Oburra H O
Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.
East Afr Med J. 1998 Apr;75(4):223-6.
The clinical stage at presentation of laryngeal and pharyngeal cancer is an important determinant of survival. Fifty six patients admitted at Kenyatta National Hospital with nasopharyngeal and laryngeal carcinoma were reviewed to determine the period of delay from onset of illness to the first otolaryngologic appointment at the hospital, their clinical features and the tumour stage at presentation. All cases of nasopharyngeal carcinoma had cervical lymphadenopathy, 70.6% being N3 status while 57.8% of laryngeal carcinoma cases underwent emergency preoperative tracheostomy due to bulky obstructive tumour. On the whole, 96.4% of the patients presented with advanced (stage 3 or 4) head and neck carcinomas. The average period of delay between the first medical attention at a primary health care facility and the first appointment at the national hospital was 8.7 months. The study suggests that this long delay was due to inherent inefficiency in the referral system and was a major contributing factor to the advanced stage at presentation.
喉癌和咽癌就诊时的临床分期是生存的重要决定因素。对56例在肯雅塔国家医院就诊的鼻咽癌和喉癌患者进行了回顾性研究，以确定从发病到首次在该医院耳鼻喉科就诊的延迟时间、他们的临床特征以及就诊时的肿瘤分期。所有鼻咽癌病例均有颈部淋巴结肿大，70.6%为N3期，而57.8%的喉癌病例因肿瘤体积大且阻塞气道而接受了急诊术前气管切开术。总体而言，96.4%的患者就诊时患有晚期（3期或4期）头颈癌。从基层医疗机构首次就诊到在国家医院首次预约之间的平均延迟时间为8.7个月。该研究表明，这种长时间的延迟是由于转诊系统固有的低效，并且是就诊时处于晚期的一个主要促成因素。
