No abstract

No abstract

BACKGROUND Metastatic malignant tumours of the Liver are common in clinical practice, ranking second only to cirrhosis as a cause of fatal liver disease. At autopsy, 30-50% of all patients dying from malignant diseases reveal hepatic secondaries. MATERIALS AND METHODS Liver metastases are 7 times commoner due to gastrointestinal primary cancers than other tumours. Patients with Liver metastasis due to GI Tract malignancies included in this study, so extra gastrointestinal causes have been excluded from this study. RESULTS 60% of liver metastases in this study is secondary to colorectal primary cancers. 96% of liver metastases are Adenocarcinomatous origin form GI tract. 2% i.e., one case of squamous cell carcinoma of oesophagus and 2% i.e., one case of NHL from small intestine. Female sex predominates as 60% of overall cases with liver secondaries. Average duration of illness before presentation and diagnosis is more in females than males. 96% of these metastases are exclusively from adenocarcinomas. CONCLUSION The surgical management of patients with hepatic metastases involves sorting through many variables and choosing an optimal course of action and utilizing technological advances which will continue to improve the outcome for these unfortunate patients with previously hopeless condition

AIM AND OBJECTIVESTo evaluate the effect of addition of adjuvant radiation to adjuvant chemotherapy in resected gastric cancer patients in terms of benefit and toxicity profile. MATERIALS AND METHODSMNJIO&RCC, Hyderabad is a tertiary care cancer hospital which caters to the cancer patients of Andhra Pradesh and its neighbouring states with a patient load of around 10,000 per year. Thirty Patients were recruited and were treated with concurrent chemotherapy of Inj. 5-FU and Inj. LV for first 3 days and last three days of radiation and two more cycles were given after 4 weeks of radiation at one month gap. Radiotherapy was delivered using Telecobalt unit of 45 Gy in 25 fractions to stomach bed after shielding left kidney after 19.8 Gy. RESULTSOur prospective study consisted of 30 patients, 25 were male and 5 were female. The mean age was 45 years (range 25-71), and the median age was 46 years. 27 patients (90%) had a performance status of ECOG PS of 0 or 1, 3 patients had ECOG PS-2. Fourteen (14) patients (45%) underwent distal gastrectomy, 10 patients (35%) underwent subtotal gastrectomy, and 6 patients (20%) underwent total gastrectomy. Of the 30 patients, 14 patients (45%) had D1-LN dissection and 16 patients (55%) had D2-LN dissection. Five (5) patients were stage IB, 8 patients (30%) were stage -IIB, 12 patients (40%) were stage-IIIA and 5 patients (15%) were stage IIIB. The full course according to protocol was completed by 28 patients (95%) and 2 patients had interruption in treatment because of grade-3 gastrointestinal toxicity. Acute toxicity as shown below was recorded during the entire course of treatment. The most common acute toxicity observed was vomiting in 19 patients (65%) followed by grade-1 mucositis in 18 patients (60%) and grade-1 neutropenia in 18 patients (60%). The median followup was 12 months and mean followup was 16 months. Among 28 patients who completed the treatment, 8 patients (28%) had recurrences during followup period (documented by endoscopy & ultrasound). 7 patients (25%) had locoregional recurrence and 1 patient (3.6%) developed liver metastasis. The median time to relapse from the end of the radiation was 11 months. The locoregional control rates were (71%) 20/28 patients. Based on the observations above mentioned, the relapses were observed in patients with stage IIIA&B, poorly differentiated adenocarcinomas. In 8 patients who experienced relapses, 5 patients had D1-LN dissection and 3 patients had D2-LN dissection. These results were compared with 30 patients of carcinoma stomach who underwent curative resection and received only adjuvant chemotherapy of Inj. 5-FU and leucovorin and kept on followup from our institute with similar tumour patient characteristics as study group, 15/30 patients (50%) relapsed locoregionally and 3/30 (10%) relapsed distantly. All the patients who relapsed during followup period had D2 lymph node dissection and mostly were stage III and IV. CONCLUSIONAddition of radiation to adjuvant 5-FU and Leucovorin chemotherapy has shown definite be...