[Epidemiology, prognosis and prevention of choriocarcinoma in University Hospital of Dakar]. / Epidémiologie, pronostic et prevention du choriocarcinome au CHU de Dakar.

The objective of this study was to define epidemiological profile of choriocarcinoma in Senegal, to evaluate its prognosis and to submit a better strategy of prevention. It's a retrospective cases-control study; all choriocarcinoma diagnosed from January 1st to December 31st 2000 at Dakar University Teaching Hospital. The control were chosen among patients who had molar abortion during the same time than the cases and did not developed the pathology after at least 12 months of medical follow up. The stability of association is checked by calculating 95 confidence interval by Miettinen method, and using Chi 2 test of Pearson with a p value of 5% or Fischer test; the prognosis survival factors was compared using logrank test. Among 1098 patients with medical care follow up of post molar abortion, 61 choriocarcinoma were diagnosed with an incidence of 5.5%. The epidemiological profile is a great multipare 40 years old or more with low socio-economical status, 51% of diagnosed cases was in metastasis stage. The prognosis was marked by a complete remission in 37.7% and by global lethality in 49.2%; the average survival was about 48 months. The risk factors of choriocarcinoma among patients who had a molar abortion are represented by an age superior or equal 40 years old, high multipare and preservation of the uterus after molar abortion. To improve the prognosis we recommend to widen preventive hysterectomy indications after molar abortion among patients with risk factors of choriocarcinoma.

[Complications of colpohysterectomy with lymph node dissection in the cervix carcinoma at the Cancer Institute of Dakar: report of 412 cases]. / Les complications des colpohystérectomies élargies avec lymphadénectomie pour cancer du col utérin à l'Institut du Cancer de Dakar: à propos de 412 cas.

The wertheim complications are dominated by the urinary dysfonction and the lymphocele which are linked at this procedure. This study reported 412 Wertheim associated to the radiotherapy. The purpose was to evaluate the complications among patients who underwent the Wertheim and to analyse the differents factors promotions the complications. The diagnosis was always late and the disease stage was advanced. The stages II, III and IV represented more than 80%. We found 86 complications (20.87%) distributed as follow: 17 urinary (19.76%), 30 secondary infections (34.88%), 8 colonic fistula (9.30%), 7 hemorrage (8.13%), 6 lymphedema (6.97%), 3 occlusions (3.48%), 1 phlebitis (1.16%), 1 lymphocele (1.16%). among all patients, 17 died, the mortality rate was 4.12%. A very good dissection preceded by radiotherapy may reduce the complications rate.