Prognostic factors influencing the outcome of thalamic glioma.

Retrospective analysis of 27 patients of thalamic glioma including adults and children treated over a period of 7 years from 1991-1997 was done. The study group included 19 males and 8 females; 9 patients were less than 15 years and 18 patients more than 15 years of age at the time of diagnosis. The commonest symptoms were headache and vomiting. 12 patients underwent VP shunt as an initial procedure and 7 underwent total or partial surgical resection. Confirmed histopathological examination was possible in 16 patients; while 12 had low grade astrocytoma, 4 cases had high grade histology. All patients were treated with radiotherapy to a total dose of 50-60 Gy in 25-30 fractions. Median follow up was 9.63 months. The disease free survival in these patients was 28% at 2 years. Prognostic factors which included age, sex, duration of symptoms, surgical procedures, histology and radiotherapy dose were evaluated for significance. A subtotal resection conferred a better prognosis.

Medical disorders associated with endometrial carcinoma.

From January, 1990 to December, 1995, 113 cases of endometrial carcinoma were registered. Of them, 24 patients (20%) had associated medical disorders. A total of 37 medical disorders were found in these 24 patients. The distribution was as follows: diabetes mellitus in 15 patients, hypertension in 13 patients, coronary artery disease in two, asthma in one, RBBB in one and hypothyroidism in five patients. Age of the patients ranged from 48-76 years (Median 62 years). Fifteen patients underwent surgery and rest nine were inoperable due to medical illnesses. Eleven patients received radiotherapy and four received chemotherapy. Of the two failures, one developed metastasis to lung and another to bone. No local recurrence was observed. Median survival was 20 months. Late radiation morbidity was noticed in four patients (36%), all of them were diabetic. CONCLUSION: Hypothyroidism which was unexpectedly found in five patients may also be a risk factor associated with endometrial carcinoma. This finding has never been reported in the literature and it needs to be curiously studied in future series. The risk of late radiation complications is higher in diabetic patients. Overall prognosis of endometrial carcinoma associated with medical illnesses is not very good.