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Das G, Arun PS, Roy PS, Sarma G, Nath J, Kalita DJ, Talukdar A. Real-World Experience of Patient's Compliance and Clinical Outcomes for Trimodality Treatment for Esophageal Cancer: a Study from a Cancer Center in North-East India. Indian J Surg Oncol 2024; 15:241-249. [PMID: 38741641 PMCID: PMC11088604 DOI: 10.1007/s13193-024-01881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/08/2024] [Indexed: 05/16/2024] Open
Abstract
Preoperative chemoradiotherapy is a standard treatment for patients with locally advanced, resectable esophageal cancer. The treatment completion rates impact the survival outcomes (Eyck et al J Clin Oncol 39(18):1995-2004, 2021). Thus, we aimed to estimate the effect of neoadjuvant chemoradiotherapy (NACRT) in terms of treatment completion rates and survival in this subset of patients and bring out the clinical outcomes in that context. This was a retrospective study done at a tertiary cancer center in North-East India. The study period was from 1 January 2018 to 31 December 2021. We included patients diagnosed with locally advanced and resectable esophageal cancer (cT2-3NanyM0) involving the middle and/or lower thoracic esophagus and who were planned for trimodality treatment in the Joint Tumor Board. Out of the 82 patients who were planned for trimodality treatment, all were squamous cell carcinomas. We found that 54.9% of patients completed the entire trimodality treatment. The median age was 56 years (range 34 to 73 years). The male to female ratio was 59:23. Adverse events, of any grade, were seen in 76% of patients who received NACRT. Fatigue (66%) was the most common toxicity. The common hematologic toxicities were neutropenia and anemia (7.3% each). A total of 45 patients (54.9%) were able to complete all the three modalities of treatment. Transthoracic esophagectomy was the preferred approach (84.4%). The site of anastomosis was in the neck of all the patients. Anastomotic leak was seen in 17.7% of patients. Postoperative pulmonary and cardiac complications occurred in 31.1% and 8.9% of patients respectively. The 30-day mortality was 6.7% (three deaths). A pathological complete response was seen in 35.6% among patients who underwent an esophagectomy. R0 resection was achieved in 93.3% of patients. The median overall survival and disease-free survival were 19 months and 17 months respectively. The completion rate of trimodality treatment in the real-world scenario was found to be low in our study, the reasons for which need to be identified and effectively resolved. Oncological outcomes were similar to the published literature.
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Affiliation(s)
- Gaurav Das
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Room No. 30, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - P. S. Arun
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - Partha Sarathi Roy
- Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Room No. 24, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - Gautam Sarma
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Room No. 109, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - Jyotiman Nath
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Room No. 109, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - Deep Jyoti Kalita
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Room No. 27, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
| | - Abhijit Talukdar
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Room No. 28, AK Azad Road, Gopinath Nagar, Guwahati, Assam 781016 India
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Ralte L, Sailo H, Kumar R, Khiangte L, Kumar NS, Singh YT. Identification of novel AKT1 inhibitors from Sapria himalayana bioactive compounds using structure-based virtual screening and molecular dynamics simulations. BMC Complement Med Ther 2024; 24:116. [PMID: 38454426 PMCID: PMC10921764 DOI: 10.1186/s12906-024-04415-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
Through the experimental and computational analyses, the present study sought to elucidate the chemical composition and anticancer potential of Sapria himalayana plant extract (SHPE). An in vitro analysis of the plant extract was carried out to determine the anticancer potential. Further, network pharmacology, molecular docking, and molecular dynamic simulation were employed to evaluate the potential phytochemical compounds for cervical cancer (CC) drug formulations. The SHPE exhibited anti-cancerous potential through inhibition properties against cancer cell lines. The LC-MS profiling showed the presence of 14 compounds in SHPE. Using network pharmacology analysis, AKT1 (AKT serine/threonine kinase 1) is identified as the possible potential target, and EGFR (Epidermal Growth Factor Receptor) is identified as the possible key signal pathway. The major targets were determined to be AKT1, EGFR by topological analysis and molecular docking. An in silico interaction of phytoconstituents employing molecular docking demonstrated a high binding inclination of ergoloid mesylate and Ergosta-5,7,9(11),22-tetraen-3-ol, (3.beta.,22E)- with binding affinities of -15.5 kcal/mol, and -11.3 kcal/mol respectively. Further, MD simulation and PCA analyses showed that the phytochemicals possessed significant binding efficacy with CC protein. These results point the way for more investigation into SHPE compound's potential as CC treatment.
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Affiliation(s)
- Laldinfeli Ralte
- Department of Botany, Mizoram University, Aizawl, Mizoram, 796004, India
| | - Hmingremhlua Sailo
- Department of Botany, Mizoram University, Aizawl, Mizoram, 796004, India
| | - Rakesh Kumar
- Department of Botany, Mizoram University, Aizawl, Mizoram, 796004, India
| | | | | | - Yengkhom Tunginba Singh
- Department of Botany, Mizoram University, Aizawl, Mizoram, 796004, India.
- Department of Life Sciences (Botany), Manipur University, Imphal, Manipur, 795003, India.
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Zomawia E, Zami Z, Vanlallawma A, Kumar NS, Zothanzama J, Tlau L, Chhakchhuak L, Pachuau L, Pautu JL, Hmangaihzuali EV. Cancer awareness, diagnosis and treatment needs in Mizoram, India: evidence from 18 years trends (2003-2020). Lancet Reg Health Southeast Asia 2023; 17:100281. [PMID: 37780980 PMCID: PMC10541469 DOI: 10.1016/j.lansea.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023]
Abstract
Background Despite being the second least populated state, Mizoram exhibits the highest incidence rate of cancer in India. Its inhabitants, constituting an endogamous and isolated population, have embraced their own distinct culture, way of life and dietary preferences, setting them apart from the rest of mainland India. In 2003, the Mizoram Population Based Cancer Registry (PBCR) was established under the auspices of the National Centre for Disease Informatics and Research (NCDIR), a division of the Indian Council of Medical Research (ICMR), in collaboration with the Department of Health & Family Welfare of the Government of Mizoram, India. Methods Cancer incidence and mortality data were extracted from the Mizoram PBCR spanning the years 2003-2020. The Age Standardized Incidence Rate (ASIR) and Age Standardized Mortality Rate (ASMR) were computed per 100,000 individuals, utilizing Segi's World Standard Population as the benchmark. The trajectory of these changes was analysed employing the Joinpoint Regression Analysis Program, Version 4.9.1.0.13, to unveil the Annual Percent Change (APC) with a 95% Confidence Interval and a Significance test (p < 0.05) using Monte Carlo Permutation. The resulting graphical visualizations were generated using Flourish Studio.15. Findings The overall ASIR for all cancer sites among men was 197.2 per 100,000, while for women, it was 164.9 per 100,000. Among men, the most prevalent cancer site was the Stomach (ASIR = 41.4), followed by Head & Neck, Lung, Oesophagus, Colorectal, Liver, Urinary, Non-Hodgkin's Lymphoma and Prostate cancers. Conversely, among women, Lung cancer exhibited the highest incidence (ASIR = 26.7), succeeded by Cervical, Breast, Stomach, Head & Neck, Colorectal, Oesophagus, Liver and Ovarian cancers. Stomach cancer emerged as the leading cause of death among men (ASMR = 22.6) and among women, Lung cancer held the highest ASMR (15.9). Joinpoint regression analysis revealed a rising trend in incidence and mortality over time for overall cancer sites. Among the primary cancer sites contributing to incidence and mortality, an increase in APC was observable for all, except Stomach cancer, in both men and women. The diagnostic approach, except for cases of cancer with unknown primary sites, involved a microscopic method. Interpretation This cross-sectional study examines PBCR reports spanning from 2003 to 2020, shedding light on a consistent uptick in cancer incidence and mortality trends in Mizoram. Stomach cancer emerges as the most prevalent and primary cause of cancer-related deaths among men, while Lung cancer takes a parallel role in women. The elevated cancer incidence and the growing trend among younger generations might stem from the static lifestyle and dietary patterns prevalent within the endogamous tribal population, potentially contributing to a genetic predisposition. The escalation in mortality rates could be attributed to a dearth of specialized diagnostic facilities and skilled human resources, treatment strategies guided by genomic research and transportation challenges. This underscores the urgent requirement for comprehensive scientific exploration across diverse facets. The implementation of easily accessible diagnostic facilities in proximity and genetic testing for pharmacogenomics to enhance prognoses would also aid in mitigating the burden and advancing the healthcare system's effectiveness. Funding Population Based Cancer Registry (PBCR) was supported by National Centre for Disease Informatics and Research (NCDIR) of the Indian Council of Medical Research (ICMR), India.
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Affiliation(s)
- Eric Zomawia
- National Health Mission, Department of Health & Family Welfare, Government of Mizoram, Dinthar, 796009, Aizawl, Mizoram, India
| | - Zothan Zami
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - Andrew Vanlallawma
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | | | - John Zothanzama
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - Lalchhanhimi Tlau
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Lalchhandama Chhakchhuak
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Lalawmpuii Pachuau
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Jeremy L. Pautu
- Department of Medical Oncology, Mizoram State Cancer Institute, Zemabawk, 796017, Aizawl, Mizoram, India
| | - Evelyn V.L. Hmangaihzuali
- Population Based Cancer Registry Mizoram, NCDIR (ICMR), Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
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Sankarapillai J, Krishnan S, Ramamoorthy T, Sudarshan KL, Das P, Chaturvedi M, Mathur P. Epidemiology of cancers among older adults in India: findings from the National Cancer Registry Programme. Public Health 2023; 223:230-239. [PMID: 37683494 DOI: 10.1016/j.puhe.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This study describes the epidemiology, clinical extent of disease at diagnosis and treatment modalities of cancer among older adults (aged 60 years and older) in India. STUDY DESIGN Secondary data analysis of the National Cancer Registry Programme, which includes 28 Population-Based Cancer Registries (PBCRs) and 96 Hospital-Based Cancer Registries (HBCRs). METHODS PBCR data were used to estimate the incidence in terms of crude rate (CR), age-adjusted incidence rate (AAR), age-specific rate (ASpR) and cumulative risk. Trends in the AAR were calculated with the Annual Percentage Change (APC) using join-point regression. HBCR data were used to describe the clinical extent of the disease at diagnosis and the treatment modalities. RESULTS There is a wide heterogeneity across the country for the incidence of cancer and for the leading cancer sites among older adults. Males had a higher incidence rate compared to females in the majority of the registries. Aizawl had the highest AARs among both genders (males: 1388.8; females: 1033.0). Females had the highest ASpR at 65-69 years (482.8), whereas for males it was above 75 years (710.4). Cervical, stomach and oesophageal cancers were on the decline. The incidence of cancer among older adults was estimated to increase by 13.5% in 2025 as compared to 2020. CONCLUSION The increasing cancer incidence among older adults in India poses a huge burden on the health system. There is a need to increase their participation in clinical trials, advocating comprehensive geriatric assessment and strengthening geriatric oncology within programs addressing older adult's care to deal with the rising cancer burden on the health system borne by them.
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Affiliation(s)
- J Sankarapillai
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - S Krishnan
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - T Ramamoorthy
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - K L Sudarshan
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - P Das
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - M Chaturvedi
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - P Mathur
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a).
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Bagal S, Budukh A, Thakur JS, Dora T, Qayyumi B, Khanna D, Fernandes D, Chakravarti P, Singh R, Patil S, Dikshit R, Chaturvedi P. Head and neck cancer burden in India: an analysis from published data of 37 population-based cancer registries. Ecancermedicalscience 2023; 17:1603. [PMID: 37799939 PMCID: PMC10550331 DOI: 10.3332/ecancer.2023.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 10/07/2023] Open
Abstract
Head and neck cancer (HNC) is a major public health problem in India. This article presents the HNC burden in different regions of India. The published population-based cancer registries (PBCRs) data from the National Cancer Registry Programme, Bengaluru, and the Tata Memorial Centre, Mumbai, India, were utilised. The 37 PBCRs were divided into six regions including central, east, north, northeast, west and south. The age-standardised incidence rate of HNC was 25.9 (95% CI 25.7-26.1) and 8.0 (95% CI 7.9-8.1) per 100,000 population, respectively, in males and females. HNC accounted for about 26% of all cancer cases in males and 8% in females. The risk of developing HNC was 1 in 33 for males and 1 in 107 for females. The northeastern registries reported the highest incidence rate 31.7 per 100,000 population in males followed by northern (28.5), central (28.3), western (24.4), southern (23.9) and eastern (18.3). In females, the incidence was in the range of 6.2-10.1 per 100,000 population. For all PBCRs together, the HNC burden was two to three times higher in the age group 60+ as compared to 20-39 years. The HNC burden in India is higher than in the USA, UK, Australia, Africa and Brazil. The PBCRs from the south-east Asia region such as the Colombo district, Sri Lanka, as well as Siraha, Saptari, Dhanusha and Mohattari - Nepal have also reported a high burden of HNC. All regions reported mouth as a leading cancer site followed by tongue, larynx, hypopharynx and tonsil except the northeastern region registries where hypopharynx was the top leading cancer. The burden of other sites of HNC is low. Raising awareness of the disease and associated risk factors, providing early detection services, as well as easy access to diagnosis and treatment are required. The government should focus on building the infrastructure and capacity building to control this disease.
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Affiliation(s)
- Sonali Bagal
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- https://orcid.org/0000-0002-2510-1751
| | - Atul Budukh
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0001-6723-802X
| | - Jarnail Singh Thakur
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
- https://orcid.org/0000-0002-8270-4268
| | - Tapas Dora
- Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centre (TMC), Sangrur 148001, India
| | - Burhanuddin Qayyumi
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Muzaffarpur 842004, India
| | - Divya Khanna
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC), Tata Memorial Centre (TMC), Varanasi 221005, India
- https://orcid.org/0000-0001-7856-8059
| | - Dolorosa Fernandes
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Visakhapatnam 530053, India
| | - Priyal Chakravarti
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- https://orcid.org/0000-0003-2163-796X
| | - Ravikant Singh
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Muzaffarpur 842004, India
| | - Suvarna Patil
- Bhaktshreshtha Kamalakarpant Laxman Walawalkar (BKLW) Hospital, Diagnostic and Research Centre, Ratnagiri 415606, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0003-4830-0486
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0002-3520-1342
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Das G, Bhutia KD, Purkayastha J, Talukdar A. Early-Onset Gastric Cancer from a Geographic Area of High Gastric Cancer Incidence in North-East India: a Retrospective Study. Indian J Surg Oncol 2023; 14:308-311. [PMID: 37324311 PMCID: PMC10267022 DOI: 10.1007/s13193-022-01675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/21/2022] [Indexed: 11/07/2022] Open
Abstract
We aim to report about the clinico-pathological characteristics of early-age gastric cancer in North-East India. It is a retrospective and observational study conducted in a tertiary care cancer centre in North-East India. We reviewed physical case records and the hospital electronic medical record system. The study population included all patients of age 40 years or less, with a confirmed diagnosis of gastric adenocarcinoma, who received treatment in the institute. The duration of the study was from 2016 to 2020. Data was collected using a pre-designed proforma, and the results were presented as percentages, ratios, median values and range. A total of 79 patients with early-age gastric cancer were found during the study period. There was female preponderance (45:34). Out of the total, 43% presented in stage IV. Most of them had good performance status (87.3% had ECOG 0-2), and none of them had documented co-morbid illness. Poorly differentiated adenocarcinoma and signet ring cell carcinoma were seen in 36.7% and 25.3% patients, respectively. Only 25 patients (31.6%) underwent definitive surgery, and they had a high nodal burden with a median metastatic lymph nodal ratio of 0.35 (range 0 to 0.91). Out of them, 40% developed systemic recurrence within a short span of time (median time to recurrence being 9.5 months). Peritoneal recurrence was the most common site of failure (80%). Early-age gastric cancer has been associated with aggressive pathological features and poor clinical outcomes in North-East India.
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Affiliation(s)
- Gaurav Das
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute (a unit of Tata Memorial Centre), Kamrup Metro, Room No. 30, AK Azad Road, Gopinath Nagar Pin, 781016 Guwahati, Assam India
| | - Karma Doma Bhutia
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute (a unit of Tata Memorial Centre), Kamrup Metro, Room No. 30, AK Azad Road, Gopinath Nagar Pin, 781016 Guwahati, Assam India
| | - Joydeep Purkayastha
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute (a unit of Tata Memorial Centre), Kamrup Metro, Room No. 11, AK Azad Road, Gopinath Nagar Pin, 781016 Guwahati, Assam India
| | - Abhijit Talukdar
- Department of Surgical Oncology, Dr. B. Borooah Cancer Institute (a unit of Tata Memorial Centre), Kamrup Metro, Room No. 28, AK Azad Road, Gopinath Nagar Pin, 781016 Guwahati, Assam India
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Saunders AC, Mutebi M, Rao TS. A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution. Ann Surg Oncol 2023; 30:3197-3205. [PMID: 36973564 PMCID: PMC10175401 DOI: 10.1245/s10434-023-13352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 03/29/2023]
Abstract
AbstractWorldwide, the capacity of healthcare systems and physician workforce is woefully inadequate for the surgical treatment of cancer. With major projected increases in the global burden of neoplastic disease, this inadequacy is expected to worsen, and interventions to increase the workforce of surgeons who treat cancer and strengthen the necessary supporting infrastructure, equipment, staffing, financial and information systems are urgently called for to prevent this inadequacy from deepening. These efforts must also occur in the context of broader healthcare systems strengthening and cancer control plans, including prevention, screening, early detection, safe and effective treatment, surveillance, and palliation. The cost of these interventions should be considered a critical investment in healthcare systems strengthening that will contribute to improvement in the public and economic health of nations. Failure to act should be seen as a missed opportunity, at the cost of lives and delayed economic growth and development. Surgeons who treat cancer must engage with a diverse array of stakeholders in efforts to address this critical need and are indispensably positioned to participate in collaborative approaches to influence these efforts through research, advocacy, training, and initiatives for sustainable development and overall systems strengthening.
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Affiliation(s)
| | | | - T Subramanyeshwar Rao
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
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