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Tata Memorial Hospital

HealthcareMumbai, India
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.


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Journal ArticleDOI
TL;DR: While respiratory training had negligible effect on breast movement during normal breathing, it resulted in a modest reduction during deep breathing, and individualized directional margins may aid in reduction of planning target volume (PTV).
Abstract: This study was designed to evaluate interfraction and intrafraction breast movement and to study the effect of respiratory training on respiratory indices. Five patients were immobilized in supine position in a vacuum bag and three-dimensional set up errors, respiratory movement of the breast during normal and deep breathing, tidal volume and breath hold time were recorded. All patients underwent respiratory training and all the respiratory indices were re-evaluated at the end of training. Cumulative maximum movement error (CMME) was calculated by adding directional maximum set up error and maximum post training movement during normal breathing. The mean set up deviation was 1.3 mm (SD +/- 0.5 mm), 1.3 mm (SD +/- 0.3 mm) and 4.4 mm (SD +/- 2.6 mm) in the mediolateral, superoinferior and anteroposterior dimensions. Pre-training mean of the maximum marker movement during normal breathing was 1.07 mm, 1.94 mm and 1.86 mm in the mediolateral, superoinferior and anteroposterior dimensions. During deep breathing these values were 2 mm, 5.5 mm and 4.8 mm. While respiratory training had negligible effect on breast movement during normal breathing, it resulted in a modest reduction during deep breathing (p = 0.2). The mean CMME recorded for these patients was 3.4 mm, 4.5 mm and 7.1 mm in the mediolateral, superoinferior and anteroposterior dimension. Respiratory training also resulted in an increase in breath hold time from a mean of 31 s to 44 s (p = 0.04) and tidal volume from a mean of 560 cm(3) to 1160 cm(3) (p = 0.04). With patients immobilized in the vacuum bag the CMMEs are relatively less. Individualized directional margins may aid in reduction of planning target volume (PTV).

42 citations

Journal ArticleDOI
TL;DR: Patients with well‐differentiated tumours had a 5‐year survival of 100% as compared to 94.4% for moderately and 53.5% for poorly differentiated tumours, and there was no significant difference in survival for patients with transitional cell carcinoma and adenocarcinoma.
Abstract: Thirty two patients—23 males and 9 females with a mean age of 52.5 years—underwent planned partial cystectomy for histologically proved muscle invasive bladder cancer. Twenty patients had transitional cell carcinoma and 12 had adenocarcinoma of the bladder. One patient had well-differentiated, 18 had moderately differentiated, and 13 had poorly differentiated tumours. The tumour size was 4 cm in 6 patients. Patients with single primary muscle invasive tumours situated in the upper half of the bladder were considered eligible for partial cystectomy. The presence of multicentric urothelial disease, of dysplasia, or carcinoma-in-situ in bladder mucosa away from the tumour on multiple random punch biopsies was considered contraindications to partial cystectomy. All patients underwent partial cystectomy with bilateral pelvic lymphadenectomy. The tumour-free margins of resection were confirmed by intraoperative frozen section examination. The bladder was closed primarily in all patients, although three patients required re-implantation of the ureter. No patient received adjuvant radiation or chemotherapy. Five patients had pathological stage Bl (T2), 18 had B2 (T3A), and 9 had C (T3B) disease. No patient had metastatic pelvic lymph nodes. There was one postoperative death due to unrelated medical cause. Five patients had minor complications that resolved with conservative measures. All patients had adequate bladder capacity of >250 cc at 6 months after surgery, and none had symptoms attributable to reduced bladder capacity. The overall actuarial survival was 80.1% at 5 years. The 5-year survival for patients with stage T2 tumours was 100%, for stage T3A 88.5%, and for stage T3B 45.7% (P = 0.028). The 5-year survival for patients with tumour size < 2 cm was 100% compared to 83. 1% for 2-4 cm and 50% for size more than 4 cm (P = 0.078). There was no significant difference in survival for patients with transitional cell carcinoma (83.8%) and adenocarcinoma (74.1%) (P = 0.511). Patients with well-differentiated tumours had a 5-year survival of 100% as compared to 94.4% for moderately and 53.5% for poorly differentiated tumours (P < 0.001). Fourteen patients relapsed—12 in the bladder and 2 in the lungs without relapse in the bladder. Of the 12 patients who relapsed in the bladder, 5 had noninvasive (stage Ta/Tl) relapses and were salvaged with transurethral resection of the tumours. Seven patients had invasive tumours at relapse that were related to tumour stage and grade. Four of these could be salvaged with radical total cystectomy, where as the remaining three and the two patients with distant relapses died due to disseminated disease. © 1995 Wiley-Liss, Inc.

42 citations

Journal ArticleDOI
01 Jul 2014-Cancer
TL;DR: 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.
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.

42 citations

Journal ArticleDOI
01 Sep 2018-Hpb
TL;DR: Chemotherapy with neoadjuvant intent in locally advanced/borderline resectable GBC showed good response rates, which resulted in curative surgical resection or disease stabilisation in significant proportion of patients.
Abstract: Background Studies evaluating neo-adjuvant chemotherapy (NACT) exclusively in gallbladder cancer (GBC) are few and there are no randomized trials on the subject. Locally advanced GBC and indications for NACT in GBC are not yet clearly defined. Methods We analysed 160 consecutive GBC patients who received NACT based on clinico-radiologic criteria suggesting high-risk disease (TMH Criteria) from January 2010 to February 2016. Results On initial assessment, 140 (87.5%) patients had T3/T4 disease and 105 (65%) patients were node positive. Response rate and clinical benefit rate was 52.5% and 70% respectively. Sixty six (41.2%) patients could undergo curative intent resection. With a median follow-up of 33 months, the median OS and EFS of the entire cohort were 13 and 8 months respectively. Patient undergoing curative surgery had a statistically superior OS (49 vs. 7 months; p = 0.0001) and EFS (25 months vs. 5 months; p = 0.0001) compared to those who did not. Conclusion Locally advanced GBC remains a disease with poor prognosis. Chemotherapy with neoadjuvant intent in locally advanced/borderline resectable GBC showed good response rates. This resulted in curative surgical resection or disease stabilisation in significant proportion of patients. Patients who undergo definitive surgery after favourable response to NACT experience good survival.

42 citations

Journal ArticleDOI
TL;DR: A novel clinical and functional significance of NOTCH1 alterations in early stage tongue squamous cell carcinoma is presented and it is anticipated that these results could form the basis for therapeutic targeting of Notch1 in tongue cancer.
Abstract: // Pawan Upadhyay 1, * , Sudhir Nair 2, * , Ekjot Kaur 3 , Jyotirmoi Aich 1 , Prachi Dani 1 , Vidyalakshmi Sethunath 1 , Nilesh Gardi 1 , Pratik Chandrani 1 , Mukul Godbole 1 , Kavita Sonawane 2 , Ratnam Prasad 1 , Sadhana Kannan 4 , Beamon Agarwal 5 , Shubhada Kane 6 , Sudeep Gupta 7 , Shilpee Dutt 3 , Amit Dutt 1 1 Integrated Genomics Laboratory, Advanced Centre for Treatment, Research and Education In Cancer, Tata Memorial Centre, Navi Mumbai- 410210, India 2 Division of Head and Neck Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre,Mumbai- 4100012, India 3 Shilpee Laboratory, Advanced Centre for Treatment, Research and Education In Cancer, Tata Memorial Centre, Navi Mumbai- 410210, India 4 Advanced Centre for Treatment, Research and Education In Cancer, Tata Memorial Centre, Navi Mumbai- 410210, India 5 Department of Pathology, Advanced Centre for Treatment, Research and Education In Cancer, Tata Memorial Centre, Navi Mumbai- 410210, India 6 Department of Pathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai- 400012, India 7 Department of Medical Oncology, Advanced Centre for Treatment, Research and Education In Cancer, Tata Memorial Centre, Mumbai- 400012, India * These authors have contributed equally to this work Correspondence to: Amit Dutt, email: adutt@actrec.gov.in Keywords: early stage tongue cancer, exome and transcriptome sequencing, IHC based expression analysis, cancer stem cell-like feature, Notch pathway inhibitors Received: January 25, 2016 Accepted: June 07, 2016 Published: July 06, 2016 ABSTRACT Background: Notch pathway plays a complex role depending on cellular contexts: promotes stem cell maintenance or induces terminal differentiation in potential cancer-initiating cells; acts as an oncogene in lymphocytes and mammary tissue or plays a growth-suppressive role in leukemia, liver, skin, and head and neck cancer. Here, we present a novel clinical and functional significance of NOTCH1 alterations in early stage tongue squamous cell carcinoma (TSCC). Patients and Methods: We analyzed the Notch signaling pathway in 68 early stage TSCC primary tumor samples by whole exome and transcriptome sequencing, real-time PCR based copy number, expression, immuno-histochemical, followed by cell based biochemical and functional assays. Results: We show, unlike TCGA HNSCC data set, NOTCH1 harbors significantly lower frequency of inactivating mutations (4%); is somatically amplified; and, overexpressed in 31% and 37% of early stage TSCC patients, respectively. HNSCC cell lines over expressing NOTCH1 , when plated in the absence of attachment, are enriched in stem cell markers and form spheroids. Furthermore, we show that inhibition of NOTCH activation by gamma secretase inhibitor or shRNA mediated knockdown of NOTCH1 inhibits spheroid forming capacity, transformation, survival and migration of the HNSCC cells suggesting an oncogenic role of NOTCH1 in TSCC. Clinically, Notch pathway activation is higher in tumors of non-smokers compared to smokers (50% Vs 18%, respectively, P =0.026) and is also associated with greater nodal positivity compared to its non-activation (93% Vs 64%, respectively, P =0.029). Conclusion: We anticipate that these results could form the basis for therapeutic targeting of NOTCH1 in tongue cancer.

42 citations


Authors

Showing all 3213 results

NameH-indexPapersCitations
Al B. Benson11357848364
Keitaro Matsuo9781837349
Ashish K. Jha8750330020
Noopur Raje8250627878
Muthupandian Ashokkumar7651120771
Snehal G. Patel7336716905
Rainu Kaushal5823216794
Ajit S. Puri543699948
Jasbir S. Arora5135115696
Sudeep Sarkar4827310087
Ian T. Magrath471078084
Pankaj Chaturvedi4532515871
Pradeep Kumar Gupta444167181
Shiv K. Gupta431508911
Kikkeri N. Naresh432456264
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20235
202232
2021223
2020244
2019206
2018239