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Chaudhari V, Ramaswamy A, Srinivas S, Agarwal A, Seshadri RA, Talwar V, Bhargava P, Goel S, Kayal S, Rebala P, Prajapati B, Parikh D, Kothari J, Ch RM, Kadamapuzha JM, Kapoor D, Chaudhary A, Goel V, Singh S, Ghosh J, Lavingia V, Gupta A, Sekar A, Misra S, Vishnoi JR, Soni S, Varshney VK, Bairwa S, Bhandare M, Shrikhande SV, Ostwal V. Practice Patterns and Survival in Patients with Resected Pancreatic Ductal Adenocarcinomas (PDAC) - Results from the Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP) Study. J Gastrointest Cancer 2023; 54:1338-1346. [PMID: 37273074 DOI: 10.1007/s12029-023-00936-1] [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] [Accepted: 04/03/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND There is limited data from India with regard to presentation, practice patterns and survivals in resected pancreatic ductal adenocarcinomas (PDACs). METHODS The Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP) included data from 8 major academic institutions across India and presents the outcomes in upfront resected PDACs from January 2015 to June 2019. RESULTS Of 288 patients, R0 resection was achieved in 81% and adjuvant therapy was administered in 75% of patients. With a median follow-up of 42 months (95% CI: 39-45), median DFS for the entire cohort was 39 months (95% CI: 25.4-52.5), and median overall survival (OS) was 45 months (95% CI: 32.3-57.7). A separate analysis was done in which patients were divided into 3 groups: (a) those with stage I and absent PNI (SI&PNI-), (b) those with either stage II/III OR presence of PNI (SII/III/PNI+), and (c) those with stage II/III AND presence of PNI (SII/III&PNI+). The DFS was significantly lesser in patients with SII/III&PNI+ (median 25, 95% CI: 14.1-35.9 months), compared to SII/III/PNI + (median 40, 95% CI: 24-55 months) and SI&PNI- (median, not reached) (p = 0.036)). CONCLUSIONS The MIPPAP study shows that resectable PDACs in India have survivals at par with previously published data. Adjuvant therapy was administered in 75% patients. Adjuvant radiotherapy does not seem to add to survival after R0 resection.
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Affiliation(s)
- Vikram Chaudhari
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Anant Ramaswamy
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sujay Srinivas
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ajit Agarwal
- Balco Medical Centre Raipur India, Uparwara, Raipur, India
| | | | - Vineet Talwar
- Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | - Prabhat Bhargava
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Shaifali Goel
- Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | - Smita Kayal
- Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India
| | | | | | | | | | - Ramesh M Ch
- Lakeshore Hospital & Research Center, Kochi, Kerala, India
| | | | | | | | - Varun Goel
- Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | - Shivendra Singh
- Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | | | | | - Amit Gupta
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Anbarasan Sekar
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sanjeev Misra
- All India Institute of Medical Sciences, Jodhpur, India
| | | | - Subhash Soni
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - Manish Bhandare
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - Vikas Ostwal
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
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Datta D, Sarwal T, Kumar R, Bairwa S, Gowda VN, Nalwa A. Interesting Presentation of Mycosis Fungoides in Staging on F-18 FDG PET/CT. Nucl Med Mol Imaging 2023; 57:243-246. [PMID: 37720879 PMCID: PMC10504174 DOI: 10.1007/s13139-023-00794-6] [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: 10/12/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023] Open
Abstract
Mycosis fungoides is the major form of primary cutaneous T cell lymphoma. Its staging is based on the percentage of body surface involvement and biopsy-proven extra cutaneous nodal or visceral involvement. Literature shows F-18 FDG accumulation in disease-involved nodes and viscera with non-specific uptake due to co-existing inflammation limits its specificity. We report an interesting case of mycosis fungoides with bilateral upper limb edema and share its findings on F-18 FDG PET/CT.
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Affiliation(s)
- Deepanksha Datta
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Tanvi Sarwal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Sandeep Bairwa
- Department of Medical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vinay N. Gowda
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Aasma Nalwa
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Waghmare P, Patra S, Thirunavukkarasu B, Bairwa S. Azacytidine-induced Sweet's syndrome. BMJ Case Rep 2022; 15:15/12/e252329. [PMID: 36572451 PMCID: PMC9806094 DOI: 10.1136/bcr-2022-252329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Prajakta Waghmare
- Dermatology, Venereology and Leprology, All India Institute of Medical Sciences - Jodhpur, Jodhpur, Rajasthan, India
| | - Suman Patra
- Dermatology, Venereology and Leprology, All India Institute of Medical Sciences - Jodhpur, Jodhpur, Rajasthan, India
| | | | - Sandeep Bairwa
- Medical Oncology, All India Institute of Medical Sciences - Jodhpur, Jodhpur, Rajasthan, India
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Sureka B, Chawla S, Khera S, Agarwal A, Birda CL, Bairwa S. A lumpy bumpy stomach: The more the murkier. SA J Radiol 2022; 26:2437. [PMID: 35812702 PMCID: PMC9257741 DOI: 10.4102/sajr.v26i1.2437] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/29/2022] [Indexed: 11/02/2022] Open
Abstract
This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy.
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Affiliation(s)
- Binit Sureka
- Department of Radiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Siddhi Chawla
- Department of Radiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Sudeep Khera
- Department of Pathology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Ashish Agarwal
- Department of Gastroenterology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Chhagan L. Birda
- Department of Gastroenterology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
| | - Sandeep Bairwa
- Department of Medical Oncology, All India Institute of Medical Sciences Jodhpur, Jodhpur, India
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Ramaswamy A, Kothari R, Desouza A, Gupta T, Bairwa S, Kapoor A, Kumar A, Ventrapati P, Ramadwar M, Mandavkar S, Chavan N, Saklani A, Ostwal V. Adjuvant chemotherapy in stage II-III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX. South Asian J Cancer 2019; 8:160-165. [PMID: 31489288 PMCID: PMC6699238 DOI: 10.4103/sajc.sajc_176_18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce. MATERIALS AND METHODS Patients who underwent upfront curative resection for colon cancer from January 2013 to December 2016 were analyzed for baseline variables and outcomes. RESULTS A total of 491 patients underwent curative resection in the predefined time period. The median age of the patients was 53 years (range: 17-87). Patients with Stage I, Stage II, and Stage III disease comprised 7.9%, 44.8%, and 45.4% of the entire cohort, respectively. Patients with Stage I cancer were observed. Adjuvant chemotherapy was planned for 384 patients (78.2%), with the doublet regimens (capecitabine-oxaliplatin, or 5-fluorouracil-oxaliplatin) being used commonly (77.6%). Common toxicities were Hand-foot syndrome (Grade 2/3 - 21.4%) and peripheral neuropathy (Grade 2/3 - 20.1%). About 85% of patients receiving monotherapy (capecitabine or 5 fluorouracil) and 81.2% of patients receiving doublet chemotherapy (mCAPOX or modified FOLFOX-7) completed their planned adjuvant treatment. With a median follow-up of 22 months, estimated 3 years event-free survival was 86%, and overall survival (OS) was 93.6%. Stage, younger age (<50 years), underlying cardiovascular abnormalities, need for dose reductions and noncompletion of planned chemotherapy predicted for inferior estimated 3-year OS on multivariate analysis. CONCLUSIONS Adjuvant chemotherapy especially with modified CAPOX appears well tolerated in the Indian population and early survival outcomes appear to be comparable to published literature.
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Affiliation(s)
- Anant Ramaswamy
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rushabh Kothari
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ashwin Desouza
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Tarachand Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sandeep Bairwa
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Akhil Kapoor
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amit Kumar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Pradeep Ventrapati
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Mukta Ramadwar
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sarika Mandavkar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nita Chavan
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Avanish Saklani
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Parajuli N, Bairwa S, Kershaw E, Dyck J. THE EFFECTS OF ADIPOCYTE-SPECIFIC ADIPOSE TRIGLYCERIDE LIPASE DELETION ON CARDIAC FUNCTION. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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