Tata Memorial Hospital

About: Tata Memorial Hospital is a healthcare organization based out in Mumbai, India. It is known for research contribution in the topics: Cancer & Breast cancer. The organization has 3187 authors who have published 4636 publications receiving 109143 citations.

Fluorescence spectroscopy for noninvasive early diagnosis of oral mucosal malignant and potentially malignant lesions.

Abstract: Background: We report the results of a clinical in vivo study to evaluate the potential of fluorescence spectroscopy for differential diagnosis of oral mucosal malignant and potentially malignant lesions. Materials and Methods: The study involved 26 healthy volunteers and 144 patients enrolled for routine medical examination of the oral cavity at the outpatient department of the Tata Memorial Hospital, Mumbai. In vivo autofluorescence spectra were recorded using a N 2 laser based portable fluorimeter developed in-house. The different tissue sites investigated belonged to either of the four histopathologic categories: 1) squamous cell carcinoma (SCC), 2) oral sub-mucous fibrosis (OSMF), 3) leukoplakia (LP) and 4) normal squamous tissue. A multivariate statistical algorithm capable of direct multi-class classification was used to predict pathological designations. Results: With respect to histopathology as the gold standard, the diagnostic algorithm was found to provide an accuracy of 82, 76, 81 and 85% based on leave-one-patient-out cross-validation in classifying the oral tissue spectra into four different pathology classes - SCC, OSMF, LP, and normal squamous tissue - respectively. When the algorithm was employed for delineating the normal oral tissues from all the abnormal oral tissues including SCC, OSMF and LP put together, a sensitivity of 98% and a specificity of 100% were obtained. Conclusion: The results suggest that it is possible to objectively classify the oral tissue into different pathology classes based on their in vivo autofluorescence spectra. Thus, the technique can potentially improve oral screening efforts in low resource settings where clinical expertise and resources are limited.

Management of Hepatoblastoma: ICMR Consensus Document

Abstract: Neuroblastoma (NBL) is the most common extra-cranial solid tumor in childhood. High-risk NBL is considered challenging and has one of the least favourable outcomes amongst pediatric cancers. Primary tumor can arise anywhere along the sympathetic chain. Advanced disease at presentation is common. Diagnosis is established by tumor biopsy and elevated urinary catecholamines. Staging is performed using bone marrow and mIBG scan (FDG-PET/bone scan if mIBG unavailable or non-avid). Age, stage, histopathological grading, MYCN amplification and 11q aberration are important prognostic factors utilized in risk stratification. Low-risk disease including Stage 1 and asymptomatic Stage 2 disease has an excellent prognosis with non-mutilating surgery alone. Perinatal adrenal neuroblastoma may be managed with close observation alone. Intermediate-risk disease consisting largely of unresectable/symptomatic Stage 2/3 disease and infants with Stage 4 disease has good outcome with few cycles of chemotherapy followed by surgical resection. Paraspinal neuroblastomas with cord compression are treated emergently, typically with upfront chemotherapy. Asymptomatic Stage 4S disease may be followed closely without treatment. Organ dysfunction and age below 3 mo would warrant chemotherapy in 4S. High-risk disease includes older children with Stage 4 disease and MYCN amplified tumors. High-risk disease has a suboptimal outcome, though the survival is improving with multimodality therapy including autologous stem cell transplant and immunotherapy. Relapse after multimodality therapy is difficult to salvage. Late presentation, lack of transplant facility, malnutrition and treatment abandonment are additional hurdles for survival in India. The review provides a consensus document on management of NBL for developing countries, including India.

COVID-19 and gynecological cancer: a review of the published guidelines.

Abstract: On March 11, 2020 the COVID-19 outbreak was declared a 'pandemic' by the World Health Organization. COVID-19 is associated with higher surgical morbidity and mortality. An array of guidelines on the management of cancer during this pandemic have been published since the first reports of the outbreak. This narrative review brings all the relevant information from the guidelines together into one document, to support patient care. We present a detailed review of published guidelines, statements, comments from peer-reviewed journals, and nationally/internationally recognized professional bodies and societies' web pages (in English or with English translation available) between December 1, 2019 and May 27, 2020. Search terms included combinations of COVID, SARS-COV-2, guideline, gynecology, oncology, gynecological, cancer. Recommendations for surgical and oncological prioritization of gynecological cancers are discussed and summarized. The role of minimally invasive surgery, patient perspectives, medico-legal aspects, and clinical trials during the pandemic are also discussed. The consensus is that elective benign surgery should cease and cancer surgery, chemotherapy, and radiotherapy should continue based on prioritization. Patient and staff face-to-face interactions should be limited, and health resources used efficiently using prioritization strategies. This review and the guidelines on which it is based support the difficult decisions currently facing us in gynecological cancer. It is a balancing act: limited resources and a hostile environment pitted against the time-sensitive nature of cancer treatment. We can only hope to do our best for our patients with the resources available to us.

PET and PET–CT imaging of gynecological malignancies: present role and future promise

Abstract: In this article, we have reviewed the current role of PET/PET-computed tomography (CT) in the management of gynecological malignancies. The promise of this technique is becoming increasingly evident, based upon several studies conducted in these malignancies. 2-fluoro-2-deoxy-D-glucose-PET appears to have a potential role in assessing response to treatment and forecasting prognosis. For cervical carcinoma, the modality has proven useful in both the staging of untreated advanced cervical cancer and restaging of the disease. Its role in prognostication of the disease and in detecting lesions in the setting of post-treatment unexplained tumor-marker elevation appears promising. PET is of great benefit as a diagnostic tool in ovarian carcinoma when there is an increase in serum CA-125 and CT/MRI or conventional imaging are inconclusive or negative. With regard to its role in endometrial carcinoma, its benefit is particularly emphasized in the setting of post-therapy surveillance of the disease, although, in a limited series, it also appears to give additional information in the pretreatment states. PET may be of value in detecting the extra-uterine lesions that are not visualized with CT/MRI. Data on the role of 2-fluoro-2-deoxy-D-glucose-PET imaging in the management of vulvar and vaginal cancer are relatively sparse at this time but the modality appears to be of value in staging disease and is more effective than conventional diagnostic modalities with respect to detecting nodal metastasis in both malignancies.