Clinical profile and treatment outcome of laryngeal cancer in a Nigerian Tertiary hospital.

BACKGROUND: Laryngeal cancer is one of the most common malignancies of the upper aerodigestive tract worldwide, and its management may sometimes be challenging, especially in developing countries due to late presentation, poverty and limited resources. AIM: This study aims to highlight the clinical profile and treatment outcome of laryngeal cancer in our centre. PATIENTS AND METHODS: This was a retrospective review of patients who were managed for laryngeal cancer between January 2011 and December 2020. RESULTS: There were 90 (89.1%) males and 11 (10.9%) females, with a male-to-female ratio of 8.2:1. The age ranged from 22 to 82 years, with a mean age of 57.2 ± 12.7 years. Fifty patients (49.5%) presented more than 1 year after the onset of the symptoms. Squamous cell carcinoma (SCCA) was the only histological diagnosis observed in our patients. The laryngeal cancer was transglottic in location in 45 (44.6%) patients, while 50 (49.5%) patients presented with Stage III disease. Twenty-one (20.8%) patients had total laryngectomy. Amongst the patients managed, 17 (17.0%) were still on follow-up. Up to 37 (37.0%) were referred for radiotherapy elsewhere after chemotherapy. Forty-one of the patients (40.0%) died during the course of their management. There was a statistically significant association between having definitive surgical management and survival beyond 5 years (Chi-square test = 8.635, P = 0.003). CONCLUSION: Majority of the patients presented late with transglottic SCCA. Surgical extirpation of the lesion was associated with better prognosis in our patients.

Giant Ovarian Endometrioma: A Case Report.

Ovarian endometrioma is quite common among women of reproductive age but rarely exceed 6 cm in diameter. Ovarian endometrioma exceeding 10 cm in dimension, often referred to as giant endometrioma, is rare and can pose a diagnostic dilemma to clinicians. We present a 33-year-old single nullipara referred to our facility with a 3-year history of recurrent abdominal pain, abdominal swelling, and difficulty in breathing. The challenges in making diagnosis of a huge ovarian endometrioma are highlighted and the literature on huge ovarian endometrioma reviewed.

Radiotherapy waiting time in Northern Nigeria: experience from a resource-limited setting.

BACKGROUND: Access and availability of radiotherapy treatment is limited in most low- and middle-income countries, which leads to long waiting times and poor clinical outcomes. The aim of our study is to determine the magnitude of waiting times for radiotherapy in a resource-limited setting. METHODS: This is a retrospective cohort study of patients with the five most commonly treated cancers managed with radiotherapy between 2010 and 2014. Data includes diagnosis, patients' demographics and treatment provided. The waiting time was categorised into intervals (1) between diagnosis and first radiation consultation (2) First consultation to radiotherapy treatment (3) Decision-to-treat to treatment and (4) Diagnosis to treatment. RESULTS: A total of 258 cases were involved, including cervical (50%; 129/258), breast (27.5%; 71/258), nasopharynx (12.8%; 33/258), colorectal (5%; 13/258) and prostate cancers (4.7%; 12/258). Mean age was 48 (±12.9) years. Treatment with radical intent comprised 67% (178/258) of cases, while 33% (80/258) had palliative treatment. The median time from diagnosis to first radiation consultation was 40 (IQR 17-157.75) days for all the patients, with prostate cancer having the longest time - 305 days (IQR 41-393.8). The median time between the first radiation oncology consultations and first radiotherapy treatment was 130.5 (IQR 14-211.5) days; cervical cancer patients waited a median of 139 (IQR 13-195.5) days. The median time between diagnosis and first radiotherapy for breast cancer patients was 329 (IQR 207-464) days, compared to 213 (IQR 101.5-353.5) days for all the patients. CONCLUSION: The study shows that waiting time for radiotherapy in Nigeria was generally longer than what is recommended internationally. This reflects the need to improve access to radiotherapy in order to improve cancer treatment outcomes in resource-limited settings.

Socio-demographic and clinico-pathologic pattern of patients with colorectal cancers seen in Ahmadu Bello University teaching Hospital, Zaria

Introduction: Colorectal cancer is a major cause of morbidity and mortality in the world. It accounts for 10.2% of cancer incidence globally, with a mortality of 9.2%. It ranks third in terms of incidence but second in terms of mortality. Colorectal cancer is not uniformly common throughout the world. Its incidence is increasing in developing countries, probably due to the acquisition of western lifestyle.Aim: The aim of this study was to determine the sociodemographic and clinicopathological pattern of patients with colorectal cancer seen in the Department of Surgery, Radiotherapy, and Oncology Centre, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a 10-year period.Materials and Methods: In this retrospective study, data were collected from the case files and treatment cards of 122 patients with colorectal cancer managed at the Surgical, Radiotherapy, and Oncology Department of ABUTH, Zaria, from January 2006 to December 2015. Data items analyzed included age, sex, residential area, occupation, duration of symptoms, presenting complaints, subsite, histological type, grade, and stage. All analyses were performed by SPSS version 20.Results: An annual incidence of 12.2 cases/annum was seen. Seventy (57.4%) were male and 52 (42.6%) were female. Male:female ratio was 1.3:1 and the age range was between 12 years and 78 years, majority were between 31 and 40 years (24.6%), with a mean age of 42.4 years and median age of 41 years. It was found to be more common among the urban dwellers, with the public/civil servants being the most affected (36.0%). The duration of presenting complain ranged from 3 weeks to 10 years, most patients presenting at 7­10 months with more than one symptom. Bleeding per rectum was the most common symptom seen in 20%. Adenocarcinoma was the predominant histology seen in 73% (n = 89) and 28.7% were well differentiated. The rectum was the most common subsite, while left-sided lesions (20%) were more common than right-sided lesions (17%). About 18% (n = 22) had distant metastasis.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. The most common presenting symptom was bleeding per rectum and majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. Bleeding per rectum being the most common complaint, majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend

Cisplatin chemotherapy for haemostasis in bleeding cervical cancer: experience from a resource-poor setting.

BACKGROUND: Cervical cancer is the commonest cancer in northern Nigeria. There are only two radiotherapy centers in the north and four centres in the south, each with only one megavoltage machine for a population of over 140 million. The number of patients requiring radiotherapy for various malignancies is beyond the available facilities and expertise leading to long waiting time and disease progression with its attendant sequelae. This is the basis of using other orthodox treatment modalities as first line. PATIENTS AND METHODS: Between January 2006 and December 2007, 116 patients with histologically confirmed cervical cancer with vaginal bleeding as the predominant symptom were treated. Patients presenting with torrential haemorrhage were excluded from this study as they constitute oncologic emergencies. Patients were interviewed with a structured pro forma on a 3-weekly basis during chemotherapy schedules to assess and evaluate per vaginal bleeding and discharge. Dose of chemotherapy was 70 mg/m² every 3 weeks. Results were analysed using Epi Info soft ware Version 3.4.1; 2007 Edition. RESULTS: The median age was 49 years (27-80 yrs). 62 patients were having per vagina bleeding for more than 6 months before commencement of chemotherapy (range 1-60 months). 49 patients had blood transfusion before chemotherapy, average of 2.7 pints of blood transfused per patient. 84 had at least FIGO stage IIIA disease. Squamous cell carcinoma is the commonest histology type followed by adenocarcinoma with 95 and 16 patients respectively. 81 patients had complete cessation of per vagina bleeding with 69 having complete cessation on or before 4th course of chemotherapy (9th week) and complete cessation of per vagina discharges was seen in 52 patients. 115 patients had a performance status KPS of below 80 prior to chemotherapy, and after completing 6 cycles, 100 patients had KPS of 80 and above. CONCLUSION: In resource-poor setting, Cisplatin based chemotherapy can be used by medical, gynaecological oncologists and general practitioners to control vaginal bleeding and improve the quality of life of patients pending radiotherapy. For optimal treatment with chemoradiotherapy, government and non-governmental agencies must do all it takes to remedy the problems of shortage of resources.