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    ABSTRACT: In Kuwait, breast cancer is the most common form of cancer among women. The present study reviews the clinical features, treatment methods and treatment results of breast cancer patients registered in the Kuwait Cancer Control Center (KCCC) and compares these features with those reported in other Arab countries, Europe and North America. The present study examines 823 patients with breast cancer who were registered in the KCCC from 1993 to 1998. Patients were identified through the Kuwait Cancer Registry and their cases were followed for at least five years. Eleven males accounted for 1.3% of all patients. The average age was one decade younger than that reported in western countries but similar to reports from Egypt and GCC countries. Surgery was applied in 90.4% of patients. Breast conservation (lumpectomy and axillary clearance) was performed in 19.6% of patients, while mastectomy and axillary clearance was adopted in 60.8%. Radiotherapy was applied in 67.7% of patients and chemotherapy in 60.8%. The long-term overall survival and disease-free survival amounted to 76+/-6.4% and 54+/-4.6% respectively. Prognostic factors were analyzed using univariate and multivariate analysis. According to multivariate analysis the nodal status, the number of involved nodes and histopathology were independent prognostic factors. Comparable results were achieved after both breast conservation and mastectomy. Since breast conservation protocols yield results similar to mastectomy, its use should be extended. Search for biological prognostic indicators should continue for their potential use as guides for treatment decisions.
    Full-text · Article · Jul 2004 · Journal of the Egyptian National Cancer Institute
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    ABSTRACT: Aim: Incidence of rectal and rectosigmoid cancer has wide geographical variation. Disease pattern in developing countries is diffe- rent from developed countries. This analysis was undertaken to describe patient profile and to review the outcome of adjuvant thera- py for rectal and rectosigmoid cancer at Kuwait Cancer Control Center.Patients and Methods: We retrospectively evaluated rectal and rectosigmoid cancer patients diagnosed between 1998 - 2004. One hundred and ninety three patients with rectal and rectosigmo- id cancer were included. Only 11% of the patients were diagnosed with stage I disease, 28% with stage II, 53% were stage III, and 7.9% were stage VI. About 76.6% underwent anterior resection while 23.3% underwent abdomino-perineal resection or Hartman pro- cedure. Only 63.2% of the patients received radiotherapy, and of those only 36 patients had preoperative radiotherapy. Only 35.2% of patients received adjuvant chemotherapy. Results:The male to female ratio was 1.4 and the median age of the patients was 52.11 years. Cancer of the rectum constituted 64.2% while rectosigmoid cancer constituted 35.8% of the cases. About 17.7% had tumor located within 5 cm from anal verge. Locally advanced or metastatic disease were found in 67.6%. Tumor involving more than _ of the lumen circumference was found in 49.1% of cases. Liver was the most frequent site (14.5%) of metastasis followed by lung (4.1%). Well, moderately and poorly differentiated adenocarcinoma constituted 16.8%, 68.8% and 14.5% of the cases, respectively. The disease free survival was influenced significantly by the lymph nodes status and chemotherapy. Among the whole group, the local recurrence was 18.7%, while the disease free survival and overall survival were 42.7 and 90.04%, respectively. Conclusions: Rectal cancer in Kuwait differs from western countries with a high propensity for locally advanced tumors because of delayed referral and misdiagnosis.
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