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Majumdar KS, Kottayasamy Seenivasagam R, Maharaj DD, Mandol A, Singh A, Agarwal S, Poonia DR, Thaduri A, Panuganti A, Kailey VS. Clinicopathological Difference Between Gingivobuccal and Oral Tongue Cancers: A Cross-Sectional Observational Study from a Tertiary Healthcare Centre in Northern India. Indian J Otolaryngol Head Neck Surg 2022; 74:6262-6267. [PMID: 36742819 PMCID: PMC9895536 DOI: 10.1007/s12070-021-03025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/28/2021] [Indexed: 02/07/2023] Open
Abstract
Gingivobuccal and oral tongue squamous cell carcinomas are commonly considered together as a single clinical entity for staging and treatment purposes. Though there is data suggesting a significant difference between SCC of various oral cavity subsites, very few studies have compared clinicopathological characteristics between the tongue and gingivobuccal primaries. We retrospectively analysed 225 patients with biopsy-proven gingivobuccal (GB) and oral tongue (OT) SCC operated between April 1, 2018 and April 30, 2021 in All India Institute of Medical Sciences, Rishikesh, India to compare their clinicopathological characteristics. Demographic, clinical and histopathological data were collected from electronic medical records. An independent sample t-test was used to compare means and Pearson chi-square test or Fisher exact test was applied to compare the distribution of categorical variables. A relative male preponderance (12:1 vs. 5:1, p = 0.036) and increased smokeless tobacco consumption (82% Vs. 69%, p = 0.003) was seen in GB-SCC. Significantly higher proportion of patients with OT-SCC presented with early primaries (T1/T2) (54.1% vs. 24.8%, p < 0.001). Similarly, a higher proportion of GB-SCC patients presented with palpable neck nodes (cN +) (81% Vs. 67%, p = 0.02). Due to early primary tumours at presentation, stage I/II disease was also significantly higher in cases of OT-SCC (36.5% Vs.13.7%, p < 0.001). No difference was noticed in age at presentation, neck node status, and other clinicopathological parameters. GB-SCC has a higher male preponderance than OT-SCC due to relatively higher consumption of smokeless tobacco in males. Oral tongue cancers presented at an earlier stage than gingivobuccal malignancies. No difference in neck node status, however, suggests a relatively aggressive disease behaviour and early regional metastasis in tongue cancers. Follow up data regarding recurrence and survival is required to further characterise the differences between these two common OSCC subsites.
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Affiliation(s)
- Kinjal Shankar Majumdar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Dungala Dileep Maharaj
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Avijit Mandol
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Ashok Singh
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Satyaprakash Agarwal
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Dharma Ram Poonia
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhinav Thaduri
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Achyuth Panuganti
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Vikramjit Singh Kailey
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India
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Kaul P, Poonia DR, Kottayasamy Seenivasagam R, Maharaj DD, Jat BR, Garg PK, Agarwal SP. Technical Considerations and Outcome Analysis of Using Extended Bipaddle Pectoralis Major Myocutaneous Flaps for Reconstructions of Large and Complex Oral Cavity Defects: Expanding the Horizons. Indian J Surg Oncol 2021; 12:484-490. [PMID: 34658575 DOI: 10.1007/s13193-021-01345-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 05/04/2021] [Indexed: 12/24/2022] Open
Abstract
Reconstruction of large and complex defects arising from resection of advanced oral cancers requires free flaps or multi-staged reconstructions using a combination of pedicled flaps. Bipaddle (pectoralis major myocutaneous (PMMC) flap is a good alternative for reconstruction of such defects, especially in low-middle-income countries (LMIC). However, care should be taken while expanding its limits to avoid unnecessary morbidity. We discuss technical considerations while extending the PMMC flap design beyond the usual boundaries and analyse surgical and quality of life (QOL) outcomes in our patients with large (≥ 10 cm) oral cavity defects while using extended bipaddle PMMC flaps. We retrospectively analysed the results of 72 oral cancer patients with large buccoalveolar defects with at least one dimension ≥ 10 cm who underwent single-stage reconstruction using extended bipaddle PMMC flaps between January 2018 and December 2019. Total flap loss was seen in one patient and partial loss in 10 (13.8%) patients, while 18 (25.1%) patients had major complications (Clavien-Dindo grade III). Discharge from hospital was delayed beyond a mean of 6 days in 15 (20.8%) patients and the start of adjuvant treatment was delayed in 5 patients (6.9%). On univariate analysis, age > 50 years, female gender, the largest dimension and flap area were significant factors increasing morbidity. The QOL outcomes were acceptable. The satisfactory results from our series reaffirm that extended bipaddle PMMC flaps are a viable alternate option for such reconstructive challenges in resource-limited centres. However, age, gender, the defect dimensions and flap area should be taken into consideration while using this flap. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-021-01345-1.
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Affiliation(s)
- Pallvi Kaul
- Department of Surgical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
| | - Dharma Ram Poonia
- Department of Surgical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
| | | | - Dungala Dileep Maharaj
- Department of Surgical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
| | - Bhinya Ram Jat
- Department of Oto-Rhino-Laryngology & Head-Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
| | - Pankaj Kumar Garg
- Department of Surgical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
| | - Satya Prakash Agarwal
- Department of Surgical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, 249203 Uttarakhand India
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Maharaj DD, Sala G, Stone MB, Kermarrec E, Ritter C, Fauth F, Marjerrison CA, Greedan JE, Paramekanti A, Gaulin BD. Octupolar versus Néel Order in Cubic 5d^{2} Double Perovskites. Phys Rev Lett 2020; 124:087206. [PMID: 32167347 DOI: 10.1103/physrevlett.124.087206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/30/2020] [Indexed: 05/13/2023]
Abstract
We report time-of-flight neutron spectroscopy and neutron and x-ray diffraction studies of the 5d^{2} double perovskite magnets, Ba_{2}MOsO_{6} (M=Zn,Mg,Ca). These materials host antiferromagnetically coupled 5d^{2} Os^{6+} ions decorating a face-centered cubic (fcc) lattice and are found to remain cubic down to the lowest temperatures. They all exhibit thermodynamic anomalies consistent with a single phase transition at a temperature T^{*}, and a gapped magnetic excitation spectrum with spectral weight concentrated at wave vectors typical of type-I antiferromagnetic orders. However, while muon spin resonance experiments show clear evidence for time-reversal symmetry breaking below T^{*}, we observe no corresponding magnetic Bragg scattering signal. These results are shown to be consistent with ferro-octupolar symmetry breaking below T^{*}, and are discussed in the context of other 5d double perovskite magnets and theories of exotic orders driven by multipolar interactions.
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Affiliation(s)
- D D Maharaj
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - G Sala
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M B Stone
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - E Kermarrec
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - C Ritter
- Institut Laue-Langevin, Boîte Postale 156, 38042 Grenoble Cédex, France
| | - F Fauth
- CELLS-ALBA Synchrotron, Carrer de la Llum 2-26, 08290 Cerdanyola del Vallès, Barcelona, Spain
| | - C A Marjerrison
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - J E Greedan
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4M1, Canada
- Department of Chemistry and Chemical Biology, McMaster University, Ontario L8S 4M1, Canada
| | - A Paramekanti
- Department of Physics, University of Toronto, 60 St. George Street, Toronto, Ontario M5S 1A7, Canada
| | - B D Gaulin
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4M1, Canada
- Canadian Institute for Advanced Research, 661 University Avenue, Toronto, Ontario M5G 1M1, Canada
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