Clinicopathological Characteristics and Management of Esophageal Cancer in Mauritania: A Retrospective Study of 78 Cases at the National Oncology Center of Nouakchott

Background: Esophageal cancer remains a major public health concern worldwide, particularly in low-resource countries where late diagnosis and limited therapeutic options contribute to poor outcomes. In West Africa, epidemiological data are sparse, and no large-scale studies have been published in Mauritania. Objectives: To describe the clinicopathological profiles, management strategies, and outcomes of esophageal cancer cases managed at the National Oncology Center (NOC) of Nouakchott and to provide foundational data for future cancer control strategies in Mauritania. Methods: This retrospective observational study included all patients with histologically confirmed esophageal cancer who were treated at the NOC between January 2017 and December 2019. Sociodemographic, clinical, endoscopic, histopathological, therapeutic, and outcome data were extracted from archived medical records and analyzed using SPSS v20.0. Results: Seventy-eight patients were included (mean age: 48.6 years, range: 18–81 years), with a male predominance (59%; male-to-female ratio, 1.4). Risk factors were undocumented in 73.1% of records; identified factors included Plummer-Vinson syndrome (14.1%), tobacco use (7.7%), and gastroesophageal reflux disease (GERD) (5.1%). Most cases originated from riverine regions (Trarza, Brakna, and Gorgol). Dysphagia was the most common symptom (91%). The lower third of the esophagus was the most frequent tumor site (38.5%). Squamous cell carcinoma accounted for 96.2% of the cases, and adenocarcinoma was rare (3.8%). Only 43.6% of cases had complete TNM staging, with most patients presenting at advanced stages (IV, 34.6%). Curative surgery was performed in only 2.6% of the patients, and most patients received palliative treatments. The overall mortality rate was 68%, with 16.6% of patients being lost to follow-up. Conclusion: Esophageal cancer in Mauritania is characterized by the predominance of squamous cell carcinoma, early age of onset, advanced-stage diagnosis, and poor outcomes. Major challenges include diagnostic delays, lack of systematic screening, limited technical resources, and incomplete data. Establishing a national cancer registry, improving early diagnosis, and enhancing technical and human capacities are urgently required to improve patient outcomes.