Filipino translation and validation of the University of Washington – Quality of Life Questionnaire (Version 4) for patients with head and neck tumors in the Philippine General Hospital

Objectives@#This study aims to develop a Filipino translation of the University of Washington Quality of Life Questionnaire (UW-QOL) version 4, and determine its internal consistency and test-retest reliability. @*Methods@#This was a cross sectional mixed methods study comprised of two parts. The first part consisted of Filipino translation of the UW-QOL version 4 questionnaire. The second part validated the internal consistency and testretest reliability through statistical analysis. @*Results@#The Cronbach’s coefficient was high (0.88) which denotes good internal consistency. Pearson’s correlation coefficient was obtained to determine the test-retest reliability of the translated questionnaire. A p value of <0.05 indicates that the questionnaire has good test-retest reliability. The p value was high in most of the items of the questionnaire. @*Conclusion@#The internal consistency of the translated questionnaire is high and comparable to other translations of the same questionnaire. The test-retest reliability is low owing to the interventions done between the test and retest.

Multiple strategies to avoid life-threatening blood loss during intralesional resection of a giant Plexiform Neurofibroma: A case report

@#Giant plexiform neurofibroma (PNs) are benign peripheral nerve sheath tumors known to contain multiple fascicles of nerve and numerous friable vascular components. Most consult due to significant disfigurement and functional deficit. Though surgery is the current standard of therapy, there is high reservation in pushing through with resection in most cases. The reservation stems from the recognized difficulty in controlling intraoperative life-threatening hemorrhage. A 25-year-old female came in our institution due to multiple debilitating giant PNs on her scalp, back, neck, shoulder, and chest. She opted for debulking surgery despite possible complications and recurrence. Multiple modalities used to prevent massive bleeding in this case included preoperative arterial embolization, energy sealing device, cutting linear stapler, and interlocking retention sutures. The aim of this case report was to discuss the utility of each of these techniques, the advantages and disadvantages of each approach based on our experience.

Clinicopathologic profile of patients with maxillofacial tumors in a tertiary level government institution

RATIONALE@#Bone tumors of the head and neck region are rare. Their occurrence, biologic behavior, and management can cause significant personal, social, behavioral and economic ramifications. The aim of this study was to describe the clinicopathologic profile of patients with maxillofacial tumors in a tertiary level government hospital. @*METHODS@#This was a retrospective, descriptive study over a five-year period (January 2013 to December 2018).@*RESULTS@#A total of 256 patients was included in the study, with females accounting for 53.5% and males for 46.5%. The mean age of presentation was 37.4 years with a range of 18-80 years. The mean age of patients with benign tumors was 36.1 years, while those with malignant tumors was higher at 61.8 years. Majority of the tumors involved the mandible. Ameloblastoma and dentigerous cysts were the most prevalent benign odontogenic tumors while squamous cell cancer was the most common malignancy. Radical surgery with composite reconstruction was done in malignant cases to ensure adequate pathologic margins, while a more conservative tissue-sparing approach was done for benign cases.@*CONCLUSION@#Management of maxillofacial tumors remains a challenge because of its relative anatomic location and locally-advanced state upon detection. Identifying these tumors at an early stage ensures adequate resection with minimal functional and aesthetic loss. The low morbidity and mortality rates reported in this study emphasizes the role of the multidisciplinary team approach, surgical experience and comprehensive perioperative care in the management of bone tumors in the head and neck.

Breast cancer in the young: A 10-year review of the diagnosis, treatment and outcomes at the Philippine General Hospital

RATIONALE@#Breast cancer is the most prevalent cancer in the world. It is usually diagnosed in women 50 years old and older, but is also found in younger women. Its occurrence in young women led to questions with regards issues on its tumor biology, survival and fertility. There is insufficient local data to formulate treatment options relevant to this age group. This study reviews the data on breast cancer in young female patients seen in a tertiary institution.@*METHODS@#This is a descriptive study involving a review of medical records of young female breast cancer patients (<35 years of age), seen at the Philippine General Hospital - Breast Care Center from January 2008 to December 2017. @*RESULTS@#A total of 119 patients were included in the study. Of these young female patients, 29.4% presented with locally advanced disease (Stage IIIB) correlating with a high number of patients who underwent neoadjuvant chemotherapy (38.7%) and modified radical mastectomies with primary closure (62.18%). @*CONCLUSION@#Breast cancer in young females should be aggressively investigated as it commonly presents in an advanced stage.

Male breast cancer: The Philippine General Hospital experience

RATIONALE/OBJECTIVE@#Breast cancer among males is often diagnosed at a later age and at an advanced stage. The study aimed to present the epidemiology, associated risk factors, clinical and pathological characteristics, treatment patterns and outcomes of male breast cancer patients treated at the Philippine General Hospital from January 2008- December 2017. Information from this study can provide for better understanding of the disease and basis for creating guidelines toward better outcomes. @*METHODS@#Retrospective study of medical records involving male breast cancer patients who underwent surgery and treatment at the Philippine General Hospital from January 2008- December 2017.@*RESULTS@#Male breast cancer accounted for 15 (0.26%) of 5,777 resected breast specimens for breast cancer patients with a 1:384 male to female ratio. The mean age of presentation was 60 years. The most common presentation was a retro-areolar mass, with 33% of patients presenting post-excision. Sixty-seven percent were at Stage II and 20% at Stage III. About 94% of patients have invasive ductal carcinoma, while the only other histology is papillary carcinoma at 13%. Majority of those tested were both estrogen receptor and progesterone receptor (ER/PR) positive (33% versus 1 %), and Her2neu negative. All patients underwent modified radical mastectomy. Only two patients were documented to have received adjuvant chemotherapy while one patient received neoadjuvant chemotherapy.@*CONCLUSION@#Breast cancer remains to be a rare disease among males, is often diagnosed at a later age and at an advanced stage. Because of its rarity, awareness is necessary not only in the community but also among healthcare providers to identify and treat the problem earlier. Further investigation and prospective studies are recommended.

Filipino translation and validation of the University of Washington - Quality of Life Questionnaire (Version 4) for patients with head and neck tumors in the Philippine General Hospital

Objectives@#This study aims to develop a Filipino translation of the University of Washington Quality of Life Questionnaire (UW-QOL) version 4, and determine its internal consistency and test-retest reliability. @*Methods@#This was a cross sectional mixed methods study comprised of two parts. The first part consisted of Filipino translation of the UW-QOL version 4 questionnaire. The second part validated the internal consistency and testretest reliability through statistical analysis. @*Results@#The Cronbach’s coefficient was high (0.88) which denotes good internal consistency. Pearson’s correlation coefficient was obtained to determine the test-retest reliability of the translated questionnaire. A p value of <0.05 indicates that the questionnaire has good test-retest reliability. The p value was high in most of the items of the questionnaire. @*Conclusion@#The internal consistency of the translated questionnaire is high and comparable to other translations of the same questionnaire. The test-retest reliability is low owing to the interventions done between the test and retest.

Benign tumors of the mandible and maxilla: The Philippine General Hospital experience (1993-2005)

OBJECTIVE: This study seeks to describe the relative frequency of benign tumors in the mandible and maxilla, the operations done to manage these tumors at the Philippine General Hospital and compare it to previous reports.METHODOLOGY: The histopathology records of patients with tumors affecting the mandible and maxilla who underwent biopsy or definitive surgery between January 1993 and December 2005 were included in this study and analyzed.RESULTS: Out of 1049 cases of tumors of the mandible and maxilla, 566 were benign tumors. Patients had a mean age of 30.77 + 15.70 (Range of 4 mos to 83 years). There is a predilection for males (1.4:1), and the mandible (1.9:1). Ameloblastoma is the most common tumor encountered (266 out of 566 or 47.00 percent). Resection is the most common operation done (380 out of 575 or 66.09 percent). Nine operations were done for tumor recurrence (9 out of 575 or 1.57 percent). Ameloblastoma is the only histologic type of tumor that resulted in recurrence.CONCLUSION: Benign tumors are more common in the mandible and maxilla. Odontogenic tumor, specifically ameloblastoma, is the most common histologic type. If has specific predilections as to site, age, and gender. In this study, resection is the most common procedure done for this tumor.

Associação de carcinoma papilífero da tireóide e hiperparatireoidismo / Association of papillary thyroid carcinoma and hyperparathyroidism

OBJETIVO: A ocorrência de carcinoma papilífero da tireóide (CPT) em doentes com hiperparatireoidismo (HPT) suscita dúvidas quanto a ser apenas coincidência ou apresentar relação causal. O objetivo deste trabalho é verificar se a incidência de CPT em diferentes formas de HPT é semelhante entre si e à incidência de CPT em achados de necropsias, assim como em doentes submetidos à tireoidectomia na mesma região. MÉTODO: Os dados de 222 pacientes consecutivos tratados por HPT foram revistos e foi analisada a incidência de CPT. Os pacientes foram estratificados em HPT primário (107) e HPT secundário (115). Os laudos anatomopatológicos foram revistos, a incidência de CPT foi pesquisada e suas características nesses indivíduos foram estudadas. Esses dados foram comparados a dados encontrados em casos de necrópsia e em 89 casos de bócio compressivo/mergulhante. Empregou-se o teste exato de Fisher e o teste t não pareado. RESULTADOS: Os laudos foram passíveis de análise em 103 casos de HPT primário, com 10 pacientes com CPT (9,7 por cento) e em 111 portadores de HPT secundário, com três CPT associados (2,7 por cento). Houve diferença entre o HPT primário e HPT secundário (p=0,04). Essa diferença também foi significativa em relação aos 1 por cento de CPT achados em necrópsia na região (p=0,0001). Não houve diferença com relação à incidência de 11,2 por cento de CPT no grupo operado por compressão e também em relação às características dos tumores, apesar de haver 80 por cento de multicentricidade no CPT de doentes com HPT primário. CONCLUSÕES: A ocorrência de CPT em HPT primário é maior que em HPT secundário e que em achados de necropsia.

BACKGROUND: Association of papillary thyroid carcinoma (PTC) and hyperparathyroidism (HPT) has not been clearly defined. The incidence of PTC in different types of HPT and necropsy or patients submitted to thyroidectomy in the same region is analyzed to verify if this association is casual or not. METHODS: Data of 222 consecutive patients operated for HPT were reviewed and incidence of PTC was defined. Patients were analyzed as primary HPT (107) and secondary (115). The incidence of PTC was compared to that found in necropsy and to that observed in 89 patients with compressive multinodular goiter submitted to thyroidectomy. Statistical analysis included Fisher's exact test and Student's t test. RESULTS: Pathology reports were available in 103 cases of primary HPT, and in 10 patients PTC was detected (9.7 percent). In 111 secondary HPT patients, PTC was found in three (2.7 percent), with statistical significant difference between primary and secondary HPT (p=0.04). This difference was also significant of the 1 percent incidence of PTC found in necropsy in the same area (p=0.0001). No difference was observed in relation to the incidence of 11.2 percent of PTC found in patients operated for compressive goiter. Tumor characteristics were not statistically different, although multicentricity was detected in 80 percent of PTC of patients with primary HPT. CONCLUSION: The incidence of PTC was elevated in patients with primary HPT, in relation to necropsy or secondary HPT cases.