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Biomedical subjects

H B Tongaonkar

Publications and source records attributed to H B Tongaonkar.

33 records · Page 2Linked to original sources
PubMed1993

Stage I testicular tumours: the Tata Memorial Hospital experience.

One hundred and fifty-six patients with stage I testicular germ cell tumours--81 seminomas and 75 nonseminomatous tumours--were treated at the Tata Memorial Hospital, Bombay over a 5 year period. Among the seminomas, 71 were treated with post-orchidectomy prophylactic radiation therapy to the retroperitoneum and/or mediastinum, while 10 patients refused radiation therapy and were put on surveillance. The disease-free and total survival in seminomas were 92.6% and 100%, respectively. Among the patients with nonseminomatous tumours, 58 had normal levels of serum biomarkers while 17 had raised biomarkers. In the normal marker group, 20 patients underwent retroperitoneal lymph node dissection (RPLND) with a nodal positivity of 30%, while the other 38 patients refused surgery and were either placed on unplanned surveillance (33 patients) or chemotherapy (5 patients). In this group, the patients undergoing RPLND had a survival rate of 100% as compared to 93.9% in those with surveillance. The overall disease-free and total survival rates in patients with normal markers were 86.2% and 96.6%, respectively. In the raised marker group, 6 patients underwent RPLND with a survival rate of 100% and 11 patients received chemotherapy with a survival of 90%, with the overall survival for patients with raised markers being 94.1%. The overall disease-free and total survival rates for all patients with stage I nonseminomatous tumours were 88% and 96%, respectively.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Neobladder after cystectomy: an Indian experience.

A continent urinary reservoir was constructed from an ileocolonic segment and anastomosed to the urethra in 30 males after radical cystectomy for infiltrating bladder cancer. A small cuff of the prostate was retained for anastomosis with the reservoir and ureteric anastomosis was done from within the reservoir by the "pull through" method. Complete continence was achieved in 29 patients, all of whom had an adequate reservoir capacity exceeding 400 ml; they were able to empty the reservoirs satisfactorily as judged by the residual urine (< 50 ml). Urodynamic study revealed an intra-abdominal pressure < 30 cm of water at rest and at reservoir capacity of 500 ml. Early post-operative complications included urinary leaks in 3 patients, intestinal obstruction in 3 and a faecal fistula in 1. Deterioration of the upper tracts was noted in 5 cases. Twenty-seven patients are alive after a mean follow-up of 36 months.

Adult↗
PubMed1993

Urethral recurrences following radical cystectomy for invasive transitional cell carcinoma of the bladder.

A total of 177 patients with invasive transitional cell carcinoma of the bladder underwent radical cystoprostatectomy, of whom 13 underwent simultaneous urethrectomy. The remaining 164 patients were followed up regularly with urethroscopy and urethral cytology. Fifteen patients developed urethral recurrences, 4 of which were associated with relapses at other sites (recurrence rate 9%), with a mean recurrence-free interval of 13.5 months. Nine of the 11 patients with isolated urethral recurrences underwent total urethrectomy and all except 1 are alive and disease-free 2 to 8 years later. One patient was salvaged by radiation therapy and refused further treatment. The 4 patients with other associated relapses died within 18 months. The urethral recurrence rate was correlated to different risk groups defined on the basis of tumour characteristics in the cystectomy specimen. This revealed a 70% urethral recurrence rate in the high risk group, 9.6% in the moderate risk group and 1.2% in the low risk group. However, no conclusion could be drawn regarding the influence of prostatic involvement on the urethral recurrence rate.

Carcinoma, Transitional Cell↗
PubMed1992

Solitary metastases from renal cell carcinoma: a review.

Nineteen patients with solitary metastatic lesions from renal cell carcinoma, 5 synchronous and 14 metachronous, were seen at the Tata Memorial Hospital over a 7 year period between 1981 and 1987. The mean metastatic interval for the metachronous lesions was 31.2 months. The commonest sites of metastases were bone, lung, and liver. The solitary nature of the metastasis was confirmed by appropriate investigations. All patients underwent nephrectomy for the primary kidney lesion. The metastatic lesions were treated with intent of cure. Only 1 patient with synchronous metastasis survived for 2 years and none survived 5 years while in the metachronous metastasis group, the estimated overall survival was 50% at 2 years and 25% at 5 years. The patients with a long metastasis-free interval were found to have a better survival. The patients with liver metastasis did poorly as compared to those with metastases at other sites. The stage of the disease also had a bearing on the survival.

Adult↗
PubMed1992

Value of retroperitoneal lymph node dissection in advanced testicular seminoma.

Seven patients with advanced seminoma of the testis (stages II C and III) were treated with 3 induction cycles of VAB-6 chemotherapy. Three patients had complete remission after chemotherapy and are alive disease free at 32, 38, and 40 months with no additional treatment. Four patients were subjected to retroperitoneal lymph node dissection for residual retroperitoneal masses measuring 2-4 cm after chemotherapy, which revealed fibrosis in 2 patients and metastatic seminoma in the other 2. Patients with metastatic residual masses were given postoperative radiation therapy to the retroperitoneum and are alive disease free at 33 and 34 months, while those with fibrosis are alive disease free at 30 and 52 months, respectively, with no additional treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Continent urinary reservoirs.

We report our experience of 30 continent urinary reservoirs (CURs) after radical cystectomy. The patients ranged in age from 35 to 70 years. There were 22 males and 8 females. Pre-operative urograms showed normal upper tracts in 22 patients, unilateral hydronephrosis in 4 and bilateral hydronephrosis in 4. The first 20 patients had a standard CUR procedure and the last 10 had a modified CUR. The mean operative time, blood loss and post-operative stay were 6.6 h, 900 ml and 25 days respectively for standard CURs and 5.7 h, 825 ml and 21 days respectively for the modified CURs. Post-operative, urinary leaks from the caecostomy site occurred in 2 patients (1 of which was fatal) while 3 other patients had prolonged ileus, burst abdomen and intestinal obstruction probably due to non-demonstrable urinary leaks. All 5 complications occurred in the first 20 patients. Upper tract status was evaluated in 28 patients 3 months after surgery and showed normal upper tracts in 19 patients, improvement in 6 (35%) and worsening in 3 (12.5%). Pouchograms showed no reflux in 25 patients, unilateral reflux in 2 and bilateral reflux in 1. Complete continence was achieved in 25 patients--2 of them had revision surgery, giving a success rate of 89% with a follow-up of 6 to 48 months (median 24). The remaining 3 patients were incontinent.

Adult↗
PubMed1991

Rhabdomyosarcoma of the bladder and prostate in children.

Fifteen children, 14 males and 1 female with a mean age of 4.9 years, were treated for rhabdomyosarcoma of the bladder and the prostate, between 1976 and 1985. In 14 patients, the disease was limited to the pelvis, while one had pulmonary metastases. The lesions were trigonal in 12 patients and involved the prostate in the other three. Eleven patients received vincristine-Adriamycin-cyclophosphamide (VAC) chemotherapy, followed by radiation therapy. Four of these 11 patients required cystoprostatectomy for residual or persistent disease. Of the remaining four patients, two underwent radical cystoprostatectomy, one partial cystectomy and the patient with pulmonary metastases received only chemotherapy. Six patients were alive at 5 years (40% 5-year survival). Six patients died of local relapse within 18 months, one patient died of an unknown cause, while two patients were lost to follow-up free of disease after 2 years.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Adenocarcinoma of the bladder: study of 14 cases and review of the literature.

Fourteen patients with adenocarcinoma of the bladder have been seen over a 14-year period; 6 tumours were of urachal origin and the remaining 8 were primary. All tumours were muscle-infiltrating. The 6 patients with urachal tumours were subjected to surgery; 3 underwent partial cystectomy and 3 radical total cystectomy. All patients who underwent partial cystectomy are alive and free of disease at 60 months, 12 months and 12 months respectively. The other 3 patients who underwent radical cystectomy suffered recurrence and 2 succumbed to their disease within 1 year. All patients with primary adenocarcinoma of the bladder underwent radical cystectomy, 5 of them after planned pre-operative radiotherapy. There were 3 post-operative deaths. One patient died of an unrelated cause 30 months after surgery and 2 died of disseminated disease 8 and 16 months after surgery. One patient developed inguinal lymph node metastases 4 months after surgery and is controlled at 12 months with radiotherapy. Only 1 of the 8 patients with primary adenocarcinoma of the bladder is alive and free of disease at 6 months.

Adenocarcinoma↗
PubMed1990

Extra-adrenal non-functioning paraganglioma.

Extra-adrenal non-functioning retroperitoneal paragangliomas are rare tumors. We herein report a case of retroperitoneal tumor which posed a diagnostic and management problem. Review of the literature shows only 16 previously reported cases of extra-adrenal paraganglioma which underwent complete surgical excision.

Adult↗
PubMedDate not supplied

The impact of cisplat based chemotherapy on advanced ovarian cancer.

Cisplatinum based chemotherapy has become the standard treatment for ovarian cancers due to its proved superiority over non-cisplat based regimes. However, the therapeutic impact of cisplat based regimes compared to cheaper non-cisplatinum based regimes is questionable when multiple variables such as residual disease, histologic type, grade are introduced. This report is a study of 110 Stage III ovarian cancer patients from 1985-89, with cisplat (n = 69) and non cisplat (n = 41) based chemotherapy. The results of both regimes with reference to the multiple variable factors are presented. We conclude that cisplat based regimes appear to be superior to non-cisplat based regimes except probably in poorly differentiated ovarian tumors where the results were similar with either regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Primary carcinoma of fallopian tube--a case study.

Primary carcinoma of fallopian tube is a rare entity. We report an interesting case of primary carcinoma of fallopian tube with contralateral lymph node involvement. The clinicopathological findings and its management is presented.

Adenocarcinoma↗
PubMedDate not supplied

Hypofractionated radiotherapy in carcinoma cervix IIIB: Tata Memorial Hospital experience.

PURPOSE OF THE STUDY: To analyze the role of hypofractionated radiotherapy in advanced carcinoma of cervix. BASIC PROCEDURE: Medical records of 62 women with advanced carcinoma cervix III3 treated during 1994-1996 were reviewed. Patients were treated with standard pelvic portals to a total dose of 39Gy in 13 fractions over 17 days followed by intracavitary brachytherapy. Forty-eight patients completed the planned treatment and were considered suitable for analysis of late reactions and survival. MAIN FINDINGS: The 5-year disease free survival was 59% and the overall survival was 50% at the mean follow up of 40 months. Twenty-one (44%) patients developed acute gastrointestinal toxicity of which 5 patients had grade III and one patient had grade IV reaction. Ten patients (21%) developed acute genitourinary complications, 13 patients (27%) had late rectal reactions and 10 patients (20%) had late bladder complications. Three patients had grade I, five had grade II and five had grade III late rectal toxicity. CONCLUSION: Survival in patients treated hypofractionated radiotherapy appears comparable to that of standard fractionation. The acute gastrointestinal and skin reactions were mainly grade I or grade II. Hypofractionated radiotherapy can certainly be considered in a select group of patients where the local disease is extensive and is unsuitable for conventional treatment.

Adenocarcinoma↗