Bowa K, Mulele C, Kachimba J, Manda E, Mapulanga V, Mukosai S
Department of Surgery, Copperbelt University School of Medicine, Ndola, Zambia.
Department of Pathology, Copperbelt University School of Medicine, Ndola, Zambia.
Ann Afr Med. 2018 Jul-Sep;17(3):99-105. doi: 10.4103/aam.aam_48_17.
Cancer of the bladder is the ninth leading cause of cancer in developed countries. It is the second most common urological malignancy. Transitional cell carcinoma (TCC) is the most common histological subtype in developed countries. In most of Africa, the most common type is squamous cell carcinoma (SCC). Cancer of bladder guidelines produced by the European Urological Association and the American Urological Association, including the tumor, node, and metastasis staging is focused on TCC of the bladder.
The purpose of the study is to review the pathogenesis, pathology, presentation, and management of cancer of the bladder in Africa and to use this information to propose a practical staging system for SCC.
The study used the meta-analysis guideline provided by PRISMA using bladder cancer in Africa as the key search word. The study collected articles available on PubMed as of July 2017, Africa Online and Africa Index Medicus. PRISMA guidelines were used to screen for full-length hospital-based articles on cancer of the bladder in Africa. These articles were analyzed under four subcategories which were pathogenesis, pathology, clinical presentation, and management. The information extracted was pooled and used to propose a practical staging system for use in African settings.
The result of evaluation of 821 articles yielded 23 full-length papers on hospital-based studies of cancer of the bladder in Africa. Cancer of the bladder in most of Africa is still predominantly SCC (53%-69%). There has been a notable increase in TCC in Africa (9%-41%). The pathogenesis is mostly schistosoma-related SCC presents late with painful hematuria and necroturia (20%). SCC responds poorly to chemotherapy or radiotherapy. The main management of SCC is open surgery. This review allowed for a practical organ-based stage of SCC of the bladder that can be used in Africa.
Bladder cancer in Africa presents differently from that in developed countries. Guidelines on cancer of the bladder may need to take account of this to improve bladder cancer management in Africa.
在发达国家，膀胱癌是第九大常见癌症。它是第二常见的泌尿系统恶性肿瘤。在发达国家，移行细胞癌（TCC）是最常见的组织学亚型。在非洲大部分地区，最常见的类型是鳞状细胞癌（SCC）。欧洲泌尿外科学会和美国泌尿外科学会制定的膀胱癌指南，包括肿瘤、淋巴结和转移分期，主要针对膀胱TCC。
本研究的目的是回顾非洲膀胱癌的发病机制、病理、临床表现及治疗，并利用这些信息为SCC提出一个实用的分期系统。
本研究采用PRISMA提供的荟萃分析指南，以非洲膀胱癌为关键搜索词。研究收集了截至2017年7月在PubMed、非洲在线和非洲医学索引上可获取的文章。PRISMA指南用于筛选非洲基于医院的膀胱癌全长文章。这些文章在发病机制、病理、临床表现和治疗四个子类别下进行分析。提取的信息汇总后用于提出一个适用于非洲的实用分期系统。
对821篇文章的评估结果产生了23篇关于非洲基于医院的膀胱癌研究的全长论文。非洲大部分地区的膀胱癌仍以SCC为主（53%-69%）。非洲的TCC有显著增加（9%-41%）。发病机制大多与血吸虫有关，SCC出现较晚，表现为疼痛性血尿和坏死尿（20%）。SCC对化疗或放疗反应不佳。SCC的主要治疗方法是开放手术。本综述得出了一个适用于非洲的基于器官的膀胱SCC实用分期。
非洲的膀胱癌表现与发达国家不同。膀胱癌指南可能需要考虑到这一点，以改善非洲的膀胱癌治疗。
