Pattern of neck metastasis in carcinoma of oral tongue-a prospective study of north eastern people

Background: North eastern part of India is one of the most vulnerable regions for all sites of cancer. There is various literature regarding the pattern of cervical metastasis from different sub sites of oral cavity, however there are very few studies from the north eastern part of India, which reports one of the world highest number of cases. The aim and objectives of this study were to study the pattern of cervical lymph node metastasis in relation to prognostic factor like histological grading, laterality, depth of invasion, lymphovascular and perineural invasion and worst pattern of invasion.Methods: A prospective study of 20 patients who had undergone surgery for carcinoma of oral tongue was conducted in State cancer institute in department of Head and neck oncology from January 2020 till June 2021. Out of 20 patients included in the study 6 (30%) were females and 14 (70%) were males. Results: Clinically 9 patients had palpable nodes but pathologically nodes were positive in 10 patients whereas when a node was clinically not palpable in 11 patients, patients was pathologically nodes negative only in 10 patients.2 patients had isolated II involvement. 1 patient has I(b) and level II involvement. 4 patients had level II and III together. Two patients had level II and level IV involvement. 1 patient had level I(A), I(B), III and IV involvement. None of the patient had level 5 involvements.Conclusions: DOI, WPOI and tumor differentiation are the important prognostic parameters. We would also like to suggest surgical excision of the tumor and measurement of WPOI, DOI and assessment of histological grading to be done from frozen section for determining the type of neck dissection in T1/T2 N0 cases

Recurrent laryngeal nerve injury (RLNI) in thyroid surgery and its prevention

Background: Vocal cord paresis or paralysis due to iatrogenic injury of the recurrent laryngeal nerve (RLNI) is one of the main problems in thyroid surgery. Although many procedures have been introduced to prevent the nerve injury, still the incidence of recurrent laryngeal nerve palsy varies between 1.5-14%.The aim of the present study is to assess the risk factors of recurrent laryngeal nerve injury during thyroid surgery.Methods: This was a prospective, observational study conducted in the Department of ENT and Head & Neck Surgery, Gauhati Medical College & Hospital, Guwahati for a period of 3 years from 1st October, 2010 to 30th September, 2013. Factors predisposing to recurrent laryngeal nerve injury were evaluated such as pathology of the lesions and the type of operations and identification of recurrent laryngeal nerve intra-operatively. Preoperative and postoperative indirect laryngoscopic examinations were performed for all patients.Results: A total of 171 cases of thyroid surgery were performed during the study period. Majority of patients were females. The most common pathology observed in the thyroid gland for which surgery was indicated, according to preoperative FNAC report, was colloid goitre. RLN injury was observed in 3 cases (1.75%) in our study which occurred post hemi thyroidectomy. All these cases had unilateral vocal cord palsy.Conclusion: RLN palsy is one of the common complications after thyroid surgery. Most of the palsy is transient. Meticulous thyroid dissection and identification of RLN during surgery can reduce the rate of RLN palsy.

Relationship of depth of invasion of tumour with neck node metastasis in oral squamous cell carcinoma: a clinico pathological correlation

Background: Squamous cell carcinomas of the oral cavity are relatively common among the head and neck cancers. The increasing depth of invasion (DOI) and the microvascular proliferation caused by neoplastic growth might determine proximity to blood vessels and lymphatics, thus facilitating the tumor’s ability to metastasize. The role of tumour DOI as a prognostic parameter for the development of nodal metastases and for the survival of patients with OSCC are important. Aim of the study was to determine the relationship of the DOI of tumor with the neck node metastasis in squamous cell carcinoma of the oral cavity.Methods: This study is conducted in the State cancer institute, Gauhati medical college over a period of 1 year from June 2021 to June 2022 among 100 patients. All patients underwent tumor resection with neck dissection, and the DOI is measured.Results: Out of 100 patients included in the study 66 were males and 34 were females. Maximum number of cases 30% were seen in the age group of 51-60 years. Gingivobuccal sulcus (32%) is the most commonly involved site. Maximum number of nodal meta-stasis present in tumours with DOI>11 mm and minimum nodal metastasis present in tumours with DOI<3 mm.   Conclusions: We conclude that tumor DOI is significantly related with neck nodal metastasis in oral cavity squamous cell carcinoma

EvoCut : A new Generalization of Albert-Barab\'asi Model for Evolution of Complex Networks

With the evolution of social networks, the network structure shows dynamic nature in which nodes and edges appear as well as disappear for various reasons. The role of a node in the network is presented as the number of interactions it has with the other nodes. For this purpose a network is modeled as a graph where nodes represent network members and edges represent a relationship among them. Several models for evolution of social networks has been proposed till date, most widely accepted being the Barab\'asi-Albert \cite{Network science} model that is based on \emph{preferential attachment} of nodes according to the degree distribution. This model leads to generation of graphs that are called \emph{Scale Free} and the degree distribution of such graphs follow the \emph{power law}. Several generalizations of this model has also been proposed. In this paper we present a new generalization of the model and attempt to bring out its implications in real life

Burden of head and neck cancers in Kamrup urban district cancer registry of Assam, India: a retrospective study

Background: Head and Neck cancers are basically squamous cell carcinomas. It is the fifth most common cancer and the sixth most common cause of cancer mortality in the world. Incidence of cancer as a whole for all sites is fourth highest in Kamrup Urban District (KUD) in males (AAR 185.2) and second highest (AAR 156.3) in females out of all Population Based Cancer Registries (PBCR) in India. Incidence of head and neck cancers in KUD is quite high both nationally and internationally. This retrospective study was carried out to assess the incidence pattern of head and neck cancers in Kamrup Urban District of Assam, India for the period of 2009-2011.  Methods: Cancer is not notifiable in India, so method of collecting information on cancer was active in PBCR Guwahati. A total of 4416 cases were registered during the three years (1st January 2009- 31st December 2011) of which 2508 were male and 1908 female. Statistical analysis used: Age Adjusted Rate (AAR), Crude Rate (CR) and Population pyramids are provided by NCRP-ICMR.Results: The relative proportion of head and neck cancers of total cancer cases registered in KUD constitutes 26% (654/2508) and 12% (225/1908) in male and female respectively. In males cancer of hypopharynx (AAR 14.7) was most common followed by tongue (AAR 9.4) and mouth (AAR 7.7). In females cancer of mouth (AAR 7.6) is most common followed by cancer of tongue (AAR 3.2).Conclusion: The pattern and incidence of various head and neck cancers is of utmost importance for primary prevention and early detection to adequately manage these cancers comprehensively in the community.

Comparison of post-operative complications in oral cancer treated with and without neoadjuvant chemotherapy

Aim: The aim of the present study was to compare the treatment outcome in oral cancer cases treated with neoadjuvant chemotherapy (NACT) and upfront surgery in localized advance disease. Materials and Methods: A randomized, prospective study was conducted in 20 cases. Patients were divided into two groups. Group A was taken up for upfront surgery and group B was taken up for surgery after two to three cycles of NACT based on patients' response, performance, and compliance. Results: Neither group showed statistically significant differences in clinical characteristics. In the present study, satisfactory outcomes were seen in nine patients belonging to NACT group and eight patients of non-NACT group had satisfactory outcomes after surgery, which were found to be statistically significant (P = 0.001). Conclusion: NACT may be considered as a treatment option for oral squamous cell carcinoma patients, particularly those with locally advanced tumors. Further prospective studies are needed to validate these findings in patients