Advanced Primary Epithelial Ovarian and Peritoneal Carcinoma-Does Diagnostic Accuracy of Preoperative CT Scan for Detection of Peritoneal Metastatic Sites Reflect into Prediction of Suboptimal Debulking? A Prospective Study.

Ovarian cancer is the seventh most common cancer in females worldwide. Optimal debulking is the standard treatment but possible only in 30-85% of advanced stages. Knowing exactly the disease extent preoperatively may predict suboptimal debulking. We analyzed diagnostic accuracy of preoperative CT scan in disease mapping and prediction of suboptimal debulking in a prospective observational study from March 2013 to May 2015 in a tertiary hospital. Adults below the age of 75 years with ECOG PS-0, 1, 2, clinically/radiologically newly diagnosed stage IIIc epithelial ovarian (EOC), and primary peritoneal carcinoma (PPC) were included. Neoadjuvant chemotherapy recipients were excluded. Preoperative multidetector CT (MDCT) scan showing deposits at 19 predetermined abdominopelvic sites were compared with the same sites seen at laparotomy and corresponding accuracies of CT scan calculated. Primary debulking surgery was done to achieve debulking to nil or less than 1-cm residual disease. Stepwise logistic regression models were used to determine the frequent suboptimal debulking sites and the predictive performance of the clinical and CT scan findings. A total of 36 patients were enrolled. The optimal debulking rate was 50%. The CT scan could detect the disease-bearing sites with overall sensitivity of 68.29%, specificity of 89%, accuracy of 78.07%, and positive and negative predictive values of 99 and 50.1%, respectively. Upon multivariate analysis, bowel mesentery (p 0.011) and omental extension (p 0.025) were associated with suboptimal debulking. CT scan accuracy at these sites (predictive performance) was 86.1%. We identified small bowel mesentery and omental extension (to spleen/stomach/colon) as sites associated with suboptimal debulking. MDCT accurately depicts peritoneal metastases, although sensitivity is reduced in certain areas of significance for optimal debulking. Further validation with more number of patients is warranted.

Speech Outcome in Oral Cancer Patients - Pre- and Post-operative Evaluation: A Cross-sectional Study.

AIM: The tongue plays a major role in articulation. Speech outcome depends on the site of lesion, extent of resection, and flexibility of the remaining structures. The aim of this study is to evaluate the speech outcome measures such as sounds that are misarticulated and speech intelligibility and its connection to tumor site before and after surgery. METHODOLOGY: Totally, 24 (12 pre- and 12 post-operative patients) patients who had buccal and tongue cancer underwent speech intelligibility rating and articulation screening. RESULT: The results show that the speech outcome is worse in postoperative patients when compared to preoperative patients. The articulation errors produced by tongue cancer patients were more than the errors produced in buccal cancer patients. The type of reconstruction also affects the speech outcome. CONCLUSION: The perceptual analysis of oral cancer patients showed specific articulation issues and reduced intelligibility of speech in regards to site of lesion and type of reconstruction surgery. To reduce the speech errors, effective rehabilitation is recommended. A comprehensive speech evaluation and analysis of error patterns would help us in planning the rehabilitative measures of speech which is the most important factor in re-establishing interpersonal communication and well-being of the individual.