Subbiah Shanmugam

Abstract

Context: Osteosarcoma is characterized by the production of malignant osteoid. It arises typically in the adolescent age group. Aims: The purpose of this study is to analyze the impact of various prognostic factors on survival in osteosarcoma patient admitted in our institution. Settings and Design: Retrospective observational study of 10 years duration from 2007 to 2017 Methods and Materials: There were 66 patients in the records. As a part of the staging work up, CT and MRI of the local part and CECT CHEST were performed . All patients received adriamycin and cisplatin with or without Ifosfamide, and PCVE regimen. Statistical analysis used: IBM SPSS Statistics version 20. Survival and percentage of necrosis was correlated by Spearman Rank correlation. Results: Sixty six patients were included in this study. The median survival of patient who underwent limb salvage surgery (LSS) was 28 months and that of patient underwent amputation was 17 months. No statistically significant survival advantage present between the two group (p=0.68). There is a statistically significant difference in percentage of necrosis in patient who receive neoadjuvant chemotherapy if ifosfamide is added to the regime (p=0.006). Spearman Rank correlation revealed that there was a strong positive Correlation (0.418) between the percentage of necrosis and survival. The correlation was statistically significant (p = 0.02). Conclusions: LSS in osteosarcoma is a safe alternative to amputation. Response to chemotherapy, with regards to necrosis correlates well with survival, thus clearly emphasizing the role of chemotherapy in the management of these tumors. Keywords: OSTEOSARCOMA, Limb salvage surgery, Amputation.

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Abstract

Ovarian tumours present with vague pelvic, abdominal and menstrual symptoms. Lack of histological diagnosis before hand with no definite evidence of malignancy intra operatively may put the surgeon at the cross roads, whether to proceed with a complete surgical staging or conservative approaches like a fertility sparing procedures or a simple ovariectomy. Frozen section done intra operatively in the above setting may help in differentiating benign and invasive ovarian tumours and help in proceeding with optimal surgical procedure. But the reliability of frozen is limited in borderline and mucinous ovarian tumours. Keywords: Frozen section, Concordance, Discordance, Accuracy, Borderline tumours of ovary (BTO), Mucinous ovarian tumors.

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