AHEAD OF PRINT

Paraneoplastic pemphigus is an autoimmune skin and mucosal disorder, rarely associated with solid malignancies, with devastating impact.

Herein, we report the case of a middle-aged patient who presented with recalcitrant stomatitis and was ultimately diagnosed with advanced-stage cervical cancer.

Despite the prompt initiation of immunosuppressive medications, in parallel with systemic therapy for her underlying neoplasm, she eventually died within 10 months.

Considering its heterogeneous clinicopathological and immunological manifestations, paraneoplastic pemphigus remains a genuine diagnostic challenge, whereas its abysmal prognosis highlights the need of additional effective immunosuppressants.

Gastrointestinal neuroendocrine tumours (GI-NETs) are actually malignant tumours, and their most common location of metastasis is the liver. In this study, we define the epidemiologic features of NETs and investigate the demographic factors, clinicopathologic features, survival, and the oncologic results related to GI-NETs.

In this 10-year study (2009–2019), all GI and liver NETs were taken out from the pathology records. When classification based on the WHO classification criteria, patients were categorized based on their location, sex, age, and proliferative index. After studying clinical charts of GI-NET cases, a complete panel of IHC markers such as Chromogranin A, ‘Ki67’ and synaptophysin were used. Results: Based on published data, the liver is not a common primary site for NETs; most liver lesions are most likely to have been metastases. The mean age of patients at diagnosis was 52.72 years. In this research, 27.78% of patients had colon NETs and 27.78 liver. Two (11.11%) patients were classified as stage II, seven (38.89%) as stage III, and one (5.56%) as stage IV. After a 120-month follow-up, 13 (72.22%) patients with colorectal NETs were alive, and 5 (27.78%) of the patients had died.

Treatment of colon and rectal NETs is difficult because it affects the patient's initial site of involvement, and this often makes treatment difficult for the patient. With suitable management, the prognosis can be positive with long survival, but it is related to the tumour variation grade, the efficiency of the selected treatment, and also to the patient's adherence to the follow-up.

Malnutrition is strongly associated with negative outcomes in aged populations with cancer. Several studies have compared the outcomes of nutritional-screening tools, but knowledge specifically covering older adult patients with cancer remains limited. The aim of this study was to compare the outcomes of two tools, the Patient-Generated Subjective Global Assessment (PG-SGA) versus the Mini Nutritional Assessment (MNA) for this population.

Cross-sectional study with 432 participants who consented to participate and were enrolled at admission to medical and surgical wards of a tertiary referral hospital. The participants’ nutritional statuses were simultaneously assessed using the PG-SGA and the MNA, and the outcomes compared using the kappa statistical test. The Receiver Operating Characteristic Curve (ROC) was employed to calculate the MNA sensitivity, specificity, positive and negative predictive values, and was compared with PG-SGA.

Prevalence of good nourishment was observed in 62.5% and 61.1% of the participants, as detected by PG-SGA and MNA, respectively. Both tools concurred moderately (kappa = 0.453). Importantly, there were significant differences in the diagnosis of malnutrition (7.6% vs. 4.6%, p = 0.000). The MNA showed sensitivity of 72.2% and specificity of 75.9% in detecting good nourishment for the population investigated.

The MNA may not present greater sensitivity, possibly due to a lack of coverage of gastrointestinal symptoms. It is a quick and efficient tool for nutritional assessment of older adult patients with cancer, but as it is more specific than sensitive, caution is recommended when identifying borderline or early malnourished individuals of this population.

Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in Asia. Most patients in Cipto Mangunkusumo Hospital have been diagnosed with an advanced stage. There had not been any survival study for OSCC in Indonesia. This study aimed to investigate the survival rate and prognostic factors of OSCC in Cipto Mangunkusumo Hospital.

A retrospective cohort study was conducted on OSCC patients diagnosed and treated in Cipto Mangunkusumo Hospital from 2014 to 2018. Data regarding age, gender, site of the primary lesion, clinical stage of the disease, tumor differentiation, invasion, and surgical margins were collected. The main outcomes measured were overall survival (OS) and disease-specific survival (DSS). The predictors of survival were then determined.

169 patients were included. The majority of patients were male (51.5%) and above 50 years old (55.6%). The most prevalent tumor site was the tongue (72.8%) followed by buccal mucosa (13%). The majority (82.2%) of patients had advanced (clinical stage IV) disease at diagnosis. A smaller majority of patients had a well-differentiated tumor (60.4%) and a low-grade tumor (53.8%). The worst one-year and two-year overall survival rates were found in the stage IV group (53.5% and 37.5%, respectively). The disease-specific survival rate was 66.9%.

The one-year and two-year overall survival rates of OSCC in Cipto Mangunkusumo Hospital were 58.6% and 43.1%. Moreover, clinical stage, tumor size, and lymph node involvement were the most significant prognostic factors for OSCC.