The Unmet Needs in the Management of Vulvar Cancer and a Review of Indian Literature.

PURPOSE: This study was undertaken to analyze our cohort of patients with vulvar cancer, the factors affecting their survival, and to review published Indian literature. MATERIALS AND METHODS: A prospectively maintained database of 18 patients with vulvar cancer who were amenable to up-front surgery and treated between 2013 and 2021 was analyzed. Patients were studied and evaluated for clinicopathological features, risk factors, stage of disease, surgical modalities, and disease outcome. This study critiques the 16 studies identified in the English literature relating to vulvar carcinoma from 1996 to 2021 from India. RESULTS: The mean age of our patients was 63.7 years. All 18 patients underwent up-front radical surgery with primary closure. Postoperative histology was squamous cell carcinoma with negative margins in all and lymph-vascular space involvement negative in 17 of 18 patients. Of the 10 patients who underwent inguinofemoral lymphadenectomy, four patients had positive lymph nodes. The estimated mean survival was 61.6 months. We reviewed the Indian literature for over 25 years. As the majority of patients presented with a locally advanced stage of the disease, the primary mode of treatment was chemoradiotherapy. Lymph node positivity and lack of appropriate management at relapse increased the risk of poor survival. CONCLUSION: This review clearly emphasizes the unmet need for more prospective multicentric trials not only to increase our understanding about the disease but also to define better treatment protocols for various stages of the disease, thereby improving disease-free and overall survival.

Influence of New FIGO 2018 Staging on Treatment Outcomes in Early-Stage Cervical Cancer: A Single-Center Study.

Satinder KaurPurpose The aim of this article was to study survival outcomes of early-stage cervical cancer patients and impact on survival after restaging them as per International Federation of Gynecology and Obstetrics (FIGO) 2018. Materials and Methods A retrospective study was conducted from June 1, 2013 to May 31, 2018 in a tertiary care hospital in North India. One-hundred patients of early-stage cervical cancer (as per FIGO 2009 staging) who had been treated by surgery followed by risk based tailored adjuvant therapy in our hospital were evaluated. The clinicopathological features and survival outcomes of these patients were analyzed. These patients were then restaged as per new FIGO 2018 staging and survival outcomes between two FIGO classifications were compared. Results The median age of the study population was 52.5 years with median follow-up of 62.1 months. Ninety percent of our patients had more than 2 years follow-up and 59% had more than 5 years follow-up. The overall survival and relapse-free survival were 87.5 and 91.4%, respectively. The study population was then reclassified according to new FIGO 2018 staging. It was seen that the patients with stage IB1and IB2 cervical cancer had overall survival of 91.1 and 90%, respectively. The overall survival of stage IB3 was 80% and the survival of stage IIIC1 was only 60%. Conclusion The new FIGO 2018 classification has a significant effect on survival outcome and in prognostication of patients with cervical cancer.

Maxillofacial prosthetic materials- an inclination towards silicones.

There have been constant searches and researches which are taking place in the field of dental materials to best suit the ideal selection criteria to satisfy the functionality, biocompatibility, aesthetics as well as the durability as a maxillofacial material. Among all the different materials, Silicone is the most popularly used, but still studies are carried out to overcome their weaknesses and to come out with a material which can be labeled as the "ideal maxillofacial prosthetic material". This article comprises the materials which were and are in use and the reason for their unpopularity. It also gives us a scope to understand the major fields where the materials lack and thus needs improvement to render an individual with the best maxillo-facial prosthesis.