Management of B-cell lineage acute lymphoblastic leukemia: expert opinion from an Indian panel Delphi consensus method.

Introduction: Currently, there are no guidelines for the management of B-cell lineage acute lymphoblastic leukemia (B-ALL) from an Indian perspective. The diagnostic workup, monitoring, and treatment of B-ALL vary among different physicians and institutes.

Objective: To develop evidence-based practical consensus recommendations for the management of B-ALL in Indian settings.

Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer.

Purpose: Preventing metastases by using perioperative interventions has not been adequately explored. Local anesthesia blocks voltage-gated sodium channels and thereby prevents activation of prometastatic pathways. We conducted an open-label, multicenter randomized trial to test the impact of presurgical, peritumoral infiltration of local anesthesia on disease-free survival (DFS).

Accuracy of digital mammography, ultrasound and MRI in predicting the pathological complete response and residual tumor size of breast cancer after completion of neoadjuvant chemotherapy.

Background: Neoadjuvant chemotherapy (NACT) is the standard of care for the treatment of locally advanced or non-metastatic breast cancer, which may increase the chances of breast conservative surgery (BCS) in place of radical mastectomy without compromising on the overall survival. The aim of this study was to evaluate the accuracy of mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) in predicting the complete response and to assess the extent of residual breast cancer in women treated with NACT.

Materials And Methods: Fifty-six consecutive patients with stage II or III breast cancer, who underwent imaging evaluation of breast with digital mammogram, US, and MRI after NACT and before the breast surgery, were included in the study.

Technique and clinical applications of dual-energy contrast-enhanced digital mammography (CEDM) in breast cancer evaluation: a pictorial essay.

This pictorial essay illustrates an overview of the basic technique used in acquiring dual-energy contrast-enhanced digital mammography (CEDM) images and its potential clinical applications in regular practice. CEDM may be used as a low-cost alternative to magnetic resonance imaging (MRI), as a problem-solving tool in clinical practice and for therapeutic planning of breast cancer, which may include high-risk screening, dense breast evaluation, mammographically equivocal lesions, local staging, treatment response evaluation, and post treatment follow-up. We share our experience of CEDM at a tertiary care cancer hospital.

Impact of naturopathy, yoga, and dietary interventions as adjuvant chemotherapy in the management of stage II and III adenocarcinoma of the colon.

Introduction: Naturopathy, Yoga and Dietary interventions are known to improve the quality of life in cancer patients. We aim to evaluate the effect of naturopathy interventions along with adjuvant chemotherapy in patients who underwent surgery for Adenocarcinoma of the Colon.

Methods: A total of 116 adult patients were randomised in to one of the two groups; the experimental group received naturopathy, Yoga and Dietary interventions and the control group received psycho-social counselling in addition to standard chemotherapy.

Carcinoma of the Tongue in Renal Transplant Recipients: An Unusual Spectrum of Malignancy at a Tertiary Care Center in India Over a Period of 26 Years.

Renal transplant recipients are at a higher risk of malignancy. We report our experience and the critical differences in the presentation of malignancy in kidney transplant patients performed at our tertiary care center and followed up over the period of 1990-2015. A total of 338 live donor transplants performed in 332 patients were analyzed.

Sphenopalatine ganglion block for relieving postdural puncture headache: technique and mechanism of action of block with a narrative review of efficacy.

The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging.

Role of postoperative radiation therapy (PORT) in pT1-T2 N0 deep tongue cancers.

Objective: Carcinoma of tongue is associated with a high risk of occult metastasis and mortality despite early-stage detection and therapy; the critical tumor thickness at which this risk increases has been demonstrated as 4 mm or greater. There are no sufficient data in the published literature to evaluate the role of postoperative radiation therapy (PORT) in the treatment of pT1-T2 N0 oral tongue cancers with depth of invasion 4 mm or greater.

Study Design: Historical cohorts of patients with primary pT1-T2 N0 oral tongue cancer of depth of invasion 4 mm or greater treated surgically from January 2010 to December 2012 were included in the study, and negative margins on initial resection were filtered.

Revision of margins under frozen section in oral cancer: a retrospective study of involved margins in pT1 and pT2 oral cancers.

Operative assessment of the resection margins by frozen section is routine in many hospitals, but the usefulness of the technique relies on its sensitivity, specificity, sampling errors, and errors associated with relocation of involved margins. Its usefulness is indicated by assessment of overall survival and locoregional recurrence in patients whose margins were initially involved but were successfully revised after frozen section compared with those of the patients whose initially-involved margins were not revised. Patients with consecutive primary pT1, pT2 oral squamous cell carcinoma in whom initial resection resulted in involved margins were selected from the patients treated during the period January 2010 to December 2011 at a tertiary cancer hospital in India.

Reliability of Incision Biopsy for Diagnosis of Oral Verrucous Carcinoma: A Multivariate Clinicopathological Study.

Introduction: Studies have reported 20 % of conventional squamous cell carcinoma in patients with verrucous carcinoma (VC), later these cancers were termed as hybrid VC. It is important to distinguish both while planning treatment since hybrid VC requires addressing regional lymphatics in addition to respective surgery. Information on odds of missing the foci of invasion on routine incision biopsy might be useful in this regard.

Multi Centricity of Oral Verrucous Carcinoma: A Case Series of 22 Cases.

Verrucous carcinoma (VC) is an uncommon variant of squamous cell carcinoma characterized by proliferative outgrowing clinical appearance of the tumor, Incidence of VC is 2-12 % among oral cancers, the true incidence of VC can be accessed only from surgically treated cases since thorough processing of the entire tumor is necessary for accurate diagnosis, foci of invasive squamous cell carcinoma are found often in the substance of these tumors, thus, over reporting of this tumor is not uncommon. The retrospective data of a tertiary cancer hospital was analysed to understand the clinical challenges and outcome of patients with VC. The frequent association of VC with second primary oral cancer (22.

Oral hybrid verrucous carcinoma: a clinical study.

Hybrid Verrucous Carcinoma is an uncommon tumour wherein Verrucous Carcinoma (VC) is coexisting with conventional Squamous Cell Carcinoma (SCC) within same maternal field. The heterogeneous nature, infrequency of occurrence and the difficulties associated with diagnosis and management of this tumor is discussed through a retrospective study. Patients of primary hybrid VC treated from Jan 2010 to May 2013 at a tertiary institute were analyzed on multivariate cox regression model.

Affect on survival per increase in each millimeter of tumor depth in tongue cancer.

The critical tumor depth at which the risk of occult metastasis increases in tongue cancer has been demonstrated as ≥4-5 mm. Conventional T staging might not be an accurate predictor for survival in situations wherein infiltrative growth pattern is easily overlooked. Thus risk of death associated with increase in tumor depth per millimeter might be useful to understand patient's disease status during follow up.

Prognostic value of frozen section in t1, t2 carcinoma of oral cavity.

Complex anatomy of oral cavity makes it difficult for a surgeon to assess margins of oral cancer accurately and positive margins compromise loco regional disease control, thus surgeon may rely on frozen section assessment for marginal status. We discussed the prognostic value of frozen section in early carcinoma of oral cavity. 90 patients with pT1 and pT2 oral cavity cancer operated from January 2010 to December 2011 under single consultant surgeon were retrospectively evaluated.

HER2/neu negative salivary duct carcinoma of parotid: A case with forty months recurrence free follow up.

Introduction: Salivary duct carcinoma (SDC) is very rare, only 1-3% of all salivary gland tumors are reported as SDC. SDC predominantly occurs in elderly males, SCD is characterized by an aggressive clinical course of the disease with less than 60% five years survival from the day of initial diagnosis, lymph node metastasis and facial nerve involvement is common, the current literature lacks protocol regarding management of this entity and the advantage of adjuvant therapy has not been evaluated due to its rare occurrence.

Presentation Of Case: We report patient with stage IV HER2/neu negative SDC successfully treated with surgery followed by adjuvant radiotherapy, patient is followed up for 40 months without evidence of recurrence or metastasis.

Close margins in oral cancers: implication of close margin status in recurrence and survival of pT1N0 and pT2N0 oral cancers.

Introduction: Among all prognostic factors, "margin status" is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as "clear margin" and 1-5 mm as "close margin." Ambiguous description of positive margin in the published data resulted in comparison of microscopically "involved margin" and "close margin" together with "clear margin" in many publications.

Analysis of silver stained nucleolar organizing regions in odontogenic cysts and tumors.

Objective: The present study aimed to investigate the probable differences in cell proliferation index of odontogenic cysts and tumors by means of a comparative silver stained nucleolar organizing region (AgNOR) quantification.

Study Design: This descriptive cross-sectional study was done on archival paraffin blocks (n = 62), consisting of 10 odontogenic keratocysts, 10 dentigerous cysts, 10 radicular cysts, 10 conventional ameloblastomas, 10 adenomatoid odontogenic tumors, 10 calcifying epithelial odontogenic tumors and 2 ameloblasic carcinomas.

Results: The mean AgNOR count of odontogenic cysts was 1.