Oesophageal cancer management guidelines for Uganda

No Abstrac

Cancer of the breast: 5-year survival in a tertiary hospital in Uganda

The objective was to investigate survival of breast cancer patients at Mulago Hospital. A retrospective study of the medical records of 297 breast cancer patients referred to the combined breast clinic housed in the radiotherapy department between 1996 and 2000 was done. The female/male ratio was 24 : 1. The age range was 22–85 years, with a median of 45 years and peak age group of 30–39 years. Twenty-three percent had early disease (stages 0–IIb) and 26% had metastatic disease. Poorly differentiated was the most common pathological grade (58%) followed by moderately differentiated (33%) and well-differentiated (9%) tumours. The commonest pathological type encountered was ‘not otherwise specified' (76%). Of all patients, 75% had surgery, 76% had radiotherapy, 60% had hormonotherapy and 29% had chemotherapy. Thirty-six (12%) patients received all the four treatment modalities. The 5-year survival probabilities (Kaplan–Meier) for early disease were 74 and 39% for advanced disease (P=0.001). The overall 5-year survival was 56%, which is lower than the rates in the South African blacks (64%) and North American whites (82–88%)

Effect of hiv serological status on outcome in patients with cancer of cervix treated with radiotherapy

Objectives: To investigate and compare the outcomes of invasive cervical cancer patients with known HIV serostatus treated with radiotherapy. Design: A retrospective study. Setting: Mulago Hospital Radiotherapy Department, Kampala, Uganda. Subjects: Medical records of thirty six patients treated in our department between May and July 2000, whose serostatus and CD4 counts were known, was done after a four-year period to determine the outcomes and survival after radiotherapy. Results: Of these, 29 (80.6%) were HIV seronegative and seven (19.4%) were HIV seropositive. All the seropositive patients had advanced disease (stage IIB and above) and only two (6.9%) among the seronegative patients had early disease (less than stage IIB) at presentation. The mean CD4 count was 289 (±122 SD) for the seropositive and 550 (± 237 SD) for the seronegative patients (p = 0.008). About 60% of all the patients received both external beam and intracavitary treatment. The one, two and three year survival probabilities (Kaplan-Meier) for the seropositive were 67%, 40% and 27% respectively while they were 89%, 62% and 51% for the seronegative patients. By the fourth year the survival probabilities had fallen to 0% for the seropositive while it was 46% for the seronegative patients. Conclusion: Radiotherapy was effective in both sets of patients with comparable good objective response. The survival probabilities for the seropositive patients were significantly lower than for the seronegative patients at all periods with a P-value of 0.0001 by the fourth year. The East African Medical Journal Vol. 83(8) 2006: 416-42

Cancer of the cervix: The Uganda guidelines

No Abstract

Radiotherapy in cancer management at the Mulago Hospital, Kampala, Uganda. A preliminary assessment of the clinical impact of the nwe ratiotherapy facilities

No Abstract. NQJHM Vol. 6 (3) 1996: pp. 153-15

Gastric Cancer Diagnosis and Treatment guidelines 2008: Uganda Cancer Working Group

In Uganda most cancers to the exception of bladder and penis are increasing in incidence. The incidence of cancer of stomach is 5.6/100,000 from 0.8/100,000 in the 1960s a seven fold increase.The purpose of this guideline document is to highlight the salient points in gastric cancer diagnosis and treatment in the Ugandan context. It doesn’t only outline what is practical and efficacious but also our aspirations of practice as resources committed to the whole area of Oncological care services improve in the country. The primary and secondary prevention strategies are outlined. The multistage process of gastric oncogenesis is discussed in relation to the scientific basis of diagnostic and screening procedures. The treatment modalities including surgery radiotherapy and chemotherapy are discussed. A prognostication scale is included. Traditionally gastric cancer presents late and with a poor prognosis. The greatest strategy we have for management is in primary and secondary prevention. However a better understanding of how it arises (risk factors) will be important in informing prevention and treatment strategies. The Uganda cancer-working group intends that this information is disseminated to wider readership in the region as part of the strategy of improving Oncological care service in the region

Cancer of the cervix: the Uganda guidelines.

Cancer of the cervix (Ca Cx) is the commonest gynecological malignancy among women in Uganda contributing about 80% of all female malignancies. The incidence rate is 40:100 000. It is the leading cause of cancer related deaths in females in Uganda. Unfortunately 80% of the patients present late and this makes treatment outcomes unsatisfactory. Most patients can only be treated palliatively. It is therefore important that the disease be detected in early stages so as to improve outcome