exudates and Adenocarcinoma

Esophageal cancer is the sixth leading cause of cancer death worldwide with considerable geographical histological variation There is a paucity of data in esophageal cancer in demographics, histology, and survival among the multi-ethnic Malaysian population. This paper is a review of esophageal cancer epidemiology and survival among esophageal cancer patients from data collected by the Malaysian Upper Gastrointestinal Surgical Society.. This is a multicenter retrospective observational study of esophageal cancer patients from six upper gastrointestinal surgical centers in Malaysia between 2005 and 2019. Patient characteristics, histological type and stage were compared and survival analyzed.. There were 820 patients with esophageal cancer included, where 442 (53.9 %) cases had squamous cell carcinoma (SCC) and 378 (46.1 %) had adenocarcinomas (AC). Malays were the predominant ethnicity with AC (66.7 %) while Indians were the ethnic majority (74.6 %) with SCC. Majority of patients (56.8 %) presented as stage IV disease. Overall, the 1-, 3-, and 5-years' survival were 35.8 %, 13.8 % and 11.0 %, respectively. Surgical resection with curative intent yielded the best 5-year survival (29.4 %). Intervention in stage IV AC yielded superior survival when compared to SCC (median survival, 7.9 months vs 4.8 months; p, 0.018) Our series demonstrated an increase in AC to SCC over the last 15 years.. There was an ethnic preponderance seen between different histology in this region, not previously discussed. An increase in AC was observed over the last 15 years. Late diagnosis seen in most patients imparts poor prognosis as curative surgery affords the best outcome.

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Humans; Malaysia; Multicenter Studies as Topic; Observational Studies as Topic

Esophagogastric junction (EGJ) adenocarcinoma has been on the increase in Western countries. However, in Asian countries, data on the incidence of EGJ adenocarcinoma are evidently lacking. In the present review, we focus on the current clinical situation of EGJ adenocarcinoma in three Asian countries: Japan, Hong Kong, and Malaysia. The incidence of EGJ adenocarcinoma has been reported to be gradually increasing in Malaysia and Japan, whereas it has stabilized in Hong Kong. However, the number of cases in these countries is comparatively low compared with Western countries. A reason for the reported difference in the incidence and time trend of EGJ adenocarcinoma among the three countries may be explained by two distinct etiologies: one arising from chronic gastritis similar to distal gastric cancer, and the other related to gastroesophageal reflux disease similar to esophageal adenocarcinoma including Barrett's adenocarcinoma. This review also shows that there are several concerns in clinical practice for EGJ adenocarcinoma. In Hong Kong and Malaysia, many EGJ adenocarcinomas have been detected at a stage not amenable to endoscopic resection. In Japan, histological curability criteria for endoscopic resection cases have not been established. We suggest that an international collaborative study using the same definition of EGJ adenocarcinoma may be helpful not only for clarifying the characteristics of these cancers but also for improving the clinical outcome of these patients.

Topics: Adenocarcinoma; Esophageal Neoplasms; Esophagogastric Junction; Hong Kong; Humans; Incidence; Japan; Malaysia

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Retrospective Studies; Tuberculosis, Pulmonary

In the global phase 3 RAINBOW study, ramucirumab plus paclitaxel significantly improved overall survival compared with placebo plus paclitaxel in patients with advanced gastric or gastro-oesophageal junction (GEJ) adenocarcinoma. RAINBOW-Asia, a bridging study with similar design to RAINBOW, aimed to evaluate the efficacy and safety of ramucirumab plus paclitaxel for advanced gastric or GEJ adenocarcinoma in Asian, predominantly Chinese, patients.. RAINBOW-Asia was a randomised, double-blind, placebo-controlled, phase 3 trial done at 32 centres in China, Malaysia, the Philippines, and Thailand. Adult patients (≥18 years) with metastatic or locally advanced, unresectable gastric or GEJ adenocarcinoma who previously received fluoropyrimidine-platinum-based chemotherapy were randomly assigned with a centralised interactive web response system in a 2:1 ratio to receive ramucirumab 8 mg/kg or placebo intravenously on days 1 and 15 plus paclitaxel 80 mg/m. Between March 2, 2017, and June 30, 2020, 440 patients were randomly assigned to receive ramucirumab plus paclitaxel (n=294) or placebo plus paclitaxel (n=146). Median progression-free survival was 4·14 months (95% CI 3·71-4·30) in the ramucirumab plus paclitaxel group compared with 3·15 months (2·83-4·14) in the placebo plus paclitaxel group (hazard ratio [HR] 0·765, 95% CI 0·613-0·955, p=0·0184). Median overall survival was 8·71 months (95% CI 7·98-9·49) in the ramucirumab plus paclitaxel group and 7·92 months (6·31-9·10) in the placebo plus paclitaxel group (HR 0·963, 95% CI 0·771-1·203, p=0·7426). The most common grade 3 or worse treatment-emergent adverse events were decreased neutrophil count (159 [54%] of 293 patients in the ramucirumab plus paclitaxel group vs 56 [39%] of 145 in the placebo plus paclitaxel group), decreased white blood cell count (127 [43%] vs 42 [29%]), anaemia (46 [16%] vs 24 [17%]), hypertension (21 [7%] vs nine [6%]), and febrile neutropenia (18 [6%] vs one [<1%]).. These findings, along with the results from RAINBOW, support the use of ramucirumab plus paclitaxel as second-line therapy in a predominantly Chinese population with advanced gastric or GEJ adenocarcinoma.. Eli Lilly and Company, USA.. For the Chinese translation of the abstract see Supplementary Materials section.

Topics: Adenocarcinoma; Administration, Intravenous; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Case-Control Studies; China; Double-Blind Method; Esophageal Neoplasms; Esophagogastric Junction; Female; Humans; Malaysia; Male; Middle Aged; Paclitaxel; Philippines; Placebos; Progression-Free Survival; Ramucirumab; Safety; Stomach Neoplasms; Thailand; Treatment Outcome; Vascular Endothelial Growth Factor Receptor-2

To determine the clinicopathological features of bladder tumours encountered over a five year period in Universiti Kebangsaan Malaysia Medical Centre.. Medical records of bladder tumour cases from 2005 till 2009 were retrospectively reviewed and tabulated.. A total of 83 cases were recorded. The incidence was highest among the Chinese (56.6%), followed by Malays (34.9%), Indians (6%) and other races (2.4%). The male-to-female ratio was 9.4:1. The median age was 65 years (range 30-91 years) and median duration of follow up was 17.2 months (range 2-60 months). The main histopathology was transitional cell carcinoma (TCC) (90.4%), followed by adenocarcinoma (6%), squamous cell carcinoma (1.2%), leiomyoma (1.2%) and myeloid sarcoma (1.2%). For the TCCs, 58.6% were superficial while 41.4% were muscle invasive, and 13.3% had nodal metastasis with distant metastasis in 8%. Of the total, 5.3% were papillary urothelial tumours of low malignant potential, 33.3% pTa, 20% pT1, 10.7% pT2, 12.0% pT3 and 18.7% pT4. Of the superficial tumours, 32.5% were high grade tumours. There were ten radical cystectomies performed for transitional cell carcinomas; two had neobladder reconstruction whereas the other eight had ileal conduits. All the adenocarcinomas and squamous cell carcinomas were treated by radiotherapy due to the advanced stage of the disease while the myeloid sarcoma received chemotherapy. Mean survival of patients with muscle invasive cancer was 33+/-5 months. By the end of the study, 18.1% of patients had died of their cancer.. The incidence of bladder tumours is highest among the Chinese. When compared to other studies, the incidence of muscle invasive and high-grade superficial tumours was greater.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Female; Humans; Lymphatic Metastasis; Malaysia; Male; Middle Aged; Neoplasm Staging; Retrospective Studies; Survival Rate; Urinary Bladder Neoplasms

Ultrasound guided lung biopsy (USLB) is a minimally invasive diagnostic tool with short examination time and real-time monitoring conducted bedside for accurate diagnosis in order to provide the best treatment. However, it is not widely performed by pulmonologists. We aim to explicate the efficacy and safety of USLB led by pulmonologists. The objective of this study is to assess safety and efficacy of USLB performed by pulmonologists in an outpatient setting.. We retrospectively enrolled patients who underwent the procedure from January 2018 to April 2022. Under real time ultrasound (Hitachi Medical ProSound F37), thoracic lesions adjacent to the chest wall were sampled with a full-core biopsy needle (CT Core Single Action Biopsy Device, 18G × 15 cm, Vigeo, Italy). Chest x-ray was performed 30 minutes post procedure ruling out pneumothorax. Patients were discharged home 1-2 hours post biopsy. Data was analysed using Microsoft Excel 2010 and Statistical Package for Social Science (SPSS) Version 26.. A total of 18 patients (14 males, 4 females) underwent USLB for lung tumours. Biopsies were histologically deemed adequate with an overall diagnostic yield of 77.8% (14/18). A total of 57% were positive for thoracic malignancy (21% squamous cell carcinoma, 21% adenocarcinoma, 15% small cell carcinoma) and another 43% were positive for extra thoracic malignancy (1 hepatocellular carcinoma, 2 DLBCL, 1 Hodgkin's lymphoma, 1 seminoma, 1 thymoma). Four patients had inconclusive results but managed to get positive results from surgical or lymph node biopsy (thymoma and adenocarcinoma). Statistical analysis showed more than two passes are needed to achieve a positive HPE yield (p value<0.05). There were nil complications to all the cases done.. USLB can safely and effectively be performed by trained pulmonologists with excellent accuracy and low complication rate in outpatients.

Topics: Adenocarcinoma; Female; Humans; Image-Guided Biopsy; Lung; Lung Neoplasms; Malaysia; Male; Pulmonologists; Retrospective Studies; Thoracic Neoplasms; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed; Ultrasonography, Interventional

Malaysia is an ethnically diverse nation, comprising Malay, Chinese, Indian and indigenous groups. However, epidemiological studies on colorectal cancer have mainly focused on the three main ethnic groups. There is evidence that the clinico-pathological characteristics of some cancers may differ in indigenous populations, namely that they occur earlier and behave more aggressively. We aimed to determine if there were similar differences in colorectal cancer, focusing on the indigenous populations of Sabah.. Histopathological reports of all patients diagnosed with colorectal carcinoma from January 2012 to December 2016 from public hospitals in Sabah were retrieved from the central computerized database of the Pathology Department of Queen Elizabeth Hospital in Kota Kinabalu, Sabah. Supplementary data was obtained from patients' case files from each hospital. Clinico-pathological data were analysed using the IBM SPSS Statistical Software Version 23 for Windows for descriptive statistics (mean, median, ASR, AR, relative risk) and inferential statistics (Chi square test).. A total of 696 patients met the inclusion criteria. The median age for colorectal cancer in Sabah was 62 years (95% CI 60.3 to 62.3), with an age specific incidence rate of 21.4 per 100 000 population. The age specific incidence rate in the indigenous populations was 26.6 per 100 000, much lower than the Chinese, at 65.0 per 100 000. The risk of colorectal cancer occurring before the age of 50 was three times higher in the indigenous population compared to the Chinese. The tumours were mainly left-sided (56.5%), adenocarcinoma in histology (98.4%) and moderately differentiated (88.7%). Approximately 79.2% of patients received curative treatment.. Indigenous populations in Sabah develop colorectal cancer at an earlier age, and present at more advanced stages. This has implications for screening and therapeutic strategic planning. 
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Topics: Adenocarcinoma; Adult; Age Distribution; Aged; Asian People; Colorectal Neoplasms; Female; Humans; Incidence; Indigenous Peoples; Malaysia; Male; Middle Aged; Neoplasm Staging

Topics: Adenocarcinoma; Feasibility Studies; Female; Gastrectomy; Humans; Incidence; Laparoscopy; Malaysia; Male; Retrospective Studies; Safety; Stomach Neoplasms; Survival Rate

Background: Cervical cancer is a preventable disease caused by human papillomaviruses. It is the third most\ common cancer to occur in women of reproductive age. The ADAM9 protein plays a role in basement membrane\ degradation and tumour metastasis in certain types of tumour. Thus, it has the potential to become a new targeted\ therapy. The objective of this study was to investigate ADAM9 expression in cervical cancer and to determine the\ factors associated with ADAM9-positive expression. Methods: This cross-sectional study was conducted in Hospital\ Universiti Sains Malaysia (HUSM) Kelantan, Malaysia from December 2010 to December 2012. Histological slides\ obtained from 95 cervical cancer cases diagnosed and/or treated in HUSM from 2000 to 2010 were analysed. The\ ADAM9 immunostain was then performed on the paraffin blocks. The statistical data entry and analysis were done\ using SPSS version 18.0. Multiple logistic regression analysis was performed to determine the factors associated with\ ADAM9-positive expression. Result: Of the 95 cervical cancer patients included in the study, 72 (75.8%) patients showed\ positive ADAM9 expression. The mean age of the patients was 53.89 (10.83) years old. Squamous cell carcinoma was\ the most common type of cervical cancer (n = 67, 70.5%). Factors that showed a statistically significant association\ with ADAM9-positive expression were tumour size (adjusted odds ratio [adj. OR]: 1.08; 95% confidence interval\ [CI]: 1.02, 1.13; p = 0.004), distant metastasis (adj. OR: 12.82; 95% CI: 1.91, 86.13; p = 0.009) and the histological\ type of cervical cancer (i.e. squamous cell carcinoma) (adj. OR: 7.39; 95% CI: 1.42, 38.51; p = 0.017). Conclusion:\ The ADAM9 immunostain was consistently positive in malignant cells. Thus, ADAM9 expression can be used as a\ prognostic/therapeutic indicator in aiding clinician decision-making regarding patient treatment (targeted therapy).

Topics: ADAM Proteins; Adenocarcinoma; Biomarkers, Tumor; Carcinoma, Squamous Cell; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Malaysia; Membrane Proteins; Middle Aged; Prognosis; Uterine Cervical Neoplasms

To evaluate the expression of estrogen receptor (ER)-beta and Ki67 in prostate cancer and study their relationship.. We analyzed 101 cases of prostate adenocarcinoma diagnosed from January 2011 to June 2015 in 100 patients. Immunohistochemical staining of ER-beta and Ki67 was analyzed according to Gleason score categorized into prognostic groups of 1 to 5. Double-immunofluorescent staining of ER-beta and Ki67 was performed in a total of 20 cases to study the co-expression and the relationship between these markers within the same tumor.. A total of 53 of 101 cases (52.5%) were positive for ER-beta expression. There was a positive correlation whereby a high percentage of ER-beta expression was seen in the higher prognostic groups (groups 4 and 5; p=0.007). High Ki67 expression was observed in the higher prognostic group, whereas low Ki67 or negative expression was found in the lower prognostic group (p<0.001). The majority of cases evaluated with double-immunofluorescent staining (14/20) showed co-expression of ER-beta and Ki67 at the individual cell level.. ER-beta and Ki67 are independent tumor markers in high prognostic groups. Hence, co-expression of ER-beta and Ki67 indicates a more aggressive tumor with a poorer prognosis.

Topics: Adenocarcinoma; Aged; Biomarkers, Tumor; Estrogen Receptor beta; Humans; Immunohistochemistry; Ki-67 Antigen; Malaysia; Male; Neoplasm Grading; Prognosis; Prostatic Neoplasms

Prostate cancer is a heterogenous disease and the mechanisms that drive it to behave differently are not well understood. Tumour expression of the ERG oncogene occurs in the majority of patients with prostate cancer in Western studies. This is considered to be oncogenic as ERG acts as a transcription factor to regulate genes involved in tumour proliferation and invasion. In this study we investigated expression of ERG in Malaysian men with prostate cancer.. Tissues were collected from 80 patients with clinically detected prostate cancer and treated with radical prostatectomy. Cases were tested for ERG by immunohistochemistry using the mouse monoclonal antibody EP111. All blocks on 48 cases were tested in order to determine the extent of heterogeneity of ERG expression within individual cases. ERG expression was analysed in relation to patient age, ethnicity and tumour stage and grade.. Forty-six percent of cases were ERG positive. There was no significant association between ERG and tumour grade or stage. Sixty-nine percent of Indian patients had ERG positive tumours; this was significantly higher (p=0.031) than for Chinese (40%) and Malay (44%) patients. Heterogeneity of ERG expression, in which both positive and negative clones were present, was seen in 35% of evaluated cases. Evaluation by tumour foci showed younger patients had more ERG positive tumour foci than older patients (p=0.01). Indian patients were more likely to have the majority of tumour foci with ERG staining positively, compared to either Chinese or Malay patients (P <0.01).. In this study, tumour expression of ERG was more likely to occur in patients of Indian ethnicity.

Topics: Adenocarcinoma; Aged; Biomarkers, Tumor; Humans; Malaysia; Male; Middle Aged; Prostatic Neoplasms; Transcriptional Regulator ERG

The multiracial population in Malaysia has lived together for almost a century, however, the risk of gastric cancer among them varies. This study aimed to determine the distribution of different gastric adenocarcinoma subtypes and Helicobacter pylori infection status among gastric adenocarcinoma patients. Patients with gastric adenocarcinoma were enrolled from November 2013 to June 2015. Blood samples were collected for detection of H. pylori using ELISA method. Gastric adenocarcinoma cases were more prevalent in the Chinese (52.8%), followed by the Malays (41.7%) and least prevalent in the Indians (5.6%). Gastric adenocarcinoma located in the cardia was significantly more prevalent in the Malays (66.7%) compared to the Chinese (26.3%), whereas non-cardia cancer was diagnosed more in the Chinese (73.7%) compared to the Malays (33.3%) [P = 0.019; OR = 5.6, 95 CI: 1.27 to 24.64]. The Malays also had significantly higher prevalence of gastric tumour located at the cardia or fundus than other gastric sites compared to the Chinese (P = 0.002; OR: 11.2, 95% CI: 2.2 to 56.9). Among the cardia gastric cancer patients, 55.6% of the Malays showed intestinal histological subtype, whereas all the Chinese had the diffuse subtype. More than half of the patients (55.3%) with gastric adenocarcinoma were positive for H. pylori infection and among them, 66.7% were Chinese patients. The risk of gastric adenocarcinoma in our population is different among ethnicities. Further studies on host factors are needed as it might play an important role in gastric cancer susceptibility in our population.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Female; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged; Stomach Neoplasms

Adjuvant chemotherapy improves survival in Dukes C colon cancers post-curative resection. However, the evidence for a role with Dukes B lesions remains unproven despite frequent use for disease characterized by poor prognostic features. In view of limited Asia-specific data, this study aimed to determine survival outcomes and identify prognostic factors in a tertiary teaching hospital in Malaysia.. A total of 116 subjects who underwent curative surgery with and without adjuvant chemotherapy for Duke B and C primary colon adenocarcinomas diagnosed from 2004-2009 were recruited and data were collected retrospectively. Five-year overall survival (OS) and disease free survival (DFS) were analysed using Kaplan-Meier survival analysis and log-rank (Mantel-Cox) test. Prognostic factors were determined using Cox proportional hazards regression with both univariate and multivariate analyses.. The survival analysis demonstrated a 5-year OS of 74.0% for all patients, with 74.9% for Dukes C subjects receiving chemotherapy compared to 28.6% in those not receiving chemotherapy (p=0.001). For Dukes B disease, the 5-year survival rate was 82.6% compared to 75.0% for subjects receiving and not receiving chemotherapy, respectively (p=0.17). Independent prognostic factors identified included a CEA level more than 3.5 ng/ml (hazard ratio (HR)=4.78; p=0.008), serosal involvement (HR=3.75; p=0.028) and completion of chemotherapy (HR= 0.20; p=0.007).. In a regional context, this study supports current evidence from the West that adjuvant chemotherapy improves survival in Dukes C colon cancers post curative surgery. However, although a clear benefit has yet to be proven for Dukes B disease, our results suggest survival improvement in selected cases.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Capecitabine; Chemotherapy, Adjuvant; Colonic Neoplasms; Female; Fluorouracil; Follow-Up Studies; Humans; Irinotecan; Leucovorin; Lymphatic Metastasis; Malaysia; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Organoplatinum Compounds; Oxaliplatin; Postoperative Period; Prognosis; Retrospective Studies; Survival Rate; Young Adult

Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence is increasing. CRC is more common with increasing age, but a proportion occurs in young adults, termed young CRC. This study assessed the incidence and the demographic of young CRC in Brunei Darussalam.. All histologically proven CRC between 1986 and 2014 registered with the Department of Pathology cancer registry were reviewed and data extracted for analyses. Young CRC was defined as cancer in patients aged less than 45 years. The various population groups were categorized into locals (Malays, Chinese and Indigenous) and expatriates.. Over the study period, there were 1,126 histologically proven CRC (mean age 59.1 ± 14.7 years, Male 58.0%, Locals 91.8% and 8.2% expatriates). Young CRC accounted for 15.1% with the proportion declining over the years, from 29% (1986-1990) to 13.2% (2011-2014). The proportion of young CRC was highest among the indigenous (30.8%), followed by the expatriates (29.3%), Malays (14.3%) and lowest among the Chinese (10.8%). The mean age of young CRC was 35.9 ± 6.2; lowest among the indigenous (33.5 ± 6.7), expatriate (34.9 ± 6.0) groupd and the Malays (35.6 ± 6.5) compared to the Chinese (38.6 ± 4.6), a similar trend being observed in the non-young CRC groups. There were no difference between the genders and tumor locations (rectum or colon) between the young and the non-young CRC cases. Female young CRC was significantly younger than male (p<0.05) without any significant variation between the various population groups (p>0.05).. Our study showed that the young CRC accounted for 15.1% of all CRC with declining trend observed over recent years. Young CRC was more common among indigenous, expatriates and Malays and least common among the Chinese. There were no differences in the gender and tumor locations.

Topics: Adenocarcinoma; Adult; Age Distribution; Aged; Brunei; China; Cohort Studies; Colonic Neoplasms; Colorectal Neoplasms; Emigrants and Immigrants; Female; Humans; Incidence; Lymphoma; Malaysia; Male; Middle Aged; Neuroendocrine Tumors; Rectal Neoplasms; Retrospective Studies; Sex Distribution

Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma.. A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presented with lower extremity edema and progressive fatigue of 1 month's duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma.. This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.

Topics: Adenocarcinoma; Anemia, Iron-Deficiency; Antineoplastic Combined Chemotherapy Protocols; Budd-Chiari Syndrome; Disease Progression; Edema; Endoscopy, Gastrointestinal; Fatigue; Female; Humans; Lower Extremity; Malaysia; Middle Aged; Neoplasm Staging; Paclitaxel; Stomach Neoplasms; Syndrome; Tomography, X-Ray Computed; Trastuzumab; Treatment Outcome; Vena Cava, Inferior

Mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) in non- small cell lung cancer (NSCLC) are predictive of response to EGFR-targeted therapy in advanced stages of disease. This study aimed to determine the frequency of EGFR mutations in NSCLCs and to correlate their presence with clinical characteristics in multiethnic Malaysian patients.. In this prospective study, EGFR mutations in exons 18, 19, 20 and 21 in formalin-fixed paraffin-embedded biopsy specimens of consecutive NSCLC patients were asessed by real-time polymerase chain reaction.. EGFR mutations were detected in NSCLCs from 55 (36.4%) of a total of 151 patients, being significantly more common in females (62.5%) than in males (17.2%) [odds ratio (OR), 8.00; 95% confidence interval (CI), 3.77-16.98; p<0.001] and in never smokers (62.5%) than in ever smokers (12.7%) (OR, 11.50; 95%CI, 5.08-26.03; p<0.001). Mutations were more common in adenocarcinoma (39.4%) compared to non-adenocarcinoma NSCLCs (15.8%) (p=0.072). The mutation rates in patients of different ethnicities were not significantly different (p=0.08). Never smoking status was the only clinical feature that independently predicted the presence of EGFR mutations (adjusted OR, 5.94; 95%CI, 1.94- 18.17; p=0.002).. In Malaysian patients with NSCLC, the EGFR mutation rate was similar to that in other Asian populations. EGFR mutations were significantly more common in female patients and in never smokers. Never smoking status was the only independent predictor for the presence of EGFR mutations.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Asian People; Carcinoma, Non-Small-Cell Lung; ErbB Receptors; Exons; Female; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Mutation; Mutation Rate; Prospective Studies; Sex Factors; Smoking

Cervical cancer is the third commonest type of cancer among women in Malaysia. Our aim was to determine the distribution of human papilloma virus (HPV) genotypes in cervical cancer in our multi-ethnic population.. This was a multicentre study with a total of 280 cases of cervical cancer from 4 referral centres in Malaysia, studied using real-time polymerase chain reaction (qPCR) detection of 12 high risk-HPV genotypes.. Overall HPV was detected in 92.5% of cases, in 95.9% of squamous cell carcinomas and 84.3%of adenocarcinomas. The five most prevalent high-risk HPV genotypes were HPV 16 (68.2%), 18 (40%), 58 (10.7%), 33 (10.4%) and 52 (10.4%). Multiple HPV infections were more prevalent (55.7%) than single HPV infections (36.8%). The percentage of HPV positive cases in Chinese, Malays and Indians were 95.5%, 91.9% and 80.0%, respectively. HPV 16 and 18 genotypes were the commonest in all ethnic groups. We found that the percentage of HPV 16 infection was significantly higher in Chinese (75.9%) compared to Malays (63.7%) and Indians (52.0%) (p<0.05), while HPV 18 was significantly higher in Malays (52.6%) compared to Chinese (25.0%) and Indians (28%) (p<0.05). Meanwhile, HPV 33 (17.9%) and 52 (15.2%) were also more commonly detected in the Chinese (p<0.05).. This study showed that the distribution of HPV genotype in Malaysia is similar to other Asian countries. Importantly, we found that different ethnic groups in Malaysia have different HPV genotype infection rates, which is a point to consider during the implementation of HPV vaccination.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; DNA, Viral; Ethnicity; Female; Follow-Up Studies; Genotype; Humans; Malaysia; Middle Aged; Neoplasm Staging; Papillomaviridae; Papillomavirus Infections; Polymerase Chain Reaction; Prevalence; Prognosis; Retrospective Studies; Risk Factors; Uterine Cervical Neoplasms

To characterise the mRNA expression patterns of early and advanced stage colorectal adenocarcinomas of Malaysian patients.. Comparative expression analysis.. We performed a combination of annealing control primer (ACP)-based PCR and reverse transcription-quantitative real-time PCR for the identification of differentially expressed genes (DEGs) associated with early and advanced stage primary colorectal tumours. We recruited four paired samples from patients with colorectal cancer (CRC) of Dukes' A and B for the preliminary differential expression study, and a total of 27 paired samples, ranging from CRC stages I to IV, for subsequent confirmatory test. The tumouric samples were obtained from the patients with CRC undergoing curative surgical resection without preoperative chemoradiotherapy. The recruited patients with CRC were newly diagnosed with CRC, and were not associated with any hereditary syndromes, previously diagnosed cancer or positive family history of CRC. The paired non-cancerous tissue specimens were excised from macroscopically normal colonic mucosa distally located from the colorectal tumours.. The differential mRNA expression patterns of early and advanced stage colorectal adenocarcinomas compared with macroscopically normal colonic mucosa were characterised by ACP-based PCR and reverse transcription-quantitative real-time PCR.. The RPL35, RPS23 and TIMP1 genes were found to be overexpressed in both early and advanced stage colorectal adenocarcinomas (p<0.05). However, the ARPC2 gene was significantly underexpressed in early colorectal adenocarcinomas, while the advanced stage primary colorectal tumours exhibited an additional overexpression of the C6orf173 gene (p<0.05).. We characterised two distinctive gene expression patterns to aid in the stratification of primary colorectal neoplasms among Malaysian patients with CRC. Further work can be done to assess and compare the mRNA expression levels of these identified DEGs between each CRC stage group, stages I-IV.

Topics: Adenocarcinoma; Colorectal Neoplasms; Gene Expression; Humans; Malaysia; Neoplasm Staging; Real-Time Polymerase Chain Reaction; RNA, Messenger; Severity of Illness Index

Despite available data from other Asian countries, the prevalence of epidermal growth factor receptor (EGFR) mutations among lung adenocarcinoma patients has not been reported in Malaysia. This study sought to determine the frequency of EGFR mutations among multiethnic Malaysian patients diagnosed with lung adenocarcinoma.. Demographic and clinical information of patients whose lung adenocarcinoma biopsy specimens were submitted for EGFR mutation testing at Sime Darby Medical Center from 2009 to 2011 were analyzed. EGFR mutations at exons 18, 19, 20, and 21 were detected either through bidirectional sequencing or real-time polymerase chain reaction.. Among 812 patients in the study, 49% were female, 63.7% were ethnic Chinese, 29.4% Malay, 4.8% Indian, and 2.1% other ethnic groups. Mutations were present in the tumors of 321 patients (39.5%), with mutations at exons 19 (23.5%) and 21 (14.9%) being the most common. Mutations were significantly more frequent among women than in men (52.5% versus 27.8%, p < 0.001). Although mutations were more common among Chinese (40.8%) compared with Malay (37.2%) or Indian (33.3%) patients, the difference was not statistically significant (p = 0.591). Of 211 patients with smoking history records, never-smokers had a higher mutation rate compared with ever-smokers (54.8% versus 20.7%, p < 0.001).. EGFR mutations were present in 39.5% of patients. Mutations were more common in women and never-smokers with no differences in mutation frequency between different ethnicities. Because of the high mutation rates, reflex testing for EGFR mutation should be a routine practice for advanced lung adenocarcinoma patients in Malaysia.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; ErbB Receptors; Female; Follow-Up Studies; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Mutation; Mutation Rate; Neoplasm Staging; Polymerase Chain Reaction; Prevalence; Prognosis; Smoking

Most gallbladder carcinoma cases are suspected pre-operatively or intra-operatively. In Malaysia histopathological examination of cholecystectomy specimens has become routine practice. The aim of this study was to assess the impact of routine histological examinations on cholecystectomy specimens from an Asian demographic, which may differ from a Caucasian demographic.. A retrospective study was performed of all histopathology reports for cholecystectomies (laparoscopic and open) undertaken over a period of 12 years (1997-2008) in a single teaching hospital.. A total of 1,375 gallbladder specimens were sent for histopathological analysis, with 7 (0.5%) being reported as malignant while only three (0.2%) were found to contain primary gallbladder carcinoma. Other premalignant findings included two specimens with dysplastic changes of the mucosa and one tubulovillous adenoma with a dysplastic epithelium. From the ten malignant and premalignant specimens, seven were diagnosed pre-operatively, two were suspected intra-operatively and one was diagnosed with dysplastic changes on the histopathology report post-operatively.. This study supports earlier research carried out in the UK and the demographic difference does not affect the impact of the histology examination on cholecystectomy specimens in diagnosing this disease. A selective policy is recommended in Malaysia.

Topics: Adenocarcinoma; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Asian People; Child; Cholecystectomy; Cholecystitis; Cholecystitis, Acute; Chronic Disease; Female; Gallbladder Neoplasms; Humans; Malaysia; Male; Middle Aged; Postoperative Care; Preoperative Care; Referral and Consultation; Retrospective Studies; Tomography, X-Ray Computed; Young Adult

To evaluate the response and progression-free survival (PFS) of Malaysian patients with advanced lung adenocarcinoma and unknown epidermal growth factor receptor (EGFR) mutation status treated with gefitinib.. A retrospective analysis of consecutive patients with EGFR mutation unknown stage III or IV lung adenocarcinoma with EGFR mutation unknown treated with gefitinib until disease progression.. Of 71 patients, none had complete response while 26 (36.6%) had partial response and 26 (36.6%) had stable disease. Multivariate analysis showed the independent predictor of response to gefitinib was Eastern Cooperative Oncology Group (ECOG) performance status 1 (odds ratio [OR] 5.39, 95% confidence interval [CI 1.64-17.74]P = 0.006). The median PFS was 6.5 months and was significantly longer in female than male patients (39.0 vs 21.2 weeks; P < 0.001), never smokers vs smokers (32.3 vs 8.3 weeks, P = 0.001), and stage III versus stage IV disease (44 vs 24 weeks, P = 0.021). In a multivariate Cox proportional hazards model with age group, gender, ethnicity, smoking history, disease stage, ECOG performance status and prior cytotoxic chemotherapy as covariates, the independent predictors of longer median PFS were female gender (HR 95% CI 0.38 [0.22-0.66]; P < 0.001) and stage III disease (HR 95% CI 0.54 [0.30-0.98], P = 0.042).. In our patients with EGFR mutation unknown advanced lung adenocarcinoma treated with gefitinib, the response rate was 36.6% and the median PFS was significantly longer in female patients, never smokers and patients with stage III disease.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Disease-Free Survival; ErbB Receptors; Gefitinib; Humans; Lung Neoplasms; Malaysia; Middle Aged; Protein Kinase Inhibitors; Quinazolines; Retrospective Studies

To assess the diagnostic potential of tumor-associated high molecular weight DNA in stool samples of 32 colorectal cancer (CRC) patients compared to 32 healthy Malaysian volunteers by means of polymerase chain reaction (PCR).. Stool DNA was isolated and tumor-associated high molecular weight DNA (1.476 kb fragment including exons 6-9 of the p53 gene) was amplified using PCR and visualized on ethidium bromide-stained agarose gels.. Out of 32 CRC patients, 18 were positive for the presence of high molecular weight DNA as compared to none of the healthy individuals, resulting in an overall sensitivity of 56.3% with 100% specificity. Out of 32 patients, 23 had tumor on the left side and 9 on the right side, 16 and 2 being respectively positive. This showed that high molecular weight DNA was significantly (p=0.022) more detectable in patients with left side tumor (69.6% vs 22.2%). Out of 32 patients, 22 had tumors larger than 1.0 cm, 18 of these (81.8%) being positive for long DNA as compared to not a single patient with tumor size smaller than 1.0 cm (p<0.001).. We detected CRC-related high molecular weight p53 DNA in stool samples of CRC patients with an overall sensitivity of 56.3% with 100% specificity, with a strong tumor size dependence.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Colorectal Neoplasms; DNA, Neoplasm; Feces; Female; Genetic Testing; Humans; Malaysia; Male; Middle Aged; Neoplasm Staging; Pilot Projects; Polymerase Chain Reaction; Prognosis; Sensitivity and Specificity

Esophageal cancer (ECA) is an important cancer in Malaysia. The aim of the study is to review the demographic data and clinical presentation of patients with ECA seen at the University of Malaya Medical Centre, Kuala Lumpur.. Patients with histologically proven ECA were recruited for the study. Patients' case notes, endoscopy and operating theater records were reviewed. All cases were histologically confirmed.. A total of 143 patients with ECA was diagnosed between 1998 and 2003. The mean age of the patients was 63.1 +/- 12.1 years with a male : female ratio of 1.8:1. Of these 50.3 percent were Indians, 32.9 percent, Chinese and 16.8 percent Malays. The overall hospital-based prevalence rates per 100 000 admissions according to races were: Malay; 23.5, Chinese; 57.4 and Indian; 134.1. The location of the tumors was: upper; 16 (11.2%) middle; 52 (36.4%) and lower; 75 (52.4%). The histological type of ECA were: squamous cell carcinomas; 113 (79.0%) and adenocarcinomas; 30 (21.0%). The ECA stage at diagnosis, was: II; 18 (12.6%), III; 23 (16.1%) and IV; 102 (71.3%). Only 24 (16.8%) patients underwent surgery and13 (9.1%) were considered curative. Overall 114 (79.7%) patients underwent palliative endoscopic stenting and six (4.2%) were given other palliative therapy including radiotherapy.. Squamous cell cancer was the predominant type. ECA presents late in our patients and only a minority of patients underwent curative surgery.

Topics: Academic Medical Centers; Adenocarcinoma; Aged; Asian People; Carcinoma, Squamous Cell; Delayed Diagnosis; Esophageal Neoplasms; Female; Humans; Malaysia; Male; Middle Aged; Neoplasm Staging; Prevalence; Retrospective Studies; Risk Factors; Smoking

Colorectal cancer (CRC) is the second most common cause of cancer mortality among men and women worldwide; the risk of its occurrence has been shown to be increased by chronic bacterial infections. A case control study was therefore carried out at Hospital Universiti Sains Malaysia (HUSM) to determine the incidence of colorectal cancer associated with S. bovis infection. A total of 166 stool specimens were collected from diseased patients and healthy individuals and S. bovis isolates were identified. Suspected colon tumor and cancer cases were diagnosed and confirmed. It was found that overall prevalence of S. bovis was 41 (24.7%) out of 166 cases studied. Some 41(48.6%) of these S. bovis isolates was found in patients with colonic polyps, adenocarcinomas, inflammatory bowel disease (IBD) and chronic gastrointestinal tract (GIT). It was also found that colorectal cancer incidence was 24.7%, adenocarinomas accounting for 51% with the highest incidence in the sigmoid part of the colon. Among the IBD and chronic GIT cases, ulcerative colitis featured in the majority of cases (41.4%). In conclusion, there is a high incidence of colorectal cancer associated with S. bovis.

Topics: Adenocarcinoma; Adult; Case-Control Studies; Chronic Disease; Colorectal Neoplasms; Female; Gastrointestinal Diseases; Humans; Incidence; Inflammatory Bowel Diseases; Malaysia; Male; Prevalence; Prognosis; Risk Factors; Streptococcal Infections; Streptococcus bovis

The objective of this study was to determine the histopathological features and cell morphology of various cervical lesions observed among Malaysian women.. A retrospective study was conducted to evaluate 77 cervical cases collected from the histopathology laboratory of Ipoh hospital from 1st January, 2005, to 31st December, 2006.. Cervical intraepithelial neoplasia (CIN) was found in 33 (42%) cases, CIN III accounting for 27%, and CIN I, CIN II and CIN II-III 5% each. The highest rate for CIN cases was 43% in the 41-50 year age group and the lowest rate was 6% in the group aged 61-70 years. Non-keratinizing and metastatic squamous cell carcinomas (SCCs) accounted for 16% and 13%, respectively, the combination being second in majority (29%), followed by adenocarcinoma (17%). The histopathological results showed CIN I to be characterized by mild papillary projections of the epithelium with some degree of nuclear enlargement, pleomorphism, mild koilocytosis, bionucleated cells and a low nucleo-cytoplasmic ratio. CIN II demonstrated typical squamous epithelium with disorganization of the lower part of the epithelium accompanied by nuclear hyperchromatism, an increased nucleo-cytoplasmic ratio, and scanty mitotic figures. CIN III was characterized by pleomorphic nuclei, atypical cells with mitotic figures, nucleo-cytoplasmic ratio, anisokaryosis and hyperchromasia.. Lesions related to cervical cancer showed tumor progression correlating with histopathological changes in cell morphology.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Disease Progression; Female; Humans; Malaysia; Middle Aged; Retrospective Studies; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

A comparison of patients with lung cancer diagnosed at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia from October 1991 to September 1999 with another group of lung cancer patients diagnosed at the same hospital during an earlier period of 1967-1976 was undertaken to determine whether there had been a change in the distribution of lung cancer cell types and patient demography. The number of histologically and/or cytologically proven lung cancer cases was 583 from October 1991 to September 1999 and 278 from 1967 to 1976. The mean (S.D.) age of the patients during the period 1991-1999, 60.1 (12.0) years was similar to that of patients during the period 1967-1976, 60.3 (12.2) years. There was no shift of the peak age distribution of lung cancer (i.e., the 7th decade) between the two periods. In the recent period, the percentage of patients with adenocarcinoma had increased significantly to 43.2% from 25.2% while that of large cell carcinoma had decreased to 3.3% from 11.9%. The percentages of patients with squamous cell carcinoma (SCC) and small cell lung cancer remained stable. In the period 1967-1976, SCC was the commonest cell type in men and in smokers while adenocarcinoma was the commonest cell type in women and in never smokers. In the period 1991-1999, adenocarcinoma was the commonest cell type in both men and women as well as in smokers and never smokers.

Topics: Adenocarcinoma; Adult; Age Distribution; Aged; Aged, 80 and over; Carcinoma, Large Cell; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Demography; Female; Hospitals, Teaching; Hospitals, University; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Retrospective Studies; Sex Distribution; Smoking

To describe the incidence trends in esophageal squamous cell carcinoma (SCC) and adenocarcinoma among the three major ethnic groups in Singapore from 1968 to 2002.. Esophageal cancer cases in Singapore citizens and permanent residents obtained from the Singapore Cancer Registry and population data derived from the national census were used to calculate the incidence rates from 1968 to 2002.. The age-standardized incidence rates (ASRs) for SCC decreased progressively from 8.31 to 3.85 per 100,000 men (p = 0.017) and from 3.43 to 0.81 per 100,000 women (p = 0.027). The rates fell for all three ethnic groups. The ASR for adenocarcinoma rose from 0 to 0.54 per 100,000 men and from 0.03 to 0.13 per 100,000 women, although these time trends did not achieve statistical significance. The frequency of regular smoking in the population decreased from 23% in 1966/1977 to 12.6% in 2004. The percentage of obesity in adults rose from 4.3% in 1982-1985 to 6.9% in 2004. The frequency of esophagitis in Singapore based on endoscopic findings increased from 3.9% in 1992 to 9.8% in 2001.. The decline in the incidence of SCC is likely to be associated with the known decrease in the frequency of smoking among Singaporeans. In contrast, there appears to be a trend toward an increase in the incidence of adenocarcinoma in Singapore, although the absolute incidence remains relatively low. This may be due to the associated rise in the frequency of reflux esophagitis and obesity in Singapore.

Topics: Adenocarcinoma; Adult; Carcinoma, Squamous Cell; China; Esophageal Neoplasms; Female; Humans; Incidence; India; Linear Models; Malaysia; Male; Middle Aged; Registries; Risk Factors; Sex Factors; Singapore

This study was carried out to determine the role of p53 and p21 in the pathogenesis of prostatic adenocarcinoma and their association with tumour grade.. Sixty-seven histologically confirmed prostatic adenocarcinoma cases collected from Hospital Universiti Kebangsaan Malaysia and General Hospital Kuala Lumpur were studied. The formalin-fixed paraffin-embedded tissues were stained with monoclonal antibody p53 (clone DO-7) and p21 (clone SX II8) using standard avidin-biotin complex immunohistochemistry (IHC) after microwave antigen retrieval. The adenocarcinomas were graded histologically according to Gleason score: low grade = score 2-4, intermediate grade = score 5-7, high grade = score 8-10. Histological grade was analysed against IHC expressions of p53 and p21 and against patient age and ethnicity.. IHC positivity for p53 was expressed in 1/2 (50%) low grade, 14/33 (42%) intermediate grade, and 21/32 (66%) high grade tumours. p21 was expressed in 0/2 low grade, 16/33 (48%) intermediate grade and 15/32 (47%) high grade tumours. p53 and p21 expressions did not show statistically significant correlation with the different grades of prostatic adenocarcinoma or with each other (p = 0.42). There was no correlation between tumour grade and age or ethnicity.. Although the p53 positivity rate was higher in high-grade prostate adenocarcinoma, this was not statistically significant. We found that a combined expression of p21 and p53 was not correlated with tumour grade. We could not confirm that p21 expression was dependent on p53 expression.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Asian People; Biomarkers, Tumor; China; Cyclin-Dependent Kinase Inhibitor p21; Humans; Malaysia; Male; Middle Aged; Prostatic Neoplasms; Tumor Suppressor Protein p53

This is a retrospective study evaluating the risk factors for clinical anastomotic leakage after anterior resection in 64 patients with rectal cancer operated from November 2001 till August 2003. The percentage of anastomosis leakage was higher in those patients with diabetic, low albumin level, neoadjuvant radiotherapy, higher staging, and poorly differentiated tumour. However, these differences were statistically not significant. There was a significant difference (p=0.03) of anastomosis leakage in those patients with very distal tumour of < 4cm from anal verge (42%), when compare to those patients with proximal tumor of > 15cm from anal verge (4.3%). The mortality associated with this complication was 30%. Hence, a surgeon may consider a covering stoma or be more vigilant in operating patients with multiple risk factors.

Topics: Adenocarcinoma; Anastomosis, Surgical; Colorectal Neoplasms; Humans; Malaysia; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors

This study aimed to determine whether the clinicopathological features of lung cancer in patients younger than 40 years differ from that of older patients in an Asian country.. We undertook a review of the clinicopathological data of all patients with confirmed primary lung cancer at the Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, from October 1991 to September 1999.. Of the 580 patients with lung cancer, 36 (6.2%; 23 males, 13 females) were 21-39 years old at diagnosis. The percentage of people who had never smoked was higher among the younger patients (58.3% vs 19.1%, P < 0.001). Although adenocarcinoma was the most common cell type in both groups, its incidence was higher in the younger patients (24/36 (66.7%) vs 228/544 (41.9%), P = 0.007). The mean World Health Organization performance status at presentation was worse in the younger patients (2.4 vs 2, P = 0.007). In the case of non-small cell lung cancer, all the younger patients presented with either stage IIIb or metastatic disease compared to 77.2% of the older patients (P < 0.001).. Younger lung cancer patients were more likely than older patients to have never smoked, to have adenocarcinoma, and to present with poorer performance status and with more advanced-stage non-small cell lung cancer.

Topics: Adenocarcinoma; Adult; Age Distribution; Aged; Aged, 80 and over; Carcinoma, Large Cell; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Neoplasm Staging; Population Surveillance; Prospective Studies; Sex Distribution; Smoking

To study the trend of different histological types of cervical carcinoma among the 3 major ethnic groups in Malaysia.. All invasive cervical carcinoma histologically diagnosed for the first time in 1991-1992 and 1996-1997 at the University Hospital, Kuala Lumpur (UHKL) were reviewed for the following parameters; age, ethnic group, histological category.. One hundred and twenty-one and 145 cases were diagnosed in 1991-1992 and 1996-1997, respectively. During both periods, squamous was followed by adeno and adenosquamous carcinoma in frequency. Patients' mean ages ranged within the 4th decade for all 3 major histological types. Ethnically, an overall predilection for the Chinese was observed. While squamous carcinomas had declined among the Chinese and Malays, adenocarcinomas were noted to increase. The converse was observed among the Indians.. Ethnically, cervical carcinoma showed a predilection for Malaysians of Chinese descent. A decreasing incidence of squamous with a worrying increasing trend of adenocarcinoma was observed, like in other populations studied.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Asian People; Carcinoma, Adenosquamous; Carcinoma, Squamous Cell; Female; Humans; Longitudinal Studies; Malaysia; Middle Aged; Uterine Cervical Neoplasms; White People

We studied the clinical patterns and outcome of patients with FIGO (1985) Stage 1b cervical cancer. In particular, looking at the clinico-pathological characteristics in relation with disease recurrence.. Ninety-nine Asian patients were managed at (the former) K K Hospital, Singapore, from 1987 to 1991. The mean and median follow-up periods were 67 and 60 months respectively. This study was performed in 1995.. The majority of the patients (81%) was treated by radical hysterectomy with or without adjuvant radiotherapy/chemotherapy while 15% were treated by radical pelvic radiotherapy alone and 4% of patients had pelvic radiotherapy following the diagnosis of cervical cancer after a simple hysterectomy. Thirteen patients developed tumour recurrence (13.1%). In these patients, there was a greater proportion of adenocarcinomas (31% vs 13%, p = 0.1065), lymph node metastases (45% vs 20%, p = 0.09) and surgical margins involvement (45% vs 7%) 7%, p = 0.004) while there seemed to be no difference in histological sub-types, vascular space involvement and cytological grading. The relative risks of developing tumour recurrence in patients with adenocarcinoma was 2.5 times (95% CI: 0.88-7.05), lymph-node metastasis: 2.3 times (95% CI: 0.96-4.93) and involved surgical margins; 5.9 times (95% CI: 2.27-15.5). The mean time to recurrence were 21.7 months with all of them detected within 36 months following primary therapy. All of them had abnormal physical findings while routine follow-up Pap smear was positive in only one patient (8%). In general, the outcome of salvage treatment was poor.. In our group of patients with FIGO Stage lb cervix cancer, majority had radical surgery performed initially. Thirteen percent had disease recurrence, in which there were greater proportions of patients with adenocarcinoma, lymph-node metastasis, and involved surgical margins. The mean time-to-recurrence was 21.7 months with all detected by 36 months. Routine follow-up Pap smear seemed to be a poor indicator of disease status.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; China; Female; Humans; Lymphatic Metastasis; Malaysia; Middle Aged; Neoplasm Recurrence, Local; Singapore; Uterine Cervical Neoplasms

A review of 119 patients (88 males and 31 females) with carcinoma of the lung seen at the Hospital University Sains Malaysia (HUSM) from 1984 to 1989 was done. The mean age of the patients was 60.3 years with a high proportion (76.6%) of them were between 41 and 70 years. Seventy five percent of patients (84% of men and 26% of women) were smokers. The Chinese have a significantly higher preponderance to carcinoma of the lung. The commonest histological type found was squamous cell carcinoma in men and adenocarcinoma in women. Small cell carcinoma was uncommon. Squamous cell and large cell/undifferentiated type of carcinoma were significantly associated with smoking behaviour of the patients.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Bronchogenic; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged; Smoking

Topics: Adenocarcinoma; Adult; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Malaysia; Male

Between 1967 and 1976, 388 cases of lung cancer were seen at the University Hospital, Kuala Lumpur, with histological confirmation in 72%. Most were aged from 50--80, with a male to female ratio of 2.8 : 1. The patients were predominantly of Chinese origin (82%) and from the lower socioeconomic strata. A history of smoking was elicited in 78%. The chief clinical and radiological features and the diagnostic methods are presented. The incidence of the histological types was squamous carcinoma 34%, adenocarcinoma 25%, large cell carcinoma 12%, small (oat) cell carcinoma 12%, "unidifferentiated/anaplastic" 15%, and others 2%. Malays appeared to have a higher percentage of adenocarcinoma. A comparison between the histologically confirmed group and the rest showed no significant difference in features. Problems pertaining to the management of Malaysian patients are discussed.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Ethnicity; Female; Humans; Lung Neoplasms; Malaysia; Male; Middle Aged

A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.

Topics: Adenocarcinoma; Adenoma; Adult; Anesthesia, Local; Carcinoma, Papillary; Cysts; Ethnicity; Female; Humans; Lidocaine; Malaysia; Male; Posture; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy

Topics: Adenocarcinoma; Child, Preschool; Humans; Malaysia; Male; Testicular Neoplasms

Topics: Adenocarcinoma; Adenolymphoma; Adolescent; Adult; Age Factors; Aged; Angiokeratoma; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Child; Child, Preschool; Female; Humans; Infant; Malaysia; Male; Middle Aged; Racial Groups; Salivary Gland Neoplasms; Salivary Glands; Sex Factors

Topics: Adenocarcinoma; Asian People; Bronchial Neoplasms; Carcinoma; Carcinoma, Squamous Cell; Humans; Malaysia

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Humans; Lymph Nodes; Lymphatic Metastasis; Malaysia; Nasopharyngeal Neoplasms