Gynaecologic mortality in Enugu, Nigeria

Anya, S E; Ezugwu, Frank Okechukwu; Okaro, JM

doi:10.1258/004947506778604652

Cited by 9 publications

(13 citation statements)

References 3 publications

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“…This agrees with results of previous studies from this center. [1114] The pattern of genital tract malignancy in this study differs from the pattern in developed countries, where ovarian cancer has taken the leading position mainly due to the effects of screening and treatment of premalignant lesions of the cervix which has lead to a dramatic decrease in the incidence of cervical cancers. [15] The number 1 position of carcinoma of the cervix in this study indicates that the effect of cervical cancer screening and treatment of premalignant lesions of the cervix may not be obtainable in Nigeria.…”

Section: Discussionmentioning

confidence: 96%

The frequency and pattern of female genital tract malignancies at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Okeke

Onah

Ikeako

et al. 2013

Ann Med Health Sci Res

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Background:Female genital tract malignancy is common in our low resource setting. Options now exist for prevention, detection, treatment, and palliative care for the wide spectrum of female genital tract malignancies. Women will continue to die from these cancers unless health professionals and civil society adopt means to control female genital tract cancers in our low resource setting.Aim:The objective was to determine the frequency and patterns of female genital tract malignancy at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.Materials and Methods:A 6-year retrospective study of female genital tract malignancies was conducted at the UNTH, Enugu. The case notes of patients admitted for female genital tract malignancy between January 1, 2003 and December 31, 2008 were retrieved from the medical records and cancer registry of the University of Nigeria Teaching Hospital, Enugu and relevant data were extracted. The data were analyzed using SPSS version 12 (SPSS Inc., Chicago, IL, USA) and the results expressed in descriptive statistics by simple percentages.Results:One hundred and sixty six (166) cases of genital malignancies were recorded during the 6-year review. Majority of the patients were in the fifth and sixth decades of life. Cancer of the cervix accounted for 66.3% (110/166) followed by ovarian cancer 21.1% (35/166). The other tumors seen during the period were tumors involving corpus uteri 9% (15/166) and vulva 3.6% (6/166). Tumors of fallopian tube and vagina were not seen during the study period.Conclusion:Despite the preventable nature of cancer of cervix, it remained the most common female genital tract malignancy in Enugu, South-East Nigeria. In our low resource setting in the developing countries, education and public enlightenment on the importance of routine screening and treatment of premalignant lesions of the cervix are necessary tools to reduce the incidence and mortality of cervical cancer.

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Section: Discussionmentioning

confidence: 96%

The frequency and pattern of female genital tract malignancies at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Okeke

Onah

Ikeako

et al. 2013

Ann Med Health Sci Res

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“…This is consistent with a previous audit of gynecological cancers in this center three decades ago and as well as the findings of a more recent report. [617] Similarly, studies across Nigeria showed that 43-62 cases of ovarian cancer would be expected to be seen in about 10 years. [7891011] These underlie the rarity of ovarian cancer in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

“…[4] In Enugu, ovarian cancer has been found to be the fourth commonest cause of gynecological mortality. [6] Previous studies done in Nigeria showed that ovarian cancer constituted 7-22% of all gynecological malignancies. [7891011] Epithelial ovarian cancer is the commonest type of ovarian cancer and is known to be a disease of postmenopausal women.…”

Section: Introductionmentioning

confidence: 99%

Incidence, pattern and management of ovarian cancer at a tertiary medical center in Enugu, South East Nigeria

Iyoke¹,

Ugwu²,

Ezugwu³

et al. 2013

Ann Med Health Sci Res

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Background:The incidence of ovarian cancer is thought to be increasing in developing countries and little is known about the pattern and incidence of this disease in South-East Nigeria.Aims:The objectives of the study were to determine the incidence, describe the pattern and management of ovarian cancer at a tertiary medical center in Enugu South East Nigeria.Materials and Methods:This was a retrospective review of cases of histologically diagnosed primary ovarian cancer at the study center over 11 years. Cases of histologically diagnosed primary ovarian cancer were identified through the records of the study center cancer registry and confirmed from the records of the histopathology department. Case notes, admission and theatre records were used to obtain data relating to clinical management, mortality and incidence of primary ovarian cancer. Statistical analysis was dose using SPSS statistical software version 17.0 for windows. Descriptive and inferential statistics were applied to obtain rates, proportions and 95% confidence intervals for these estimates.Results:There were 20,227 gynecological admissions during the study period (from January 2000 to December 2010) and 206 gynecological cancers. There were 54 cases of primary ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% confidential interval [CI] 0.23%, 0.38%) or 2.4% (54/206) per gynecological cancer per year. Epithelial ovarian cancer constituted 68% of cases of ovarian cancer (95% CI 54%, 82%): Sex cord and germ cell tumors constituted 16% each (95% CI 6%, 26%). Approximately 60% of women who had epithelial ovarian cancer were aged 50 years or below (95% CI 47%, 74%) and 72% of epithelial ovarian cancer occurred in multiparous women (95% CI 72.1%, 91.9%). Over 84% of ovarian cancer presented in stages 3 and 4 of the disease (95% CI 94%, 72%). The mainstay of management was surgery: Compliance with cis-platinum based adjuvant chemotherapy was poor. Case-specific mortality rate within 1 year of diagnosis was, at least, 70% (95% CI 64%, 84%).Conclusions:Primary ovarian cancer was uncommon and consisted mainly of epithelial cancer. Epithelial ovarian cancer occurred more in multiparous women and in women under 50 years in our center contrary to the known pattern of the disease.

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“…Gynecological cancers have been shown to contribute overwhelmingly to gynecological mortality in our environment 9. However, we found scanty literature on the management of these cancers.…”

Section: Introductionmentioning

confidence: 91%

Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

Iyoke¹,

Ugwu²,

Ezugwu³

et al. 2014

IJWH

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BackgroundThere are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries.ObjectiveThe purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria.MethodsThis study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software.ResultsRecords of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the prescribed courses of chemotherapy. Most patients with endometrial and vulval cancers had only surgical treatment, as compliance with follow-up for adjuvant chemotherapy or radiotherapy was poor. Functional radiotherapy facilities were not available at the center during the study period, thereby necessitating external referrals to centers hundreds of kilometers away.ConclusionLate presentation of cases, noncompliance with treatment regimens, lack of use of cutting edge cytotoxic drugs, the poor outcome of radical surgeries, and lack of a functional radiotherapy facility combined to create a very difficult gynecological cancer care environment at the study center.

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Gynaecologic mortality in Enugu, Nigeria

Cited by 9 publications

References 3 publications

The frequency and pattern of female genital tract malignancies at the University of Nigeria Teaching Hospital, Enugu, Nigeria

The frequency and pattern of female genital tract malignancies at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Incidence, pattern and management of ovarian cancer at a tertiary medical center in Enugu, South East Nigeria

Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

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