Assessment of GI-Related Quality of Life among Cervical and Endometrial Cancer Patients Who Received Curative Radiotherapy at Black Lion Specialized Hospital, Addis Ababa,Ethiopia.
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Date
2023-12
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Addis Ababa University
Abstract
Background: Vulvar cancer is a rare condition, representing only 4% of gynecological malignancies, with an estimated 26,800 new cases worldwide. According to data from the Addis Ababa City Cancer Registry (AACCR) in 2012, the age-standardized incidence of vulvar cancer was 1.4 cases per 100,000 women annually in Addis Ababa (1,2,3). In Ethiopia, there are few studies that have evaluated the survival outcomes of patients with vulvar cancer.
Objectives: This study aims to present the clinical characteristics, treatment patterns, and survival outcomes of vulvar cancer patients in Ethiopia. Methods A retrospective cohort study was conducted, analyzing patient records to gather data on demographics, treatment modalities, and survival outcomes from 2016 to 2022 after obtaining ethical clearance from the institution. Survival probabilities were estimated using the Kaplan–Meier
method: Multivariate Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for prognostic factors.
Result :We identified 81 patient records for the analysis of vulvar cancer. Among these patients, 59.3% were in the age group of 31 to 50 years, with a mean age of 43.9 (SD ± 12.5). The most common presenting symptom was swelling, observed in 76.5% of cases, and the mean tumor diameter exceeded 4 cm in two-thirds of patients. Additionally, 63% of the cases were HIV positive. Among those diagnosed with invasive cancers, 92.8% were classified as squamous cell carcinoma (SCC) by histology, and 40.7% were at stage IV upon clinical staging. Out of the 73 patients who received treatment, two third underwent surgery or received radiotherapy. The overall survival rate was 30.9%, with a median survival time of 34 months (95% CI: 24.2–43.7). The cumulative survival rates at 1, 2, and 5 years were 86.4%, 64.2%, and 27.6%, respectively. A statistically significant correlation was found between the time from diagnosis to treatment and the risk of death, with a hazard ratio of 0.95 (95% CI: 0.91–0.99) and a p-value of 0.037.
Conclusion and recommendation :The findings of this study suggest that vulvar cancer remains a significant health concern among middle aged and HIV positive women. Advanced stage disease during presentation, delays in treatment and 30.9% overall survival indicate challenging prognosis. These findings emphasize the necessity for enhanced awareness, screening, and access to care for vulvar cancer in Ethiopia, particularly among vulnerable populations.
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Radiation GI symptoms Cervical Cancer Endometrial Cancer