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Background: Mechanics of inflammation and oncogenesis are intertwined with each other. Thus, the role of inflammatory markers like neutrophil-lymphocyte ratio (NLR) as a foreteller of lung carcinoma is retrospectively appraised in this study., Material and Methods: Retrospective assessment of hospital records of carcinoma lung patients was done between January 2018 and January 2020 and pretreatment NLR was calculated. Median NLR was taken as cut off and thereafter correlation was studied between pretreatment NLR and overall survival, using Kaplan-Meier survival analysis. Cox regression analysis was applied to identify factors affecting survival., Results: Study population included 135 eligible patients with median age of 60 years and male to female ratio of 8.6:1. 47.41% patients were of stage III and 52.59% patients belonged to stage IV. The duration of follow-up ranged between 0.5 and 22 months. Median NLR was 3.1 (range, 0.90-11.25) and median overall survival in patients with NLR <3.1 and ≥3.1 was 6 months versus 3 months, respectively (P-value = 0.001). NLR value in nonsmall cell and small cell lung cancer was analyzed separately and showed significant variation in median survival in nonsmall cell lung cancer patients only (P-value = 0.001)., Conclusions: Study results summarized that pretreatment NLR can be taken as a cheap and easily available predictor of prognosis in carcinoma lung cases and more so in nonsmall cell lung carcinoma cases. Large prospective trials are warranted to further potentiate this fact., (Copyright © 2023 Copyright: © 2023 Journal of Cancer Research and Therapeutics.)

Context: Immune checkpoint inhibitors combined with chemotherapy are being evaluated in neoadjuvant settings in early triple-negative breast cancer (TNBC)., Aim: To evaluate efficacy and safety of checkpoint inhibitors in early TNBC., Methods: Electronic search was done using PubMed, EMBASE, Google Scholar, Cochrane Central Register of Controlled Trials and clinicaltrials.gov to identify relevant articles till October 31, 2020. Clinical trials evaluating checkpoint inhibitors as neoadjuvant therapy in early-stage TNBC were included. Outcomes assessed included pathologic complete response (pCR), event-free survival (EFS), and safety., Statistical Analysis Used: Meta-analysis was conducted using Cochrane review manager (RevMan) version 5.4. Randomized controlled trials (RCTs) were assessed for quality using Cochrane Collaboration risk of the bias assessment tool, version 2.0 (ROB-2). GRADE analysis was done to assess the overall quality of evidence for all outcomes., Results: Out of 116 studies screened, 5 RCTs were included in meta-analysis. Compared to control group, programmed death-1 (PD-1)/programmed death-ligand 1 (PDL-1) inhibitor group was associated with significant increase in rate of pCR (odd ratio [OR] =1.71 [1.38-2.11]; P < 0.00001) and EFS (1.77 [1.21-2.60]; P = 0.003). There was a significant increase in risk of serious adverse events (risk ratio [RR] =1.53 [1.28-1.83]; P < 0.00001), adverse events of special interest (AESI) of any grade (RR: 1.5 [1.34-1.69], P < 0.00001) and grade 3 or higher AESI (RR: 2.8 [1.87-4.19], P < 0.00001) with PD-1/PDL-1 inhibitors compared to control., Conclusions: PD-1/PDL-1 inhibitors in combination with neoadjuvant chemotherapy for early TNBC show significant improvement in pCR irrespective of PDL-1 status and cancer stage., Competing Interests: None

Context: As the number of head-and-neck cancer (HNC) patients are high in our subcontinent, the study was designed to reduce the treatment time and increase efficacy., Aims: Comparative evaluation of the efficacy, toxicity, local control, and survival of concomitant boost radiotherapy (CBRT), CBRT with concurrent chemoradiation (CBRT + CCT) and conventionally fractionated radiotherapy with concomitant chemotherapy (CFRT + CCT) in locally advanced HNC (LAHNC)., Materials and Methods: Patients with LAHNC were randomly assigned to 3-groups of 30-patients each. Group I (CBRT) received, 45 Gy/25#/5-weeks and 18 Gy/10# concomitant boost in the last 2-week of treatment, receiving a total dose of 63 Gy. Group II (CBRT + CCT) received CBRT with concomitant cisplatin 75 mg/m 2 on day 1, 17, and 34. Group III (CFRT + CCT) received 64 Gy/32#/6.2 weeks, concurrent with injection cisplatin 75 mg/m 2 on day 1, 22, and 42., Statistical Analysis Used: Stata 9.0 SPSS and Chi-square test were used for analysis and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method., Results: The median follow-up period was 8.2 months. At last follow-up, locoregional control was 36%, 57%, and 40% and DFS was seen in 33%, 53%, and 40% of patients in Group I, II, and III, respectively. Grade-3 cutaneous reactions were significantly higher in Group-II as compared to that of Group-III (P = 0.033) and Group-I (P = 0.715)., Conclusion: All three groups have similar response rates and DFS with manageable toxicity., Competing Interests: None

Aims: The clinical presentation and frequency of urogenital tumors varies in different regions of the world. This study was undertaken to analyze the frequency, clinical presentation, and the histopathological spectrum of the various male urogenital tumors diagnosed over a period of 3 years in a tertiary care institute., Materials and Methods: Three-year data were collected from the histopathology laboratory, which included all the cases of male urogenital tumors which were diagnosed histopathologically between November 2012 and October 2015., Results: A total of 10,297 surgical specimens of male patients were received in 3 years, of which 1749 were tumors of various organs in males. Of 1749 surgical specimens, 455 were genitourinary tumors. Frequency of urogenital tumors in males was 13.05%. Malignant tumors comprised the majority (99.53%). The age of the patients ranged from 19 to 98 years. The maximum number of patients was in the 5 th -7 th decade and the mean age of presentation was 64 years. Urinary bladder was the most common site for urogenital tumors (61.09%), with urothelial carcinoma being the most common histological type. Prostatic adenocarcinoma, renal cell carcinoma, and penile squamous cell carcinoma accounted for a significant number of cases. Testicular tumors were the least common and included predominantly mixed germ cell tumors., Conclusion: This study can be taken as a small step toward making the registry of patients with urogenital tumors providing valuable information regarding the frequency, clinical presentation, and histological spectrum. Large population-based studies for a longer duration of time across both males and females are needed in the ever-changing trends of urogenital tumors., Competing Interests: None

Aims: To find the spectrum and frequency of lower gastrointestinal malignancies and diagnostic accuracy of colonoscopic brush cytology in their diagnosis., Materials and Methods: This was a prospective study carried out on 49 patients in the Department of Pathology over 1 year. Brushing material was smeared directly onto at least two clean glass slides. The air dried smears were stained with May Grunwald Giemsa stain. The endoscopic biopsies were examined grossly and were fixed in 10% formalin, processed and stained with Hematoxylin and Eosin stain, respectively. Special stains were used wherever required., Observation and Results: The study was done on 49 patients presented with colorectal and anal lesions. Age of the patients ranged from 17 to 72 years with male to female ratio being 1.57:1. On statistical analysis, the sensitivity of colonoscopic brush cytology was found to be 85.71% and specificity 61.53%. The accuracy came out to be 79.16%., Conclusion: Brush cytology is a reliable, safe, inexpensive, and rapid method of diagnosing gastrointestinal lesions. Since brushing is a relatively noninvasive procedure, routine use of brushings of colonoscopically visible lesions should be done, in addition, to biopsy to increase the diagnostic yield., Competing Interests: There are no conflicts of interest

Aims: The study is undertaken to correlate the fine-needle aspiration cytology (FNAC) findings with histopathology in a spectrum of thyroid lesions and to find the diagnostic accuracy of fine-needle aspiration (FNA) so that unnecessary thyroidectomies can be avoided in benign lesions., Materials and Methods: This study was carried out over the period of 1-year (May 1, 2012-April, 30 2013). FNA specimens obtained from 200 patients were analyzed. Of these, only 40 patients underwent surgery and their thyroid specimens were subjected to histopathological examination., Results: The age of the patients ranged from 9 to 82 years with mean age being 43 years. There was female preponderance, with male to female ratio being 1:7. On cytology out of 200 cases, 148 (74%) were benign, 25 (12.5%) were malignant, 16 (8%) were indeterminate, and 11 (5.5%) were nondiagnostic. Only 40 patients underwent surgery. On histopathology, 21 (52.5%) cases were benign and 19 (47.5%) were malignant. The statistical analysis of cytohistological correlation for both benign and malignant lesions revealed sensitivity, specificity, and diagnostic accuracy of 84%, 100% and 90%, respectively., Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure for the assessment of patients with thyroid lesions and has high -sensitivity and specificity. It acts as a good screening test and avoids unnecessary thyroidectomies.

Aim: To find the spectrum and frequency of upper gastrointestinal malignancies and diagnostic accuracy of endoscopic brush cytology in their diagnosis., Materials and Methods: This study was a prospective study carried out on 251 patients over 1-year in the Department of Pathology. Brushing material was smeared directly on to at least two clean glass slides and was stained with May-Grunwald-Giemsa stain. The endoscopic biopsies were examined grossly and were fixed in 10% formalin, processed, and stained with hematoxylin and eosin stain., Observation and Results: The age range of the patients varied from 8 to 90 years, with the mean being 56 years. Male to female ratio was 2.5:1. On brush cytology, out of 251 cases, 110 had benign lesions and 97 had malignant lesions. Forty-four samples were considered suspicious of malignancy. On histopathology, benign lesions were present in 105 patients while malignant lesions were seen in 139 patients. In seven cases, results were inconclusive due to inadequate/superficial biopsy., Statistical Analysis: Statistical analysis revealed the overall sensitivity of upper gastrointestinal brush cytology as 83.45% and specificity 80.95%. The accuracy of brush cytology came out to be 82.37% in upper gastrointestinal tract., Conclusion: Brush cytology is a reliable, safe, inexpensive, and rapid method of diagnosing upper gastrointestinal lesions. Although endoscopic biopsies are established gold standard for diagnosing gastrointestinal malignancy, use of both biopsy and brushing together increases the diagnostic accuracy.

Background: Concurrent chemoradiation (CCRT) is currently considered to be the standard of care in locally advanced head and neck cancer. The optimum radiotherapy schedule for best local control and acceptable toxicity is not yet clear. We aimed at shortening of treatment time by using accelerated radiation, thereby comparing the disease response, loco-regional tumor control and tolerability of accelerated radiation (six fractions per week) against CCRT in locally advanced head and neck cancer., Materials and Methods: We conducted the prospective randomized study for a period of 2 years from June 2011 to May 2013 in 133 untreated patients of histologically confirmed squamous cell carcinoma of head and neck. Study group (66 patients) received accelerated radiotherapy with 6 fractions per week (66Gy/33#/5½ weeks). Control group (67 patients) received CCRT with 5 fractions per week radiation (66 Gy/33#/6½ weeks) along with intravenous cisplatin 30 mg/m(2) weekly. Tumor control, survival, acute and late toxicities were assessed., Results: Median overall treatment time was 38 days and 45 days in the accelerated radiotherapy and concurrent chemoradiation arm, respectively. At a median follow up of 12 months, 41 patients (62.1%) in the accelerated radiotherapy arm and 47 patients (70.1%) in the CCRT arm were disease free (P = 0.402). Local disease control was comparable in both the arms. Acute toxicities were significantly higher in the CCRT arm as compared with accelerated radiotherapy arm. There was no difference in late toxicities between the two arms., Conclusion: We can achieve, same or near to the same local control, with lower toxicities with accelerated six fractions per week radiation compared with CCRT especially for Indian population.

Squamous cell carcinoma of urinary tract is a rarely encountered tumor. It is more frequently reported in urinary bladder and male urethra than renal pelvis. Squamous cell carcinoma of renal pelvis is usually associated with nephrolithiasis. However, coexistence of keratinizing squamous cell carcinoma with xanthogranulomatous pyelonephritis is exceedingly rare with only one case on record so far. We report two such cases detected incidentally in patients who have undergone nephrectomy for hydronephrosis. The post operative histological evaluation revealed unsuspected squamous cell carcinoma of renal pelvis with concomitant xanthogranulomatous pyelonephritis.