Background: The global incidence of cervical cancer varies (5 lakhs new cases/year), highest in developing countries with >50% dying. Identification of risk factors is necessary to curb the disease.Methods: In this study 1000 married women, attending A.H. Regional Cancer Centre Gynecological-Oncology OPD, from April 2016- March 2017 were randomly selected and subjected to Pap smear test of cervix and abnormal smears, biopsied. Histopathological report of HSIL/invasive carcinoma had HPV-DNA testing. Factors like menarche, coitarche, age at marriage, parity, contraception, smoking habit and socio-economic status were noted.Results: In our study, HSIL was 4.2% and invasive cancer was 2.8%. Multiparity (>5) showed invasive cancer in 57.1% of cases. Menarche between 11-13 years had invasive cancer in 67.9%. Incidence of invasive carcinoma in women married < 15 years was 42.9%. Barrier contraception showed protective role. In patients below poverty line, 78.6%, showed invasive cancer. Rural women showed a higher incidence of invasive carcinoma (67.9%). About 53.6% of invasive cancers were positive for HPV DNA.Conclusions: Early menarche, early coitarche, early marriage, high parity, use of contraception other than barrier, low socioeconomic status, poor habitat and HPV infection, carried a high risk of developing cervical cancer. None of the patients in the study group smoked. HPV infection was the most important risk factor. Improvement of socioeconomic status, education and cervical cancer screening of the high-risk group can reduce cervical cancer mortality and morbidity significantly.
Background and Aims The main objective of this study was to analyze the clinicopathological profile and prognostic factors of granulosa cell tumor (GCT).
Method All the cases of ovarian cancer which were seen at our institute between January 2000 and December 2017 were reviewed. Data were analyzed with failure-free survival (FFS) as the primary end point.
Results GCTs consisted of 2.66% of all ovarian cancers at our institute. The median age was 43 years. Majority of the patients (62.5%) were unstaged. Six patients (25%) had a fertility-preserving procedure. Forty two percent of the patients received adjuvant chemotherapy. Thirty eight percent of the patients developed recurrence. Considering tumor-related prognostic factors, there was a statistically significant decrease in FFS with the presence of hemorrhage (p = < 0.001), larger tumors (p = 0.042), and juvenile variant (p = 0.002). On the contrary, when treatment-related factors were considered, there was no statistically significant improvement in FFS with the performance of lymphadenectomy (p = 0.218), omentectomy (p = 0.453), fertility sparing surgery (p = 0.152), or administration of adjuvant chemotherapy (p = 0.45).
Conclusion Inherent tumor-related biological factors tend to play a more important role compared with treatment-related factors in GCTs. Hence, the traditional practice of performance of extensive staging procedures and routine adjuvant chemotherapy should be reviewed. Fertility-preserving surgery appears safe to be offered in early stages when desired. Although it is common knowledge that GCTs tend to be hemorrhagic tumors, this factor has not been well recognized as a prognostic indicator till date. Our study sheds some light on this aspect. Since these tumors have a tendency toward late recurrences, a long follow-up is prudent.
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