Expression of biomarkers vimentin and Metastasis Associated 1(MTA1) protein in different stages of laryngeal cancer and their impacts on survival

Laryngeal cancer is the second most common cancer after the lip and oral cavity cancer ofhead and neck region1. Laryngeal malignancy is the seventh most common malignancy in males in India. Total number of new laryngeal cancer and death from laryngeal cancer have been estimated 12410 and 3760 respectively in 20192. As per last survey available the number of new cases diagnosed and total number of deaths from laryngeal malignancy were 25,460 and 17,560 respectively in 2012 in India3 . The incidence of cancer larynx is 1.26-8.18 per 100,000 populations in different regions of India. Carcinoma larynx constitutes40% of all Head and Neck cancers. Squamous cell carcinoma constitutes 95% of all malignancies of larynx. Glottis being the most common subsite followed by supraglottis and the least common site is the subglottis. There is an increasing incidence rate of this malignancy among middle aged and elderly men and women throughout the world. Expression of Biomarkers at different stages of laryngeal cancers and their impact on survival can play a crucial role in future management of laryngeal malignancies. In spite of having different modalities of treatments like surgery, radiotherapy, chemoradiation, the prognosis of laryngeal malignancies is still poor. The most common adverse factor for laryngeal cancer has been found lymph node metastasis. The process of progression of LSCC is complex and difficult to know it completely. Despite multi-modality therapeutic advances in recent decades, improvements in overall survival and disease free survival is very less. In this study we emphasized the role of expression of biomarkers vimentin and metastasis associated 1(MTA1) protein in different stages of laryngeal cancer and their impacts on survival.

Cancer and tuberculosis: A lethal duo

Cancer patients are at an increased risk of developing active Tuberculosis (TB) disease. Immunosuppression because of cancer or its treatment modalities, including chemo-radiotherapy, places these patients at an increased risk of developing active TB. We describe the case of a fifty-eight-year-old male patient who was diagnosed and treated for carcinoma larynx but later succumbed to pulmonary TB. Active screening and treatment for Latent TB Infection (LTBI) at the start of cancer treatment in these patients may potentially help reduce the reactivation risk of active TB disease among them. Keywords: tuberculosis; TB; cancer; malignancy; mortality; LTBI; chemo-radiotherapy

A retrospective analysis of cancers in a rural tertiary care centre

Background: In the last couple of decades, cancer incidence has been raising heavily, probably due to our changing lifestyle, habits, and increased life expectancy. The situation is so alarming that every fourth person is having a lifetime risk of cancer.Methods: The study was conducted as a retrospective study among the various cancer patients admitted in our tertiary care centre for a period of 10 years from 2011 to 2020. The data and the case sheets from the hospital records were obtained from the MRD department. The case sheets were reviewed by the investigators on the variables viz age, gender, diagnosis, cancer site, investigations and treatment aspects. The data were entered in the MS excel sheet and analyzed using Statistical package for social sciences (SPSS) software version 21. The data were expressed in terms of frequencies and percentages.Results: Total cases reported were 121 of which in the year 2014 and 2015, the cancer cases reported were 32% and 26% respectively. Then again there was a peak in 2018 and 2019 with 8% and 31% with one case each in the year 2017 and 2020. High prevalence is seen with Breast cancer, which showed 60% followed by carcinoma stomach which is 18% and carcinoma rectum which is 9%. The cancers showed low prevalence, which is 1% include carcinoma prostate, carcinoma larynx, gastro intestinal stromal tumor and retro peritoneal lipo sarcoma.Conclusions: Our study revealed that the cancer cases are high and it showed increasing trend which suggests that the population based cancer registries to be made at all levels of health care to identify the time trends so that prevention measures can be implemented at the community level.

Patterns of second primary malignancies in carcinoma larynx and hypopharynx following surgical management

<p class="abstract"><strong>Background:</strong> The objective was to determine the incidence of second primary in patients with squamous cell carcinoma larynx and hypopharynx following surgical management with or without adjuvant treatment.</p><p class="abstract"><strong>Methods:</strong> A retrospective quantitative descriptive study was conducted on 289 patients who underwent surgical management of squamous cell carcinoma (SCC) of larynx and hypopharynx with or without adjuvant treatment and later developed second primary. This study comprised of patients undergoing treatment during the time period of January 2016 to January 2019 at the department of head and neck surgery, Kidwai institute of oncology.</p><p class="abstract"><strong>Results:</strong> Second primary malignancies (SPM) developed in 3.1% of patients within a median follow up period of 28 months. Majority of the second primaries developed in patients with hypopharyngeal malignancy.</p><p class="abstract"><strong>Conclusions:</strong> SPMs are amongst the leading causes of mortality in patients with SCC larynx and hypopharynx. Hence careful surveillance is essential for the early detection of a second primary.</p>

Neutrophil-lymphocyte ratio as a prognostic tool for the evaluation of laryngeal carcinoma

<p class="abstract"><strong>Background: </strong>The objective of the study was to review the neutrophil lymphocyte ratio (NLR) as a prognostic tool in carcinoma larynx.</p><p class="abstract"><strong>Methods: </strong>Patients who were fulfilling inclusion criteria after screening were selected for study. On the basis of cutoff pretreatment NLR (&lt;3 or &gt;3) divided into two groups high pretreatment NLR and low pretreatment NLR. Patient undergo chemo or radiotherapy and at the end of follow up these two group NLR were compared with tumor negative prognostic score, survival at the end of follow up, resolving of symptoms, staging change, tumor regression and overall prognosis at the end of follow up were assessed.</p><p class="abstract"><strong>Results: </strong>Mean value of tumor negative prognostic score of early carcinoma with low NLR, early carcinoma with high NLR, late carcinoma with low NLR and late carcinoma with High NLR were 13.833±2.80, 24.04±4.5538, 37.833±8.68 and 55.33±6.429 respectively. 10 (17.5%) patients with high NLR show more than 50% tumor regression while 17 (29.82%) with high NLR show &lt;50% tumor regression. 26 (45.61%) patients with low NLR show &gt;50% tumor regression and 4 (7.01%) show &lt;50% tumor regression.</p><p class="abstract"><strong>Conclusions:</strong> It was concluded in our study that pretreatment NLR is an acceptable prognostic tool in carcinoma larynx. High NLR was associated with poor prognosis and low NLR was associated with better prognosis.</p>

Incidence of Malignant Diseases in Punjab: A Retrospective Study in a Tertiary Level Government Hospital in Punjab

Introduction: Cancer is a grave problem with increase in incidence of various malignancies at an alarming rate in Punjab. Crude annual incidence rate of all cancers in Punjab has increased from 58.0 in 1990 to 85.5 in 2016 while crude mortality incidence ratio of all cancers in Punjab is 0.61 in females and 0.81 in males. Not only it is increasing mortality and morbidity, but it is also increasing the economic burden on a state already facing financial crisis. The exact burden of malignancies is not well known, although many local surveys have been done. Aim: To know the accurate burden of malignant diseases in patients presenting to a tertiary level government hospital in Punjab. Materials and Methods: A retrospective observational study in which data of all cases diagnosed to have malignant disease on histopathology at Government Medical College and Rajindra Hospital, Patiala, Punjab, from January, 2006 to December, 2015. The data was retrieved on yearly basis and total of each malignant disease was done to know the exact incidence of various malignancies over the decade by the measure of relative frequency. Results: A total of 4270 patients (41.65% in age group 41 to 70 years) were diagnosed to have malignant disease on histopathology out of which 2341 (54.82%) were females and 1929 (45.18%) were males. Leading causes of malignancy were the cancers of the f emale genital organs i.e., 20.05%, followed by breast cancer i.e., 1 8.17% and cancers of lip, oral cavity and pharynx i.e., 15.36%. Conclusions: Maximum incidence was seen in Carcinoma Breast followed by carcinoma cervix and carcinoma larynx. Early screening, timely diagnosis and management along with regular scrutiny of records should be done in routine to know the actual burden of cancer in the society.