Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : oncology

Outcome of treatment among chronic lymphocytic leukemia and its correlation to Rai staging system in Kurdistan region of Iraq

Zhala Ahmad; Kawa Hasan; Hisham Al-Rawi; Ahmed K. Yassin; Bryar Rashid; Tavan Mahmood; Zeki Mohamed; Nawsherwan Mohammed; Sana Jalal; Basil Abdulla; Dana Abdullah; Shokhan Mustafa; Shlan Mohammed; Lara Abdulrahman; Mrawa Karam; Ghanem Obaid; Rozhat Yousif; Ranan Polus; Rawand Shamoon

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 2, Pages 100-108
DOI: 10.33899/mmed.2021.130017.1090

Background: Chronic lymphocytic leukemia is common adulthood leukemia with low incidence in Kurdistan region of Iraq. Staging of chronic lymphocytic leukemia is essential in treatment planning and the pattern of response is variable.
Aim of study: To evaluate the Rai staging distribution of patients with chronic lymphocytic leukemia in Kurdistan region/Iraq and its correlation with the treatment outcome.
Patients & Methods: A retrospective cross sectional review study conducted in three Hemato/oncology centers in Kurdistan for duration of eleven years through the period from 1st of January, 2010 to 31st of December, 2020 on convenient sample of 170chronic lymphocytic leukemia patients. Diagnosis of chronic lymphocytic leukemia was done according to the International Workshop on Chronic Lymphocytic Leukemia. The Rai staging was done by the clinical hematologist in Hemato/oncology center  according to clinical evaluation and laboratory investigations. The pattern of the treatment response was determined according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL)
Results: The Rai staging of our patients was 0 in 15.3% of them, stage I in 12.4%, stage II 30%, stage III 13.5% and stage IV 28.8%.  The treatment response of studied sample was complete response (43.5%), partial response (17.6%), stable (14.1%), no response (21.8%) and progressive (2.9%).A highly significant association was observed between no response to treatment and advanced Rai staging and also a highly significant association was observed between death outcome of patients and advanced Rai staging.
Conclusions: The treatment response of patients with chronic lymphocytic leukemia is directly related to Rai staging as patients with advanced Rai staging had lower treatment response rate.

The Association Of Body Mass Index And Prostatic Cancer Histopathological Grade

Marwa Muzahim; Adil Siwan AL- aqabi

Annals of the College of Medicine, Mosul, 2021, Volume 43, Issue 2, Pages 139-143
DOI: 10.33899/mmed.2021.130724.1099

Background: Obesity, a global public health concern, has been repeatedly linked to the development of different cancers in epidemiologic and basic  research studies, Prostate cancer  is the most frequently encountered solid tissue cancer in men. Gleason score  of  the prostate cancer is one of  the most important parameter, which provides the most important data about biological behavior of the cancer and affect on  the selection of the treatment and its outcomes. Therefore, accuracy of  Gleason score, based on  histopathological analysis of the biopsy material, has a critical importance
Patients and Methods:  A cross-sectional study with retrospective  analytical elements, among prostate cancer patients who were  diagnosed based on histopathology of  prostate gland ,then classified accorrding to  G.S (gleasson score) and body mass index.
Aim of this study: To evaluate the association between high  body mass index  and Gleason grade  of  prostate cancer.
Results: The results of this study  showed that patients with high body mass index Significantly associated with high grade of prostate cancer, as ( 46.4%  and 62.2% of overweight and obese patients respectively had high Gleason score  above 7 while  12.5% of overweight and 8.1% of obese patients had low Gleason score  and the p Value was (0.002).
Conclusion: This study found that high body mass index associated with increase high grade of  prostate cancer

Evaluation of the Patients with spinal metastasis of unknown primary tumor origin.

Alya A.Zobair

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 2, Pages 119-125
DOI: 10.33899/mmed.2020.129029.1062

Background: The spine is not only the most frequent site of skeletal metastasis of a known carcinoma but it is also the most frequent site of bone metastasis of unknown primary tumor origin, however, most of the existing reports that analyzed the clinical features of patients who presented with skeletal metastasis of unknown origin have included cases of bone metastasis at any location. Objective: This study was conducted to analyze the clinical features, survival, and specific diagnostic implications in patients presented with spinal metastasis of unknown primary malignant tumor. Method: In this prospective study, 40 patients presented with spinal metastasis of unknown primary tumor origin to Mosul Oncology Hospital were followed up. Result: The primary malignant tumor was identified in (97.5%) of cases, lung cancer was the most frequently identified primary tumor (35%) followed by carcinoma of the breast (30%) and prostatic cancer (12.5%). We found that Computed tomography scan of the chest, abdomen, and pelvis were the most useful diagnostic modality to identify the primary malignant tumor and there was a significant difference in the overall survival of patients with different primary tumor sites, shorter survival time was observed for aggressive tumor like lung cancer compared to patients having less aggressive primary tumor like breast and prostatic cancer.
Conclusion: Spinal metastasis of unknown primary carries a diagnostic challenge to the clinician, it is possible to detect the primary site in the majority of patients if we follow optimal diagnostic strategies. Detection of primary tumor site could help the clinician to provide the best therapeutic strategies.

Under-Graduate Oncology Education in Iraq: Roadmap for Improvement

Layth Yahya Ibrahim Mula-Hussain; Bassam Al-Zuhairy; Saif Al-Izzi; Alyaa Mula-Hussain; Muzahim Al-Khyatt

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 1, Pages 90-98
DOI: 10.33899/mmed.2020.127346.1033

Oncology is a branch of medicine that specializes in the diagnosis and treatment of cancer and is divided into surgical oncology, radiation oncology, and medical oncology. Cancer is one of the leading causes of morbidity and mortality worldwide and there is a distinct shortage of adequately qualified oncologists in Iraq. Oncology education should be introduced at the beginning of medical school (college) as every doctor may face cancer patients in their training and practice after graduation. However, there is a gap in this area, as this branch is relatively new compared to other clinical branches. Holistic cancer care and a patient-centered approach should be the goal of modern oncology. Comprehensive under-graduate oncology education should be a critical component in medical education. This work is aiming to present a roadmap for an ideal oncology curriculum, which can be integrated and implemented into the Iraqi medical schools’ curricula.