Trans-hiatal oesophagectomy as a palliative treatment for carcinoma of the oesophagus

Adegboye, V O; Obajimi, M O; Ogunseyinde, AO; Brimmo, I A; Adebo, A O

doi:10.4314/eamj.v79i6.8851

Cited by 6 publications

(9 citation statements)

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“…Of the 34 studies on management and outcomes of EC, 18 (52.9%) were conducted in South Africa[98-114], 7 (20.6%) were conducted in Egypt[115-121], and 3 in Kenya (8.8%)[122-124] , 2 in Sudan (5.9%)[125,126], 1 each in Ethiopia (2.9%)[127], Malawi (2.9%)[128] and Nigeria (2.9%)[129], and 1 (2.9%) multi-country[130] (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Esophagectomy: Esophagectomy remains the primary treatment modality of early oesophageal cancer, however in our study most studies attempted to find out its role in palliation for patients with advanced oesophageal cancer. Different approaches were employed that include; transhiatal esophagectomies[104,129], transthoracic approach esophagectomies such as left transthoracic and Ivor Lewis appro-aches[125-127,137] and McKeon approach[126].…”

Section: Resultsmentioning

confidence: 99%

“…Esophagectomy associated mortality was reported in seven studies. The highest 30 d perioperative mortality was 50% in a study with a population of 10 patients, however, in the follow-up study with 21 patients the morbidity decreased to 14.3%[129]. The lowest mortality reported was 10% in a study with a study population of 100 patients[126].…”

Section: Resultsmentioning

confidence: 99%

“…Other studies reported a mortality 11.8% in a study population of 127 patients[104], mortality 27.8% in a resected population of 61 patients[125], mortality 28% in a resected population of 34 patients and mortality 30% in a resected population of 25 patients[137]. Four studies reported on morbidity and the common complications includes; hemorrhage, anaesthetic complication, pneumonia, respiratory failure, pleural enteritis, chest wall infection, anastomotic leakage and heart failure[125,127,129,137].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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BACKGROUND Esophageal cancer (EC) is associated with a poor prognosis, particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease. AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity, and socio-economic challenges faced on the African continent. METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology, risk factors, management and outcomes of EC. A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer, and the Cancer in Sub-Saharan reports. We searched EMBASE, PubMed, Web of Science, and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved. Random effects meta-analyses were used to assess heterogeneity between studies and to obtain odds ratio (OR) of the associations between EC and risk factors; and incidence rate ratios for EC between sexes with their respective 95% confidence intervals (CI). RESULTS The incidence of EC is higher in males than females, except in North Africa where it is similar for both sexes. The highest age-standardized rate is from Malawi (30.3 and 19.4 cases/year/100000 population for males and females, respectively) followed by Kenya (28.7 cases/year/100000 population for both sexes). The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old. Meta-analysis shows a strong association with tobacco (OR 3.15, 95%CI: 2.83-3.50). There was significant heterogeneity between studies on alcohol consumption (OR 2.28, 95%CI: 1.94-2.65) and on low socioeconomic status (OR 139, 95%CI: 1.25-1.54) as risk factors, but these could also contribute to increasing the incidence of EC. The best treatment outcomes were with esophagectomy with survival rates of 76.6% at 3 years, and chemo-radiotherapy with an overall combined survival time of 267.50 d. CONCLUSION Africa has high incidence and mortality rates of EC, with preventable and non-modifiable risk factors. Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption. Management requires a multidisciplinary approach, and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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“…VII) Bamako 1988–1992 1 0.99 12 (1.5) 7 (0.8) 19 IARC (2002) CI5 (vol. VIII) Bamako 1994–1996 1 1.17 17 (3.0) 9 (1.7) 26 Niger IARC (2003) CIA Niamey 1993–1999 1 0.94 7 (1.0) 7 (1.3) 14 IARC (In press) CIA Niamey 2006–2009 1 2.08 13 (1.2) 2 (0.2) 15 Nigeria Awojobi (1996) Literature Eruwa, Oyo state 1986–1995 1 0.83 5 6 11 Ojo (1996) Literature Ife-Ijesha 1993–1995 1 1.00 2 2 4 Adegboye (2002) [ 56 ] Literature Ibadan 1986–1996 2 2.10 21 10 31 …”

Section: Resultsmentioning

confidence: 99%

Esophageal cancer male to female incidence ratios in Africa: A systematic review and meta-analysis of geographic, time and age trends

Middleton

Bouaoun

Hanisch

et al. 2018

Cancer Epidemiology

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HighlightsWe conducted a review and meta-analysis of esophageal cancer sex ratios in mainland Africa using data from 197 populations in 36 countries.We observed a consistent male excess in incidence rates overall and in the high-risk Eastern and Southern African regions.A male excess was evident in 30–39 year olds in high-risk Eastern and Southern African regions.Our findings suggest that a substantial fraction of the African EC burden could be avoided by targeting gender-specific exposures.

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Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

Buckle

Mahapatra

Mwachiro

et al. 2020

Intl Journal of Cancer

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Esophageal cancer (EC) is a leading cause of cancer morbidity and mortality in Africa. Despite the high burden of disease, optimal management strategies for EC in resource‐constrained settings have yet to be established. This systematic review evaluates the literature on treatments for EC throughout Africa and compares the efficacy and safety of varying treatment strategies in this context (PROSPERO CRD42017071546). PubMed, Embase and African Index Medicus were searched for studies published on treatment strategies for EC in Africa from 1980 to 2020. Searches were supplemented by examining bibliographies of included studies and relevant conference proceedings. Methodological quality/risk of bias was assessed using the Cochrane Risk‐of‐Bias tool and the Newcastle‐Ottawa Scale. Forty‐six studies were included. Case series constituted the majority of studies: 13 were case series reporting on outcomes of esophagectomies, 17 on palliative luminal or surgical interventions, four on radiotherapy and three on concurrent chemoradiation. Nine randomized controlled trials were identified, of which four prospectively compared different treatment modalities (one investigating radiotherapy vs chemoradiation, three evaluating rigid plastic stents vs other treatments). This review summarizes the research on EC treatments in Africa published over the last four decades and outlines critical gaps in knowledge related to management in this context. Areas in need of further research include (a) evaluation of the safety and efficacy of neoadjuvant therapy in patients with locally advanced disease; (b) strategies to improve long‐term survival in patients treated with definitive chemoradiation; and (c) the comparative effectiveness of modern palliative interventions, focusing on quality of life and survival as outcome measures.

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Trans-hiatal oesophagectomy as a palliative treatment for carcinoma of the oesophagus

Cited by 6 publications

References 0 publications

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Esophageal cancer male to female incidence ratios in Africa: A systematic review and meta-analysis of geographic, time and age trends

Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

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