https://www.nepjol.info/index.php/njc/issue/feed Nepalese Journal of Cancer 2020-10-08T17:46:29+00:00 Nirmal Lamichhane bpkmchhospital@gmail.com Open Journal Systems <p>Nepalese Journal of Cancer (NJC) is the official journal of the B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal. The journal is internationally peer reviewed, covering&nbsp; biomedical topics relating to cancer care and research in Nepal and in the Region.</p> https://www.nepjol.info/index.php/njc/article/view/31680 Impact of COVID-19 Pandemic on Cancer Screening Services 2020-10-08T17:45:54+00:00 Gambhir Shrestha gamvir.stha@gmail.com Rashmi Mulmi gamvir.stha@gmail.com <p>Not available.</p> 2020-10-01T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31733 Carcinosarcoma of the Uterus: An Elusive Diagnosis 2020-10-08T17:46:18+00:00 Anupama Bhattarai jipariyar@yahoo.com Jitendra Pariyar jipariyar@yahoo.com Sameer Neupane jipariyar@yahoo.com Srijana Koirala jipariyar@yahoo.com Pratit Pokhrel jipariyar@yahoo.com Subhas Pandit jipariyar@yahoo.com <p><strong>Introduction</strong>: Carcinosarcoma or Malignant Mixed Mullerian Tumor (MMMT) of the uterus is a rare malignant tumor comprising both carcinomatous and sarcomata’s components. Worldwide it accounts for two to five percentages of all uterine malignancies. However, there is a paucity of reports in Nepalese literature.</p> <p><strong>Case report:</strong> A 62 year’s postmenopausal woman with diabetes and hypertension presented with urinary symptoms for two months and passage of fleshy mass per vagina for two days. Ultrasound was inconclusive, whereas, Magnetic Resonance Imaging (MRI) showed an endo-cervical mass. Pre-operative biopsy of the masssuggested leiomyosarcoma. Abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic andpara-aortic lymphadenectomy was performed. Per-operatively, an atrophic uterus, a dimple in the funds, andballooning of the lower uterine segment and vagina were noted. The cut section showed an exophytic polypoidalmass with base in the fundus. Histopathology revealed Stage IA carcinosarcoma with aggressive mitotic figures. Immunohistochemistry confirmed the diagnosis of carcinosarcoma with a heterogonous rhabdomyosarcomatouscomponent. Adjuvant chemotherapy and radiation therapy was advised.</p> <p><strong>Conclusion:</strong> The preoperative diagnosis of carcinosarcoma or MMMT was difficult and might be missed on biopsy as well. Owing to its aggressive nature and higher rates of post-surgical recurrence, carcinosarcoma accounts for around one-fifth of deaths due to uterine malignancies. Surgery is the primary treatment modality, yet much study is needed before evidence-based adjuvant management for improving its outcome is established.</p> 2020-10-02T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31781 Squamous Cell Carcinoma in Non-Functioning Kidney Associated with Staghorn Calculi: Uncommon Presentation of Common Malignancy 2020-10-08T17:46:19+00:00 Shankar Bastakoti drshankarbastakoti@gmail.com Nirmal Lamichhane drshankarbastakoti@gmail.com <p>Cancers of the kidney account for 2% of all the total human cancer. Squamous cell carcinoma (SCC) of renal pelvis is a rare neoplasm, accounting for only 0.5 to 0.8% of malignant renal tumors. In most cases, renal SCC is associated with chronic infections, chronic renal calculi, radiotherapy or any factor that can irritate the urothelium. We report a female patient aged 60 years diagnosed with Right Non-functioning Kidney with Nephrolithiasis with Suspicious Mass. Histopathological diagnosis with Squamous Cell Carcinoma in Stage III with Staghorn Calculi. In long standing urolithiasis, possibility of concomitant harboring of malignancy needs to be taken into consideration.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31783 A Case Report of Giant Cell Tumor of Proximal Fibula in Children 2020-10-08T17:46:20+00:00 Sushil Adhikari drsushil6550@gmail.com Arun Sigdel drsushil6550@gmail.com Rajesh Kumar Sah drsbikram@gmail.com Luna Devkota drsbikram@gmail.com <p>Giant cell tumour (GCT) is histopathologically benign tumor of long bone particularly in distal femur and the proximal tibia. It commonly occurs in adults of age 20-40 years but rare in children. GCT is considered to be locally aggressive tumor and tendency of recurrence is higher even after surgery. The clinical features are nonspecific, the principle symptoms are pain, swelling and limiting adjacent joint movements. Diagnosis is based on the radiographic appearance and histopathological findings .In our case X-ray showed ill defined lytic lesion on proximal fibula with cortical thinning and MRI finding revealed expansile lyticlesion in meta-epiphysis of right fibula 16×16×28mm adjacent to growth plate with fluid level. The sclerotic rim appears hypo intense on T1 &amp; hyper intense on T2. Core needle biopsy showed giant cell tumor on proximal fibula. Considering the risk of recurrence wide local excision was done. Management of GCT of proximal fibula in young patient is critical for preventing recurrence and enhancing functional outcomes by saving adjacent anatomical structure. No evidence of local recurrence and metastasis was found in 24 months of follow up.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31848 Upper Esophageal Schwannoma: Rare Differential Diagnosis of Dysphagia 2020-10-08T17:46:22+00:00 Bigyan Acharya drbigyanacharya@gmail.com Binay Thakur drbigyanacharya@gmail.com Mukti Devkota drbigyanacharya@gmail.com Greta Pandey drbigyanacharya@gmail.com Anup Shrestha drbigyanacharya@gmail.com Manish Chaudhary drbigyanacharya@gmail.com <p>Esophageal schwannomas are rare primary sub mucosal tumors, 45 cases have been reported so far. We &nbsp;herein report the 46th case of an esophageal schwannoma from Nepal. A 60-year-old woman presented with progressivedysphagia. Oesophago-Gastro-Duodenoscopy (OGD) showed a sub mucosal mass with mucosal puckering in the upper esophagus; Computed tomography (CT) of the chest showed an upper esophageal mass of size 8x7x6cm3compressing the trachea. Bronchoscopy showed external compression of the mid trachea. The patient under went three incision VATS esophagectomy. Histopathological examination and immunohistochemical (IHC) staining confirmed the diagnosis of schwannoma.</p> 2020-10-07T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31851 Surface brachytherapy in Skin Cancer with High Dose Rate Remote After Loader: An Experience from NCHRC 2020-10-08T17:46:23+00:00 Gisupnikha Prasiko bpkmchhospital@gmail.com Bibek Acharya bpkmchhospital@gmail.com Ambuj Karn bpkmchhospital@gmail.com Ranjana Karmacharya bpkmchhospital@gmail.com Sudhir Silwal bpkmchhospital@gmail.com Navin Bajracharya bpkmchhospital@gmail.com S Venu Gopal bpkmchhospital@gmail.com Suman Baral bpkmchhospital@gmail.com Prafulla Jha bpkmchhospital@gmail.com <p><strong>Background:</strong> In recent years, the incidence of prostate cancer (PCa) is increasing. Advanced PCa has a poor prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value of &nbsp;P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa.</p> <p>&nbsp;<strong>Objective</strong>: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical significance.</p> <p><strong>Methods:</strong> Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group. The expression of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry.</p> <p><strong>Results</strong>: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5%and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%, The difference between the two groups was statistically significant (p&lt;0.05). PCa bone or lymph node metastasis was positively correlated with Ki-67 (r=0.423, p&lt;0.05) and Gleason score (r=0.446, p&lt;0.05), indicating a stronger correlation with Gleasonscore.</p> <p><strong>Conclusion:</strong> The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential diagnosis of PCa. High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor prognosis.</p> 2020-10-07T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31778 Caring Cancer Patients While Living With COVID-19: An Experience of a Tertiary Cancer Care Center 2020-10-08T17:46:27+00:00 Murari Man Shrestha bpkmchhospital@gmail.com Hari Prasad Dhakal bpkmchhospital@gmail.com Banita Gurung bpkmchhospital@gmail.com Sajin Rajbhandary bpkmchhospital@gmail.com Sachin Shakya bpkmchhospital@gmail.com Ranish Shrestha bpkmchhospital@gmail.com Sumitra Gurung bpkmchhospital@gmail.com Bishwash Sharma bpkmchhospital@gmail.com Lahar Maya Bhasinka bpkmchhospital@gmail.com Sampurna Tuladhar bpkmchhospital@gmail.com Neeraj Joshi bpkmchhospital@gmail.com Sunita Maleku Amatya bpkmchhospital@gmail.com Kapendra Shekhar Amayta bpkmchhospital@gmail.com Saroj Prakash Chataut bpkmchhospital@gmail.com Bijesh Raj Ghimire bpkmchhospital@gmail.com Sudip Shrestha bpkmchhospital@gmail.com <p>COVID-19 has emerged as a serious public health crisis of 21st century affecting millions of people around the world. First identified in Wuhan China, COVID-19 has spread globally claiming millions of human life and suffering. The Government of Nepal (GoN) has accelerated control measures through mass media, laboratory testing, quarantine, isolation and treatment of COVID patients in designated hospitals. With rapid spread of COVID-19, the government owned as well as the private hospitals and health institutions across the nation face a great challenge to contain the spread of the novel virus. Nepal Cancer Hospital and Research Center (NCHRC) has been managing uninterrupted treatment services to cancer patients since the beginning of spread of COVID-19 in Nepal. Early planning and preparedness has been crucial to ensure patient care in the midst of COVID-19 pandemic.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31685 Detection of Circulating Tumor Cells and Its Application in Prostate Cancer 2020-10-08T17:45:55+00:00 Jin-Qi Song chengdexuhui@163.com Ya-Nan Zhou chengdexuhui@163.com Gang-Liang Tu chengdexuhui@163.com Chang-Li Xu chengdexuhui@163.com Hui Xu chengdexuhui@163.com <p>In recent years, circulating tumor cells have become the focus of tumor research. In-depth study of the role of circulating tumor cells in the genesis, development, and evolution of tumors will be of great significance for the early detection, early diagnosis, early treatment, and prognosis of tumors. Prostate cancer is one of the common male malignant tumors, and the role of circulating tumor cells in prostate cancer has been increasing year by year. This article will focus on the progress of circulating tumor cells detection and its application in prostate cancer.</p> 2020-10-01T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31709 Importance of Circumferential Resection Margin in Management of Esophageal Cancer 2020-10-08T17:45:57+00:00 Binay Thakur binaythakur@hotmail.com Mukti Devkota binaythakur@hotmail.com Li Aiming binaythakur@hotmail.com Ashis Pun binaythakur@hotmail.com Manish Chaudhary binaythakur@hotmail.com <p>Esophagectomy (R0) remains the gold standard for the management of esophageal cancer. But due to close vicinity of esophagus with the major structures like heart, aorta, vertebral column, tracheobronchial tree and lungs, a wider circumferential resection is generally not possible and a R1/ R2 resection might occur. Therefore, locoregional recurrence rates of esophageal cancer are reported to be as high as 52%. The Royal College of Pathologists (RCP) and The College of American Pathologists (CAP) define circumferential resection margin (CRM) differently. A mean overall CRM involvement was found to be 40.7% (RCP criteria) and 11.8% (CAP criteria). Twometa-analyses have shown poor survival in CRM positive cases. CRM positivity in T1/ T2 lesions should not occur unless there is a surgical fault. For T3 lesions, a higher rate of CRM positivity has been documented. Therefore, a wider CRM using transthoracic approach appears mandatory, especially for T3 lesions.</p> 2020-10-02T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31766 Observation on the Effect of Local Flap Transfer and Sclera Transplantation in Repairing Skin Defect after Eyelid Tumor Operation 2020-10-08T17:45:59+00:00 Ying-Hui Ma shliugang1976@163.com Gang Liu shliugang1976@163.com Jie Yang shliugang1976@163.com <p><strong>Introduction:</strong> Eyelid tumor refers to the primary eyelid skin and accessory tumors, which not only affects the appearance and vision, and even local infiltration and distant metastasis, thereby threatening life. Surgical resection is the most important and effective treatment, but tumor resection often leads to a wide range of eyelid defects, significantly affecting the shape and function of the eyelid. Therefore, the eyelid defect must be repaired after resection to achieve the purpose of aesthetic appearance and protection of the eyeball. The objective of the study was to analyze the clinical results of local flap transfer and scleral transplantation in repairing skin defect after eyelid tumor operation.</p> <p><strong>Methods:</strong> Forty patients with postoperative skin defects of eyelid tumors admitted from December 2008 to December 2018 were taken for analysis and divided into two groups, 20 cases in each group. The control group underwent autologous lip mucous membrane transfer and nearby skin flap, while the experimental group received local skin flap rotation and scleral allograft repair. The clinical effect of repair of the two groups were compared.</p> <p><strong>Results:</strong> In the experimental group, the effect of clinical repairs were better, the difference of height of palpebralfissure and the length of palpebral fissure were compared with the control group, which showed statistical significance favoring the experimental group.</p> <p><strong>Conclusion:</strong> Local flap transfer and scleral transplantation has better clinical outcome to repair the skin defect after operation&nbsp;of eyelid tumor.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31767 Awareness Regarding Cervical Cancer among Women Residing in Bharatpur, Chitwan 2020-10-08T17:46:01+00:00 Laxmi Shrestha basu.mp12@gmail.com Mina Kumari Ranabhat basu.mp12@gmail.com Basanta Thapa basu.mp12@gmail.com Radha Paudel basu.mp12@gmail.com <p><strong>Introduction</strong>: Cervical cancer is one of the most prevalent cancer affecting women globally. It is the fourth most common cancer in women and the seventh overall. Cervical cancer can be cured and prevented by regular pelviccheck-up, screening test and vaccination against human papilloma virus. The objective of this study was to find out awareness regarding cervical cancer among women aged 18-49 years residing in Bharatpur MetropolitanCity-5, Chitwan.</p> <p><strong>Methods</strong>: A community based descriptive cross-sectional research design was used, 186 women were selected using simple random sampling method. Structured interview schedule was used to collect the data within 2weeks. The collected data was entered in Epi data 3.1 and exported into IBM SPSS version 20. Data was analysed in terms of descriptive and inferential statistics.</p> <p><strong>Results</strong>: The study revealed that 72.6% of the women were &gt;30 years and 93% of women were literate, among them 35.2% had completed secondary level of education. It was found that only 28.0% of women had good level of awareness and 43.5% of them had poor level of awareness regarding cervical cancer. There was statistically significant relationship between level of awareness with age (p=0.029), ethnicity (p=0.013), marital status (p=0.018) and heard about organism that causes cervical cancer (p=&lt;0.001).</p> <p><strong>Conclusions:</strong> Based on the findings of the study, it is concluded that, almost half of the women have poor level of awareness regarding cervical cancer. Hence, there is need for community awareness program on cervical cancer, its screening and preventive measures through the medium of health personnel, friends and mass media.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31771 Palliative Hypofractionated Radiotherapy in Advanced Squamous Cell Carcinoma of Head and Neck 2020-10-08T17:46:03+00:00 Deepa Gautam gautamdeepa09@yahoo.com Arati Shah gautamdeepa09@yahoo.com <p><strong>Introduction:</strong> A significant proportion of patients with advanced squamous cell carcinoma of head and neck (HNSCC) are unsuitable for radical treatment and we aim to evaluate the acute toxicity, symptom relief and disease response after palliative hypo fractionated radiotherapy in such patients.</p> <p><strong>Methods:</strong> A prospective observational study was conducted from November 2014 to November 2015 at the Department of Radiation Oncology, B.P. Koirala Memorial Cancer Hospital, Bharatpur in 30 patients with stage III or stage IV HNSCC who received radiotherapy of 30 Gy in 10 fractions over two weeks. Pain, dysphagia, insomniaand dyspnoea at presentation were assessed using 11 point numerical scale. Acute treatment toxicities we reassessed using Common Terminology Criteria for Adverse Events (CTCAE) at the end of two weeks. After six weeks of completion of radiotherapy, percentage of symptom relief and disease response based on Response Evaluation Criteria in Solid Tumors (RECIST) were recorded. A few patients were selected for further curative radiotherapy.</p> <p><strong>Results:</strong> Common symptoms were pain (86.7%) and dysphagia (50%). Two-third of patients with pain and dysphagia, and about 90% patients with dyspnoea and insomnia had more than 75% symptom relief. An objective response rate of 70% and disease progression of 13.3% were observed. Acute radiation toxicities were acceptable with no grade 3 or 4 toxicities. It was observed that 46.3% of patients had mucositis, 13.3% had dysphagia, and 6.7 % had hoarseness and dermatitis each.</p> <p><strong>Conclusion:</strong> Palliative radiotherapy is a suitable modality of treatment for patients with advanced HNSCC for symptom relief and tumour control, with acceptable toxicity.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31775 Effects of Concentrated Growth Factor and Cervical Lymph Node Metastasis on the Prognosis of Mucoepidermoid Carcinoma of the Parotid Gland 2020-10-08T17:46:05+00:00 Shang-Zhi Han shangzhihanhan@163.com Xin Lv shangzhihanhan@163.com Xi-Bo Chen shangzhihanhan@163.com Ying-Ying Xu shangzhihanhan@163.com Rui Liu shangzhihanhan@163.com Xing-Le Zhang shangzhihanhan@163.com <p><strong>Introduction:</strong> Mucoepidermoid carcinoma (MEC) is a common salivary gland malignancy. As studies reported on large cases of mucoepidermoid carcinoma of the parotid glands are few, this paper aims to research the effects of clinical and pathological factors, such as applying concentrated growth factor (CGF) on repairing and cervical lymph node metastasis, on the prognosis of mucoepidermoid carcinoma of the parotid gland.</p> <p><strong>Methods:</strong> The retrospective analysis of prognostic factors was conducted based on 176 cases with mucoepidermoidcarcinoma of the parotid gland, who received treatment at the Affiliated Hospital of &nbsp;Chengde Medical College during the period of March 2000 to March 2012.</p> <p><strong>Results:</strong> The Five-year overall survival rate was 75.57%, while the Five-year tumor-free survival rate was 64.77%. Univariate analysis showed that the influential factors for the prognosis of mucoepidermoid carcinoma of the parotid gland included surgical approach, tumor size, clinical stage, pathological grade, lymph node metastasis, and distant metastasis, etc; among which pathological grade, lymph node metastasis, and distant metastasis were indicated by multivariate analysis to be the independent risk factors.</p> <p><strong>Conclusion:</strong> The survival rate of mucoepidermoid carcinoma of the parotid gland is relatively high. Lymph node metastasis, pathological grade, and distant metastasis are the independent risk factors that affect the prognosis of patients with mucous epidermis carcinoma of the parotid gland.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31787 The Prognostic Ability of Staging System in Men with Penile Cancer: An Analysis of SEER Database 2020-10-08T17:46:07+00:00 Aditya Jalan dradityajalan@gmail.com Ravi Kanodia dradityajalan@gmail.com Sarita Rana Gurung dradityajalan@gmail.com Rajeev Kumar Malhotra dradityajalan@gmail.com Umesh Nepal dradityajalan@gmail.com Gyan Prasad Pokhrel dradityajalan@gmail.com Nirmal Lamichhane dradityajalan@gmail.com <p><strong>Background:</strong> Penile cancer is now a rare condition. The low incidence of the disease makes a valid estimation of its prognosis difficult. In this study, we made an attempt and propose a nomogram to develop a prognostic rule that could predict the Cancer-Specific Mortality (CSM) free rates in patients with primary penile squalors cell carcinoma of the penis (PPSCC).Methods: This study included 1304 patients diagnosed with PPSCC between the years 2004 &amp; 2011 and treated with penile tumor excision. Subjects were staged as per Surveillance, Epidemiology &amp; End Results stage (SEER), American Joint Committee on Cancer (AJCC), TNM classification and tumor grade (TG). CSM free rates were determined. Univariate and multivariate Cox regression model was used to test the prediction of the CSM free rate. The predictive rule accuracy was created using the receiver operating characteristic curve.</p> <p><strong>Results</strong>: The clinico-pathological profile depicts a mean age of 64.66 ± 14.38 yrs. The most common primary site involved was glans penis (n= 483, 37%) and the disease was most commonly diagnosed at AJCC stage I (n= 670, 51.4%) disease. The cumulative 5-year CSM free rates according to Fine &amp; Gray, &amp; Kaplan-Meier methods were 81.8% and 79.8%, respectively. The predictive accuracy as per SEER stage, AJCC stage, TNM stage alone were 68.8%, 70.3%, 72.3%, respectively. When TG was combined, the predictive accuracy increased to 72.8%, 73.1%, and 75.0%, respectively. TNM stage with TG was most accurate in predicting CSM free rate compared to other models.</p> <p><strong>Conclusions</strong>: TNM stage with TG and AJCC stage with TG appear to have comparable accuracy to predict the CSM free rate in patients with PPSCC, the TNM stage with TG is the most accurate (75%) method to predict the CSM free rates. The addition of the TG variable improved the accuracy of these prognostic models.</p> 2020-10-04T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31847 Institutional Audit of Pediatric and Adolescent Malignancy in Nepal 2020-10-08T17:46:09+00:00 Krishna Sagar Sharma akrish630@gmail.com Sabita Panthi akrish630@gmail.com Kishor Pradhananga akrish630@gmail.com Bhaktaman Shrestha akrish630@gmail.com <p><strong>Background:</strong> There have been no records of the incidence of pediatric malignancy recorded in Nepal until recently. The aim of this study is to analyze the cases of pediatric malignancy reported in 2006 in order to find out the relative frequency and geographical distribution of childhood malignancy throughout Nepal.</p> <p><strong>Methods:</strong> All the data for 2006 were collected from the Hospital-based Cancer Registry of Nepal (B P Koirala Memorial Cancer Hospital Registry Programme). All the cases included in the report were analyzed for geographical distribution, age, sex and relative frequency of the various types of childhood malignancies. The cancers were all classified according to the International Classification of Childhood Cancer (ICCC) and separated into 12 major groupings.</p> <p><strong>Result:</strong> A total 343 children and adolescents from seven tertiary care hospitals located in the western, middle and eastern regions of Nepal were registered in the Hospital-based Cancer Registry Program of Nepal. A majority of the patients were from the eastern and mid-eastern regions. The others were from the western, far-western and mid-western regions. Very few of them were from the far-western and mid-western regions. The males had a higher reported rate of malignancies than the females, 60% vs. 40%. The adolescent population (13-19 years old) had 43% of the malignancies: a significant number. Leukemia (33%), lymphoma (18%) and bone tumors (13%) were the first, second and third most common cancers among the 12 groups. The number of reported cases has increased each year from 2003 to 2006.</p> <p><strong>Discussion:</strong> The Hospital-based Cancer Registry was started in 2003. At that time not much attention was given during the collection of data to making note of the different variables. The incidence of pediatric malignancies has not been known till now. This study shows that the relative frequencies of pediatric malignancies and leukemiaare the same as in western countries. Knowledge of the national incidence is necessary in order to make proper policies for the treatment of children with cancer and for research in the field of pediatric oncology. Brain tumors are the second most common cancer in developed countries but in our study it is the fifth most common malignancy: 20% Vs 5%. We have a higher percentage of bone tumors 10% vs. 5% unlike other developed countries where population based registry data are available.</p> 2020-10-07T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31849 The Value of P504s, 34βE12, Ki-67 and PSA in Diagnosis and Prognosis of Prostate Cancer 2020-10-08T17:46:11+00:00 Jin-Qi Song chengdexuhui@163.com Ya-Nan Zhou chengdexuhui@163.com Gang-Liang Tu chengdexuhui@163.com Hui Xu chengdexuhui@163.com <p><strong>Background:</strong> In recent years, the incidence of prostate cancer (PCa) is increasing. Advanced PCa has a poor prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value of &nbsp;P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa.</p> <p><strong>Objective</strong>: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical significance.</p> <p><strong>Methods:</strong> Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group. The expression of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry.</p> <p><strong>Results</strong>: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5% and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%. The difference between the two groups was statistically significant (p&lt;0.05). PCa bone or lymph node metastasis was positively correlated with Ki-67 (r=0.423, p&lt;0.05) and Gleason score (r=0.446, p&lt;0.05), indicating a stronger correlation with Gleasonscore.</p> <p><strong>Conclusion:</strong> The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential diagnosis of PCa. High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor prognosis.</p> 2020-10-07T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31852 A Retrospective Analysis of Breast Cancer at BPKMCH, Nepal 2020-10-08T17:46:12+00:00 Chin Bahadur Pun chinbahadurpun@hotmail.com Sadina Shrestha chinbahadurpun@hotmail.com Ranjan Raj Bhatta chinbahadurpun@hotmail.com Greta Pandey chinbahadurpun@hotmail.com Suraj Uprety chinbahadurpun@hotmail.com Shankar Bastakoti chinbahadurpun@hotmail.com Ishan Dhungana chinbahadurpun@hotmail.com Nandita Jha chinbahadurpun@hotmail.com <p><strong>Introduction</strong>: Breast cancer is the most common cancer and also the leading cause of cancer related mortality in women worldwide which impact 2.1 million women each year. Breast cancer rates are increasing in nearly every region globally. <strong>Methods</strong>: This was retrospective study at Department of Pathology in B P Koirala Memorial Cancer Hospital effective from 15 April 2018 to 14 April 2019. All the data were retrieved and analyzed.</p> <p><strong>Results</strong>: Total 205 breast cancer cases were analyzed, among them 198 cases were females accounting 96.5 %and 7 cases were males accounting 3.5 %.Among 205 cases, 181 (88.6%) cases were invasive ductal Carcinoma No Special Type. Majority of cases 111(54%) were diagnosed with Nottingham grading system grade II of breast cancer. According to our study breast cancer was most common in the age group 41-50 years (32.2%).</p> <p><strong>Conclusion:</strong> Breast cancer is more common in females than in males. Most common affected age group was 41-50 years. Most common histological type was invasive ductal carcinoma NST. Similarly, left sided breast cancer was more common than right.</p> 2020-10-07T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31859 Pediatrics Germ Cell Tumors: A Ten Year Audit in a Cancer Center of Nepal 2020-10-08T17:46:14+00:00 Krishna Sagar Sharma akrish630@gmail.com S Mehta akrish630@gmail.com D Misra akrish630@gmail.com Jitendra Pariyar akrish630@gmail.com Sabita Panthi akrish630@gmail.com <p><strong>Introduction:</strong> Pediatric Germ cell tumors are rare disease in pediatric and adolescent age group. Germ cell tumors are the most frequently found malignancies which are highly chemo sensitive. GCTs are curable if diagnosed and treated adequately even in resources poor setting in resource constraints countries like Nepal.</p> <p><strong>Objective:</strong> To study the clinic pathological profile and treatment outcome of Pediatrics Germ cell tumors (GCTs) among children and adolescent group seeking treatment at B.P. Koirala Memorial Cancer Hospital (BPKMCH), Nepal.</p> <p><strong>Methodology:</strong> Descriptive study was done at BPKMCH Nepal. All available case records of pediatric and adolescent girls diagnosed to have GCTs from 2002 to 2011 were collected and analyzed in terms of age, clinical features, malignancy types, treatment modalities and outcome.</p> <p><strong>&nbsp;Results:</strong> Total 70 girls were with female gynecological malignancy. There are 46 (76.66%) with ovarian malignancies. Among the ovarian cancers, 42 had malignant germ cell cancer (91.3%) among all ovarian malignancies which are enrolled in the study. The commonest presentation was abdominal distension and pain in70%. Onset of symptoms ranged from three days to 730 days (mean 95 days). Disease stage at presentation was early stage 18 (30%) and advanced disseminated disease 42 (70%). In treatment modality, 8 (13.33%) underwent fertility sparing surgery only, 21(35%) underwent chemotherapy only and 31(51.66%) underwent multimodality treatment. 82.5% patients who were completed recommended treatment were cured.</p> <p><strong>Conclusion</strong>: Malignant germ cell cancer is the commonest ovarian malignancies among pediatric and adolescent girls. Early presentation and prompt appropriate treatment would offer chances of cure even with preservation of fertility.</p> 2020-10-08T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31860 Peri-Operative Morbidity and Outcomes of Radical Cystectomy- Institutional Experience of Single Center 2020-10-08T17:46:16+00:00 Amit Mani Upadhyay amitmaniupadhyay@gmail.com Ashok Kumar Kunwar amitmaniupadhyay@gmail.com Manik Lama amitmaniupadhyay@gmail.com Kabir Tiwari amitmaniupadhyay@gmail.com Sanjesh Bhakta Shrestha amitmaniupadhyay@gmail.com Anil K. Shah amitmaniupadhyay@gmail.com Bishnu Dutta Poudel amitmaniupadhyay@gmail.com Kapendra Shekhar Amatya amitmaniupadhyay@gmail.com <p><strong>Introduction:</strong> The incidence of urinary bladder carcinoma increases distinctly with increasing age. Radicalcystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or recurrent high-grade non-muscle invasive bladder cancer. Our study aimed to see the peri-operative morbidity and surgical outcomes of the patient who had undergone radical cystectomy in our low volume center.</p> <p><strong>Methods:</strong> We retrospectively reviewed the inpatient charts as well as the outpatient records of 10 patients who had undergone radical cystectomy performed in our center for 9 years. A review of the literature on perioperativemorbidity of radical cystectomy was also done using the combination of keywords like mortality, complications, and outcomes of surgery.</p> <p><strong>Results:</strong> Age of the patients ranged from 40-80 years. Eight of them were male and two were female. Painlesshematuria (70%) was the commonest presenting symptom, 80% of them were smokers. Three patients received neoadjuvant chemotherapy. Nine patients had radical cystectomy with an ileal conduit, whereas one patient hadradical cystectomy with orthotropic neo-bladder. In postoperative complications, five patients had Clavien-Dindograde I, three patients had grade II, one patient had grade IIIB and one patient had grade V complications. Two years of cancer-free survival was 90% and five years of cancer-free survival was 50%.</p> <p><strong>Conclusions:</strong> Radical cystectomy with ileal conduit was still the choice of surgery in muscle-invasive and recurrent high-grade non-muscle invasive bladder cancer.</p> 2020-10-08T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31732 Development of Oncology Nursing in Nepal: Historical Perspective 2020-10-08T17:45:58+00:00 Sarojini Sharma sarojini.josi@gmail.com <p>Professional nursing in general and oncology nursing in particular underwent significant changes and a distinct paradigm shift in oncology nursing education and practice in the 30 year period of time (1991 to 2020), which promoted the advancement of oncology nursing. This historical review and reflection provides lessons for contemporary clinical cancer nurses, researchers, policy makers and educators to approach the nursing issues, necessity of cooperation/ collaboration and maintaining the passion for increasingly complex nursing specialty.</p> 2020-10-02T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer https://www.nepjol.info/index.php/njc/article/view/31706 Modified Palliation in Cancer Patients during COVID-19 Pandemic 2020-10-08T17:46:25+00:00 Bhawna Wagle bit2wagle@yahoo.com Eliza Koirala bit2wagle@yahoo.com <p>Corona virus disease 2019 (COVID 19) has put huge challenge to the health delivery system all across the globe. The risk of mortality due to COVID 19 is highest on critically ill patients and those with preexisting disease. Palliative and end of life care are no exceptions to the surge in increased demand for health care services. It is now an essential part of global health care. The benefits of early palliative care are already well established. In the pandemic like this, we must not pull back the services, particularly in these vulnerable groups. It is important to determine how best to deliver palliative care during this crisis. It may include preparedness to shift the focus of resources to community level and the innovative use of telemedicine. Use of telemedicine is to ease patients and minimize caregiver distress, and to prevent hospitalizations. The fear of contracting COVID-19 and the emotional burden during diagnosis requires the need of continuous psychosocial support. These challenges should be handled by specialized and skilled interdisciplinary palliative care team.</p> 2020-10-02T00:00:00+00:00 Copyright (c) 2020 Nepalese Journal of Cancer