Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

Abstract

Introduction The treatment outcome of cancer is poor in the African setting due to inadequate treatment and diagnostic facilities. However, there is a paucity of data on solid cancers in Kenya. Hence, this study aimed to investigate the treatment outcomes and its determinant factors among adult patients diagnosed with selected solid malignancies at Kenyatta National Hospital (KNH). Materials and Methods A prospective cohort study was employed at the Oncology Department of KNH from 1 st July 2020 to 31 st December 2021. All new patients with a confirmed diagnosis of lymphoma, prostate cancer and breast cancer were studied. A consecutive sample of 99 breast cancer, 50 lymphomas, and 82 prostate cancer patients was included in the study. Semi-structured questionnaires consisting of socio-demographics, clinical characteristics, and quality of life were employed to collect the data. All enrolled patients were followed prospectively for 12 months. Treatment outcomes were reported as mortality, cancer-specific survival and health-related quality of life. The data were entered and analyzed using the SPSS 20.0 statistical software. Survival outcomes and its predictors were evaluated using the Kaplan–Meier analysis and Cox regression analyses, respectively. Results The study showed that the mortality rate among breast and prostate cancer patients was 3% and 4.9%, respectively. In contrast, the mortality rate was 10% among lymphoma patients. Most of the patients had partial remission and a good overall global health-related quality of life. Older age above 60 years, co-morbidity, distant metastasis and advanced stages of disease were significant predictors of mortality. Conclusion Although the mortality was not high at 12 months, only a few patients had complete remission. For many patients, the disease was progressing, despite 12-month mortality was not high. Therefore, longer follow-up will be required to report cancer mortality accurately. In addition, most of the patients had a good overall global health-related quality of life.

Survival Patterns Among Patients With Breast Cancer in Sub-Saharan Africa

“…More than two-thirds of the studies were published after 2010. Thirty-one studies (63.3%) included only female participants, while the remaining studies included both female and male (30.6%) or only male (6.1%) participants . The proportion of female participants was higher in the studies that included both sexes.…”

“…Following a thorough full-text review, 69 studies were reviewed. Of these, 49 studies that met the eligibility criteria were included in the narrative synthesis, and 40 of them underwent meta-analysis for a more in-depth and comprehensive analysis (Figure 1).…”

“…Of 49 studies included in the systematic review, 13 were conducted in Nigeria; 4 each in Ethiopia and South Africa; 3 each in Sudan, Ghana, Uganda, and Burkina Faso; 2 each in Kenya, Malawi, Cameroon, Senegal, and multiple countries; and 1 each in Gambia, Zimbabwe, Tanzania, Mozambique, Congo, and Guinea . More than two-thirds of the studies were published after 2010.…”

“…Following a thorough full-text review, 69 studies were reviewed. Of these, 49 studies that met the eligibility criteria 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 were included in the narrative synthesis, and 40 of them 20 , 21 , 22 , 23 , 25 , 27 , 29 , 30 , 31 , 32 ,…”

“…Of 49 studies included in the systematic review, 13 were conducted in Nigeria 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ; 4 each in Ethiopia 33 , 34 , 35 , 36 and South Africa 37 , 38 , 39 , 40 ; 3 each in Sudan, 41 , 42 , 43 Ghana, 44 , 45 , 46 Uganda, 47 , 48 , 49 and Burkina Faso 50 , 51 , 52 ; 2 each in Kenya, 53 , 54 Malawi, 55 , 56 Cameroon, 57 , 58 Senegal, 59 , 60 and multiple countries 61 , 62 ; and 1 each in Gambia, 63 Zimbabwe, 64 Tanzania, 65 Mozambique, 66 Congo, 67 and Guinea. 68 More than two-thirds of the studies were published after 2010.…”