Patterns of Treatment and Outcomes in Epithelial Ovarian Cancer: A Retrospective North Indian Single-Institution Experience

Rajendra Kumar Meena, Nisar Ahmad Syed, Zahoor Ahmad Sheikh, Faisal Rashid Guru, Mohmad Hussain Mir, Saquib Zaffar Banday, Arun Krishnan Mp, Shaheena Parveen, Nazir Ahmad Dar, Gull Mohammad Bhat, Rajendra Kumar Meena, Nisar Ahmad Syed, Zahoor Ahmad Sheikh, Faisal Rashid Guru, Mohmad Hussain Mir, Saquib Zaffar Banday, Arun Krishnan Mp, Shaheena Parveen, Nazir Ahmad Dar, Gull Mohammad Bhat

Abstract

Purpose: Ovarian cancer (OC) is ranked as the third most common gynecologic cancer in various Indian cancer registries. In India, OC is seen in the younger age group, with a median age < 55 years being reported by most of the studies. The majority of patients are diagnosed in advanced stage (70%-80%), where the long-term (10-year) survival rate is poor, estimated at 15%-30%. The aim of this study was to evaluate clinical epidemiology, treatment patterns, and survival outcomes in patients with epithelial OC.

Methods: This was a retrospective analysis of patients with epithelial OC who were treated at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, over a period of 9 years, from January 2010 to December 2018.

Results: OC constituted 2.94% of all cancers registered. Epithelial OC constituted 88.4% of all OCs, with a median age 50 years. More than two third of patients belonged to rural background and the majority (76.9%) of the patients were in stage III or IV at the time of diagnosis. The main presenting symptoms were abdominal distension/bloating (46.5%) and gastrointestinal disturbances (35.2%). The most common histologic types were serous (65.9%) followed by mucinous carcinoma (15%). Median overall survival for the whole study cohort was 30 months (95% CI, 28.0 to 31.9). Median overall survival for stage I, II, III, and IV was 72, 60, 30, and 20 months, respectively.

Conclusion: Most of the patients presented in advanced stage of the disease and have poor outcome. Delay in diagnosis and improper management before registering in tertiary cancer center and lack of tertiary care facilities are the root causes of poor outcomes. The general population and primary care physicians need to be made aware of OC symptoms.

Figures

FIG 1
FIG 1
(A) Kaplan-Meier plot of OS (months) in relation to stage. (B) Kaplan-Meier plot of PFS in months for different stages. OS, overall survival; PFS, progression-free survival.
FIG 2
FIG 2
Kaplan-Meier plot depicting OS (months) in relation to extent of surgery. OS, overall survival.
FIG 3
FIG 3
Kaplan-Meier plot depicting OS in terms of surgeon expertise. OS, overall survival.
FIG 4
FIG 4
Kaplan-Meier plot depicting OS in relation with treatment approach. f/b, followed by; NAct, neoadjuvant chemotherapy; OS, overall survival; Sx, surgery.

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Source: PubMed

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