The intercostobrachial nerve (ICBN) is responsible for the sensory</span></span></span></span></span><span><span><span><span><span><span style="font-...The intercostobrachial nerve (ICBN) is responsible for the sensory</span></span></span></span></span><span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> innervation of a part of the inner side of the arm. Injury of the intercostobrachial nerve is </span><span style="font-family:Verdana;">a complication of axillary dissection during lymph node dissection.</span> <b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">This study aimed to determine the effect of preservation of the</span><span style="font-family:Verdana;"> intercostobra</span><span><span style="font-family:Verdana;">chial nerve on postoperative sensory disturbances. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a</span></span><span style="font-family:Verdana;"> prospective, single-center study which was carried out in 90 patients followed in the oncology department of the Aristide Le Dantec hospital in Dakar, suffering </span><span style="font-family:Verdana;">from breast cancer and having undergone breast surgery associated with</span><span style="font-family:Verdana;"> axillary </span><span style="font-family:Verdana;">dissection, for a period of 6 months. The patients were divided into two</span><span style="font-family:Verdana;"> groups depending on whether the intercostobrachial nerve (ICBN) was preserved or </span><span style="font-family:Verdana;">not. The two groups were compared in terms of the incidence of sensory</span><span style="font-family:Verdana;"> disturbances. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Sixty patients without nerve preservation and 30 patients with nerve preservation were included in the study, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;">, 90 patients in total. </span><span style="font-family:Verdana;">ICBN was injured in 60 pa展开更多
<strong>Objectives:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> To study the epidemiological, diagnos...<strong>Objectives:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> To study the epidemiological, diagnostic, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognostic aspects of gastric adenocarcinoma at the Joliot Curie Institute in Dakar. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">We conducted a retrospective study over </span><span style="font-family:Verdana;">a seven-year period</span><span style="font-family:Verdana;"> from January 2010 to December 2017 at the Joliot Curie Institute in Dakar. All cases of gastric adenocarcinoma proven by </span><span style="font-family:Verdana;">fibroscopy</span><span style="font-family:Verdana;"> followed by histology or proven on the histological analysis of a surgical specimen were taken into account. The parameters studied were age, risk factors, stages of the disease, treatment </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognosis. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There were 54 cases of gastric adenocarcinoma </span><span style="font-family:Verdana;">over a period of</span><span style="font-family:Verdana;"> 7 years. The average age was 54.74 years with extremes of 25 and 84 years. A male predominance was noted (35/54). The main risk factors found were alcohol (5/54), tobacco (13/54), </span><i><span style="font-family:Verdana;">Helicobacter </span><span style="font-family:Verdana;">pilori</span></i><span style="font-family:Verdana;"> (4/54), gastric ulcer (12/54). Epigastralgia was the most frequent clinical manifestation. </span><span style="font-family:Verdana;">FOGD</span><span style="font-family:Verdana;"> was carried out in 77.8% of patients. Histology was obtained before surgery in 40 patients (74.1% of cases) and </span><span style="font-family:Verdana;">on</span><span style="font-family:Ve展开更多
<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have imp...<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have improved the toxicities of radiotherapy. We are evaluating the 3D technique in prostate cancer. </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Retrospective study from January 2015 to December 2015 with 29 files. Survival was calculated by Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We collected 29 patient records over the study period. The median age was 75 years with the following extremes: 54 years and 83 years. The median PSA level was 12 ng/ml with a range of 3.05 to 79 ng/ml. Gleason score analysis showed 6 patients (20.69%) with a score of 6 (3 + 3), 23 patients (79.31%) with a score of 7 including 12 patients (41.38%) with grade 3 and 11 patients (37.93%) with grade 4. The median dose delivered was 74 Gy, with a mean dose of 73.79 Gy and extremes of 70 Gy for the minimum and 76 Gy for the maximum. Hormone therapy was combined with radiotherapy in 17 patients (58.62%). Sev</span><span style="font-family:Verdana;">en patients (24.14%) had grade 1 acute bladder toxicity and one patient</span><span style="font-family:Verdana;"> (3.45%) </span><span style="font-family:Verdana;">had grade 2 acute toxicity. Late bladder toxicity was grade 1 in 5 patients</span><span style="font-family:Verdana;"> (17.24%), grade 2 in 3 patients (10.34%) and grade 3 in 1 patient (3.45%). </span><span style="font-family:Verdana;">Late rectal toxicity, grade 2 in 3 patients (10.34%), grade 3 in 1 patient, was noted. Overall survival at 2 years was 100% and 89.65% at 5 years. Relapse-free </span><span><span style="font-family:Verdana;">survival at 2 years was 82.76% and 62.07% at 5 years. There were 3 deaths (10.34%) of which only one was related to prostate cancer. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span></span><展开更多
<strong>Introduction: </strong>A shoulder mass revealing metastatic prostate cancer is very rare. We report a case of metastatic prostate cancer diagnosed on a shoulder mass and treated with analgesic radi...<strong>Introduction: </strong>A shoulder mass revealing metastatic prostate cancer is very rare. We report a case of metastatic prostate cancer diagnosed on a shoulder mass and treated with analgesic radiotherapy and chemotherapy and androgen deprivation therapy (ADT).<strong> Observations:</strong> A 66 years old patient was referred for a painful right shoulder mass whose biopsy and pathological examination found a Gleason 8 (4 + 4) moderately differentiated adenocarcinoma. The PSA level was 508.52 ng/ml. The patient was treated with analgesic radiotherapy on the right shoulder and chemo-hormonal therapy. At 2 years follow-up, the disease was well controlled. <strong>Conclusion:</strong> A shoulder mass revealing metastatic prostate cancer is not common. Local treatment of the symptomatic metastasis while continuing chemotherapy and ADT improves the quality of life.展开更多
<strong>Objective:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Describe the epidemiological, diagnostic, therapeutic...<strong>Objective:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Describe the epidemiological, diagnostic, therapeutic and evolutionary profile of triple negative breast cancer at the Dakar Cancer Institute in Senegal. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study between January 1, 2011 and December 31, 2014. All patients with a triple negative molecular profile were included. The data were collected from the medical records of the patients. The data were entered and analyzed with SPSS edition 16 software under Windows 7</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Two hundred and twenty-five patients were selected. The mean age was 47.9 ± 12.5 years with extremes of 25 and 90 years. The main reason for consultation was dominated by the finding of a breast lump. The mean clinical tumor size was 8</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">54 cm with a large majority of T3-T4 tumors 26% and 63% respectively, lymph node involvement in one hundred and seventy-two cases (76.4%);twenty eight patients (12.4%) were metastatic from the outset. Non-specific invasive carcinoma was the most common histologic type (78.2%), and more than half of the patients (53.3%) had an aggressive tumor (Scarff-Bloom-Richardson grading III). Neoadjuvant chemotherapy was performed in 65.78% of cases. We noted 27.7% total response and 41.7% partial response in patients who have received this neoadjuvant chemotherapy. The surgery was radical in 77% of cases, conservative in 14% and cle展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data to codify the management. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The objective was to study the clinical and therapeutic aspects and the fate of patients after a follow-up of at least 4 years. Thus contributing to the limited body of knowledge on these tumors. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> a retrospective analysis of the files from 2013 to 2017 was carried out and patients were followed up until 2021at Hassan II Hospital. Epidemiological, clinical and therapeutic aspects were studied. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We collected 12 charts of patients treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years. The circumstance of discovery was marked by the presence of nodule in all patients. The coupled echo-mammography examination classified the nodules, ACR 4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological examination revealed a phylloid sarcoma in 11 patients and a borderline phylloid tumor in 1 patient. All patients had radical surgery with positive margins in 2 patients, 16.66%. One patient had revision surgery. Histological examination of the surgical specimens showed phylloid sarcoma on all specimens. All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2 Gy and a boost of 10 Gy was done in one patient. The median spread of radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3 patients respectively. The median time from surgery to radiotherapy was 2.95 months. 3 patients relapsed after 13.6 months of follow-up. The recurrence-free survival at 1 and 3 years was 83% and 75% respectively. Overall survival at 3 and 5 y展开更多
Diagnostic Reference Levels (DRLs) are indicators that allow assessing the quality of equipment and procedures from the point of view of the doses delivered to patients and subsequently initiate corrective actions if ...Diagnostic Reference Levels (DRLs) are indicators that allow assessing the quality of equipment and procedures from the point of view of the doses delivered to patients and subsequently initiate corrective actions if necessary. The purpose of this study is to encourage health professionals to investigate patient radiation doses and to determine whether those doses comply with the principles of radiation protection in medical fields so as to improve practices by reducing patient exposure without reducing clinical effectiveness. To perform this work, we have investigated patient doses for different radiological examinations from six (6) medical centers in Dakar, including the following nine routine types: chest (PA), abdomen (AP), pelvis (AP), cervical spine (AP), lumbar spine (AP, Lat), hip (AP), thoracic spine (AP, Lat). Three types of data were collected, <em>i.e.</em>, X-ray tube machine data, patient data and output measurements. The data were analyzed statistically and the median, minimum, maximum, and third quartile values were calculated and displayed throughout boxplots graphs for all exams and medical centers. The two sigma range (95% confidence interval) was also checked. Comparison of third quartiles of Entrance Surface Dose (ESD) and Dose Area Product (DAP) by type of examination with recommended international DRLs was performed. The third quartile of ESD for pelvis (AP) and thoracic spine (AP) was up to 16% and 38% higher, respectively than their corresponding DRLs in the European Commission Report RP 180 Part 2. For all exams, except thoracic spine (lat), the third quartiles of the dose area product were higher than the corresponding DRLs in the above report. The source of dose variability between medical centers was related to many parameters such as poor radiographic techniques, lack of modern X-ray machines and adequately documented radiation protection practices. The results show the need to develop protocols for dose measurement as well as to carry out quality assurance programs and dose optimiz展开更多
文摘The intercostobrachial nerve (ICBN) is responsible for the sensory</span></span></span></span></span><span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> innervation of a part of the inner side of the arm. Injury of the intercostobrachial nerve is </span><span style="font-family:Verdana;">a complication of axillary dissection during lymph node dissection.</span> <b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">This study aimed to determine the effect of preservation of the</span><span style="font-family:Verdana;"> intercostobra</span><span><span style="font-family:Verdana;">chial nerve on postoperative sensory disturbances. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a</span></span><span style="font-family:Verdana;"> prospective, single-center study which was carried out in 90 patients followed in the oncology department of the Aristide Le Dantec hospital in Dakar, suffering </span><span style="font-family:Verdana;">from breast cancer and having undergone breast surgery associated with</span><span style="font-family:Verdana;"> axillary </span><span style="font-family:Verdana;">dissection, for a period of 6 months. The patients were divided into two</span><span style="font-family:Verdana;"> groups depending on whether the intercostobrachial nerve (ICBN) was preserved or </span><span style="font-family:Verdana;">not. The two groups were compared in terms of the incidence of sensory</span><span style="font-family:Verdana;"> disturbances. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Sixty patients without nerve preservation and 30 patients with nerve preservation were included in the study, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;">, 90 patients in total. </span><span style="font-family:Verdana;">ICBN was injured in 60 pa
文摘<strong>Objectives:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> To study the epidemiological, diagnostic, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognostic aspects of gastric adenocarcinoma at the Joliot Curie Institute in Dakar. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">We conducted a retrospective study over </span><span style="font-family:Verdana;">a seven-year period</span><span style="font-family:Verdana;"> from January 2010 to December 2017 at the Joliot Curie Institute in Dakar. All cases of gastric adenocarcinoma proven by </span><span style="font-family:Verdana;">fibroscopy</span><span style="font-family:Verdana;"> followed by histology or proven on the histological analysis of a surgical specimen were taken into account. The parameters studied were age, risk factors, stages of the disease, treatment </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognosis. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There were 54 cases of gastric adenocarcinoma </span><span style="font-family:Verdana;">over a period of</span><span style="font-family:Verdana;"> 7 years. The average age was 54.74 years with extremes of 25 and 84 years. A male predominance was noted (35/54). The main risk factors found were alcohol (5/54), tobacco (13/54), </span><i><span style="font-family:Verdana;">Helicobacter </span><span style="font-family:Verdana;">pilori</span></i><span style="font-family:Verdana;"> (4/54), gastric ulcer (12/54). Epigastralgia was the most frequent clinical manifestation. </span><span style="font-family:Verdana;">FOGD</span><span style="font-family:Verdana;"> was carried out in 77.8% of patients. Histology was obtained before surgery in 40 patients (74.1% of cases) and </span><span style="font-family:Verdana;">on</span><span style="font-family:Ve
文摘<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have improved the toxicities of radiotherapy. We are evaluating the 3D technique in prostate cancer. </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Retrospective study from January 2015 to December 2015 with 29 files. Survival was calculated by Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We collected 29 patient records over the study period. The median age was 75 years with the following extremes: 54 years and 83 years. The median PSA level was 12 ng/ml with a range of 3.05 to 79 ng/ml. Gleason score analysis showed 6 patients (20.69%) with a score of 6 (3 + 3), 23 patients (79.31%) with a score of 7 including 12 patients (41.38%) with grade 3 and 11 patients (37.93%) with grade 4. The median dose delivered was 74 Gy, with a mean dose of 73.79 Gy and extremes of 70 Gy for the minimum and 76 Gy for the maximum. Hormone therapy was combined with radiotherapy in 17 patients (58.62%). Sev</span><span style="font-family:Verdana;">en patients (24.14%) had grade 1 acute bladder toxicity and one patient</span><span style="font-family:Verdana;"> (3.45%) </span><span style="font-family:Verdana;">had grade 2 acute toxicity. Late bladder toxicity was grade 1 in 5 patients</span><span style="font-family:Verdana;"> (17.24%), grade 2 in 3 patients (10.34%) and grade 3 in 1 patient (3.45%). </span><span style="font-family:Verdana;">Late rectal toxicity, grade 2 in 3 patients (10.34%), grade 3 in 1 patient, was noted. Overall survival at 2 years was 100% and 89.65% at 5 years. Relapse-free </span><span><span style="font-family:Verdana;">survival at 2 years was 82.76% and 62.07% at 5 years. There were 3 deaths (10.34%) of which only one was related to prostate cancer. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span></span><
文摘<strong>Introduction: </strong>A shoulder mass revealing metastatic prostate cancer is very rare. We report a case of metastatic prostate cancer diagnosed on a shoulder mass and treated with analgesic radiotherapy and chemotherapy and androgen deprivation therapy (ADT).<strong> Observations:</strong> A 66 years old patient was referred for a painful right shoulder mass whose biopsy and pathological examination found a Gleason 8 (4 + 4) moderately differentiated adenocarcinoma. The PSA level was 508.52 ng/ml. The patient was treated with analgesic radiotherapy on the right shoulder and chemo-hormonal therapy. At 2 years follow-up, the disease was well controlled. <strong>Conclusion:</strong> A shoulder mass revealing metastatic prostate cancer is not common. Local treatment of the symptomatic metastasis while continuing chemotherapy and ADT improves the quality of life.
文摘<strong>Objective:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Describe the epidemiological, diagnostic, therapeutic and evolutionary profile of triple negative breast cancer at the Dakar Cancer Institute in Senegal. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study between January 1, 2011 and December 31, 2014. All patients with a triple negative molecular profile were included. The data were collected from the medical records of the patients. The data were entered and analyzed with SPSS edition 16 software under Windows 7</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Two hundred and twenty-five patients were selected. The mean age was 47.9 ± 12.5 years with extremes of 25 and 90 years. The main reason for consultation was dominated by the finding of a breast lump. The mean clinical tumor size was 8</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">54 cm with a large majority of T3-T4 tumors 26% and 63% respectively, lymph node involvement in one hundred and seventy-two cases (76.4%);twenty eight patients (12.4%) were metastatic from the outset. Non-specific invasive carcinoma was the most common histologic type (78.2%), and more than half of the patients (53.3%) had an aggressive tumor (Scarff-Bloom-Richardson grading III). Neoadjuvant chemotherapy was performed in 65.78% of cases. We noted 27.7% total response and 41.7% partial response in patients who have received this neoadjuvant chemotherapy. The surgery was radical in 77% of cases, conservative in 14% and cle
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data to codify the management. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The objective was to study the clinical and therapeutic aspects and the fate of patients after a follow-up of at least 4 years. Thus contributing to the limited body of knowledge on these tumors. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> a retrospective analysis of the files from 2013 to 2017 was carried out and patients were followed up until 2021at Hassan II Hospital. Epidemiological, clinical and therapeutic aspects were studied. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We collected 12 charts of patients treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years. The circumstance of discovery was marked by the presence of nodule in all patients. The coupled echo-mammography examination classified the nodules, ACR 4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological examination revealed a phylloid sarcoma in 11 patients and a borderline phylloid tumor in 1 patient. All patients had radical surgery with positive margins in 2 patients, 16.66%. One patient had revision surgery. Histological examination of the surgical specimens showed phylloid sarcoma on all specimens. All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2 Gy and a boost of 10 Gy was done in one patient. The median spread of radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3 patients respectively. The median time from surgery to radiotherapy was 2.95 months. 3 patients relapsed after 13.6 months of follow-up. The recurrence-free survival at 1 and 3 years was 83% and 75% respectively. Overall survival at 3 and 5 y
文摘Diagnostic Reference Levels (DRLs) are indicators that allow assessing the quality of equipment and procedures from the point of view of the doses delivered to patients and subsequently initiate corrective actions if necessary. The purpose of this study is to encourage health professionals to investigate patient radiation doses and to determine whether those doses comply with the principles of radiation protection in medical fields so as to improve practices by reducing patient exposure without reducing clinical effectiveness. To perform this work, we have investigated patient doses for different radiological examinations from six (6) medical centers in Dakar, including the following nine routine types: chest (PA), abdomen (AP), pelvis (AP), cervical spine (AP), lumbar spine (AP, Lat), hip (AP), thoracic spine (AP, Lat). Three types of data were collected, <em>i.e.</em>, X-ray tube machine data, patient data and output measurements. The data were analyzed statistically and the median, minimum, maximum, and third quartile values were calculated and displayed throughout boxplots graphs for all exams and medical centers. The two sigma range (95% confidence interval) was also checked. Comparison of third quartiles of Entrance Surface Dose (ESD) and Dose Area Product (DAP) by type of examination with recommended international DRLs was performed. The third quartile of ESD for pelvis (AP) and thoracic spine (AP) was up to 16% and 38% higher, respectively than their corresponding DRLs in the European Commission Report RP 180 Part 2. For all exams, except thoracic spine (lat), the third quartiles of the dose area product were higher than the corresponding DRLs in the above report. The source of dose variability between medical centers was related to many parameters such as poor radiographic techniques, lack of modern X-ray machines and adequately documented radiation protection practices. The results show the need to develop protocols for dose measurement as well as to carry out quality assurance programs and dose optimiz
