Oesophageal Cancer In Sub-Saharan Africa: The Lagos Experience

Abstract

Background Esophageal cancer is the eight most common cancer and sixth leading cause of cancer-related death worldwide with a five year survival rate of <25%. It is very common in regions of the Asian belt and South Africa. Esophageal cancer is a relatively uncommon malignancy in our environment compared to breast, prostate and colon cancers but it is highly lethal. Its incidence and mortality rate are almost at par in most developing countries. The two prominent histological types are squamous cell carcinoma and adenocarcinoma. The study highlights the epidemiologic pattern, clinical presentations and treatment outcomes at Lagos University Teaching Hospital; Lagos, Nigeria Methodology Data obtained from clinical and operating theatre records of patients with esophageal cancer who presented between January 2014 and June 2021. Data extracted included demography; clinical presentation, radiologic and histological diagnosis, modalities of treatment and outcome. Results There were 25 patients (18 males, 7 females) with a mean age of 63.04±14.052 years. Dysphagia and weight loss were the commonest symptoms. Squamous cell carcinoma was seen in 76%.. Sixty percent of the tumors were located in the middle third of the esophagus whilst the rest occurred in the lower third and cardia. Majority (92%) of the patients present with stage 4 disease. Management was mostly palliative and esophageal resection possible only in 12% of cases. Conclusion: oesophageal cancer remains a relatively uncommon but lethal disease. Late presentation is a major challenge in our country with a dismal prognosis. Steps to improve outcome should be encouraged by policy makers