EGFR and HER-2/neu expression in gallbladder carcinoma: an institutional experience

Background: Gallbladder cancer [GBC] is the most common malignancy of the biliary tract in India. Despite the recent advancement in the understanding of the cancer biology, the disease still remains a therapeutic challenge with poor prognosis and low survival. Surgery is the primary modality of treatment and rest of the modalities are basically adjuvant in nature. This study was performed to evaluate the epidermal growth factor receptor [EGFR] and human epidermal growth factor receptor-2 [HER-2/neu] expression in GBC

Methods: The present study was prospective and done in tertiary super-specialty institute of northern India. This was a pilot study, and at the time of completion, 29 samples were found suitable which were later submitted for EGFR and HER-2/neu evaluation. The sample includes both cases of GBC [n=18] and cholecystitis [n=11] as control. [Table 1] After performing necessary processing, slides were incubated with primary antibody [EGFR] ready to use [RTU] BioGenex, India and HER-2/neu dilution 1: 600, Dakopatts [Denmark]. Then slides were incubated with secondary antibody [Real Envision Detection Kit, Dakopatts, Denmark]. Finally in mounted slides, cell membrane staining was used to assess positivity for EGFR and HER-2/neu

Results: EGFR was positive in 21/29 [72.41%] overall, out of which 14/18 [77.78%] positive in cases and 7/11 [63.64%] positive in control. [Table 1, 3][Figure 2]. For HER-2/neu, it was positive in 21/29 [72.41%] overall, just like in EGFR mentioned above, but positive 12/18 [66.67%] in cases and 9/11 [81.82%] in control respectively. [Table 1, 3][Figure 3]

Conclusion: Despite the efforts by many investigators, GBC continues to represent a major challenge in oncology. Surgical resection remains the only curative treatment for this disease. The roles of radiation, chemoradiation, and chemotherapy in neoadjuvant and adjuvant settings remained to be defined in prospective studies. With further studies based on molecular understanding and developing new targeted therapies, we will be in better position to manage GBC and increase the survival rate

Quantitative tumor volume vs. TNM staging: the impact on prognosis in head and neck cancer

To evaluate the prognostic value of tumor volume [TV] by clinical method [CM] and Computerized Tomography [CT] scan in head and neck [H and N] cancer. Total 25 patients' [pts] pretreatment tumor volume [PT TV] was assessed clinically by cuboid volume method. Afterwards contrast enhanced computerized tomography [CECT] images of the pts were transferred to workstation by DICOM software. The computerized tomography tumor volume [CT TV] was obtained on Radworks 6.0, using mouse control cursor. After assessment, the patients were given 3 cycles of neoadjuvant chemotherapy followed by radiotherapy by conventional method on Co-60 Theratron 780 C. After 1 month of treatment, TV was again measured. Statistical analysis was done on MSTAT statistical analysis software. Two-tailed student t test, chi square test and test for two proportions for significance had been used. Large variations in tumor volume were found both in intra as well as inter T-stages. As the tumor size increases with T stages, the differences in measurement of TV by both methods decreases. CT TV results pre as well as post-treatment were more consistent than clinical method. The use of TV as a prognostic factor by CT scan seems to be more useful parameter than the CM. TV should be included in the TNM [tumor, node, and metastasis] classification after setting the strict guidelines for tumor delineation, to solve the discrepancy of treatment outcome in the same clinical stage