Publications by authors named "Shet T"

Article Synopsis
  • Variations in access to drugs globally make it hard to assess the effectiveness of modern treatments for patients with relapsed and refractory mature T-cell and NK-cell lymphomas in a study of 925 patients.
  • * The study found that relapsed lymphoma patients had better overall survival rates compared to refractory patients after second-line treatment, with several factors identified as predictors of survival.
  • * A new prognostic index (PIRT) categorizes patients based on risk factors into low, intermediate, or high risk, impacting 3-year overall survival rates, and highlights the superior outcomes of novel therapies compared to traditional chemotherapy.
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Context.—: Gross evaluation of post-neoadjuvant chemotherapy breast carcinoma is challenging when the primary tumor is not localized before therapy with a radio-opaque wire/clip, a situation common in resource-constrained settings.

Objective.

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Article Synopsis
  • Multicolor flow cytometry (MFC) is an important tool for detecting minimal bone marrow (BM) involvement in non-Hodgkin lymphomas (NHL) that are often missed by trephine biopsies or imaging.
  • In a study of 1,084 BM samples from patients with B-NHL, MFC identified 172 samples that appeared morphologically negative but had detectable lymphoma cells, demonstrating the technique's effectiveness.
  • CD305 emerged as a critical marker in flow cytometry for identifying minimal BM involvement, with many cases showing only low-level presence of lymphoma cells that conventional techniques could overlook.
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Surgical resection stands as the preeminent therapeutic approach for both primary hepatocellular carcinoma and metastatic liver malignancies. Its efficacy is contingent upon the attainment of a comprehensive excision while ensuring a sufficient future liver remnant (FLR). However, post-hepatectomy liver failure (PHLF) remains a significant challenge, particularly in patients with preexisting liver disease.

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  • The incidence of breast cancer in urban India is rising due to lifestyle changes and risk factors, with younger women often diagnosed at advanced stages.
  • The lack of awareness and existing social taboos make it difficult for women to seek timely medical help, leading to significant financial burdens on families and challenges in accessing quality care.
  • This article reviews breast cancer management from diagnosis to treatment, emphasizing the unique context of low-middle-income countries and discussing both early and advanced stages of the disease.
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Unlabelled: We report a deep next-generation sequencing analysis of 13 sequentially obtained tumor samples, eight sequentially obtained circulating tumor DNA (ctDNA) samples and three germline DNA samples over the life history of 3 patients with triple-negative breast cancer (TNBC), 2 of whom had germline pathogenic BRCA1 mutation, to unravel tumor evolution. Tumor tissue from all timepoints and germline DNA was subjected to whole-exome sequencing (WES), custom amplicon deep sequencing (30,000X) of a WES-derived somatic mutation panel, and SNP arrays for copy-number variation (CNV), while whole transcriptome sequencing (RNA-seq) was performed only on somatic tumor.There was enrichment of homologous recombination deficiency signature in all tumors and widespread CNV, which remained largely stable over time.

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  • High-grade B-cell non-Hodgkin lymphomas (NHLs) are more prevalent in patients with HIV, and this study reflects on the treatment outcomes of such patients treated with a specific chemotherapy regimen called DA-EPOCH(+/-R) from 2011 to 2015.
  • The analysis included 40 patients with various types of B-cell NHL, and a notable 82.5% had a 5-year overall survival rate, indicating the regimen's effectiveness.
  • While most patients experienced significant side effects, such as febrile neutropenia and mucositis, the treatment remains a viable option even for those with serious health challenges related to HIV.
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Background: Treatment of lymph node basins is prognostic and therapeutic for axillary lymph nodes (ALN) as well as internal mammary lymph nodes (IMLNs) in breast cancer. IMLNs can be the first echelon node for the inner/central quadrants of the breast. We evaluated the yield of IMLN dissection (IMLND) mainly in patients with inner and central tumors.

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The staging, prognostication, and treatment of ENKTL has evolved over the years with better understanding of the disease biology. There is significant heterogeneity in the treatment followed across the world. Literature from India have been few with small number of patients.

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  • Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare type of lymphoma making up over 95% of CNS lymphomas, and its classification into cell-of-origin (COO) subtypes is debated compared to systemic versions of the disease.* -
  • The study evaluated 143 cases using immunohistochemistry and classified them into COO subtypes with both Hans and Choi algorithms, revealing a high discordance rate but 91.8% overall agreement between the two methods.* -
  • Results showed that 84.9% of cases were non-germinal center B-cell (GCB) subtype and 90.7% were activated B-cell (ABC) subtype,
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Context.—: Human epidermal growth factor (HER2/neu) gene amplification, a poor prognostic factor in invasive breast cancer, has shown substantial utility as a predictive marker, with significantly improved survival following anti-HER2 therapies like trastuzumab. Dual-color dual in situ hybridization (D-DISH), a recently introduced fully automated assay for HER2/neu evaluation on light microscopy, has several advantages over fluorescence in situ hybridization (FISH).

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Background: Axillary lymph node (LN) positivity is an important prognostic factor in breast cancer. Almost 30% clinically node negative (cN0) early breast cancers have positive nodes on pathology, wherein an axillary dissection is done as a second stage surgery. Intra operative frozen section (FS) potentially avoids redo surgery.

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Article Synopsis
  • The study focuses on non-metastatic breast cancer in elderly patients (>70 years) and aims to determine factors influencing their outcomes.
  • Data was collected from medical records, with survival outcomes analyzed using statistical methods to evaluate the impact of various prognostic factors.
  • Results show that despite hormonal therapy and surgery, important predictors of survival include age, tumor size, lymphovascular invasion, and molecular subtype, highlighting gaps in treatment approaches like breast-conserving therapy.
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Numerous years of cell line‑based studies have enhanced the current understanding of cancer and its treatment. However, limited success has been achieved in treating hormone receptor‑positive, HER2‑negative metastatic breast cancers that are refractory to treatment. The majority of cancer cell lines are unsuitable for use as pre‑clinical models that mimic this critical and often fatal clinical type, since they are derived from treatment‑naive or non‑metastatic breast cancer cases.

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Background: Neoadjuvant chemotherapy (NACT) is routinely used in all cases of locally advanced breast cancer and some cases of early breast cancer. We previously reported a pathological complete response (pCR) rate of 8.3%.

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Management of acquired immunodeficiency syndrome (AIDS)-related diffuse large B-cell (DLBCL) and plasmablastic lymphomas (PBL) poses significant challenges. The evidence supports use of dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) with or without rituximab as first-line therapy. The need for central venous access, growth factors and significant toxicities limits its use in resource-constrained settings.

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Background: Molecular tests in solid tumours for targeted therapies call for the need to ensure precision testing. To accomplish this participation in the External Quality Assessment Program (EQAS) is required. This evaluates the consistency of diagnostic testing procedures and offers guidance for improving quality.

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Purpose: There are sparse data in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer with brain metastases from real-world settings, especially where access to newer targeted therapies is limited.

Methods: This was a single institution, retrospective cohort study of patients with HER2-positive breast cancer diagnosed between January 2013 and December 2017 to have brain metastases and treated with any HER2-targeted therapy. The main objectives were to estimate progression-free survival (PFS) and overall survival (OS) from the time of brain metastases.

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Article Synopsis
  • - In children with HIV/AIDS, hematolymphoid cancers like non-Hodgkin lymphomas are frequently seen, especially plasmablastic lymphoma, which is rare and typically found in the head and neck region.
  • - A case is presented of a 4-year-old boy who had a solitary bony swelling in his right knee, which was diagnosed as plasmablastic lymphoma after further tests.
  • - The child underwent combination chemotherapy, intrathecal chemotherapy, and early highly active antiretroviral therapy, resulting in continued remission.
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Background: Treatment of Diffuse Large B-Cell Lymphoma (DLBCL) in the elderly aims to achieve disease remission while minimizing treatment-related toxicities. The use of anthracycline in the elderly is associated with increased risk of cardiotoxicity and myelosuppression. Non-anthracycline-based regimens have commonly been used in patients with cardiac contraindications or anticipated severe toxicities to anthracyclines.

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We present the findings of 18 F-FDG PET and 68 Ga-fibroblast activation protein PET scans done in a case of bilateral breast carcinoma with 2 different histopathology, left breast tubulolobular carcinoma and right breast invasive breast carcinoma of no special type.

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Background: Diagnosis of MALT lymphoma in the oral cavity is challenging. There is a great overlap in the histopathologic, immuno-histochemical and molecular features of MALT lymphoma with reactive lymphoid proliferations. The literature shows a very few case reports of primary MALT lymphoma of oral cavity.

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Background: Triple negative Breast tumor (TNBC) is an aggressive tumor with sparse data worldwide.

Methods: We analyzed non-metastatic TNBC from 2013 to 2019 for demographics, practice patterns, and survival by the Kaplan Meir method. Prognostic factors for OS and DFS were evaluated using Cox Proportional Hazard model estimator for univariate and multivariable analysis after checking for collinearity among the variables.

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