MyMedR

Fulltext Gastric cancer in Malaysia: the need for early diagnosis

Kandasami P, Tan WJ, Norain K

Med J Malaysia, 2003 Dec;58(5):758-62.

PMID: 15190664 MyJurnal

Gastric cancer is an important cause of death among patients with malignancies in Malaysia. Survival of patients with gastric cancer is dependent on the stage at which diagnosis is made. We report our experience in dealing with gastric cancer in a major Ministry of Health Hospitals in Malaysia. A retrospective review of two hundred and fifty consecutive histologically proven gastric adenocarcinoma at Hospital Ipoh for the period January 1988 to 1998 was performed. The study confirms that gastric cancer is a disease of the elderly and has a male preponderance. It is also identifies the Chinese and Indians to be at increased risk of gastric cancer when compared to the Malays. The most striking finding in this study was the very late stage of disease at time of presentation. Eighty-two percent of the patients presented with stage IV disease and curative surgery was offered only to a 16% of them. In a substantial number of patients not even a palliative procedure was offered. Early detection is the key to improving survival in gastric cancer patients. There is an urgent need for clinicians to change their approach to the management of the disease. Patients with dyspeptic symptoms should be investigated early rather then wait for classical symptoms of gastric cancer.

Matched MeSH terms: Stomach Neoplasms/diagnosis

Gastric Schwannoma in an elderly man: A case report

Mohamad MA, Jarmin R, Md Pauzi SH

Malays J Pathol, 2020 Dec;42(3):455-459.

PMID: 33361729

Schwannomas are mesenchymal tumors that are characteristically benign and slow growing, which originate from any nerve with Schwann cell sheath. Gastrointestinal schwannomas are rare with distinct morphologic features as compared to schwannomas of soft tissue or central nervous system. A 77-year-old male patient was diagnosed with gastrointestinal stromal tumor based on radiological findings and clinical impression when he presented with worsening abdominal discomfort and pain. He underwent distal gastrectomy however histopathological examination of the tumour revealed schwannoma. This case report presents a rare case of a symptomatic gastric schwannoma, whose definitive diagnosis was established by histopathological and immunohistochemical findings postoperatively.

Matched MeSH terms: Stomach Neoplasms/diagnosis

Fulltext Development of an E-learning System for the Endoscopic Diagnosis of Early Gastric Cancer: An International Multicenter Randomized Controlled Trial

Yao K, Uedo N, Muto M, Ishikawa H, Cardona HJ, Filho ECC, et al.

EBioMedicine, 2016 Jul;9:140-147.

PMID: 27333048 DOI: 10.1016/j.ebiom.2016.05.016

BACKGROUND: In many countries, gastric cancer is not diagnosed until an advanced stage. An Internet-based e-learning system to improve the ability of endoscopists to diagnose gastric cancer at an early stage was developed and was evaluated for its effectiveness.

METHODS: The study was designed as a randomized controlled trial. After receiving a pre-test, participants were randomly allocated to either an e-learning or non-e-learning group. Only those in the e-learning group gained access to the e-learning system. Two months after the pre-test, both groups received a post-test. The primary endpoint was the difference between the two groups regarding the rate of improvement of their test results.

FINDINGS: 515 endoscopists from 35 countries were assessed for eligibility, and 332 were enrolled in the study, with 166 allocated to each group. Of these, 151 participants in the e-learning group and 144 in the non-e-learning group were included in the analysis. The mean improvement rate (standard deviation) in the e-learning and non-e-learning groups was 1·24 (0·26) and 1·00 (0·16), respectively (P<0·001).

INTERPRETATION: This global study clearly demonstrated the efficacy of an e-learning system to expand knowledge and provide invaluable experience regarding the endoscopic detection of early gastric cancer (R000012039).

Matched MeSH terms: Stomach Neoplasms/diagnosis*

Experience with gastroscopy in the diagnosis of stomach cancer in Malaysia

Paramarajah S

Southeast Asian J. Trop. Med. Public Health, 1985 Dec;16(4):609-12.

PMID: 3835705

Two hundred and eight patients underwent oesophago-gastro-duodenoscopy within the first year of its introduction at a peripheral general hospital in Malaysia. There were 7 cases of gastric cancer, proved histologically, as compared to 38 cases of benign gastric ulcer. The frequencies of the common symptoms and signs in the two conditions are compared. Of the 3 main ethnic groups, Malays, Chinese and Indians, the incidence of gastric ulcer was highest among the Chinese, next the Indians; however, the number of gastric cancers were too few for analysis of its racial incidence.

Matched MeSH terms: Stomach Neoplasms/diagnosis*

Fulltext Upper gastrointestinal endoscopy as an initial investigation in dyspepsia--a Malaysian experience

Kudva MV, Thein-Htut

Med J Malaysia, 1988 Dec;43(4):311-7.

PMID: 3241596

Matched MeSH terms: Stomach Neoplasms/diagnosis

A Review of Gastric Cancer Research in Malaysia

Lim KG, Palayan K

Asian Pac J Cancer Prev, 2019 Jan 25;20(1):5-11.

PMID: 30677863

Incidence rates of gastric cancer in Malaysia has declined by 48% among males and 31% among females in the latest reporting period of 13 years. Malays used to have age-standardized-rates only a fifth of those in Chinese and Indians, but the incidence among them is slightly rising even as the rates drop in the other races. Besides ethnicity, a low level of education, high intake of salted fish and vegetables, H pylori infection and smoking are risk factors. Consumption of fresh fruit and vegetable is protective. Variation in the strains of H pylori infection affect gastric cancer risk, with hspEAsia isolates among Chinese appearing linked to a high incidence than with hpAsia2 or hpEurope strains among Indians and Malays. It was reported in the 1980s that only about 3% of patients presented with early gastric cancer, but more encouraging rates reaching 27% with Stage 1 and 2 disease have been reported in the twenty-first century from leading centres. More tumours occur in the distal stomach except in Kelantan, where the incidence is low and main site is the cardia. Prompt endoscopy is advocated and open access, with direct referrals, to such services using a weighted scoring system should be more utilized. In view of the high rate of late disease laparoscopic staging unnecessary laparotomy needs to be avoided. Late presentation of gastric cancer however, is still predominant and the mortality to incidence ratio is relatively high. Besides seeking to reduce risk factors and achieve early detection, implementation of improved care for patients with late disease must be promoted in Malaysia.

Matched MeSH terms: Stomach Neoplasms/diagnosis

Fulltext Gastric precancerous lesions are associated with gene variants in Helicobacter pylori-susceptible ethnic Malays

Maran S, Lee YY, Xu S, Rajab NS, Hasan N, Syed Abdul Aziz SH, et al.

World J Gastroenterol, 2013 Jun 21;19(23):3615-22.

PMID: 23801863 DOI: 10.3748/wjg.v19.i23.3615

To identify genes associated with gastric precancerous lesions in Helicobacter pylori (H. pylori)-susceptible ethnic Malays.

Matched MeSH terms: Stomach Neoplasms/diagnosis

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