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RÉSUMÉ
Introduction. La prise en charge des tumeurs osseuses malignes (TOM) a connu de réels progrès dans les pays développés, avec un impact favorable sur la survie. En revanche, dans les contextes à ressources limitées, les contraintes diagnostiques et thérapeutiques peuvent altérer le pronostic. Cette étude visait à décrire les modalités thérapeutiques et la survie à cinq ans des TOM à Yaoundé. Méthodologie. Il s’agissait d’une étude observationnelle de type cohorte rétrospective, multicentrique, menée de juin 2015 à mai 2025 dans trois hôpitaux tertiaires de Yaoundé. Ont été inclus tous les patients présentant une TOM confirmée histologiquement, pris en charge et suivis. Les variables étudiées étaient les modalités thérapeutiques et le statut vital. La survie globale à cinq ans a été estimée par la méthode de Kaplan-Meier. Résultats. Nous avons inclus 127 patients dans notre étude. Parmi eux, 36.2% souffraient de tumeurs malignes primitives (TMP) et 63,8% de tumeurs secondaires (TMS). La prise en charge reposait sur une approche multimodale associant chirurgie, chimiothérapie et radiothérapie. Le traitement chirurgical des TMP était dominé par les amputations (29,3%) et les résections intra-lésionnelles (39,1%). La chimiothérapie néo-adjuvante a été administrée chez 27 (58,7 %) patients atteints de TMP et chez 20 (24,7 %) patients présentant des tumeurs secondaires. La chimiothérapie adjuvante concernait 18 (39,1 %) cas de TMP et 20 (24,7 %) cas de tumeurs secondaires. La radiothérapie a été réalisée chez 4 (8,7 %) patients avec TMP et 13 (16 %) patients avec tumeurs secondaires. La survie à cinq ans était de 33,3 % pour les TMP et de 14,3 % pour les tumeurs secondaires, avec une survie globale de 20,1 %. Conclusion. La prise en charge des TOM à Yaoundé reste marquée par des limitations thérapeutiques, notamment en chirurgie conservatrice et en reconstruction. Ces contraintes, associées aux retards de prise en charge, contribuent à une faible survie à moyen terme.
ABSTRACT
Introduction. The management of malignant bone tumours (MBTs) has seen significant progress in developed countries, with a positive impact on survival. However, in resource-limited settings, diagnostic and therapeutic constraints can adversely affect prognosis. This study aimed to describe the treatment modalities and five-year survival rates for MBTs in Yaoundé. Methodology. This was a retrospective, multicentre, observational cohort study conducted from June 2015 to May 2025 in three tertiary hospitals in Yaoundé. All patients with histologically confirmed MBT who were treated and followed up were included. The variables studied were treatment modalities and survival status. Five-year overall survival was estimated using the Kaplan-Meier method. Results. We included 127 patients in our study. Of these, 36.2% had primary malignant tumours (PMT) and 63.8% had secondary tumours (ST). Management was based on a multimodal approach combining surgery, chemotherapy and radiotherapy. Surgical treatment of PMTs was dominated by amputations (29.3%) and intra-lesional resections (39.1%). Neoadjuvant chemotherapy was administered to 27 (58.7%) patients with PMTs and to 20 (24.7%) patients with secondary tumours. Adjuvant chemotherapy was administered in 18 (39.1%) cases of primary brain tumours and 20 (24.7%) cases of secondary tumours. Radiotherapy was administered to 4 (8.7%) patients with primary brain tumours and 13 (16%) patients with secondary tumours. Five-year survival was 33.3% for primary brain tumours and 14.3% for secondary tumours, with an overall survival rate of 20.1%. Conclusion. The management of brain tumours in Yaoundé remains characterised by therapeutic limitations, particularly in terms of conservative surgery and reconstruction. These constraints, combined with delays in treatment, contribute to poor medium-term survival.
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References
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- 27. Ahmed SJ. Advancements in Lung Cancer detection: harnessing innovative techniques for enhanced diagnosis. Int J Comput Digit Syst. 2024;16(1):1–16.
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References
1. Franchi A. Epidemiology and classification of bone tumors. Clin Cases Miner Bone Metab. 2012;9(2):92‑5.
2. Hosseini H, Heydari S, Hushmandi K, Daneshi S, Raesi R. Bone tumors: a systematic review of prevalence, risk determinants, and survival patterns. BMC Cancer. 21 févr 2025;25(1):321.
3. Xu Y, Shi F, Zhang Y, Yin M, Han X, Feng J, et al. Twenty-year outcome of prevalence, incidence, mortality and survival rate in patients with malignant bone tumors. Int J Cancer. 2024;154(2):226‑40.
4. Yu K, Chen Y, Tian Y, Kang H, Song K, Dong Y, et al. Characteristics, incidence, and risk factors for death from fatal pneumonia among patients with primary malignant bone tumors: a SEER-based observational study. Transl Cancer Res. août 2021;10(8):3659‑70.
5. Kgagudi MP, Ramokgopa MT, Jingo M. Epidemiology and Chemosensitivity of Primary Malignant Bone Tumors at a Teaching Hospital in South Africa: A 5-Year Retrospective Analysis. Med Sci Monit Int Med J Exp Clin Res. 4 août 2025;31:e948274.
6. Ogunrewo T, Alonge T, Ogunbiyi J. The Incidence of Primary Malignant Bone Tumour at the University College Hospital, Ibadan, Oyo State, Nigeria, from 2007 to 2022: A Current Update. J West Afr Coll Surg. 2025;15(2):142‑5.
7. Deka KM, Talukdar A. A retrospective analysis of bone tumours and tu- mour-like lesions: A hospital based study of 76 cases. Int J Res Med Sci. 2017;5(11):4915-18.
8. Kumar M, Gupta B. Global incidence of primary malignant bone tumours. 2016 Available from: www.c-orthopaedicpractice.com [last accessed: 05/04/2025].
9. Pillay Y, Ferreira N, Marais LC. Primary malignant bone tumours: Epidemiological data from an Orthopaedic Oncology Unit in South Africa. SA Orthop J. 2016;14(4):12-16.
10. Kong P, Yan J, Liu D, Ji Y, Wang Y, Zhuang J, et al. Skeletal-related events and overall survival of patients with bone metastasis from nonsmall cell lung cancer - A retrospective analysis. Medicine (Baltimore). déc 2017;96(51):e9327.
11. Weilbaecher KN, Guise TA, McCauley LK. Cancer to bone: a fatal attraction. Nat Rev Cancer. juin 2011;11(6):411‑25.
12. Hong S, Youk T, Lee SJ, Kim KM, Vajdic CM. Bone metastasis and skeletal-related events in patients with solid cancer: A Korean nationwide health insurance database study. PLoS ONE. 17 juill 2020;15(7):e0234927.
13. Sofulu Ö, Erol B. Evaluation of factors affecting survival rate in primary bone sarcomas with extremity and pelvis involvement. Acta Orthop Traumatol Turc. mai 2020;54(3):234‑44.
14. Ciechanowicz D, Kotrych D, Starszak K, Prowans P, Zacha S, Kamiński A, et al. Delay in Diagnosis and Treatment of Bone Sarcoma-Systematic Review. Cancers. 14 mars 2025;17(6):981.
15. Kotrych D, Ciechanowicz D, Pawlik J, Szyjkowska M, Kwapisz B, Mądry M. Delay in Diagnosis and Treatment of Primary Bone Tumors during COVID-19 Pandemic in Poland. Cancers. 8 déc 2022;14(24):6037.
16. Ren G, Esposito M, Kang Y. Bone metastasis and the metastatic niche. J Mol Med Berl Ger. nov 2015;93(11):1203‑12.
17. Ibrahima F, Motah M, Nonga BN, Singwe MN, Bahebeck J, Sosso M, et al. PRISE EN CHARGE DES TUMEURS OSSEUSES AU CAMEROUN. NOTRE EXPERIENCE INITIALE. Health Sci Dis [Internet]. 2011 [cité 2 avr 2026];12(2). Disponible sur: https://www.hsd-fmsb.org/index.php/hsd/article/view/93
18. Oyemade GA, Abioye AA. Primary malignant tumors of bone: incidence in Ibadan, Nigeria. J Natl Med Assoc. janv 1982;74(1):65‑8.
19. Sadykova LR, Ntekim AI, Muyangwa-Semenova M, Rutland CS, Jeyapalan JN, Blatt N, et al. Epidemiology and Risk Factors of Osteosarcoma. Cancer Invest. mai 2020;38(5):259‑69.
20. Bahebeck J, Atangana R, Eyenga V, Pisoh A, Sando Z, Hoffmeyer P. Bone tumours in Cameroon: incidence, demography and histopathology. Int Orthop. 2003;27(5):315‑7.
21. Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev. 2001; 27:165–176. [PubMed: 11417967].
22. Mundy GR. Metastasis to bone: causes, consequences and therapeutic opportunities. Nature Rev Cancer. 2002; 2:584–593. [PubMed: 12154351].
23. Ell B, Kang Y. SnapShot: Bone Metastasis. Cell. oct 2012;151(3):690-690.e1.
24. Yoshikawa H, Nakase T, Myoui A, Ueda T. Bone morphogenetic proteins in bone tumors. J Orthop Sci. 2004;9(3):334–40.
25. Ong W, Zhu L, Tan YL, Teo EC, Tan JH, Kumar N, Vellayappan BA, Ooi BC, Quek ST, Makmur A. Application of machine learning for differentiating bone malignancy on imaging: a systematic review. Cancers. 2023;15(6):1837.
26. Bi WL, Hosny A, Schabath MB, Giger ML, Birkbak NJ, Mehrtash A, Allison T, Arnaout O, Abbosh C, Dunn IF. Artificial intelligence in cancer imaging: clini- cal challenges and applications. Cancer J Clin. 2019;69(2):127–5.
27. Ahmed SJ. Advancements in Lung Cancer detection: harnessing innovative techniques for enhanced diagnosis. Int J Comput Digit Syst. 2024;16(1):1–16.
28. Xu, Y.; Shi, F.; Zhang, Y.; Yin, M.; Han, X.; Feng, J.; Wang, G. Twenty-year outcome of prevalence, incidence, mortality and survival rate in patients with malignant bone tumors. Int. J. Cancer 2024, 154, 226–240. [CrossRef].
29. Luetke, A.; Meyers, P.A.; Lewis, I.; Juergens, H. Osteosarcoma treatment—where do we stand? A state of the art review. Cancer Treat. Rev. 2014, 40, 523–532. [CrossRef].
30. Smeland, S.; Bielack, S.S.; Whelan, J.; Bernstein, M.; Hogendoorn, P.; Krailo, M.D.; Gorlick, R.; Janeway, K.A.; Ingleby, F.C.; Anninga, J.; et al. Survival and prognosis with osteosarcoma: Outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort. Eur. J. Cancer 2019, 109, 36–50.