Introduction:Most cancer disparities research has traditionally focused on two key outcomes, access to appropriate treatment and survival, but they do not encompass important aspects of patient-centered care such as the timeliness of diagnosis and treatment. Prolonged time intervals between symptom onset and treatment initiation increase the risk of poorer clinical outcomes and are associated with worse patient experience of subsequent cancer care. This study aims to assess the delay from symptom onset to the start of definitive treatment and to identify the possible contributory factors and its impact on response in cancers of head and neck, breast, cervix, and lung.Materials and Methods:This was a retrospective study of patients enrolled between 2015 and 2017. A questionnaire was filled in about socioeconomic aspects, patient history, tumor data, professionals who evaluated the patients, and the respective time delays. Statistical test included Mann–Whitney U test, univariate and multivariate test, and one-way ANOVA to evaluate the correlations.Results:Stage migration was significant with patient delay (P < 0.01). In head and neck squamous cell carcinoma (HNSCC) and Carcinoma lung, a significant correlation was found between referral delay and residence (P < 0.01) and treatment delay and reason for referral (HNSCC only) (P = 0.04). Referral delay and treatment delay were correlated to response in breast and cervix, respectively (P < 0.01).Conclusion:Social awareness, regularly updating primary care physicians about alarming symptoms of cancer, developing guidelines to identify these symptoms, promoting continuity of care, and enabling access to specialist expertise through prompt referral should all help prevent delays in cancer diagnosis.

Background: All treatment guidelines currently mandate KRAS and NRAS mutation analysis as a pretreatment workup of colorectal cancers (CRCs), in view of their prognostic and predictive significance. Objectives: In this study, we aimed to assess the prevalence of the extended-spectrum of KRAS and NRAS mutations in patients with CRCs from Kolkata, in eastern India. Materials and Methods: This retrospective observational study was conducted from January 2017 to January 2020 in patients registered for treatment at the IPGMER and SSKM Hospitals, in Kolkata, India. Patients diagnosed with CRCs with adenocarcinoma histology were included in the study. The formalin-fixed paraffin-embedded tumor tissues of the patients were assessed for the extended-spectrum of KRAS and NRAS mutations using a real-time polymerase chain reaction. The cut-off used for “Tumor Not Present” (TNP) reporting was 15%. These mutations were then mapped with the tumor location. Data were analyzed in a de-identified manner, using simple descriptive statistical methods. The two-tailed Fisher's exact test was used to determine any statistically significant association between variables. Results: TNP was reported in 13 (8.12%). A total of 147 patients with CRC were included in the study. Extended RAS mutations were found in 59 (40.1%) patients. KRAS and NRAS were found to be mutated in 55 (37.4%) and 4 (2.7%) patients, respectively. The most common mutation in KRAS was in G12 in exon 2 (34, 61.8%). Followed by Q61 in exon 3 (8, 14.5%) and A146 in exon 4 (8, 14.5%). Half of the NRAS mutations were in codons 12–13 in exon 2 and half were in codon 61 in exon 3. Dual KRAS mutations were observed in one patient, while two patients had both a KRAS and an NRAS mutation. Extended RAS, KRAS, and NRAS mutations were numerically more common in right-sided CRCs (47.2%, 43.4%, and 3.8%, respectively) than in left-sided CRCs (37.2%, 34%, and 2.1%, respectively). The rectum had numerically higher extended RAS and KRAS mutations but lower NRAS mutations (43.1%, 41.37%, and 1.72% respectively) as compared to the colon (37.36%, 34.06%, and 3.29% respectively). Conclusions: Extended RAS mutations are present in about 40% of the patients with CRC in eastern India, with KRAS (37.4%) mutations more prevalent than NRAS (2.7%) mutations. The right-sided CRCs have predictably more RAS mutations than the left.

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Background: The cornerstone of management of phyllodes tumor is surgery. No standard of care exists regarding adjuvant therapy; however, local recurrence is a predominant pattern of failure. The aims of this study were to evaluate the clinical characteristics and treatment patterns of phyllodes tumor and to compare local recurrence and disease-free survival rates of patients with borderline and malignant phyllodes tumor treated with or without adjuvant radiotherapy. Materials and Methods: We analyzed the demographic data, treatment details, and recurrence patterns of all patients with nonmetastatic phyllodes tumors of the breast (n = 34) treated with a multimodality approach who presented to our institute from January 2015 to December 2020. Results: The median age at presentation was 41.2 years, and the median tumor size was 12.5 cm. All patients underwent definitive surgical procedures in the form of wide local excision or mastectomy. No recurrence was noted in the patients with a benign histology. After a median follow-up period of 38 months, the local recurrence rate was 27% for the patients with borderline and malignant histology treated with adjuvant radiotherapy (n = 11) versus 47% for those (n = 17) who did not receive adjuvant radiotherapy. The 3-year local recurrence-free survival rate was 72% in the adjuvant radiotherapy group, versus 51% in the surgery only group. Conclusion: The results of the current study confirm the excellent prognosis of patients with benign phyllodes tumor undergoing surgery alone. Local recurrence was the predominant mode of failure in the patients with borderline and malignant histology. Locoregional control was improved with the addition of postoperative radiotherapy in the patients with borderline and malignant histology irrespective of margin status.