Clinical Profiles and Survival Analysis of Patients with Carcinoma Cervix at a Tertiary Care Center: A Retrospective Study

Introduction: Cervical cancer is the fourth most frequent cancer in women with an estimated 570,000 new cases in 2018representing 6.6% of all female malignancies. Apparently 90% of deaths from cervical cancer occurred in low- and middleincome countries; the annual death rate was more than 26,600.Aim: This study aims to assess the clinical profiles, overall survival, and disease-free survival (DFS) of carcinoma cervix andto assess the factors that determine the treatment outcome.Materials and Methods: Atotal of 298 patients who met the inclusion criteria of newly diagnosed patients with histopathologicallyconfirmed cervical carcinoma were included in the study. The clinical profile, status of presentation, staging, compliance withtreatment and follow-up, as well as the response to the treatment in terms of OS and DFS of the treated patients and itscontributing factors were the outcome measures.Results: Two hundred and forty-five (82.2%) of 298 patients of the study population completed the scheduled radical treatment. Themost common presentation was Stage 2B with 125 (41.9%) patients followed by 3B with 87 (29.2%) patients and 4A with 12 (4%).The common histology was squamous cell carcinoma (90.6 %). Mean duration of treatment time in concurrent chemoradiotherapy +brachy was 10.93 weeks and external beam radiotherapy + brachy was 10.63 weeks. The median follow-up duration was 4.8 years.The overall survival rate was 97.1% and the mean disease-free survival period rate was 93.4%. In the treatment group, 17 (6.9%)patients showed recurrence, 4 (1.6%) deaths of the total of 20 recurrences, and 8 deaths in the study population.Conclusion: Similar outcome in the treatment group in terms of overall survival and DFS compared to other studies, withstatistical significance in factors contributed to the recurrence. Although treatment defaulters and follow-up defaulters werereaching a good number of the study group, for which care and provision of awareness measures should be taken.

The Cardiac Dysfunction of Anthracycline based Chemotherapy in Patients with Breast Cancer

Introduction: Cancer outcomes continue to improve dueto earlier detection and newer targeted therapies, withanthracycline chemotherapy playing a major role in themodern era of cancer treatment. Anthracyclines are listedamong the World Health Organization (WHO) model list ofessential medicines. Study aimed to evaluate the incidenceof the subclinical cardiac dysfunction associated withAnthracyclines based regimen in patients with breast cancerat a tertiary care center.Material and Methods: 110 patients with breast cancerpatients receiving Anthracycline-based chemo regimenwere enrolled in the study. All enrolled patients with breastcancer underwent baseline cardiac assessment and periodicmonitoring of cardiac function by noninvasive diagnostictoolsResults: The incidence of Anthracycline-induced cardiacabnormalities in this study was 38.1%. The incidence ofsubclinical cardiac dysfunction was more than overt cardiacdysfunction. The overt cardiac abnormality was observed in13.6% and subclinical cardiac dysfunction was observed in24.5% of our patients.Conclusion: Early identification of patients with subclinicalcardiac dysfunction aids in early intervention and preventionof further deterioration of cardiac dysfunction.

​Pre-operative Evaluation of Ovarian Masses with Color Doppler and its Correlation with Pathological Finding

Introduction: The management of ovarian tumors remains a common clinical gynecologic problem. The early and definitediagnosis of ovarian malignancy is of grave clinical importance. Recently, the role of color and spectral Doppler in the diagnosisof ovarian malignancy has been a subject of enormous debate.Aim: The purpose of the study was to evaluate the efficiency of color flow Doppler and its parameters with pulsatility index (PI)and resistive index (RI), to discriminate the benign and malignant ovarian masses.Methods: In 24 months period selected 100 patients, in whom adnexal mass was detected by ultrasound and had further evaluatedby Color flow Doppler at the radiology department. PI was calculated from the reproducible spectral waveforms generated fromflow central to peripheral within the mass or adjacent to the mass. The resistive index was calculated as the mean of threeconsecutive waveforms with the lowest RI. Each lesion was categorized on the basis of gray scale morphology as benign,borderline, and malignant. Other parameters such as a wall and septal thickness and echogenicity also were recorded. Theseimage-guided indices were further confirmed with histopathological findings to differentiate benign and malignant ovarian tumors.Results: Of the 100 patients 85 were benign, two were borderline, and 13 were a malignant ovarian mass with mean age 35.2,45.0, and 48.3, respectively. The threshold of PI >1 and RI >0.4 was diagnosed as benign. PI <0.8 and RI <0.4 were low andused as predictors of ovarian malignancy. Similarly, other parameters were calculated to discriminate the lesion.Conclusion: The study showed a high positive predictive value of high impedance flow in benign and predominant low impedanceflow in the malignant lesion. In the present study, fairly good specificity and sensitivity with PI <1 and the resistive index <0.4were achieved in ovarian malignancy. Color Doppler study was the diagnostic modality of choice for the patients with adnexalmass to establish the diagnosis of malignant ovarian tumors.