Pub Date : 2020-01-02DOI: 10.1080/20742835.2020.1745461
R. Wadee, W. Grayson
Endometrial carcinomas are common malignancies worldwide. Microsatellite instability is often identified in endometrioid endometrial carcinomas (EECs) and in most Lynch syndrome (LS) associated tumours. The authors aimed to identify the number of EECs at a South African public hospital, using the four-mismatch repair immunohistochemical stains, which may suggest possible LS, for the period 2009–2015. Following ethical clearance, 145 cases of archived EEC underwent immunohistochemical testing for MLH1, MSH2, MSH6 and PMS2. Cases demonstrating loss of MLH1 staining were subjected to EpiTYPER for quantitative methylation of the MLH1 promoter region using the Agena MassARRAY® platform. Forty-one (28.28%) cases showed complete loss of tumour nuclei staining for ≥ 1 immunohistochemical stains. Twenty cases (13.79%) showed loss of MLH1/PMS2, 16 cases (11.03%) demonstrated isolated MLH1 loss and one case (0.69%) showed loss of MLH1, PMS2 and MSH6. Two cases showed isolated MSH6 loss and 2 cases showed loss of MSH2 and MSH6. Thirty-seven (90.24%) of 41 mismatch repair-deficient cases showed MLH1 loss. Most (83.78%) of these showed promoter hypermethylation, suggesting a sporadic occurrence of carcinogenesis. The patients from whom the two cases with isolated MSH6 loss, two cases with MSH2/MSH6 loss, and the six cases whereby MLH1 was not explained by methylation should be identified and offered genetic counselling with a view to possible germline mutation assessment as these patients are suspected of having Lynch syndrome. Thus, this study demonstrates a possible 10/145 (6.90%) patients who may have LS and require further testing and suggests a need to screen possible LS patients in the South African population.
{"title":"Identification of possible Lynch syndrome in endometrial carcinomas at a public hospital in South Africa","authors":"R. Wadee, W. Grayson","doi":"10.1080/20742835.2020.1745461","DOIUrl":"https://doi.org/10.1080/20742835.2020.1745461","url":null,"abstract":"Endometrial carcinomas are common malignancies worldwide. Microsatellite instability is often identified in endometrioid endometrial carcinomas (EECs) and in most Lynch syndrome (LS) associated tumours. The authors aimed to identify the number of EECs at a South African public hospital, using the four-mismatch repair immunohistochemical stains, which may suggest possible LS, for the period 2009–2015. Following ethical clearance, 145 cases of archived EEC underwent immunohistochemical testing for MLH1, MSH2, MSH6 and PMS2. Cases demonstrating loss of MLH1 staining were subjected to EpiTYPER for quantitative methylation of the MLH1 promoter region using the Agena MassARRAY® platform. Forty-one (28.28%) cases showed complete loss of tumour nuclei staining for ≥ 1 immunohistochemical stains. Twenty cases (13.79%) showed loss of MLH1/PMS2, 16 cases (11.03%) demonstrated isolated MLH1 loss and one case (0.69%) showed loss of MLH1, PMS2 and MSH6. Two cases showed isolated MSH6 loss and 2 cases showed loss of MSH2 and MSH6. Thirty-seven (90.24%) of 41 mismatch repair-deficient cases showed MLH1 loss. Most (83.78%) of these showed promoter hypermethylation, suggesting a sporadic occurrence of carcinogenesis. The patients from whom the two cases with isolated MSH6 loss, two cases with MSH2/MSH6 loss, and the six cases whereby MLH1 was not explained by methylation should be identified and offered genetic counselling with a view to possible germline mutation assessment as these patients are suspected of having Lynch syndrome. Thus, this study demonstrates a possible 10/145 (6.90%) patients who may have LS and require further testing and suggests a need to screen possible LS patients in the South African population.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"12 1","pages":"12 - 6"},"PeriodicalIF":0.3,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2020.1745461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42515173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-02DOI: 10.1080/20742835.2020.1740434
A. Botha, L. Mbodi, R. Wadee
Neuroendocrine carcinomas (Merkel cell carcinomas) of the vulva are extremely rare tumours, with very few cases reported to date. Herein, a primary neuroendocrine carcinoma (Merkel cell carcinoma) of the vulva is reported. A 34-year-old HIV-positive female on antiretroviral therapy presented with a four-month history of a right-sided vulval mass. She underwent surgical excision of a histologically confirmed neuroendocrine carcinoma. Twenty-four weeks after surgery, she died. This case illustrates the importance of a broad differential diagnosis for neoplasms in the usual sites, and the aggressive nature of this tumour, which to date has had limited effective treatment options.
{"title":"Advanced neuroendocrine carcinoma (Merkel cell carcinoma) of the vulva: a case report and literature review","authors":"A. Botha, L. Mbodi, R. Wadee","doi":"10.1080/20742835.2020.1740434","DOIUrl":"https://doi.org/10.1080/20742835.2020.1740434","url":null,"abstract":"Neuroendocrine carcinomas (Merkel cell carcinomas) of the vulva are extremely rare tumours, with very few cases reported to date. Herein, a primary neuroendocrine carcinoma (Merkel cell carcinoma) of the vulva is reported. A 34-year-old HIV-positive female on antiretroviral therapy presented with a four-month history of a right-sided vulval mass. She underwent surgical excision of a histologically confirmed neuroendocrine carcinoma. Twenty-four weeks after surgery, she died. This case illustrates the importance of a broad differential diagnosis for neoplasms in the usual sites, and the aggressive nature of this tumour, which to date has had limited effective treatment options.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"12 1","pages":"1 - 5"},"PeriodicalIF":0.3,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2020.1740434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47676158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-02DOI: 10.1080/20742835.2020.1754659
Sanele E Mhlongo, T. Naidoo, Bongumusa S Makhathini
Background: A study was conducted to determine the accuracy of preoperative endometrial sampling histology type and tumour grade results compared with the final postoperative diagnosis. Methods: This was a retrospective chart audit of patients with endometrial cancer and atypical hyperplasia admitted to Grey’s Hospital in Pietermaritzburg, South Africa, from January 2013 to December 2017. Results: Sixty patients met the inclusion criteria. For endometrial cancer histological types, the accuracy of preoperative endometrial sampling was 94.7% (36/38) for endometrioid adenocarcinoma, 42.9% (3/7) for serous papillary carcinoma, 85.7% (6/7) for carcinosarcoma and 75% (9/12) for atypical hyperplasia. A kappa value of 0.825 was obtained with a p-value of 0.000 for agreement between preoperative endometrial sampling and the final postoperative diagnosis. For endometrioid adenocarcinoma tumour grading 1–3 (G1–3), only 16/38 (42.1%) patients met the criteria to compare the pre- and postoperative results, which were as follows: of the eight patients with grade 1 tumour on preoperative sampling one patient (1.25%) was upgraded to grade 2 tumour postoperatively. There were no changes in tumour grading for grade 2 and 3 tumours, 3/3 and 5/5 respectively. Conclusion: Our study results for endometrioid adenocarcinoma are comparable to previous literature. However, there were significant discrepancies for non-endometrioid adenocarcinoma. Deficiencies that need to be addressed by laboratories in order to improve both preoperative surgical staging and postoperative adjuvant therapy planning were also highlighted.
{"title":"Discrepancy between preoperative endometrial sampling and hysterectomy diagnosis in endometrial cancer","authors":"Sanele E Mhlongo, T. Naidoo, Bongumusa S Makhathini","doi":"10.1080/20742835.2020.1754659","DOIUrl":"https://doi.org/10.1080/20742835.2020.1754659","url":null,"abstract":"Background: A study was conducted to determine the accuracy of preoperative endometrial sampling histology type and tumour grade results compared with the final postoperative diagnosis. Methods: This was a retrospective chart audit of patients with endometrial cancer and atypical hyperplasia admitted to Grey’s Hospital in Pietermaritzburg, South Africa, from January 2013 to December 2017. Results: Sixty patients met the inclusion criteria. For endometrial cancer histological types, the accuracy of preoperative endometrial sampling was 94.7% (36/38) for endometrioid adenocarcinoma, 42.9% (3/7) for serous papillary carcinoma, 85.7% (6/7) for carcinosarcoma and 75% (9/12) for atypical hyperplasia. A kappa value of 0.825 was obtained with a p-value of 0.000 for agreement between preoperative endometrial sampling and the final postoperative diagnosis. For endometrioid adenocarcinoma tumour grading 1–3 (G1–3), only 16/38 (42.1%) patients met the criteria to compare the pre- and postoperative results, which were as follows: of the eight patients with grade 1 tumour on preoperative sampling one patient (1.25%) was upgraded to grade 2 tumour postoperatively. There were no changes in tumour grading for grade 2 and 3 tumours, 3/3 and 5/5 respectively. Conclusion: Our study results for endometrioid adenocarcinoma are comparable to previous literature. However, there were significant discrepancies for non-endometrioid adenocarcinoma. Deficiencies that need to be addressed by laboratories in order to improve both preoperative surgical staging and postoperative adjuvant therapy planning were also highlighted.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"12 1","pages":"13 - 16"},"PeriodicalIF":0.3,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2020.1754659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43819294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-03DOI: 10.1080/20742835.2019.1667627
Bongumusa S Makhathini, G. Dreyer, E. Buchmann
Background: A study was undertaken to describe the outcomes of gestational trophoblastic disease (GTD) and to determine the influence of antecedent pregnancy, the distance travelled by patients to Grey's Hospital (GH), and HIV status on the disease and clinical outcomes. Methods: The files of all patients admitted to GH with a diagnosis of GTD from January 2013 to December 2017 were retrospectively reviewed. Results: Sixty-three files were analysed. Thirty-six (57.1%) patients travelled < 80.5 km and 27 (42.9%) travelled ≥ 80.5km to GH. Eighteen (29%) patients were HIV positive with CD4 count ≥ 200 cells/mm3. Twenty-six (41.3%) patients had antecedent term pregnancies, 12 (19.1%) and 11 (17.5%) had antecedent hydatidiform molar pregnancy (HMP) and spontaneous miscarriage respectively. Fifty (79.4%) patients presented with vaginal bleeding. Thirty (47.6%) patients were diagnosed with molar pregnancy and 33 (52.4%) patients had gestational trophoblastic neoplasia (GTN). Fourteen (42.4%) patients received single-drug chemotherapy while 19 (57.6%) received multidrug chemotherapy with a remission rate of 90.9%. The final outcome of the study patients was 41 (65.1%) alive without disease, 2 (3.2%) alive with disease, 3 (4.8%) who died and 17 (27%) lost to follow-up. Antecedent term pregnancy was associated with delayed diagnosis, while HMP was associated with early diagnosis of GTN. Long distance travelled by patients was associated with statistically significant levels of poor compliance and final outcomes. HIV-positive status was associated with higher FIGO staging. Conclusions: The study showed that antecedent pregnancy, HIV status and distance travelled by the patients have an influence on the diagnosis, staging and treatment outcomes of GTN respectively. However, more prospective research is needed to further substantiate these findings.
{"title":"Gestational trophoblastic disease managed at Grey's Tertiary Hospital: a five-year descriptive study","authors":"Bongumusa S Makhathini, G. Dreyer, E. Buchmann","doi":"10.1080/20742835.2019.1667627","DOIUrl":"https://doi.org/10.1080/20742835.2019.1667627","url":null,"abstract":"Background: A study was undertaken to describe the outcomes of gestational trophoblastic disease (GTD) and to determine the influence of antecedent pregnancy, the distance travelled by patients to Grey's Hospital (GH), and HIV status on the disease and clinical outcomes. Methods: The files of all patients admitted to GH with a diagnosis of GTD from January 2013 to December 2017 were retrospectively reviewed. Results: Sixty-three files were analysed. Thirty-six (57.1%) patients travelled < 80.5 km and 27 (42.9%) travelled ≥ 80.5km to GH. Eighteen (29%) patients were HIV positive with CD4 count ≥ 200 cells/mm3. Twenty-six (41.3%) patients had antecedent term pregnancies, 12 (19.1%) and 11 (17.5%) had antecedent hydatidiform molar pregnancy (HMP) and spontaneous miscarriage respectively. Fifty (79.4%) patients presented with vaginal bleeding. Thirty (47.6%) patients were diagnosed with molar pregnancy and 33 (52.4%) patients had gestational trophoblastic neoplasia (GTN). Fourteen (42.4%) patients received single-drug chemotherapy while 19 (57.6%) received multidrug chemotherapy with a remission rate of 90.9%. The final outcome of the study patients was 41 (65.1%) alive without disease, 2 (3.2%) alive with disease, 3 (4.8%) who died and 17 (27%) lost to follow-up. Antecedent term pregnancy was associated with delayed diagnosis, while HMP was associated with early diagnosis of GTN. Long distance travelled by patients was associated with statistically significant levels of poor compliance and final outcomes. HIV-positive status was associated with higher FIGO staging. Conclusions: The study showed that antecedent pregnancy, HIV status and distance travelled by the patients have an influence on the diagnosis, staging and treatment outcomes of GTN respectively. However, more prospective research is needed to further substantiate these findings.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"15 - 19"},"PeriodicalIF":0.3,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1667627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45716787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-03DOI: 10.1080/20742835.2019.1702299
J. Butt, M. Botha
Introduction: Bony metastases in cervical carcinoma are rare; however, autopsy studies indicate that they are underdiagnosed. A retrospective study was undertaken to describe the risk factors and tumour characteristics and estimate the prevalence of bone involvement in women with cervical cancer at a tertiary institution in South Africa. Methods: A retrospective cohort analysis of women with cervical cancer diagnosed between 2014 and 2015 was undertaken. Demographic, treatment and follow-up data were collected for all women with bone metastases confirmed by imaging. Descriptive statistics were generated. Results: The study identified 642 patients with cervical carcinoma, of whom 25 (3.89%) were diagnosed with bone involvement. Ten women had bone involvement at diagnosis and 15 women at recurrence, occurring a median of 286 days after primary treatment. Survival after the diagnosis of bone metastases was short, with 88% of patients dying within six months. The WHO performance status score at diagnosis was a significant predictor of survival (p = 0.024). A prognostic score was utilised and those with a high score had a significantly shorter survival (median 61 days) than those with a low score (median 158 days) (p = 0.0065). Conclusions: Although bone metastases are rare in women with cervical cancer, they are important to recognise. Healthcare workers should be vigilant regarding increased analgesic use and chronic pain, as these may indicate bone involvement. As survival is short, a prognostic score is valuable in tailoring treatment. A patient’s quality of life may be greatly improved by an appropriate radiotherapy and palliative care plan.
{"title":"Bone involvement in patients with cervical carcinoma: a single-institution cohort study","authors":"J. Butt, M. Botha","doi":"10.1080/20742835.2019.1702299","DOIUrl":"https://doi.org/10.1080/20742835.2019.1702299","url":null,"abstract":"Introduction: Bony metastases in cervical carcinoma are rare; however, autopsy studies indicate that they are underdiagnosed. A retrospective study was undertaken to describe the risk factors and tumour characteristics and estimate the prevalence of bone involvement in women with cervical cancer at a tertiary institution in South Africa. Methods: A retrospective cohort analysis of women with cervical cancer diagnosed between 2014 and 2015 was undertaken. Demographic, treatment and follow-up data were collected for all women with bone metastases confirmed by imaging. Descriptive statistics were generated. Results: The study identified 642 patients with cervical carcinoma, of whom 25 (3.89%) were diagnosed with bone involvement. Ten women had bone involvement at diagnosis and 15 women at recurrence, occurring a median of 286 days after primary treatment. Survival after the diagnosis of bone metastases was short, with 88% of patients dying within six months. The WHO performance status score at diagnosis was a significant predictor of survival (p = 0.024). A prognostic score was utilised and those with a high score had a significantly shorter survival (median 61 days) than those with a low score (median 158 days) (p = 0.0065). Conclusions: Although bone metastases are rare in women with cervical cancer, they are important to recognise. Healthcare workers should be vigilant regarding increased analgesic use and chronic pain, as these may indicate bone involvement. As survival is short, a prognostic score is valuable in tailoring treatment. A patient’s quality of life may be greatly improved by an appropriate radiotherapy and palliative care plan.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"31 - 37"},"PeriodicalIF":0.3,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1702299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47906024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-03DOI: 10.1080/20742835.2019.1701257
P. G. Shiba, Vinay Sharma
Background: Venous thromboembolism (VTE) is a frequent cause of morbidity in patients with cervical cancer. The aim of this study was to investigate the survival outcomes of patients with cervical cancer and VTE in a South African population. Material and methods: The records of 47 cervical cancer patients with a concomitant diagnosis of a deep vein thrombosis (DVT)/VTE who were admitted to the radiation oncology ward at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2015 and 2016 were identified and analysed retrospectively. Data collected included the age, stage, human immunodeficiency virus (HIV) status and details of diagnosis of VTE and the treatment received. The survival of patients from diagnosis of VTE and the two-year overall survival (OS) rate was calculated using the Kaplan–Meier method. Univariate and multivariate analyses of factors influencing survival were performed on selected clinical variables. Results: The majority of patients (60%) had stage IIIB cervical cancer; 60% of patients were HIV-positive. The median survival of patients from the time of diagnosis of VTE was 2.7 months (interquartile range [IQR]: 0.97–6.93 months) and the 12-month survival from diagnosis of VTE for this cohort was 17%. Once a VTE was diagnosed the survival becomes poor irrespective of age, stage or HIV status. The two-year OS of this cohort from date of diagnosis of cancer was 29.8%. Patients who were diagnosed with a VTE before or during radiotherapy had a significantly lower OS than that of patients who were diagnosed with a VTE after radiotherapy (12.5% versus 38.7%), p = 0.004. Conclusion: The diagnosis of VTE is a poor prognostic factor in patients with locally advanced cervical cancer.
背景:静脉血栓栓塞(VTE)是宫颈癌患者发病的常见原因。本研究的目的是调查南非人群中宫颈癌和静脉血栓栓塞患者的生存结果。材料与方法:回顾性分析2015年和2016年在Charlotte Maxeke约翰内斯堡学术医院(CMJAH)放射肿瘤学病房收治的47例合并深静脉血栓形成(DVT)/VTE的宫颈癌患者的记录。收集的数据包括年龄、分期、人类免疫缺陷病毒(HIV)状况、静脉血栓栓塞的诊断细节和接受的治疗。采用Kaplan-Meier法计算VTE诊断后患者的生存率和2年总生存率(OS)。对选定的临床变量进行影响生存的单因素和多因素分析。结果:大多数患者(60%)为IIIB期宫颈癌;60%的患者呈hiv阳性。患者自诊断为静脉血栓栓塞后的中位生存期为2.7个月(四分位数间距[IQR]: 0.97-6.93个月)，该队列患者自诊断为静脉血栓栓塞后的12个月生存率为17%。一旦被诊断出静脉血栓栓塞，无论年龄、阶段或艾滋病毒状况如何，生存率都很低。该队列自癌症诊断之日起的两年总生存率为29.8%。放疗前或放疗中诊断为静脉血栓栓塞的患者的OS明显低于放疗后诊断为静脉血栓栓塞的患者(12.5% vs 38.7%)， p = 0.004。结论:静脉血栓栓塞的诊断是影响局部晚期宫颈癌患者预后的重要因素。
{"title":"The impact of venous thromboembolism on the outcomes of patients with cervical carcinoma, a retrospective analysis at a single institution","authors":"P. G. Shiba, Vinay Sharma","doi":"10.1080/20742835.2019.1701257","DOIUrl":"https://doi.org/10.1080/20742835.2019.1701257","url":null,"abstract":"Background: Venous thromboembolism (VTE) is a frequent cause of morbidity in patients with cervical cancer. The aim of this study was to investigate the survival outcomes of patients with cervical cancer and VTE in a South African population. Material and methods: The records of 47 cervical cancer patients with a concomitant diagnosis of a deep vein thrombosis (DVT)/VTE who were admitted to the radiation oncology ward at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2015 and 2016 were identified and analysed retrospectively. Data collected included the age, stage, human immunodeficiency virus (HIV) status and details of diagnosis of VTE and the treatment received. The survival of patients from diagnosis of VTE and the two-year overall survival (OS) rate was calculated using the Kaplan–Meier method. Univariate and multivariate analyses of factors influencing survival were performed on selected clinical variables. Results: The majority of patients (60%) had stage IIIB cervical cancer; 60% of patients were HIV-positive. The median survival of patients from the time of diagnosis of VTE was 2.7 months (interquartile range [IQR]: 0.97–6.93 months) and the 12-month survival from diagnosis of VTE for this cohort was 17%. Once a VTE was diagnosed the survival becomes poor irrespective of age, stage or HIV status. The two-year OS of this cohort from date of diagnosis of cancer was 29.8%. Patients who were diagnosed with a VTE before or during radiotherapy had a significantly lower OS than that of patients who were diagnosed with a VTE after radiotherapy (12.5% versus 38.7%), p = 0.004. Conclusion: The diagnosis of VTE is a poor prognostic factor in patients with locally advanced cervical cancer.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"25 - 30"},"PeriodicalIF":0.3,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1701257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48020983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-03DOI: 10.1080/20742835.2019.1679528
AD Olanlesi-Aliu, PD Martin, F. Daniels
Objective: Through the identification of the barriers to the uptake of prevention services for cervical cancer and ways to promote prevention of cervical cancer in the community, this research study purposed the development of a community-based model for promoting cervical cancer prevention among Yoruba women living in Ibadan, Nigeria. Method: An exploratory, descriptive design was used to collect data from 20 health workers and four policy makers using semi-structured interviews and key informant interviews respectively. The PEN-3 cultural model developed by Airhenbuwa in 1998 guided the exploration of the barriers to the uptake of available prevention services for cervical cancer, and the ways to promote the prevention of cervical cancer. Three interrelated and interdependent primary domains, namely cultural identity, relationships and expectations, and cultural empowerment, form the basis of the PEN-3 model. Cultural identity emphasises the subjective responses in relation to the community and cervical cancer prevention. Relationships and expectations determined health workers’ and policy-makers’ experience of community members’ perception of cervical cancer. Enablers and nurturers alluded to the availability and accessibility of cervical cancer prevention resources, and the reinforcing factors that the women receive from their social networks. The central assumption of this theory is that health beliefs and actions that are harmful to health should be changed and the community's positive decisions and practices related to promoting a healthy lifestyle should be identified. Results: Findings from the health workers and policy-makers confirmed that community members lack knowledge and awareness of cervical cancer. Moreover, the findings show that the inaccessibility and unavailability of cervical cancer screening services play a role in its poor uptake. Conclusion: There is need for awareness creation of cervical cancer, and provision of prevention services at the community level. Screening services should be provided to women at subsidised cost. In order to contextualise the discussion, theoretical perspectives on cervical cancer are alluded to.
{"title":"Towards the development of a community-based model for promoting cervical cancer prevention among Yoruba women in Ibadan Nigeria: application of PEN-3 model","authors":"AD Olanlesi-Aliu, PD Martin, F. Daniels","doi":"10.1080/20742835.2019.1679528","DOIUrl":"https://doi.org/10.1080/20742835.2019.1679528","url":null,"abstract":"Objective: Through the identification of the barriers to the uptake of prevention services for cervical cancer and ways to promote prevention of cervical cancer in the community, this research study purposed the development of a community-based model for promoting cervical cancer prevention among Yoruba women living in Ibadan, Nigeria. Method: An exploratory, descriptive design was used to collect data from 20 health workers and four policy makers using semi-structured interviews and key informant interviews respectively. The PEN-3 cultural model developed by Airhenbuwa in 1998 guided the exploration of the barriers to the uptake of available prevention services for cervical cancer, and the ways to promote the prevention of cervical cancer. Three interrelated and interdependent primary domains, namely cultural identity, relationships and expectations, and cultural empowerment, form the basis of the PEN-3 model. Cultural identity emphasises the subjective responses in relation to the community and cervical cancer prevention. Relationships and expectations determined health workers’ and policy-makers’ experience of community members’ perception of cervical cancer. Enablers and nurturers alluded to the availability and accessibility of cervical cancer prevention resources, and the reinforcing factors that the women receive from their social networks. The central assumption of this theory is that health beliefs and actions that are harmful to health should be changed and the community's positive decisions and practices related to promoting a healthy lifestyle should be identified. Results: Findings from the health workers and policy-makers confirmed that community members lack knowledge and awareness of cervical cancer. Moreover, the findings show that the inaccessibility and unavailability of cervical cancer screening services play a role in its poor uptake. Conclusion: There is need for awareness creation of cervical cancer, and provision of prevention services at the community level. Screening services should be provided to women at subsidised cost. In order to contextualise the discussion, theoretical perspectives on cervical cancer are alluded to.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"20 - 24"},"PeriodicalIF":0.3,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1679528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48576179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-02DOI: 10.1080/20742835.2019.1589183
Lwangila W Shabani, M. Moodley, T. Naidoo
Objectives: This study compared the knowledge, awareness and attitude towards the human papilloma virus (HPV) vaccine between urban and rural population groups. Materials and methods: A comparative and descriptive study was undertaken of 200 women attending gynaecological services in the Pietermaritzburg Hospitals Complex. A systematic random sampling and interview-administered questionnaire was conducted. The study analysed demographic data and compared the similarities/differences in terms of awareness, knowledge, attitude and uptake of HPV vaccine between the groups. Results: Some 29% of urban participants as compared with 27% of rural participants knew about HPV; 72% lacked knowledge and awareness of HPV (71.0% urban and 73% rural). Of the urban population, 12% knew that HPV vaccine existed and protected against HPV transmission, 54% did not know, whilst 34% wished to know more. Only 7% of the rural population knew that the HPV vaccine existed and protected against HPV transmission, 57% did not know and 36% expressed the wish to know more. Overall 25% of the participants agreed on HPV vaccine safety (urban, 28 vs. rural, 22), while among the rest of the participants 75% were unsure. In total 57% of participants were unsure as to whether the HPV vaccine could encourage sexual promiscuity (urban, 56 vs. rural, 59), 21 urban dwellers agreed that the HPV vaccine could encourage sexual promiscuity and 23 disagreed. In the rural populations, 24 agreed and 17 disagreed. Conclusion: The knowledge and awareness of the HPV vaccine was generally poor among both the urban and rural population groups. However, both rural and urban dwellers expressed the need for more information about the HPV vaccine before they could recommend the vaccine.
{"title":"Knowledge, awareness and attitude towards human papilloma virus vaccine in a resource-constrained setting: a comparison between an urban and rural population in South Africa","authors":"Lwangila W Shabani, M. Moodley, T. Naidoo","doi":"10.1080/20742835.2019.1589183","DOIUrl":"https://doi.org/10.1080/20742835.2019.1589183","url":null,"abstract":"Objectives: This study compared the knowledge, awareness and attitude towards the human papilloma virus (HPV) vaccine between urban and rural population groups. Materials and methods: A comparative and descriptive study was undertaken of 200 women attending gynaecological services in the Pietermaritzburg Hospitals Complex. A systematic random sampling and interview-administered questionnaire was conducted. The study analysed demographic data and compared the similarities/differences in terms of awareness, knowledge, attitude and uptake of HPV vaccine between the groups. Results: Some 29% of urban participants as compared with 27% of rural participants knew about HPV; 72% lacked knowledge and awareness of HPV (71.0% urban and 73% rural). Of the urban population, 12% knew that HPV vaccine existed and protected against HPV transmission, 54% did not know, whilst 34% wished to know more. Only 7% of the rural population knew that the HPV vaccine existed and protected against HPV transmission, 57% did not know and 36% expressed the wish to know more. Overall 25% of the participants agreed on HPV vaccine safety (urban, 28 vs. rural, 22), while among the rest of the participants 75% were unsure. In total 57% of participants were unsure as to whether the HPV vaccine could encourage sexual promiscuity (urban, 56 vs. rural, 59), 21 urban dwellers agreed that the HPV vaccine could encourage sexual promiscuity and 23 disagreed. In the rural populations, 24 agreed and 17 disagreed. Conclusion: The knowledge and awareness of the HPV vaccine was generally poor among both the urban and rural population groups. However, both rural and urban dwellers expressed the need for more information about the HPV vaccine before they could recommend the vaccine.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"1 - 6"},"PeriodicalIF":0.3,"publicationDate":"2019-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1589183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43403120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-02DOI: 10.1080/20742835.2019.1591808
R. Wadee
Diffuse large B-cell lymphomas are fairly common adult haematolymphoid malignancies. Approximately 40% of such tumours may present in an extranodal site. These lymphomas are, however, infrequently identified in the female genital tract and even more rarely, identified in the endometrium. The histopathological features and molecular findings of endometrial diffuse large B-cell lymphoma are discussed herein. A 36-year old female presented with per vaginal bleeding. She underwent an endometrial curettage, which demonstrated morphological and immunophenotypical features of a diffuse large B-cell lymphoma. Amplification of the immunoglobulin heavy chain (IgH) gene by polymerase chain reaction (PCR) confirmed B-cell clonality. Epstein–Barr encoding region (EBER) in-situ hybridisation was positive in tumour cells. Fluorescent in-situ hybridisation (FISH) for the detection of BCL6 and MYC gene rearrangement as well as for the detection of the t(14;18) (q32;q21) translocation was performed, all of which yielded negative results. Unfortunately, the patient was lost to follow-up. Whilst diffuse large B-cell lymphoma is not a commonly identified tumour within the uterine cavity, it should be included in the differential diagnosis of endometrial neoplastic infiltrates so as not to misdiagnose this tumour. This facilitates rapid commencement of further management for the patient.
{"title":"Diffuse large B-cell lymphoma of the endometrium: an unusual site for primary presentation","authors":"R. Wadee","doi":"10.1080/20742835.2019.1591808","DOIUrl":"https://doi.org/10.1080/20742835.2019.1591808","url":null,"abstract":"Diffuse large B-cell lymphomas are fairly common adult haematolymphoid malignancies. Approximately 40% of such tumours may present in an extranodal site. These lymphomas are, however, infrequently identified in the female genital tract and even more rarely, identified in the endometrium. The histopathological features and molecular findings of endometrial diffuse large B-cell lymphoma are discussed herein. A 36-year old female presented with per vaginal bleeding. She underwent an endometrial curettage, which demonstrated morphological and immunophenotypical features of a diffuse large B-cell lymphoma. Amplification of the immunoglobulin heavy chain (IgH) gene by polymerase chain reaction (PCR) confirmed B-cell clonality. Epstein–Barr encoding region (EBER) in-situ hybridisation was positive in tumour cells. Fluorescent in-situ hybridisation (FISH) for the detection of BCL6 and MYC gene rearrangement as well as for the detection of the t(14;18) (q32;q21) translocation was performed, all of which yielded negative results. Unfortunately, the patient was lost to follow-up. Whilst diffuse large B-cell lymphoma is not a commonly identified tumour within the uterine cavity, it should be included in the differential diagnosis of endometrial neoplastic infiltrates so as not to misdiagnose this tumour. This facilitates rapid commencement of further management for the patient.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"11 - 14"},"PeriodicalIF":0.3,"publicationDate":"2019-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1591808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49139316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-02DOI: 10.1080/20742835.2019.1603833
K. Hapsari, J. Makin, G. Dreyer
Background: The purpose of the study was to evaluate the predictive value of serum CA-125 levels in the preoperative assessment of endometrial carcinoma in a setting where late presentation is common. Method: This retrospective study evaluated women with pathologically proven endometrial carcinoma scheduled for surgery between January 2012 and January 2017, who had preoperative serum CA-125 test results. The association of CA-125 with a variety of histological factors was evaluated using Spearman’s correlation and receiver operator characteristic (ROC) curves to evaluate sensitivity and specificity. Results: Fifty-eight patients were included in the study, 34 (58.6%) of whom were FIGO stage II–IV. Elevated CA-125 levels were significantly correlated with late FIGO stage (p < 0.001), myometrial invasion (p < 0.001) and lymph node metastases (p < 0.001). The most appropriate cut-off point of CA-125, where an increase in sensitivity was not associated with a fall-off in specificity, was 20 IU/ml, reaching a sensitivity of 90% and a specificity of 67% for detection of lymph node metastases. Conclusion: Among this group of women with endometrial cancer, the preoperative serum CA-125 level was associated with lymph node metastases and we found a CA-125 of 20 IU/ml or more to be predictive. These findings suggest that, among similar populations, CA-125 could be done preoperatively and could be used to determine the need for node dissection. Since our findings are from a small retrospective cohort, this should be validated in a prospective study on early stage disease.
{"title":"The accuracy of preoperative serum CA-125 levels to predict lymph node metastasis in a population of South African women with endometrial carcinoma","authors":"K. Hapsari, J. Makin, G. Dreyer","doi":"10.1080/20742835.2019.1603833","DOIUrl":"https://doi.org/10.1080/20742835.2019.1603833","url":null,"abstract":"Background: The purpose of the study was to evaluate the predictive value of serum CA-125 levels in the preoperative assessment of endometrial carcinoma in a setting where late presentation is common. Method: This retrospective study evaluated women with pathologically proven endometrial carcinoma scheduled for surgery between January 2012 and January 2017, who had preoperative serum CA-125 test results. The association of CA-125 with a variety of histological factors was evaluated using Spearman’s correlation and receiver operator characteristic (ROC) curves to evaluate sensitivity and specificity. Results: Fifty-eight patients were included in the study, 34 (58.6%) of whom were FIGO stage II–IV. Elevated CA-125 levels were significantly correlated with late FIGO stage (p < 0.001), myometrial invasion (p < 0.001) and lymph node metastases (p < 0.001). The most appropriate cut-off point of CA-125, where an increase in sensitivity was not associated with a fall-off in specificity, was 20 IU/ml, reaching a sensitivity of 90% and a specificity of 67% for detection of lymph node metastases. Conclusion: Among this group of women with endometrial cancer, the preoperative serum CA-125 level was associated with lymph node metastases and we found a CA-125 of 20 IU/ml or more to be predictive. These findings suggest that, among similar populations, CA-125 could be done preoperatively and could be used to determine the need for node dissection. Since our findings are from a small retrospective cohort, this should be validated in a prospective study on early stage disease.","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"11 1","pages":"10 - 7"},"PeriodicalIF":0.3,"publicationDate":"2019-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2019.1603833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44879598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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