Surgical oncology at a major referral center in Ghana: Burden, staging, and outcomes Journal Article


Authors: Gyedu, A.; Gaskill, C. E.; Agbedinu, K.; Salazar, D. R.; Kingham, T. P.
Article Title: Surgical oncology at a major referral center in Ghana: Burden, staging, and outcomes
Abstract: Background and Objectives: Outcome data after surgery for cancer in Sub-Saharan Africa are insufficient. We aimed to describe the presentation and outcomes of patients with solid cancers managed at a tertiary hospital in Ghana. Methods: Records of cancer patients admitted to Komfo Anokye Teaching Hospital general surgery wards from 2013 to 2016 were reviewed for data on presentation, staging, management, and mortality. Patients discharged alive were followed-up by biannual telephone calls to establish their postdischarge status. Survival analysis was performed for patients with pathologic or radiologic confirmation of cancer and adequate staging. Results: A total of 343 patients were included. Of these, 76% were female. The most common diagnoses were breast 136 (40%), foregut 70 (20%), and colorectal 63 (18%) cancers. Cancer diagnosis was confirmed by pathology or radiology in 281 (82%) patients, but only 112 (40%) had adequate staging. Seventy-four (66%) patients were stage IV. Two-year overall survival for all 343 patients was 22% to 69%, depending on cancer site. Among those with adequate staging who were alive after postoperative 90 days, 3-year survival was similar for curative compared with palliative operations (P = 0.64). Conclusions: Improved capacity for both therapeutic and palliative cancer care is needed to achieve better outcomes by more appropriate allocation of surgery with respect to the goal of treatment. © 2018 Wiley Periodicals, Inc.
Keywords: adolescent; adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; cancer surgery; major clinical study; overall survival; cancer localization; cancer patient; cancer radiotherapy; cancer staging; follow up; antineoplastic agent; cancer diagnosis; colorectal cancer; breast cancer; palliative therapy; cancer mortality; cancer hormone therapy; surgery; stomach cancer; esophagus cancer; outcomes; duodenum cancer; foregut; surgical oncology; ghana; very elderly; cancer; human; male; female; priority journal; article; tertiary care center; solid malignant neoplasm; immunological antineoplastic agent; low- and middle-income counties
Journal Title: Journal of Surgical Oncology
Volume: 118
Issue: 3
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2018-09-01
Start Page: 581
End Page: 587
Language: English
DOI: 10.1002/jso.25168
PUBMED: 30095201
PROVIDER: scopus
PMCID: PMC6160332
DOI/URL:
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. T Peter Kingham
    612 Kingham