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Introduction: Patients with pancreatic cancer (pCA) have a high propensity for cachexia even in the absence of metastases. On the other hand, patients with pancreatic neuroendocrine tumors (pNET) often maintain their weight and muscle mass for a long period of time even with liver metastases. Aim(s): We undertook a study to compare the magnitude of cachexia in patients with pNET and pCA. Materials and methods: We screened our clinical nutrition database and identified patients with pNET and pCA who had full nutritional work up with subjective global assessment scores (SGA), and body mass index (BMI). Cachexia was defined as SGC=C and or BMI<18.5 Kg/M2. The pNET were compared with pCA. Results" There were 316 pCA patients and 38 pNET patients with age ranging from 11 to 95 years. The SGA scores were A=39.5%; B=55.3%; C=5.3% in NET group and A=12.7%; B=52.5%; C=34.8% in pCA group. BMI<18.5 was significantly higher in the pCA group. Malnutrition (SGA B+C) and Cachexia were significantly higher in pCA group. Odds ratio (p value) for cachexia in pNET group after adjusting for age and sex was 0.249 (p=0.0009). Several pNET patients with multiple liver metastases had good nutrition status without cachexia for long periods. Conclusion: Our study confirms that patients with pNET are far less prone to cancer cachexia even in the presence of multiple liver metastases. Further research (e.g. Ghrelin secretion by NET or activation of Ubiqutin-Proteasome pathways) would help in understanding the mechanisms better. [ABSTRACT FROM AUTHOR]

Background: The north and north-eastern regions of India have among the highest incidence of gallbladder cancer (GBC) in the world. We report the clinicopathological charateristics and outcome of GBC patients in India., Methods: Electronic medical records of patients diagnosed with GBC at Tata Medical Center, Kolkata between 2017 and 2019 were analyzed., Results: There were 698 cases of confirmed GBC with a median age of 58 (IQR: 50-65) years and female:male ratio of 1.96. At presentation, 91% (496/544) had stage III/IV disease and 30% (189/640) had incidental GBC. The 2-year overall survival (OS) was 100% (95% CI: 100-100); 61% (95% CI: 45-83); 30% (95% CI: 21-43); and 9% (95% CI: 6-13) for stages I-IV, respectively (p = <0.0001).   For all patients, the 2-year OS in patients who had a radical cholecystectomy followed by adjuvant therapy (N = 36) was 50% (95% CI: 39-64), compared to 29% (95% CI: 22-38) for those who had a simple cholecystectomy and/or chemotherapy (N = 265) and 9% (95% CI: 6-14) in patients who were palliated (N = 107) (p = <0.0001)., Conclusion: The combined surgical/chemotherapy approach for patients with stage II GBC showed the best outcomes. Early detection of GBC remains problematic with the majority of patients presenting with stage III-IV and who have a median survival of 9.1 months. Our data suggests that the tumor is chemoresponsive and multi-center collaborative clinical trials to identify alternative therapies are urgently required., (© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Context: Tumor budding (TBud) is recognized as a poor prognostic marker in colorectal cancer (CRC) with important treatment implications in Stage II cancers and malignant polyps. There are multiple propositions for bud count reporting but without an uniformly accepted system. The International TBud consensus conference (ITBCC) proposed mandatory reporting of budding on the single worst ×20 high power field (0.785 mm 2 area) with a 3-tier scoring system (low/intermediate/high for 0-4, 5-9, and ≥10 buds/×20 field)., Aims: Due to the lack of availability of ×20 objective, we aimed to validate a simple ×40 field count (0.236 mm 2 area) for wider applicability., Methods: Bud count was done on hematoxylin and eosin-stained slides of 92 archived cases of colon cancer on the worst ×20 and ×40 fields (0.95 mm 2 and 0.236 mm 2 area) (hotspot method). Count for 0.785 mm 2 area was calculated using ITBCC normalization factor of 1.2. Interobserver variability between two observers was assessed. Score groups for ×20 field and proposed score groups for 40× field (low/intermediate/high for 0-1, 2-4 and ≥5 buds) were compared with disease-free survival., Results: High bud score was seen in 20.6% and 31.5% cases, respectively, using the ×20 and ×40 methods. High interobserver concordance was noted (ICC 0.95). Both the ITBCC bud score and our proposed 40× scoring correlated significantly with prognosis (P = 0.030, log-rank test)., Conclusions: : In centers lacking 20× objective, we propose using the worst 40× hotspot method for reporting of budding for all CRCs as a simple, reproducible and prognostically significant scoring system., Competing Interests: There are no conflicts of interest

Objective: To compare the incidence of six gastrointestinal cancers (colorectal, oesophageal, gastric, liver, gallbladder and pancreatic) among the six main 'non-White' ethnic groups in England (Indian, Pakistani, Bangladeshi, Black African, Black Caribbean and Chinese) to each other and to Whites., Methods: We analysed all 378 511 gastrointestinal cancer registrations from 2001-2007 in England. Ethnicity was obtained by linkage to the Hospital Episodes Statistics database and we used mid-year population estimates from 2001-2007. Incidence rate ratios adjusted for age, sex and income were calculated, comparing the six ethnic groups (and combined 'South Asian' and 'Black' groups) to Whites and to each other., Results: There were significant differences in the incidence of all six cancers between the ethnic groups (all p<0.001). In general, the 'non-White' groups had a lower incidence of colorectal, oesophageal and pancreatic cancer compared to Whites and a higher incidence of liver and gallbladder cancer. Gastric cancer incidence was lower in South Asians but higher in Blacks and Chinese. There was strong evidence of differences in risk between Indians, Pakistanis and Bangladeshis for cancer of the oesophagus, stomach, liver and gallbladder (all p<0.001) and between Black Africans and Black Caribbeans for liver and gallbladder cancer (both p<0.001)., Conclusions: The risk of gastrointestinal cancers varies greatly by individual ethnic group, including within those groups that have traditionally been grouped together (South Asians and Blacks). Many of these differences are not readily explained by known risk factors and suggest that important, potentially modifiable causes of these cancers are still to be discovered.

Background: Although combining targeted agents with conventional, first-line cytotoxic therapy has improved survival outcomes in patients with advanced colorectal cancer, further improvements in outcomes and tolerability are needed., Methods: This phase I study evaluated the feasibility of combining oral pazopanib, an agent that targets multiple proangiogenic factors, with FOLFOX6 (oxaliplatin, leucovorin, and 5-fluorouracil) or CapeOx (oxaliplatin and capecitabine). This phase I study evaluated the optimally tolerated regimen of daily pazopanib (dose-escalated) plus standard FOLFOX6 or CapeOx in patients with advanced colorectal cancer. At the optimally tolerated regimen, each cohort was expanded to further evaluate safety and clinical response., Results: The optimally tolerated regimens were pazopanib 800 mg plus FOLFOX6 and pazopanib 800 mg plus reduced CapeOx (capecitabine 850 mg/m(2)). The most commonly reported adverse events in the FOLFOX6 cohorts included decreased appetite, neutropenia, diarrhea, peripheral neuropathy, and vomiting. Similarly, the most commonly reported adverse events in the CapeOx cohorts included fatigue, vomiting, and decreased appetite. The overall response rate was 40 % (8/20 patients) in the pazopanib plus FOLFOX6 cohorts and 38 % (8/21 patients) in the pazopanib plus CapeOx cohorts., Conclusion: Pazopanib combined with FOLFOX6 or reduced CapeOx was adequately tolerated in this patient population.