tailieunhanh - Schistosomiasis and Cancer in Egypt: Review

Schistosomiasis is not known to be associated with any malignant disease other than bladder cancer. Bladder cancer is still the most common malignant tumor among males in Egypt and some African and Middle East countries. However, the frequency rate of bladder cancer has declined significantly during the last 25 years. This drop is mainly related to the control of Schistosomiasis. Many studies have elucidated the pathogenic events of Schistosomal-related bladder cancer with a suggested theory of pathogenesis. Furthermore, the disease presents with a distinct clinicopathologic profile that is quite different from bladder cancer elsewhere with younger age at presentation, more male predominance, more invasive stages, and occurrence of squamous cell carcinoma pathologic subtype. However, recent data suggest that this profile has been dramatically changed over the past 25 years leading to minimization of the differences between its features in Egypt and that in Western countries. Management of muscle-invasive localized disease is mainly surgery with 5-year survival rates of 30–50%. Although still a debatable issue, adjuvant and neoadjuvant chemotherapy and radiotherapy have improved treatment outcomes including survival and bladder preservation rates in most studies. | Journal of Advanced Research 2013 4 461-466 Cairo University Journal of Advanced Research REVIEW Schistosomiasis and Cancer in Egypt Review Hussein Khaled Medical Oncology National Cancer Institute Cairo University Cairo 11796 Egypt ARTICLE INFO ABSTRACT Article history Received 30 June 2012 Received in revised form 16 June 2013 Accepted 17 June 2013 Available online 26 June 2013 Keywords Schistosomiasis Bilharziasis Bladder cancer Squamous cell carcinoma Schistosomiasis is not known to be associated with any malignant disease other than bladder cancer. Bladder cancer is still the most common malignant tumor among males in Egypt and some African and Middle East countries. However the frequency rate of bladder cancer has declined significantly during the last 25 years. This drop is mainly related to the control of Schistosomiasis. Many studies have elucidated the pathogenic events of Schistosomal-related bladder cancer with a suggested theory of pathogenesis. Furthermore the disease presents with a distinct clinicopathologic profile that is quite different from bladder cancer elsewhere with younger age at presentation more male predominance more invasive stages and occurrence of squamous cell carcinoma pathologic subtype. However recent data suggest that this profile has been dramatically changed over the past 25 years leading to minimization of the differences between its features in Egypt and that in Western countries. Management of muscle-invasive localized disease is mainly surgery with 5-year survival rates of 30-50 . Although still a debatable issue adjuvant and neoadjuvant chemotherapy and radiotherapy have improved treatment outcomes including survival and bladder preservation rates in most studies. This controversy emphasizes the need of individualized treatment options based on a prognostic index or other factors that can define the higher risk groups where more aggressive therapy is needed. The treatment for locally advanced and or metastatic disease has