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Kashyap L, Singh A, Tomar S, Gupta A, Sansar B, Chaudhary AK, Mishra BK, Sambasivaiah K, Kapoor A. Pattern of Care and Outcomes of Gallbladder Cancer Patients: Retrospective Study from a High Incidence Region in India. South Asian J Cancer 2023; 12:245-249. [PMID: 38047044 PMCID: PMC10691906 DOI: 10.1055/s-0043-1761440] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Lakhan KasyapIntroduction Gallbladder cancer (GBC) is the 20th most common cancer in India with a crude incidence rate of 2.3 per 100,000 persons. Of note, it is relatively common in states which fall in the Gangetic plains. Patients often present in the advanced stage and have an unfavorable prognosis. Materials and Methods From January to June 2021, 170 treatment-naive GBC (adenocarcinoma) patients who were registered at a tertiary care cancer center in North India, were included. Data were extracted from electronic medical records and was analyzed with SPSS. Results Median age was 56 years (range 32-77 years) and 65.5% ( n = 112) were female. Incidental GBC was found in 20% patient ( n = 34). Majority of patients (79.4%, n = 135) had preserved performance status. Advanced GBC was present in 85.8% ( n = 146) patients (locally advanced = 37.0% and metastatic = 48.8%). Biliary drainage procedure was performed in 24% of patients (68% of patients with obstructive jaundice). More than half of patients (53.5%) were lost to follow-up without any treatment. There were 33 patients (19.4%) who underwent surgery and 20 of them received neoadjuvant chemotherapy. Adjuvant chemotherapy and adjuvant radiotherapy were received by 13 and 2 patients, respectively. Palliative chemotherapy was administered to 46 patients. The most common chemotherapy regimen was gemcitabine-cisplatin. At a median follow-up of 1.7 months (95% confidence interval, 1-2.4 months), 42 patients (24%) progressed and 24 patients (14%) died, with 6 months estimated progression-free survival and overall survival being 60.2 and 79%, respectively. Conclusion GBC is an aggressive and lethal malignancy predominantly affecting females in the fifth decade with dismal outcomes. Improved access to health care, an aggressive approach in operable cases, and optimization of systemic and adjuvant therapy are the need of the hour.
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Affiliation(s)
- Lakhan Kashyap
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Arpita Singh
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Subham Tomar
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Anuj Gupta
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Bipinesh Sansar
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Amit Kumar Chaudhary
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Bal Krishna Mishra
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Kuraparthy Sambasivaiah
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
| | - Akhil Kapoor
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre and Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, Uttar Pradesh, India
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Affiliation(s)
- K Sambasivaiah
- Departments of Medical Oncology, Neurology, and Radiology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - Srikanth Reddy
- Departments of Medical Oncology, Neurology, and Radiology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - B Praveen Kumar
- Departments of Medical Oncology, Neurology, and Radiology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - P Suneetha
- Departments of Medical Oncology, Neurology, and Radiology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
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Patnayak R, Jena A, Rukmangadha N, Chowhan AK, Sambasivaiah K, Phaneendra BV, Reddy MK. Hormone receptor status (estrogen receptor, progesterone receptor), human epidermal growth factor-2 and p53 in South Indian breast cancer patients: A tertiary care center experience. Indian J Med Paediatr Oncol 2015; 36:117-22. [PMID: 26157289 PMCID: PMC4477374 DOI: 10.4103/0971-5851.158844] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED Breast cancer, in India, is the second commonest cancer in females. Receptor status with ER/PR/Her 2 is now routinely done in patients with invasive carcinoma. The tumour suppressor gene, p53, is also present in most breast cancers. Proteins produced by a mutated p53 gene, accumulate in the nucleus of tumour cells and are detected by immunohistochemistry (IHC). We have undertaken this study with the aim to evaluate the ER, PR, HER-2 and p53 expressions in invasive breast carcinomas by IHC and to compare the HER-2 expression with various clinicopathological parameters. MATERIALS AND METHODS In this retrospective single institutional study from January 2001 to December 2010, 389 cases of histopathologically diagnosed infiltrating carcinoma of breast were evaluated taking into account various parameters like age, tumour size, grade, lymph node involvement, ER and PR. HER-2 and p53 was done in 352 cases. RESULTS The age range was 23-90 years with a mean of 50.7 years. Majority of tumours were T2 (79.6%) and Grade II (60.9%). Our data showed overall 47.6% ER, 48.8% PR, 29.6% HER-2 and 69.2% p53 positivity. There was no significant correlation between HER-2 and age, tumour size, lymph node status, ER, and PR. There was significant correlation between HER-2 and tumour grade (P = 0.031), p53 (P < 0.001). There was no inverse correlation between HER-2 and combined ER, PR status. Triple-negative breast cancers which constituted 22.7% of our cases did not reveal any correlation with various parameters. CONCLUSION In our study, ER status was low, and incidence of p53 was high. These findings suggest that many of the tumours in Indian females may be of an aggressive type, and novel treatment approaches may be tried. We conclude that the assessment of all four markers is desirable.
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Affiliation(s)
- Rashmi Patnayak
- Department of Pathology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Amitabh Jena
- Department of Surgical Oncology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Nandyala Rukmangadha
- Department of Pathology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Amit Kumar Chowhan
- Department of Pathology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - K Sambasivaiah
- Department of Medical Oncology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | | | - Mandyam Kumaraswamy Reddy
- Department of Pathology, Sri Venkateswar Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Ranade AA, Bapsy PP, Nag S, Raghunadharao D, Raina V, Advani SH, Patil S, Maru A, Gangadharan VP, Goswami C, Sekhon JS, Sambasivaiah K, Parikh P, Bakshi A, Mohapatra R. A multicenter phase II randomized study of Cremophor-free polymeric nanoparticle formulation of paclitaxel in women with locally advanced and/or metastatic breast cancer after failure of anthracycline. Asia Pac J Clin Oncol 2013; 9:176-81. [PMID: 23176568 DOI: 10.1111/ajco.12035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 12/01/2022]
Abstract
AIMS Paclitaxel is extensively used in the treatment of advanced carcinomas of the breast, ovary and non-small cell lung cancer. In clinical use it is formulated in the non-ionic surfactant polyethoxylated castor oil (Cremophor) and dehydrated alcohol to enhance drug solubility. Cremophor adds to toxic effects of paclitaxel by producing or contributing to the well-described hypersensitivity reactions that commonly occur during its infusion, affecting a large number of patients. This randomized trial was conducted to evaluate efficacy and safety of novel nanoparticle-based paclitaxel in the treatment of patients with advanced breast cancer. METHOD Patients were randomized to receive either nanoparticle paclitaxel (NP) 300 mg/m(2) , (NP300) or NP220 mg/m(2) or Cremophor paclitaxel 175 mg/m(2) (CP 175). NP was administered as a 1-h infusion without premedication and CP as a 3-h infusion with premedication every 3 weeks. RESULTS In total, 194 patients who had been administered at least one dose were included for safety analysis and 170 patients who completed at least two cycles of therapy were analyzed for efficacy. NP showed an overall response rate (complete response + partial response) of 40% in the NP220 and NP300 arms as compared to 31% in the CP arm. The incidence of neutropenia (all grades) was lowest in the NP220 arm (39.4%) compared to the NP300 (55%) and CP arm (50%). CONCLUSION NP is well tolerated and can be safely administered without any premedication in comparison to conventional paclitaxel, which requires the use of premedication before administration. NP demonstrates promising efficacy with a favorable safety profile.
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Sambasivaiah K, Samson S, Prasanna V, Shankar AH. Vermian metastasis causing truncal ataxia and hydrocephalus as initial presentation of carcinoma stomach. Trop Gastroenterol 2008; 29:101-102. [PMID: 18972771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The common presentation of carcinoma stomach includes haematemesis, malaena and gastric outlet obstruction. Symptoms due to metastases to the liver and lung as part of the disease progression are usually preceded by the detection of a primary in the stomach. Carcinoma stomach, where the primary is silent, and which presents with truncal ataxia and features of hydrocephalus due to isolated metastatic deposit in the cerebellar vermis is exceptionally rare. The prognosis of such patients is poor and the treatment is palliative.
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Affiliation(s)
- K Sambasivaiah
- Narayana Medical College Hospital, Nellore, Andhra Pradesh, India.
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Sampathkumar N, Sambasivaiah K, Naga M. Triple negative breast cancer with isolated leptomeningeal metastasis. Indian J Med Paediatr Oncol 2008. [DOI: 10.4103/0971-5851.51429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractIsolated Leptomeningeal metastasis in breast cancer is rare. The diagnosis requires T1W MR scan of brain with gadolinium enhancement and demonstration of malignant cells in CSF. The treatment is palliative, which includes whole brain radiotherapy and chemotherapy.
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Affiliation(s)
- N Sampathkumar
- Department of Neurology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - K Sambasivaiah
- Department of Medical Oncology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - M Naga
- Department of Neurology, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
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Kumar CJ, Baboo CA, Krishnan BU, Kumar A, Joy S, Jose T, Philip A, Sambasivaiah K, Hegde BM. The socioeconomic impact of the chikungunya viral epidemic in India. Open Med 2007; 1:e150-2. [PMID: 21673944 PMCID: PMC3113220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2007] [Revised: 10/10/2007] [Accepted: 10/10/2007] [Indexed: 11/29/2022]
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Sambasivaiah K, Reddy K, Lakshmi AY, Menon B, Varma VS. Gastric cancer with isolated leptomeningeal metastases: a case report. Trop Gastroenterol 2007; 28:39-40. [PMID: 17896611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Leptomeningeal carcinomatosis due to gastric cancer is rare. Gadolinium enhanced MRI and CSF analysis for malignant cells are necessary to confirm the diagnosis.
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Affiliation(s)
- K Sambasivaiah
- Department of Pathology, Radiology and Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507, Andhra Pradesh, India.
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Suman R, Bhushan JV, Reddy K, Chandrasekhar K, Sambasivaiah K. Choroid Plexus Carcinoma in a Child : A Case Report. Indian J Med Paediatr Oncol 2006. [DOI: 10.1055/s-0041-1733177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- R Suman
- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507. Andhra Pradesh, India
| | - JV Bhushan
- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507. Andhra Pradesh, India
| | - Kumaraswamy Reddy
- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507. Andhra Pradesh, India
| | - K Chandrasekhar
- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507. Andhra Pradesh, India
| | - K Sambasivaiah
- Department of Neurosurgery, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507. Andhra Pradesh, India
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Sambasivaiah K, Ibrarullah M, Reddy MK, Reddy PVR, Wagholikar G, Jaiman S, Reddy DG, Sarma KVS, Hegde GN. Clinical profile of carcinoma stomach at a tertiary care hospital in south India. Trop Gastroenterol 2004; 25:21-6. [PMID: 15303466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Carcinoma of the stomach is an important cause of mortality due to cancer. Carcinoma of the stomach is common in the southern region of India. We conducted a retrospective study on the epidemiological, clinical and survival patterns among the patients with carcinoma of the stomach, attending our hospital from June 19, 1995 to 1st January 2003. All the patients had histopathological confirmation of malignancy. Patients with gastrooesophageal junction lesions were excluded. Surgery was performed with curative as well as palliative intent in suitable patients. Chemotherapy has been incorporated in to the combined modality treatment in our hospital since July 2000. Postoperative chemotherapy comprised commonly used intravenous chemotherapy regimens, while oral chemotherapy (etoposide) was given to patients with disease not amenable to surgery, and those having poor performance and nutritional status. Oral etoposide was given in a dose of 50 mg/day for 14 days, in a 28 day cycle. Quality of life was assessed in the oral chemotherapy group. Out of the 1749 cancer patients seen during the period, 151 had gastric malignancy (8.6%). The median age was 55 years (range 15-84 years). The male to female ratio was 4:1. Adenocarcinoma was found in 148 patients, 2 had stromal tumours and 1 had non-Hodgkin lymphoma. Stage disribution was as follows; stage 2-1 patient , stage 3a-25, stage3b-49, stage4-3 1, Metastatic-28. Staging was not completed in 17 patients. Eighty-nine patients underwent surgery. Fifty-nine patients (39%) did not have surgery. One patient underwent polypectomy. Curative gastrectomy was performed in 11 patients. Thirty-nine patients underwent palliative tumour resection. Palliative gastro-jejunostomy for relief of symptoms was performed in 26 patients and exploratory laparotomy alone was perforaied in 13. Thirty-eight patients received chemotherapy. Out of these, only 2 patients had prior complete resection of the tumour and 36 received palliative chemotherapy. Intravenous chemotherapy was given to 17 patients and oral chemotherapy to 19; All the patients who received oral etoposide did not experience any toxicity. Patients who received intravenous chemotherapy (n=17) had the following toxicities: grade 3 emesis in 4 (20%), discoloration of the skin and nails in 6(31%), alopecia in 8 (50%), grade 3 diarrhoea in 3 (15%) and neutropenic fever in 4 patients (20%). Median survival for the cohort was 10.4 months. Quality of life parameters, such as sleep, appetite, weight, pain, work and general sense of ill health showed improvement. In conclusion, 8.6% of all cancers at our hospital were due to cancer of stomach, in whom distal gastric tumor were more frequent and most were non-resectable. Median survival was 10.4 months. Oral etoposide was found to be safe, improved the quality of life and may play a role in the palliative management of advanced carcinoma of the stomach.
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Affiliation(s)
- K Sambasivaiah
- Departments of Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517507, Andhra Pradesh.
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Affiliation(s)
- Mohammad Ibrarullah
- Departments of Gastroenterology, Oncology, and Pathology, SV Institute of Medical Sciences, Tirupati, India
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