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Background: Phyllodes tumour is a rare breast neoplasm having three histological types i. e benign, borderline and malignant. Surgical excision is the mainstay of treatment, but quantification of adequate margin required during excision is still a matter of debate. Role of adjuvant radiotherapy also remains controversial. Aims: Study of prognostic factors in patients with phyllodes tumour of breast and their effect on survival. Setting and design: A retrospective analysis. Material and methods: From the year 2016 to 2019 we included 54 patients in this study and assessment of clinical and histopathological features, requirement of adjuvant radiotherapy and their effect on DFS (disease free survival) and OS (overall survival) was done. Log-rank test was used for univariate analysis and multivariate analysis was done by using Cox propotion hazard ratio method. Statistical analysis: Descriptive statistics was used for calculating proportion and median value. Survival analysis was done by using Kaplan Meier method. P value of

The role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with multiple myeloma (MM) and other plasma cell disorders is well-known. Solitary plasmacytoma (SP), an extremely rare form within this entity accounting for approximately 4% of plasma cell malignancies, can be classified as solitary bone plasmacytoma (SBP) or solitary extramedullary plasmacytoma (SEMP). Extramedullary plasmacytoma (EMP) is a rare neoplasm characterized by the monoclonal proliferation of plasma cells outside the bone marrow. Breast and craniocerebral regions are the uncommon sites of the presentations of EMP, rarely reported in the literature. The most frequent site of presentation is the upper airways. The EMPs have similar pathogenesis as MM; however, they differ in management as they are radiosensitive in nature, and radiotherapy is the preferred treatment modality. As SEMP has a better prognosis than SPB with a lower conversion rate to MM, accurate staging is essential to plan for the treatment. The 18F-FDG PET/CT has higher sensitivity for the evaluation of treatment response. In the present case series, it was aimed to depict the role of 18F-FDG PET/CT in newly diagnosed SEMP with different sites of origin to exclude further lesions leading to changes in the treatment plan and treatment response assessment. [ABSTRACT FROM AUTHOR]

The clinical dilemma of management of isolated contralateral axillary metastasis (CAM) in carcinoma breast remains unsolved. We report a case of metachronous contralateral left axillary metastasis in a 54-year-old postmenopausal woman, its management, and review of literature. After ruling out distant metastasis and occult primary in the opposite breast, curative treatment was planned. She underwent left axillary lymph node dissection which on histopathology showed metastatic carcinoma. Management of CAM with curative or palliative intent and whether to consider them as locoregional or distant metastasis remains controversial. CAM may occur due to the locoregional spread of disease, and hence, curative intent of treatment should be offered to these patients. [ABSTRACT FROM AUTHOR]

Retrospective review of operated carcinoma esophagus - our institutional experience Aim:- To assess the outcome of carcinoma esophagus operated in our institute. Materials and methods:- A retrospective analysis of 210 patients of carcinoma esophagus operated in between 2010-2016 in our institute. Patients were evaluated in terms of neo-adjuvant treatment, surgery, post surgical results and follow-up. Patients of carcinoma esophagus clinical stage ? T2 were considered. Advanced cases, cases with other histology (Leiomyoma, NET and Sarcomatoid Carcinoma), and patients taken other regimen of treatment before surgery like (curative CTRT, palliative RT etc) are excluded from the study Results:- Mean age of presentation was 51.7 year. 56.4% are Male and 43.6% female. 30.5 %(64) patient mid 1/3rd, 36%(76) patient lower 1/3rd and 33.5%(70) patient have GE Junction tumor. 74.8% were Squamous cell carcinoma and 25.2% adenocarcinoma in all three regions SCC was main histological type. 56.7%(119) patients were Upfront operated, 25.3%(53) received NACT(neo-adjuvant chemotherapy) and 18%(38) received NACT+ RT(neo-adjuvant chemo-radiation) Most common drug used in NACT was combination of PACLITAXEL+CARBOPLATIN, and most common NACTRT regimen was 45GY/25# radiation in combination with weekly single agent carboplatin for a duration of 5 weeks. Dose of radiation was adjusted in some patients according to their BMI and performance status. 18.5 %(22) patient were inoperable in Upfront surgery group, 11.3%(6) in NACT group, and 18.4%(7) in NACTRT group. Commonest cause of inoperability was disease adherent to trachea, bronchus and celiac axis. 48.5 %(47) patient were node positive in Upfront surgery group, 42.5%in NACT and NACTRT had the lowest 29% node positivity rate on final Histopathology . PCR(Primary complete response) was highest 29% in NACTRT group .Average blood loss during surgery was highest in NACTRT group(295 ml in Upfront surgery, 332 ml in NACT, 436 ml in NACTRT) Average Hospital stay and ICU stay was comparable in all three group. Most common complication in post operative period was pulmonary followed by anastomotic leak. Recurrence is highest in NACT group (42.5%) and lowest in NACTRT group (16%). The most common site of recurrence was systemic liver, Lung and bone being commonest. 76 patients included in the study are still alive Discussion:- Thus NACT+RT has shown the best outcome in terms of survivorship as 71%(27) patients are still alive, Lowest recurrence rate and highest 29% PCR rate among the group . The only drawback is that NACTRT has higher intraoperative blood loss. CONCLUSION:- our study favours NACT+RT followed by surgery to be the best treatment modality for carcinoma esophagus patients with the least recurrence and better survival. DATA TABLE ( UPFRONT ) Total Patients ---- 119 Gender Ratio (M:F) ---- 67:52 Mean Age in years ---- 55(M), 50.5(F) Operable patients ----- 97 Histopathology ---- Adeno CA - 31, SCC - 88 Surgery: (THE, LAP THE, 3Stage, Ivor Lewis, Thoracolaparoscopic) THE = 37 LAP THE = 4 Thoraco-Lap- Eso= 25 Open Three stage E= 21 Ivor Lewis = 10 INOPERABLE = 22 Anastamosis (Hand Sewn: Stapler) --- 82:15 No. Of Nodes retrieved ---- 10 Adverse Prognostic Factors (PNE/PNI/LVI) ---- PNE = 14, PNI = 10, LVI = 22 Early Complications ---- Pulmonary: 19 (16%), Leak: 16 (16%), Other: 5 (4.2%), Hoarseness : 10 Recurrence ---- Local :3, Regional : 11, Systemic : 21 Stage ---- PCR - 0, 0 - 0, I - 10, II - 42, III - 45 Site ---- Mid - 31, Lower - 50, GEJ - 38 Average Blood Loss ---- 295 ml Average hospital stay ---- 14 days Average ICU stay ---- 5 days Patients still alive ---- 33(27. 7%) ( NACT ) Total Patients ---- 53 Gender Ratio (M:F) ---- 31:22 Mean Age in years ---- 51(M), 48(F) Operable patients ----- 47 Histopathology ---- Adeno CA - 18, SCC - 35 Surgery: (THE, LAP THE, 3Stage, Ivor Lewis, Thoracolaparoscopic) THE = 23 LAP THE = 3 Thoraco-Lap- Eso= 8 Open Three stage E= 12 Ivor Lewis = 1 INOPERABLE = 6 Anastamosis (Hand Sewn: Stapler) --- 39:8 No. Of Nodes retrieved ---- 10 Adverse Prognostic Factors (PNE/PNI/LVI) ---- PNE = 9, PNI = 2, LVI = 15 Early Complications ---- Pulmonary: 14 (26%), Leak: 5 (10.6%), Other: 3 (5.6%), Hoarseness : 12 Recurrence ---- Local :0, Regional : 8, Systemic : 12 Stage ---- PCR - 2, 0 - 0, I - 9, II - 20, III - 16 Site ---- Mid - 18, Lower - 15, GEJ - 20 Average Blood Loss ---- 332 ml Average hospital stay ---- 13 days Average ICU stay ---- 4 days Patients still alive ---- 16(30%) ( NA CTRT ) Total Patients ---- 38 Gender Ratio (M:F) ---- 22:16 Mean Age in years ---- 49.3(M), 48.6(F) Operable patients ----- 31 Histopathology ---- Adeno CA - 4, SCC - 34 Surgery: (THE, LAP THE, 3Stage, Ivor Lewis, Thoracolaparoscopic) THE = 8 LAP THE = 1 Thoraco-Lap- Eso= 4 Open Three stage E= 17 Ivor Lewis = 1 INOPERABLE = 7 Anastamosis (Hand Sewn: Stapler) --- 23:8 No. Of Nodes retrieved ---- 9 Adverse Prognostic Factors (PNE/PNI/LVI) ---- PNE = 2, PNI = 1, LVI = 0 Early Complications ---- Pulmonary: 8 (21%), Leak: 2 (6.4%), Other: 5 (13%), Hoarseness : 10 Recurrence ---- Local : 0, Regional : 1, Systemic : 4 Stage ---- PCR - 8, 0 - 1, I - 8, II -10, III -4 Site ---- Mid - 15, Lower - 11, GEJ - 12 AverageBlood Loss ---- 436 ml Average hospital stay ---- 14 days Average ICU stay ---- 4 days Patients still alive ---- 27 (71%). [ABSTRACT FROM AUTHOR]

Background: Adequate lymphadenectomy in middle- and lower-third esophagus cancer is still a matter of debate. This study aims to find out the extent of histopathological supracarinal lymph nodes positivity rate to establish an adequate lymph node dissection in esophageal squamous cell carcinoma cases operated up-front or after neoadjuvant chemotherapy (CT) + radiotherapy (RT) and its short-term oncological outcome., Materials and Methods: After approval from institutional board review, a retrospective study was conducted from April 2017 to September 2019. A total of 76 patients having mid- or lower-third carcinoma esophagus were operated at our institute for partial/total esophagectomy with extended two-field lymph node dissection were followed. Intraoperative nodal stations were harvested separately and lebeled individually according to the Japanese Esophageal Classification and sent for histopathological examination., Results: The patients had an average age of 52 years. Histologically all were squamous cell carcinoma (SCC). Forty-four patients received preoperative concurrent RT plus drug therapy, whereas 18 cases were operated up-front. Fourteen patients were operated after palliative treatment (CT/RT). The average total lymph node yield was 22 nodes (range 3-69). In 26 patients (34.2%), lymph nodes were positive (N+ disease). Supracarinal nodes were positive in 20 cases (26.31%). The average supracarinal lymph node yield was 10.33 nodes (range 2-32). Five patients (6.5%) had only supracarinal lymph nodes positive on histopathological examination. Seventeen patients had a complete pathological response rate (pCR)., Conclusion: In cases of mid-third esophageal carcinoma, extended two fields with supracarinal lymphadenectomy is strongly recommended even after the patient has received neoadjuvant treatment, although the same for lower-third/gastroesophageal (GE) junction tumors should be considered.