Potential latitudinal variation in orodigestive tract cancers in Africa

Background. Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down the length of Africa. Objectives. To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN 2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools were used to depict regional variations in cancer morbidity and mortality.Methods. Data on 13 African countries between longitude 20° and 30° east and latitude 35° north and 35° south were examined for variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the 13 countries were compared. Results. Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors.Conclusions. Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental organisations and international agencies

Functional and Selective Neck Dissection (IIa) Following Squamous Cell Carcinoma of the Plate

Background: Neck dissection has been an adjunct surgical procedure in the management of malignancies affecting the head and neck region. Radical neck dissection was the original surgical procedure for the treatment of regional neck metastases. The aim of this paper is to report the management of a female patient with regional neck metastases from squamous cell carcinoma affecting the hard palate.Methods: A case report of a 60-year-old patient with squamous cell carcinoma of the palate who later manifested with an enlarged unilateral cervical lymph node ten weeks after surgery on the primary site. A functional and selective neck dissection in which the accessory nerve; internal jugular vein and sternocleidomastoid muscle were preserved and only the lymph node at the IIa level was removed was carried out under local anaesthesia.Results: The malignant ulcer on the palate was excised and the neck was dissected to remove the clinically enlarged lymph node. These procedures were uneventful and patient was referred for post- operative radiotherapy for possible residual tumours.Conclusion: There is need to reduce the morbidity and mortality associated with the radical neck dissection and this has led to the use of various levels of selective neck dissections as in the case presented