Abstract: Abstract:Background: Background: Background: Background: Background: Lung cancer has been the most common cancer in the world since 1985 and the leading cause of cancer death. Worldwide it is by far the most common cancer of men and increasingly being recognized in Bangladesh.

Background: Colorectal cancer with liver metastases (CRLM) is stage IV disease. Only 60% patients present with palpable liver or a liver mass and at laparotomy 80% hepatic metastases can be detected. Synchronous CRLM (SCRRLM) is indicative of poor prognosis than metachronous (MCRLM) counterpart. Only 13-15% of SCLM are eligible for curative resection. Surgical intervention offers long term cure with overall survival in 37-58% patients. This study was designed to validate different approaches of management to patients with CRLM in Bangladeshi patients. Methods: In this prospective observational study, we observed different management approaches in 41 Bangladeshi individuals with CRLM from January 2010 to January 2018 in different tertiary care hospitals of Dhaka. They were thoroughly evaluated and prepared for surgical resection. After detection both synchronous and metachronous CRLM, patients were treated surgically with colonic resection and liver resection with simultaneous approach, lesion first approach, liver first approach. Intraoperative ultrasound was valuable in localization of liver lesions. Patients were followed up for a minimum 6 months to maximum period of 61 months. Results: The study included 41 patients between ages of 21 to 70 years, of them 22 (53.65%) males and 19 (46.34%) were female. Among them, 19 patients (46.34%) had synchronous lesion and 22 (53.66%) had metachronous lesion. Neoadjuvant therapy was given in 9 (21.95%) patients. All the patients received adjuvant therapy. Multiple metastetectomy was done in 31 (75.60%) patients. In our series, following margin negative hepatic resection,14 (34.14%) patients survived 3 years and 3(7.31 %) patients survived 5 years. Conclusion: CRLM signifies an advanced disease at presentation. Hepatic resection following resection of colorectal primary is curative. Simultaneous liver with colonic resection is safe and effective in cases of small hepatic metastases. Birdem Med J 2019; 9(3): 207-212

Background: Breast cancer is one of the most common cancers in Bangladeshi women. Breast sacrificing treatment is still now the common practice in our country. Now a day’s breast conservative treatment is the standard treatment of breast cancer without compromising the survival. Objective: To observe local recurrence and distant metastasis free survival and overall survival of patients with breast cancer. Methods: Between January 1996 and December 2010, breast conserving treatment was carried out in 237 female patients with breast cancer in different Institutions of Bangladesh. Clinical staging was recorded by physical examination, relevant investigations as well as surgical records. Revised breast conserving surgery was carried out in those who had positive surgical margins or palpable disease. The patients with large but operable cancer or locally advanced cancer were treated by neoadjuvant chemotherapy followed by breast conserving surgery. Systemic adjuvant therapy (chemotherapy and or hormone therapy) and adjuvant radiotherapy were given in all patients. After completion of treatment, the patients were followed up with a standard protocol and data were compiled and analysed. Results: Among 237 patients who underwent breast conserving therapy 13 patients were excluded from the study for various reasons. Total 224 female patients with breast cancer who followed all the treatment schedules and attended for regular follow up were included in the study. They were between 22- 74 years of age, mean age 42.35 years; premenopausal 152 (68%). Sixty five percent (146 patients) was localized cancer (T1-2N0M0), 31.6% was regional cancer (T1-3N1M0), five cases were locally advanced stage (T4bN12M0) and two metastastatic cancer (T2-3N1M1).  All most all (98%) were Infiltrating duct cell carcinoma except four which were Intraductal carcinoma in situ (IDIS).  Estrogen and progesterone receptors were positive in 57% , HER2 positive (+++) in 24% of Patients. Lumpectomy/quandrentectomy with/without axillary clearance was done in 158 patients, revised breast conserving surgery in 53 cases, mastectomy in 8 cases and only biopsy done but no surgical treatment in five cases.Chemotherapy was given in 192 patients (86%); adjuvant 122 cases and neoadjuvant 70 cases. Hormone therapy in 182 patients. Radiotherapy: in 222 cases. Follow up period  was 4 years  to 19 years, median 10 years. Overall survival (OS) and disease free survival (DFS) was 84% and 70% respectively. Local recurrence occurred in 14(6%) cases and distant metastasis in 54 cases (24%). Conclusion: Breast conserving treatment was satisfactory for appropriate case selection and optimized therapy. Survival was no way worse than breast sacrificing treatment. Journal of Surgical Sciences (2015) Vol. 19 (2) : 55-60

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