Medical Journal of Malaysia最新文献

{"title":"Diagnostic Evaluation of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography in the Differential Diagnosis of Parkinsonism in Hospital Kuala Lumpur: A preliminary experience.","authors":"K Kamarulzaman, N Abd Razak, A S Mawardi, S Z Amir Hassan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinsonian syndrome encompasses a group of movement disorders characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While Idiopathic Parkinson's disease is the most common cause, several other etiologies can also result in parkinsonism. Identifying the specific type of Parkinsonian syndrome is essential due to its varying therapeutic and prognostic implications. This study aims to evaluate the role of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography (Tc-99m TRODAT-1 SPECT-CT) in patients with parkinsonism.</p><p><strong>Materials and methods: </strong>The clinical data and scintigraphy findings of patients referred to the Department of Nuclear Medicine, Hospital Kuala Lumpur for Tc-99m TRODAT-1 SPECT-CT from July 2022 to July 2023 were retrospectively reviewed. Follow-up with primary team was conducted to determine the clinical implications and subsequent therapeutic management of the patients.</p><p><strong>Results: </strong>Tc-99m TRODAT-1 SPECT-CT was performed on sixteen patients (10 females and 6 males) with a mean age of 55.2 years (range 26 to 75 years). Five patients exhibited normal scintigraphy findings, while eleven patients showed abnormal Tc-99m TRODAT-1 SPECT-CT results. The scintigraphy findings led to changes in therapeutic management for 81.3% of the patients. Additionally, 19% of the patients were referred for further evaluation with Fluorine-18 fluorodeoxyglucose PET to assist in diagnosing atypical Parkinsonian disease.</p><p><strong>Conclusions: </strong>Tc-99m TRODAT-1 SPECT-CT is a readily available tool for assessing presynaptic dopamine transporters in patients with parkinsonism. This study demonstrated that Tc-99m TRODAT-1 SPECT-CT significantly impacts the diagnostic and therapeutic outcomes for patients with parkinsonism.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"690-702"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of educational intervention on knowledge and awareness regarding glaucoma among working adults in northeast of Malaysia.","authors":"W K Chong, D S K Phang, I Mohd Ismail, A H Siti-Azrin, A T Liza-Sharmini, Y Azhany","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>To determine the level of good awareness and knowledge on glaucoma and their associated factors as well as the effectiveness of the glaucoma educational intervention among the working adults in northeast of Malaysia.</p><p><strong>Materials and methods: </strong>Participants from the governmental departments were recruited and divided into intervention group and control group. A translated and validated questionnaire on awareness and knowledge related to glaucoma were used. Educational interventions were given for both groups. Post-test assessments were completed at one month and three months post intervention.</p><p><strong>Results: </strong>A total of 202 participants enrolled for the study (102 intervention group and 100 control group). 64.9% of the participants were aware of glaucoma and 49% of the participants had good knowledge score on glaucoma. Higher educational attainments (bachelor and diploma holders) were the only factors significantly associated with good glaucoma knowledge (p <0.001). There was significant increase in the proportion of good glaucoma knowledge in the intervention group one month after the educational intervention (p < 0.001) and the effect persisted after three months (p < 0.003). There was also significantly higher proportion of good post-test glaucoma knowledge between intervention and control group (p = 0.003).</p><p><strong>Conclusion: </strong>Although the public was well aware of glaucoma, there was relatively little understanding of the condition. Educational interventions can be effective to bridge the gap in promoting the glaucoma awareness and better understanding of glaucoma.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"770-776"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicentre, retrospective study of epidemiology and outcome of aplastic anaemia among adult population in Sabah and Sarawak from year 2006 to 2017.","authors":"G W C Lee, M Y Yeap, X Y Tan, A S O Tang, Y F Ho, K B Law, S W F Lee, L P Chew, L L L Wong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Aplastic anaemia (AA) is a rare disorder of bone marrow failure, characterized by bone marrow hypocellularity with pancytopenia. The annual incidence rates of AA in Asia are observed to be two to three times higher than Europe and North America. Since the introduction of immunosuppressive therapy (IST) and of allogenic stem cell transplant (SCT), the outcome of severe AA has significantly improved. We conducted a 12-year multi-centre retrospective study among the adult AA population in Sabah and Sarawak.</p><p><strong>Materials and methods: </strong>A total of 119 AA patients had been identified from hospital records of the involved sites, namely Queen Elizabeth Hospital in Sabah, Sarawak General Hospital, Sibu Hospital, Miri Hospital and Bintulu Hospital in Sarawak from Jan 2006 to Dec 2017.</p><p><strong>Results: </strong>The median age at diagnosis was 46 years, and native ethnic group from Sabah, Kadazan-Dusun, recorded the highest percentage of 41.2%, which could be explained by higher frequency of HLA-DRB1*15:01, an alelle linked to increased risk of AA, among this ethnic group. The majority of patients (59.7%) received cyclosporine (CsA) as monotherapy or in combination with other non-IST agents such as danazol, which was instituted in 48.7% of the patients, while a third of them (33.7%) received antithymocyte globulin (ATG) therapy with or without CsA, and 12.4% underwent allogenic SCT. The five-year overall survival (OS) for all AA patients was 76.1%. Elderly patients >60 years old and those with severe disease had more inferior 5-year survival.</p><p><strong>Conclusion: </strong>A prospective study is warranted to determine the true incidence rate, epidemiological distributions, treatment outcome and overall survival of AA patients in Malaysia. Establishment of allogenic SCT in East Malaysia is imperative to make this curative therapy more accessible to patients with severe disease and improve the outcome.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"749-756"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental perception on home therapy and its associated factors for children with cerebral palsy: A qualitative study in Malaysia.","authors":"T Chandrabose, S Suppiah, A A Fauzi, J P Engkasan, M H Romli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Children with cerebral palsy (CP) benefit from consistent rehabilitation intervention. Home therapy (HT) consists of therapeutic exercises and activities targeting physical and functional improvement. HT is vital to ensure the rehabilitation provided in the clinical setting is further continued by the client. However, the success of HT mostly depends on compliance and support from caregivers, especially the parents. The objective of this study was to explore parents' perceptions of home therapy and to identify facilitating factors and barriers to it.</p><p><strong>Materials and methods: </strong>An interview-based qualitative study was conducted in a public university hospital in Malaysia, utilizing in-depth interviews. Audio recordings of the interviews were transcribed verbatim. The transcript data were coded, and the codes were then organized into themes using a thematic analysis approach.</p><p><strong>Results: </strong>Data from twelve mothers and three fathers among a total of fifteen children with CP were acquired. Nine themes were derived from transcript data namely : HT is a simple home prescription,HT empowers and enhances experiences of care, Negative experience, goal-directed positive attitude, External Support System, physical health as a barrier, psychological health as barrier, limited time and limited external support system.</p><p><strong>Conclusion: </strong>Real-life experiences of parents with CP children regarding HT was explored and valuable outcomes were derived from this study to help clinicians to manage children with CP more efficiently and understand their family dynamics better in the local context. Overall, parents perceived HT as doable and it provided physical, functional, and psychological benefits for them as well as improved their confidence and skills to perform exercises on their children and empowered them to monitor their children's progression.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"721-728"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in critically ill COVID-19 patients: A retrospective study.","authors":"W Wulandari, M Z Syahrul, S Ermayanti, Z D Rofinda, E Usman, D Kurnia, M Lailani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Critical coronavirus disease (COVID-19) patients have a high mortality rate. To identify high-risk patients, first-level healthcare facilities can use the neutrophil-lymphocyte ratio (NLR) and the plateletlymphocyte ratio (PLR) as prognostic markers. We aimed to assess the NLR and the PLR profile in critically ill COVID-19 patients to predict disease severity.</p><p><strong>Materials and methods: </strong>This descriptive retrospective study featured 221 patients diagnosed with clinically critical COVID-19 from August 2021 to March 2022 in the Intensive Care Unit (ICU) of RSUP Dr. M. Djamil, Padang, Indonesia. The study employed a total sampling technique to collect data from medical records in the hospital. Patients aged 18 years or older who underwent testing for leukocytes, platelets, neutrophils, and lymphocytes were included in the study. We analysed the data using descriptive univariate analysis. Then, the NLR and PLR of the patients were statistically compared based on comorbidities and coincidence.</p><p><strong>Results: </strong>According to the study, most patients with critically ill COVID-19 exhibited high levels of NLR (88.2%) and PLR (71.1%). The severe COVID-19 patients with comorbidity of kidney disease had the highest NLR (Mean ± SD) of 31.74 ± 27.95 (p-value <0.001) and the highest mean PLR (Mean ± SD) of 469.33 ± 362.95 (p-value 0.001).</p><p><strong>Conclusion: </strong>Our findings showed a significantly higher NLR and PLR in patients with critically ill COVID-19, particularly in patients with comorbidity of kidney disease. Thus, elevated levels of NLR and PLR were identified as potential prognostic markers for predicting disease severity in COVID-19 patients, especially those with kidney comorbidity.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"743-748"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical deliberations on video recording of patients in healthcare facilities- a scoping review.","authors":"H Zainal Abidin, H Y H Razali","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The modern healthcare landscape with the emergence of video recording, has found applications in research, training, audit, quality improvement, and safety surveillance. Notably, advancements in camera technology have led to the development of smaller, lighter devices, enabling discreet usage and enhancing usability in clinical settings. Its adoption represents more than technological advancement; it entails a complex balance between improving patient care and respecting individual rights. Ethical considerations surrounding patient privacy, ownership of recordings, patient autonomy and healthcare provider responsibilities have garnered significant attention. In Malaysia, the adoption of video recordings in clinical interactions and consultations has been accepted in research, training and several medical fields. However, recording patients during clinical practice can be challenging, as there are scarce ethical guidelines for its practice. This review aims to gather and categorise the ethical challenges associated with recording videos of patients in healthcare facilities globally and identify research gaps specific to Malaysian healthcare settings. By addressing the ethical challenges globally, we can ensure the responsible and ethical use of video recording technology to enhance patient care while respecting individual rights.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Articles from Scopus, Web of Science and PubMed databases were collected following PRISMA guidelines. Key term searches included \"video recording,\" \"ethical issues,\" and \"patients.\" Inclusion criteria encompassed video and audio recording interactions between healthcare providers and patients in any clinical setting, final publications, and the English language. Exclusions were imaging or photography recording and non-clinical settings. The qualitative synthesis involved iterative reading, thematic coding analysis in Excel, and specific analysis to address the research question.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Initial database search, identified 363 records. After screening, a total of 22 articles were included for analysis. Five themes were identified from the selected articles: i) privacy and confidentiality, ii) informed consent, iii) beneficence and non-maleficence, iv) integrity and professionalism and v) governance, policy and legal framework. Majority of the reviewed articles concentrate on backgrounds within the fields of psychiatry, neurology and surgical-based medical specialities. The identified themes have demonstrated consistency across the majority of the articles analysed. Among the most frequently discussed themes, it's evident that ethical concerns extend beyond just the patient's realm to encompass the responsibilities of the healthcare provider (HCP) as well. Both patients and HCPs have their respective rights and responsibilities in ensuring the ethical use of video recording in clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: ","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"785-793"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Take C.A.R.E of patient safety: A call to action.","authors":"A R J Kim, K S Chew, H U Ngian","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a dynamic healthcare environment, patient safety is crucial. A \"Conscious Actions Reduce Errors\" (C.A.R.E) approach is needed to safeguard safety and reduce medical errors. The dual process theory highlights two thinking modes: intuitive (fast, automatic) and analytical (slow, deliberate). Intuitive thinking, though quick and often effective, can lead to cognitive biases like anchoring and availability heuristics. A C.A.R.E approach incorporating tools like the TWED checklist (Threat, What if I'm wrong? What else?, Evidence, Dispositional factors) and Shisa Kanko (Japanese method of pointing and calling) can help to improve decision-making and action precision in clinical settings.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"800-802"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of vagus nerve stimulation for epilepsy in Malaysia.","authors":"S L Fong, K S Lim, A A Raymond, H J Tan, C S Khoo, A R Mohamed, C Y Fong, A H Sanihah, I Zamzuri, M A Jafri, D T Sangita, A Azmi, S C Suganthi, S Sapiah, A Y Nor, S S Tan, C T Tan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The first vagus nerve stimulation (VNS) implantation in Malaysia was back in 2000, and the implantation rate increased tremendously since 2019. VNS has been used in patients who had persistent seizures despite epilepsy surgeries or were not candidates for epilepsy surgeries. We aimed to study the efficacy of VNS in Malaysia.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cross-sectional study on the VNS done in Malaysia. We included DRE patients from all age groups who underwent VNS from 1st January 2000 to 31st December 2022. We analysed the efficacy of VNS for patients with at least one year of implantation.</p><p><strong>Results: </strong>A total of 62 implantations were performed from 2000 to 2022. Most patients (52.5%) had implantation at <18 years old, 54.0% had focal seizures, 34.4% had Lennox Gastaut Syndrome and 23.0% had developmental epileptic encephalopathy. A total of 22.6%, 42.8%, and 63.3% of patients achieve ≥ 50% seizure reduction at three months, six months, and one-year post-implantation, respectively. At their last follow-up, 73.5% of patients had ≥ 50% seizure reduction. The majority of responders were at a current intensity of ≥ 2mA (98.0%) and 81.6% were at a duty cycle of ≥35%. No significant difference was found between responders and non-responders by age at implantation, duration of epilepsy, and seizure type.</p><p><strong>Conclusion: </strong>VNS is effective for patients with refractory epilepsy in Malaysia with two-third achieving more than 50% seizure reduction at one year and the last follow-up.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"729-734"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring alternative approaches to next of kin consenting in the semi-emergency neurosurgical scenario.","authors":"E N Zakaria, N A Abdullah, D Ganesan","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Prior to any surgical intervention, obtaining informed consent is necessary. In situations where patients are unable to provide informed consent due to mental incapacity or reduced consciousness, the responsibility falls on surrogate decision-makers, typically family members. This predicament commonly arises during neurosurgical emergencies. Various types of surgical emergencies exist, each with its own classification. In cases of life-threatening neurosurgical emergencies and in the absence of next of kin, two consultants have the authority to decide and grant surgical consent. However, for urgent and semi-emergency surgical cases, obtaining consent from the next of kin is crucial. The conventional requirement for the physical presence of the next of kin at the hospital often causes delays in the procedure. This study aims to explore alternative methods for efficiently and compliantly securing this consent for urgent and semi-emergency neurosurgical cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A prospective, observational crosssectional survey was conducted from 1st May 2022 to 31st December 2022 at the University of Malaya Medical Centre, Kuala Lumpur. This survey included all neurosurgical patients aged 18 and above requiring urgent and semiemergency surgery. The next of kin were interviewed using a standardised questionnaire to obtain their perspectives on the effectiveness of the current consenting process, as well as to explore potential alternative methods for obtaining consent. Data were analysed using IBM SPSS Statistics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The survey had 103 responses. The analysis revealed that the most common semi-emergency surgical procedures were craniotomy (22 cases) and external ventricular drain insertion (18 cases), followed by burr hole and drainage (14 cases). The most common primary diagnosis that needed urgent intervention was acute hydrocephalus. Interestingly, more than half of the patients (58 cases, 56.3%) had to wait for over 30 minutes to obtain consent from their next of kin prior to surgery. The next of kin interviewed had an age range of 25 to 72 years. The relationships of the next of kin were children (33 subjects), spouses (26 subjects), siblings (25 subjects), and parents (16 subjects) of the patients. Additionally, 96.1% of the respondents owned a smartphone with a mobile internet data connection, and 85.4% had internet connectivity at home. The most preferred method of telecommunication for this exercise was via WhatsApp. An interesting finding was the association between the level of trust in medical professionals and the preferred consent method. It was discovered that individuals who preferred physical consent had lower trust in the hospital and doctors, while those who preferred remote consent had higher trust.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The urban Malaysian population are ready to embrace telecommunication for next-of-kin consent in semiemergen","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"735-742"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative carcino-embryonic antigen prognosticates early disease-free survival following curative surgery for non-small cell lung cancer.","authors":"A Sachithanandan, A A B Sajak, H H Hoh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Serum carcinoembryonic antigen (CEA) is prognostic for recurrence and survival in treated NSCLC. This prospective observational study evaluated CEA as a prognostic or surveillance biomarker in resectable early NSCLC.</p><p><strong>Materials and methods: </strong>18 patients with histologically confirmed early NSCLC (stage I-IIIA) were recruited from October 2019 to January 2021. The serum CEA was measured pre-operatively, and then at 6, 12, 18 and 24 months post-operatively, in conjunction with routine CT and/or CT-PET surveillance scans.</p><p><strong>Results: </strong>All patients had a curative R0 anatomical resection (lobectomy) with concurrent systematic mediastinal nodal dissection via a uniportal minimally invasive approach under single lung ventilation general anaesthesia. There was no operative, in-hospital or 30-day mortality. 7 patients (39%) had an elevated pre-operative baseline CEA level > 5.0ng/ml. The mean number of nodes sampled intraoperatively was 15. At median follow-up of 42 months, 11/18 (61.1%) patients were recurrence-free. There were no deaths and two recurrences (18.2%) amongst patients with a CEA < 5 (n=11). In the CEA > 5 subgroup (n=7), there were two deaths (28.5%) and 5/7 (71.4%) patients had a radiological recurrence. There was no difference in overall survival however disease-free survival (DFS) was significantly inferior in patients with a baseline CEA > 5. Median DFS was not reached in patients with CEA < 5 and 18 months in those with an elevated CEA > 5 (p<0.001) Conclusion: Almost 40% of local NSCLC patients had an elevated baseline CEA suggesting this is a useful prognostic and surveillance biomarker to incorporate in the routine work-up for any newly diagnosed NSCLC. Despite curative R0 resection and extensive intra-operative mediastinal lymph node sampling, an elevated pre-operative CEA was associated with a significantly reduced DFS and may be a surrogate for more aggressive tumour biology. Such patients will benefit from meticulous post resection surveillance and adjuvant therapy beyond conventional TNM criteria.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"683-689"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}