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Item Impact of axillary node-positivity and surgical resection margins on survival of women treated for breast cancer in Ibadan, Nigeria(ecancermedicalscience, 2020) Ayandipo, O. O.; Ogun, G. O.; Adepoju, O. J.; Fatunla, E. O.; Afolabi, A. O.; Osuala, P. C.; Ogundiran, T. O.Introduction: Oncologic surgical extirpation, the mainstay of loco-regional disease control in breast cancer, is aimed at achieving negative margins and lymph node clearance. Even though axillary lymph nodal metastasis is a critical index of prognostication, establishing the impact of lymph node ratio (LNR) and adequate surgical margins on disease specific survivorship would be key to achieving longer survival. This study examines the prognostic role of pN (lymph nodes positive for malignancy), LNR and resection margin on breast cancer survival in a tertiary hospital in Ibadan, Nigeria. Methods: We conducted a longitudinal cohort study of 225 patients with breast carcinoma, documented clinico-pathologic parameters and 5-year follow up outcomes – distant metastasis and survival. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with patients’ survival. The receiver operating characteristic curve was plotted to deter mine the proportion of metastatic lymph nodes which predicted survival. The survival analysis was done using Kaplan–Meier method. Results: Sixty (26.7%) patients of the patients had positive resection margins, with the most common immuno-histochemical type being Lumina A. 110 (49%) patients had more than 10 axillary lymph nodes harvested. The mean age was 48.6 + 11.8 years. Tumour size (p = 0.018), histological type (p = 0.015), grade (p = 0.006), resection margin (p = 0.023), number of harvested nodes (p < 0.01), number of metastatic nodes (p < 0.001) and loco-regional recurrence (p < 0.01) are associated with survival. The overall 5-year survival was 65.3%. Conclusion: Unfavourable survival outcomes following breast cancer treatment is multifactorial, including the challenges faced in the multimodal treatment protocol received by our patients.Item Experience with managing retrosternal goitres in ibadan, Nigeria(Wolters Kluwer - Medknow, 2016) Ayandipo, O. O.; Afolabi, A. O.; Afuwape, O. O.; Bolaji, B. E.; Salami, M. A.Background: There is no general consensus on the definition of retrosternal goitre however thyroidectomy remains the gold standard of treatment with or without a sternotomy Aim: To review the outcome of surgical management of retrosternal goitres. Methodology: Retrospective review of records of patients who had thyroidectomy for retrosternal goitre over a 15-year period. Results: Out of a total of 45 patients, 34(76%) were females and 11(24%) were males with a male/female ratio of 3:1; while their age ranged between 28 and 72years with a mean of 57+15SD. All the patients were euthyroid and a quarter did not have symptoms apart from a neck mass. In all, 15% of the patients had recurrent goitre. CT scan of neck and chest was done in 31 (72%) patients; while 44 (98%) patients had cervical retrosternal goitres, 1(2%) patient had ectopic retrosternal goitre. A cervical incision was sufficient in 28 (62%) patients while 17 (38%) patients required additional sternotomy. Total thyroidectomy was done in all the patients. There were post-operative complications in 19 (42%) patients. Histopathology showed that 3(6.6%) patients had papillary thyroid carcinoma while 42(93.4%) had benign pathology findings. Conclusion: Surgical removal is the treatment of choice. Most retrosternal goitres can be resected through a collar stud incision; however the possibility of a need for a sternotomy should always be planned. The simultaneous occurrence of cervical and ectopic retrosternal goitre should always be ruled out with a CT scan.Item Colon and rectal cancer in Ibadan, Nigeria: an update(The Association of Coloproctology of Great Britain and Ireland, 2010) Irabor, D. O.; Arowolo, A.; Afolabi, A. A.Introduction Colorectal cancer was hitherto a rarity in the rural African in general and in Nigerians inclusive. Ibadan is a sprawling city in Western Nigeria with a population of about 2.5 million inhabitants. Lately, several publications from surgeons in this city have alluded to an increase in the number of colorectal cancer cases managed in the teaching hospital. Objectives To examine the incidence of this disease over 10 years in order to confirm or exclude the apparent significant increase in colorectal cancer cases in Ibadan, Nigeria. Method This is a retrospective study highlighting the age, sex, clinical features, operations performed and histopathological subtypes of patients who had surgery for colorectal cancer in the University College Hospital Ibadan between July 1995 and August 2004. Results Two and sixty-eight patients were seen over 10 years. The male: female ratio was 1.16:1. The mean age was 41 years and the peak age was the 51- to 60-years group. Fourteen per cent of the patients were 30 years and below. Sixty-two per cent of the patients had rectal carcinoma while 33.2% had colonic carcinoma. Around 60.7% of colonic lesions were right-sided. The most common histopathological subtype was adenocarcinoma (78.8%), mucinous adenocarcinoma was 10.8% and signet ring type was 2.6%. Conclusion Colorectal cancer is a disease on the increase in Ibadan. The mean age of 41 years is much lower than in the Western world. The male: female ratio still favours male patients slightly. About one in seven patients are 30 years and below. Adenomatous polyps were absent in the resected specimens.Item An analysis of skin cancer in albinos in ibadan(2015) Ademola S.A.Context: Skin cancers are common among albinos living in Africa. Deleterious effect of ultraviolet rays from sunlight and nearness to the equator places the African Albinos at risk for skin cancer. Aims: This study aims to present skin cancers in albinos as seen by a plastic surgeon, sensitize the public to the magnitude of dangers that albinos are exposed to, highlight the challenges faced in their management and suggest strategies for improved outcomes. Settings and Design: A retrospective review of skin cancers among albinos was conducted at the University College Hospital, Ibadan, Nigeria. Methods and Material: The charts, operation and cancer registry records of all albinos referred to a plastic surgery division over a ten year period was reviewed. Demographic data and relevant information relating to skin lesions were extracted. Statistical Analysis: Descriptive analysis was done with the aid of statistical package for social sciences (SPSS) version 20. Results: Nineteen patients with fifty nine skin lesions comprising 13 males and 6 females were reviewed. Mean age of the patients was 33.6 (SD 12.8) years, 50% were unmarried, over 90% were Christians and 44% were not employed. The lesions were on the face in 84.6% while scalp and neck lesions were present in 36.8 and 31.6% of patients respectively. In 73.7% of the patients, the lesions were advanced. Basal cell carcinoma and squamous cell carcinoma were of equal proportion. Conclusions: Albinos in Nigeria should be exposed to public health intervention to reduce the incidence of skin cancers through targeted public health educational programmes; structured multicenter and population based research, surveillance, and improved access to healthcare.