RT Journal
A1 Gyorki DE, Muyco A, Kushner AL, Brennan MF, Kingham T
T1 Cancer surgery in low-income countries: An unmet need
JF Archives of Surgery
JO Archives of Surgery
YR 2012
FD December 1
VO 147
IS 12
SP 1135
OP 1140
DO 10.1001/archsurg.2012.1265
UL http://dx.doi.org/10.1001/archsurg.2012.1265
AB Objectives 
                  To describe the surgical oncology experience at a major regional hospital in Malawi and to identify barriers to improved outcomes.Design 
                  Retrospective review of operating logbooks from a single tertiary referral center.Setting 
                  Major tertiary referral center (Kamuzu Central Hospital) in Lilongwe, Malawi, in sub-Saharan Africa.Patients 
                  Patients were identified with a suspected diagnosis of cancer from January 1, 2004, through March 7, 2007.Main Outcome Measures 
                  Cancer cases were classified according to patient demographic characteristics, disease location, and therapeutic intent. The Malawi data were compared with US data from the Surveillance Epidemiology and End Results database.Results 
                  A malignant diagnosis was suspected in 255 of the 1440 patients undergoing a major resection (17.8%) (mean patient age, 53 years). The most common cancers in males were prostate, esophageal, and gastric. In females, the most common cancers were breast, colon, and esophageal. Many of the procedures were performed with palliative intent.Conclusions 
                  Cancer surgery comprises a significant proportion of the surgical caseload in low-income countries. Patients often present with late-stage, inoperable cancer. The participation of the surgical community is critical for addressing barriers to effective cancer care.