Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting
Identifieur interne : 000C71 ( Pmc/Checkpoint ); précédent : 000C70; suivant : 000C72Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting
Auteurs : Japhet M. Gilyoma [Tanzanie] ; Peter F. Rambau [Tanzanie] ; Nestory Masalu [Tanzanie] ; Neema M. Kayange [Tanzanie] ; Phillipo L. Chalya [Tanzanie]Source :
- BMC Research Notes [ 1756-0500 ] ; 2015.
Abstract
Head and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding head and neck cancers in Tanzania, and Bugando Medical Centre in particular. This study describes the clinicopathological profile of HNC in our local setting and highlights the challenges in the management of this disease.
This was a retrospective study of histopathologically confirmed cases of head and neck cancers treated at Bugando Medical Center between January 2009 and December 2013.
A total of 346 patients (M:F = 2.1:1) were studied representing 9.5 % of all malignancies. The median age of patients was 42 years. Cigarette smoking (76.6 %) and heavy alcohol consumption (69.9 %) were the most frequently identified risk factors for head and neck cancer. The majority of patients (95.9 %) presented late with advanced stages. Twenty-five (7.2 %) patients were HIV positive with a median CD4+ count of 244 cells/μl. The oral cavity (37.3 %) was the most frequent anatomical site affected. The most common histopathological type was carcinomas (59.6 %) of which 75.7 % were squamous cell carcinoma. A total of 196 (56.6 %) patients underwent surgical procedures for HNC. Radiotherapy and chemotherapy was reported in 9.5 and 16.8 % of patients, respectively. Only 2 (0.6 %) patients received chemo-radiation therapy. The mortality rate was 24.4 %. The overall 5-year survival rate (5-YSR) was 20.6 %. The predictors of overall 5-YSR were age of patient at diagnosis, stage of disease, extent of lymph node involvement, HIV seropositivity and CD4+ count <200 cells/μl (P < 0.001). Local recurrence was reported in 22 (23.4 %) patients and this was significantly associated with positive resection margins, stage of the tumor and presence of metastasis at diagnosis and non-adherence to adjuvant therapy (P < 0.001).
Head and neck cancers are not uncommon at Bugando Medical Centre and show a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage cancer. Therefore, public enlightenment, early diagnosis, and effective cost-effective treatment and follow-up are urgently needed to improve outcomes of these patients in our environment.
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DOI: 10.1186/s13104-015-1773-9
PubMed: 26654449
PubMed Central: 4676813
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting</title><author><name sortKey="Gilyoma, Japhet M" sort="Gilyoma, Japhet M" uniqKey="Gilyoma J" first="Japhet M." last="Gilyoma">Japhet M. Gilyoma</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Rambau, Peter F" sort="Rambau, Peter F" uniqKey="Rambau P" first="Peter F." last="Rambau">Peter F. Rambau</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Masalu, Nestory" sort="Masalu, Nestory" uniqKey="Masalu N" first="Nestory" last="Masalu">Nestory Masalu</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Kayange, Neema M" sort="Kayange, Neema M" uniqKey="Kayange N" first="Neema M." last="Kayange">Neema M. Kayange</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Chalya, Phillipo L" sort="Chalya, Phillipo L" uniqKey="Chalya P" first="Phillipo L." last="Chalya">Phillipo L. Chalya</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26654449</idno><idno type="pmc">4676813</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676813</idno><idno type="RBID">PMC:4676813</idno><idno type="doi">10.1186/s13104-015-1773-9</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000815</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000815</idno><idno type="wicri:Area/Pmc/Curation">000814</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000814</idno><idno type="wicri:Area/Pmc/Checkpoint">000C71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000C71</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting</title><author><name sortKey="Gilyoma, Japhet M" sort="Gilyoma, Japhet M" uniqKey="Gilyoma J" first="Japhet M." last="Gilyoma">Japhet M. Gilyoma</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Rambau, Peter F" sort="Rambau, Peter F" uniqKey="Rambau P" first="Peter F." last="Rambau">Peter F. Rambau</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Masalu, Nestory" sort="Masalu, Nestory" uniqKey="Masalu N" first="Nestory" last="Masalu">Nestory Masalu</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Kayange, Neema M" sort="Kayange, Neema M" uniqKey="Kayange N" first="Neema M." last="Kayange">Neema M. Kayange</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author><author><name sortKey="Chalya, Phillipo L" sort="Chalya, Phillipo L" uniqKey="Chalya P" first="Phillipo L." last="Chalya">Phillipo L. Chalya</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza</wicri:regionArea><wicri:noRegion>Mwanza</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Research Notes</title><idno type="eISSN">1756-0500</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Head and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding head and neck cancers in Tanzania, and Bugando Medical Centre in particular. This study describes the clinicopathological profile of HNC in our local setting and highlights the challenges in the management of this disease.</p></sec><sec><title>Methods</title><p>This was a retrospective study of histopathologically confirmed cases of head and neck cancers treated at Bugando Medical Center between January 2009 and December 2013.</p></sec><sec><title>Results</title><p>A total of 346 patients (M:F = 2.1:1) were studied representing 9.5 % of all malignancies. The median age of patients was 42 years. Cigarette smoking (76.6 %) and heavy alcohol consumption (69.9 %) were the most frequently identified risk factors for head and neck cancer. The majority of patients (95.9 %) presented late with advanced stages. Twenty-five (7.2 %) patients were HIV positive with a median CD4+ count of 244 cells/μl. The oral cavity (37.3 %) was the most frequent anatomical site affected. The most common histopathological type was carcinomas (59.6 %) of which 75.7 % were squamous cell carcinoma. A total of 196 (56.6 %) patients underwent surgical procedures for HNC. Radiotherapy and chemotherapy was reported in 9.5 and 16.8 % of patients, respectively. Only 2 (0.6 %) patients received chemo-radiation therapy. The mortality rate was 24.4 %. The overall 5-year survival rate (5-YSR) was 20.6 %. The predictors of overall 5-YSR were age of patient at diagnosis, stage of disease, extent of lymph node involvement, HIV seropositivity and CD4+ count <200 cells/μl (P < 0.001). Local recurrence was reported in 22 (23.4 %) patients and this was significantly associated with positive resection margins, stage of the tumor and presence of metastasis at diagnosis and non-adherence to adjuvant therapy (P < 0.001).</p></sec><sec><title>Conclusion</title><p>Head and neck cancers are not uncommon at Bugando Medical Centre and show a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage cancer. Therefore, public enlightenment, early diagnosis, and effective cost-effective treatment and follow-up are urgently needed to improve outcomes of these patients in our environment.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Nwawolo, Cc" uniqKey="Nwawolo C">CC Nwawolo</name></author><author><name sortKey="Ajekigbe, At" uniqKey="Ajekigbe A">AT Ajekigbe</name></author><author><name sortKey="Oyeneyin, Jo" uniqKey="Oyeneyin J">JO Oyeneyin</name></author><author><name sortKey="Nwankwo, Kc" uniqKey="Nwankwo K">KC Nwankwo</name></author><author><name sortKey="Okeowo, Pa" uniqKey="Okeowo P">PA Okeowo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fan, Cy" uniqKey="Fan C">CY Fan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ringstrom, E" uniqKey="Ringstrom E">E Ringström</name></author><author><name sortKey="Peters, E" uniqKey="Peters E">E Peters</name></author><author><name sortKey="Hasegawa, M" uniqKey="Hasegawa M">M Hasegawa</name></author><author><name sortKey="Posner, M" uniqKey="Posner M">M Posner</name></author><author><name sortKey="Liu, M" uniqKey="Liu M">M Liu</name></author><author><name sortKey="Kelsey, Kt" uniqKey="Kelsey K">KT Kelsey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Otoh, Ec" uniqKey="Otoh E">EC Otoh</name></author><author><name sortKey="Johnson, Nw" uniqKey="Johnson N">NW Johnson</name></author><author><name sortKey="Danfillo, Is" uniqKey="Danfillo I">IS Danfillo</name></author><author><name sortKey="Adeleke, Oa" uniqKey="Adeleke O">OA Adeleke</name></author><author><name sortKey="Olasoji, Ha" uniqKey="Olasoji H">HA Olasoji</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garfinkel, L" uniqKey="Garfinkel L">L Garfinkel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tobias, Js" uniqKey="Tobias J">JS Tobias</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zagar, Gk" uniqKey="Zagar G">GK Zagar</name></author><author><name sortKey="Smith, Jl" uniqKey="Smith J">JL Smith</name></author><author><name sortKey="Norante, Jd" uniqKey="Norante J">JD Norante</name></author><author><name sortKey="Mcdonald, S" uniqKey="Mcdonald S">S McDonald</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Watkinson, Jc" uniqKey="Watkinson J">JC Watkinson</name></author><author><name sortKey="Gaze, Mn" uniqKey="Gaze M">MN Gaze</name></author><author><name sortKey="Wilson, Ja" uniqKey="Wilson J">JA Wilson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sanghvi, Ld" uniqKey="Sanghvi L">LD Sanghvi</name></author><author><name sortKey="Rao, Dn" uniqKey="Rao D">DN Rao</name></author><author><name sortKey="Joshi, S" uniqKey="Joshi S">S Joshi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jemal, A" uniqKey="Jemal A">A Jemal</name></author><author><name sortKey="Siegel, R" uniqKey="Siegel R">R Siegel</name></author><author><name sortKey="Ward, E" uniqKey="Ward E">E Ward</name></author><author><name sortKey="Murray, T" uniqKey="Murray T">T Murray</name></author><author><name sortKey="Xu, J" uniqKey="Xu J">J Xu</name></author><author><name sortKey="Smigal, C" uniqKey="Smigal C">C Smigal</name></author><author><name sortKey="Thun, M" uniqKey="Thun M">M Thun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lilly Tariah, Ob" uniqKey="Lilly Tariah O">OB Lilly-Tariah</name></author><author><name sortKey="Somefun, Ao" uniqKey="Somefun A">AO Somefun</name></author><author><name sortKey="Adeyemo, Wl" uniqKey="Adeyemo W">WL Adeyemo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bhatia, Pl" uniqKey="Bhatia P">PL Bhatia</name></author><author><name sortKey="Jha, Bk" uniqKey="Jha B">BK Jha</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Oude Ophuis, Mb" uniqKey="Oude Ophuis M">MB Oude Ophuis</name></author><author><name sortKey="Roelofs, Hm" uniqKey="Roelofs H">HM Roelofs</name></author><author><name sortKey="Van Den Brandt, Pa" uniqKey="Van Den Brandt P">PA Van Den Brandt</name></author><author><name sortKey="Peters, Wh" uniqKey="Peters W">WH Peters</name></author><author><name sortKey="Manni, Jj" uniqKey="Manni J">JJ Manni</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Adeyemi, Bf" uniqKey="Adeyemi B">BF Adeyemi</name></author><author><name sortKey="Adekunle, Lv" uniqKey="Adekunle L">LV Adekunle</name></author><author><name sortKey="Kolude, Bm" uniqKey="Kolude B">BM Kolude</name></author><author><name sortKey="Akang, Eeu" uniqKey="Akang E">EEU Akang</name></author><author><name sortKey="Lawoyin, Jo" uniqKey="Lawoyin J">JO Lawoyin</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Licitra, L" uniqKey="Licitra L">L Licitra</name></author><author><name sortKey="Felip, E" uniqKey="Felip E">E Felip</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Deschamps, Dr" uniqKey="Deschamps D">DR Deschamps</name></author><author><name sortKey="Spencer, Hj" uniqKey="Spencer H">HJ Spencer</name></author><author><name sortKey="Kokoska, Ms" uniqKey="Kokoska M">MS Kokoska</name></author><author><name sortKey="Spring, Pm" uniqKey="Spring P">PM Spring</name></author><author><name sortKey="Vural, Ea" uniqKey="Vural E">EA Vural</name></author><author><name sortKey="Stack, Bm" uniqKey="Stack B">BM Stack</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Abdul Hamid, G" uniqKey="Abdul Hamid G">G Abdul-Hamid</name></author><author><name sortKey="Saeed, Nm" uniqKey="Saeed N">NM Saeed</name></author><author><name sortKey="Al Kahiry, W" uniqKey="Al Kahiry W">W Al-Kahiry</name></author><author><name sortKey="Shukry, S" uniqKey="Shukry S">S Shukry</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Otoh, Ec" uniqKey="Otoh E">EC Otoh</name></author><author><name sortKey="Johnson, Nw" uniqKey="Johnson N">NW Johnson</name></author><author><name sortKey="Mandong, Bm" uniqKey="Mandong B">BM Mandong</name></author><author><name sortKey="Danfillo, Is" uniqKey="Danfillo I">IS Danfillo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vokes, Ee" uniqKey="Vokes E">EE Vokes</name></author><author><name sortKey="Weichselbaum, Rr" uniqKey="Weichselbaum R">RR Weichselbaum</name></author><author><name sortKey="Lippman, Sm" uniqKey="Lippman S">SM Lippman</name></author><author><name sortKey="Hong, Wk" uniqKey="Hong W">WK Hong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Onotai, Loi" uniqKey="Onotai L">LOI Onotai</name></author><author><name sortKey="Nwogbo, Ac" uniqKey="Nwogbo A">AC Nwogbo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Donkor, P" uniqKey="Donkor P">P Donkor</name></author><author><name sortKey="Boateng, Ka" uniqKey="Boateng K">KA Boateng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nwaorgu, O" uniqKey="Nwaorgu O">O Nwaorgu</name></author><author><name sortKey="Kokong, D" uniqKey="Kokong D">D Kokong</name></author><author><name sortKey="Onakoya, P" uniqKey="Onakoya P">P Onakoya</name></author><author><name sortKey="Adoga, S" uniqKey="Adoga S">S Adoga</name></author><author><name sortKey="Ibekwe, T" uniqKey="Ibekwe T">T Ibekwe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmad, Bm" uniqKey="Ahmad B">BM Ahmad</name></author><author><name sortKey="Pindiga, Uh" uniqKey="Pindiga U">UH Pindiga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Iseh, Kr" uniqKey="Iseh K">KR Iseh</name></author><author><name sortKey="Malami, Sa" uniqKey="Malami S">SA Malami</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amusa, Yb" uniqKey="Amusa Y">YB Amusa</name></author><author><name sortKey="Olabanji, Jk" uniqKey="Olabanji J">JK Olabanji</name></author><author><name sortKey="Akinpelu, Vo" uniqKey="Akinpelu V">VO Akinpelu</name></author><author><name sortKey="Ogundipe, Ov" uniqKey="Ogundipe O">OV Ogundipe</name></author><author><name sortKey="Olateju, S" uniqKey="Olateju S">S Olateju</name></author><author><name sortKey="Agbakwuru, Ea" uniqKey="Agbakwuru E">EA Agbakwuru</name></author><author><name sortKey="Ndukwe, N" uniqKey="Ndukwe N">N Ndukwe</name></author><author><name sortKey="Fatusi, Oa" uniqKey="Fatusi O">OA Fatusi</name></author><author><name sortKey="Ojo, Os" uniqKey="Ojo O">OS Ojo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haddad, R" uniqKey="Haddad R">R Haddad</name></author><author><name sortKey="Annino, D" uniqKey="Annino D">D Annino</name></author><author><name sortKey="Tishler, Rb" uniqKey="Tishler R">RB Tishler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Saboorian, Mh" uniqKey="Saboorian M">MH Saboorian</name></author><author><name sortKey="Ashfaq, R" uniqKey="Ashfaq R">R Ashfaq</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Adoga, Aa" uniqKey="Adoga A">AA Adoga</name></author><author><name sortKey="Silas, Oa" uniqKey="Silas O">OA Silas</name></author><author><name sortKey="Nimkur, Tl" uniqKey="Nimkur T">TL Nimkur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hermans, R" uniqKey="Hermans R">R Hermans</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Adeyi, A" uniqKey="Adeyi A">A Adeyi</name></author><author><name sortKey="Olugbenga, S" uniqKey="Olugbenga S">S Olugbenga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chrong, N" uniqKey="Chrong N">N Chrong</name></author><author><name sortKey="Vokes, E" uniqKey="Vokes E">E Vokes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kumar, S" uniqKey="Kumar S">S Kumar</name></author><author><name sortKey="Pandey, M" uniqKey="Pandey M">M Pandey</name></author><author><name sortKey="Lal, P" uniqKey="Lal P">P Lal</name></author><author><name sortKey="Rastogi, N" uniqKey="Rastogi N">N Rastogi</name></author><author><name sortKey="Maria Das, Kj" uniqKey="Maria Das K">KJ Maria Das</name></author><author><name sortKey="Dimri, K" uniqKey="Dimri K">K Dimri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Larsen Reindorf, R" uniqKey="Larsen Reindorf R">R Larsen-Reindorf</name></author><author><name sortKey="Owusu Afriyie, O" uniqKey="Owusu Afriyie O">O Owusu-Afriyie</name></author><author><name sortKey="Acheampong, Ao" uniqKey="Acheampong A">AO Acheampong</name></author><author><name sortKey="Boakye, I" uniqKey="Boakye I">I Boakye</name></author><author><name sortKey="Awuah, B" uniqKey="Awuah B">B Awuah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gilbert, H" uniqKey="Gilbert H">H Gilbert</name></author><author><name sortKey="Kagan, Ar" uniqKey="Kagan A">AR Kagan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Res Notes</journal-id><journal-id journal-id-type="iso-abbrev">BMC Res Notes</journal-id><journal-title-group><journal-title>BMC Research Notes</journal-title></journal-title-group><issn pub-type="epub">1756-0500</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26654449</article-id><article-id pub-id-type="pmc">4676813</article-id><article-id pub-id-type="publisher-id">1773</article-id><article-id pub-id-type="doi">10.1186/s13104-015-1773-9</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Gilyoma</surname><given-names>Japhet M.</given-names></name><address><email>drgilyoma2@yahoo.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Rambau</surname><given-names>Peter F.</given-names></name><address><email>prambau@bugando.ac.tz</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Masalu</surname><given-names>Nestory</given-names></name><address><email>nmasalu4@gmail.com</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Kayange</surname><given-names>Neema M.</given-names></name><address><email>n_eema@yahoo.com</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Chalya</surname><given-names>Phillipo L.</given-names></name><address><email>drphillipoleo@yahoo.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1"><label></label>Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</aff><aff id="Aff2"><label></label>Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</aff><aff id="Aff3"><label></label>Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</aff><aff id="Aff4"><label></label>Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania</aff></contrib-group><pub-date pub-type="epub"><day>12</day><month>12</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>12</day><month>12</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>8</volume><elocation-id>772</elocation-id><history><date date-type="received"><day>28</day><month>12</month><year>2014</year></date><date date-type="accepted"><day>30</day><month>11</month><year>2015</year></date></history><permissions><copyright-statement>© Gilyoma et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Head and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding head and neck cancers in Tanzania, and Bugando Medical Centre in particular. This study describes the clinicopathological profile of HNC in our local setting and highlights the challenges in the management of this disease.</p></sec><sec><title>Methods</title><p>This was a retrospective study of histopathologically confirmed cases of head and neck cancers treated at Bugando Medical Center between January 2009 and December 2013.</p></sec><sec><title>Results</title><p>A total of 346 patients (M:F = 2.1:1) were studied representing 9.5 % of all malignancies. The median age of patients was 42 years. Cigarette smoking (76.6 %) and heavy alcohol consumption (69.9 %) were the most frequently identified risk factors for head and neck cancer. The majority of patients (95.9 %) presented late with advanced stages. Twenty-five (7.2 %) patients were HIV positive with a median CD4+ count of 244 cells/μl. The oral cavity (37.3 %) was the most frequent anatomical site affected. The most common histopathological type was carcinomas (59.6 %) of which 75.7 % were squamous cell carcinoma. A total of 196 (56.6 %) patients underwent surgical procedures for HNC. Radiotherapy and chemotherapy was reported in 9.5 and 16.8 % of patients, respectively. Only 2 (0.6 %) patients received chemo-radiation therapy. The mortality rate was 24.4 %. The overall 5-year survival rate (5-YSR) was 20.6 %. The predictors of overall 5-YSR were age of patient at diagnosis, stage of disease, extent of lymph node involvement, HIV seropositivity and CD4+ count <200 cells/μl (P < 0.001). Local recurrence was reported in 22 (23.4 %) patients and this was significantly associated with positive resection margins, stage of the tumor and presence of metastasis at diagnosis and non-adherence to adjuvant therapy (P < 0.001).</p></sec><sec><title>Conclusion</title><p>Head and neck cancers are not uncommon at Bugando Medical Centre and show a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage cancer. Therefore, public enlightenment, early diagnosis, and effective cost-effective treatment and follow-up are urgently needed to improve outcomes of these patients in our environment.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Head and neck cancers</kwd><kwd>Clinicopathological</kwd><kwd>Challenges</kwd><kwd>Resource-limited setting</kwd><kwd>Tanzania</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Tanzanie</li></country></list><tree><country name="Tanzanie"><noRegion><name sortKey="Gilyoma, Japhet M" sort="Gilyoma, Japhet M" uniqKey="Gilyoma J" first="Japhet M." last="Gilyoma">Japhet M. Gilyoma</name></noRegion><name sortKey="Chalya, Phillipo L" sort="Chalya, Phillipo L" uniqKey="Chalya P" first="Phillipo L." last="Chalya">Phillipo L. Chalya</name><name sortKey="Kayange, Neema M" sort="Kayange, Neema M" uniqKey="Kayange N" first="Neema M." last="Kayange">Neema M. Kayange</name><name sortKey="Masalu, Nestory" sort="Masalu, Nestory" uniqKey="Masalu N" first="Nestory" last="Masalu">Nestory Masalu</name><name sortKey="Rambau, Peter F" sort="Rambau, Peter F" uniqKey="Rambau P" first="Peter F." last="Rambau">Peter F. Rambau</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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