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.

Rotationplasty for bone tumors: is there still a role?

Abstract: We evaluated the disease status and functional results in 30 patients (range, 6-25 years) who underwent rotationplasty for bone sarcomas from January 2000 to February 2004. Plating was used for fixation in all 27 distal femur resections. In the proximal femur tumor, the distal femur was contoured and fixed to the ilium with cancellous screws. In the two cases involving the entire femur, the upper end of the tibia was articulated with the acetabulum in one case and an Austin Moore prosthesis was inserted in the upper end of the tibia in the other. Two patients underwent an amputation after postoperative vascular compromise. Other complications included venous congestion in two patients, who recovered after exploration, partially recovered nerve palsy in one, wound infection in two, local recurrence in one, and nonunion with subsequent bone grafting in one. Functional evaluation was documented in 26 patients with a followup ranging from 24 to 60 months. Using the Musculoskeletal Tumor Society scoring system, the score was 25 or greater in 20 of 26 patients. In appropriately indicated cases, rotationplasty provides good local disease control and good function.

Carcinoma of the penis: the Indian experience

Abstract: A total of 150 evaluable patients with carcinoma of the penis were treated at the Tata Memorial Hospital between 1984 and 1987. The majority of patients were in the 4th to 7th decades. All patients presented with a growth on the penis, the biopsy of which revealed squamous carcinoma. The primary lesions were T1 in 34, T2 in 73, T3 in 41, and T4 in 2 patients, respectively. The inguinal nodes were not palpable (N0) in 77 patients, palpable but histologically not metastatic in 39 patients, and metastatic in 34 patients. The treatment of the primary lesion was surgery in 142 patients and radiation therapy in 8 patients. Patients with nonpalpable nodes were kept under surveillance and those with pathologically metastatic nodes were subjected to bilateral ilioinguinal lymphadenectomy. The size related 5 year survivals were 83.3% for T1, 60.4% for T2, and 39.5% for T3 lesions. The 5 year survivals for patients with grade I lesions were 90.3%, for grade II 58.6%, and for grade III 16.7%. The 5 year survival rate for patients for N0 nodes was 75.4% while the 3 year survival rates for patients with N1 and N2 nodes were 40% and 38.8%, respectively. The factors signifying poor survival were perinodal extension and iliac node metastases. There were 8 penile stump recurrences, of which 6 could be salvaged. Metachronous inguinal node metastases developed in 16 patients among whom surgical lymphadenectomy was possible in 12 while 4 had unresectable metastases.

Efficacy and safety of radotinib in chronic phase chronic myeloid leukemia patients with resistance or intolerance to BCR-ABL1 tyrosine kinase inhibitors

Abstract: Radotinib (IY5511HCL), a novel and selective BCR-ABL1 tyrosine kinase inhibitor, has shown pre-clinical and phase I activity and safety in chronic myeloid leukemia. This phase II study investigated the efficacy and safety of radotinib in Philadelphia chromosome-positive chronic phase-chronic myeloid leukemia patients with resistance and/or intolerance to BCR-ABL1 tyrosine kinase inhibitors. Patients received radotinib 400 mg twice daily for 12 cycles based on results from the phase I trial. The primary end point was rate of major cytogenetic response by 12 months. A total of 77 patients were enrolled. Major cytogenetic response was achieved in 50 (65%; cumulative 75%) patients, including 36 (47%) patients with complete cytogenetic response by 12 months. Median time to major cytogenetic response and complete cytogenetic response were 85 days and 256 days, respectively. Major cytogenetic response and complete cytogenetic response rates were similar between imatinib-resistant and imatinib-intolerant patients, but were higher in patients without BCR-ABL1 mutations. Overall and progression-free survival rates at 12 months were 96.1% and 86.3%, respectively. All newly-occurring or worsening grade 3/4 hematologic abnormalities included thrombocytopenia (24.7%) and anemia (5.2%); grade 3/4 drug-related non-hematologic adverse events included fatigue (3.9%), asthenia (3.9%), and nausea (2.6%). The most common biochemistry abnormality was hyperbilirubinemia (grade 3/4 23.4%), and 12 of 18 cases were managed with dose modification. Study findings suggest radotinib is effective and well tolerated in chronic phase-chronic myeloid leukemia patients with resistance and/or intolerance to BCR-ABL1 tyrosine kinase inhibitors and may represent a promising alternative for these patients. (clinicaltrials.gov identifier: 01602952)

Use of banked tissue in plastic surgery.

Abstract: The availability of safe and reliable, banked tissues in India has enabled the use of human bone allografts as a viable alternative to autografts in reconstructive surgery. Lyophilised, irradiated bone grafts were used in 2 cases of rhinoplasty, a case of hemifacial atrophy, and as a chin implant. In the patient with revision rhinoplasty the rib graft was resorbed. The patient with hemifacial atrophy developed seroma and infection in the zygomatic and infraorbital area and the rib graft had to be removed. The graft from the same rib that was placed over the mandible was retained well and incorporated completely. The iliac crest cortico-cancellous grafts did well in the second case of augmentation rhinoplasty and in the augmentation of chin. The primary objective of reconstructive surgery in the treatment of burns, non-healing wounds and pressure sores is to remove the dead tissue and restore the continuity of the skin without delay. Lyophilised, irradiated, human amnion is a temporary biological dressing conveniently available off-the-shelf. It was used in twenty four patients with burns, eight patients with bedsores and six patients with non-healing ulcers mainly on the foot. The total surface areas of burns sustained were from 2% to 40%. The burns ranged from second degree to deep third degree burns. Amnion was not used in patients with infected third degree burns. The amnion provided good biological cover in all the patients. It was easy to handle and apply, and provided pain relief. The duration of healing varied depending on the extent and depth of the wound and the amount of exudate. The superficial bedsores healed with a single application of amnion. Reduced exudate, healthy granulation tissue and enhanced epithelisation were observed following application of amnion.

Adenocarcinoma arising in "J" pouch after total proctocolectomy for familial polyposis coli.

Abstract: A patient of familial adenomatous polyposis (FAP) without extra intestinal lesions is presented. The patient underwent a proctocolectomy with J pouch ileal reservoir with an ileoanal anastomosis. The clinical course was further complicated by an adenocarcinoma developing in the J pouch. This was excised totally and a terminal illeostomy was constructed. The aim of doing a prophylactic proctocolectomy in familial polyposis coli is to prevent a malignancy developing and to restore function with an illeoanal pouch. However polyps can occur in the gastric, duodenal and intestinal mucosa, which can lead to malignancy. Greater awareness and close follow up is needed even after prophylactic proctocolectomy.