Prognostic Factors and Survival of Patients with Primitive Lung Cancer in Douala and Yaounde

Author(s): Hugo Mbatchou, Jean Paul Engbang, Laurent-Mireille Mangamba Endale, Liliane Amina Nga, Marcelin Ngowe Ngowe

Background: Primary lung cancer (PLC) represents a real public health problem. It is one of the main types of cancer in the world in terms of incidence and also the main cause of death from cancer. In Africa primary bronchial cancer appears to be a rare entity.

Objective: To study the prognostic factors and survival of patients with PLC in Douala and Yaoundé. Patients and method: We performed an analytical, longitudinal (retrospective) study over a period from January 2010 to December 2019 including all records of patients in whom the diagnosis of PBC was histologically proven. The data collected were recorded and analyzed by SPSS version 25. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model. A value less than 0.05 were considered significant.

Results: A total of 94 patients were included in the study. The sex ratio was 1.24. The median age at cancer diagnosis was 62 years old. More than half of the population (61 cases; 64.9%) resided in urban areas; 51 (54.3%) were exposed to tobacco, 14 (14.9%) had occupational exposure and 88.1% of women were exposed to biomass smoke. The average smoking index was 29.24 ± 26.27 pack-years and the average duration of exposure was 30.17 ± 4.36 years. The histological types encountered were in order of decreasing frequency: adenocarcinoma (48 cases; 51.1%), squamous cell carcinoma (33 cases; 35.1%), small cell lung cancer (8 cases; 8.5 %) and undifferentiated large cell carcinoma (5 cases 5.3%); in the majority of cases the cancer was diagnosed at stage IV for non-small cell lung cancer (62 out of 86 cases) and at the localized stage for small cell lung cancer (6 out of 8). Of the 94 cases collected, 56 (59.6%) had adhered to anti-tumor treatment. The median overall survival was 4 months with 95% CI [1.52-6.79]. The overall survival rates at 6 months, 12 months, 24 months and 36 months were 50%, 17.4%; 12% and 8.7% respectively. The poor prognostic factor found was: The presence of brain metastases (HR: 80.01; p-value: 0.004).

Conclusions: Survival was very low with a median overall survival of 4 months. The overall survival rates at 6 months, 12 months, 24 months and 36 months were 50%, 17.4%, 12% and 8.7% respectively. The poor prognostic factor found was: the presence of brain metastases.

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