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Background: Esophageal squamous cell carcinoma (ESCC) is a major cause of cancer morbidity and mortality in
Eastern Africa. The majority of patients with ESCC in Eastern Africa present with advanced disease at the time of diag-
nosis. Several palliative interventions for ESCC are currently in use within the region, including chemotherapy, radia-
tion therapy with and without chemotherapy, and esophageal stenting with self-expandable metallic stents; however,
the comparative effectiveness of these interventions in a low resource setting has yet to be examined.
Methods: This prospective, observational, multi-center, open cohort study aims to describe the therapeutic land-
scape of ESCC in Eastern Africa and investigate the outcomes of different treatment strategies within the region.
The 4.5-year study will recruit at a total of six sites in Kenya, Malawi and Tanzania (Ocean Road Cancer Institute and
Muhimbili National Hospital in Dar es Salaam, Tanzania; Kilimanjaro Christian Medical Center in Moshi, Tanzania; Ten-
wek Hospital in Bomet, Kenya; Moi Teaching and Referral Hospital in Eldoret, Kenya; and Kamuzu Central Hospital in
Lilongwe, Malawi). Treatment outcomes that will be evaluated include overall survival, quality of life (QOL) and safety.
All patients (≥18 years old) who present to participating sites with a histopathologically-confirmed or presumptive
clinical diagnosis of ESCC based on endoscopy or barium swallow will be recruited to participate. Key clinical and
treatment-related data including standardized QOL metrics will be collected at study enrollment, 1 month following
treatment, 3 months following treatment, and thereafter at 3-month intervals until death. Vital status and QOL data
will be collected through mobile phone outreach.Discussion: This study will be the first study to prospectively compare ESCC treatment strategies in Eastern Africa,
and the first to investigate QOL benefits associated with different treatments in sub-Saharan Africa. Findings from this
study will help define optimal management strategies for ESCC in Eastern Africa and other resource-limited settings
and will serve as a benchmark for future research |
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