Choriocarcinoma in Enugu, South east Nigeria: a need for a shift from mortality to survival.

Background: The diagnosis of cancer in Nigeria is often translated to mean an imminent death for the patient. This contrasts the situation in some developed settings where cancer survivorship and its management have evolved. Choriocarcinoma is a rare but curable tumour so; it became necessary to review cases of this curable cancer managed at a tertiary health center in a typical resourced-constrained setting.

Methods: A retrospective analysis of consecutive choriocarcinoma cases managed at a tertiary hospital in Enugu, South-eastern Nigeria over a five year period. Data analysis was descriptive.

Results: Five non-metastatic and 10 metastatic cases of choriocarcinoma were managed. The mean age of patients was 33.6 9.1 years. All patients had vaginal bleeding with a mean duration of 4 5.19 months. The commonest predisposing factor and metastatic site were abortion (46.7%) and lungs (40.0%) respectively. The mean unit of blood transfusion during treatment was 5.3 3.8 units. Eight patients (53.3%) died on admission while 7 (46.7%) were lost to follow-up during chemotherapy 20.0% or after chemotherapy (26.7%).

Conclusion: The case fatality for choriocarcinoma and loss of patients to follow-up in Enugu, Nigeria were high. To shift from this situation of high mortality to that of survival, an improved follow-up of post-abortal patients and aggressive tracing of defaulters are recommended.