Alita S. Mrema

Survival in Cervical Cancer and Its Predictors at Ocean Road Cancer Institute From January to December 2012

PURPOSE In Tanzania, cancer of cervix is the most commonly diagnosed cancer and is the leading cause of cancer-related deaths. There are very little data about survival of patients with cervical cancer after treatment in Tanzania. The aims of this study were to determine 5-year overall survival (OS) rate and its predictors among patients with cervical cancer treated at Ocean Road Cancer Institute (ORCI) from January to December 2012. MATERIALS AND METHODS This was retrospective study done at ORCI by reviewing medical charts of 202 patients with cervical cancer treated at ORCI from January to December 2012. A structured questionnaire was used to extract information about characteristics of the respondents. Survival curves were estimated by using Kaplan-Meir analysis and were compared by using log-rank test. RESULTS The 5-year OS rate was 26%. The mean and median survival times were 33.9 and 19 months, respectively. Factors that were positively associated with 5-year OS rate include the hemoglobin level more than 9 g/dL at presentation, early International Federation of Gynecology and Obstetrics stage at presentation, high dose of radiotherapy, and use of concurrent chemoradiotherapy. Histology type and HIV status were not associated with survival. CONCLUSION The 5-year overall survival rate was 26%. Predictors of OS were hemoglobin level, stage at presentation, radiotherapy dose, and the use of concurrent chemoradiotherapy.

HIV and Early Treatment Outcomes Among Women With Cervical Cancer Treated With Concurrent Chemoradiation in Tanzania

PURPOSE Cervical cancer (CC) is the leading malignancy in Tanzania. Low-income countries are faced with double epidemics of HIV and CC. This study aimed to investigate how HIV and cancer stage at diagnosis affect early treatment outcomes among women with CC treated with concurrent chemoradiation in Tanzania in the highly active antiretroviral therapy era. MATERIALS AND METHODS This was a prospective cohort study of patients newly diagnosed with CC at the Ocean Road Cancer Institute from November 2019 to January 2020. The tumor response was assessed using RECIST 3 months post-treatment. The tumor response was categorized as a complete or partial response according to the ultrasound and pelvic examination findings. The univariate and multivariate logistic regression explained the relationship between several covariates (age, stage, HIV status, equivalent dose in 2 Gy fractions, chemotherapy cycles, and treatment time) and treatment response. RESULTS A total of 102 patients with CC were included in this study at baseline. After adjusting for other covariates, only completion of treatment within 56 days (odds ratio [OR], 9.23; 95% CI, 1.53 to 55.85; P = .016) and receiving at least three cycles of cisplatin (OR, 5.6; 95% CI, 1.47 to 21.34; P = .012) were significantly associated with complete tumor response. HIV status was not significantly associated with complete tumor response (OR, 1.534; 95% CI, 0.424 to 5.545; P = .5144). CONCLUSION Early treatment response was independent of HIV status. With wide coverage of anitretroviral therapy, patients with HIV can receive radical treatment and have the same early outcomes as their HIV-negative counterparts.