The Spectrum of Clinical Presentations of Gestational Trophoblastic Disease from a Tertiary Care Center

Introduction: Gestational trophoblastic disease (GTD) is a disease of pregnancy and therefore a disease of women. GTDcomprises the heterogeneous group of related lesions arising from abnormal proliferation of trophoblast of the placenta witha spectrum of disorders ranging from benign to malignant disease. The malignant form of GTD collectively called gestationaltrophoblastic neoplasia (GTN).Aim: The aim of this study was to analyze the clinical characteristics, outcomes, and factors affecting response to treatment.Materials and Methods: We undertook a retrospective review of GTD cases treated at our center from 2017 to 2019, inwhich patients demographic profile and clinical information were identified including age, gravidity, symptoms, gestational age,consanguinity, pathologic diagnosis, investigations, treatment, and follow-up data, and subsequently, statistical analysis was done.Results: During the 3-year period, 78 cases of GTD were reviewed. Complete and partial molar pregnancies were diagnosed in49 (68%) and 29 (32%) cases, respectively. According to the International Federation of Gynecology and Obstetrics anatomicalstaging, the most GTN patients were assessed as Stage I and Stage III, at 80.0% and 11.4%, respectively. Post-molar GTNdeveloped more frequently in women who had a pathologic diagnosis of complete mole, uterus larger than 14-week size, andpretreatment human chorionic gonadotropin levels more than 150,000 mIU/mL. Our study demonstrated a superior responseto single-agent actinomycin D (90%). The overall cure rate at our center approached 96% during the study period.Conclusion: GTD results in significant maternal morbidity, which leads to mortality if not detected early. The patients shouldbe risk stratified for proper management and referred to experienced centers that have capabilities for adequate supportivecare and consequent treatment.

A Study of Correlation of Clinical Variables with Presenting Stage and Type of Endometrial Cancer at a Tertiary Care Hospital - A Retrospective Study

Introduction: The prevalence of gynecological cancers has been increasing in the Asian population. With the recent changingtrend in lifestyle and reproductive profile of women, the number of cases being diagnosed with endometrial cancer is increasing.Aim: The aim of this study is to evaluate the correlation of various clinical risk factors of endometrial carcinoma on thehistopathology and presenting stage of the disease.Materials and Methods: A hospital-based, retrospective study included 100 patients of endometrial carcinoma presented atthe Institute of Obstetrics and Gynaecology, Chennai, India, between January 2016 and June 2019. The correlation of age(≤40 years and >40 years), parity status (parous and nulliparous), menstrual status (premenopause and postmenopause),diabetes, hypertension, duration of complaint (≤6 months and >6 months), and body mass index (BMI) with the stage of thedisease (clinical/radiological and pathological stages) and histological class was analyzed.Results: The mean age of patients was 56.4 ± 11.3 years. Among the 100 patients, a total of 62 (63.6%) patients had presentedwith clinical/radiological stage-I, of which 6 patients had defaulted for treatment and 6 patients had the stage-IV disease. Of the88 patients who underwent staging laparotomy, 59 (67%) patients had pathological stage-I carcinoma and 3, 18, and 8 patientspresented in stage II, III, and IV disease, respectively. Histopathological evaluation revealed endometrioid adenocarcinomaas the most common type, in 79 patients (79%). No significant correlation of any of the risk factors on clinical/radiological,pathological as well as on histopathology was observed.Conclusion: The study did not state the statistically significant association of age, parity status, menopause, diabetes,hypertension, BMI, and the duration of complaints with the histological class of endometrial carcinoma and presenting clinicaland pathological stages of endometrial carcinoma.

Prospective Analysis of Quality of Life in Patients with Inoperable Esophageal Carcinoma with Definitive Concurrent Chemoradiotherapy – A Single-center Study

Introduction: Cancer of the esophagus is a fatal disease and ranked the 6th most common cause of cancer-related deathworldwide. Treatment for esophageal carcinoma is characterized as curative or palliative. Data from different studies showonly 20% of patients present with cancer of the esophagus that is truly localized to the esophagus, indicating that at the timeof diagnosis, approximately 80% of patients have either locally advanced or distant disease.Aim: This study aims to study the clinical assessment of quality of life (QOL) before, during, and after treatment of concurrentchemoradiotherapy in inoperable esophageal cancers.Materials and Methods: A single-arm prospective study of patients undergoing definitive chemoradiation treatment for locallyadvanced esophageal carcinoma was included in the study. All patients will have to undergo QOL assessment by the EuropeanOrganisation for Research and Treatment of Cancer questionnaire before, during, and after treatment.Results: A total of 40 patients were included in the study. Among the functional scales, emotional functioning, cognitivefunctioning, role functioning, physical functioning, and anxiety show a significant positive mean difference. This indicates ahealthy level of functioning after treatment.Conclusion: Definitive concurrent chemoradiation with cisplatin and 5-fluorouracil (FU) was well tolerated, promising a reasonabletherapeutic option for patients with inoperable locally advanced esophageal squamous cell carcinoma.