Journal Issue: Vol.13 No.1 - January 2014

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Panitumumab plus FOLFIRI vs. Bevacizumab plus FOLFIRI for First Line Treatment of Metastatic Colorectal Cancer with Wild-Type KRAS Tumors; a retrospective study.

Dr Emad Dawoud, Dr Dalia El Shorbagy, Dr Dina Hamza, Dr Adel Aref

  1. Dr Emad Dawoud
    MD, PhD.rn
    Lecturer of Clinical Oncology, Faculty of Medicine, Al Azhar University, Egypt.rnDubai Hospital, UAE
  2. Dr Dalia El Shorbagy
    MD, PhD.
    Dubai Hospital, UAE.rn
  3. Dr Dina Hamza
    Dubai Hospital, UAE.
  4. Dr Adel Aref
    Dubai Hospital, UAE.

Purpose The primary objective of this study is to estimate the treatment effect on progression-free survival (PFS), response rate and resection rate of panitumumab relative to bevacizumab in combination with FOLFIRI chemotherapy as first-line therapy in subjects with tumors expressing wild-type KRAS, unresectable metastatic colorectal cancer (mCRC).

Clinico-pathological Study of Carcinoma Breast in Females Presenting with Breast Lumps

Dr Shahnaj Pervin, Dr Mamun Al-Amin, Dr Anis uddin Ahmed, Dr Mazibar Rahman

  1. Dr Shahnaj Pervin
    Lecturer, Anatomy Department, Dhaka Medical College and Hospital
  2. Dr Mamun Al-Amin
    Lecturer, Department of Pharmacy, North South University
  3. Dr Anis uddin Ahmed
    Medical Officer, National Institute of Ophthalmology and Hospital
  4. Dr Mazibar Rahman
    Professor, Popular Medical College and Hospital

Breast physiology might be disturbed by many causes including inflammation and carcinoma. Analysis of incidence, pattern and prevalence of breast disease in the patient with breast lump could provide important suggestions for the physicians. Moreover, early diagnosis can save patient from metastases. Methods: In this retrospective cross sectional study, female patient presenting with palpable breast lump were recruited at Mymensingh Medical College, Bangladesh from 2011- 2012. Data was collected on variables of interest by interview, observation, clinical examination and necessary investigations. A total of 100 female cases were investigated through histopathological examinations by conventional methods. Results: In this study of total 100 cases, 58% benign and 42% were malignant. Pain in the breast 42%, nipple retraction 14%, nipple discharge 13%, lymph node involvement 10%, skin fixation over lump 9%, peau’d orange 8%, ulceration over lump 4% were found in the patient. Fibroadenoma (31%) was common benign lesion followed by fibroadenosis (17%). Lesions were mostly found at average age of 27 years, malignant lesions found around the average 46 year. Nipple discharge was common in breast carcinoma (21.4%) followed by fibroadenosis (17.6%). The most common surgery was Simple Mastectomy with Axillary Clearance (57.2%). Conclusion: The main problem of breast lump consists in its risk of being malignant, early detection is crucial and prompt treatment is required

Extramammary Paget’s Disease in an Asian Population: A Single Centre’s Experience

Dr Lee Chee Meng, Dr Cheong Kai Xiong, Dr Kesavan S, Dr Melissa Teo Ching Ching

  1. Dr Lee Chee Meng
    National Cancer Centre Singapore
  2. Dr Cheong Kai Xiong
    National Cancer Centre Singapore
  3. Dr Kesavan S
    National Cancer Centre Singapore
  4. Dr Melissa Teo Ching Ching
    National Cancer Centre Singapore

Aims: Extramammary Paget’s Disease (EMPD) is a rare intra-epithelial neoplasm affecting the skin of areas such as the scrotum, vulva and perineal region. This study examines the patient demographics, presenting symptoms, disease characteristics, and recurrence rates after surgical treatment, and overall prognosis of the condition. Methods: This retrospective analysis examined all patients (n=11) who were treated at the National Cancer Centre Singapore from 2003 to 2011. Information regarding the patients’ demographics, disease characteristics, treatment modalities and outcomes were collected. Results: The median age was 68 years, and patients were predominantly Chinese males who presented with skin rash. No concomitant malignancy was picked up amongst all the patients. All patients underwent wide excision, while groin dissection was performed in 2 patients with clinical lymphadenopathy. 5 patients had microscopically invasive disease while 6 had intraepidermal EMPD. Patients with intraepidermal EMPD had a significantly longer mean overall survival period of 35.5 months (range: 5-104) compared to 29 months (range: 3-59) for those with invasive disease. (p=0.0855). Mortality rate was 40% in those with microinvasive disease, at time of follow up. The 2 patients who eventually passed away were noted to have lymphadenopathy at diagnosis. Conclusions: Physicians should consider EMPD as a differential in the evaluation of persistent skin rash, especially for that in the genital region. The best chance of cure remains surgical resection, with adequate margins. Computed Tomography should be used as an adjunct to look for concomitant malignancy and to assess nodal disease. Patients who presented with metastatic disease had poor outcomes even with surgery, and should be considered for palliative management.

Projections of the Incidence of Pharyngeal, Tongue and Parotid Gland Cancer in Western Australia

Dr Derbi Hajer Abdelhafied, Prof Estie Kruger, Prof Marc Tennant

  1. Dr Derbi Hajer Abdelhafied
    International Research Colloaborative - Oral Health and Equity,rnThe Univeristy of Western Australia
  2. Prof Estie Kruger
    International Research Colloaborative - Oral Health and Equity,rnThe Univeristy of Western Australia
  3. Prof Marc Tennant
    International Research Colloaborative - Oral Health and Equity,rnThe Univeristy of Western Australia

Aims: The aims of this study are to provide updated estimates of the burden of pharyngeal, tongue and parotid cancer in Western Australia for the period 1982-2009, and also present the estimated projections of cases of these specific sites of cancer over the next decade. Methods: Incidence data for the current analysis were obtained from the Western Australian Cancer Registry for the period 1995 to 2004. Two widely acknowledged methods have been used to generate projection data for these statistics through to the year 2025.Results: Projections indicate increasing population rates of pharyngeal and tongue cancers and decrease in parotid gland cancer in Western Australia for the next 15 years. The projected trends in this study indicate a rise of pharyngeal cancer among men but remain stable among women. For tongue cancer, projections indicate that both female and male incidence rates remain stable or show a slight change for the next 15 years. Rates of parotid cancer are expected to decrease. The projected trends indicate a rise of parotid incidence rates in the 60-69 and 70-79 year female age groups and a marketable decrease of parotid cancer among 80+ male age group. Conclusion: Quantifying the future burden of cancer incidence in terms of expected numbers of cases is important in optimising the allocation of resources for screening, diagnostic, and therapeutic services, as well as providing a baseline from which the success of future interventions can be judged.

Primary Mediastinal Large B-Cell Lymphoma as a Diagnostic Dilemma: A Case Report

Dr Manas R Baisakh, Dr Nachiketa Mohapatra, Dr Debashish Nayak, Dr Raghunath Mohapatra

  1. Dr Manas R Baisakh
    MD; PDCC
    Consultant, Department of Pathology,Apollo Hospitals
  2. Dr Nachiketa Mohapatra
    MD; PDCC
    Consultant, Department of Pathology,Apollo Hospitals
  3. Dr Debashish Nayak
    Consultant, Department of Cardiothoracic Surgery, Apollo Hospitals
  4. Dr Raghunath Mohapatra
    MS; MCH
    Consultant, Department of Cardiothoracic Surgery, Apollo Hospitals

Primary mediastinal large B-cell lymphoma (PMLBL) is an unique diffuse type of B-cell lymphoma of thymic origin. We report a 19 year old male patient presented with bulky mediastinal disease. Extensive areas of fibrosis and sclerosis on frozen section biopsy and paraffin sections created diagnostic difficulty. Immunohistochemistry played an important role in discriminating the tumor from its close differentials.

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