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Prevalence, Stage and Sociodemographic Pattern of Breast Cancer in a Tertiary Health Institution, South West Nigeria
Ndidi Okunnuga,
Adetokunbo Okunnuga,
Salewa Osho,
Patrick Olanrewaju Osho,
Omolayo Olubosede
Issue:
Volume 6, Issue 3, September 2021
Pages:
109-114
Received:
5 May 2021
Accepted:
24 May 2021
Published:
9 July 2021
Abstract: Background: Breast cancer is the commonest cancer found amongst women in Nigeria. It is a major cause of cancer mortality. The prevalence and presentation of breast cancer varies with the Socio-demographic pattern. The stage at presentation also determines the outcome. The burden of Breast cancer is high among women of all age groups in Nigeria. The prevalence of Breast cancer among women in Ondo state South West Nigeria is increasing and majority of the women present in the advance form of the disease. Objectives: To determine the Prevalence, stage and Sociodemographic factors associated with Breast Cancer. Method: The study is a retrospective analysis of clinical records of confirmed breast cancer patients between March 2013 and April 2019 attending the Oncology outpatient clinic at University of Medical Science Teaching Hospital, Akure, Ondo state Nigeria. The socio-demographic data were collated and analyzed. Results: A total of Four hundred breast cancer patients were seen. Their ages ranged from 20 to 89 years with a (mean age of 48.4 +/- 12.9 years). The Median age of 49.4 years. 99% were females and majority (68%) was premenopausal. Those younger than 40 years constituted 37.5% of the sample population while those older constituted 74.5%. The peak age of incidence was in the 4th decade. Majority of the participants 53.2% completed secondary education and 43% of the population had stage 4 disease. Conclusion: Breast cancer is the commonest cancer in women. The level of education does not correlate with a better knowledge of the disease and majority of the women presented with advance stage of the disease.
Abstract: Background: Breast cancer is the commonest cancer found amongst women in Nigeria. It is a major cause of cancer mortality. The prevalence and presentation of breast cancer varies with the Socio-demographic pattern. The stage at presentation also determines the outcome. The burden of Breast cancer is high among women of all age groups in Nigeria. Th...
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Solitary Fibrous Tumor Low Rectum Simulating Cancer
Rajaonarivony Tianarivelo,
Mosa Fasoa,
Andrianarijon Heritiana Nandrianina,
Rakotomena Solonirina Davidà,
Rahantasoa Finaritra Casimir Fleur Prudence,
Rakoto Ratsimba Hery Nirina
Issue:
Volume 6, Issue 3, September 2021
Pages:
115-117
Received:
29 March 2021
Accepted:
21 April 2021
Published:
13 July 2021
Abstract: Introduction: The solitary fibrous tumor is a benign mesenchymal tumor of rare extra-pleural location. We report a case of solitary fibrous tumor observed in the lower rectum simulating cancer. The objective was to discuss the diagnostic and therapeutic management of the solitary fibrous in Madagascar. Observation: This is a sixty-five-year-old man, seen in consultation for dyskinesia, with no family history of neoplasia. The digital rectal examination revealed a large, non-budding, firm mass at the level of the right posterolateral surface with a lower pole located 2 cm from the anal margin, the remains of the physical examination are normal. Abdominal computed tomography showed a mass measuring 8 × 7 × 5.5 cm at the expense of the rectal wall of regular tissue density, without a mesenteric node or secondary localization. the biopsy had not found any malignant cells. This result is due to insufficiently deep biopsy samples of the mass, which led us to perform a complete surgical excision by coloprotectomy. The operative follow-up to which was simple. Immunohistochemical study of the surgical specimen confirmed the diagnosis with a positive CD 34 marker. The outcome was favourable without metastasis or recurrence after a six-month follow-up. Conclusion: The rectal localization of the solitary fibrous tumor is exceptional. The diagnosis is histological confirmed by the immunohistochemical study with a positive CD 34 marker.
Abstract: Introduction: The solitary fibrous tumor is a benign mesenchymal tumor of rare extra-pleural location. We report a case of solitary fibrous tumor observed in the lower rectum simulating cancer. The objective was to discuss the diagnostic and therapeutic management of the solitary fibrous in Madagascar. Observation: This is a sixty-five-year-old man...
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Male Sexual Disorders of Patients with Cancer in Medical Oncology Service in University Hospital of Brazzaville
Judith Nsondé Malanda,
Roland Banga-Mouss,
Chellet Bilquis Bambi,
Aubierge Victoire Kimpamboudi Matondo,
Inès Frédérique Nsondé Mondzié,
Bab Salam Ngouaka,
Siméon Stéphane Moubié
Issue:
Volume 6, Issue 3, September 2021
Pages:
118-124
Received:
8 July 2021
Accepted:
16 July 2021
Published:
23 July 2021
Abstract: Considered as taboo, sexual difficulties and couple intimacy remain rarely tackled by patients and again less by the oncologist practicians. It might seem that faced with the vital stake of disease, this kind of worries seem to be frivolous, indeed shameful to be tackled. The current study had an objective to assess the impacts of cancer on male sexuality followed and treated in medical service in University Hospital of Brazzaville. Studying male sexual disorder of patients with cancer in medical oncology service in university hospital of Brazzaville. It was a retrospective study, from April 1st to July 31st 2018. All patients with cancer aged at least 18 years old with a performance of WHO between 0-2 were included. About one hundred (100) patients we examined whose eighty four (84) men, it appears that the most sexual disorder found is the one of craving, then the one of orgasm. Certain troubles had a link with the onset of cancer (p<5). The men presented a great number of sexual disorder had a cancer of digestive type (47.6%), urogenital (22.6%) and soft tissue (19%). In terms of received treatments: surgery-chemotherapy (men 22%), chemotherapy only (21.4%), surgery only (19%). The global frequency of sexual disorders to all patients is 98.4% in medical oncology service. It is important to consider those sexual disorders at the time of the care of those patients according to their repercussion on life quality during and after all treatment even in the absence of all progressive nature of disease. The most sexual disorder found is the one of craving.
Abstract: Considered as taboo, sexual difficulties and couple intimacy remain rarely tackled by patients and again less by the oncologist practicians. It might seem that faced with the vital stake of disease, this kind of worries seem to be frivolous, indeed shameful to be tackled. The current study had an objective to assess the impacts of cancer on male se...
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Multimodal Therapy for Patients with High-Grade, High-Risk Prostate Cancer with Long-Term Follow-up
Jason Robert Gee,
John André Libertino
Issue:
Volume 6, Issue 3, September 2021
Pages:
125-129
Received:
5 July 2021
Accepted:
19 July 2021
Published:
24 July 2021
Abstract: High risk prostate cancer requires a multimodal approach to treatment. Surgery has played an increasing role for these patients although long-term follow-up and experience with neoadjuvant therapy, a basic tenet of cancer treatment, remains limited. Here we report our experience with neoadjuvant hormonal ablation followed by surgery and postoperative radiation with greater than 20-year follow-up. From 1990-2012, 82 patients with clinically organ-confined prostate cancer and 10 years median follow-up underwent multimodal therapy (MMT) consisting of neoadjuvant hormonal ablation followed by radical retropubic prostatectomy and postoperative radiation. High-risk prostate cancer was defined preoperatively as Gleason Score 8-10 or PSA>20. Patients with negative surgical margins were observed initially and treated with salvage XRT in the instance of recurrence. The MMT protocol was well tolerated in all 82 patients with no treatment-related discontinuation of therapy. Final surgical pathology revealed stage pT3-T4 in 58/82 (71%) and nodal involvement in 7/82 (9%). Distant metastatic disease was identified in 10/82 patients (12%). For patients undergoing MMT at 10, 15 and 20 years, cancer-specific survival was 78/82 (95%), 77 /82 (94%) and 77/82 (94%), overall survival was 68/82 (83%), 66/82 (80%) and 60/82 (73%), and biochemical recurrence was 61/82 (74%), 51/82 (62%) and 35/82 (43%). These findings establish the MMT protocol as an effective treatment strategy for high-risk prostate cancer with excellent long-term cancer-specific survival. Recurrence occurring primarily as a rising PSA as opposed to distant metastatic disease suggests limited morbidity as well among patients treated with this protocol.
Abstract: High risk prostate cancer requires a multimodal approach to treatment. Surgery has played an increasing role for these patients although long-term follow-up and experience with neoadjuvant therapy, a basic tenet of cancer treatment, remains limited. Here we report our experience with neoadjuvant hormonal ablation followed by surgery and postoperati...
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Histopathologic Regression and Survival in RAS Wildtype Metastatic Colorectal Cancer Under First-Line Treatment – Subgroup Analysis of the VOLFI Trial (AIO-KRK-0109)
Stefanie Noepel-Duennebacke,
Henrik Juette,
Celine Lugnier,
Dominik Paul Modest,
Uwe Martens,
Renate Klaassen-Mielke,
Volker Heinemann,
Thomas Seufferlein,
Michael Geissler,
Andrea Tannapfel,
Anke Reinacher-Schick,
Iris Tischoff
Issue:
Volume 6, Issue 3, September 2021
Pages:
130-135
Received:
24 June 2021
Accepted:
12 July 2021
Published:
27 July 2021
Abstract: Aim: The VOLFI trial demonstrated an improved objective response rate through the addition of panitumumab to FOLFOXIRI in untreated all-RAS-wildtype mCRCs compared to FOLFOXIRI alone. In this subgroup analysis, we focused on histopathological response as a predictive marker for PFS. Additionally, we analyzed chemotherapy induced steatosis hepatitis (CASH) in both treatment arms. Methods: Histopathological response, CASH, sinusoidal obstructive syndrome, ballooning, steatosis, cholestasis, fibrosis and inflammation were determined in 14 resected liver metastasis. PFS was estimated using Kaplan-Meier method, the logrank test was used for the statistical comparison. The trial is registered with Clinical Trials. gov, NCT01328171. Results: Tissue of 14/18 resected pts. was evaluable. Median age was 57.5 yrs. (32–67), 7 male and 7 females. All primary tumors were located in the left colon. Molecular analysis detected one BRAF V600E mutation and one MSI-H tumor. Median treatment duration until resection were 7 cycles (3 – 12) panitumumab/mFOLFOXIRI and 9.5 cycles (7 - 11) FOLFOXIRI. 7 pts. achieved very good histopathological response corresponding to ≤20% vital tumor cells (panitumumab/ mFOLFOXIRI vs. FOLFOXIRI 2/5) and 7 pts. showed vital tumor cells >20% (panitumumab/mFOLFOXIRI vs. FOLFOXIRI 2/5). A very good histopathological response (residual tumor cells in proportion to the total tumor area ≤20%) showed a trend to an improved PFS in comparison to >20% (median PFS 12.40; 95% CI 6.43-51.22 vs. PFS 9.88; 95% CI 6.17-15.26 months). The severity of CASH was not increased by the addition of panitumumab or longer duration of chemotherapy. Discussion: In this analysis histopathological response seems to correlate with a better PFS after secondary metastasis resection. By analysis of liver toxicity, no relevant difference of CASH were detectable regarding panitumumab/mFOLFOXIRI vs. FOLFOXIRI or the duration of chemotherapy.
Abstract: Aim: The VOLFI trial demonstrated an improved objective response rate through the addition of panitumumab to FOLFOXIRI in untreated all-RAS-wildtype mCRCs compared to FOLFOXIRI alone. In this subgroup analysis, we focused on histopathological response as a predictive marker for PFS. Additionally, we analyzed chemotherapy induced steatosis hepatitis...
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Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix
Husnaion Zubery,
Mahbuba Shirin,
Falguni Binte Rahman,
Biswajit Bhowmik,
Mohammad Ibrahim,
Zakia Sultana
Issue:
Volume 6, Issue 3, September 2021
Pages:
136-140
Received:
7 July 2021
Accepted:
24 July 2021
Published:
2 August 2021
Abstract: Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. Tumor size also provides a prognostic value, as larger tumors predict risk for distant spread of disease and poor prognostic outcomes. The objective of this study was to determine the sensitivity and specificity of Magnetic Resonance Imaging in the measurement of actual tumor size of invasive cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard. This prospective cross sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all were undergone pelvic examination clinically by EUA. Then all of them underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium are taken with a prefixed standard protocol and reporting was done by Radiologist. Comparison was done between the MRI and clinical assessment of actual tumour size. Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 53.3% and 75%, respectively, with a difference of <0.5 cm, and an accuracy of 88.3% and 100%, respectively, with a difference of 0.5-1.0 cm. The study also concluded MRI staging was more concordant with pathological stage compared to the clinical stage. Concordance rate of 95.0% in MRI and 65.0% in clinical staging respectively. FIGO staging concurred with histopathology in 39 (65.0%) cases and differed in 21 (35.0%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate determination of tumour size as well as staging of cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard.
Abstract: Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. T...
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Malignant Psoas Syndrome Demonstrated by PET/CT in the Context of Metastatic Non Small Cell Lung Cancer
Michael Jerome McKay,
Aaron Chindewere,
Laura Wise,
Fraser Brown,
Kim Louise Taubman,
Timothy Michael McKay
Issue:
Volume 6, Issue 3, September 2021
Pages:
141-144
Received:
26 July 2021
Accepted:
4 August 2021
Published:
18 August 2021
Abstract: The significant cancer pain syndrome of malignant psoas syndrome (MPS), was first reported as a neurooncologic occurrence in 1990. The Syndrome is characterised by malignant infiltration of a psoas muscle, either directly or by involvement with haematogenously disseminated metastatic cancer. Direct involvement has been from primary tumours of the psoas muscle, or by extension from malignant paraaortic lymphadenopathy. Treatment is difficult, complex analgesia is essential, and benefits have been achieved from chemotherapy, radiotherapy and in select cases, surgery. Here, the case of a 60 year old female who presented with three months of moderate dyspnoea, low back and left inguinal region pain/numbness and lassitude, is reported. Chest radiograph and CT showed a large anterior mediastinal mass. FDG PET/CT revealed the mass to be intensely avid, with heterogeneous central areas of photopaenia. Avid lymphadenopathy was also present in two mediastinal nodal stations. Subdiaphragmatically, there was a metabolically FDG avid soft tissue mass in the superior part of the left psoas muscle, presumably accounting for her pain. There was no FDG avidity elsewhere. Core biopsy of the psoas mass revealed adenocarcinoma of probable lung origin. The patient responded symptomatically to intermediate dose radiation therapy. The pathophysiology of MPS is discussed and the range of cancer types associated with the Syndrome is updated.
Abstract: The significant cancer pain syndrome of malignant psoas syndrome (MPS), was first reported as a neurooncologic occurrence in 1990. The Syndrome is characterised by malignant infiltration of a psoas muscle, either directly or by involvement with haematogenously disseminated metastatic cancer. Direct involvement has been from primary tumours of the p...
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