Assessment of Pretreatment Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Prognosis of Oral Squamous Cell Carcinoma.

PURPOSE: Recent data have provided evidence of systemic inflammatory markers playing an important role in determining the disease-free survival (DFS) and overall survival (OS) of patients with oral squamous cell carcinoma (OSCC). The aim of the present study was to determine the prognosis of OSCC using the preoperative neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). PATIENTS AND METHODS: We enrolled 130 patients with OSCC who received treatment in the present retrospective study. Both PLR and NLR correlated with the demographic data, tumor characteristics, and prognosis. The optimal cutoff for PLR and NLR was determined by receiver operating characteristic curve analysis and was 142 and 3.1 for PLR and NLR, respectively. The prognostic significance of both markers was determined by univariate and multivariate analysis. Survival curves were plotted using the Kaplan-Meier method. RESULTS: The clinicopathologic variables correlated with cumulative survival on univariate analysis. Advanced clinical lymph node stage (P = .001), pathologic lymph node stage (P = .001), pathologic tumor stage (P = .049), pathologic TNM stage (P = .006), receipt of multimodality treatment (P = .013), and high PLRs (P = .001) and NLRs (P = .002) showed a statistically significant association with shorter DFS. A multivariate Cox proportional hazard regression model demonstrated that a high PLR (hazard ratio [HR], 2.998; 95% confidence interval [CI], 1.128 to 7.968; P = .028) and patient age (HR, 1.100; 95% CI, 0.750 to 1.613; P = .025) were independent factors for determining DFS and OS. CONCLUSIONS: We observed that high PLRs and NLRs were significant in determining the prognosis. The PLR was superior to the NLR in determining DFS and OS and can be used as an independent prognostic indicator in patients with OSCC.

The nuances of brachytherapy taught by teachers from beyond: Questionnaire-based assessment of the first cadaveric hands-on brachytherapy workshop in India.

PURPOSE: A questionnaire-based assessment of a cohort of young radiation oncologists attending the first human cadaveric hands-on brachytherapy workshop in India. METHODS AND MATERIALS: The cadaveric workshop for hands-on training in head/neck and gynecologic cancers was a novel process conducted at M.S. Ramaiah Medical College and Hospital, for which 30 attendees from all regions of India took part with an opportunity to interact with experienced resource persons, individually perform the procedure, and indulge in all aspects of brachytherapy process. The questionnaire was part of the workshop and enquired on common practices for head/neck and gynecologic brachytherapy followed by the attendees at their hospitals and their opinion on avenues for learning the skill of brachytherapy and its future as a therapeutic modality. RESULTS: Twenty-seven of thirty attendees were practicing brachytherapy at their centers out of which only 14 (46%) were doing head/neck brachytherapy. In gynecologic procedures, 89% were performing only intracavitary brachytherapy. Twenty attendees (66%) felt lack of expertise was the primary reason for dwindling brachytherapy practice in India. Ten (33%) of them felt that advancements in external radiotherapy were the second major cause for it. Some less important reasons given were lack of suitable cases, fear of toxicity, and reduced remuneration. CONCLUSIONS: Cadaveric brachytherapy workshops may be a practical and cost-effective method to inculcate this unique skill set in the next generation of radiation oncologists. This questionnaire-based assessment has tried to validate this opinion.

Sentinel node detection in endometrial cancer using indocyanine green and fluorescence imaging-a case report.

Sentinel lymph node mapping in endometrial cancer can help to provide the prognostic information needed while avoiding the morbidity associated with a complete lymphadenectomy. Studies with blue dye and technetium colloid have only given about 80% detection rates whereas with indocyanine green injection and fluorescence imaging, it gives about 88-100% detection rates. Herein, we report a case where indocyanine green was injected intracervically and sentinel nodes were detected at the paraaortic nodal area.