METHODS AND MATERIALS: Patients with T3-4, N2 M0 breast cancer diagnosed between January 2005 and December 2008 and who received at least one cycle of neoadjuvant chemotherapy were eligible for this study. Thirty-four patients were identified from the Chemotherapy Daycare Records and their medical records were reviewed retrospectively. The neoadjuvant chemotherapy regimen administered was at the discretion of the treating oncologist. Breast tumour size and nodal status was assessed at diagnosis, at each cycle and before surgery.
RESULTS: All 34 patients had invasive ductal cancer. The median age was 52 years (range 27-69). 65% had T4 disease and 76% were clinically lymph node positive at diagnosis. The median size of the breast tumour at presentation was 80 mm (range 42-200 mm). Estrogen and progesterone receptor positivity was seen in less than 40% and HER2 positivity, by immunohistochemistry, in 27%. The majority (85%) of patients had anthracycline based chemotherapy, without taxanes. The overall response rate (clinical CR+PR) was 67.6% and pathological complete responses were apparent in two (5.9%). 17.6% of patients defaulted part of their planned treatment. Recurrent disease was seen in 44.1% and the median time to relapse was 11.3 months. The three year disease free and overall survival rates were 52.5% and 58% respectively.
CONCLUSION: Neoadjuvant chemotherapy for locally advanced breast cancer in a Malaysian setting confers response and pCR rates comparable to published clinical trials. Patients undergoing neoadjuvant chemotherapy are at risk of defaulting part of their treatment and therefore their concerns need to be identified proactively and addressed in order to improve outcomes.
MATERIALS AND METHODS: Medical records of 407 cervical cancer patients between 1st January 2002 to 31st December 2012 were reviewed. Some 32 cases with positive PALN were identified to have received definitive extended field radiotherapy with or without chemotherapy. Treatment outcomes, clinicopathological factors affecting survival and radiotherapy related acute and late effects were analyzed.
RESULTS: Totals of 13 and 19 patients underwent EFRT and CCEFRT respectively during the period of review. The median follow-up was 70 months. The 5-year overall survival (OS) was 40% for patients who underwent CCEFRT as compared to 18% for patients who had EFRT alone, with median survival sof 29 months and 13 months, respectively. The 5-years progression free survival (PFS) for patients who underwent CCEFRT was 32% and 18% for those who had EFRT. Median PFS were 18 months and 12 months, respectively. Overall treatment time (OTT) less than 8 weeks reduced risk of death by 81% (HR=0.19). Acute side effects were documented in 69.7% and 89.5% of patients who underwent EFRT and CCEFRT, respectively. Four patients (12.5%) developed radiotherapy late toxicity and there was no treatment-related death observed.
CONCLUSIONS: CCEFRT is associated with higher 5-years OS and median OS compared to EFRT and with tolerable level of acute and late toxicities in selected patients with cervical cancer and PALN metastasis.
Materials and Methods: This study was carried out in ten cases of biopsy-proven GCTs: five males and five females, in the age group between 18 and 39 years. All patients were given three doses of zoledronic acid, one pre-operative and two post-operative. Extended curettage was done three weeks after the pre-operative dose of zoledronate. The cavity was left empty in all the cases. Fibular struts were used to support the cavity from collapse. Patients were followed-up for post-operative local recurrence. The functional status of the patients was assessed during each visit using the Musculoskeletal Tumour Society (MSTS) score.
Results: There were no recurrences at a follow-up of two years. All patients had a stable knee and were able to bear weight fully. The average knee flexion was 75º. The average MSTS score of the study was 92%.
Conclusion: Extended curettage using hydrogen peroxide, systemic zoledronic acid adjuvant and leaving the cavity empty without using cancellous bone graft did not lead to a recurrence of GCT. Non-vascularised fibular strut provided adequate support while the cavity left empty after curettage did not collapse and there was good knee function.
Methods: This was a qualitative study with patients diagnosed with recurrent ovarian cancer and receiving chemotherapy at a hospital gynecologic day-care unit. In-depth individual interviews were conducted with patients to explore how they coped with recurrence of ovarian cancer. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically.
Results: The participants' (n = 10) age range was 52-84 years, the three most common ethnic backgrounds were represented (Malay, Chinese, and Indian), and most of the patients were well educated. All patients were on chemotherapy. Six coping strategies were identified: (1) maintaining a mindset of hopefulness, (2) avoidance of information, (3) accepting their condition, (4) seeking spiritual help, (5) relying on family for support, and (6) coping with financial costs.
Conclusions: Coping strategies employed during ovarian cancer recurrence in this setting were rarely based on the accurate information appraisal, but rather on the individual emotion and personal beliefs.
Methods: This is a multinational, multicenter, longitudinal, and observational registry of PC patients presenting to participating tertiary-care hospitals in eight Asian countries (www.clinicaltrials.gov NCT02546908. Registry Identifier: NOPRODPCR4001). Approximately 3500-4000 eligible patients with existing or newly diagnosed high-risk localized PC (cohort 1), nonmetastatic biochemically recurrent PC (cohort 2), or metastatic PC (cohort 3) will be consecutively enrolled and followed-up for 5 years. An enrollment cap of 600 patients each will be applied to cohorts 1 and 2. Disease status is collected at enrollment, and outcome variables captured at 3-monthly intervals include diagnostic/staging, treatments including reason for change, laboratory results, comorbidities, and concomitant medications. Treatments and survival outcomes will be captured real time until study end. Patient-reported quality-of-life will be measured every 6 months, and medical resource utilization summarized at study end. Data analysis will include exploratory analyses of potential associations between multiple risk factors and socioeconomic variables with disease progression and evaluation of various treatments for PC including novel therapies on clinical outcome and health-related quality-of-life outcomes.
Results: 3636 men with PC were enrolled until July 2018; 416 in cohort 1, 399 in cohort 2 and 2821 in cohort 3.
Discussion: A total of 3636 patients were enrolled until July 2018. The prospective disease registry will provide comprehensive and wide-ranging real-world information on how PC is diagnosed and treated in Asia. Such information can be used to inform policy development for best practice and direct clinical study design evaluating new treatments.
MATERIALS AND METHODS: CML patients on tyrosine kinase inhibitor (TKI) therapy and on regular follow up at University Kebangsaan Malaysia Medical Center (UKMMC) were selected. A comparative study was conducted between FISH and QRT-PCR for BCR-ABL transcripts at diagnosis and during follow-up.
RESULTS: There was good correlation between FISH and QRT-PCR for BCR-ABL. At 6th month of follow-up post diagnosis, FISH had a sensitivity of 83.3% and specificity of 65.2% (k >0.339, p<0.033). At 12th month, the sensitivity of FISH was 83% and the specificity was 59.1% (k >0.286, p <0.065). Similarly, at the 24th month, FISH had a sensitivity of 100% and specificity of 68.8% (k >0.642, p<0.000).
DISCUSSION: Early achievement of major molecular response (MMR) and complete cytogenetic remission (CCyR) were reliable predictors of long-term maintenance of molecular remission.
MATERIALS AND METHODS: Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination.
RESULTS: Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love's Pin test was positive in all cases (100%). Hildreth's test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours.
CONCLUSION: Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.