Indian J Med Res 2020; 152:S92-S93. [PMID: 35345142 PMCID: PMC8257151 DOI: 10.4103/ijmr.ijmr_2154_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pramanik R, Das P, Sharma A, Kumar S, Bhoriwal S, Pathy S, Saraya A. NOTCH3 expression predicts poor survival in advanced esophageal squamous cell cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Singh R, Bhoriwal S, Gogia A, Sharma D, Deo S. Routine cavity shave during breast conservation surgery is a good alternative to frozen sections. Breast 2019. [DOI: 10.1016/s0960-9776(19)30375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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