exudates and Carcinoma--Squamous-Cell

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

Microinvasive squamous cell carcinoma of the uterine cervix is a recognized entity and is defined as carcinoma with invasion of less than 5 mm penetration of the stroma and seldom metastasized. Our patient was a 70-year-old, multiparous woman who had a microinvasive, cervical, squamous cell carcinoma. The tumor had spread superficially into the entire endometrial cavity up to the fundus, totally replacing the columnar epithelium. This is an extremely rare phenomenon, with fewer than 20 cases reported so far in the literature.

Topics: Aged; Biopsy; Carcinoma, Squamous Cell; Endometrium; Epithelium; Female; Humans; Malaysia; Neoplasm Invasiveness; Uterine Cervical Neoplasms

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

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

Renal cancer is rare and its incidence is 1.9 per 100,000 in the Malaysian population, which consists of three major ethnic groups (Malay, Chinese and Indians). A retrospective study was her conducted to identify clinical characteristics and ethnic background influences on presentation. The study included all renal cancer patients from a single medical institution over ten years, with a total of 75 cases. Seventy-three patients underwent surgery while 2 received only radiotherapy or chemotherapy. The male to female ratio was 2.75:1. Incidence was equal among the Malay (49.3%) and Chinese ethnic groups (45.3%). Mean age of patients were 57.1 (18-93) years old. There were 26 (37.4%) patients with Stage I disease, 14 (18.7%) at Stage II, 23 (30.7%) at Stage III and 12 (16%) at Stage IV. The Chinese race presented at mean older age (p= 0.02) and later stage of disease (p= 0.046). Patients above 40 years old had more advanced stage disease (p= 0.023). Tumour histology were clear cell (72%), urothelial cell (13.3%), sarcomatoid cell and nephroblastoma each contributed 2.7%. The mean tumour size was 8.1 (2-20) cm. There was substantial agreement between the pre and post operative staging (kappa 0.691). In conclusion we observed significant influences of age and race in the clinical presentation of renal cancer in our institution based population. There was larger male to female ratio and mean tumour size as compared to previous epidemiology studies.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Papillary; Carcinoma, Renal Cell; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Incidence; Kidney Neoplasms; Malaysia; Male; Middle Aged; Neoplasm Staging; Prognosis; Radiotherapy Dosage; Risk Factors; Survival Rate; Time Factors; Wilms Tumor; Young Adult

Malaysia has the third highest crude mortality rates of bladder cancer within Southeast Asia. We aimed to identify the prognostic factors for bladder cancer patients in Malaysia.. A retrospective population-based study was conducted among patients diagnosed between 2007 and 2011. Death date until 31 December 2016 was updated. Cox proportional hazard regression analysis was performed to examine clinical variables as prognostic factors of death.. Identified prognostic factors of 1828 analyzed patients were age groups, ethnicity, morphology, stage, and surgery. As compared to patients aged 15-44, the adjusted Hazard Ratio for those aged 45-54, 55-64, 65-74, and ≥75 were 1.59, 1.87, 2.46, and 3.47, respectively. Malay and other ethnic groups had 1.22- and 1.40-times the risk of death compared to Chinese. Patients with squamous cell carcinoma were at 1.47-times the hazard of death compared to urothelial carcinoma patients. Stages II, III and IV patients had 2.20-, 2.98-, and 4.12-times the risk of death as compared to stage I. Patients who did not receive surgery were at 50% increased hazard of death.. Early detection and/or surgery, especially for those more than 75 years old, Malay, and squamous cell carcinoma could potentially improve survival. The findings could inform national cancer control programs.

Topics: Aged; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Humans; Malaysia; Prognosis; Retrospective Studies; Urinary Bladder Neoplasms

The Bornean sun bear (

Topics: Animals; Carcinoma, Squamous Cell; Gammaherpesvirinae; Malaysia; Mouth Neoplasms; Ursidae

In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population.In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P < .25.A total of 211 OSCC cases were registered in Hospital Universiti Sains Malaysia from January 1, 2000 to December 31, 2018. Majority of them were male (57.82%), non-smoker (54.97%), non-alcohol consumer (91.94%), and non-betel quid chewer (93.83%) Malay (60.66%) patients. The tongue was the most commonly involved part of the oral cavity (41.52%). Histologically, the majority of the cases had moderately-differentiated OSCC (52.82%). Most of the patients were diagnosed at stage IV at the time of diagnosis (61.61%). When this study was performed, the survival status of the majority of the patients was alive (68.24%).Within the analyzed socio-demographic and clinicopathological parameters, gender, alcohol consumption, T-classification, histological grading, and treatment status have been demonstrated as an independent risk factors for mortality rate in multivariate analysis. Hence, these parameters need to be taken into account for the individualized therapy management of OSCC patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Retrospective Studies; Risk Factors; Survival Analysis; Young Adult

Background: Interleukin-10 (IL10) genotypes have been closely correlated to the susceptibility for oral squamous cell\ carcinoma. More than half of oral cancers in the world occur in Asia with estimated 168,850 new cases were diagnosed\ in this geographical region alone. Considering the rising numbers of oral cancer cases in Malaysia, association of IL10\ A1082G gene polymorphism was correlated. Methodology: 41 oral squamous cell carcinoma (OSCC) cases and 48\ healthy controls of comparable age, gender, and with habits like smoking, alcohol consumption and betel quid chewing\ were selected. In this case-control study, samples were collected from the Oral Cancer Research and Coordinating\ Centre (OCRCC), Faculty of Dentistry, University of Malaya, Malaysia. Genotyping conditions were evaluated by\ polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The PCR products were subjected\ to digestion by MnlI enzyme (NEB, UK) to screen for the IL10 A-1082G. Digested DNA products were analyzed by\ electrophoresis on 4% (w/v) agarose gel, stained with ethidium bromide and imaged under UV illumination. Chi-square\ test and Fisher’s Exact test were used in statistical analysis. Results: AG genotypes were present in 81.3% and 86.0% of\ healthy control and OSCC cases respectively (OR=0.468, 95% CI=0.133-1.653). No significant association was found\ between IL10 A1082G polymorphism with risk habits, clinico-pathological parameters and 5-years overall survival.\ The findings also show no significant correlation between the IL10 genotype and features of OSCC within the case\ group as measured by tumor size, lymph node involvement, stage, invasive front, grading, depth, pattern of invasion.\ Conclusion: This study suggests that functional polymorphism AG of IL10 A1082G may have no influence with OSCC\ susceptibility. However, further investigation with larger sample sizes can be conducted to provide additional evidence\ to support the lack of association of IL10 A1082G polymorphism in oral cancer.

Topics: Carcinoma, Squamous Cell; Case-Control Studies; Female; Follow-Up Studies; Genetic Predisposition to Disease; Genotype; Humans; Interleukin-10; Lymphatic Metastasis; Malaysia; Male; Middle Aged; Mouth Neoplasms; Polymorphism, Single Nucleotide; Prevalence; Prognosis; 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

There has been a rising incidence of skin cancers among Asians in recent years. We present a retrospective analysis of 106 skin cancers and analysed the demography, clinical subtypes of skin cancers and surgical techniques used for skin cancer treatment. In our population, skin cancers were most frequently basal cell carcinomas and diagnosed among ethnic Chinese patients.

Topics: Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Ethnicity; Female; Humans; Lymphoma, T-Cell, Cutaneous; Malaysia; Male; Middle Aged; Paget Disease, Extramammary; Retrospective Studies; Sarcoma, Kaposi; Sex Distribution; Skin Neoplasms; Urban Population

With an age-standardized incidence rate of 2 per 100 000, esophageal cancer is not common among Malaysians, but they are nevertheless important due to its poor prognosis. The study is to clarify whether the human papillomavirus (HPV) is associated with esophageal cancer in Malaysians as there has been no report to date on this in Malaysians and other South East Asians.. Altogether 67 esophageal squamous cell carcinomas histologically diagnosed between 1 January 2004 and 31 December 2014 at the Department of Pathology, University of Malaya Medical Center, Malaysia were considered for HPV analysis using two commercially available methods, polymerase chain reaction with flow-through hybridization (21 HPV GenoArray Diagnostic Kit) and multiplex real-time polymerase chain reaction (Anyplex II HPV28 Detection). The DNA amplifiability of the formalin-fixed, paraffin-embedded tumor was checked by amplification of a 268 bp segment of the human β-globin gene (GH20/PC04) prior to HPV detection.. HPV detection was finally carried out in 51 patients. HPV16 was detected in the moderately differentiated, stage IV lower esophageal tumor of a 32-year-old Malaysian-born Chinese woman by both methods. Except for a predilection for Indians, the clinical characteristics of esophageal squamous cell carcinomas in this Malaysian cohort were generally similar to those of other populations.. It appears that HPV is rare and an unlikely oncovirus in esophageal squamous cell carcinomas of Malaysians.

Topics: Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cohort Studies; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Humans; Malaysia; Male; Middle Aged; Papillomaviridae

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting.. A time trend study of upper gastrointestinal disease and H. pylori infection in three time periods: 1989-1990, 1999-2000 and 2009-2010 spanning a period of 20 years was carried out.. Consecutive first time gastroscopies carried out on patients attending the University of Malaya Medical Center were studied. Diagnoses and H. pylori infection status were carefully recorded.. A steady decline in prevalence of duodenal ulcer (DU) and gastric ulcer (GU) from 21.1% to 9.5% to 5.0% and from 11.9% to 9.4% to 9.9% while an increase in erosive oesophagitis (EO) from 2.0% to 8.4% to 9.5% (chi-square for trend; P < 0.001) for the periods 1989-1990, 1999-200 and 2009-2010 were observed. The overall prevalence of H. pylori had also decreased from 51.7% to 30.3% to 11.1% for the same periods of time. The proportion of H. pylori positive ulcers had also decreased: DU (90.1%-69.8%-28.9%) and GU (86.6-56.8%-18.9%) (P < 0.001). This was observed in Malays, Chinese and Indians but the difference over time was most marked in Malays. There was a steady decline in the proportion of patients with gastric and oesophageal cancers.. Peptic ulcers have declined significantly over a 20-year period together with a decline in H. pylori infection. In contrast, a steady increase in erosive oesophagitis was observed. Gastric and oesophageal squamous cell cancers have declined to low levels.

Topics: Adult; Aged; Asian People; Carcinoma, Squamous Cell; Duodenal Ulcer; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Gastrointestinal Diseases; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer; Population Surveillance; Stomach Ulcer; Time Factors

This study includes the direct sequencing of cornulin (CRNN) gene to elucidate the possible mechanism of CRNN downregulation and explore the genetic imbalances at 1q21.3 across oral squamous cell carcinoma (OSCC) samples.. In mutation screening of CRNN gene, gDNA from OSCC tissues were extracted, amplified, and followed by direct sequencing. OSCC samples were also subjected to fragment analysis on CRNN gene to investigate its microsatellite instability (MSI) and loss of heterozygosity (LOH). Immunohistochemistry was performed to validate CRNN downregulation in OSCC samples.. No pathogenic mutation was found in CRNN gene, while high frequency of allelic imbalances was found at 1q21.3 region. MSI was found more frequent (25.3 %) than LOH (9.3 %). Approximately 22.6 % of cases had high MSI which reflects higher probability of inactivation of DNA mismatch repair genes. MSI showed significant association with no betel quid chewing (p = 0.003) and tongue subsite (p = 0.026). LOH was associated with ethnicity (p = 0.008) and advanced staging (p = 0.039). The LOH at 1q21.3 was identified to be as an independent prognostic marker in OSCC (HRR = 7.15 (95 % CI, 1.41-36.25), p = 0.018). Downregulation of CRNN was found among MSI-positive OSCCs and was associated with poor prognosis (p = 0.044).. This study showed a significant correlation between LOH/MSI at 1q21.3 with clinical outcomes and that downregulation of CRNN gene could be considered as a prognostic marker of OSCC.. Insights of the downregulation mode of CRNN gene lays the basis of drug development on this gene as well as revealing its prognostic value.

Topics: Carcinoma, Squamous Cell; Down-Regulation; Genomic Instability; Humans; Immunohistochemistry; Loss of Heterozygosity; Malaysia; Membrane Proteins; Microsatellite Instability; Mouth Neoplasms; Neoplasm Proteins; Polymerase Chain Reaction; Prognosis

Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC).. All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage.. A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia.. The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Combined Modality Therapy; Developing Countries; Head and Neck Neoplasms; Humans; Malaysia; Middle Aged; Neoplasm Staging; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; Treatment Outcome; Universities

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

A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, α-tocopherol and β-carotene with the risk of oral cancer.. This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, α-tocopherol and β-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively.. It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and α-tocopherol among cases (0.177±0.081, 1.649±1.670μg/ml) were significantly lower than in controls (0.264±0.137, 3.225±2.054μg/ml) (p<0.005). Although serum level of β-carotene among cases (0.106±0.159 μg/ml) were lower compared to controls (0.134±0.131μg/ml), statistical significance was not observed. Logistic regression analysis showed that high serum level of retinol (OR=0.501, 95% CI=0.254-0.992, p<0.05) and α-tocopherol (OR=0.184, 95% CI=0.091-0.370, p<0.05) was significantly related to lower risk of oral cancer, whereas no relationship was observed between β-carotene and oral cancer risk.. High serum levels of retinol and α-tocopherol confer protection against oral cancer risk.

Topics: Adult; Aged; Aged, 80 and over; alpha-Tocopherol; Carcinoma, Squamous Cell; Case-Control Studies; Chromatography, High Pressure Liquid; Female; Follow-Up Studies; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Prognosis; Risk Factors; Vitamin A; Vitamins; Young Adult

The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia.. One hundred and twenty cervical cancer patients diagnosed between 1st July 1995 and 30th June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups.. The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)].. The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

Topics: Adult; Carcinoma, Squamous Cell; Female; Hospitals, University; Humans; Malaysia; Middle Aged; Neoplasm Staging; Prognosis; Retrospective Studies; Survival; Uterine Cervical Neoplasms

Topics: Adenocarcinoma, Sebaceous; Carcinoma, Squamous Cell; Chalazion; Diagnosis, Differential; Female; Humans; Malaysia; Middle Aged; Sebaceous Gland Neoplasms

The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients.. Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves.. 87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001).. Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Lymphatic Metastasis; Malaysia; Male; Middle Aged; Mouth Neoplasms; Neck Dissection; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Salivary Gland Neoplasms; Survival Rate; Young Adult

The purpose of this study was to evaluate the role of HPV and p53 polymorphisms in oral squamous cell carcinomas (OSCC) affecting Malaysian population.. We analysed frozen samples from 105 OSCC as well as 105 oral specimens derived from healthy individuals. PCR assays targeting two regions of the virus were used. PCR amplification for the analysis of p53 codon 72 arginine/proline alleles was carried out in a separate reaction.. HPV DNA was detected in 51.4% OSCC samples, while 24.8% controls were found to be HPV positive. HPV was found to be significantly associated with OSCC (P < 0.001, OR = 4.3 after adjustment for habits) when compared to controls. High-risk HPV was found to be significantly associated with OSCC cases (P < 0.05). Demographic profiles of age, gender, race and habits were not associated with HPV presence in cases and controls. However, significantly less HPV positivity was seen in poorly differentiated compared to well-differentiated OSCCs. No significant association was found between HPV positivity and p53 polymorphisms in cases and control groups. Additionally, we found no association of codon 72 polymorphism with oral cancer.. This study indicates that high-risk HPV infection is one of the contributing factors for OSCCs. HPV 16 was the predominant type found in Malaysian patients with OSCC. Further, we did not find any association between p53 codon 72 polymorphism and HPV infection or between the p53 polymorphism and the risk of oral cancer.

Topics: Adult; Aged; Alphapapillomavirus; Arginine; Carcinoma, Squamous Cell; Case-Control Studies; DNA, Viral; Female; Humans; Logistic Models; Malaysia; Male; Middle Aged; Mouth Neoplasms; Odds Ratio; Papillomavirus Infections; Polymerase Chain Reaction; Polymorphism, Single Nucleotide; Proline; Retrospective Studies; Risk Assessment; Risk Factors; Tumor Suppressor Protein p53; Tumor Virus Infections

Loss of heterozygosity (LOH) and microsatellite instability (MSI) have been documented as important events in oral squamous cell carcinoma (OSCC). Five microsatellite markers D3S192, D3S966, D3S647, D3S1228 and D3S659 were selected on chromosome 3p because of high frequency of alterations reported in head and neck squamous cell carcinoma and the involvement of von Hippel Lindau (VHL) at 3p25-26 and the fragile histidine triad (FHIT) at 3p14.2 genes proven in many tumour types. A total of 50 archival tissue samples of OSCC and corresponding normal samples were analyzed for LOH and MSI status. The overall LOH for the markers selected on 3p was 56 out of 189 informative cases (29.6%). The most frequent LOH was identified for the marker D3S966 which was 18/42 (42.8%) of informative cases suggesting the presence of putative tumour suppressor genes (TSGs) in this loci. In this study, high frequency of microsatellite instability was found in D3S966 which was 28.6% of informative cases; this reveals the possibility of mutations of MMR genes in this region. Frequent microsatellite alterations (MA) were observed in 3 markers D3S966 (71.4%), D3S1228 (56.7%) and D3S192 (41.0%). There was no significant association between LOH with gender, tumour stages and differentiation grades. However, there was a significant association between tumour stage and differentiation grades with MSI status in OSCC in Malaysian population with p values of 0.002 and 0.035, respectively. There was also a significant association between MA and differentiation grades (p=0.041).

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Genes, Tumor Suppressor; Humans; Loss of Heterozygosity; Malaysia; Male; Microsatellite Instability; Microsatellite Repeats; Middle Aged; Mouth Neoplasms

To assess the cross-sectional construct validity of the Malay-translated and cross-culturally adapted FACT-H&N (v 4.0) for discriminative use in a sample of Malaysian oral cancer patients. A cross-sectional study of adults newly diagnosed with oral cancer. HRQOL data were collected using the FACT-H&N (v 4.0), a global question and a supplementary set of eight questions ('MAQ') obtained earlier in pilot work. Of the 76 participants (61.8% female; 23.7% younger than 50), most (96.1%) had oral squamous cell carcinoma; two-thirds were in Stages III or IV. At baseline, patients' mean FACT summary (FACT-G, FACT-H&N, FACT-H&N TOI, and FHNSI) and subscale (pwb, swb, ewb, fwb, and hnsc) scores were towards the higher end of the range. Equal proportions (36.8%) rated their overall HRQOL as 'good' or 'average'; fewer than one-quarter rated it as 'poor', and only two as 'very good'. All six FACT summary and most subscales had moderate-to-good internal consistency. For all summary scales, those with 'very poor/poor' self-rated HRQOL differed significantly from the 'good/very good' group. All FACT summary scales correlated strongly (r>0.75). Summary scales showed convergent validity (r>0.90) but little discriminant validity. The discriminant validity of the FHNSI improved with the addition of the MAQ. The FACT-H&N summary scales and most subscales demonstrated acceptable cross-sectional construct validity, reliability and discriminative ability, and thus appear appropriate for further use among Malaysian oral cancer patients.

Topics: Adult; Aged; Aged, 80 and over; Asian People; Carcinoma, Squamous Cell; Cross-Cultural Comparison; Cross-Sectional Studies; Diagnostic Self Evaluation; Discriminant Analysis; Female; Health Status; Humans; Language; Malaysia; Male; Middle Aged; Mouth Neoplasms; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Translations; Young Adult

Oral squamous cell carcinoma (OSCC) has high local recurrence, partly caused by the lack of clear margin identification on surgical removal of cancerous tissues. Direct visualization by immunostaining and fluorescent in situ hybridization (FISH) in tissue sections gives more definite information about genetic damage at margins with appropriately selected biomarkers.. To determine the usefulness of immunohistochemical techniques and FISH of the tumour suppressor TP 53 gene to identify microinvasion in marginal tissue sections and to relate the possible correlation between protein expression and genetic aberrations in OSCC cases in Malaysia.. Immunohistochemistry and FISH of TP 53 genes were applied on 26 OSCC formalin fixed paraffin embed (FFEP) blocks selected from two oral cancer referral centers in Malaysia.. For p53 protein immunohistochemistry, 96% of the 26 OSCC studied showed positive immunostaining at the excision margins. In FISH assay, 48.9±9.7% of the cancerous cells were monoploid for p53 probe signals, 41.0±9.5 % were diploid, and 10.2±7.8 % were polyploid. A correlation between p53 immunostaining and TP53 gene aberrations was noted (p< 0.05).. Immunohistochemical analysis of p53 protein expression and FISH of TP53 gene could be applied as screening tool for microinvasion of OSCC.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Malaysia; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Neoplasm Invasiveness; Tumor Suppressor Protein p53

Nasopharyngeal carcinoma is the third most common cancer among men in Peninsular Malaysia. However, no information is available about the prognostic factors. The objective of this study was to identify factors with an influence on outcome in patients treated in Hospital Kuala Lumpur.. A total of 159 patients with non-metastatic nasopharyngeal carcinoma treated during 2002-2003 in Hospital Kuala Lumpur were included in this study. All received radiotherapy. Fifty three patients were treated with radiotherapy alone, while 106 patients received combination chemotherapy. Overall survival and local recurrence-free survival were analyzed using the Kaplan-Meier method and univariate analysis was performed using the log-rank test.. This study found out that 5-year overall survival and 5-year local recurrence-free survival rates were 58.6% and 54.2% respectively. The stage specific 5-year overall survival rates were: Stage I, 100%; Stage II; 93.3%, Stage III, 62.7%; Stage IVA, 42.2%; and Stage IVB, 40.6%. On univariate analysis, gender (p<0.05), T-classification (p<0.001), N-classification (p<0.05), stage (p<0.05) and cranial nerve involvement (p<0.001) were found to be significant prognostic factors for 5-year overall survival, while gender (p<0.05) and N-classification (p<0.05) were significant prognostic factors for 5-year local recurrence-free survival.. The overall survival rate of patients for this study was low. The patient factor that significantly affected 5-year overall survival was gender, while disease factors were stage, T-classification, N-classification and cranial nerve involvement.

Topics: Adolescent; Adult; Aged; Carcinoma; Carcinoma, Squamous Cell; Combined Modality Therapy; Cross-Sectional Studies; Disease-Free Survival; Female; Humans; Malaysia; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Recurrence, Local; Prognosis; Sex Factors; Survival Rate; Treatment Outcome; Young Adult

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

Cervical cancers (CC) demonstrate the second highest incidence of female cancers in Malaysia. The costs of chronic management have a high impact on nation's health cost and patient's quality of life that can be avoided by better screening and HPV vaccination.. Respondents were interviewed from six public Gynecology-Oncology hospitals. Methods include experts' panel discussions to estimate treatment costs by severity and direct interviews with respondents using costing and SF-36 quality of life (QOL) questionnaires. Three options were compared i.e. screening via Pap smear; quadrivalent HPV Vaccination and combined strategy (screening plus vaccination). Scenario based sensitivity analysis using screening population coverage (40-80%) and costs of vaccine (RM 300-400/dose) were calculated.. 502 cervical pre invasive and invasive cervical cancer (ICC) patients participated in the study. Mean age was 53.3 +/- 11.2 years, educated till secondary level (39.4%), Malays (44.2%) and married for 27.73 +/- 12.1 years. Life expectancy gained from vaccination is 13.04 years and average Quality Adjusted Life Years saved (QALYs) is 24.4 in vaccinated vs 6.29 in unvaccinated. Cost/QALYs for Pap smear at base case is RM 1,214.96/QALYs and RM 1,100.01 at increased screening coverage; for HPV Vaccination base case is at RM 35,346.79 and RM 46,530.08 when vaccination price is higher. In combined strategy, base case is RM 11,289.58; RM 7,712.74 at best case and RM 14,590.37 at worst case scenario. Incremental cost-effectiveness ratio (ICER) showed that screening at 70% coverage or higher is highly cost effective at RM 946.74 per QALYs saved and this is followed by combined strategy at RM 35,346.67 per QALYs saved.. Vaccination increase life expectancy with better QOL of women when cancer can be avoided. Cost effective strategies will include increasing the Pap smear coverage to 70% or higher. Since feasibility and long term screening adherence is doubtful among Malaysian women, vaccination of young women is a more cost effective strategy against cervical cancers.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Cost-Benefit Analysis; Cross-Sectional Studies; Economics, Pharmaceutical; Female; Humans; Malaysia; Middle Aged; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Quality-Adjusted Life Years; Survival Rate; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Young Adult

This study was performed to determine oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.. The medical records of 118 Malay patients with oral cancer admitted in HUSM from 1st January 1986 to 31st December 2005 were reviewed. Data collected include socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients. Survival status and duration were determined by active validation until 31st December 2006. Data entry and analysis were accomplished using SPSS version 12.0. The Kaplan-Meier method was used to perform survival estimates while the log-rank test and the Cox proportional hazards regression model were employed to perform univariate analysis and multivariable analysis of the variables, respectively.. The overall five-year survival rate of Malay patients with oral cancer was 18.0%, with a median survival time of 9 months. Significant factors that influenced survival of the patients were age, sex, tumour site, TNM stage, histological type, and treatment received.. Survival of oral cancer patients in HUSM was very low. Being elderly, male, presenting with an advanced stage at diagnosis, and not having treatment all contributed to poor survival.

Topics: Carcinoma, Squamous Cell; Female; Hospitals, University; Humans; Malaysia; Male; Medical Records; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Survival Rate; Treatment Outcome

The MDM2 SNP309 has been associated with increased expression of the protein which could suppress p53 function, and has been shown to modulate risk to cancer. We have previously shown that overexpression of MDM2 is a common event in oral cancers. In the present study, we determined the association between the MDM2 SNP309 polymorphism and oral cancer in 207 oral cancer patients and 116 normal subjects. We genotyped the MDM2 SNP309 by PCR-RFLP. Logistic regression was adapted to calculate odds ratios for MDM2 SNP309 polymorphism from univariate and multivariable adjusted models. Our results suggest that MDM2 SNP309 does not confer increased risk to oral cancer (OR=1.55, 95% CI=0.77-3.11). However, the GG/TG genotype was associated with later disease onset in women above 55 years of age. Collectively, our data suggests that MDM2 SNP309 may modulate the risk to oral cancer and is a modifier of the age at oral cancer onset in women above the age of 55 years.

Topics: Age of Onset; Aged; Carcinoma, Squamous Cell; Case-Control Studies; Female; Genetic Predisposition to Disease; Humans; Logistic Models; Malaysia; Male; Middle Aged; Mouth Neoplasms; Odds Ratio; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Polymorphism, Single Nucleotide; Proto-Oncogene Proteins c-mdm2; Risk Factors

Oral squamous cell carcinoma (OSCC) is a world health problem and is associated with exposure to different risk factors. In the west, smoking and alcohol consumption are considered to be the main risk factors whilst in India and southeast Asia, betel quid (BQ) chewing is predominant. In this study, we compared the gene expression patterns of oral cancers associated with BQ chewing to those caused by smoking using Affymetrix microarrays. We found that 281 genes were differentially expressed between OSCC and normal oral mucosa regardless of aetiological factors including MMP1, PLAU, MAGE-D4, GNA12, IFITM3 and NMU. Further, we identified 168 genes that were differentially expressed between the BQ and smoking groups including CXCL-9, TMPRSS2, CA12 and RNF24. The expression of these genes was validated using qPCR using independent tissue samples. The results demonstrate that whilst common genes/pathways contribute to the development of oral cancer, there are also other gene expression changes that are specific to certain risk factors. The findings suggest that different carcinogens activate or inhibit specific pathways during cancer development and progression. These unique gene expression profiles should be taken into consideration when developing biomarkers for future use in prognostic or therapeutic applications.

Topics: Adult; Aged; Aged, 80 and over; Areca; Carcinoma, Squamous Cell; Female; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; Malaysia; Male; Microarray Analysis; Middle Aged; Mouth Neoplasms; Polymerase Chain Reaction; Risk Factors; Smoking

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

Inactivation of the retinoblastoma (pRB) pathway is a common event in oral squamous cell carcinoma particularly through the aberrant expression of the components within this pathway. This study examines the alterations of molecules within the pRB pathway by looking at the presence of homozygous deletions in p16(INK4A) and the expression patterns of pRB, cyclin D1 and CDK4, as well as the presence of human papillomavirus (HPV) in our samples. In our study, 5/20 samples demonstrated deletions of p16(INK4A) exon 1alpha. pRB overexpression was found in 20/20 samples, the expression was mainly observed in all layers of the epithelia, particularly in the basal layer where cells are actively dividing and aberrant pRB expression was found in 12/20 samples. Cyclin D1 and CDK4 overexpression was detected in 6/20 and 2/20 samples respectively in comparison to hyperplasias where both proteins were either not expressed or expressed at minimal levels (<10%). Strikingly, HPV was found to be present in all of our samples, suggesting that HPV plays a significant role in driving oral carcinogenesis. Notably, 17/20 of our samples showed more than one alteration in the pRB pathway, however, we did not find any significant relationship between the presence of HPV, homozygous deletion of p16(INK4A) and overexpression of pRB, cyclin D1 and CDK4. Collectively, this data demonstrates that alterations in the pRB pathway are a common event and involve the aberration of more than one molecule within the pathway. Furthermore, the involvement of HPV in all our samples suggests that HPV infection may play an important role in oral carcinogenesis.

Topics: Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Cyclin D1; Cyclin-Dependent Kinase 4; Cyclin-Dependent Kinase Inhibitor p16; Exons; Female; Gene Deletion; Homozygote; Humans; Immunohistochemistry; Malaysia; Male; Mouth Neoplasms; Papillomaviridae; Papillomavirus Infections; Retinoblastoma Protein; Tumor Suppressor Proteins

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

An adult, female Malayan sun bear (Helarctos malayanus) was diagnosed with squamous cell carcinoma of the rostral mandible. Initial treatment included bilateral mandibulectomy rostral to the lingual frenulum followed by intra- and perilesional cisplatin injections. Recovery after the procedure was uneventful and the Malayan sun bear adapted well to a shortened mandible. Histopathology indicated incomplete surgical excision of the tumor; therefore, radiation therapy was instituted weekly for four treatments at 2 Gy in parallel opposed fields (total 4 Gy each treatment) with one additional cisplatin treatment. Two years after initial presentation, the animal showed no recurrence of neoplasia.

Topics: Animals; Antineoplastic Agents; Carcinoma, Squamous Cell; Cisplatin; Female; Malaysia; Mandibular Neoplasms; Treatment Outcome; Ursidae

Some oral verrucal lesions may constitute parts of the clinicopathological spectrum of proliferative verrucous leukoplakia (PVL). Because of its idiopathic yet sinister nature, it is possible that PVL may exist in other populations. The aim of this study was to review the clinicopathological features of persistent, multifocal, oral verrucal lesions in Malaysian population.. Patients with multifocal oral verrucal lesions were selected from surgical and histopathological records.. Nine patients of diverse ethnicity with 43 biopsies were reviewed. The mean age at the presentation was 62 years. The most frequent sites affected were gum, sulci, cheek and tongue. Indulgence in risk habits was reported in about 70% of patients. Four cases developed multifocal carcinoma from multifocal leukoplakia.. In retrospect, none of the cases fulfilled the original PVL criteria, although three cases were suggestive of PVL. Nevertheless, these findings do not necessarily preclude the existence of PVL as a clinicopathological entity in Malaysian population.

Topics: Adult; Age Factors; Aged; Carcinoma, Squamous Cell; Carcinoma, Verrucous; Cell Transformation, Neoplastic; Ethnicity; Female; Gingival Neoplasms; Humans; Leukoplakia, Oral; Malaysia; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Risk Factors; Tongue Neoplasms; Warts

Pregnancy complicated by lung cancer has been rarely reported. The regional incidence of this complex situation is likely to increase in the future and optimal management needs to be established to better deal with this situation. We report two patients with metastatic lung cancer complicating pregnancy to highlight the evaluation and management difficulties associated with this problem and to contribute to the limited information in the literature.

Topics: Adult; Bronchoscopy; Carcinoma, Squamous Cell; Fatal Outcome; Female; Gestational Age; Humans; Lung Neoplasms; Malaysia; Neoplasm Metastasis; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Risk Assessment; Tomography, X-Ray Computed

The objective of this study was to determine the socio-demography (age, race and gender) of a group of Malaysian patients who were diagnosed as suffering from oral lichen planus (OLP). The occurrence of malignancy was also investigated. A total of 77 clinical and biopsy records of patients with OLP were studied. Females were affected more than males, with the female to male ratio being 2:1. Middle-aged Indian and Chinese females tend to be affected by OLP when compared with the rest of the population. Only 19 patients returned for further follow-up. One adult Indian female with a six-year history of lichenoid reaction showed the presence of malignancy.

Topics: Adolescent; Adult; Age Distribution; Aged; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; China; Female; Humans; India; Lichen Planus, Oral; Malaysia; Male; Middle Aged; Oral Hygiene; Retrospective Studies; Sex Ratio; Tongue Neoplasms

During 1990-1992, 282 Chinese residents of Selangor and the Federal Territory, Malaysia with histologically confirmed nasopharyngeal carcinoma (NPC) were interviewed about occupational history, diet, alcohol consumption, and tobacco use, as were an equal number of Malaysian Chinese population controls, pair-matched to cases by age and sex.. Exposures to 20 kinds of workplace substances, solar and industrial heat, and cigarette smoke, were analysed by univariate and multivariate methods.. Nasopharyngeal carcinoma was associated with occupational exposures to construction, metal and wood dusts; motor fuel and oil; paints and varnishes; certain other chemicals; industrial heat; solar heat from outdoor occupations; certain smokes; cigarette smoking; and childhood exposure to parental smoking. After adjustment for risk from diet and cigarette smoke, only wood dust (OR = 2.36; 95% CI : 1.33- 4.19), and industrial heat (OR = 2.21; 95% CI : 1.12-4.33) remained clearly associated. Wood dust remained statistically significant after further adjustment for social class. No significant crude or adjusted association was found between NPC and formaldehyde (adjusted OR = 0.71; 95% CI : 0.34-1.43).. This study supports previous findings that some occupational inhalants are risk factors for NPC. The statistical effect of wood dust remained substantial after adjustment for diet, cigarette smoke, and social class. Intense industrial heat emerged as a previously unreported risk factor, statistically significant even after adjustment for diet and cigarette smoke. No association was found between NPC and formaldehyde.

Topics: Adult; Age Factors; Aged; Carcinoma, Squamous Cell; China; Dust; Female; Formaldehyde; Hot Temperature; Humans; Logistic Models; Malaysia; Male; Matched-Pair Analysis; Middle Aged; Nasopharyngeal Neoplasms; Occupational Exposure; Sex 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

The delay in the diagnosis of oral cancer has been variously reported as being contributed by the clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.

Topics: Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Dentistry; Diagnostic Errors; Family Practice; Female; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Patient Acceptance of Health Care; Referral and Consultation; Risk Factors; Time Factors

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

We reviewed biopsy records for 37 cases of oral histoplasmosis for patient characteristics, clinical features, and histopathologic findings. These represented cases diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur between July 1967 and October 1994. All were male patients who ranged in age from 11 to 79 years (mean age, 56.7 years). There were 40.6% Malays, 37.8% Chinese, 18.9% Indians, and 2.7% other races. Five patients with mouth lesions as the initial presenting lesions were proven to be cases of disseminated histoplasmosis. In the remaining cases apart from the biopsy-proven oral histoplasmosis lesions, the extent of the disease elsewhere was unknown. The majority of these lesions involved the gingiva, tongue, and palate in decreasing order of frequency. The most frequent presenting symptom was oral mucosal ulceration. Squamous cell carcinoma and tuberculosis were the two most common clinical differential diagnoses. Our present findings compare favorably with published reports from other regions.

Topics: Adolescent; Adult; Carcinoma, Squamous Cell; Child; Diagnosis, Differential; Ethnicity; Histoplasmosis; Humans; Malaysia; Male; Mouth Diseases; Mouth Neoplasms; Tuberculosis, Oral

The surge of information on the aetiological association of the human papillomavirus (HPV) with some epithelial tumours emanating from various centres has prompted the initiation of a large-scale retrospective study at the Department of Pathology, University Hospital Kuala Lumpur to determine the prevalence and importance of this virus in some epithelial tumours of Malaysian patients. A retrospective analysis of 100 cases of large cell non-keratinising carcinoma of the uterine cervix by in-situ hybridisation on archival formalin-fixed, paraffin-embedded tissue has revealed the presence of HPV type 16 in 47% and type 18 in 41% of cases. This gives an overall detection rate of 88% of the two HPV types most commonly encountered in cervical carcinomas. Except for the unusually high frequency of HPV 18 detected in the cases, the overall prevalence is comparable to that reported in studies from most other centres. Although this higher frequency of HPV 18 may be due to geographical variation, the selection of the large cell non-keratinising type of squamous cell cervical carcinoma for study remains a possible reason for this phenomenon. In comparison to cervical carcinomas, HPV appears to be uncommon in penile carcinomas and HPV 6 was detected in only 1 of 23 cases studied.

Topics: Carcinoma, Squamous Cell; DNA, Neoplasm; Female; Humans; In Situ Hybridization; Malaysia; Male; Papillomaviridae; Papillomavirus Infections; Penile Neoplasms; Prevalence; Retrospective Studies; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

The association of arsenical poisoning with the development of skin cancer is well-known. In Malaysia, arsenic has been shown to coexist with tin in tin-mining land. Our preliminary investigation has shown that the level of arsenic in well water from a tin-mining area is high. We report 3 patients with cutaneous lesions typical of chronic arsenical poisoning such as hyperpigmentation, keratoses and skin cancer. These patients have positive histories of previous domicility in tin-mining areas. We conclude that these patients developed chronic arsenical poisoning from drinking well water polluted with arsenic from the tin-mining soil.

Topics: Adult; Arsenic Poisoning; Carcinoma; Carcinoma in Situ; Carcinoma, Squamous Cell; Chronic Disease; Female; Humans; Malaysia; Male; Middle Aged; Mining; Skin Neoplasms; Tin; Water Pollution, Chemical; Water Supply

A retrospective study of cases with carcinoma of the larynx seen in the Universiti Kebangsaan Malaysia (UKM) and General Hospital Kuala Lumpur (GHKL) between 1981 to 1988 was performed. The aim was to document the distribution and the pattern of behaviour of this tumour amongst our patients. There were 137 cases, the majority of whom were Chinese (54%). The peak incidence was in the seventh decade and the male to female ratio was 7.6:1. The most common symptom at presentation was hoarseness (90%). The most common histological type was squamous cell carcinoma (87%) whilst by site, transglottic involvement was commonest (55%). The overall 3 year survival rate was 68%. Supraglottic carcinoma behaved differently in that a significantly large number presented with dysphagia (33.3%) and neck nodes (42%). Compared to tumours of other sites of the larynx, they had the poorest 3 year survival rate of 50%. Amongst the T2 and T3 tumours, the results of surgery appeared better than primary radiotherapy. Considering that 26% of patients presented with stridor, 20% with neck nodes and 55% with multiple site involvement, it can be concluded that our patients present themselves late.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma; Carcinoma, Squamous Cell; Female; Humans; Incidence; Laryngeal Neoplasms; Malaysia; Male; Middle Aged; Retrospective Studies

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

Topics: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Areca; Carcinoma, Squamous Cell; Female; Habits; Humans; Malaysia; Male; Middle Aged; Mouth; Mouth Neoplasms; Plants, Medicinal; Smoking

The prevalence rate of 749 cases of oral squamous cell carcinomas (SCC) recorded between 1978-1984 was studied. Results showed that the Indians formed the dominant group (63.8%) followed by the Malays (19.6%) and Chinese (16.6%). The peak incidences were generally located between the sixth and eighth decades. Only in the Chinese group a male preponderance was noted. In the Indians, the buccal mucosa was the most prevalent site; in the Malays and Chinese males, the gingiva and alveolus; and the Chinese female, the tongue. In all three groups, the well-differentiated SCC was the commonest type and the poorly differentiated least common.

Topics: Adult; Age Factors; Aged; Carcinoma, Squamous Cell; China; Female; Humans; India; Malaysia; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Sex Factors

We conducted a case-control study of nasopharyngeal carcinoma among Malaysian Chinese to test inhalants, salted fish consumption, and use of tobacco, alcohol, and nasal ointments as risk factors for the disease. Interviews with 100 cases and 100 controls indicated that salted fish consumption during childhood was a significant risk factor (relative risk, 3.0; p = 0.04); childhood daily consumption of this food item compared to nonconsumption carried a relative risk of 17.4 [95% confidence interval = (2.7, 111.1)]. Occupational exposure to smokes (relative risk, 6.0; p = 0.006) and to dusts (relative risk, 4.0; p less than 0.001) was also significantly associated with nasopharyngeal carcinoma. The two risk factors (consumption of salted fish and exposure to smoke and/or dust) were independent of each other. There was no association between nasopharyngeal carcinoma and tobacco, alcohol, or nasal ointments.

Topics: Administration, Intranasal; Adult; Alcohol Drinking; Carcinoma, Squamous Cell; China; Feeding Behavior; Female; Fish Products; Humans; Malaysia; Male; Middle Aged; Nasopharyngeal Neoplasms; Risk; Smoking

Topics: Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Child; Female; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Racial Groups

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

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Humans; Malaysia; Male; Middle Aged; Sex Factors; Tongue Neoplasms

Topics: Adult; Aged; Alveolar Process; Carcinoma, Squamous Cell; Female; Gingival Neoplasms; Humans; Jaw Neoplasms; Lip Neoplasms; Malaysia; Male; Middle Aged; Mouth Floor; Mouth Neoplasms; Palatal Neoplasms; Tongue Neoplasms

A "registry" of all known cases of nasopharyngeal carcinoma in Malaysia, 1968-72, was established. Attention was focused on the State of Selangor where conditions are best for case finding. Age-adjusted incidence rates among Chinese males and females were 17·3 and 7·3 per 100,000; among Malay males and females, the rates were 2·5 and 0·3 and among Indian males, 1·1. The detailed ethnicity of 192 cases in Selangor was established. Estimated incidence rates for the Chinese sub-groups agreed with the pattern observed elsewhere: highest among the Cantonese, lowest among the Hokkien/Teochiu, with the Khek in between. There was no correlation between histological type and sub-ethnic group among the Chinese cases.

Topics: Adolescent; Adult; Age Factors; Aged; Asian People; Carcinoma; Carcinoma, Squamous Cell; Child; Child, Preschool; China; Female; Humans; India; Malaysia; Male; Middle Aged; Nasopharyngeal Neoplasms; Sex Factors

Topics: Adult; Aged; Carcinoma, Squamous Cell; China; Female; Gingival Neoplasms; Humans; India; Malaysia; Male; Middle Aged; Mouth Neoplasms; Racial Groups; Sex Factors; Tongue Neoplasms

Topics: Adult; Age Factors; Aged; Carcinoma, Squamous Cell; Cheek; China; Ethnicity; Female; Gingival Neoplasms; Humans; Malaysia; Middle Aged; Mouth Neoplasms; Palatal Neoplasms; Sex Factors; Tongue Neoplasms

Topics: Adolescent; Adult; Age Factors; Carcinoma in Situ; Carcinoma, Squamous Cell; Female; Humans; Malaysia; Methods; Middle Aged; Uterine Cervical Neoplasms; Vaginal Smears

Topics: Adenoma, Pleomorphic; Adolescent; Adult; Age Factors; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Child; Choriocarcinoma; Female; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Nasopharyngeal Neoplasms; Palatal Neoplasms; Pregnancy; Racial Groups; Tongue 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