CLINICOPATHOLOGICAL CHARACTERISTICS OF PATIENTS WITH SYNCHRONOUS PRIMARY OVARIAN AND ENDOMETRIAL CANCERS

Purpose: Synchronous primary endometrial and ovarian cancers are infrequent. The objective of this study is to evaluate clinicopathological characteristics of synchronous endometrial and ovarian cancers treated in our institution.Materials and Methods: The clinicopathological characteristics of 12 patients with synchronous ovarian and endometrial cancers treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, from July 2005 to July 2015, were reviewed retrospectively in depth from hospital database. The WHO committee classification was used for the histologic determination and staged based on International Federation of Gynaecology and Obstetrics (FIGO) staging. Results: The median age at the time of diagnosis was 50 years (range 23–66 years). The incidence of synchronous primary endometrial and ovarian cancers was 2.01% in patients with endometrial cancer. A total of seven patients were menopausal (58%) and eight patients were nulliparous (66%); the median body mass index (BMI) was 29 kg/m2 (range, 20–38). Abnormal uterine bleeding was the most common presenting symptom. According to FIGO stage, 10 cases of endometrial were Stage I/II (84%) and two cases were Stage III (16%). Of the ovarian cancers, nine cases were Stage I/II (83.3%) and two cases were Stage III (16.7%). Endometrial cancer was the main pathological type in uterine carcinoma (86%) followed by serous carcinoma (14%), and similarly, for ovarian cancer, endometrial was the most common pathology (67%) followed by serous/clear cell (16%) and mucinous (16.7%). Most endometrial and ovarian primaries in our series were Grade I and II tumours, 83% and 66%, respectively. 8 patients (66%) had similar histology in both primaries. All patients underwent surgical intervention. Only one patient did not receive any post-operative adjuvant therapy. 10 patients received platinum-based adjuvant chemotherapy and six patients received adjuvant radiotherapy. Conclusion: Synchronous primary endometrial and ovarian cancers are infrequent and distinct set of patients. Abnormal per vaginal bleed was the most common symptom which helped in early detection. Majority of the patients belong to concordant endometrial histology, low grade, had younger age and high BMI. Treatment should be tailored to the stage, histology and grade of the individual tumours. Key words: Endometrial cancer, ovarian cancer, synchronous tumour

HYPOFRACTIONATED RADIOTHERAPY IN GLIOBLASTOMA MULTIFORME

Purpose: The purpose of this study was to assess the outcomes in glioblastoma patients treated with hypofractionated radiotherapy.Materials and Methods: We reviewed all glioblastoma patients treated at our specialist cancer centre over 7 and a 1⁄2 years using hypofractionated radiotherapy (HRT) postoperatively. The HRT regimen was 48 Gy given at 3 Gy/ fractions in 16 fractions. We calculated overall survival using time to event analyses. Results: A total of 62 patients were identi ed of whom 44 (71%) were male. The median age of these patients was 50 years (range: 20–71 years). Eastern Cooperative Oncology Group (ECOG) performance status was 0 in 47 (76%) and 1 in 15 (24%) patients. 7 (11%) of the patients underwent gross total resection, 52 (83%) had subtotal resection and 3 (5%) had a biopsy only. Response assessment on magnetic resonance imaging at 3-month post-HRT showed that 14 (22%) patients had regression, 21 (34%) were stable and 22 (35%) had a progressive primary tumour. 5 (8%) patients were lost to follow up. With a median follow-up of 7.8 months, the median overall survival was 9 months. Patients with ECOG-0 showed a median survival of 7 months as compared to 6 months for those with ECOG-1. Patients with stable or partial response showed a median overall survival of 8 months in comparison to 6 months for those with progressive disease. There were no signi cant differences in median survival based on the extent of surgery. A Cox multivariate model con rmed signi cant correlation of age and response to radiotherapy with survival. Conclusion: HRT consisting of 48 Gy in 3 weeks can be used for selected glioblastoma patients to reduce the overall treatment time of conventional radiotherapy by 35–40% without apparent increased toxicity or decrement in survival in a low resource environment. Key words: Chemoradiation, glioblastoma, hypofractionated radiotherapy, survival

IMPACT ON PROJECT SUCCESS THROUGH HUMAN RESOURCE MANAGEMENT AND KNOWLEDGE MANAGEMENT: MEDIATION MODEL FROM COMPETENCY: Kamran Ali, Bilal Ghaffar, Sumera Asghar Butt

The impact of development perspective of human resource management and lesson learned system of knowledge management on project success with the mediation of project management competency retention is examined by collecting the data from the regular employees of telecommunication sector (PTCL, Ufone, Warid, Zong and Mobilink), GEPCO and Sui Northern Gas Pipeline limited of Gujranwala District of Punjab, Pakistan. For this purpose 380 questionnaires were distributed out of which 321 questionnaire were returned and the study gains an actual response rate of 84.4%. Some questionnaires were excluded because of missing values by using list-wise deletion method which includes particular statistical analysis and after that 310 complete questionnaires were selected for further proceeding. The relationship of Development Perspective of Human Resource Management, Lesson Learned System of Knowledge Management and Project Success with mediation of Project Management Competency Retention is examined by using the statistical techniques such as “Pearson’s Correlation”, “Descriptive Statistics” and “Factor Analysis”. The results confirmed that development perspective of human resource management and lesson learned system of knowledge management has insignificant positive relationship with project management competency retention and project success. There is no mediation of project management competency retention has been proved between development perspective of human resource management, lesson learned system of knowledge management and project success. A significant positive relationship has been proved between project management competency retention and project success. Finally the results suggested that it is crucial for the organizations to retain competency to achieve project success

Investigating the Predictors and Outcomes of Entrepreneurial Bricolage

Entrepreneurial leaders have the ability to influence business model innovation and entrepreneurial bricolage. Introducing alternative ideas and behaviors in an enterprise nowadays often linked to innovation. Companies are eager to take advantage of or benefit from new goods or services or technological marketing channels in this context. Due to the recognition of leadership as an important driver of business innovation, a perceptual framework has been established in order to study the consequences of entrepreneurial leadership on the desire to build business model innovation in organizations, with business acting as a mediating moderating function on entrepreneurial bricolage and entrepreneurial self-efficacy. To explore the conceptual model of the study, five hypotheses have been proposed. A self-managed survey was conceived to acquire cross-sectional responses from 325 people working in the Punjab, Pakistan manufacturing industry. The results demonstrated that, when entrepreneurial self-efficacy is high, the link between entrepreneurial leadership and business model innovation models is stronger. As a result, this is a one-of-a-kind cross-sectional study that investigates the mediating-moderating process of business bricolage and entrepreneurial self-efficacy in Pakistan's manufacturing industry. The study contributes to existing research while also assisting legislators in taking action to govern workplace self-efficacy and encouraging leaders to use entrepreneurial bricolage techniques and business model innovation