ABSTRACT
Background:Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods:A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults(<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P?0.05 was considered statistically significant.Results:CRC among younger adults comprised 40.3% of total patientsmedian age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history,lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histologycompared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients haddistant metastasis at diagnosis compared to in one fourth patients in older patients. Peritoneal metastasis was significantly higher among younger adults compared to older patients (p=0.000). Significantly greater proportion of patients among younger adults initially presented with bowel obstruction (p=0.034), for which upfront emergency surgical procedures was performed in significantly higher proportion of patients compared to the older age group (p=0.007).Conclusions:Advanced stage and aggressive disease biology of CRC in younger adult warrants inclusion of one decade younger age group into present screening recommendation.
ABSTRACT
Background: Concurrent chemoradiation is considered the standard care for locoregionally advanced non-small cell lung cancer. This study aimed to compare the treatment response, progression free survival and treatment toxicities between cisplatin and carboplatin based concurrent chemoradiation.Methods: Between October 2015 and September 2017, 60 eligible patients were enrolled and divided into two arms of 30 patients each. Arm A received EBRT to chest (60Gy/30 fractions) with concurrent weekly Injection Cisplatin 35mg/m2. Arm B received EBRT to chest (60Gy/30 fractions) with concurrent weekly Injection Carboplatin at a dose of AUC-2. Early treatment response was assessed at 1 month and late treatment response at 6 months after completion of radiation using RECIST criteria. Treatment toxicities was assessed using RTOG toxicity criteria. All statistical analysis was carried out using SPSS version 21.Results: Most patients were in the age range of 61-70 years. Mean age of presentation was 67.53±11.038 years in Arm A and 66.03±12.794 years in Arm B. Median follow up was 16 months for both arms. Response rate of was slightly better in Arm A (73.3% versus 60%). 1 year PFS rate was 53.33% in Arm A and 36.67% in Arm B. Median time to progression was better in Arm A (11 months vs 10 months). Toxicities were almost comparable in both the arms.Conclusions: Use of carboplatin in combination with radiation therapy is comparable to cisplatin in terms of treatment outcomes with better compliance and lower toxicity.
ABSTRACT
Breast cancer in young women (BCYW) is showing an increasing trend in incidence among women of India and other Asian countries compared to western countries. Methods: A retrospective study was carried out on total 579 patients treated between January 2010 and December 2017 to evaluate the clinico-epidemiological and pathological characteristics in BCYW. Cases were divided into two groups i.e the younger (<40 years) and the older (≥40 years) age group. Data were analyzed by chi square test using IBM SPSS version 21 for windows. P value less than 0.05 was considered significant. Results: The breast cancer in younger women (<40 years) was found in 20.2% of cases and was found to have greater proportion of unmarried women (p=0.002), higher frequency of nulliparity (p=0.006), greater incidence of bilateral breast cancer (p=0.017), greater incidence of multifocal or multicentric tumour (p=0.033), higher grade tumours (p=0.007), advanced T stage (p=0.003), advanced N stage (p=0.012) and overall advanced TNM stage (p=0.011) at diagnosis, higher frequency of lymphovascular invasion (p=0.00013), higher frequency of estrogen and progesterone receptor negativity (p=0.0005 and 0.0001 respectively). HER-2 expression rate was not found different between the two groups, whereas its expression rate was found significantly lower among women of age >50 years at diagnosis (p=0.001). Higher frequency of triple negative breast cancer was found in the younger age group (33.3% vs. 19.3%, p=0.001). Conclusions: Advanced stage presentation of BCYW warrants inclusion of younger age women in breast cancer screening and encouraging for breast self-examination.