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.

Oral cancer: review of current management strategies.

Abstract: Background. India has one of the highest incidences of oral cancer and accounts for about 30% of all new cases annually. A high prevalence of smokeless tobacco use has led to an increasing incidence, which in combination with delayed presentation has made oral cancer a major health problem in India. Limited access to cancer care, relative lack of trained healthcare providers and financial resources are some of the challenges to the management of oral cancer in India despite improvements in diagnostic techniques and management strategies. Methods. We reviewed the literature pertaining to the epidemiology, aetiopathogenesis, pre-malignancy, tumour progression, management of the primary site, mandible, neck lymph node metastases, reconstruction options and screening of oral cancer. The parameters evaluated were overall survival, disease-free survival, recurrence and loco-regional control. Results. Nine studies on surgical intervention were reviewed. There were 23 studies on the management of chemotherapy and 30 trials analysing radiotherapy as an intervention. Conclusion. India has one of the highest incidences of oral cancer and delayed stage presentation is common. Surgery remains the treatment of choice and adjuvant treatment is recommended in high-risk patients. Elective neck dissection is warranted in clinically lymph node-negative neck for patients with thick tumours, imaging-suspected lymph nodes and those who may not have a reliable follow-up. Functional outcomes and treatment-related morbidity needs to be considered, and reconstruction with free tissue transfer provides the best results. Natl Med J India 2013;26:152–8

Clinical Efficacy and Safety Comparison of 177Lu-EDTMP with 153Sm-EDTMP on an Equidose Basis in Patients with Painful Skeletal Metastases.

Abstract: This prospective study compared 177Lu-ethylene diamine tetramethylene phosphonate (EDTMP) with 153Sm-EDTMP for painful skeletal metastases. Methods: Half of the 32 patients were treated with 177Lu-EDTMP and half with 153Sm-EDTMP, at 37 MBq/kg of body weight. Analgesic, pain, and quality-of-life scores (EORTC, Karnofsky, ECOG) and bone proliferation marker were used to examine efficacy. Hematologic toxicity was evaluated using NCI-CTCAE and compared between groups at baseline and each month till 3 mo after therapy. Pain relief was categorized as complete, partial, minimal, or none. Results: Pain relief with 177Lu-EDTMP was 80%: 50% complete, 41.67% partial, and 8.33% minimal. Pain relief with 153Sm-EDTMP was 75%: 33.33% complete, 58.33% partial, and 8.33% minimal. The difference was not significant (P = 1.000). Quality of life at 3 mo after therapy improved significantly in both groups as per ECOG score (P = 0.014 and 0.005 for 177Lu-EDTMP and 153Sm-EDTMP, respectively), Karnofsky index (P = 0.007 and 0.023 for 177Lu-EDTMP and 153Sm-EDTMP, respectively), and EORTC score (P = 0.004 and

Deep Deconvolutional Residual Network Based Automatic Lung Nodule Segmentation

Abstract: Accurate and automatic lung nodule segmentation is of prime importance for the lung cancer analysis and its fundamental step in computer-aided diagnosis (CAD) systems. However, various types of nodule and visual similarity with its surrounding chest region make it challenging to develop lung nodule segmentation algorithm. In this paper, we proposed the Deep Deconvolutional Residual Network (DDRN) based approach for the lung nodule segmentation from the CT images. Our approach is based on two key insights. Proposed deep deconvolutional residual network trained end to end and captures the diverse variety of the nodules from the 2D set of the CT images. Summation-based long skip connection from convolutional to deconvolutional part of the network preserves the spatial information lost during the pooling operation and captures the full resolution features. The proposed method is evaluated on the publicly available Lung Image Database Consortium and Image Database Resource Initiative (LIDC/IDRI) dataset. Results indicate that our proposed method can successfully segment nodules and achieve the average Dice scores of 94.97%, and Jaccard index of 88.68%.

The prognosis of N2b and N2c lymph node disease in oral squamous cell carcinoma is determined by the number of metastatic lymph nodes rather than laterality: Evidence to support a revision of the American Joint Committee on Cancer staging system

Abstract: BACKGROUND A study was conducted to assess for prognostic heterogeneity within the N2b and N2c classifications for oral cancer based on the number of metastatic lymph nodes and to determine whether laterality of neck disease provides additional prognostic information. METHODS An international multicenter study of 3704 patients with oral cancer undergoing surgery with curative intent was performed. The endpoints of interest were disease-specific survival and overall survival. Model fit was assessed by the Akaike Information Criterion and comparison of models with and without the covariate of interest using a likelihood ratio test. RESULTS The median number of metastatic lymph nodes was significantly higher in patients with N2c disease compared to those with N2b disease (P < .001). In multivariable analyses stratified by study center, the addition of the number of metastatic lymph nodes improved model fit beyond existing N classification. Next, the authors confirmed significant heterogeneity in prognosis based on the number of metastatic lymph nodes (≤ 2, 3-4, and ≥ 5) in patients with both N2b and N2c disease (P < .001). A proposed reclassification combining N2b and N2c disease based on the number of metastatic lymph nodes demonstrated significant improvement in prognostic accuracy compared with the American Joint Committee on Cancer staging system, and no improvement was noted with the addition of a covariate for contralateral or bilateral neck disease (P = .472). CONCLUSIONS The prognosis of patients with oral cancer with N2b and N2c disease appears to be similar after adequate adjustment for the burden of lymph node metastases, irrespective of laterality. Based on this finding, the authors propose a modified lymph node staging system that requires external validation before implementation in clinical practice. Cancer 2014;120:1968–1974. © 2014 American Cancer Society.