Outcome of Oesophageal Cancer Treatment at a National Hospital, from 2015 to 2017
Keywords:Oesophageal cancer survival, Dysphagia grade, Treatment outcome, Cancer recurrence
Oesophageal cancer is among the most common cancers in Tanzania. Patients usually, unfortunately, come to medical care with advanced disease and for this reason, despite advancement in treatment of cancer and multidisciplinary treatment approaches (surgery and chemoradiotherapy), Oesophageal cancer still has a 5-year survival rate of less than 20% and high rate of recurrence after initial treatments. Here in Dar es Salaam, we studied the outcomes of treatment in these cases to have an estimation of the general prognosis of patients and have a general picture of the treatment modalities and outcomes.
In this retrospective study we reviewed data of patients which included cancer stage at diagnosis, types of treatments and their treatment outcomes. This involved data from patients who were admitted from January 2015 to December 2017. The total period of survival recorded was taken up to 2yrs from the date of onset of treatment. This study was done in Muhimbili National hospital and Ocean Road Cancer Institute, both located in Dar es Salaam, Tanzania.
The Study included 128 patients of which 77(60.2%) were males with a general median age of 55.9 years (range: 20 years to 91 years). Majority of the patients were diagnosed at an advanced stage of the disease. Stage III or IV was observed in 82.5% (106/128) of patients with Oesophageal cancer, rendering them to get only palliative therapy (79%). The overall 2-year survival rate was 8%, and the mean duration for local recurrence was 3.6 ± 1.2 months. Late diagnosis was the main factor for poor outcomes and hence low 2-year survival rate.
Conclusion and recommendation
Oesophageal cancer has higher mortality and shorter survival period because it is diagnosed very late. The treatment offered, therefore, at this stage is usually palliative which doesn’t alter the dismal course of the disease. More efforts are needed to sensitize the general population to seek consultation for early diagnosis and treatment.