Skip to main content
Top
Published in: World Journal of Surgery 3/2017

01-03-2017 | Scientific Review

Is Clinical Research in Oesophageal Cancer in South Africa in Crisis? A Systematic Review

Authors: E. Loots, B. Sartorius, T. E. Madiba, C. J. J. Mulder, D. L. Clarke

Published in: World Journal of Surgery | Issue 3/2017

Login to get access

Abstract

Oesophageal cancer (OC) is responsible for the second highest number of cancer-related deaths in South Africa (SA). Squamous cell carcinoma is the most prevalent type with an incidence of 46.7/100,000 and 19.2/100,000 for males and females. This is a systematic review of the clinical diagnosis and management of OC within the South African context. This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42016034053) with adherence to PRISMA guidelines. An online search was performed using MEDLINE, EBSCOHost and PubMed. Eligibility criteria for articles included published, original peer-reviewed research addressing clinical management of oesophageal cancer in South Africa. Review articles, case reports, scientific letters and studies published in languages other than English or Afrikaans were excluded. The research terms were ‘etiology’, ‘human’, ‘esophageal cancer’, ‘esophageal carcinoma’, ‘oesophageal cancer’, and ‘oesophageal carcinoma’, ‘squamous cell carcinoma’, ‘Africa’ and ‘South Africa’. A total of 336 articles were identified. Of these, 146 were immediately excluded and a further 159 were excluded after review. A total of 31 appropriate articles, i.e. 9.2% of searched articles, were included. Thirteen articles addressed chemotherapy and/or radiotherapy, 9 oesophageal luminal therapy, 7 oesophageal surgery and 2 screening. OC research of in SA over the last two decades has mainly been in the form of reviews and opinion papers. Clinical research, auditing and prospectively analysing OC management and outcomes in SA hospitals are sorely needed and should be promoted by both healthcare workers and policy makers alike.
Literature
1.
go back to reference Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF et al (2015) The global burden of cancer 2013. JAMA Oncol 1(4):505–527CrossRefPubMed Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF et al (2015) The global burden of cancer 2013. JAMA Oncol 1(4):505–527CrossRefPubMed
2.
go back to reference Tay SK (2012) Cervical cancer in the human papillomavirus vaccination era. Curr Opin Obstet Gynecol 24(1):3–7CrossRefPubMed Tay SK (2012) Cervical cancer in the human papillomavirus vaccination era. Curr Opin Obstet Gynecol 24(1):3–7CrossRefPubMed
3.
go back to reference Dochez C, Bogers JJ, Verhelst R, Rees H (2014) HPV vaccines to prevent cervical cancer and genital warts: an update. Vaccine 32(14):1595–1601CrossRefPubMed Dochez C, Bogers JJ, Verhelst R, Rees H (2014) HPV vaccines to prevent cervical cancer and genital warts: an update. Vaccine 32(14):1595–1601CrossRefPubMed
4.
go back to reference Dandara C, Robertson B, Dzobo K, Moodley L, Parker MI (2015) Patient and tumour characteristics as prognostic markers for oesophageal cancer: a retrospective analysis of a cohort of patients at Groote Schuur Hospital. Eur J Cardiothorac Surg. 49(2):629–634. doi:10.1093/ejcts/ezv135 CrossRefPubMed Dandara C, Robertson B, Dzobo K, Moodley L, Parker MI (2015) Patient and tumour characteristics as prognostic markers for oesophageal cancer: a retrospective analysis of a cohort of patients at Groote Schuur Hospital. Eur J Cardiothorac Surg. 49(2):629–634. doi:10.​1093/​ejcts/​ezv135 CrossRefPubMed
6.
go back to reference Van Rensburg SJ, Bradshaw ES, Bradshaw D, Rose EF (1985) Oesophageal cancer in Zulu men, South Africa: a case–control study. Br J Cancer 51(3):399–405CrossRefPubMedPubMedCentral Van Rensburg SJ, Bradshaw ES, Bradshaw D, Rose EF (1985) Oesophageal cancer in Zulu men, South Africa: a case–control study. Br J Cancer 51(3):399–405CrossRefPubMedPubMedCentral
9.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRefPubMed
10.
go back to reference Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C et al (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65(9):934–939CrossRefPubMed Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C et al (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65(9):934–939CrossRefPubMed
11.
go back to reference Procter DS (1967) The ‘ink-well’ anastomosis in oesophageal reconstruction. S Afr Med J 41(8):187–190PubMed Procter DS (1967) The ‘ink-well’ anastomosis in oesophageal reconstruction. S Afr Med J 41(8):187–190PubMed
12.
go back to reference de Moor NG (1968) Preliminary report of survey conducted by the Johannesburg group of hospitals on cancer of the eosophagus in the African: aims, policies and results. S Afr Med J 42(34):892–894PubMed de Moor NG (1968) Preliminary report of survey conducted by the Johannesburg group of hospitals on cancer of the eosophagus in the African: aims, policies and results. S Afr Med J 42(34):892–894PubMed
13.
go back to reference Mannell A, Plant M (1980) Total oesophagectomy in black patients with cancer of the oesophagus. S Afr Med J 58(7):285–289PubMed Mannell A, Plant M (1980) Total oesophagectomy in black patients with cancer of the oesophagus. S Afr Med J 58(7):285–289PubMed
14.
go back to reference Mannell A, Becker PJ, Nissenbaum M (1988) Bypass surgery for unresectable oesophageal cancer: early and late results in 124 cases. Br J Surg 75(3):283–286CrossRefPubMed Mannell A, Becker PJ, Nissenbaum M (1988) Bypass surgery for unresectable oesophageal cancer: early and late results in 124 cases. Br J Surg 75(3):283–286CrossRefPubMed
15.
go back to reference Angorn IB, Haffejee AA (1983) Retrosternal gastric bypass for the palliative treatment of unresectable oesophageal carcinoma. A simple technique. S Afr Med J 64(23):901–904PubMed Angorn IB, Haffejee AA (1983) Retrosternal gastric bypass for the palliative treatment of unresectable oesophageal carcinoma. A simple technique. S Afr Med J 64(23):901–904PubMed
16.
go back to reference Bryer JV, Haffejee AA, Kramer B, Jordaan JP (1991) Assessing operability in squamous carcinoma of the oesophagus. Are pre-operative investigations unreliable? S Afr Med J 80(4):179–180PubMed Bryer JV, Haffejee AA, Kramer B, Jordaan JP (1991) Assessing operability in squamous carcinoma of the oesophagus. Are pre-operative investigations unreliable? S Afr Med J 80(4):179–180PubMed
17.
go back to reference Alberts AS, Schoeman L, Burger W, Greef F, Falkson G (1992) A phase II study of 5-fluorouracil and leucovorin in advanced carcinoma of the esophagus. Am J Clin Oncol 15(1):35–36CrossRefPubMed Alberts AS, Schoeman L, Burger W, Greef F, Falkson G (1992) A phase II study of 5-fluorouracil and leucovorin in advanced carcinoma of the esophagus. Am J Clin Oncol 15(1):35–36CrossRefPubMed
18.
go back to reference Alberts AS, Falkson G, Badata M, Terblanche AP, Schmid EU (1988) Trimetrexate in advanced carcinoma of the esophagus. Invest New Drugs 6(4):319–321CrossRefPubMed Alberts AS, Falkson G, Badata M, Terblanche AP, Schmid EU (1988) Trimetrexate in advanced carcinoma of the esophagus. Invest New Drugs 6(4):319–321CrossRefPubMed
19.
go back to reference Ansell SM, Alberts AS, Falkson G (1989) Ifosfamide in advanced carcinoma of the esophagus: a phase II trial with severe toxicity. Am J Clin Oncol 12(3):205–207CrossRefPubMed Ansell SM, Alberts AS, Falkson G (1989) Ifosfamide in advanced carcinoma of the esophagus: a phase II trial with severe toxicity. Am J Clin Oncol 12(3):205–207CrossRefPubMed
20.
go back to reference Falkson G, Ryan LM, Haller DG (1992) Phase II trial for the evaluation of trimetrexate in patients with inoperable squamous carcinoma of the esophagus. Am J Clin Oncol 15(5):433–435CrossRefPubMed Falkson G, Ryan LM, Haller DG (1992) Phase II trial for the evaluation of trimetrexate in patients with inoperable squamous carcinoma of the esophagus. Am J Clin Oncol 15(5):433–435CrossRefPubMed
21.
go back to reference Slabber CF, Falkson G, Burger W, Schoeman L (1996) 13-Cis-retinoic acid and interferon alpha-2a in patients with advanced esophageal cancer: a phase II trial. Invest New Drugs 14(4):391–394CrossRefPubMed Slabber CF, Falkson G, Burger W, Schoeman L (1996) 13-Cis-retinoic acid and interferon alpha-2a in patients with advanced esophageal cancer: a phase II trial. Invest New Drugs 14(4):391–394CrossRefPubMed
22.
go back to reference Slabber CF, Nel JS, Schoeman L, Burger W, Falkson G, Falkson CI (1998) A randomized study of radiotherapy alone versus radiotherapy plus 5-fluorouracil and platinum in patients with inoperable, locally advanced squamous cancer of the esophagus. Am J Clin Oncol 21(5):462–465CrossRefPubMed Slabber CF, Nel JS, Schoeman L, Burger W, Falkson G, Falkson CI (1998) A randomized study of radiotherapy alone versus radiotherapy plus 5-fluorouracil and platinum in patients with inoperable, locally advanced squamous cancer of the esophagus. Am J Clin Oncol 21(5):462–465CrossRefPubMed
23.
go back to reference Schmid EU, Alberts AS, Greeff F, Terblanche AP, Schoeman L, Burger W et al (1993) The value of radiotherapy or chemotherapy after intubation for advanced esophageal carcinoma—a prospective randomized trial. Radiother Oncol 28(1):27–30CrossRefPubMed Schmid EU, Alberts AS, Greeff F, Terblanche AP, Schoeman L, Burger W et al (1993) The value of radiotherapy or chemotherapy after intubation for advanced esophageal carcinoma—a prospective randomized trial. Radiother Oncol 28(1):27–30CrossRefPubMed
24.
go back to reference Sur M, Sur R, Cooper K, Levin V, Bizos D, Dubazana N (1996) Morphologic alterations in esophageal squamous cell carcinoma after preoperative high dose rate intraluminal brachytherapy. Cancer 77(11):2200–2205CrossRefPubMed Sur M, Sur R, Cooper K, Levin V, Bizos D, Dubazana N (1996) Morphologic alterations in esophageal squamous cell carcinoma after preoperative high dose rate intraluminal brachytherapy. Cancer 77(11):2200–2205CrossRefPubMed
25.
go back to reference Sur RK, Donde B, Levin VC, Mannell A (1998) Fractionated high dose rate intraluminal brachytherapy in palliation of advanced esophageal cancer. Int J Radiat Oncol Biol Phys 40(2):447–453CrossRefPubMed Sur RK, Donde B, Levin VC, Mannell A (1998) Fractionated high dose rate intraluminal brachytherapy in palliation of advanced esophageal cancer. Int J Radiat Oncol Biol Phys 40(2):447–453CrossRefPubMed
26.
go back to reference Sur RK, Levin CV, Donde B, Sharma V, Miszczyk L, Nag S (2002) Prospective randomized trial of HDR brachytherapy as a sole modality in palliation of advanced esophageal carcinoma—an International Atomic Energy Agency study. Int J Radiat Oncol Biol Phys 53(1):127–133CrossRefPubMed Sur RK, Levin CV, Donde B, Sharma V, Miszczyk L, Nag S (2002) Prospective randomized trial of HDR brachytherapy as a sole modality in palliation of advanced esophageal carcinoma—an International Atomic Energy Agency study. Int J Radiat Oncol Biol Phys 53(1):127–133CrossRefPubMed
27.
go back to reference Sur R, Donde B, Falkson C, Ahmed SN, Levin V, Nag S et al (2004) Randomized prospective study comparing high-dose-rate intraluminal brachytherapy (HDRILBT) alone with HDRILBT and external beam radiotherapy in the palliation of advanced esophageal cancer. Brachytherapy 3(4):191–195CrossRefPubMed Sur R, Donde B, Falkson C, Ahmed SN, Levin V, Nag S et al (2004) Randomized prospective study comparing high-dose-rate intraluminal brachytherapy (HDRILBT) alone with HDRILBT and external beam radiotherapy in the palliation of advanced esophageal cancer. Brachytherapy 3(4):191–195CrossRefPubMed
28.
go back to reference Fuchs CS, Tomasek J, Yong CJ, Dumitru F, Passalacqua R, Goswami C et al (2014) Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 383(9911):31–39CrossRefPubMed Fuchs CS, Tomasek J, Yong CJ, Dumitru F, Passalacqua R, Goswami C et al (2014) Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 383(9911):31–39CrossRefPubMed
29.
go back to reference Rosenblatt E, Jones G, Sur RK, Donde B, Salvajoli JV, Ghosh-Laskar S et al (2010) Adding external beam to intra-luminal brachytherapy improves palliation in obstructive squamous cell oesophageal cancer: a prospective multi-centre randomized trial of the International Atomic Energy Agency. Radiother Oncol 97(3):488–494CrossRefPubMed Rosenblatt E, Jones G, Sur RK, Donde B, Salvajoli JV, Ghosh-Laskar S et al (2010) Adding external beam to intra-luminal brachytherapy improves palliation in obstructive squamous cell oesophageal cancer: a prospective multi-centre randomized trial of the International Atomic Energy Agency. Radiother Oncol 97(3):488–494CrossRefPubMed
30.
go back to reference Procter DS (1968) Experiences with oesophageal intubation for oesophageal carcinoma with a review of the literature. S Afr J Surg 152:967–974 Procter DS (1968) Experiences with oesophageal intubation for oesophageal carcinoma with a review of the literature. S Afr J Surg 152:967–974
31.
go back to reference Hegarty MM, Angorn IB, Bryer JV, Henderson BJ, Le Roux BT, Logan A (1977) Pulsion intubation for palliation of carcinoma of the oesophagus. Br J Surg 64(3):160–165CrossRefPubMed Hegarty MM, Angorn IB, Bryer JV, Henderson BJ, Le Roux BT, Logan A (1977) Pulsion intubation for palliation of carcinoma of the oesophagus. Br J Surg 64(3):160–165CrossRefPubMed
33.
go back to reference Angorn IB, Haffejee AA (1983) Pulsion intubation v. restrosternal gastric bypass for palliation of unresectable carcinoma of the upper thoracic oesophagus. Br J Surg 70(6):335–338CrossRefPubMed Angorn IB, Haffejee AA (1983) Pulsion intubation v. restrosternal gastric bypass for palliation of unresectable carcinoma of the upper thoracic oesophagus. Br J Surg 70(6):335–338CrossRefPubMed
34.
go back to reference Sur RK, Didcott CC, Levin CV, Kulhavy M, Donde B, Schafer M et al (1996) Palliation of carcinoma of the oesophagus with brachytherapy and the Didcott dilator. Ann R Coll Surg Engl 78(2):124–128PubMedPubMedCentral Sur RK, Didcott CC, Levin CV, Kulhavy M, Donde B, Schafer M et al (1996) Palliation of carcinoma of the oesophagus with brachytherapy and the Didcott dilator. Ann R Coll Surg Engl 78(2):124–128PubMedPubMedCentral
35.
go back to reference Hatzitheofilou C, Kakoyiannis S, Charalambides D, Degiannis E, Ross J, Demetriades D (1993) Iatrogenic oesophageal perforations in patients with cancer of the oesophagus. S Afr J Surg 31(3):90–93PubMed Hatzitheofilou C, Kakoyiannis S, Charalambides D, Degiannis E, Ross J, Demetriades D (1993) Iatrogenic oesophageal perforations in patients with cancer of the oesophagus. S Afr J Surg 31(3):90–93PubMed
36.
go back to reference Sanyika C, Corr P, Haffejee A (1999) Palliative treatment of oesophageal carcinoma–efficacy of plastic versus self-expandable stents. S Afr Med J 89(6):640–643PubMed Sanyika C, Corr P, Haffejee A (1999) Palliative treatment of oesophageal carcinoma–efficacy of plastic versus self-expandable stents. S Afr Med J 89(6):640–643PubMed
37.
go back to reference Liakos DDD, Florizoone M, Bizos DB (2010) Is oesophageal stenting for cancer the answer? A report from a secondary hospital in the developing world. S Afr J Surg 48(2):43–49 Liakos DDD, Florizoone M, Bizos DB (2010) Is oesophageal stenting for cancer the answer? A report from a secondary hospital in the developing world. S Afr J Surg 48(2):43–49
38.
go back to reference Motilall SRMMC, Tsatsi LDR, Becker PJ (2011) Trial of self-expandable metallic stents in the palliation of tracheo-oesophageal fistula in carcinoma of the oesophagus. S Afr J Sci 45(1):24–27 Motilall SRMMC, Tsatsi LDR, Becker PJ (2011) Trial of self-expandable metallic stents in the palliation of tracheo-oesophageal fistula in carcinoma of the oesophagus. S Afr J Sci 45(1):24–27
39.
go back to reference Govender M, Aldous C, Ferndale L, Thomson SR, Clarke DL (2015) Self-expanding metal stent placement for oesophageal cancer without fluoroscopy is safe and effective. S Afr Med J 105(10):858–861CrossRefPubMed Govender M, Aldous C, Ferndale L, Thomson SR, Clarke DL (2015) Self-expanding metal stent placement for oesophageal cancer without fluoroscopy is safe and effective. S Afr Med J 105(10):858–861CrossRefPubMed
40.
go back to reference Cotton RG, Langer R, Leong T, Martinek J, Sewram V, Smithers M et al (2014) Coping with esophageal cancer approaches worldwide. Ann N Y Acad Sci 1325:138–158CrossRefPubMed Cotton RG, Langer R, Leong T, Martinek J, Sewram V, Smithers M et al (2014) Coping with esophageal cancer approaches worldwide. Ann N Y Acad Sci 1325:138–158CrossRefPubMed
41.
go back to reference Jaskiewicz K, Venter FS, Marasas WF (1987) Cytopathology of the esophagus in Transkei. J Natl Cancer Inst 79(5):961–967PubMed Jaskiewicz K, Venter FS, Marasas WF (1987) Cytopathology of the esophagus in Transkei. J Natl Cancer Inst 79(5):961–967PubMed
42.
go back to reference Lazarus C, Jaskiewicz K, Sumeruk RA, Nainkin J (1992) Brush cytology technique in the detection of oesophageal carcinoma in the asymptomatic, high risk subject; a pilot survey. Cytopathology 3(5):291–296CrossRefPubMed Lazarus C, Jaskiewicz K, Sumeruk RA, Nainkin J (1992) Brush cytology technique in the detection of oesophageal carcinoma in the asymptomatic, high risk subject; a pilot survey. Cytopathology 3(5):291–296CrossRefPubMed
43.
go back to reference Zheng X, Mao X, Xu K, Lü L, Peng X, Wang M et al (2015) Massive endoscopic screening for esophageal and gastric cancers in a high-risk area of China. PLoS ONE 10(12):e0145097CrossRefPubMedPubMedCentral Zheng X, Mao X, Xu K, Lü L, Peng X, Wang M et al (2015) Massive endoscopic screening for esophageal and gastric cancers in a high-risk area of China. PLoS ONE 10(12):e0145097CrossRefPubMedPubMedCentral
44.
go back to reference Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A et al (2015) The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot? Cancer Epidemiol 39(2):143–149CrossRefPubMedPubMedCentral Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A et al (2015) The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot? Cancer Epidemiol 39(2):143–149CrossRefPubMedPubMedCentral
45.
go back to reference Kendig CE, Samuel JC, Tyson AF, Khoury AL, Boschini LP, Mabedi C et al (2013) Cancer treatment in Malawi: a disease of palliation. World J Oncol 4(3):142–146PubMedPubMedCentral Kendig CE, Samuel JC, Tyson AF, Khoury AL, Boschini LP, Mabedi C et al (2013) Cancer treatment in Malawi: a disease of palliation. World J Oncol 4(3):142–146PubMedPubMedCentral
46.
go back to reference Ali A, Ersumo T, Johnson O (1998) Oesophageal carcinoma in Tikur Anbessa Hospital, Addis Ababa. East Afr Med J 75(10):590–593PubMed Ali A, Ersumo T, Johnson O (1998) Oesophageal carcinoma in Tikur Anbessa Hospital, Addis Ababa. East Afr Med J 75(10):590–593PubMed
47.
go back to reference White RE, Parker RK, Fitzwater JW, Kasepoi Z, Topazian M (2009) Stents as sole therapy for oesophageal cancer: a prospective analysis of outcomes after placement. Lancet Oncol 10(3):240–246CrossRefPubMed White RE, Parker RK, Fitzwater JW, Kasepoi Z, Topazian M (2009) Stents as sole therapy for oesophageal cancer: a prospective analysis of outcomes after placement. Lancet Oncol 10(3):240–246CrossRefPubMed
Metadata
Title
Is Clinical Research in Oesophageal Cancer in South Africa in Crisis? A Systematic Review
Authors
E. Loots
B. Sartorius
T. E. Madiba
C. J. J. Mulder
D. L. Clarke
Publication date
01-03-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 3/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3778-5

Other articles of this Issue 3/2017

World Journal of Surgery 3/2017 Go to the issue