Palliative Surgery for Cancer in Southwest Nigeria

Background: Most patients with cancer in the low-income environment present late, when the chances of cure are remote. Palliative care which includes surgery is needed to improve quality of life and minimize suffering and emotional disturbances associated with end of life. Methodology: Retrospective study of palliative surgery cases over five years. Data extracted included demographic features, diagnosis, procedure carried out, clinical status at 30 days postoperative, and survival. Results: 1,581 patients were operated over the study period. 227 patients were operated for malignancies; of these 91 patients (40%) had palliative procedures. The diagnoses in palliative surgery cases: prostate cancer 50 patients (54.9%), breast cancer 14.3%, stomach cancer 9.9%, and others. Indications for surgery were: urinary bladder outlet obstruction 46.1%, pleural effusion 14.3 %, obstructive jaundice 13.2%, and others. Bilateral total orchidectomy was performed in 50.5%, tube thoracostomy in 14.3%, laparotomy and biopsy in 11%. Thirteen patients (14.3%) died postoperatively; 57 patients (62.6%) were alive and well at 30 days after surgery. Survival period was <1 to 53 months with a mean of 8 months. Conclusion: Palliative surgery is useful in some patients with cancer. Facilities for less invasive procedures should be improved.