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Abdelhafiz N, Mahmoud D, Gad M, Essa H, Morsy A. Effect of definitive hypo-fractionated radiotherapy concurrent with weekly cisplatin in locally advanced squamous cell carcinoma of the head and neck. J Med Life 2023; 16:743-750. [PMID: 37520484 PMCID: PMC10375354 DOI: 10.25122/jml-2023-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/11/2023] [Indexed: 08/01/2023] Open
Abstract
To mitigate the risk of COVID-19 infection in cancer patients, it is recommended to utilize hypo-fractionated treatment schedules that aim to minimize the overall duration of treatment. In this study, we aimed to determine whether hypo-fractionated intensity-modulated radiotherapy (hypo-IMRT) with concurrent chemotherapy was practical, effective, and could achieve acceptable tumor control rates for squamous cell carcinoma of the head and neck (SCCHN). We enrolled 62 patients with high-risk stage II, stage III, and IVA SCCHN who received hypo-IMRT (62.5 Gy in 25 fractions over 5 weeks 2.5Gy/fraction with weekly cisplatin 40 mg/m2). Our primary endpoint was to assess acute toxicity, while our secondary endpoints were late toxicity, loco-regional control, disease-free survival, and overall survival. The percentages of grade 3 acute pain, dermatitis, mucositis, and dysphagia were 71%, 19.4%, 72.6%, and 41.9%, respectively. The rates of late xerostomia, dysphagia, dental complications, grade 3 pain, and grade 3 weight loss were 72.6%, 62.9%, 27.4%, 4.8%, and 4.3%, respectively. At a median follow-up time of 24 months, 2-year loco-regional control and overall survival were 87.1% and 83.9%, respectively. Disease-free survival was 100%, 89.5%, and 69% in stages II, III, and IV%, respectively, with a significant p-value of 0.024. This regimen was effective and relatively safe, with acceptable and tolerable acute and late toxicity. Given the reduced need for hospital visits, hypo-fractionated schedules may represent an alternative treatment during the COVID-19 outbreak.
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Affiliation(s)
- Nora Abdelhafiz
- Department of Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Doaa Mahmoud
- Department of Clinical Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Clinical Oncology, Saudi German Hospital Aseer, Khamis Mushait, Saudi Arabia
| | - Mohamed Gad
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hoda Essa
- Department of Clinical Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Aiat Morsy
- Department of Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
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2
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Dendl K, Finck R, Giesel FL, Kratochwil C, Lindner T, Mier W, Cardinale J, Kesch C, Röhrich M, Rathke H, Gampp H, Ristau J, Adeberg S, Jäger D, Debus J, Haberkorn U, Koerber SA. FAP imaging in rare cancer entities-first clinical experience in a broad spectrum of malignancies. Eur J Nucl Med Mol Imaging 2021; 49:721-731. [PMID: 34342669 PMCID: PMC8803688 DOI: 10.1007/s00259-021-05488-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/04/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE 68 Ga-FAPI (fibroblast activation protein inhibitor) is a rapidly evolving and highly promising radiotracer for PET/CT imaging, presenting excellent results in a variety of tumor entities, particularly in epithelial carcinomas. This retrospective analysis sought to evaluate the potential and impact of FAPI-PET/CT in rare cancer diseases with respect to improvement in staging and therapy, based on tracer uptake in normal organs and tumors. MATERIAL AND METHODS Fifty-five patients with rare tumor entities, defined by a prevalence of 1 person out of 2000 or less, received a 68 Ga-FAPI-PET/CT scan. Fourteen women and 41 men (median age 60) were included within the following subgroups: cancer of unknown primary (n = 10), head and neck cancer (n = 13), gastrointestinal and biliary-pancreatic cancer (n = 17), urinary tract cancer (n = 4), neuroendocrine cancer (n = 4), and others (n = 7). Tracer uptake was quantified by standardized uptake values SUVmax and SUVmean and the tumor-to-background ratio (TBR) was determined (SUVmax tumor/SUVmean organ). RESULTS In 20 out of 55 patients, the primary tumor was identified and 31 patients presented metastases (n = 88), characterized by a high mean SUVmax in primary (10.1) and metastatic lesions (7.6). The highest uptake was observed in liver metastases (n = 6) with a mean SUVmax of 9.8 and a high TBR of 8.7, closely followed by peritoneal carcinomatosis (n = 16) presenting a mean SUVmax of 9.8 and an excellent TBR of 29.6. In terms of the included subgroups, the highest uptake regarding mean SUVmax was determined in gastrointestinal and biliary-pancreatic cancer with 9.8 followed closely by urinary tract cancer with 9.5 and head and neck cancer (9.1). CONCLUSION Due to excellent tumor visualization and, thereby, sharp contrasts in terms of high TBRs in primary and metastatic lesions in different rare malignancies, 68 Ga-FAPI-PET/CT crystallizes as a powerful and valuable imaging tool, particularly with respect to epithelial carcinomas, and therefore an enhancement to standard diagnostics imaging methodologies. The realization of further and prospective studies is of large importance to confirm the potential of FAP imaging in oncology.
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Affiliation(s)
- K Dendl
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - R Finck
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - F L Giesel
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Department of Nuclear Medicine, Düsseldorf University Hospital, Düsseldorf, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - T Lindner
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - W Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - J Cardinale
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - C Kesch
- Department of Urology, German Cancer Consortium (DKTK), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - M Röhrich
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - H Rathke
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - H Gampp
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - J Ristau
- National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
| | - S Adeberg
- National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
| | - D Jäger
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - J Debus
- National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,German Cancer Consortium (DKTK), partner site Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany
| | - S A Koerber
- National Center for Tumor Diseases (NCT), Heidelberg, Germany. .,Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany. .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.
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Aggarwal N, Yadav J, Chhakara S, Janjua D, Tripathi T, Chaudhary A, Chhokar A, Thakur K, Singh T, Bharti AC. Phytochemicals as Potential Chemopreventive and Chemotherapeutic Agents for Emerging Human Papillomavirus-Driven Head and Neck Cancer: Current Evidence and Future Prospects. Front Pharmacol 2021; 12:699044. [PMID: 34354591 PMCID: PMC8329252 DOI: 10.3389/fphar.2021.699044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022] Open
Abstract
Head and neck cancer (HNC) usually arises from squamous cells of the upper aerodigestive tract that line the mucosal surface in the head and neck region. In India, HNC is common in males, and it is the sixth most common cancer globally. Conventionally, HNC attributes to the use of alcohol or chewing tobacco. Over the past four decades, portions of human papillomavirus (HPV)-positive HNC are increasing at an alarming rate. Identification based on the etiological factors and molecular signatures demonstrates that these neoplastic lesions belong to a distinct category that differs in pathological characteristics and therapeutic response. Slow development in HNC therapeutics has resulted in a low 5-year survival rate in the last two decades. Interestingly, HPV-positive HNC has shown better outcomes following conservative treatments and immunotherapies. This raises demand to have a pre-therapy assessment of HPV status to decide the treatment strategy. Moreover, there is no HPV-specific treatment for HPV-positive HNC patients. Accumulating evidence suggests that phytochemicals are promising leads against HNC and show potential as adjuvants to chemoradiotherapy in HNC. However, only a few of these phytochemicals target HPV. The aim of the present article was to collate data on various leading phytochemicals that have shown promising results in the prevention and treatment of HNC in general and HPV-driven HNC. The review explores the possibility of using these leads against HPV-positive tumors as some of the signaling pathways are common. The review also addresses various challenges in the field that prevent their use in clinical settings.
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Affiliation(s)
- Nikita Aggarwal
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Joni Yadav
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Suhail Chhakara
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Divya Janjua
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Tanya Tripathi
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Apoorva Chaudhary
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Arun Chhokar
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Kulbhushan Thakur
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Tejveer Singh
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
| | - Alok Chandra Bharti
- Molecular Oncology Laboratory, Department of Zoology, Faculty of Science, University of Delhi, Delhi, India
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4
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Ramdulari AV, Izzuddeen Y, Benson R, Mallick S, Venkatesulu B, Giridhar P. Laryngeal soft tissue sarcoma: Systematic review and individual patient data analysis of 300 cases. Head Neck 2021; 43:1421-1427. [PMID: 33448036 DOI: 10.1002/hed.26604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Laryngeal sarcoma is rare. We performed a systematic review and individual patient analysis to evaluate the patterns of care, prognostic factors, and role of radiotherapy in laryngeal soft tissue sarcoma. METHODS A systematic search on PubMed and Google scholar was done. An individual patient data analysis was done. RESULTS Of the 300 cases of laryngeal sarcoma, 80% underwent surgery. 44% underwent larynx preservation surgery and 25% received radiotherapy with surgery. Median progression free survival (PFS) was 48 months and overall survival (OS) of 224 months for the entire cohort. Patients with large primary, cartilage invasion, and positive margins had numerically worse PFS. Cartilage invasion and primary tumor size >3 cm were the most common risk factors for adjuvant radiation therapy. Patients receiving radiotherapy were not associated with better survival. CONCLUSION Laryngeal sarcoma associated with a good survival. Larynx preservation surgery is feasible in nearly half patients. Adjuvant radiotherapy may be warranted in patients poor prognostic factors.
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Affiliation(s)
- Anjali V Ramdulari
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Yousra Izzuddeen
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Rony Benson
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, India
| | - Supriya Mallick
- Department of Radiation Oncology, National Cancer Institute, All India Institute of Medical Sciences, Badsa, India
| | | | - Prashanth Giridhar
- Department of Radiation Oncology, National Cancer Institute, All India Institute of Medical Sciences, Badsa, India
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5
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Adoga AA, Kokong DD, Ma'an ND, Silas OA, Dauda AM, Yaro JP, Mugu JG, Mgbachi CJ, Yabak CJ. The epidemiology, treatment, and determinants of outcome of primary head and neck cancers at the Jos University Teaching Hospital. South Asian J Cancer 2020; 7:183-187. [PMID: 30112335 PMCID: PMC6069340 DOI: 10.4103/sajc.sajc_15_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction: This study aims to evaluate the epidemiology, treatment, and factors that determine the outcomes of head and neck cancers (HNC). Patients and Methods: Retrospective analytical review of HNC managed at the Jos University Teaching Hospital between May 2007 and April 2017 using the International Classification of Diseases version 10. Results: Of 487 head and neck neoplasms, 129 (26.5%) were malignant and 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13 years to 85 years (mean = 51 years; standard deviation = ±16.0 years). The most common presenting feature was nasal obstruction (n = 47; 38.5%). The most common tumor site was the nasopharynx (n = 34; 27.9%). Mean duration of symptoms was 13.3 months. Alcohol (P = 0.02), cigarette smoking (P = 0.01), and cooking wood smoke (P = 0.01) were associated with advanced tumor stage. Squamous cell carcinoma was the most common histological type. Posttreatment complication rate was 47.5%. Lost to follow-up rate was 55.7%. The lungs were the most common distant metastatic site. The case fatality rate was 18.0%. Conclusion: HNC constitutes almost a quarter of head and neck tumors affecting twice the number of males in their sixth decade with nasopharyngeal cancers being the most common in both genders. Several modifiable variables are noted to target appropriate future cancer education for lifestyle modification, screening for early detection and treatment.
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Affiliation(s)
- Adeyi A Adoga
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Daniel D Kokong
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Nuhu D Ma'an
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Olugbenga A Silas
- Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria
| | - Ayuba M Dauda
- Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria
| | - John P Yaro
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Joyce G Mugu
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Chukwunonso J Mgbachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Caleb J Yabak
- Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Nigeria
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6
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Co-presence of human papillomaviruses and Epstein-Barr virus is linked with advanced tumor stage: a tissue microarray study in head and neck cancer patients. Cancer Cell Int 2020; 20:361. [PMID: 32774155 PMCID: PMC7397600 DOI: 10.1186/s12935-020-01348-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background Human papillomaviruses (HPVs) and Epstein–Barr virus (EBV), known oncoviruses, can be co-present and cooperate in the initiation and/or progression of human carcinomas, including head and neck. Based on this fact, we recently reported the prevalence of both HPVs and EBV in cervical and breast cancers. Methods We herein explore for the first time the co-prevalence of high-risk HPVs and EBV in 98 head and neck (HN) squamous cell carcinoma (SCC) tissues from Bosnian patients using polymerase chain reaction (PCR) and immunohistochemistry (IHC) analysis, as well as tissue microarray methodology. Results The majority of these cancer tissue cases were from the oral cavity (68%). We found that high-risk HPVs and EBV are co-present in 34.7% of the SCC samples; with a significant correlation between the various HPV types and EBV co-incidence (p = 0.03). Our data showed that 30.8% of oral SCCs are positive for E6 oncoprotein of high-risk HPVs and 44.6% are positive for LMP1 of EBV. The most commonly expressed HPVs in our HNSCC samples include HPV types 16, 18, 45 and 58. Additionally, 37.5% of oral SCCs are positive for both HPVs and EBV, with statistically significant association between high-risk HPV types and EBV (p < 0.05). More importantly, our data revealed that the co-presence of HPV and EBV is strongly correlated with advanced tumor stage (p = 0.035). Conclusion In this study we show that HPV and EBV oncoviruses are co-present in HNSCC, particularly in oral cancer, where they can cooperate in the initiation and/or progression of this cancer. Thus, further studies are necessary to elucidate the mechanism of this cooperation.
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7
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Is 68Ga-DOTA-FAPI a new arrow in the quiver of dose painting in radiation dose planning in head and neck cancers? Eur J Nucl Med Mol Imaging 2020; 47:2718-2720. [PMID: 32488339 PMCID: PMC7567717 DOI: 10.1007/s00259-020-04895-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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8
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Adoga AA, Kokong DD, Ma'an ND, Mugu JG, Mgbachi CJ, Dauda AM. The predictive factors of primary head and neck cancer stage at presentation and survival in a developing nation's tertiary hospital. SAGE Open Med 2018; 6:2050312118792416. [PMID: 30140440 PMCID: PMC6096671 DOI: 10.1177/2050312118792416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 07/09/2018] [Indexed: 01/04/2023] Open
Abstract
Background: Stage of head and neck cancers at presentation is a strong determinant of
outcomes. Objective: To evaluate predictors of stage of head and neck cancers at presentation and
survival in a Nigerian tertiary hospital. Patients and methods: Health records that met the inclusion criteria for head and neck cancers were
retrieved using the International Classification of Diseases, 10th revision
and analyzed with associations between variables modeled using logistic
regression analysis. Results: From a record of 487 head and neck neoplasms, 129 (26.5%) were malignant of
which 122 health records met the criteria for analysis consisting of 83
(68.0%) males and 39 (32.0%) females aged 13–85 years (mean = 51 years;
standard deviation = ±16 years). Alcohol (odds ratio = 1.99; 95% confidence
interval = 1.08–3.69; p = 0.02) and tobacco exposure (odds ratio = 3.07; 95%
confidence interval = 1.32–7.16; p = 0.01) were associated with increased
odds for advanced tumor stage at presentation. Stage IV cancer (hazard
ratio = 1.44; 95% confidence interval = 1.80–2.59), alcohol (hazard
ratio = 2.19; 95% confidence interval = 1.18–4.10) and tobacco use (hazard
ratio = 3.40; 95% confidence interval = 1.22–8.74) were associated with
increased hazards for death. Conclusion: Alcohol, tobacco use and smoke from cooking wood are predictive factors for
advanced HNC stage at presentation. Stage IV cancer, alcohol and tobacco use
were associated with an increased hazard for death.
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Affiliation(s)
- Adeyi A Adoga
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, Jos University Teaching Hospital/University of Jos, Jos, Nigeria
| | - Daniel D Kokong
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, Jos University Teaching Hospital/University of Jos, Jos, Nigeria
| | - Nuhu D Ma'an
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, Jos University Teaching Hospital/University of Jos, Jos, Nigeria
| | - Joyce G Mugu
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, Jos University Teaching Hospital/University of Jos, Jos, Nigeria
| | - Chukwunonso J Mgbachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, Jos University Teaching Hospital/University of Jos, Jos, Nigeria
| | - Ayuba M Dauda
- Department of Pathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
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Akinyamoju AO, Adeyemi BF, Adisa AO, Okoli CN. Audit of Oral Histopathology Service at a Nigerian Tertiary Institution over a 24-Year Period. Ethiop J Health Sci 2018; 27:383-392. [PMID: 29217940 PMCID: PMC5615027 DOI: 10.4314/ejhs.v27i4.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Biopsies are often essential for definitive diagnosis of oro-facial lesions and are a part of oral diagnostic procedures carried out in histopathology laboratories. At present, there is paucity of literature on the audit of oral histopathology services in Nigeria. The objectives of this study were to determine the prevalence of biopsied oral lesions in a Nigerian tertiary institution. Also to profile the usage of oral pathology service and to identify challenges that may be present in an oral histodiagnostic service. Methods This was a retrospective study performed at the Oral Pathology Department of the University of Ibadan/ University College Hospital, Ibadan, Nigeria. Reports of all biopsies submitted at the Oral Pathology laboratory, for the period 1990-2014, were reviewed and data extracted. Descriptive analysis was done using SPSS software, version 20. Results The total number of reports was 1,998; invalid reports constituting 220(11%) were subsequently excluded leaving 1,778(89%) valid reports. The mean age of patients was 36.70±19.79, while the peak age of presentation was in the 3rd decade. Male to female ratio was 1:1.1, and the mandible was the most common site of lesions 619(34.8%). These services were mainly utilized by oral surgeons (83.9%) and ameloblastoma (11.5%) was the most frequently diagnosed lesion. CD45 (16.7%) was the most frequently requested immuno-diagnostic test. Conclusion Biopsied oral lesions were more prevalent in females, while oral and maxillofacial surgeons utilized these services the most. Inadequate biopsy specimens or unrepresentative specimens and deficient documentation were challenges identified in this study.
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Affiliation(s)
- Akindayo O Akinyamoju
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Bukola F Adeyemi
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Akinyele O Adisa
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Chidinma N Okoli
- Department of Oral Pathology, University College Hospital, Ibadan, Nigeria
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Aliyu UM, Folasire AM, Ntekim AI. Treatment outcome of patients with nasopharyngeal carcinoma in Nigeria: An institutional experience. PRECISION RADIATION ONCOLOGY 2018. [DOI: 10.1002/pro6.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
| | | | - Atara Isaiah Ntekim
- College of Medicine; University of Ibadan; Ibadan Nigeria
- University College Hospital; Ibadan Nigeria
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Nweke MC, Okolo CA, Daous Y, Esan OA. Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries. Arch Pathol Lab Med 2018; 142:696-699. [PMID: 29848027 DOI: 10.5858/arpa.2017-0565-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes.
Objectives.—
To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries.
Data Sources.—
Peer-reviewed literature and experience of some of the authors.
Conclusions.—
Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.
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Affiliation(s)
| | | | | | - Olukemi Ayotunde Esan
- From the Department of Pathology, University College Hospital Ibadan, Ibadan, Nigeria (Messrs Nweke and Okolo); and the Department of Pathology, West Virginia University, Morgantown (Drs Daous and Esan)
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Naveed H, Abid M, Hashmi AA, Edhi MM, Sheikh AK, Mudassir G, Khan A. Diagnostic accuracy of touch imprint cytology for head and neck malignancies: a useful intra-operative tool in resource limited countries. BMC Clin Pathol 2017; 17:25. [PMID: 29204102 PMCID: PMC5702091 DOI: 10.1186/s12907-017-0063-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/13/2017] [Indexed: 02/07/2023] Open
Abstract
Background Intraoperative consultation is an important tool for the evaluation of the upper aerodigestive tract (UAT) malignancies. Although frozen section analysis is a preferred method of intra-operative consultation, however in resource limited countries like Pakistan, this facility is not available in most institutes; therefore, we aimed to evaluate the diagnostic accuracy of touch imprint cytology for UAT malignancies using histopathology of the same tissue as gold standard. Methods The study involved 70 cases of UAT lesions operated during the study period. Intraoperatively, after obtaining the fresh biopsy specimen and prior to placing them in fixative, each specimen was imprinted on 4-6 glass slides, fixed immediately in 95% alcohol and stained with Hematoxylin and Eosin stain. After completion of the cytological procedure, the surgical biopsy specimen was processed. The slides of both touch Imprint cytology and histopathology were examined by two consultant histopathologists. Results The result of touch imprint cytology showed that touch imprint cytology was diagnostic in 68 cases (97.1%), 55 (78.6%) being malignant, 2 cases (2.9%) were suspicious for malignancy, 11 cases (15.7%) were negative for malignancy while 2 cases (2.9%) were false negative. Amongst the 70 cases, 55 cases (78.6%) were malignant showing squamous cell carcinoma in 49 cases (70%), adenoid cystic carcinoma in 2 cases (2.9%), non-Hodgkin lymphoma 2 cases (2.9%), Mucoepidermoid carcinoma 1 case (1.4%), spindle cell sarcoma in 1 case (1.4%). Two cases (2.9%) were suspicious of malignancy showing atypical squamoid cells on touch imprint cytology, while 13 cases (18.6%) were negative for malignancy, which also included 2 false negative cases. The overall diagnostic accuracy of touch imprint cytology came out to be 96.7% with a sensitivity and specificity of 96 and 100%, respectively while PPV and NPV of touch imprint cytology was found to be 100 and 84%, respectively. Conclusion Our experience in this study has demonstrated that touch imprint cytology provides reliable specific diagnoses and can be used as an adjunct to histopathology, particularly in developing countries, where the facility of frozen section is often not available, since a rapid preliminary diagnosis may help in the surgical management planning.
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Affiliation(s)
| | | | - Atif Ali Hashmi
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | | | | | - Amir Khan
- Kandahar University, Kandahar, Afghanistan
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Rogers SN, Barber B. Using PROMs to guide patients and practitioners through the head and neck cancer journey. PATIENT-RELATED OUTCOME MEASURES 2017; 8:133-142. [PMID: 29184455 PMCID: PMC5687779 DOI: 10.2147/prom.s129012] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The measurement of patient-reported outcome measures (PROMs) following head and neck cancer (HNC) has the capacity to substantially enhance the care of patients and their care-givers following the diagnosis and treatment of HNC. Literature concerning PROMs has increased exponentially in the past 2 decades, producing a vast array of data upon which the multidisciplinary team can reflect. For this review, “Handle On QOL” has been used as a source of references to illustrate the points raised. PROMs are contextualized by considering the clinically-distinct key stages that cancer patients endure: diagnosis, treatment, acute toxicity, early recovery, late effects, recurrence, and palliation. The PROMs are considered in six main categories: 1) those addressing cornucopia of issues not specific to cancer; 2) those addressing issues common to all cancers; 3) questionnaires with items specific to HNC; 4) questionnaires that focus on a particular aspect of head and neck function; 5) those measuring psychological concerns, such as depression, anxiety, or self-esteem; and 6) item prompt lists. Potential benefits of PROMs in clinical practice are discussed, as are barriers to use. The way forward in integrating PROMs into routine HNC care is discussed with an emphasis on information technology.
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Affiliation(s)
- Simon N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK.,Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK
| | - Brittany Barber
- Head and Neck Department, Icahn School of Medicine at Mount Sinai (MSSM), New York, NY, USA
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Okwor VC, Fagbamigbe AF, Fawole OI. Survivorship of patients with head and neck cancer receiving care in a tertiary health facility in Nigeria. Cancer Manag Res 2017; 9:331-338. [PMID: 28790865 PMCID: PMC5531721 DOI: 10.2147/cmar.s133108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Head and neck cancer (HNC) is a major clinical and public health concern worldwide which impairs the vital functions of life. The treatment of metastatic HNCs is mainly palliative. This study examined the survival patterns and treatment outcomes in patients with HNCs in a tertiary hospital in Nigeria. Materials and methods A review of the case files and treatment cards of patients with histological diagnosis of HNCs seen between January 2002 and December 2011 at the Radiotherapy Department, University College Hospital, Ibadan, was conducted. A total of 494 cases were identified, of which 481 had valid records. Analyses were done using Kaplan–Meier survival function and Cox proportional hazard regression techniques at 5% significance level. Results The median age of patients was 42 years with a male-to-female ratio of 2:1. Most patients presented at stages 3 (50.7%) and 4 (36.8%). Nasopharyngeal carcinoma was the most common (42.6%) HNC, followed by paranasal sinus (17.7%) and laryngeal cancer (11.6%). The lung was the most common site of metastasis (25.5%). Patients who presented at stages 1 and 4 disease had a median survival of 7.8 years and 1.9 years, respectively. Patients treated with a combination of chemotherapy and radiotherapy had a median survival of 8.0 years compared with those who had a single modality of treatment (~6.3 years). Conclusion Patient survival was inversely proportional to the stage of the disease. To encourage the early presentation of HNC cases, health education of the population on routine medical check-ups and on the symptoms suggestive of HNC is recommended. Health care providers should be trained to refer suspected cases promptly to tertiary health facilities for management.
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Affiliation(s)
- Vitalis C Okwor
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Radiation Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Adeniyi F Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Erinoso OA, Okoturo E, Gbotolorun OM, Effiom OA, Awolola NA, Soyemi SS, Oluwakuyide RT. Emerging Trends in the Epidemiological Pattern of Head and Neck Cancers in Lagos, Nigeria. Ann Med Health Sci Res 2016; 6:301-307. [PMID: 28503348 PMCID: PMC5414443 DOI: 10.4103/amhsr.amhsr_30_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Unfortunately, despite an increase in medical knowledge, survival rates of head and neck cancers (HNCs) have not been observed to improve greatly. This is true, especially in tumors located in obscure primary sites or late presentation. Aim: The purpose of this study is to assess the epidemiologic pattern of HNCs and to evaluate its emerging trends and patterns in Lagos state. Subjects and Methods: A retrospective study was conducted from 2003 to 2013 that analyzed histologically diagnosed cases of HNC at the Pathology Departments of the two tertiary teaching hospitals in Lagos. Data analysis was performed using the Statistical Package for the Social Sciences (version 20) statistical software. Results: One thousand and eighty-three cases of head and neck malignancies were recorded. A female: male ratio of 1.01:1 was reported with mean age of 39.6 (standard deviation 21.1) years. The oral cavity was the most affected anatomic site (21.2%, 230/1083) in the period under review. Malignant epithelial tumors accounted for 72% (779/1083) of cases seen. Carcinomas were the most common histological variant seen (67%, 726/1083) and squamous cell carcinoma accounted for 58% (421/726) of carcinomas recorded. Oral cavity malignancies (21.8%, 118/540) were the most common in males while thyroid malignancies (28.5%, 155/543) were the most seen in females. In children (≤15 years), the most common histologic findings were carcinomas (42.3%; 77/182) and retinoblastomas (23.6%; 43/182). Conclusion: Epithelial malignancies were the most common malignancy in the study, and the oral cavity appears to be the increasingly predominant site for HNCs. A changing pattern in gender predominance, age distribution, and frequency with histological variants and anatomical sites was also observed in this study.
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Affiliation(s)
- O A Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos university teaching Hospital, Lagos, Nigeria
| | - E Okoturo
- Department of Oral and Maxillofacial Surgery College of Medicine, Lagos State University/Lagos State University Teaching Hospital, Lagos, Nigeria
| | - O M Gbotolorun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - O A Effiom
- Department of Oral and Maxillofacial Pathology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - N A Awolola
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - S S Soyemi
- Department of Oral and Maxillofacial Pathology, Lagos State University/Lagos State University Teaching Hospital, Lagos, Nigeria
| | - R T Oluwakuyide
- Department of Oral and Maxillofacial Pathology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
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Gilyoma JM, Rambau PF, Masalu N, Kayange NM, Chalya PL. Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting. BMC Res Notes 2015; 8:772. [PMID: 26654449 PMCID: PMC4676813 DOI: 10.1186/s13104-015-1773-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 11/30/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSION 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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Affiliation(s)
- Japhet M Gilyoma
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.
| | - Peter F Rambau
- Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.
| | - Nestory Masalu
- Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.
| | - Neema M Kayange
- Department of Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.
| | - Phillipo L Chalya
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania.
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Lasisi TJ, Adisa AO, Olusanya AA. Appraisal of jaw swellings in a Nigerian tertiary healthcare facility. J Clin Exp Dent 2013; 5:e42-7. [PMID: 24455050 PMCID: PMC3892236 DOI: 10.4317/jced.51011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 01/06/2013] [Indexed: 01/12/2023] Open
Abstract
Introduction: The mandible and maxilla can be the site of myriads of lesions that may be categorized as neoplastic, cystic, reactive and infective or inflammatory. Literature reviewing jaw swellings in an amalgamated fashion are uncommon, probably because aetiologies for these swellings are varied. However, to appreciate their relative relationship, it is essential to evaluate the clinico-pathologic profile of jaw swellings. The aim of this appraisal is to describe the array of jaw swellings seen at our hospital from 1990 to 2011, to serve as a reference database.
Material and Methods: Biopsy records of all histologically diagnosed cases of jaw swellings seen at the department of Oral Pathology, University College Hospital between January 1990 and December 2011 were retrieved, coded and inputted into SPSS version 20. Data on prevalence, age, sex, site and histological diagnosis were analysed descriptively for each category of jaw swellings. All patients below 16 years were regarded as children.
Results: A total of 638 jaw swellings were recorded in the 22-year study period. The Non Odontogenic Tumours (NOT) were the commonest, accounting for 46.2% of all jaw swellings. Odontogenic Tumours (OT) formed 45% of all adult jaw swelling while it formed 25.2% in children and adolescents. Ameloblastoma was the commonest while the most common NOT was ossifying fibroma (OF). Chronic osteomyelitis of the jaws was about 6 times commoner in adult females than males and mostly involved the mandible. The most common malignant jaw swelling was Burkitts’ lymphoma (BL) that was about 7 times more in children than adults. Osteogenic sarcoma was the most common malignancy in adults.
Conclusion: Jaw swellings are extensively varied in types and pattern of occurrence. This study has categorized jaw swellings in a simple but comprehensive fashion to allow for easy referencing in local and international data acquisition and epidemiological comparison.
Key words:Jaw swellings, odontogenic, Nigeria.
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Affiliation(s)
- Taye J Lasisi
- Lecturer/Consultant. Department of Oral Pathology, University of Ibadan/University College Hospital. Ibadan, Nigeria
| | - Akinyele O Adisa
- Lecturer/Consultant. Department of Oral Pathology, University of Ibadan/University College Hospital. Ibadan, Nigeria
| | - Adeola A Olusanya
- Lecturer/Consultant. Department of Oral and maxillofacial surgery, University of Ibadan/University College Hospital. Ibadan, Nigeria
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Abdulai AE, Nuamah IK, Gyasi R. Head and neck tumours in Ghanaian children. A 20 year review. Int J Oral Maxillofac Surg 2012; 41:1378-82. [PMID: 22771221 DOI: 10.1016/j.ijom.2012.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 04/24/2012] [Accepted: 06/08/2012] [Indexed: 11/16/2022]
Abstract
Histological reports on tumour specimens recorded at a teaching hospital in Accra, Ghana from 1989 to 2008 were reviewed to determine the incidence of head and neck tumours in children less than 16 years old. There were 4546 reports of head and neck tumours (2041 malignant, 2505 benign). Of these 613 met the study age selection criteria. 186(30.3%) were malignant and 427(69.7%) benign. The male to female ratio for malignant tumours was 1.86:1, benign 0.73:1 and for all tumours 1:1.04. Lymphoma (54.8%), nasopharyngeal carcinoma (19.9%) and rhabdomyosarcoma (14%), together constituted over 88% of malignant neoplasms. The commonest benign neoplasm was squamous papilloma (76/427) 17.8%, and then haemangioma (60/427) 14.05%. The incidence increased with age, peaking in those aged 12-16 years. The commonest site for benign tumours was the larynx and for malignant tumours the neck (cervical lymph nodes). Relative to all head and neck malignancies, the incidence of childhood head and neck malignancies was 11% (186/2041). This study reveals that malignant head and neck tumours are not rare in Ghana compared to benign tumours and the incidence of rhabdomyosarcoma is higher in females.
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Affiliation(s)
- A E Abdulai
- Department of Oral and Maxillofacial Surgery, University of Ghana Dental School, Korle Bu, Accra, Ghana.
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Nthumba PM, Juma PI. Malignant peripheral nerve sheath tumors in Africa: a clinicopathological study. ISRN SURGERY 2011; 2011:526454. [PMID: 22084762 PMCID: PMC3200093 DOI: 10.5402/2011/526454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/16/2011] [Indexed: 11/23/2022]
Abstract
Introduction. Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas associated with poor prognosis, that most commonly affect patients aged 20 to 50 years, but have also been reported in children. There is little reported in literature on these tumors in Africa. Materials and Methods. A search of the hospital pathology database between 1992 and 2008 revealed 333 nerve sheath tumors, of which 31 were MPNSTs. Four representative case reports are presented. Discussion. MNPSTs have rarely been reported from sub-Saharan Africa; in this study, they constituted 9.3% of all nerve sheath tumors. The trunk (42%) and limbs (45%) were the most frequently affected anatomical sites. Late presentation of malignant lesions in this environment is exemplified by the four case presentations patients. Conclusions. This report confirms observations from studies on MPNSTs from other environments. Anatomically centrally located MPNSTs may have a higher incidence in sub-Saharan Africa than in the West. Because NF1-associated MPNSTs are difficult to diagnose clinically, and because surgery is the only mode of therapy that offers a complete cure, a lifetime follow-up is important, as this would enable diagnosis of early lesions amenable to surgical extirpation.
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Affiliation(s)
- Peter M Nthumba
- Plastic, Reconstructive and Hand Surgery Unit, AIC Kijabe Hospital, Kijabe 00220, Kenya
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Al Yamani AO, Al Sebaei MO, Bassyoni LJ, Badghaish AJ, Shawly HH. Variation of pediatric and adolescents head and neck pathology in the city of Jeddah: A retrospective analysis over 10 years. Saudi Dent J 2011; 23:197-200. [PMID: 23960516 DOI: 10.1016/j.sdentj.2011.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Revised: 07/20/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022] Open
Abstract
This study was conducted to present a comprehensive view of the most common head and neck pathologies among the pediatric and adolescent population of the city of Jeddah, Saudi Arabia. Data were collected from the oral and maxillofacial surgery (OMFS) records at King Abdulaziz University Hospital and King Fahad Hospital Jeddah (KFHJ) from the period 1998 to 2009. All patients who were 18 years of age and younger were included in the study. Identified lesions were classified into four categories: cystic, neoplastic, vascular and fibro-osseous. Age and sex distribution of the lesions were also calculated. A total of 155 patients were included in this study. Of all the lesions, 143 (92.26%) were benign and 12 (7.74%) were malignant; 63 (40.65%) were cysts; 48 (30.97%) were neoplasms; 23 (14.84%) were vascular and 21 (13.55%) were fibro-osseous tumors. The most common lesions were hemangioma (20 cases; 12.9%) followed by retention cyst (19 cases; 12.26%) and dentigerous cyst (15 cases; 9.68%). The most common benign odontogenic neoplasm was odontoma (7 cases; 4.52%), of which central giant cell granuloma (6 cases; 3.87%) was the most frequent benign nonodontogenic tumor and lymphoma (6 cases; 3.87%) was the most common malignant one. Although this study might benefit clinicians in guiding them through differential diagnosis of pediatric and adolescent head and neck pathology in reference to their sex and age groups, governmental efforts are badly needed to establish a Saudi childhood pathology registry.
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Affiliation(s)
- Ahmed O Al Yamani
- Department of Oral and Maxillofacial Rehabilitation, Faculty of Dentistry, King Abdulaziz University, P.O. Box 10703, Jeddah 21443, Saudi Arabia
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Sengupta S, Pal R, Saha S, Bera SP, Pal I, Tuli IP. Spectrum of head and neck cancer in children. J Indian Assoc Pediatr Surg 2011; 14:200-3. [PMID: 20419020 PMCID: PMC2858881 DOI: 10.4103/0971-9261.59601] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: To assess the incidence of different head and neck cancers in pediatric age group in a referral hospital. Methods: In this prospective study, children below the age of 12 years underwent a thorough clinical, ENT examination and the diagnosis was conformed histologically in all the cases. Results: Fifty-three were diagnosed to be suffering from different head and neck neoplasms among 21,216 children (0.25%). Male-to-female sex distribution was 1.78:1. The lymphomas were the most common (43.39%) followed by the rhabdomyosarcoma (20.75%) and the nasopharyngeal carcinoma (15.09%). Of the lymphomas, the non-Hodgkin's lymphoma was predominant (26.41%). Other lesions were thyroid carcinomas and mucoepidermoid carcinoma of parotid. Conclusions: Malignancy should always be considered in the differential diagnosis of masses in the head and neck region in children.
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Affiliation(s)
- Subhabrata Sengupta
- Department of Oto-Rhino-Laryngology, Sikkim-Manipal Institute of Medical Sciences (SMIMS) and Central Referral Hospital (CRH), 5th Mile Tadong, Gangtok, Sikkim-737 102, India
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Adeyemi BF, Olusanya AA, Lawoyin JO. Oral Squamous Cell Carcinoma, Socioeconomic Status and History of Exposure to Alcohol and Tobacco. J Natl Med Assoc 2011; 103:498-502. [DOI: 10.1016/s0027-9684(15)30364-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Clinico-pathological profile of head and neck malignancies at University College Hospital, Ibadan, Nigeria. Head Face Med 2011; 7:9. [PMID: 21569492 PMCID: PMC3115889 DOI: 10.1186/1746-160x-7-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 05/13/2011] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan. METHODOLOGY One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology. RESULTS There was an annual hospital frequency of 62 cases per year. The overall mean age for these malignancies was 43.9 (SD ± 19.3) years. The lesions from the respiratory tract were the most frequent (43.2%) of all cases. The palate was the most frequent intra-oral site (13.8%). Epithelial malignancies constituted 73.4% of all cases with a male: female ratio of 2:1, a mean age of 48.1 (SD ± 17.5) years and were mostly located in the larynx (19.7%). Lymphomas constituted 17.5% of all head and neck cancers with a male: female ratio of 1.6:1, a mean age of 35.1 (SD ± 20.6) years and nodal involvement (39.7%) was most common. Sarcomas constituted 8.9% of all malignancies with a male: female ratio of 1.5:1, mean age of 27.1 (SD ± 16.7) years and the maxillofacial bones (42.5%) were most commonly involved. Neuroendocrine malignancies accounted for 0.2% of head and neck malignancies with a male: female ratio of 1:1, a mean age of 28.5 (SD ± 6.4) years and both cases involved the nose. CONCLUSION This study has further confirmed that carcinomas remain the most frequent cancers of the head and neck region in south-western Nigeria.
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Laffers W, Eggert K, Schildhaus HU, Bootz F, Gerstner AOH. Histologic diagnoses in persistently swollen cervical lymph nodes. Head Neck 2011; 34:371-5. [PMID: 21472886 DOI: 10.1002/hed.21742] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2011] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Biopsy and histological examination of persistently enlarged cervical lymph nodes represent a major health care issue and have high impact on further clinical therapy. Tertiary health centers are faced with an increased demand for diagnostic workup to rule out malignancy. We performed a retrospective study from January 2000 to June 2008 to identify patients referred to us for diagnostic biopsy and to document the histopathological result. METHODS Patients with a diagnostic biopsy, but neither clinical signs of head and neck cancer nor other malignancies, were identified within the records. Patient characteristics and histopathological diagnosis were retrieved. RESULTS Three hundred twenty-six patients were identified (146 women, and 180 men). One hundred twenty-three patients (38%; 44 women, and 79 men) had a malignancy: 61 with metastatic disease and 62 with malignant lymphoma; the youngest was 15 years old and the oldest was 92 years old. CONCLUSION Persistently swollen cervical lymph nodes should trigger a thorough clinical examination and prompt biopsy for histopathological workup.
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Affiliation(s)
- Wiebke Laffers
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
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Pattern of acquired neck masses in a Kenyan paediatric population. Int J Oral Maxillofac Surg 2010; 40:384-7. [PMID: 21129917 DOI: 10.1016/j.ijom.2010.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 07/29/2010] [Accepted: 10/26/2010] [Indexed: 11/21/2022]
Abstract
Acquired paediatric neck masses constitute a diagnostic challenge. Their pattern is important in formulating management protocol. Reports from developing countries including Kenya are scarce. This study describes the causes, location, clinical features and gender distribution of these masses in a Kenyan paediatric population. This prospective cross-sectional study was carried out in a regional Eastern and Central African referral centre in Kenya. Children aged 16 years and below with neck masses, who presented to various clinics and wards in a 5 month period were examined. One hundred and eighty four of 235 masses (78%) were acquired. Inflammatory cases were the most common (64%), followed by malignant neoplasm (32%). The most common inflammatory cases were abscesses, reactive lymphadenopathy and tuberculous adenitis. They mainly involved upper cervical and submandibular lymph nodes and were more prevalent in those aged less than 4 years. Lymphomas were the most common malignant masses (42%). Malignant masses were widespread in location; non-tender, and most frequent in those aged 4-8 years. In conclusion, inflammatory conditions consistent with upper airway infection cause most acquired paediatric neck masses, but malignant neoplasms constitute a significant proportion. Prudent management of infection and early confirmation of diagnosis are recommended.
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Abstract
PURPOSE OF REVIEW Sub-Saharan Africa has the largest population of people living with AIDS in the world, with Nigeria having the third largest after South Africa and India. With the advent of treatment programs, more people in Nigeria are now living with the virus but are at increased risk of cancer similar to the experience in other parts of the world. This review uses publications on HIV-associated cancers emanating from Nigeria in 2008 to map the current landscape of prevention, diagnosis and treatment of these conditions. The opportunities and challenges identified in this review will provide a template for designing appropriate clinical and public health intervention to stem another epidemic, this time of AIDS-associated malignancies. RECENT FINDINGS There is a paucity of literature on AIDS-associated cancers from Nigeria, and most reports are based on hospital or pathology case series. Poor case identification and diagnosis and rudimentary cancer registration militate against adequate quantification of the prevalence of AIDS-associated cancers in Nigeria. Several initiatives, working with the HIV treatment programs, governmental and nongovernmental local and international agencies, are rising to the challenge and creating new opportunities for cancer prevention, treatment and research that takes advantage of improved treatment infrastructure provided for people living with HIV/AIDS. SUMMARY Nigeria is about to witness substantial increase in the background incidence of cancers due to high prevalence of HIV and expanded treatment programs. Creative methods are needed to deploy effective prevention, case identification, registration and treatment programs that are consistent with the socioeconomic development of the country.
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da Lilly-Tariah OB, Somefun AO, Adeyemo WL. Current evidence on the burden of head and neck cancers in Nigeria. HEAD & NECK ONCOLOGY 2009; 1:14. [PMID: 19476614 PMCID: PMC2694192 DOI: 10.1186/1758-3284-1-14] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 05/28/2009] [Indexed: 01/09/2023]
Abstract
Background Head and neck cancers (HNC) constitute 5–8% of total body cancers in Europe and America. It is difficult to appreciate the problem of cancers in Nigeria because most studies available are hospital-based studies. The aim of this study is to highlight current evidence on the burden of head and neck cancers in Nigeria based on literature review and to discuss potential health care actions to improve management. Methods A literature search using Medline was conducted for publications on head and neck cancer in Nigeria. Identified publications were manually searched for additional relevant non-Medline articles or abstracts. The full-texts of these articles were thoroughly examined for the occurrence, distribution, identified risks factors, presentations, diagnostic method, treatment, prognosis and challenges associated with the management of HNC. Results A total of twenty-seven relevant published articles on Head and neck cancers from 1968 to 2008 were reviewed. The age of patients with HNC ranged from nine months to over 80 years with peak between 3–6th decade of life. The male to female ratio ranged from 1:1 to 2.3:1. Identified risks factors were scanty, namely kola nuts and tobacco chewing, tobacco smoking, farming, viral infections, alcohol and smoking. Reports on the overall pattern of Head and neck cancers from different regions of the country cited nasopharynx as the commonest site for HNC, the sino-nasal is the second commonest while larynx, is the third commonly affected site. The majority of HNC was epithelial in origin and was mostly squamous cell carcinoma. Late presentation with advanced disease is common and treatment in most cases is palliative either with surgery or chemotherapy, and radiotherapy when available. There are few reports on the outcome of HNC treatment in Nigeria. Conclusion The burden of managing HNC in Nigeria is enormous and the government should set up the National Cancer Institute with a view of educating the public on cancer prevention, detection and treatment.
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Affiliation(s)
- Opubo B da Lilly-Tariah
- Department of Surgery, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
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