How a Cancer Registry Was Set Up in Senegal: An Example to Follow for a Developing Country

Objectives: Senegal, with the support of WHO, had begun the establishment of a National Cancer Registry in 2009, although it had been at a standstill since 1969;the objective of this work was to test the reliability of data collection tools and feasibility stages necessary for the validation of media before the establishment of a national cancer registry. Methodology: We conducted a non-exhaustive preliminary study over a period of three months from the first of January to 31 March 2010 at four major hospitals in Dakar at the time. Results: Two hundred and eighty-nine cases had been identified: 44% of men (n = 127) and 56% of women (n = 162) with a sex ratio of 0.8. The ages ranged from 20 to 90 years with an average of 50 years. The main diagnostic mode was essentially histological, with 76% of cases (n = 219). The most frequent locations were: ORL (ENT meaning Ear, Nose and Throat) with 25% of cases, liver 7% and bronchopulmonary 4.5% of cases. In men, liver cancer was the most common location and women for cervical cancer with 16%. Squamous cell carcinoma was the most common histological type with 68% of cases followed by adenocarcinoma with 22% of cases. Thirty-eight percent of patients were classified as stage III and IV. A quarter of our patients had received palliative treatment. In contrast, 15 (15%) had received chemotherapy and 4% had received radiotherapy. Data collection was satisfactory. Conclusion: Cancer is a reality in Senegal but it remains underdiagnosed. The materials made it possible to make the cancer registry effective throughout the country.

Surgery for Early Stage Invasive Cervical Cancer. Experience of the Oncology Department of Ledantec Hospital

Background: Surgery is the treatment for early-stage cervical cancer. Radiochemotherapy is used in the treatment of locally advanced stages. But the choice of treatment can be difficult. Objective: The objective of this work was to evaluate the therapeutic aspects of cervical cancer in the early stages IA to IIA in the oncology department of A Ledantec Hospital in Dakar. Patients and methods: This was a descriptive retrospective study, from January 2015 to December 2020, in the oncology department of A Ledantec Hospital, including all the patients who had been treated for early-stage invasive cervical cancer. Results: We included 28 patients. The average age was 49.54 years old. There were 11 patients (39.3%) with a stage ≤ IB1. Surgery was the first in 14 patients (50%). The initial approach was a midline supra and subumbilical laparotomy. The surgery was R0 in 65.22%. Postoperative complications were found in 4 patients including 1 case of operative wound suppuration, 1 case of dysuria, 1 case of postoperative eventration and 1 case of rectovaginal fistula. Concomitant Radiochemotherapy was neoadjuvant in 7 cases (25%), adjuvant in 14 cases (50%). The chemotherapy was neoadjuvant in 09 cases (56.25%) and adjuvant in 7 cases (43.75%) with minor toxicities. We had recorded 2 deaths. Conclusion: The treatment of the early stages of invasive cervical cancer is based on surgery. Neoadjuvant treatments may be useful in particular situations.

Cystic Breast Cancer. A Confusing Entity. Study of 8 Cases at Dakar University Surgical Oncology Unit

Introduction: Cystic breast cancer is a rare entity. Breast cysts are most often benign. The clinical characteristics of malignancy are not specific. Objective: To report a series of malignant cystic tumors of the breast and to describe their different characteristics. Materials and Methods: This was an observational study carried out between January 2018 and October 2021 at the Dakar university surgical oncology unit. We studied the clinical appearance, imaging, histopathology, extent of disease and treatment. We did not include cases of pure, single, or multiple chronically progressive cysts. Results: There were 8 patients, 6 women and 2 men. The average age was 44. All patients presented with a palpable unilateral deforming skin mass without inflammatory character. One patient presented with a bloody discharge. The cyst was multilocular without intracystic growth in 2 cases and presented a growth signal in 6 cases. Imaging was ACR 3 in 5 cases and ACR 4 in 3 cases. Histopathology found 6 invasive carcinomas including 2 papillary, 3 Invasive Carcinoma of No Special Type (ICNST), 1 lobular carcinoma as well as one case of lobular carcinoma in situ of the comedocarcinoma type in women and 2 ICNST in men. The extension workup was found in only 1 male patient in the presence of metastases. Treatment included chemotherapy, mastectomy and radiotherapy for 6 of the patients. There wasn’t any complete response for invasive cases. Survival is 100% to date. Conclusion: Cystic breast tumors sometimes hide the cancer that is difficult to diagnose. The prognosis seems favorable, however.