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Cause of death among head and neck skin cancer patients in a Nigerian hospital: significance of the cranium

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Abstract

Background

Most cancers in the head and neck region spread locally. This study was designed to evaluate the involvement of the cranium in cause of death among head and neck skin cancer patients.

Methods

All cases of skin malignancy appearing in the head and neck region were documented. Cause of death was noted for all deceased head and neck skin cancer patients. Cranial involvement, or not, was recorded in each case. Recurrent lesions, types of previous treatment, if any, and cranial perforation, when present, were documented.

Results

One hundred thirty-one patients were seen. One hundred eighteen (90.1 %) had lesions involving the cranium. Thirty-four head and neck cancer patients died during study period. Thirty-two (94.1 %) died as a result of local spread of disease to the brain through the cranium. Recurrent and persistent lesions were accounted for 35 (26.7 %) cases; out of which, 18 (13.7 %) had been excised and wound was immediately closed directly; 10 (7.6 %) had been excised and wound immediately primarily closed using vascularized free flaps. Five (3.8 %) had previously been managed solely with radiotherapy. Two (1.5 %) applied 5FU ointment on prescription for basal cell carcinoma, which transmuted to squamous cell carcinoma. Eleven (8.4 %) referral cases with cranial perforation presented after recurrence.

Conclusions

Deaths that were caused by spread of cancer to the brain through the cranium were 94.1 %. Radiotherapists should be educated on the grave danger of causing osteoradionecrosis of the cranium. The value of medical remedies for malignancies around the cranium should be properly reevaluated. Surgery appears to be the favoured therapy for cranium-involved skin cancer.

Level of Evidence: Level IV, risk / prognostic study

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Acknowledgments

The authors would like to thank Dr. Akinbo Ayanmo Omolara, Dr. Nwadinigwe Chinonso Theresa and Dr. Atoyebi Sunday Oluwaseyi for their clinical assistance.

Conflict of interest

None.

Patient consent

Consent for inclusion in this study was given by all patients.

Ethical statement

This study has been carried out with approval from ethical committee of National Hospital Abuja in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Department of Facial Surgery, National Hospital, Abuja, Nigeria

    Bayo Aluko-Olokun, Funmilola Seun Adenaike & Oluwaseyi Ibukun-Obaro

  2. Department of Oral and Maxillofacial Surgery, Lagos State University, Lagos, Nigeria

    Ademola Abayomi Olaitan

  3. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

    Reni Initari Mike-Ogiasa

  4. Department of Radiology, National Hospital, Abuja, Nigeria

    Oluseun Abidemi Aluko-Olokun

  5. Department of Surgery, Asokoro General Hospital, Abuja, Nigeria

    Openiyi Anuoluwa Alade

Authors
  1. Bayo Aluko-Olokun
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  2. Ademola Abayomi Olaitan
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  3. Reni Initari Mike-Ogiasa
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  4. Oluseun Abidemi Aluko-Olokun
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  5. Funmilola Seun Adenaike
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  6. Oluwaseyi Ibukun-Obaro
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  7. Openiyi Anuoluwa Alade
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Correspondence to Bayo Aluko-Olokun.

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Aluko-Olokun, B., Olaitan, A.A., Mike-Ogiasa, R.I. et al. Cause of death among head and neck skin cancer patients in a Nigerian hospital: significance of the cranium. Eur J Plast Surg 38, 103–108 (2015). https://doi.org/10.1007/s00238-014-1037-2

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  • DOI: https://doi.org/10.1007/s00238-014-1037-2

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