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Pattern of head and neck cancer in a tertiary institution in Lagos, Nigeria.
... In this study, HNCs accounted for 10.0% of all new cases of cancer diagnosed during the period under review. This concur with 10.3% incidence recorded in South western Nigeria (Sowunmi et al., 2015) and the overall global picture (Fan, 2004). Our finding is however lower than 16.5% incidence observed in Maiduguri/North Eastern Nigeria (Kodiya et al., 2016). ...
The paper looks at the age, gender distribution and histological pattern of head and neck malignancies in Delta State University Teaching Hospital, Nigeria
... Head and Neck cancers in this study were found to be about 7.3% of all the cancers in the body system which was within the range of 5-50% found in previous studies 1, 3,10,11 in Nigeria and beyond. The male to female ratio 1.1:1 which was also within the range of 1:1 to 2.3:1 reported in a review article on evidence on the burden of 12 head and neck cancers in Nigeria. ...
BACKGROUND:
Head and neck cancers remain a major public health concern with increasing prevalence in Africa. The aim of this study was to highlight the current trends of head and neck cancers and compare with previous studies.
METHODS:
A retrospective study of head and neck cancers seen in University of Ilorin Teaching Hospital over a 6-year period (2013 – 2018) was done. Information was retrieved from the clinic, theatre and cancer registry centre. Sites of tumours, duration of symptoms before presentation, reasons for late presentation and histopathological diagnosis were extracted.
RESULT:
A total of 143 cases were recruited . The age ranged from 2 – 100 years with a mean age of 52 years. The duration of symptoms at presentation was found to range from 3 months to 78 months. Over 80% presented late. Reasons for late presentation were financial constraints (60.5%), ignorance/wrong beliefs (32.4%), traditional treatment (41.6%) and delayed referral (22.5%). Commonest sites were sinonasal region (13.3%), larynx (11.9%), and the nasopharynx (11.2%). Of these, 58.0% were carcinomas, 25.2% were lymphomas, 7.0% were sarcomas while 9.8% were blastomas.
CONCLUSION:
The clinicopathological pattern of head and neck cancers revealed no significant change over the past 20 years. However, it is expedient to carry out this kind of study at regular intervals to enable health care professionals update existing records. It will help in the revision of policies that are tailored towards reducing the prevalence of head and neck tumours.
Background:
Recurrent cancers of the head and neck are associated with poor survival outcome. Yet, their burden in Africa is not reliably known. We therefore aimed to estimate the prevalence of recurrence and the 5-year overall survival among patients treated for head and neck cancers (HNC) in Africa.
Method:
In this systematic review and meta-analysis, we searched four electronic databases (Pubmed, CINAHL, MEDLINE, and Web of Science) and the grey literature for studies reporting the prevalence of HNC recurrence and 5-year overall survival post treatment, published between January 1, 2002, and December 31, 2022. We contacted corresponding authors of relevant studies. Searches were extended to reference lists of review articles and other relevant sources for potentially eligible studies. Each record was assessed for inclusion or exclusion by two independent reviewers. Records with individual-level data on recurrence and survival conducted in Africa were included while exclusion was based on the study design and availability of relevant data. Data were independently extracted by three reviewers from eligible studies, and summary estimates were sought. Our primary outcomes were recurrence and 5-year overall survival of patients who have been treated for HNC, and our secondary outcomes included risk factors, tumor site, squamous cell histology, clinical stage of tumor, and treatment options received. Only records selected for primary outcomes were assessed for secondary outcome data extraction. Random-effects meta-analysis was conducted for each outcome. Meta-regression models were used in addressing sample heterogeneity among the studies. Protocol for this study was registered with PROSPERO, CRD42022372307.
Findings:
This systematic review and meta-analysis returned 3998 records, yielding 28 included studies after exclusion. Eighteen studies reported on the prevalence of HNC recurrence while 24 articles reported on the 5-year overall survival. Of the pooled total study population, 7199 (70.5%) of 10,218 patients were males while 2603 (25.5%) were females. We found that the prevalence of HNC recurrence was 15.4% (I2 = 96.2%; 95% CI: 9.5-22.3; n = 3214; k = 18), and the 5-year overall survival was 54.4% (I2 = 99.5%; 95% CI: 40.1-68.4; n = 9798; k = 24). We also found that the prevalence of smoking and alcohol consumption as risk factors for HNC were 42.6% (I2 = 98.8%; 95% CI: 25.2-61.0; n = 4374; k = 15) and 35.8% (I2 = 98.9%; 95% CI: 21.7-51.4; n = 4110; k = 11) respectively. The pooled current prevalence for advanced HNC (clinical stages III-IV) was 80.0% (I2 = 99.2%; 95% CI: 68.6-89.5; n = 7624; k = 18) compared to 12.2% (I2 = 96.4%; 95% CI: 6.2-19.8; n = 7624; k = 18) in early disease (clinical stages I-II).
Interpretation:
The results showed significantly high prevalence of cancer recurrence, poor 5-year overall survival and very high prevalence of advanced cancers at time of diagnosis. This study provides robust evidence for strategies towards prompt diagnosis and appropriate management of HNC to improve patients' outcome in the African continent.
Funding:
This study was not supported by any funding.
Background UADT neoplasms is a heterogenous diseases entity which includes primaries arising from nose and paranasal sinuses, nasopharynx, oral cavity, oropharynx, hypopharynx and larynx. Squamous cell carcinoma is the predominant histologic type. The likelihood of having nodal diseases at presentation may have a wide range depending the size and site of the primary tumor with significantly higher risk for patients with nasopharyngeal primaries and advanced T stage of other sub-sites of upper aerodigestive tract. Chances of having multiple and bilateral nodes also have direct correlation with the size of the primary tumors. Positive cervical nodal status is one of the most reliable prognostic factors which drops cure rate significantly. It is also responsible for treatment failure, local recurrence and reduction of survival rate and its a reliable indicator of development of distant metastasis. The pattern of distribution of nodal involvement is different for each site. Thorough study of distribution of most likely involved lymph node levels for each sub site helps to customize the neck treatment accordingly by avoiding radical treatments with significant functional and aesthetic morbidity.
Objective To define prevalence and pattern of nodal and distant metastasis of UADT-SCC patients at the time of diagnosis.
Method Institution based retrospective cross sectional medical chart review of patients from September 2015- September 2020 was conducted. 259 patients who fulfilled the inclusion criteria were selected using systematic random sampling technique and data was collected using questioner.
Result A total of 259 medical records were reviewed. Mean age at presentation is 44.8. Male to female ratio is 2.6:1. Prevalence of positive nodal diseases at presentation is 71%. Site specific analysis showed 50% of nose and PNS, 86.1% nasopharyngeal, 73.2% oral cavity, 70% oropharyngeal, 66.7% hypo-pharyngeal and 57.2% laryngeal primaries had positive nodal diseases at presentation. Majority of late presentations had positive nodal diseases (p<0.05).Nasopharynx is the commonest site of primary tumor (30.5%). It is also the commonest site with higher percentage of positive nodal diseases (86.1%).Most patients had advanced stage at presentation (cTNM stage III and IV- 88.1%). Distant metastasis was found in 10.8% of patients and had strong association with T stage (p<0.05).
Conclusion and recommendation This study concluded that majority of patients fall in the age group of 31 to 40 with male predominance of 2.6 to 1. Late presentation is a rule since most patients with UADT-SCC has advanced disease at presentation with significant nodal neck diseases. Nasopharynx is the commonest site of primary tumor for both males and females. It's also the commonest site of primaries with higher percentage of positive nodal diseases at presentation. Chances of having positive cervical nodal disease at presentation were very high in patients with advanced T diseases. Pattern of metastasis of most sites are inline with the current accepted knowledge of practice. Research designs with better strength should be used to study the clinicopathologic behavior of UADT-SCC both nation wide and in region specific setups. Institutional cancer registry should be improved and made easily accessible to researchers.Patient’s medical records should be complete. Policies on preventive measures and screening tools should be designed.Health seeking behavior of the community should be improved.Referral system should be made easy for patients with suspected cases.
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