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2008

Saidi, H, Nyaim EO, Githaiga JW, Karuri D.  2008.  CRC surgery trends in Kenya, 1993-2005., 2008 Feb. World journal of surgery. 32(2):217-23. Abstract

CRC (CRC) rates are low but increasing in Africa. Data on detection, treatment, and outcome are scarce.

2007

Saidi, H, Nyaim EO, Karuri D, Githaiga JW.  2007.  Young patients with colorectal cancer at a tertiary hospital in Kenya, 1993–2005. Annals of African Surgery. 1 AbstractWebsite

BACKGROUND: The onset of colorectal cancer appears to be two to three decades earlier in developing countries. Data on whether colorectal cancer in the young has worse prognosis than in older patients is conflicting.
METHOD: Clinical charts of 70 patients ≤40 years old were reviewed to determine clinical and pathological patterns and treatment outcomes. Their data were compared with a
larger group of older patients treated between 1993-2005 at Kenyatta National Hospital in Nairobi, Kenya.
RESULTS: The data retrieval was highest for sub-site distribution and lowest for pathology information. Patients ≤ 40 years of age comprised 27.3% of all colorectal cancer
cases treated over the study period. There were 41 males (58.6%) and 29 (41.4%) females patients. The most common symptoms were abdominal pain (76.9%), change in bowel habit
(71.4%) and rectal bleeding (54.3%). The mean duration of symptoms was 24.6 ± 30 months. The rate of advanced colorectal disease (Duke C and D) was 73.5%. Mean follow-up time was 5.8 months with median survival of only 6.9
months. The Duke staging, histology, symptom duration, locations of tumours, follow-up and the complication rates were similar for young and older patients.
CONCLUSION: Younger patients form a significant proportion of colorectal cancer burden. Both the clinico-pathological
characteristics and treatment outcome correspond to older individuals. It is suggested that the concluded colorectal symptoms in younger patients should also be aggressively
evaluated including early endoscopy. A prospective follow-up study of patients with the disease will unravel the true survival picture.

2000

EN Opot, Magoha GAO.  2000.  Testicular cancer at Kenyatta National Hospital, Nairobi. East African Medical Journal. 77(2) AbstractWebsite

Objective: To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital. Design: Retrospective case study of testicular cancer patients over a fifteen year period.

Setting: Kenyatta National Hospital, a referral and teaching hospital.
Participants: All histologically confirmed testicular cancer patients recorded at theHistopathology Department of Kenyatta National Hospital between 1983 and 1997.

Results: The mean age was 34.8 years with a peak incidence in the 30-44 year age group. History of cryptochirdism was obtained in 10.26% of the patients. Thirty one patients (79.49%) presented with painless testicular swellings, eleven (28.08%) with pain, nine
(23.08%) with scrotal heaviness, six (15.38%) with abdominal swellings and one (2.56%) each with gynaecomastia and eye swelling. On examination 32 patients (82.05%) had testicular masses, ten (25.64%) had abdominal masses, seven (17.91%) had supraclavicular
and cervical lymphadenopathy, and one each (2.56%) had gynaecomastia and eye mass respectively. More than eighty nine per cent had germ cell cancers with seminoma accounting for 67.35%, teratoma 12.24%, embroyonal carcinoma 8.16%, rhabdomyosarcoma 6.12% and malignant germ cell tumour, orchioblastoma and dysgerminoma each accounted for 2.04%. Three patients (7.7%) had orchidectomy and radiotherapy and chemotherapy, sixteen (41.03%) had orchidectomy and radiotherapy, six (15.38%) had orchidectomy and chemotherapy, ten (25.64%) had radiotherapy and chemotherapy, three (7.7%) and two (5.13%) had only chemotherapy and radiotherapy respectively. No cisplastin based chemotherapy regime was used. Follow up was effected for eighteen patients (46.15%) and seven patients (38.89%) were alive after five years.

Conclusion: Prognosis with current regimes was poor with survival of only 38.89% after five years. Cisplastin based chemotherapy with up to 90% cure rates should be included as a component of testicular cancer management at Kenyatta National Hospital.

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