Background. Retinoblastoma (RB) is one of the most common cancers occurring in young children in sub-Saharan Africa. The incidence rate reported in the literature is 9,000 new cases per year, which corresponds to 1 in 15,000 births. This study aimed at analyzing the clinicopathological findings in children with RB in Uganda. Purpose. The purpose of this study was to describe and analyze the clinicopathological findings in the patients with RB. Design. This was a cross-sectional analytical study involving 234 eyeball surgical specimens from 214 patients with RB diagnosed between January 2006 and December 2015. Results. The mean age of the patients was 27.8 months (SD = 21.413, range: 1–132 months). More than half of the cases, 50.9%, presented with leucokoria. Invasion of choroid, sclera, anterior chamber, and optic nerve was found in 26.5% (n = 58), 51.2% (n = 88), 26.2% (n = 45), and 29.2% (n = 49), respectively. Twenty-six percent (n = 56) of the cases with intraocular tumour were at stage I and all patients with metastasis 4.7% (n = 11) had stage IV. The correlation between postlaminar optic nerve invasion and massive choroidal invasion was statistically significant (P=0.002). Also, there was a statistical significance difference between metastasis and postlaminar invasion (P=0.004). Conclusion. The majority of children with RB in Uganda present clinically with leucokoria, and their parents or guardians seek medical intervention at a later stage. Moreover, there was a noticeably significant lag period for the patients to begin treatment after the diagnosis was done.
PURPOSE Standard treatment guidelines improve patient outcomes, including disease-specific survival, in cancer care. The African Cancer Coalition was formed in 2016 to harmonize cancer treatment guidelines for sub-Saharan Africa. METHODS The African Cancer Coalition collaborated with the National Comprehensive Cancer Network (NCCN) and the American Cancer Society to harmonize 46 cancer treatment guidelines for use in sub-Saharan Africa. Harmonization for each guideline was completed by a group of approximately 6-10 African cancer experts from a range of specialties and with representation across resource levels. Each working group was chaired by an African oncologist and included a member of the appropriate NCCN guidelines panel. Treatment recommendations from the parent guidelines were distinguished as options that are generally available and should be considered standard care in most of the region or as highly advanced options for which cost or other resources may limit widespread availability. Additional recommendations specific to sub-Saharan Africa were added. RESULTS The NCCN Harmonized Guidelines for sub-Saharan Africa, available for download on the NCCN website and mobile application, provide flexible recommendations appropriate for the range of resources seen in African cancer programs, from private comprehensive cancer centers to resource-constrained public hospitals. IBM (Armonk, NY) has developed a digital interface—the Cancer Guidelines Navigator—that allows oncologists to access the treatment recommendations for the first five guidelines through an interactive web-based application. CONCLUSION Harmonized guidelines that reflect the diversity of resource levels that characterize the current state of clinical care for cancer in Africa have the potential to fill a crucial gap in efforts to standardize and improve cancer care in Africa.
Aims: The aims of the current study were to determine the prevalence of epidermal growth factor (EGFR) receptor in patients diagnosed with esophageal squamous cell carcinoma (ESCC) as well as assessing the correlation of overexpression of EGFR with age, gender and tumor grades of the cases. Study Design: This was a cross-sectional analytical study. Place and Duration of Study: The study was conducted in the pathology laboratory at the department of pathology, Makerere College of Health Sciences, Kampala-Uganda for five months. Methodology: A sample of 127 archival tissue blocks from patients with ESCC diagnosed between 2010 and 2012 were retrieved from the tissue repository and used to assess overexpression of EGFR using monoclonal mouse Anti-human wild type EGFR antibody. For association between age and overexpression of EGFR, Kruskal- Wallis H test was used and for tumor grade and sex and EGFR, Chi-Square test was performed using SPSS version 16.0. P ˂ .05 was considered statistically significant. Results: The age range of the patients with ESCC in this study was 35-99 years with mean of 59.55 years. The peak age of the cases was 55-64 years. Males and females were 68.5% and 31.5% respectively. Moderately differentiated tumors dominated by comprising 59.9%. The prevalence of overexpression of EGFR was 61.4%. The highest overexpression of EGFR was seen in cases with grade 2 compared to grade 1 and 3 but not statistically significant (P = .255). Overexpression of EGFR was relatively higher in cases with age ≥ 50 years, but the difference was not statistically significant (P = .931). Males expressed relatively higher EGFR than females, however, the difference was not statistically significant (P = .944). Conclusions: Majority of patients with ESCC in Uganda have moderately differentiated tumor and a significant number of them tend to show overexpression of EGFR antigen.
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