1.A Meta-Analysis on the Impact of Induction Chemotherapy on Survival Outcomes for Sinonasal Squamous Cell Carcinoma
Ruth S. GOH ; Christopher Goh Hood KENG
Journal of Rhinology 2025;32(1):10-16
Background and Objectives:
Malignant neoplasms of the nasal cavity and paranasal sinuses are an aggressive form of tumour that tends to be diagnosed at a locoregionally advanced stage. Among its various histological subtypes, squamous cell carcinomas (SCC) are the most common form of sinonasal cancer, with approximately 50%–60% of sinonasal malignancies being SCC. This review aims to investigate the impact of induction chemotherapy on survival outcomes for patients undergoing cancer care for sinonasal squamous cell carcinomas (SNSCC).
Methods:
Two reviewers independently assessed 2,118 studies pooled from four bibliographic databases, namely MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science and hand-searched grey literature. This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. As this was a time-to-event analysis, hazard ratios (HRs) and standard errors were derived from individual studies and pooled together for analysis. If these values were not available directly, statistical methods were used to indirectly extract the required data via Kaplan-Meier curves or via the p-value and the numbers of events.
Results:
Results suggest a notable improvement in overall survival (HR=0.56, 95% confidence interval [CI]=[0.36, 0.86], p<0.009) and a promising improvement in disease-free survival (HR=0.82, 95% CI=[0.62, 1.08], p=0.16) for patients who underwent induction chemotherapy in addition to definitive treatment for SNSCC.
Conclusion
Our findings add to existing literature by providing a precise pooled estimate of the beneficial effects, revealing that induction chemotherapy is not just a viable add-on to traditional treatment regimens but also improves survival outcomes when compared to definitive local therapy as a standalone treatment. Clinicians should consider incorporating induction chemotherapy as a treatment option for locoregionally advanced SNSCC.
2.A Meta-Analysis on the Impact of Induction Chemotherapy on Survival Outcomes for Sinonasal Squamous Cell Carcinoma
Ruth S. GOH ; Christopher Goh Hood KENG
Journal of Rhinology 2025;32(1):10-16
Background and Objectives:
Malignant neoplasms of the nasal cavity and paranasal sinuses are an aggressive form of tumour that tends to be diagnosed at a locoregionally advanced stage. Among its various histological subtypes, squamous cell carcinomas (SCC) are the most common form of sinonasal cancer, with approximately 50%–60% of sinonasal malignancies being SCC. This review aims to investigate the impact of induction chemotherapy on survival outcomes for patients undergoing cancer care for sinonasal squamous cell carcinomas (SNSCC).
Methods:
Two reviewers independently assessed 2,118 studies pooled from four bibliographic databases, namely MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science and hand-searched grey literature. This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. As this was a time-to-event analysis, hazard ratios (HRs) and standard errors were derived from individual studies and pooled together for analysis. If these values were not available directly, statistical methods were used to indirectly extract the required data via Kaplan-Meier curves or via the p-value and the numbers of events.
Results:
Results suggest a notable improvement in overall survival (HR=0.56, 95% confidence interval [CI]=[0.36, 0.86], p<0.009) and a promising improvement in disease-free survival (HR=0.82, 95% CI=[0.62, 1.08], p=0.16) for patients who underwent induction chemotherapy in addition to definitive treatment for SNSCC.
Conclusion
Our findings add to existing literature by providing a precise pooled estimate of the beneficial effects, revealing that induction chemotherapy is not just a viable add-on to traditional treatment regimens but also improves survival outcomes when compared to definitive local therapy as a standalone treatment. Clinicians should consider incorporating induction chemotherapy as a treatment option for locoregionally advanced SNSCC.
3.A Meta-Analysis on the Impact of Induction Chemotherapy on Survival Outcomes for Sinonasal Squamous Cell Carcinoma
Ruth S. GOH ; Christopher Goh Hood KENG
Journal of Rhinology 2025;32(1):10-16
Background and Objectives:
Malignant neoplasms of the nasal cavity and paranasal sinuses are an aggressive form of tumour that tends to be diagnosed at a locoregionally advanced stage. Among its various histological subtypes, squamous cell carcinomas (SCC) are the most common form of sinonasal cancer, with approximately 50%–60% of sinonasal malignancies being SCC. This review aims to investigate the impact of induction chemotherapy on survival outcomes for patients undergoing cancer care for sinonasal squamous cell carcinomas (SNSCC).
Methods:
Two reviewers independently assessed 2,118 studies pooled from four bibliographic databases, namely MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science and hand-searched grey literature. This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. As this was a time-to-event analysis, hazard ratios (HRs) and standard errors were derived from individual studies and pooled together for analysis. If these values were not available directly, statistical methods were used to indirectly extract the required data via Kaplan-Meier curves or via the p-value and the numbers of events.
Results:
Results suggest a notable improvement in overall survival (HR=0.56, 95% confidence interval [CI]=[0.36, 0.86], p<0.009) and a promising improvement in disease-free survival (HR=0.82, 95% CI=[0.62, 1.08], p=0.16) for patients who underwent induction chemotherapy in addition to definitive treatment for SNSCC.
Conclusion
Our findings add to existing literature by providing a precise pooled estimate of the beneficial effects, revealing that induction chemotherapy is not just a viable add-on to traditional treatment regimens but also improves survival outcomes when compared to definitive local therapy as a standalone treatment. Clinicians should consider incorporating induction chemotherapy as a treatment option for locoregionally advanced SNSCC.
4.De Novo Focal Segmental Glomerulosclerosis (FSGS) Post Covid 19 Vaccination: Case Series in A Single Centre in Malaysia
Jonathan Thian Hooi Yong ; Xun Quan Sze ; Christopher Thiam Seong Lim ; Bak Leong Goh
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):360-363
Introduction: Mass COVID-19 vaccination has been pivotal in the fight against this pandemic. The occurrence of
glomerular disease following COVID-19 vaccinations particularly mRNA vaccine has been reported. The reported
cases in the region are limited and number of cases reported are low in contrast to the total number of vaccine doses
given worldwide, the healthcare providers should be alerted about such issues to provide swift and proper management. Case Series: Here, we report 3 cases of Focal segmental glomerulosclerosis (FSGS) following COVID-19 vaccination and their outcomes. Two of the patients received BNT162b2 vaccination and one received CoronaVac vaccination. The mean age of the patients was 33+/-7 years old. The mean duration onset of FSGS was 23+/-19 days post
vaccinations. Two of the patients (BNT162b2 vaccination and CoronaVac vaccination) achieved complete remission
after corticosteroid therapy. This is the first reported case of De Novo FSGS following CoronaVac vaccination in the
literature. The third patient, who received BNT162b2 vaccination and presented late (42 days post vaccination) was
not in remission despite three months of immunosuppressive treatment. Conclusion: The treating physician needs to
be aware of the possibility of the development of FSGS associated with COVID-19 vaccination and how to proceed
with vaccination schedule in these populations. Overall, the advantage of COVID-19 vaccination far outweighs the
possibility of COVID-19 vaccine-associated glomerular disease.
6.Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction
Zahra RASHIDBENAM ; Mohd Hafidzul JASMAN ; Pezhman HAFEZ ; Guan Hee TAN ; Eng Hong GOH ; Xeng Inn FAM ; Christopher Chee Kong HO ; Zulkifli Md ZAINUDDIN ; Reynu RAJAN ; Fatimah MOHD NOR ; Mohamad Aznan SHUHAILI ; Nik Ritza KOSAI ; Farrah Hani IMRAN ; Min Hwei NG
Tissue Engineering and Regenerative Medicine 2019;16(4):365-384
BACKGROUND: Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering. METHODS: Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database. RESULTS: Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering. CONCLUSION: Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a prevascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.
Cicatrix
;
Data Collection
;
Hair
;
Humans
;
Mesenchymal Stromal Cells
;
Mouth Mucosa
;
Myocytes, Smooth Muscle
;
Porosity
;
Skin
;
Tissue Engineering
;
Transplants
;
Urethra
;
Urethral Stricture
;
Urinary Tract
7.Drainless Parotidectomies versus Conventional Parotidectomies: Randomised Control Study on Efficacy and Safety.
Dennis Yk CHUA ; Christopher Hk GOH
Annals of the Academy of Medicine, Singapore 2016;45(11):513-515
Adenolymphoma
;
surgery
;
Adenoma, Pleomorphic
;
surgery
;
Compression Bandages
;
Drainage
;
Facial Nerve Diseases
;
epidemiology
;
Female
;
Fibrin Tissue Adhesive
;
therapeutic use
;
Health Care Costs
;
Hospitalization
;
economics
;
statistics & numerical data
;
Humans
;
Length of Stay
;
Male
;
Middle Aged
;
Parotid Gland
;
surgery
;
Parotid Neoplasms
;
surgery
;
Postoperative Complications
;
epidemiology
;
Singapore
;
epidemiology
;
Tissue Adhesives
;
therapeutic use
8.Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study.
Xeng Inn FAM ; Praveen SINGAM ; Christopher Chee Kong HO ; Radhika SRIDHARAN ; Rozita HOD ; Badrulhisham BAHADZOR ; Eng Hong GOH ; Guan Hee TAN ; Zulkifli ZAINUDDIN
Korean Journal of Urology 2015;56(1):63-67
PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.
Constriction, Pathologic/*diagnosis
;
Humans
;
Hydronephrosis/diagnosis
;
Kidney/ultrasonography
;
Prospective Studies
;
Risk Factors
;
Ureter/*pathology/ultrasonography
;
Ureteral Calculi/*therapy
;
Ureterolithiasis/*surgery
;
Ureteroscopy/*adverse effects
;
Urinary Bladder/ultrasonography
9.Inflamatory Pseudotumor of the Bladder: A Histopathological Diagnostic Challenge from Its Malignant Variant
Muhammad Akbar ; Praveen S ; Christopher HCK ; Goh EH ; Swaminathan ; Zulkifli MZ
Journal of Surgical Academia 2012;2(1):46-49
Inflammatory Pseudotumor (IP) of bladder is one of a variety of lesions which may arise from spindle cell lesions in the bladder. It is benign in nature compared to the other end of the spectrum of spindle cell lesions, such as sarcoma, sarcomatoid carcinoma and leiomyosarcoma. The diagnosis of IP and its differentiation from a malignant pathology is a diagnostic dilemma for Urologist and Pathologist as both entities share certain similar morphological and histo-pathological appearance as well as immuno-histo chemistry staining. It is however crucial to avoid misdiagnosis as the treatment option varies significantly between a radical or partial cystectomy with future surveillance cystoscopes. Hereby, we highlight a case of a benign variant of spindle cell tumour of bladder which needed second pathology review for confirmation and thus avoiding a radical cystectomy. We also review the literature on its presentation and emphasis characteristics differentiating a benign from a malignant pathology.
10.Iatrogenic Ureter Injuries: Eleven Years Experience in A Tertiary Hospital
Hans Alexander Mahendran ; Praveen Singam ; Christopher Ho ; Goh Eng Hong ; Tan Guan Hee ; Zuklifli Md Zainuddin
The Medical Journal of Malaysia 2012;67(2):169-172
Iatrogenic ureteric injuries are rare complications of
abdomino-pelvic surgery but associated with high morbidity
from infection and possible loss of renal function. A
successful repair is related to the timing of diagnosis, site of injury and method of repair. This study was a retrospective review of outcomes of iatrogenic ureteric injury and factors contributing to successful operative repair. Twenty consecutive cases referred to the Urology Unit of the UKM Medical Center during an 11-year period from 1998 to 2009 were reviewed. Thirteen patients were diagnosed intraoperatively and underwent immediate repair. Seven patients had delayed diagnosis but also underwent immediate repair.
In our series, there was no significant difference in outcome between injuries diagnosed intraoperatively versus injuries with delayed diagnosis. There was significant difference in the outcomes between methods of ureteric repair where ureter reimplantation via psoas hitch or Boari flap yielded better results than primary end-to-end anastomosis Three patients suffered loss of renal function from unsuccessful ureter repair. We conclude that all iatrogenic ureteric injury should be repaired immediately in the absence of overt sepsis. Ureter reimplantation using a Boari flap or psoas hitch is preferred to the end-to-end anastomosis especially when there is delayed diagnosis


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