Background. Determining cancer incidence and mortality is a key factor in the implementation of health policies and cancer prevention strategies. This report aims to describe the trends of cancer incidence in a single referral oncology department from the Marrakech region (Morocco). Material and Methods. All new cancer cases of age ≥ 15 years registered at the Medical Oncology department of Mohammed VI University Hospital of Marrakesh between January 1, 2012, and December 31, 2019, were included. Central nervous system (CNS) cancers, tumors of hematopoietic and lymphoid tissues, and thyroid cancers for which chemotherapy was not indicated or was managed in other cancer-specialized departments were excluded from the analysis. Manual data collection from printed archived medical records of the study population was performed. Descriptive statistics were analyzed using R software and Joinpoint Regression Program. Results. A total of 15648 new cancer cases were analyzed. Missing data ( n = 1822 ) accounted for 11.64%, and 4.1% ( n = 652 ) were excluded. The final statistical analysis and registration included 13174 cases. The median age at diagnosis is 54 years for females and 61 years for males. Female patients outnumbered males with a ratio of 1.58 among all age groups except those aged ≥75 y. The age-standardized incidence rate (ASIR) for all sites was 68,0 per 100.000 person-years, which has increased with an annual percent change (APC) of 10.61%. The five most common malignancies among males are lung, stomach, prostate, colic, and rectal cancers. Among females, the five most frequent cancers are breast, cervix, ovary, colon, and stomach. Conclusion. The higher incidence observed in our results translates into a growing burden on the center and is expected to impact our ability to deliver cancer care. Epidemiological studies to identify risk factors and effective efforts are needed to further invest in cancer control and prevention plans.
The progress on cancer diagnosis and treatment has attained, in the last decade, enormous achievements by any estimate. Immunotherapy, new generations of targeted therapies, Chimeric antigen T-cells, cancer vaccines and the fascinating breakthroughs in translational research and cancer biology have changed the direction of cancer care. However, the fact that all patients worldwide cannot have access to these advances is dramatic. Alongside this, taking part in clinical research is one way to improve and invest in cancer care. Patients from African—and most low-resources countries—are rarely offered the chance of being included in clinical trials. This well-known fact paints a disheartening picture of what having cancer is like in the poorest settings. This situation will further decline with population aging, major changes in risk profile imported from developed countries and life expectancy increasing in most African countries. If no radical changes are made, this North–South contrast will become more critical and continue to grow. Yet, there is room for hope because only when we acknowledge the problem can we begin to address it. We need a better understanding of the reasons behind this gap and to advocate for more representation from African patients in clinical trials, with respect to the socio-economic, epidemiological and unique demands of each country across the continent.
Background Germ cell tumors account for more than 95% of testicular cancers followed by sex-cord stromal tumors. The occurrence of serous cystadenocarcinoma in testicular and paratesticular tissue is very rare with distinct clinical behavior. Case presentation Herein, we report the case of a 39-year-old man who presented with right testicular swelling. Anatomopathological examination of the right orchiectomy revealed a high-grade paratesticular serous cystadenocarcinoma. Long-term follow-up with close monitoring was adopted in the absence of concomitant metastasis. The patient was disease-free at two years post-surgery. Conclusion Owing to its scarcity, there are no standardized guidelines for optimal management of this histological entity. Sharing case reports provide valuable information to support clinical decisions.
Background: Gastric cancer represents the fifth most common tumor and the thirdleading cause of cancer-related death worldwide. The results of surgical treatment of locally advanced gastric cancer remain generally poor due to the high rate of relapse after surgery. In the last decade, neoadjuvant chemotherapy has become the standard of care for patients with stage IB resectable advanced gastric cancer. The benefit in progression-free and overall survival was confirmed by several randomised trials and meta-analyses compared to immediate surgery. However, data in the "reallife" setting are rare. We conducted a retrospective study to clarify the question of whether this benefit is achievable under real-life conditions.Methods: Our retrospective study concerned patients with histologically-confirmed advanced gastric cancer clinical stage II-IIIc according to UICC (8th edition) treated at the University Hospital of Marrakech between January 2017 and December 2018. They received 2-4 cycles/3 weeks of neoadjuvant chemotherapy based on FLOT, FOLFOX, XELOX, EOX or 5FU-Cisplatin protocols.Results: 48 patients with a median age of 56 years were diagnosed with advanced gastric cancer. 67% of them are male were. Only 16 patients (33,3%) had received neoadjuvant chemotherapy and 19 were operated immediately (39,5%). Protocols used in perioperative were FLOT in 8 patients (50%) and FOLFOX in 4 patients (25%). The rest have received either EOX (1 patient), XELOX (2 patients) or 5FU-cisplatin (1 patient). 7 patients (43,75%) received 4 cycles of neoadjuvant chemotherapy. Side effects were represented by mycosis grade 2 in 2 patients, neutropenia grade 2 in 4 patients and only one patient had grade 3 toxicity. After neoadjuvant chemotherapy, we observed 3 cases of partial response and 4 of stable disease. 5 patients (31,25%) underwent surgery (R0 in all cases) by total gastrectomy and D2 lymphadenectomy. 68,42% of the group who did not receive neoadjuvant chemotherapy, were treated by concomitant chemoradiotherapy. The median overall survival in the neoadjuvant group was 21 months compared to only 12 in the second group. Conclusion:Despite the small number of patients treated, our analysis showed that selected patients with locally advanced adenocarcinoma can be safely managed with perioperative chemotherapy in daily clinical practice and our results confirm the survival benefit of perioperative treatment.Legal entity responsible for the study: The authors.
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