Carcinoma of the oesophagus

Ihekwaba, F. N.; Solanke, Toriola F.

doi:10.1002/bjs.1800710213

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…Of the 48 studies on epidemiology of EC, 13 (27.1%) were conducted in South Africa[23-35], 8 (16.7%) in Kenya[36-43], 4 (8.3%) in Uganda[44-47], 3 each in Zimbabwe (6.3%)[48-50], Malawi (6.3%)[51-53], Sudan (6.3%)[54-56] and Nigeria (6.3%)[57-59], 2 each in Tanzania (4.2%)[60,61] and Zambia (4.2%)[62,63], 1 each in Egypt (2.1%)[64], Mozambique (2.1%)[65], Senegal (2.1%)[66] and Botswana (2.1%)[67], and 3 (6.3%) studies were multi-country[22,68,69].…”

Section: Resultsmentioning

confidence: 99%

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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BACKGROUND Esophageal cancer (EC) is associated with a poor prognosis, particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease. AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity, and socio-economic challenges faced on the African continent. METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology, risk factors, management and outcomes of EC. A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer, and the Cancer in Sub-Saharan reports. We searched EMBASE, PubMed, Web of Science, and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved. Random effects meta-analyses were used to assess heterogeneity between studies and to obtain odds ratio (OR) of the associations between EC and risk factors; and incidence rate ratios for EC between sexes with their respective 95% confidence intervals (CI). RESULTS The incidence of EC is higher in males than females, except in North Africa where it is similar for both sexes. The highest age-standardized rate is from Malawi (30.3 and 19.4 cases/year/100000 population for males and females, respectively) followed by Kenya (28.7 cases/year/100000 population for both sexes). The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old. Meta-analysis shows a strong association with tobacco (OR 3.15, 95%CI: 2.83-3.50). There was significant heterogeneity between studies on alcohol consumption (OR 2.28, 95%CI: 1.94-2.65) and on low socioeconomic status (OR 139, 95%CI: 1.25-1.54) as risk factors, but these could also contribute to increasing the incidence of EC. The best treatment outcomes were with esophagectomy with survival rates of 76.6% at 3 years, and chemo-radiotherapy with an overall combined survival time of 267.50 d. CONCLUSION Africa has high incidence and mortality rates of EC, with preventable and non-modifiable risk factors. Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption. Management requires a multidisciplinary approach, and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy.

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Section: Resultsmentioning

confidence: 99%

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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“…Thirteen studies were case series reporting outcomes following esophagectomy (Table 3). 6,7,19,32,44‐52 …”

Section: Resultsmentioning

confidence: 99%

“…In many of the remaining studies on esophagectomies, surgical resection was a first‐line intervention due to few alternative treatment options 44‐46,48‐50,52 . In these studies, advanced preoperative imaging (CT, endoscopic ultrasound [EUS] or positron emission tomography [PET]) was largely unavailable, and >90% of patients were found to have advanced disease at the time of operation.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies were case series reporting outcomes following esophagectomy (Table 3). 6,7,19,32,[44][45][46][47][48][49][50][51][52] All nine RCTs were single-center studies conducted in South Africa (Table 4). Three studies compared intubation with plastic stents to other treatments (dilation with bleomycin, 54 retrosternal gastric bypass 53 and SEMS 60 ), and two evaluated intubation combined with either chemotherapy, radiotherapy or chemoradiation as compared to intubation alone.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In many of the remaining studies on esophagectomies, surgical resection was a first-line intervention due to few alternative treatment options. [44][45][46][48][49][50]52 In these studies, advanced preoperative imaging (CT, endoscopic ultrasound [EUS] or positron emission tomography…”

Section: Esophagectomymentioning

confidence: 99%

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Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

Buckle

Mahapatra

Mwachiro

et al. 2020

Intl Journal of Cancer

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Esophageal cancer (EC) is a leading cause of cancer morbidity and mortality in Africa. Despite the high burden of disease, optimal management strategies for EC in resource‐constrained settings have yet to be established. This systematic review evaluates the literature on treatments for EC throughout Africa and compares the efficacy and safety of varying treatment strategies in this context (PROSPERO CRD42017071546). PubMed, Embase and African Index Medicus were searched for studies published on treatment strategies for EC in Africa from 1980 to 2020. Searches were supplemented by examining bibliographies of included studies and relevant conference proceedings. Methodological quality/risk of bias was assessed using the Cochrane Risk‐of‐Bias tool and the Newcastle‐Ottawa Scale. Forty‐six studies were included. Case series constituted the majority of studies: 13 were case series reporting on outcomes of esophagectomies, 17 on palliative luminal or surgical interventions, four on radiotherapy and three on concurrent chemoradiation. Nine randomized controlled trials were identified, of which four prospectively compared different treatment modalities (one investigating radiotherapy vs chemoradiation, three evaluating rigid plastic stents vs other treatments). This review summarizes the research on EC treatments in Africa published over the last four decades and outlines critical gaps in knowledge related to management in this context. Areas in need of further research include (a) evaluation of the safety and efficacy of neoadjuvant therapy in patients with locally advanced disease; (b) strategies to improve long‐term survival in patients treated with definitive chemoradiation; and (c) the comparative effectiveness of modern palliative interventions, focusing on quality of life and survival as outcome measures.

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Oesophageal Carcinoma: A comparative study of laser recanalization versus intubation in the palliation of gastro-oesophageal carcinoma

Carter

Smith

1986

Laser Med Sci

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Carcinoma of the oesophagus

Cited by 9 publications

References 8 publications

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

Oesophageal Carcinoma: A comparative study of laser recanalization versus intubation in the palliation of gastro-oesophageal carcinoma

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