ABSTRACT
Srikanth SomaIntroduction Surveillance of patients following definitive treatment of rectal malignancy is based on the predicament that early detection of recurrence may provide an opportunity for cure. Available methods for monitoring include clinical, radiological, and serum tests. The purpose of this study was to determine the effectiveness of CEA in detecting recurrences. Materials and Methods Retrospective analysis of patients with adenocarcinoma rectum treated with curative intent between 2012 to 2020 at our institute was performed. Postoperatively, patients were followed with CEA measurements according to our institution protocol and elevation of serum CEA above 5 ng/dL was considered as suspicious of recurrence. Results One hundred ninety patients who received curative treatment were deemed eligible for the analysis. Among these 61 patients had recurrences during the follow-up period and postoperative CEA measurements at the time of recurrence were analyzed in all the patients. Sensitivity, specificity, positive predictive value, and negative predictive value of postoperative CEA to detect recurrences are 81.9, 92.2, 83.3, and 91.5%, respectively. Conclusion CEA surveillance following definitive management of rectal cancer detects recurrences in majority of the patients and hence strongly recommended.
ABSTRACT
The aim of this study was to analyze the influence of neoadjuvant treatment on nodal harvest after rectal cancer surgery and its impact on long-term oncological outcomes. A retrospective analysis of patients with rectal cancer who received curative intent treatment from 2002 to 2012 in our institution was performed. Data on various clinic-pathological and treatment details were recovered from the records. The number of nodes harvested after surgery was analyzed. The influence of number of nodes harvested on overall survival and disease free survival was analyzed. Among the 459 patients included in this study, 326 underwent surgery after neoadjuvant treatment (NAT). The mean number of nodes harvested was significantly lower in patients who received NAT compared with those who did not (8.9 ± 5.77 vs 14 ± 9.84, p < 0.001). However, the mean number of pathologically positive nodes was not significantly different. A minimum of 12 nodes were harvested in only 27.9% of patients who received NAT. No lymph nodes were identified in the specimen in 15 patients (4.6%) who underwent surgery after NAT. The only independent factors influencing harvest of a minimum of 12 nodes were patient age and NAT. The 5-year overall survival was not significantly different in patients in whom < 12 or ≥ 12 nodes were harvested (64% vs 69% respectively, p = 0.5). Neoadjuvant chemoradiation significantly reduces nodal harvest in patients undergoing treatment for rectal cancer. However, this reduced nodal harvest did not adversely impact survival in patients. However, every effort must be made by the surgeon and the pathologist to maximize the nodal harvest.
ABSTRACT
Low-grade fibromyxoid sarcoma (LGFMS) are rare soft-tissue sarcomas that usually come to attention as slow growing masses. Males and females are affected approximately equally and typically arising in the soft tissue of the proximal extremities. Primary occurrence within the head and neck is exceedingly rare. We report a case arising from the hard palate of a 40-year-old male and according to our knowledge this is the first ever case of LGFMS involving the palate to be reported.
ABSTRACT
Primitive neuroectodermal tumours (PNETs) are a malignant group of neoplasms and are neuroectodermal in origin. In most large series published to date, peripheral primitive neuroectodermal tumours usually present in the second decade of life, with a slight male preponderance. Those which occurs peripherally resemble soft tissue sarcomas. Peripheral PNET is rare in presentation and of which only few cases involving the soft tissues of the abdominal wall have been reported. We present a case affecting a young female who presented to us with a progressively enlarging swelling involving the anterior abdominal wall. She underwent wide excision followed by adjuvant therapy based on final histopathology report.
ABSTRACT
Penile metastases are rare in occurrence and are usually secondary to other genitourinary primary tumours. It is a debilitating near terminal condition at presentation with a dismal prognosis and poor survival rates. Supportive and palliative care is generally recommended to improve the quality of life of patients. We present a case of penile metastases in a 74-year-old male patient with prostatic adenocarcinoma in association with multiple skeletal metastases.
