Background:Cancers in teenage and young adults (TYAs), though an increasing cause of mortality in our country, have been scarcely studied. The lack of studies of TYAs can significantly affect the outcomes of the youth in the prime of their lives.Aims:The aim of this study was to study the type of cancers in the TYA at a rural cancer center in central India.Design and Methods:A prospective study in the department of medical oncology, from the period of January 2013 till March 2016, was done. Data regarding socioepidemiological factors were collected for new cancer patients between the age group of 15–30 years in semi-structured questionnaire and from the hospital records. Cancers were classified according to the Birch classification. The cases were analyzed according to the epidemiological profile, classification of cancer, and age-wise distribution using descriptive analysis.Results:In this study, out of 5221 cancer patients, TYAs accounted for 327 (6.26%) with 189 males and 138 females (M: F– 1.37:1). The maximum cases were seen in 25–30 years’ age group. Carcinoma was the most common malignancy (54.74%) with an increase from 19.56% in the 15–19 years’ age group to 64.82% in the 25–30-year-old patients.Conclusion:The present study gives a glimpse of the TYA cancers in the central India. More than half of the young cancer patients suffer from carcinomas with about half of these being head and neck cancers.
Background: Malignant mediastinal masses can develop from structures that are normally located or pass through the mediastinum during development, as well as from metastases of malignancies that arise elsewhere in the body. Since many tumors that occur in the mediastinum are undifferentiated and have overlapping histologic features, one must consider a broad differential diagnosis and perform a thorough evaluation. This is particularly important since appropriate therapy for various mediastinal tumors differs considerably and may significantly impact survival.Methods: Ours was a retrospective descriptive study of 48 patients who presented or referred to medical oncology department from January 2014 to December 2017 and in whom malignant cause of mediastenal mass was established. All details of the patients pertinent epidemiology, clinical history and pathological including immunohistochemistry details were studied.Results: Out of 48 patients,14 cases (29.2%) were in adolescent and young adult age group (15-29 years). Majority of the patients were symptomatic (91.6%) with most common being cough (87.5%) followed by chest pain (81.5%) and dyspnoea (79.1%). Four of the patients presented with superior vena-caval syndrome. Most of the tumors (64.6%) are in anterior mediastenum region. Histopathological examination revealed non-hodgkins lymphoma in 31.25%, Hodgkins lymphoma in 18.75%, leukaemia in 6.25%, germ cell tumor in 8.33%, thymic neoplasms in 4.16%, neurogenic tumors in 4.16%, lung carcinoma in 10.4% and metastatic carcinoma in 10.4%.Conclusions: Malignant mediastinal masses have a broad range of diagnosis, establishing of which is important. While imaging help in narrowing the differential diagnosis, adequate pathological categorization should be done as many patients responds to specific line of therapy.
Background Stem cell transplantations (SCTs) in India have increased exponentially, which has improved survival in hematologic cancers, and allogeneic transplants have improved survival in transplant-treatable disorders. Greater progress in providing SCTs has occurred in metropolitan areas because insurance coverage and financial resources are more readily available there than in rural areas. In India, there are still many underserved areas where per capita income is US$800 to US$1100 per year. In those areas, the stigma and fear of transmission of cancers and hematologic disorders add to the many challenges in providing SCTs for all who need them. In addition, HLA matching and blood typing face financial challenges. Sri Aurobindo Medical College and Postgraduate Institute (SAIMS) in Indore is located in one such area, covering 22 districts of Madhya Pradesh. It has a hematology specialty department and a postgraduate residential program in hemato-oncology. The Teenage and Young Adult Cancer Foundation (TYAcan) is a nonprofit organization working in the same region. Objectives One of the most important objectives is building capacity in western Madhya Pradesh to provide affordable and effective SCTs for children and young adults with aplastic anemia, relapsed leukemia, and thalassemia.
Background: Patients with chronic or resolved hepatitis B virus (HBV) infection have a risk of reactivation after chemotherapy. Japanese guidelines recommend that all patients on chemotherapy should be screened for HBV infection. Although Asian peoples are considered to be a high risk population of HBV infection, little is known about the screening rate in Japan. Methods: We analyzed health insurance claims data linked with hospital-based cancer registry. Patients diagnosed with cancer in 2014, 20 years and older, who received at least one dose of systemic anticancer therapy in 2014-15 entered the analyses. We assessed the HBV screening rates by HBsAg or anti-HBc test ordered around initial treatment, HBV-DNA test and entecavir prescription. A multiple logistic regression model was used to identify factors related to the receipt of screening. Results: Of 177636 patients (mean [SD] age, 65.6 [12.2] years), 82.6%, 12.9%, 4.5% patients had solid tumor other than hepatocellular carcinoma (HCC), hematologic malignancy and HCC, respectively. Among them, 88.5%, 8.8%, 2.6% patients received cytotoxic chemotherapy, targeted therapy and anti-CD20 antibody, respectively. Overall, 70.6% of patients were screened but 34.5% were tested HBsAg only. The positive predictors of the HBV screening were hematologic malignancy (OR 2.45; 95%CI, 2.35-2.55) and negative predictors were age 85 (OR 0.75 compared to age <65, 95%CI, 0.71-0.80), age 75-84 (OR 0.77; 95%CI, 0.75-0.79), targeted therapy (OR 0.79; 95%CI, 0.76-0.82). Among the screened patients, 13.2% were tested HBV-DNA and 1.49% were prescribed prophylactic entecavir. Conclusions: This is the largest study to evaluate the HBV screening rate before systemic anticancer therapy in Japan. Although the screening rate is higher than previous reports from other countries (13-19%), half of the screened patients were tested HBsAg only. The elderly patients and patients who received targeted therapy were less screened. Legal entity responsible for the study: Takahiro Higashi. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest. 421O Assessment and comparison of CISNE model versus MASCC model in clinically stable febrile neutropenia patients
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