Purpose The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done-complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I-IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0-3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1-6) days, and length of hospital stay was 7 (7-15) days. Clavien-Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% (p = 0.76). 10% in ASA I compared to 26% of ASA II (p = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 (p = 0.01) had grade II complication. Four (1%) patients had Grade C III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. Conclusions Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.

BACKGROUNDCytological screening of the uterine cervix by Papanicolaou test has reduced the incidence of cervical cancer. But cytological diagnosis in clinically suspicious lesions of cervix is provisional and has to be corroborated with histopathological findings for effective treatment response. MATERIALS AND METHODSStudy Design-A descriptive study. Three hundred patients attending Gynaecological Oncology OPD of A.H. Regional Cancer Centre, Cuttack during the period April 2016-March 2017, were studied. History taking, clinical examination was followed by cervical smear and multiple punch biopsies, in patients with unhealthy cervix. The cytological and histopathological results were correlated with each other and clinically. RESULTSClinically, cancer was detected in 77.6% cases. Cytologically, 73.3% reported carcinoma and 3.33% squamous intraepithelial lesions. Histopathologically, 74.6% showed carcinoma and 3.7% SIL. The cytohistopathological agreement was 69.2% in inflammatory lesions and 90.5% in invasive carcinomas. In clinically unhealthy cervix, a report of squamous intraepithelial-lesion by cytology was seen in 17.02% and by histopathology was found in 19.15%. Cytological proof of cancer was obtained in 73.3% of cases and histopathological proof in 74%. On overall analysis of 300 cases of suspicious cervix, 229 correlated well with cytology, labelling them as abnormal and 246 cases were stamped as diseased by histopathology. CONCLUSIONThis study proves that cytology can be used as a very effective screening tool to catch high risk cases, which can be biopsied to detect cancer early. Both cytology and histopathology correlate well with clinically obvious lesions of the cervix.

Aim:The study aimed to analyze the clinicopathological profile, surgical practices, and survival outcomes of the patients with uterine sarcoma in eastern India. Background: Uterine sarcomas are a rare entity among gynecological malignancies with a very unfavorable prognosis. Due to its rarity, there is no consensus on a standardized treatment approach. Materials and methods: A retrospective analysis of all patients with a histopathological diagnosis of uterine sarcomas who were treated in our institute from 2012 to 2016 was done. The clinical parameters, treatment given, histopathological report, stage, and follow-up details of all patients were reviewed. Survival analysis was done using Kaplan-Meier method. Results: From 2012 to 2016, 40 patients with a diagnosis of uterine sarcoma were recorded. The median age of the patients was 44 years (range, 18-68 years). The youngest patient who got treated was an 18-year-old with low-grade endometrial stromal sarcoma (LGESS) with stage IIIC disease. Majority of the patients presented with abnormal uterine bleeding (60%) followed by abdominal pain (30%). Low-grade endometrial stromal sarcoma (42%) was the most frequent histological subtype of uterine sarcoma encountered followed by leiomyosarcoma (LMS) (40%), adenosarcoma (AS) (7.5%), undifferentiated endometrial sarcoma (UES) (5%), high-grade endometrial stromal sarcoma (HGESS) (2.5%), and uterine smooth muscle tumor of uncertain malignant potential (STUMP) (2.5%). Majority of the patients were diagnosed at stage I (92.5%) and only 2.5% of patients had stage IIIC disease. The patients were followed up for a median duration of 15 (range, 4-180) months. The median survivals of the patients diagnosed with different histological subtypes were 32, 11, 4, 9.5, 26, and 42 months for LGESS, LMS, HGESS, UES, AS, and STUMP, respectively. Median disease-free survival (DFS) for the entire cohort of uterine sarcoma was 32 months, and median overall survival (OS) was 57 months. Conclusion: Uterine sarcoma, when diagnosed even at an early stage was associated with increased recurrence rate and mortality. Clinical significance: Due to its aggressive behavior, an early diagnosis and a multimodal treatment approach should be considered.

Background: Ovarian cysts are the most common indication for surgery. Some cysts are due to endocrine dysfunction and mostly do not require surgery. Case description: We report a case of a 32-year-old female who presented with large ovarian masses and pituitary enlargement seen in association with hypothyroid. Initially, her radiological imaging and risk of malignancy index (RMI) were in favor of malignancy. On further workup of the patient, high thyroid stimulating hormone (TSH) and prolactin levels were found and she was planned for surgery after optimization. There was a dramatic symptomatic relief as well as a decrease in the size of the ovarian mass after four months of thyroxin supplementation. Conclusion:In young patients presenting with bilateral multicystic ovarian masses, a thyroid function test is mandatory and if thyroid dysfunction is detected, it should be addressed before any surgical intervention. Clinical significance: Hypothyroidism should be considered in differential diagnosis of female with multicystic ovarian mass.

2022-RA-1326-ESGO Figure 2 Overall survival kaplanmeier graphic Conclusion Our study demonstrate that robotics surgery could be considered as an alternative cytoreduction option without worst survival outcomes respect laparotomic approach in highly selected patients.