Research Article
An Audit and Analysis of Causes of Treatment Default in Head and Neck Cancer: A Single Tertiary Cancer Centre Experience
Issue:
Volume 9, Issue 2, June 2024
Pages:
25-30
Received:
24 February 2024
Accepted:
20 March 2024
Published:
11 April 2024
Abstract: Background: Treatment default is widespread among cancer patients and usually compromise patients’ clinical outcome. This not only compromises the management plan but also makes it harder to measure our treatment outcomes. Method: We reviewed Outpatient department (OPD) clinical record files of head and neck cancer patients who were registered at our hospital in a year. Patients were chosen on the basis of availability of record files at the time of sampling. All patients' OPD files were evaluated for treatment completion and causes of treatment default were recorded from the OPD record file. If information was not available in the OPD record file, patients or patients' relatives (if a contact number was available) were called for further information and cause of default. The Google spreadsheet was prepared to record demographics and causes of treatment default. Results: 72.19% were male among 205 patients analysed for the study. Most common site was oral cavity (30.24%), followed by oropharynx (21.9%), larynx (20%) and others. Intent was curative in 175 patients (85.36%) and palliative in 22patients (10.73%). 112 curative intent patients (64%) and 11 palliative intent (50%) completed planned treatment, 27 curative intent patients (15.42%) and 7 palliative patients (31.81%) defaulted during treatment and 36 curative patients (20.57%) and 4 palliative patients (18.18%) defaulted before starting Primary treatment (Surgery or Radiotherapy). Treatment related toxicities in 20 patients (26.31%) waiting time for radiotherapy in 14 patients (18.42%) were major causes of default in this study. In curative intent cases, 44 patients (39.28%) had complete response, 41 patients (36.3%) had partial response, 10 patients (8.92%) had progressive disease and 6 patients (5.35%) had metastatic disease, 3-month post treatment. Conclusion: Among various reasons for noncompliance, few can be addressed immediately like arranging multidisciplinary team discussions at an institutional level to prioritize management. Further large-scale studies are needed to estimate the exact dimensions of the issues in our setup.
Abstract: Background: Treatment default is widespread among cancer patients and usually compromise patients’ clinical outcome. This not only compromises the management plan but also makes it harder to measure our treatment outcomes. Method: We reviewed Outpatient department (OPD) clinical record files of head and neck cancer patients who were registered at o...
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Case Report
A Secondary Urothelial Carcinoma of the Penis Diagnosed
Faye Samba Thiapato*
,
Diallo Thierno Amadou,
Thiam Jafar Abou Talib,
Niang Rokhaya Désiré,
Kikalulu Kiambote Hamidou,
Dembele Mamadou,
Jalloh Mohamed,
Kane Racine,
Niang Lamine
Issue:
Volume 9, Issue 2, June 2024
Pages:
31-35
Received:
9 March 2024
Accepted:
1 April 2024
Published:
28 April 2024
Abstract: Aim: Penile cancer is one of the rarest urogenital cancers. Penile metastases after cystectomy are possible and seem to be associated with the existence of an extensive tumor on the surgical specimen. Case Presentation: We report here the case of old man 78 years old, with a history of Radical Cysto-Prostatectomy with Bricker type urinary diversion, indicated for a pT3N0M0R0 infiltrating urothelial carcinoma of the bladder. He had consulted 7 years post surgery for an indurated lesion of the penis with urethrorrhagia. On examination, he presented an ulcerative-necrotic lesion under the left lateral coronal area of the penis, a diffuse induration of corporal bodies from the glans to the bulb, bilateral inguinal macro lymphadenopathies. Magnetic Resonance Imaging of the penis suggested a tumor extending over the entire penis, infiltrating the corpora cavernosa and spongiosa, with invasion of the albuginea, adjacent fat and skin. In view of this picture, a total penectomy with emasculation was performed. The histology of the surgical specimen showed a poorly differentiated urothelial carcinoma with an immunohistochemical study in favor of a primary urothelial origin (GATA3+). The tumor infiltrated both corpora cavernosa and the urethra with positive margins of resection. The right inguinal lymph node dissection showed one metastatic node out of two. The left inguinal lymph node dissection showed one metastatic lymph node out of six with capsular rupture. Thoracic-abdominopelvic CT Scan showed a right inguinal adenopathy with no other lesions suggestive of secondary localization. The diagnosis of secondary urothelial carcinoma of the penis classified as pT4N2M0R1 was made and the patient underwent chemotherapy on tumor board meeting. Conclusion: Secondary cancers of the penis, although rare, can occur years after radical treatment of the primary tumor. Immuno-histochemestry was esential to differentiate from primary squamous cell carcinoma in our case.
Abstract: Aim: Penile cancer is one of the rarest urogenital cancers. Penile metastases after cystectomy are possible and seem to be associated with the existence of an extensive tumor on the surgical specimen. Case Presentation: We report here the case of old man 78 years old, with a history of Radical Cysto-Prostatectomy with Bricker type urinary diversion...
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