Clinical Abstracts From Overseas

By Stanton R. Mehr
Published: Thursday, Jun 10, 2010
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â–º India

Different HIV-Associated Cancers in India

In the United States, one of the most common cancers in patients with human immunodeficiency virus infection (HIV) is Kaposi’s sarcoma. However, a new study finds that in other countries, such as India, Kaposi’s sarcoma may not be common at all in patients with HIV infection.

Researchers from Tata Memorial Hospital, Mumbai, India, studied patients registered in the facility’s HIV Cancer Clinic. They recorded the site of any cancer occurring in these patients from 2002, and used this figure to estimate the site-specific incidence of cancer in patients with HIV infection over five years.

They found increased proportions of non-Hodgkin’s lymphoma, with a higher rate in males than females (proportional incidence ratio, 17.1 in males and 10.3 in females), and anal cancer (10.3 in men, 6.5 in females), and several other cancers (Table) that are not deemed to be “AIDS-defining.” The higher rate of cervical cancer (4.1 in women) and of vaginal cancer (7.7 in women) indicates an “urgent need for screening programs” among women with HIV infection. They did not observe any instance of Kaposi’s sarcoma, which they attribute to the low prevalence of HHV-8 virus in the Indian population.

Higher incidence of cancer found in

Indian patients with HIV infection.
Non-Hodgkin’s Lymphoma
Anal Cancer
Testicular Cancer
Colon Cancer
Head and Neck Cancer
Cervical Cancer
Vaginal Cancer
Hodgkin’s Disease

The researchers concluded that the spectrum of HIV-related malignancies differs in India from that in other regions.
Dhir AA, Sawant S, Dikshit RP, et al: Spectrum of HIV/AIDS related cancers in India. Cancer Causes Control 2008;19:147-153.

â–º United Kingdom

Does Surgery Have a Role In Improving Quality of Life In Patients With Spinal Metastases?

For patients whose cancer has spread to the spine, there is no consensus as to the value of spinal surgery to remove the tumors or the benefit of different surgical approaches. However, an article from London, England, explains that some benefit might be gained in these cases..

The surgeons from multiple centers included 223 patients (mean age, 61 yr) in the study who were confirmed to have metastasis to vertebral epithelial tissue. Breast, lung, renal, and prostate cancer accounted for twothirds of the primary tumors. In the majority of patients (60%), spinal tumors were characterized as widespread. Each of the patients underwent either debulking or excisional surgery (74%), or palliative decompression (26%) over a two-year period. Adjuvant therapy was administered in approximately half of the patients.

The surgery was deemed relatively safe, with a 30-day mortality of 6%. After the surgical intervention, 71% of patients who reported continual pain indicated lower pain levels. Urinary control improved in 39% of the 49 patients who had abnormal urinary sphincter function (few were incontinent before surgery).

The surgeons noted a significantly longer median survival (P = .003) for patients undergoing excisional surgery compared with those who received palliative decompression. They cautioned that although the numbers of patients in this noncontrolled study were too small to make sweeping conclusions and the use of different surgeons may confound the results, based on these findings, active surgical treatment may show both quality of life and survival benefits for patients with spinal metastases.

Ibraham A, Crockard A, Antonietti P, et al: Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter perspective observational study of 223 patients. J Neurosurg Spine 2008;8:271-278.

â–º Belgium / Italy

Pharmacogenomics Guides Treatment in Metastatic Colorectal Cancer

Everyday, new molecular markers and genotypes are being identified that help define whether one pharmaceutical agent or another is best suited to specific therapy in individual patients. Unfortunately, the options for patients and clinicians in the presence of metastatic colorectal cancer are limited. Therapies are not associated with high response rates, but new findings from Belgian, Italian, and American researchers have pinpointed with greater accuracy which patients with metastatic colorectal cancer will benefit most from panitumumab treatment.

View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Community Practice Connections™: 18th Annual International Lung Cancer Congress®Oct 31, 20181.5
Provider and Caregiver Connection™: Addressing Patient Concerns While Managing Chemotherapy Induced Nausea and VomitingOct 31, 20182.0
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