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Context: Pediatric bone sarcoma is a rare entity with low incidence of around 2.5-6 per million population in India. Management of this condition is well standardized, and global survival data are available; however, there is a paucity of data in the Indian perspective. Aim of the Study: The aim of this study is to analyze various prognostic factors and survival outcome. The purpose of this study is to assess the role of surgery, multiagent chemotherapy, and radiation in the management of these tumors. Patients and Methods: Retrospective analysis of patients aged 18 and less, diagnosed as bone sarcomas and treated in our tertiary cancer center. All the patients received at least one form of therapy depending on stage and site of the primary lesion. Results: Twenty-one patients of Ewing sarcoma and 20 patients of osteosarcomas were eligible and were included in the study. In Ewing sarcoma, completing the full course of standard chemotherapy and radiotherapy to the local site was associated with improved survival. In osteosarcoma, limb salvage surgery (LSS) had a significant difference in overall survival compared to amputation. Induction chemotherapy was associated with better percentage of necrosis and showed improved survival. The percentage of necrosis correlated positively with survival which was statistically significant (P = 0.015). Conclusion:The median survival in both these bone sarcomas is inferior to global trends. Probable reasons for such discrepancy are lack of compliance to treatment protocols due to age factors and late presentation. Completion of multiagent chemotherapy in both the tumors add to better survival. Radiotherapy in Ewing sarcoma improves survival. In osteosarcoma, LSS is an oncologically safe alternative to amputation. The percentage of necrosis following chemotherapy in osteosarcoma is a reliable predictor of prognosis.

Background: Depth of invasion is included in the staging of oral cavity malignancies in the recent 8 th edition of American Joint Committee on Cancer or tumour, node and metastasis staging system. This study analyses the impact of diffuse optical imaging (DOI) on incidence of lymph node involvement, stage migration, postoperative margin and independency. Methods: Postoperative HPE of fifty patients with oral cavity malignancy operated in our institute from January 2018 were collected. Depth of invasion and other pathological parameters were documented. DOI divided into three groups and statistical analysis done. Results: No lymph node metastasis is found in superficial tumours, 43% of intermediate thickness and 76% of deep tumours had lymph node involvement. Positive margin is seen only in patients with tumour DOI more than 0.5 cm, more than 50% of deep tumours had close margins while 75% of superficial tumours had adequate margin. Out of the 24 T3 tumours in this study 13 were upstaged due to inclusion of DOI, which would have been T2 according to the previous staging system. There is 54.1% (13 out of 24) upstaging in T3 tumours (T2 to T3), 23% (3 out of 13) in T2 (T1 to T2). There is no significant correlation between DOI and anatomical site, tumour size, tumour thickness, lymphovascular invasion and grade. Conclusions: Depth of invasion in oral cavity malignancies impacts adversely lymph node metastasis and margin status. It is an independent prognostic factor in oral cavity malignancy.

<p class="abstract"><strong>Background:</strong> The purpose of this retrospective analysis was to review our single institute based experience with the pharyngocutaneous fistula following total laryngectomy and to determine the impact of pharyngeal closure technique in the development of PCF in our patients.</p><p class="abstract"><strong>Methods:</strong> The medical records of the patients, who underwent total laryngectomy for squamous cell carcinoma of the larynx and hypopharynx in Government Royapettah Hospital, center for oncology between January 2010 and December 2017, were retrospectively reviewed.  </p><p class="abstract"><strong>Results:</strong> 26 patients were included in the study of which 25 were male and 1 was female. Mean age of the patients were 58 years. Horizontal closure was done in 9 patients (35%) and T closure was done in 17 patients (65%). PCF was observed in 1 of 9 patients in horizontal closure. Remaining 17 patients underwent T closure of whom 8 patients developed PCF (p=0.06). Eight out of 18 patients (44%) developed PCF after salvage surgery after radiotherapy failure, Remaining 8 patients underwent primary laryngectomy for advanced stage cancers with cartilage involvement, of whom 1 patient developed PCF (12.5%) (p=0.11). In salvage laryngectomy (n=18), 1 of 6 cases developed PCF in horizontal closure and 7 of 12 cases in T closure technique (p=0.09).</p><p class="abstract"><strong>Conclusions:</strong> The incidence of fistula in our study was 34%. Horizontal closure was associated with decreased incidence of PCF when compared to ‘T’ closure of the defect. Prior radiotherapy had increased incidence of PCF.</p>

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