A Six-Year Review of Head and Neck Cancers at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

Larsen‐Reindorf, Rita; Owusu-Afriyie, Osei; Acheampong, Alex; Boakye, Isaac; Awuah, Baffour

doi:10.4236/ijohns.2014.35050

Cited by 11 publications

(19 citation statements)

References 18 publications

(25 reference statements)

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“…In keeping with other authors in developing countries [ 12 , 35 , 38 ], the follow-up of patients in this study was generally poor as more than 60 percent of patients were lost to follow-up at the end of 5 years. We could not establish the reasons for the large number of loss to follow up in this study.…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

“…Despite recent advances in the diagnosis and treatment of head and neck cancer, there has been little evidence of improvement in 5-year survival rates over the last few decades [ 35 , 38 ]. In this study, the overall 5-year survival rate of 20.6 % is significantly low compared to the survival rate for patients with advanced (stage III–IV) head and neck cancers managed in developed countries which ranges from 30 to 50 percent [ 19 , 35 , 38 ]. The lower survival rate in this study is consistent with data from most cancer sites in developing countries and is likely to be due to late diagnosis, late referrals, poor access of patients to our centre and the reliability on traditional healers and medicine man [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting

et al. 2015

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BackgroundHead and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding head and neck cancers in Tanzania, and Bugando Medical Centre in particular. This study describes the clinicopathological profile of HNC in our local setting and highlights the challenges in the management of this disease.MethodsThis was a retrospective study of histopathologically confirmed cases of head and neck cancers treated at Bugando Medical Center between January 2009 and December 2013.ResultsA total of 346 patients (M:F = 2.1:1) were studied representing 9.5 % of all malignancies. The median age of patients was 42 years. Cigarette smoking (76.6 %) and heavy alcohol consumption (69.9 %) were the most frequently identified risk factors for head and neck cancer. The majority of patients (95.9 %) presented late with advanced stages. Twenty-five (7.2 %) patients were HIV positive with a median CD4+ count of 244 cells/μl. The oral cavity (37.3 %) was the most frequent anatomical site affected. The most common histopathological type was carcinomas (59.6 %) of which 75.7 % were squamous cell carcinoma. A total of 196 (56.6 %) patients underwent surgical procedures for HNC. Radiotherapy and chemotherapy was reported in 9.5 and 16.8 % of patients, respectively. Only 2 (0.6 %) patients received chemo-radiation therapy. The mortality rate was 24.4 %. The overall 5-year survival rate (5-YSR) was 20.6 %. The predictors of overall 5-YSR were age of patient at diagnosis, stage of disease, extent of lymph node involvement, HIV seropositivity and CD4+ count <200 cells/μl (P < 0.001). Local recurrence was reported in 22 (23.4 %) patients and this was significantly associated with positive resection margins, stage of the tumor and presence of metastasis at diagnosis and non-adherence to adjuvant therapy (P < 0.001).ConclusionHead and neck cancers are not uncommon at Bugando Medical Centre and show a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage cancer. Therefore, public enlightenment, early diagnosis, and effective cost-effective treatment and follow-up are urgently needed to improve outcomes of these patients in our environment.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting

et al. 2015

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“…The incidence of head and neck squamous cell carcinoma (HNSCC) differ widely in Africa, from 0.8 per 100,000 in Ghana to 11.1 per 100,000 in South Africa [ 3 , 4 ]. Moreover, previous studies in Ghana have also shown that tumours of the pharynx, larynx and oral cavity formed the largest group of HNCs and most of the patients presented with late (stage IV) disease [ 5 , 6 ]. Molecular targeted therapy seeks to block tumour growth and spread by interfering with molecular carcinogenic pathways [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Expression of immunohistochemical markers in non-oropharyngeal head and neck squamous cell carcinoma in Ghana

et al. 2018

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BackgroundHead and neck cancers include carcinomas of the oral cavity, larynx, sinonasal tract and nasopharynx. Studies on molecular expression of prognostic tumour markers in Ghana are scarce. The purpose of this study was to determine the expression of p53, p16, EGFR, Cyclin-D1 and HER2 among patients with non-oropharyngeal head and neck squamous cell carcinoma (HNSCC).MethodologyTissue microarrays from 154 histologically confirmed non-oropharyngeal HNSCC at the Komfo Anokye Teaching Hospital from 2006–2014 were constructed using duplicate cores of representative and viable areas from tumours. Expression of EGFR, p53, p16, Cyclin-D1 and HER2 was evaluated using immunohistochemistry.ResultsFor non-oropharyngeal HNSCC, majority of the cases (66.2%; 102/154) had stage IV disease. EGFR was the most expressed molecular marker (29.4%; 25/85) followed by p53 (24.0%; 29/121), p16 (18.3%; 23/126) and Cyclin-D1 (10.0%; 12/120). HER2 was not expressed in any of the cases. There was a significantly (p = 0.022) higher expression of Cyclin-D1 in tumours of the oral cavity (19.6%; 9/46) than in those of the larynx (4.7%; 2/43) and nose (3.2%; 1/31). Tumours in stages I–III were more frequently positive for p16 (28.6%; 12/42) than tumours in stage IV (13.1%; 11/84).ConclusionExpression of p53, EGFR, p16 and Cyclin-D1 in non-oropharyngeal HNSCC in Ghana is largely similar to what has been reported in published studies from other countries.

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“…With the current prevalence rate of 29% of all head and neck cancers [22] and 1.2–1.3% of all cancers in Ghana [23], and the number of cases in Korle-Bu Teaching Hospital (KBTH), Ghana, increasing steadily over the last few years, a study in this regard is very necessary to provide baseline data on the presence of HPV and EBV DNA in NPC tissue samples.…”

Section: Introductionmentioning

confidence: 99%

Detection of Human Papillomavirus Genotypes and Epstein-Barr Virus in Nasopharyngeal Carcinomas at the Korle-Bu Teaching Hospital, Ghana

Asante

Asmah

Adjei

et al. 2017

The Scientific World Journal

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Nasopharyngeal carcinomas (NPC) are endemic in Far East Asia and commonly harbour Epstein-Barr virus (EBV) which is known to serve as a key oncogenic promoter. Human papillomavirus (HPV) is known to contribute to the pathogenesis of NPC. However, in Ghana these two viruses have not been linked to NPC prevalence. This study was designed to determine the HPV genotypes and EBV involved in NPC tissue biopsies. A retrospective study design involving 72 formalin-fixed paraffin-embedded tissue (FFPET) samples of NPC from 2006 to 2012 were retrieved from the Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences. Sections were taken for histological analysis and for DNA lysate preparation. The DNA lysates were subjected to polymerase chain reaction (PCR) analysis to determine the presence of HPV genotypes and EBV. HPV specific primers were used to type for fourteen HPV genotypes (HPV-16, 18, 6/11, 31, 33, 35, 44, 42, 43, 45, 56, 52, 58, and 59). Out of the 72 NPC biopsies analyzed by PCR, EBV DNA was present in 18 (25%) cases and HPV DNA in 14 (19.23%). High risk HPV (HR-HPV) genotypes 18 and 31 were associated with the NPC. There were 3 (4.2%) cases of coinfection by both viruses. The EBV DNA present in the undifferentiated variant of the NPC and the histopathology of the NPC in Ghana is similar to the type described in endemic areas.

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A Six-Year Review of Head and Neck Cancers at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

Cited by 11 publications

References 18 publications

Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting

Head and neck cancers: a clinico-pathological profile and management challenges in a resource-limited setting

Expression of immunohistochemical markers in non-oropharyngeal head and neck squamous cell carcinoma in Ghana

Detection of Human Papillomavirus Genotypes and Epstein-Barr Virus in Nasopharyngeal Carcinomas at the Korle-Bu Teaching Hospital, Ghana

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