Clinico-pathological profile of hypopharyngeal cancer at two largest tertiary hospitals in Tanzania

Abstract

 Background: Hypopharyngeal cancer being one of the upper aerodigestive malignancies has a very poor prognosis due to its late presentation, delay in diagnosis and initiation of treatment. The study aimed to determine the clinicopathological profile of hypopharyngeal cancer at the two largest tertiary hospitals in Tanzania. 

Materials and methods: This study was conducted at Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute (ORCI) both located in Dar es Salaam, Tanzania and it was conducted from September 2019 to February 2020 where 119 patients were recruited after a thorough clinical evaluation and histopathological confirmation of the tissue biopsies. Structured questionnaires were used to collect data and it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The chi-square test was used to determine the relationship between independent and dependent variables and a p-value <0.05 was considered  statistically significant.

Results : The study depicted male preponderance (male to female ratio being 2.6:1) and the majority of the patients (87.23%) were aged above 60 years. Progressive dysphagia and persistent sore throat (100%) were the predominant clinical features. Regarding the involvement of anatomical subsites of the hypopharynx by cancer, the majority of patients had more than one anatomical subsite involvement (89.08%) followed by the pyriform fossa (5.88%) posterior pharyngeal wall (3.36%) and least affected site is the post cricoid space (1.68%). Postcricoid space was found to affect women only. The majority of the patients (88.2%) were diagnosed at advanced stages. Histopathologically, the predominant subtype was found to be carcinoma (98.5%) with invasive squamous cell carcinoma (95.8%) predominating. 

Conclusion : Progressive dysphagia and persistent sore throat were the predominant clinical features whilst the majority of patients had more than one anatomical site involved. Most patients presented at advanced stages due to delayed diagnosis and similarly, the predominant histopathological subtype was carcinoma.