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  1. Fulltext Patterns of breast cancer relapse at University of Malaya Medical Centre
    Rozita, A.M., Marniza, S., Mastura, M.Y., Wan Zamaniah, W.I., Yip, C.H., Taib, N.A.
    JUMMEC, 2010;13(1):24-32.
    MyJurnal
    Despite being the major cause of cancer-related death in Malaysian women,local data on patterns of breast cancer relapse and their long term outcomes are still scarce. We conducted a retrospective study on all patients treated for non-metastatic invasive breast cancer in 1999-2000 at the University of Malaya Medical Centre (UMMC), who subsequently developed relapse. We sought to analyse the patterns of relapse, their associated clinicopathological features and the overall survival ratefollowing the relapses. Univariate and multivariate analyses were used to analyse demographics and clinicopathological factors. Survival was analysed using the Kaplan and Meier method and compared by the log rank test. A total of 268 patients with a mean age of 50, were identified for the study. At a median follow-up of 50 months, 73 patients (27.2%) had relapsed. Local, regional and distant relapse rates were 5.5%, 1.9% and 19.8% respectively, whereas, the 5-year survival rates were 61%, 40% and 21% respectively (p < 0.01). Most relapses occurred within the first five years of diagnosis. Patients with long disease-free interval had better survival. The most common distant relapse site was the lungs while bone was the distant relapse site with the best prognosis. Disease stage, nodal status and oestrogen receptor status were found to have correlation with the risk of relapse. We concluded that the survival of patients with relapsed breast cancer was associated with the site(s) of first relapse and the disease free interval and clinicopathological factors can be used to predict the risk of relapse.
  2. Definitive concurrent chemoradiotherapy in cervical cancer--a University of Malaya Medical Centre experience
    Zamaniah WI, Mastura MY, Phua CE, Adlinda A, Marniza S, Rozita AM
    Asian Pac J Cancer Prev, 2014;15(20):8987-92.
    PMID: 25374241
    BACKGROUND: The efficacy of concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer is well established. We aimed to investigate the long-term efficacy of definitive concurrent chemoradiotherapy for cervical cancer in the University of Malaya Medical Centre.

    MATERIALS AND METHODS: A cohort of 60 patients with FIGO stage IB2-IVA cervical cancer who were treated with definitive concurrent chemoradiotherapy with cisplatin followed by intracavitary brachytherapy or external beam radiotherapy (EBRT) boost between November 2001 and May 2008 were analysed. Patients were initially treated with weekly intravenous cisplatin (40 mg/m2) concurrent with daily EBRT to pelvis of 45-50 Gy followed by low dose rate brachytherapy or EBRT boost to tumour. Local control rate, progression free survival, overall survival and treatment related toxicities graded by the RTOG criteria were evaluated.

    RESULTS: The mean age was 56. At the median follow-up of 72 months, the estimated 5-year progression-free survival (PFS) (median PFS 39 months) and the 5-year overall survival (OS) (median OS 51 months) were 48% and 50% respectively. The 5-year local control rate was 67.3%. Grade 3-4 late gastrointestinal and genitourinary toxicity occurred in 9.3% of patients.

    CONCLUSIONS: The 5-year PFS and the 5-year OS in this cohort were lower than in other institutions. More advanced stage at presentation, longer overall treatment time (OTT) of more than fifty-six days and lower total dose to point A were the potential factors contributing to a lower survival.

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