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Biomedical subjects

V K Sethi

Publications and source records attributed to V K Sethi.

At least 19 recordsLinked to original sources
PubMed1996

Patient profile and survival in 270 computer tomography-staged patients with nasopharyngeal cancer treated at the Singapore General Hospital.

This is a report analysing the patient profile and survival results in 270 patients with nasopharyngeal carcinoma treated with radiation therapy between July 1987 and December 1988. The patients had a median age of 52.6 months, and a male-female ratio of 2.5:1. Ninety-four percent of patients were Chinese. The commonest presentation was that of a neck mass (found in approximately 65% of patients). Approximately two-thirds presented with disease more advanced than Ho's stage II. At a median follow-up of 52.6 months, the 5-year actuarial survival rate was 53% and the freedom from relapse rate was 57%. One hundred and seven patients died within the observation period. Of these, 46 patients had disease in the post nasal space, 41 in the neck and 60 in sites outside the head and neck.

Actuarial Analysis↗
PubMed1994

Half body irradiation for palliation of widespread metastatic bone disease.

An analysis is made of 134 patients treated by a single dose half body irradiation at the Department of Therapeutic Radiology, Singapore General Hospital. A total of 149 fields were treated with 15 patients receiving both upper and lower half treatments. This technique achieved a more than 70% subjective pain relief in the patients who had widespread bony metastases. Side effects were minimal and this technique has been used on an outpatient basis since the first preliminary study in 1986. There was a dose response, more than 75% (75 out of 97 patients) with pain relief using doses of 700 cGy and above. Sensitive tumours also produced better results with nasopharyngeal carcinoma, prostate and breast having pain relief in more than 70% of patients. The largest group of patients (51 cases) treated was nasopharyngeal carcinoma, as this tumour is fairly common locally and often presents with bony metastases as the first site of spread.

Ambulatory Care↗
PubMed1990

Differentiated thyroid cancer: outcome of treatment in 80 cases.

The author carried out a retrospective analysis, with 6-13 years follow up, of 80 patients with differentiated thyroid cancer. The patients were treated with surgery, radioactive iodine, radiation therapy and suppression hormone therapy. The results, 5 year and 12 year survivals of 97% and 85%, are comparable with the results of much larger series with longer periods of follow up. The most significant prognostic factor was age at presentation. No patient below the age of 45 died from the cancer even if, at presentation, there was very advanced local disease or multiple distant metastases. In addition, sex, extent of local disease and presence of multiple metastases were also important in predicting survival. Cervical node involvement, by itself, did not worsen the prognosis and long survival with lung secondaries is possible.

Adolescent↗
PubMed1988

Radiotherapy of early glottic cancer Singapore, 1978-1981.

This study analyses the results of primary radiotherapy for 44 patients with early glottic cancer (Tis, T1 stage) given at the Therapeutic Radiology Department, Singapore General Hospital during the 4-year period from 1978 to 1981. Irradiation was delivered using cobalt teletherapy with free set-ups, and without "air-gap" compensation. Total doses of 55Gy to 64Gy were given in daily fractions of 1.8Gy, treating five times a week. The crude 5-year survival rate for Tis/T1a tumours was 88.9% and for T1b lesions, 81%. On correcting for deaths from intercurrent disease, the survival rates improved to 95.5% and 92.6% respectively. In 33 cases where the quality of voice after radiation was assessed, 15 patients (45.4%) retained good voice quality with an additional 11 patients (33.3%) having acceptable voice quality. In seven cases the voice after radiation was rated as poor. Nine patients had local recurrence, giving a rate of 20.4%. One other patient had cervical node metastasis and subsequently developed lung secondaries. Surgery, solely or with re-irradiation, was an effective treatment for local recurrence. Re-irradiation alone failed to control any case with recurrence.

Carcinoma, Squamous Cell↗
PubMed1987

Advanced colorectal carcinoma--5 year survival of 76 cases treated at the Department of Therapeutic Radiology, Singapore General Hospital.

The results of 76 cases of advanced colorectal carcinoma treated at the Department of Therapeutic Radiology, Singapore General Hospital, from 1977 to 1978, are presented. All cases had "Curative" Surgery and were given adjuvant radiotherapy or chemotherapy or both. All were adenocarcinoma and had lymph node involvement as well as tumour infiltration through the bowel wall. 44 cases of rectal carcinoma were given radiotherapy to the pelvis followed by I/V 5-fluorouracil for at least one year. 32 cases of colon cancer were given I/V 5-fluorouracil for at least one year. 20 of these cases had cancer of the sigmoid colon and were given pelvic irradiation as well. The five year actuarial survival rates were 27.8% for rectal cancer and 24.3% for colon cancer.

Actuarial Analysis↗
PubMed1986

Serum thyroglobulin (Tg) and thyroglobulin antibodies (TgAb) in thyroid cancer.

Serum thyroglobulin antibodies (TgAb) and serum thyroglobulin (Tg) levels were measured in 28 normal controls and 32 patients with differentiated thyroid cancer. The TgAb and Tg levels were measured in the patients when they were on replacement thyroxine therapy prior to the whole body radioiodine I-131 scan (WBS), using immunoradiometric assay kits. The TgAb level in normal controls was from 0-4.8 micrograms/ml, with a mean of 0.6 microgram/ml, while the Tg level in these controls was from 0.0-48.0 ng/ml, with a mean of 4.2 ng/ml. In the patients with thyroid cancer, the TgAb levels were normal except for a few patients who had residual thyroid or tumour in the neck and had raised levels of TgAb. Their Tg levels were normal except for 7 patients who had elevated values. 2 of these 7 had no evidence of disease on X-ray, bone scan, or WBS (I-131) while the other 5 had evidence of metastases. However, 4 patients had metastatic disease with normal Tg levels, and 2 of these patients had residual thyroid in the neck and raised TgAb levels, while in the remaining 2 patients, both Tg and TgAb were low. Serum Tg is a useful tumour marker for recurrent or metastatic thyroid cancer, but the presence of residual normal thyroid would interfere with the results.

Adenocarcinoma↗
PubMed1986

Differentiated thyroid carcinoma--long term survival at the Singapore General Hospital.

The results of 48 cases of differentiated thyroid carcinoma treated at the Singapore General Hospital in the 5-year period 1977 to 1981 are presented. The peak incidence was in the 4th decade of life. Surgery, radiotherapy, radioactive iodine and hormones were the treatment modalities that were combined. 25% of the patients received radiotherapy while 74% were given at least one dose of radioactive iodine. The overall 5-year and 9-year actuarial (uncorrected) survival rates were 94.5% and 82.2% respectively. The 4 patients who died were in the older age group while younger patients had a good prognosis.

Adenocarcinoma↗
PubMed1985

Radiotherapy of carcinoma of the uterine cervix in Singapore, 1973-1975.

The results of 322 patients with uterine cervix carcinoma treated by radiotherapy at the Singapore General Hospital in the 3-year period from 1973 to 75 are presented. Two hundred seventy-nine patients were treated with a combination of intracavitary radium, using Fletcher-Suit applicators and cobalt teletherapy; the remaining 43 patients received only cobalt teletherapy. One hundred thirty-four patients (41.6%) presented with FIGO Stage III disease. Only 46 patients (14.3%) presented with Stage I disease, showing that patients tended to present late in the disease course. Five-year actuarial (uncorrected) survival rates of 86.7% for Stage I, 65.0% for Stage II, 41.4% for Stage III and 4.9% for Stage IV were obtained with corresponding 10 year rates of 79.6%, 60.2%, 35.2% and 0%. The overall 5 and 10 year survival rates were 54.0% and 48.2%, respectively. The survival rates "flattened off" at about 7-8 years, reflecting late deaths after the fifth anniversary of treatment. Non-severe complications consisted mainly of chronic proctitis (41.3%) and vaginal stenosis (20.8%). Major complications were intestinal stricture (1.2%) and fistula formation (1.6%).

Adult↗
PubMed1982

Thyrotoxicosis and thyroid cancer.

It is generally held that thyroid cancer is uncommonly associated with thyrotoxicosis. We report here nine patients with thyroid cancer amongst 720 patients with thyrotoxicosis. Three patients presented with features of malignancy together with thyrotoxicosis (Group A), one of whom had triiodothyronine (T3)-toxicosis. The remaining six patients were diagnosed following histological examination of tissues removed during subtotal thyroidectomies for hyperthyroidism (Group B). Two patients in Group A had follicular carcinoma; the rest were papillary in type. All the patients were rendered euthyroid initially, followed by ablative therapy for two patients in Group A and four patients in Group B. All but one are alive after one to nine years (mean of 3 . 4 years). The diagnosis of thyroid carcinoma is infrequently considered in the presence of thyrotoxicosis. The association is not clinically apparent in the majority of patients. The optimum management of such occult malignancies in thyrotoxicosis remains to be defined.

Adenocarcinoma↗
PubMed1981

Thyroid scanning & the significance of the solitary cold nodule.

Since thyroid scanning was introduced in Singapore in 1968 there has been progressive increase in the demand for these scans. 215 patients comprising 153 females and 62 males were scanned in 1976 using 131I. The solitary nodule was the commonest condition referred for scans (60%) and next was the multinodular goitre 919%). Other indications for scan included postthyroidectomy cases, aberrant thyroids, retrosternal goitres, thyrotoxicosis and metastases from thyroid carcinoma. 73 cases of solitary cold nodules were discovered and 43 of these were operated on. 7 of these were found to be malignant, giving an incidence of 16%. The incidence of malignancy in the cold nodule varies in the reported literature. By itself the 131I scan cannot diagnose malignancy but is it a useful supplementary test in addition to the clinical and other investigations.

Adult↗
PubMed1981

Non-surgical treatment of thyroid carcinoma.

Thyroid carcinoma, as a rule, is a slow growing tumour and overall results are good. However, the failure to control the primary tumour in a high percentage of patients makes it necessary that adequate, appropriate treatment be given at the first opportunity. Surgery, radiotherapy, radioiodine, hormones and chemotherapy all have a role to play. It is recommended that combination treatment should be used whenever possible. A treatment strategy is outlined. Generally, for differentiated carcinoma, the younger the patient at the time of diagnosis, the better the prognosis.

Adenocarcinoma↗