RESUMEN
Background: Surgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR). Objective: We investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria. Methods: Longitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR. Results: Ninety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%. Conclusion: LRR is dependent on lymph node involvement as well as and tumor aggressiveness.
Asunto(s)
Neoplasias de la Mama , Femenino , Humanos , Estudios Longitudinales , Ganglios Linfáticos , Metástasis Linfática , Márgenes de Escisión , Mastectomía , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , NigeriaRESUMEN
INTRODUCTION: The pyramidal lobe of the thyroid gland is derived from remnant of the thyroglossal duct. Its presence may be missed clinically; however radiologic and intra-operative findings reveal its presence in up to 50% of cases. The incidence of pyramidal lobe is however not clearly known in Sub-Saharan Africa, particularly in Nigeria. Our aim is to determine the incidence and histological variation of pyramidal lobe of the thyroid gland among surgical patients who underwent thyroid surgery in the University College Hospital, Ibadan. METHODOLOGY: Consecutive surgical patients that underwent total thyroidectomy in the Endocrine Surgery Division, Department of Surgery, University College Hospital, Ibadan between April 2013 and April 2017 were recruited irrespective of age, sex and clinical diagnosis. The presence, anatomy and subsequent histological diagnosis of the pyramidal lobe were noted. RESULTS: One hundred sixty thyroid surgeries were done. Pyramidal lobe was found in 70 patients (44.0%). The presence of the pyramidal lobe was most often associated with multinodular goitres 42 (61.8%) and least found in thyroids with malignant tumours 3 (4.4%). The pyramidal lobe originated commonly from the midline (50.0%) and least from the right (10.3%). The length of the pyramidal lobes ranged from 8 to 80 mm (average 50 mm) in males and 5 to 54 mm (average 42 mm) in females. CONCLUSION: The presence of a pyramidal lobe is not uncommon in people of southwestern Nigeria with its morphologic and histologic profile akin to what obtains in other geographical locations of the world.