Uro-Genital Cancers in Nigerians: Clinical Patterns and Challenges of Management
Clinical patterns of urogenital cancers and management challenges in a tertiary hospital over ten years are presented. This study aims to highlight the incidence, relative ratio frequencies, management difficulties and outcomes with urogenital cancers. Three hundred and ninety-eight patients (M: F=1:1.1), were analysed for age, sex, site, types of tumours, histopathological stages, management challenges and outcomes. Carcinomas of cervix uteri (39.2%) and prostate (36.4%), constituted (75.6%) of urogenital cancers in the series. Others included cancers of uterine body (4.5%), nephroblastoma (4.0%), bladder (3.8), renal cells, testicles and ovaries (3.3% respectively), vulva (2.0%) and penis (0.3%). Of 13 testicular tumours, 8 were GCT (61.5%) and 3 were non-GCT (23%)]. Histology reports of two patients (15.4%) were missing. Only 11 of 15 (73.3%) bladder tumours (M: F=14:1), were biopsied, returning 6 TCC (54.5%), 4 SCC (36.4%) and 1 rhabdomyosarcoma (9%). All presented with advanced disease and refused surgery. Late presentations (80%), inoperability and non-availability of appropriate chemotherapy presented major challenges. Uterine carcinomas were treated mostly by radical hystero-salpingectomy, prostate cancer by medical and surgical hormonal palliation, renal cancers by surgery and pre and post-operative anti-neoplastic and hormonal therapies. Most survived for less than twelve months. Addition of medroxyprogesterone after radical nephrectomy for adult clear-cell carcinoma though now obsolete, produced arguably favourable results. One patient with stage three disease inexplicably survived for 4 years after radical nephrectomy without additional therapy. Apart from cervical, prostatic, and renal cancers (in children), we did not see enough of the other cancers to establish a regular pattern of treatment.