Amit Saklani - Academia.edu (original) (raw)
Papers by Amit Saklani
Radiotherapy and Oncology, 2019
Cancer in children and adolescents is rare and at the same time characterized by a wide variety o... more Cancer in children and adolescents is rare and at the same time characterized by a wide variety of tumour types, often different from the common adult cancers. Over the past decades, paediatric cancer treatment results have improved significantly: up to 80% of children and adolescents with cancer are currently cured of their disease, although survival figures for the individual cancers vary significantly. This is mainly the result of multi-modality treatment protocols including chemotherapy, surgery, and biological treatment, in addition to selective use of more sophisticated radiotherapy techniques. In addition to that, a better knowledge of molecular characteristics has lead to an increasing personalisation of treatment based on risk stratification, which has allowed to further improve cure rates with a reduction in treatment-related morbidity. This is especially important for radiotherapy as treatment modality since almost every organ system is subject to some late effects caused by radiotherapy, in addition to the risk of developing secondary cancers. However, we should take into account that there is a significant variation in frequency of these long-term complications. They are more determined by the affected site, the irradiated volume, the age at time of treatment and the dose given than by the original tumour type treated. Obviously, interaction with chemotherapy may also play a role and should also be taken into consideration. The significant increase in paediatric cancer cure rate over the past years has also increased the number of cancer survivors at risk for developing late effects. While with the passing of time, the risks of cancer relapse recede, monitoring for late effects of treatment becomes more important as they can, as mentioned, affect any body system. The majority of patients will have some form of long-term sequelae, some minor, some major and some that can be ameliorated by timely intervention. Therefor it is strongly recommended that patients should be followed in a multidisciplinary clinic. A detailed treatment summary will help to predict the risk of complications and should guide this long-term followup. Finally, increasingly more sophisticated and welltargeted radiotherapy techniques should allow to further minimise the risk of late effects, but that too is still to be investigated and examined long after treatment has finished.
Radiotherapy and Oncology, 2018
International Journal of Research in Medical Sciences
Background: Metastatic cervical cancer carries poor prognosis. The factors associated with distan... more Background: Metastatic cervical cancer carries poor prognosis. The factors associated with distant metastasis in newly diagnosed cervical cancer patients are not clear.Methods: A retrospective analytical study was performed to study the pattern of distant metastasis, and to evaluate the factors associated with de-novo metastatic cervical cancer. Univariate and multivariate analysis (by MANOVA) were used to evaluate the association. P≤0.05 was considered significant.Results: Out of 1321 newly diagnosed cervical cancer patients, 54 (4.1%) had de-novo metastatic disease and most of which (81%) were found at single site. Common sites of distant metastasis were non-regional nodes, followed by liver, lung, peritoneum and bone. Univariate analysis showed the factors associated with de-novo metastasis were non squamous subtype, high grade histology, bulky primary tumor (>4 cm), pelvic/para-aortic lymphadenopathy, and hydroureteronephrosis. Multivariate analysis revealed the factors assoc...
Asian Journal of Oncology, 2018
Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of GI... more Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of GI tract. They are recently recognized as a distinct pathological entity although previously they were grouped with sarcomas of smooth muscle origin, i.e., leiomyomas, leiomyoblastomas, or leiomyosarcomas. However, apart from GI tract, GIST can occur in any smooth muscle-like in the urinary bladder. Proper diagnosis by immunohistochemistry stain CD133 and risk stratification by morphological parameters has been the cornerstone of treatment. Materials and Methods: This study was conducted as a retrospective analysis to audit the number of cases presenting as GIST in the tertiary medical colleges of eastern India and find out the patterns of care with the available modalities of therapy. Results: Out of total 15 cases, the median age of presentation was 45 years; the Male: Female (M: F) ratio was 2:3 and persisting dragging prolonged chronic abdominal pain was present in the majority. Intest...
Global journal for research analysis, 2021
Context: Esophageal cancer (EC) is highly fatal malignancy with considerable geographical variati... more Context: Esophageal cancer (EC) is highly fatal malignancy with considerable geographical variation in its distribution, etiologies, histopathological subtypes, and mortality. Methods: A retrospective analysis was performed to study the clinicopathology, and risk factors of distant metastasis (DM) among 255 cases of EC treated between January 2015 and December 2019 in a tertiary cancer center in south India. Statistical analysis: Chi-square test and multivariate analysis (MVA) were used for analysis. P < 0.05 was considered signicant. Results: The median age at diagnosis of EC was 57 years, higher for male. Younger EC patients (≤ 40 years) constituted 8.2%, and were commonly female, non-smoker, non-alcoholic, squamous cell carcinoma (SCC). Male: female ratio was 1.67:1. Lower thoracic esophagus was the commonest site. SCC was the commonest histology. Adenocarcinoma (ADC) was common among older age, male, esophagogastric junction (EGJ), high grade tumor, and carried higher risk o...
Background: Cervical cancer in young women is rare and disparity exists in its characteristics in... more Background: Cervical cancer in young women is rare and disparity exists in its characteristics in the available reports. The study aimed to determine the disease burden and to compare its clinicopathological characteristics with older women. Materials and methods: Retrospective study was performed by retrieving data from the cancer registry for consecutive 843 cervical cancer patients treated in the center between 2017 and 2020. Patients were divided into younger (<40 years) and older (≥ 40 years) age. Statistical analysis was performed using SPSS software version 23 for windows. Chi square test was used for analyzing the categorical variables and P < 0.05 was considered signicant. Results: Cervical cancer in young women constituted 9.4%, with majority (96.2%) belonged to 30-39 years age. Higher prevalence of human immunodeciency virus (HIV) was found among younger compared to older women (P = 0.000). Younger women commonly presented late compared to older women (patients pr...
International Journal of Advances in Medicine
Background: Colorectal cancer (CRC) is a common cancer worldwide with significant geographical va... more Background: Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods: A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults (<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P≤0.05 was considered statistically significant.Results: CRC among younger adults comprised 40.3% of total patients median age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history, lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histology compared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients had distant metastasis at diagnosis ...
Radiotherapy and Oncology, 2019
Cancer in children and adolescents is rare and at the same time characterized by a wide variety o... more Cancer in children and adolescents is rare and at the same time characterized by a wide variety of tumour types, often different from the common adult cancers. Over the past decades, paediatric cancer treatment results have improved significantly: up to 80% of children and adolescents with cancer are currently cured of their disease, although survival figures for the individual cancers vary significantly. This is mainly the result of multi-modality treatment protocols including chemotherapy, surgery, and biological treatment, in addition to selective use of more sophisticated radiotherapy techniques. In addition to that, a better knowledge of molecular characteristics has lead to an increasing personalisation of treatment based on risk stratification, which has allowed to further improve cure rates with a reduction in treatment-related morbidity. This is especially important for radiotherapy as treatment modality since almost every organ system is subject to some late effects caused by radiotherapy, in addition to the risk of developing secondary cancers. However, we should take into account that there is a significant variation in frequency of these long-term complications. They are more determined by the affected site, the irradiated volume, the age at time of treatment and the dose given than by the original tumour type treated. Obviously, interaction with chemotherapy may also play a role and should also be taken into consideration. The significant increase in paediatric cancer cure rate over the past years has also increased the number of cancer survivors at risk for developing late effects. While with the passing of time, the risks of cancer relapse recede, monitoring for late effects of treatment becomes more important as they can, as mentioned, affect any body system. The majority of patients will have some form of long-term sequelae, some minor, some major and some that can be ameliorated by timely intervention. Therefor it is strongly recommended that patients should be followed in a multidisciplinary clinic. A detailed treatment summary will help to predict the risk of complications and should guide this long-term followup. Finally, increasingly more sophisticated and welltargeted radiotherapy techniques should allow to further minimise the risk of late effects, but that too is still to be investigated and examined long after treatment has finished.
Radiotherapy and Oncology, 2018
International Journal of Research in Medical Sciences
Background: Metastatic cervical cancer carries poor prognosis. The factors associated with distan... more Background: Metastatic cervical cancer carries poor prognosis. The factors associated with distant metastasis in newly diagnosed cervical cancer patients are not clear.Methods: A retrospective analytical study was performed to study the pattern of distant metastasis, and to evaluate the factors associated with de-novo metastatic cervical cancer. Univariate and multivariate analysis (by MANOVA) were used to evaluate the association. P≤0.05 was considered significant.Results: Out of 1321 newly diagnosed cervical cancer patients, 54 (4.1%) had de-novo metastatic disease and most of which (81%) were found at single site. Common sites of distant metastasis were non-regional nodes, followed by liver, lung, peritoneum and bone. Univariate analysis showed the factors associated with de-novo metastasis were non squamous subtype, high grade histology, bulky primary tumor (>4 cm), pelvic/para-aortic lymphadenopathy, and hydroureteronephrosis. Multivariate analysis revealed the factors assoc...
Asian Journal of Oncology, 2018
Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of GI... more Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of GI tract. They are recently recognized as a distinct pathological entity although previously they were grouped with sarcomas of smooth muscle origin, i.e., leiomyomas, leiomyoblastomas, or leiomyosarcomas. However, apart from GI tract, GIST can occur in any smooth muscle-like in the urinary bladder. Proper diagnosis by immunohistochemistry stain CD133 and risk stratification by morphological parameters has been the cornerstone of treatment. Materials and Methods: This study was conducted as a retrospective analysis to audit the number of cases presenting as GIST in the tertiary medical colleges of eastern India and find out the patterns of care with the available modalities of therapy. Results: Out of total 15 cases, the median age of presentation was 45 years; the Male: Female (M: F) ratio was 2:3 and persisting dragging prolonged chronic abdominal pain was present in the majority. Intest...
Global journal for research analysis, 2021
Context: Esophageal cancer (EC) is highly fatal malignancy with considerable geographical variati... more Context: Esophageal cancer (EC) is highly fatal malignancy with considerable geographical variation in its distribution, etiologies, histopathological subtypes, and mortality. Methods: A retrospective analysis was performed to study the clinicopathology, and risk factors of distant metastasis (DM) among 255 cases of EC treated between January 2015 and December 2019 in a tertiary cancer center in south India. Statistical analysis: Chi-square test and multivariate analysis (MVA) were used for analysis. P < 0.05 was considered signicant. Results: The median age at diagnosis of EC was 57 years, higher for male. Younger EC patients (≤ 40 years) constituted 8.2%, and were commonly female, non-smoker, non-alcoholic, squamous cell carcinoma (SCC). Male: female ratio was 1.67:1. Lower thoracic esophagus was the commonest site. SCC was the commonest histology. Adenocarcinoma (ADC) was common among older age, male, esophagogastric junction (EGJ), high grade tumor, and carried higher risk o...
Background: Cervical cancer in young women is rare and disparity exists in its characteristics in... more Background: Cervical cancer in young women is rare and disparity exists in its characteristics in the available reports. The study aimed to determine the disease burden and to compare its clinicopathological characteristics with older women. Materials and methods: Retrospective study was performed by retrieving data from the cancer registry for consecutive 843 cervical cancer patients treated in the center between 2017 and 2020. Patients were divided into younger (<40 years) and older (≥ 40 years) age. Statistical analysis was performed using SPSS software version 23 for windows. Chi square test was used for analyzing the categorical variables and P < 0.05 was considered signicant. Results: Cervical cancer in young women constituted 9.4%, with majority (96.2%) belonged to 30-39 years age. Higher prevalence of human immunodeciency virus (HIV) was found among younger compared to older women (P = 0.000). Younger women commonly presented late compared to older women (patients pr...
International Journal of Advances in Medicine
Background: Colorectal cancer (CRC) is a common cancer worldwide with significant geographical va... more Background: Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods: A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults (<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P≤0.05 was considered statistically significant.Results: CRC among younger adults comprised 40.3% of total patients median age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history, lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histology compared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients had distant metastasis at diagnosis ...