So-called "historical" necrotic breast cancers: a terrifying actuality in Africa. The case of Burkina Faso.

Study the epidemiological, diagnostic, and treatment features and outcomes of necrotic breast cancer in women. This observational, longitudinal, and descriptive study covered the period from January, 2011, to the end of May, 2016 at the Surgery and Gynecology Departments of Yalgado Ouedraogo University Hospital and Schiphra Medical Center. The study included all women with necrotic breast cancers. Survival was calculated by the Kaplan Meier method and survival comparison was possible with the log-rank method. À risk of error of 0.05 was allowed. Necrotic cancer accounted for 9.1% of all breast cancers. The median age of the patients was 46 years old. The median interval before consultation was 12.4 months. The histological type was invasive ductal carcinoma in 90.8% of cases. Surgery was performed in 51 patients (52%). It was a palliative (cleaning) procedure in 92.2% of cases. Chemotherapy was performed in 28 patients. Overall survival was 61.8% at 6 months, 39.5% at 1 year, and 9.2% at 3 years. Median survival was 10 months: 13 months for women with surgery and 6 months for those without it (p<0.001). Necrotic breast cancer is still common in Ouagadougou. Surgery is the mainstay of the treatment. Survival is mediocre. It therefore seems urgent to focus on raising population awareness and organizing screening campaigns.

Level of Concordance of Pre-, Intra-, and Postoperative Staging in Cervical Cancers (TREYA Study).

Concomitant radiochemotherapy is the therapeutic standard for locally advanced (Ib2 to IVa stage FIGO) cervical cancer. In the absence of a radiotherapy in many of our Sub-Saharan African countries, surgical resection is the only therapeutic method available in hopes of achieving a definite cure. However, criteria for curative surgery are not always met due to preoperative understaging of most of our patients. In addition to socioeconomic factors, the causes for understaging are numerous. These include the lack of personnel or underqualified personnel and the absence of complete workup to assess the resectability of the tumor, but above all the lack of decision-making through multidisciplinary consultation meetings. This study makes a plea in order to provide our hospitals with qualified personnel and adequate technical platform to allow efficient management of our patients with cervical cancer.

[Survival of malignant and paramalignant pleural effusions in Ouagadougou]. / Survie des pleurésies malignes et paramalignes à Ouagadougou.

This study aimed to present the survival of patients with malignant and paramalignant pleural effusion (MPE) in a context of resource-limited countries. We retrospectively studied patients received for malignant and paramalignant pleural effusion in three health facilities in Ouagadougou from 1st August 2009 to 30 July 2015. Survival was analyzed according to various characteristics related to patients and disease. Eighty patients with a mean age of 54 years were selected. The sex-ratio was 0.9. Sixteen patients had comorbidities. Pleural effusion was revealing, synchronous and metachronous in respectively 55 %, 26.3 % and 17.5 % of cases. Lung cancer was the most common cause of MPE (27.5 %), followed by breast cancer (18.7 %). The median overall survival was 3 months; it varied between primary cancers: 5 months for primary cancer unknown, 4 months for lung cancers and 2 months for breast cancers. Sex and the presence of comorbidities were independent factors influencing survival of patients. In this study, patient survival length is strongly compromised by inadequacies of medical technical equipment.

[Inventory of fixtures on the tolerance of the treatment) of the resistant multi-tuberculosis (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex- ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: L'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

Dégénérescence carcinomateuse d'un kyste trichilemmal proliférant

Le kyste trichilemmal proliférant est une tumeur annexielle cutanée bénigne rare. Des cas de transformation maligne ont exceptionnellement été rapportés. Au travers d'une revue de la littérature, nous analysons un cas de transformation maligne diagnostiqué au CHU de Brazzaville en insistant sur les caractéristiques épidémiologiques, clinico-pathologiques et les difficultés de traitement dans notre contexte d'exercice

[State of tolerance of multi resistant tuberculosis treatment (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex-ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: l'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

[Factors linked to late diagnosis in breast cancer in Sub-Saharan Africa: case of Côte d'Ivoire]. / Facteurs liés au diagnostic tardif des cancers du sein en Afrique-sub-saharienne: cas de la Côte d'Ivoire.

OBJECTIVE: To identify in Ivorian environment, reasons involved in late diagnosis of breast cancer. PATIENTS AND METHODS: Retrospective study over 4 years (January 2008 to December 2011) including 350 patients with breast adenocarcinoma. A questionnaire was created and filled according to the medical files of the patients. Linear regression analysis applied to the data showed concordance between the factors and the delay before diagnosis. RESULTS: Thus 78.9% of the patients sought for care above 10 months with inflammatory cancers (54%) and necrotic ulcerations (18%). Factors found during interview were the lack of financial means (36%), cultural habits with first intent traditional treatment (41.1%), misdiagnosis (7.1%) and lack of therapeutic care. Yet, when comparing each of these factors to the delay, no significant link was found. Chemotherapy was the first therapeutic method. CONCLUSION: In our context, the conjunction of ignorance, poverty and socio-cultural habits were the key factors in late diagnosis of breast cancers in Côte d'Ivoire.

[Prostate cancer: Gleason scores correlation between biopsies and surgical gross specimen]. / Cancer de la prostate : corrélation des scores de Gleason entre les biopsies et les pièces opératoires.

UNLABELLED: The Gleason score is a histopronostic criterion which gives an appraisal of prostate cancer aggressiveness and outcomes. OBJECTIVE: The goal of this retrospective study was to assess the relationship between Gleason scores appreciated on biopsies and later on surgical gross specimen. RESULTS: During the period of the study, 123 patients benefit of a histological diagnosis of prostate cancer recording Gleason score on biopsies and postsurgical intervention on gross specimen. After analysis of biopsies and for gross specimen the reported Gleason scores vary from 3 to 9 and the mean was 5.9 and 6.1 respectively. There was a good concordance between the Gleason scores for biopsies and gross specimen in about 32.5% of cases. We noted a difference of score of one point in 37.3% of patients and a difference of two points and more in 30% of cases. In 28.4% the Gleason scores were overestimated while in 39% they were underestimated. More than half of the patients' cohort was classified in the group of histologically moderately differentiated cancer. When grouping the patients according to the histological types well, moderately or less differentiated cancers, the Gleason scores concordance for biopsies and for gross specimen change from 32.5% up to 74.8%. The correlation can be considered good for the less differentiated cancers. CONCLUSION: Gleason score showed some limits in the appreciation of the prediction. The grouping of patients according to the three distinct histological differentiation groups increases the concordance between the score of Gleason on biopsy specimen and gross specimen but it seems less powerful for cancers well and moderately differentiated cancers.