Uro-Genital Cancers in Nigerians: Clinical Patterns and Challenges of Management

Abstract

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.