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Fulltext Colorectal Cancer Immunotherapy: Options and Strategies

Johdi NA, Sukor NF

Front Immunol, 2020;11:1624.
PMID: 33042104 DOI: 10.3389/fimmu.2020.01624

Colorectal cancer is the third most common cancer in the world with increasing incidence and mortality rates globally. Standard treatments for colorectal cancer have always been surgery, chemotherapy and radiotherapy which may be used in combination to treat patients. However, these treatments have many side effects due to their non-specificity and cytotoxicity toward any cells including normal cells that are growing and dividing. Furthermore, many patients succumb to relapse even after a series of treatments. Thus, it is crucial to have more alternative and effective treatments to treat CRC patients. Immunotherapy is one of the new alternatives in cancer treatment. The strategy is to utilize patients' own immune systems in combating the cancer cells. Cancer immunotherapy overcomes the issue of specificity which is the major problem in chemotherapy and radiotherapy. The normal cells with no cancer antigens are not affected. The outcomes of some cancer immunotherapy have been astonishing in some cases, but some which rely on the status of patients' own immune systems are not. Those patients who responded well to cancer immunotherapy have a better prognostic and better quality of life.

Matched MeSH terms: Neoplasm Recurrence, Local
Collapsed wall: destructive and reconstructive surgery of anterior abdominal wall tumour in a young girl

Che Ghazali K, Mazian HA, Keat KC, Kai MWP, Md Hashim MN, Zakaria AD, et al.

J Surg Case Rep, 2019 Feb;2019(2):rjy345.
PMID: 30788087 DOI: 10.1093/jscr/rjy345

Natural history of abdominal wall soft tissue sarcoma is still poorly understood due to its rarity. In unpublished data of our institution, only seven cases of abdominal wall soft sarcoma with ICD-10 coding of 49.4 were found for past 10 years. We illustrate a case of juvenile fibrosarcoma of anterior abdominal wall. This is a case of young girl with anterior abdominal wall tumour, underwent wide local excision with immediate reconstruction. There are few options of surgical treatment for this case, but which is the best. It is always a challenge in managing young patient with giant abdominal wall defect in view of long term effect namely weakened abdominal wall, pregnancy related issue and risk of herniation and surgical site recurrence as well.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Wong JHD, Zaili Z, Abdul Malik R, Bustam AZ, Saad M, Jamaris S, et al.

J Appl Clin Med Phys, 2021 Aug;22(8):139-147.
PMID: 34254425 DOI: 10.1002/acm2.13338

PURPOSE: This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation-induced skin toxicity.
METHODOLOGY: A total of 21 breast cancer patients who underwent breast-conserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid-term skin toxicities were evaluated at 3 and 6 months post-IORT.
RESULTS: The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post-IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post-IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose.
CONCLUSION: EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient-specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.

Matched MeSH terms: Neoplasm Recurrence, Local
Role of radiotherapy in early breast cancer: an overview

Joshi SC, Khan FA, Pant I, Shukla A

Int J Health Sci (Qassim), 2007 Jul;1(2):259-64.
PMID: 21475437

Radiotherapy has an established role in reducing the local relapses in breast cancer patients. The objective of this review was to investigate whether radiotherapy or its omission after breast surgery has measurable consequences on local tumor recurrence and patient survival. The late excess of cardiac deaths has also been published in various reports but important advances in the delivery of radiotherapy have overcome this problem to the extent that, excess cardiac deaths do not appear to be occurring in more recent trials. In this article some recent data, suggesting that radiotherapy following mastectomy and/or breast conserving surgery has a beneficial effect on survival is reviewed. Omission of radiotherapy is associated with a large increase in risk of ipsilateral breast tumor recurrence and with a small increase in the risk of patient's mortality.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Adenoid cystic carcinoma – a case report and review of literature

Kanneppady, Sham Kishor, Sakri, Santosh B., Chatra, Laxmikanth, Prashanth, Shenoy K.

Malaysian Dental Journal, 2010;31(2):79-83.
MyJurnal

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that arises within secretary glands, most commonly the major and minor salivary glands. It has a tendency for a prolonged clinical course, perineural invasion, with local recurrences and distant metastases. The three recognized histopathologic pattern of ACC are cribriform, tubular, and solid with the cribriform being most common. Standard treatment for salivary gland ACC is surgery and postoperative radiotherapy. We report a case of ACC of palate in a 30-year-old female and review the literature.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Endoscopic Transoral Resection of an Axial Chordoma: A Case Report

Taran S, Yusof AH, Yusof MI

Malays Orthop J, 2015 Nov;9(3):75-77.
PMID: 28611918 MyJurnal DOI: 10.5704/MOJ.1511.015

Upper cervical chordoma (UCC) is rare condition and poses unique challenges to surgeons. Even though transoral approach is commonly employed, a minimally invasive technique has not been established. We report a 44-year old Malay lady who presented with a 1 month history of insidious onset of progressive neck pain without neurological symptoms. She was diagnosed to have an axial (C2) chordoma. Intralesional resection of the tumour was performed transorally using the Destandau endoscopic system (Storz, Germany). Satisfactory intralesional excision of the tumour was achieved. She had a posterior fixation of C1-C4 prior to that. Her symptoms improved postoperatively and there were no complications noted. She underwent adjuvant radiotherapy to minimize local recurrence. Endoscopic excision of UCC via the transoral approach is a safe option as it provides an excellent magnified view and ease of resection while minimizing the operative morbidity.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Radiation-induced meningioma following radiotherapy for pituitary adenonoma: a case report

Ellyda, M.N., Win Mar@Salmah, J.

International Medical Journal Malaysia, 2013;12(1):63-66.
MyJurnal

It is well known that ionizing radiation has an onco-genetic activity and has been implicated in the causation of brain tumors. However, when a new growth appears adjacent to the site of previous tumor, the diagnosis is more toward recurrence. In addition to that, the possible cause might be overlooked, when it occurs many years after radiation treatment. We report a case of radiation-induced meningioma developed 20 years after the patient received radiotherapy for pituitary adenoma.

Matched MeSH terms: Neoplasm Recurrence, Local
Congenital leukaemia: a case report

Tuck, Sang Hoe, Kok, Wai Chum

Malaysian Journal of Child Health, 1992;4(1):38-40.
MyJurnal

A five-week-old infant presented with infantile acute lymphoblastic leukaemia. He devel-oped an early CNS and bone marrow relapse despite intensive treatment. This paper discusses infantile leukaemia and its treatment.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Thymoma: a case report and review of the literature

Hamidah, A., Poulsaeman, V., Suria, A.A., Zarina, A.L., Zulfiqar, M.A., Jamal, R.

Medicine & Health, 2010;5(1):49-54.
MyJurnal

Thymomas comprise about 1% of all mediastinal tumours and are rare in children. Typically, these tumours are aggressive, with a poor outcome. The current treatment of invasive thymoma is often multidisciplinary. We report a 16-year-old boy with invasive thymoma who was successfully treated with systemic chemotherapy, surgical resection and irradiation. The patient has been in continuous remission for 6 years without radiographic evidence of tumour recurrence.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Oncocytic schneiderian papilloma: a rare sinonasal papilloma removed via endoscopic medial maxillectomy

Faizah, A.R., Mazita, A., Marina, M.B., Jeevanan, J., Isa, M.R.

Medicine & Health, 2010;5(1):55-59.
MyJurnal

There are three types of papilloma which arises from the Schneiderian membrane namely inverted, fungiform and oncocytic. Oncocytic papilloma is the rarest type and occurs predominantly in the older age group. Clinically, its behaviour is similar to inverted papilloma in having both local recurrence and associated malignancy. We report a rare case of oncocytic papilloma arising from the maxillary sinus, extending into the nasal cavity and nasopharynx, in a 78-year-old lady. Despite the longstanding history there was no evidence of associated malignancy in this lesion. An endoscopic medial maxillectomy was successfully utilized for approach and complete tumour excision. In conclusion, oncocytic papilloma should be considered as a differential diagnosis in patients presenting with unilateral polypoid nasal lesions especially in the elderly. In addition, endoscopic medial maxillectomy can provide an adequate approach for complete tumour removal.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Multicompartmental congenital intracranial immature teratoma

Ganesan, Dharmendra, Sheau, Fung Sia, Narayann, Vairavan, Kumar, Gnana, Lum, Lucy, Chan,Lucy, et al.

Neurology Asia, 2013;18(1):117-121.
MyJurnal

Congenital intracranial tumors are rare and account for 0.5 to 1.5% of all childhood tumours. We report a case of a 3 week old baby presenting with multi compartmental congenital intracranial immature teratoma, first of its kind in the literature. The child had gross total excision in two stages with aid of neuronavigation. The short term outcome was good. The four years of follow-up with serial imaging showed no tumour recurrence with a stable hydrocephalus after shunting. However, there is global developmental delay with full time dependence of care giver.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext A rare case of recurrent orbital solitary fibrous tumour with intracranial extension

Ainal Adlin N, Umi Kalthum MN, Amizatul Aini S, Reena Rahayu MZ

Journal of Surgical Academia, 2016;6(1):59-61.
MyJurnal

A 47-year-old lady, presented with progressive proptosis of left eye with deterioration of vision. She had a history of left solitary fibrous tumour and had undergone left frontal craniotomy and orbitotomy in 2004. Surveillance Magnetic resonance imaging (MRI) six years later showed tumour recurrence with intracranial extension. However, she did not follow-up and only presented again 3 years, later. Tumour resection and left exenteration was performed. Histology showed ‘patternless’ pattern of neoplastic cells, and CD34 staining was diffusely positive. Diagnosis of recurrent solitary fibrous tumour with intracranial extension was made.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Tissue Diagnosis for Musculoskeletal Tumours

Saw, A.

Malays Orthop J, 2007;1(2):1-2.
MyJurnal

Musculoskeletal tumour is much less common compared to tumours of epithelial origin. Most of these tumours are benign, with only about 1% malignant in nature. A general orthopaedic surgeon may only come across a malignant primary bone or soft tissue tumour a few times in his entire medical career. The current recommendation is for these conditions to be investigated and treated in centres with musculoskeletal oncology service. Careful clinical evaluation with appropriate plain radiography can provide adequate information for definitive diagnosis and treatment for most cases, especially the benign tumours. For some other cases, further investigations will be necessary. Magnetic resonance imaging (MRI) can provide excellent details on anatomical location of a tumour and delineate vital structures that may have been distorted by the lesion. For primary malignant tumours, computerized tomography scanning is still the gold standard for evaluation of pulmonary metastasis, and bone scan can allow early detection of distant metastasis to other bones. Whole body MRI has recently been recommended for tumour staging but the potential benefit for musculoskeletal tumour is not that convincing. PET may be very helpful for follow up detection of tumour recurrence but its role in diagnosis and staging of musculoskeletal tumours is still being evaluated...

Matched MeSH terms: Neoplasm Recurrence, Local
Juvenile onset respiratory papillomatosis : a theraputic challenge

Irfan Mohamad, Abdul Halim Shibgatullah, Rosdan Salim

Malaysian Journal of Paediatrics and Child Health, 2007;15(1):37-41.
MyJurnal

Respiratory papillomatosis is a disease of viral origin which is characterized by warty exophytic lesions in the aerodigestive tract. It is the most common benign lesion of larynx and the second most common cause of hoarseness in children. It has the tendency to recur and to spread through out the entire length of the aerodigestive tract. Although a benign disease, it has the potential of morbid consequences in view of airway complications and the risk of malignant transformation. We report a case of juvenile onset of respiratory papillomatosis and its therapeutic challenges.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Posterior Fossa Intradiploic Epidermoid Cyst: A case report

Ng, Wei Ping, Liew, BS, Gee, TS, Azmin KR

International Medical Journal Malaysia, 2015;14(2):67-70.
MyJurnal

Epidermoid cysts are rare, benign congenital tumours of ectodermal origin which typically present between
the third to fifth decade. These tumours comprise approximately 0.2-1.8% of all intracranial tumours. Though
these pearly tumours are potentially curable, subtotal resection may lead to catastrophic complications such as
recurrence, granulomatous meningitis and carcinomatous degeneration of cyst wall. We herein report the case
of a 36-year-old man who presented with an unusual mixed density posterior fossa epidermoid cyst on imaging
studies. Total removal not only cures both tumour and seizure attack in this case but also preserves patient’s
neurological function.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Targeting Lung Cancer Stem Cells: Research and Clinical Impacts

Zakaria N, Satar NA, Abu Halim NH, Ngalim SH, Yusoff NM, Lin J, et al.

Front Oncol, 2017;7:80.
PMID: 28529925 DOI: 10.3389/fonc.2017.00080

Lung cancer is the most common cancer worldwide, accounting for 1.8 million new cases and 1.6 million deaths in 2012. Non-small cell lung cancer (NSCLC), which is one of two types of lung cancer, accounts for 85-90% of all lung cancers. Despite advances in therapy, lung cancer still remains a leading cause of death. Cancer relapse and dissemination after treatment indicates the existence of a niche of cancer cells that are not fully eradicated by current therapies. These chemoresistant populations of cancer cells are called cancer stem cells (CSCs) because they possess the self-renewal and differentiation capabilities similar to those of normal stem cells. Targeting the niche of CSCs in combination with chemotherapy might provide a promising strategy to eradicate these cells. Thus, understanding the characteristics of CSCs has become a focus of studies of NSCLC therapies.

Matched MeSH terms: Neoplasm Recurrence, Local
Five-year Survival Data on the Role of Endoscopic Endonasal Nasopharyngectomy in Advanced Recurrent rT3 and rT4 Nasopharyngeal Carcinoma

Wong EHC, Liew YT, Loong SP, Prepageran N

Ann Otol Rhinol Laryngol, 2020 Mar;129(3):287-293.
PMID: 31701754 DOI: 10.1177/0003489419887410

AIM: Endoscopic endonasal nasopharyngectomy (EEN) for recurrent nasopharyngeal carcinoma (rNPC) is being increasingly used due to the added high magnification, reduced morbidities associated with open procedures and good survival outcomes. Most studies looked at usage of EEN in patients with lower recurrent staging (rT1 and rT2) although more and more surgeons are studying the outcome of EEN in advanced rNPC (rT3 and rT4). The aims of this study were to report the long-term 5-year survival outcome of EEN performed in patients with advanced rNPC, and to determine any prognostic factors for patients' survival.
METHODS: All patients who underwent EEN for advanced rNPC between January 2003 and December 2015 inclusive were analyzed. All surgeries were performed in University Malaya Medical Centre in Kuala Lumpur and Queen Elizabeth Hospital in Sabah. We reported the 5-year overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and any related complications and significant prognostic factors.
RESULTS: Twelve patients with rNPC (2 rT3 and 10 rT4) were followed-up over a mean duration of 44.8 months (range, 40-440 weeks). The 5-year OS was 50.0% (mean 44.75 months), DFS was 25.0% (mean 35.25 months) and the DSS was 58.3% (mean 43.33 months). No severe operative complications were encountered and no independent prognostic factors for survival outcome were identified.
CONCLUSION: This is the first report in English that exclusively described the long-term 5-year survival data in patients with both rT3 and rT4 recurrent NPC after EEN. The data suggest that EEN is a feasible treatment to improve survival with minimal morbidities in patients with rT3 and rT4 recurrent NPC. However, more studies with larger patient size is recommended.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Longitudinally Extensive Transverse Myelitis in Highly Active Relapsing-remitting Multiple Sclerosis

Ng CF, Remli R, Tan HJ

Neurol India, 2021 11 9;69(5):1412-1413.
PMID: 34747827 DOI: 10.4103/0028-3886.329533

Transverse myelitis in multiple sclerosis is typically a short cord lesion with patchy distribution. Rarely, longitudinally extensive transverse myelitis can be seen in those with highly active disease or frequent relapses. The recognition of this uncommon phenotype in multiple sclerosis is important as the treatment is largely different from other demyelinating diseases. We describe a patient with highly active relapsing-remitting multiple sclerosis on interferon beta-1a who developed LETM after multiple relapses.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Pharmacogenomics DNA Biomarkers in Colorectal Cancer: Current Update

Ab Mutalib NS, Md Yusof NF, Abdul SN, Jamal R

Front Pharmacol, 2017;8:736.
PMID: 29075194 DOI: 10.3389/fphar.2017.00736

Colorectal cancer (CRC) remains as one of the most common cause of worldwide cancer morbidity and mortality. Improvements in surgical modalities and adjuvant chemotherapy have increased the cure rates in early stage disease, but a significant portion of the patients will develop recurrence or advanced disease. The efficacy of chemotherapy of recurrence and advanced CRC has improved significantly over the last decade. Previously, the historical drug 5-fluorouracil was used as single chemotherapeutic agent. Now with the addition of other drugs such as capecitabine, irinotecan, oxaliplatin, bevacizumab, cetuximab, panitumumab, vemurafenib, and dabrafenib, the median survival of patients with advanced CRC has significantly improved from less than a year to the current standard of almost 2 years. However, the side effects of systemic therapy such as toxicity may cause fatal complications and have a major consequences on the patients' quality of life. Hence, there is an urgent need for key biomarkers which will enable the selection of optimal drug singly or in combination for an individual patient. The application of personalized therapy based on DNA testing could aid the clinicians in providing the most effective chemotherapy agents and dose modifications for each patient. Yet, some of the current findings are controversial and the evidences are conflicting. This review aims at summarizing the current state of knowledge about germline pharmacogenomics DNA variants that are currently used to guide therapeutic decisions and variants that have the potential to be clinically useful in the future. In addition, current updates on germline variants conferring treatment sensitivity, drug resistance to existing chemotherapy agents and variants affecting prognosis and survival will also be emphasized. Different alteration in the same gene might confer resistance or enhanced sensitivity; and while most of other published reviews generally stated only the gene name and codon location, we will specifically discuss the exact variants to offer more accurate information in this mini review.

Matched MeSH terms: Neoplasm Recurrence, Local
Curative lung metastectomy and complete pathological response after neo-adjuvant GEMOX chemotherapy for relapse fibrolamellar hepatocellular carcinoma

Eng JY, Soon SY, Winnie Ling HY

Med J Malaysia, 2018 02;73(1):46-48.
PMID: 29531203 MyJurnal

Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of hepatocellular carcinoma. It is commonly reported in the younger population with no underlying chronic liver disease and free of viral Hepatitis B and C. Local recurrence and distant metastasis are common despite better prognosis compared to conventional hepatocellular carcinoma. Complete surgical resection is associated with higher median survival and is the mainstay treatment option for localized FL-HCC. Multi-modality therapies such as TACE can be used to downstage upfront unresectable FL-HCC. Complete response with GEMOX chemotherapy has been reported in advanced metastatic FL-HCC and should be considered in upfront unresectable or metastatic disease. We present a case of biopsied proven relapse FL-HCC with oligo- left lung metastasis who successfully underwent a left lung lobectomy after neo-adjuvant GEMOX chemotherapy, and is disease free at 24 months follow up.

Matched MeSH terms: Neoplasm Recurrence, Local

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