Death of 43 Indonesian women with ovarian cancer: A case series

Mulawardhana, Pungky; Hartono, Poedjo; Nugroho, Hari; Ayuningtyas, Atika

doi:10.1016/j.ijscr.2020.12.067

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…In Indonesia, patients are mostly diagnosed with advanced-stage ovarian cancer (39.53%). 15 BRCA mutation was not examined in this patient due to our country’s lack of the required facility.…”

Section: Discussionmentioning

confidence: 99%

Advanced Stage Clear Cell Ovarian Carcinoma Mimicking Uterine Sarcoma Without Gross Residual Tumor During Primary Surgery: A Case Report

Angelina

Tjokroprawiro

2023

Clin Med Insights Case Rep

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Background: Clear cell ovarian carcinoma is rare and accounts for 1%-12% of ovarian epithelial carcinomas, depending on ethnicity. The prevalence of clear cell ovarian carcinoma in Asian, White, and Black women is 11.1%%, 4.8%, and 3.1%, respectively. Magnetic resonance imaging (MRI) shows that clear cell ovarian carcinomas are typically unilocular cyst-solid (34.9%) or multilocular-solid (41.4%); only 23.7% are solid with papillary projections. MRI can detect clear cell ovarian carcinoma with a sensitivity and specificity of 90% and 87%, respectively. Notably, sometimes ovarian masses have a solid feature and should be differentiated from uterine masses. Clear cell ovarian carcinoma has a better prognosis compared to serous carcinoma when diagnosed at an early stage, but it has a poorer prognosis at an advanced stage. The absence of a residual tumor is a favorable prognostic factor in patients with advanced-stage clear cell ovarian carcinoma. Herein, we present a case in which clear cell ovarian carcinoma was misdiagnosed as uterine sarcoma because imaging showed a mass with a solid uterine-like and necrotic area. In the present case, cytoreductive surgery was performed to remove the entire tumor and its infiltration to the sigmoid colon and left ureter. Hence, the patient had a better prognosis. Case report: A 57-year-old Indonesian woman presented to our hospital (Dr. Soetomo General Hospital) with post-menopausal bleeding, a large solid pelvic mass, and abdominal discomfort. The patient was diagnosed with uterine sarcoma due to the solid feature observed during ultrasonography and MRI. During the surgery, the mass was observed to originate from the left ovary, and primary debulking surgery with a multidisciplinary team was performed with zero residual tumor tissue. The tumor was histopathologically confirmed as clear cell carcinoma. Conclusion: MRI of clear cell ovarian carcinoma can be misdiagnosed as uterine sarcoma due to its solid feature. Additionally, the enlarged mass distorts the anatomical landmarks. Surgery with no residual tumor improves the prognosis for advanced-stage clear cell ovarian carcinoma.

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Section: Discussionmentioning

confidence: 99%

Advanced Stage Clear Cell Ovarian Carcinoma Mimicking Uterine Sarcoma Without Gross Residual Tumor During Primary Surgery: A Case Report

Angelina

Tjokroprawiro

2023

Clin Med Insights Case Rep

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“…15 The presence of spheroid cells (mesothelial and tumor) in ascites also causes chemoresistance thereby resulting in shorter DFS and OS. [16][17][18][19][20] Tumor conditions with ascites have worse prognoses because they have a much greater potential for metastases. 21 We found that mucinous and clear cell histopathology had a worse survival outcome than those of other histologic types.…”

Section: Discussionmentioning

confidence: 99%

“…1 Based on the Globocan 2018 data, new cases of ovarian cancer in Indonesia reach 13,310 cases every year, ranking in the top 10 countries in terms of new cancer cases. 2 More than half of the ovarian cancers are diagnosed in the advanced stage and have a high recurrence rate. 3 The survival curve after cancer recurrence will not flatten again.…”

Section: Introductionmentioning

confidence: 99%

Correlation between clinicopathological factors and clinical outcomes of recurrent epithelial ovarian cancer at a tertiary hospital in Surabaya, Indonesia

2022

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Introduction: Ovarian cancer is one of the leading causes of cancer death in women globally. The objective of this study was to determine the correlation and the association between age, stage, histopathology, grade, ascites, tumor residual, CA-125 level, and type of surgery on recurrence, disease-free survival, overall survival and mortality of epithelial ovarian cancer patients. Methods: An analytical retrospective study using medical records and interviews of epithelial ovarian cancer patients was conducted in Dr. Soetomo Hospital. The study included the data from January 2016-December 2020. Kaplan-Meier and log-rank test were used to assess the factors associated with disease-free survival (DFS) and overall survival (OS). Results: A total of 358 patients with epithelial ovarian cancer from 2016 to 2020 were included in the study of which 153 of recurrence cases. Clinicopathological factors that correlated with disease-free survival were stage, histopathology, grade, ascites, tumor residual, CA-125, and type of surgery (p<0.05). The factors that correlated with overall survival were stage, histopathology, grade, ascites, residual tumor, and CA-125 value (p<0.05). The most significant factors associated with recurrence and mortality were stage, grade, and ascites. Stage II and III had an HR (hazard ratio) of 1.9 and 2.1 for recurrence compared to stage I, respectively. Grade II and III patients had HRs of 2.1, and 3.4 for recurrence compared to stage I, respectively. The presence of ascites had an HR of 1.5 compared to those had no ascites. Stage III had an HR of 1.9 for mortality compared to stage I, respectively. Grade II and III patients had HRs of 3.6, and 5.0 for death compared to stage I, respectively. The presence of ascites had an HR of 1.6 compared to patients with no ascites. Compared to serous type, those patients with mucinous and clear cell had HR of 1.8 and 3.1 for mortality, respectively Conclusion: Stage, grade, and ascites were the most significant factors in the incidence of recurrence and mortality of epithelial ovarian cancer.

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“…Pada penelitian yang dilakukan di RSUP dr. Soetomo, didapatkan sebanyak 62.79% pasien dengan kanker ovarium di diagnosa pertama kali pada usia 40-59 tahun. 8 Namun temuan di atas tidak sejalan dengan data di dunia, dimana diketahui salah satu faktor risiko kanker ini adalah bertambahnya usia. 9 Kanker ini lebih sering dijumpai pada usia lebih dari 65 tahun dan umumnya terjadi pada perempuan pasca menopause.…”

Section: Pembahasanunclassified

Akurasi kadar serum Secretory Leukocyte Protease Inhibitor (SLPI) dalam menunjang diagnosis kanker ovarium: suatu uji diagnostik

Putra

Suwiyoga

Budiana

et al. 2022

Intisari Sains Medis

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Background: Ovarian cancer is one of the most common malignant tumors found in reproductive organs in vitro. Secretory Leukocyte Protease Inhibitor (SLPI) protein is essential for the growth of ovarian cancer cells, a protein that maintains the survival of ovarian cancer cells, inhibits antiproliferative effects, and reverses the proapoptotic effect of elastase. This study aims to evaluate the role of SLPI in diagnosing ovarium cancer. Methods: The research was conducted at the Obstetrics and Gynecology Polyclinic, Sanglah Hospital, Denpasar and the Prodia Laboratory. Sampling of this study has been carried out by previous researchers in research on the accuracy of serum levels of insulin-like growth factor binding protein 2 in diagnosing ovarian cancer. The research sample (intended sample) was women aged 18 years and over with ovarian tumors who came to the Obstetrics and Gynecology Polyclinic, Sanglah Hospital, Denpasar. Data were analyzed using SPSS versi 22 for Windows. Results: The proportion of epithelial types was significantly higher in the ovarian cancer group. In ovarian cancer samples, the most samples were obtained at FIGO III Stage. Median CA125 levels, RMI scores, and SLPI levels were significantly higher in the group with ovarian cancer. The cut off value of serum SLPI used in this study was 54,000 pg/ml which was obtained from preliminary analysis on 26 training samples. Sensitivity: 78.3; specificity:66.7%; Positive predictive value: 78.3%; Negative predictive value: 66.7% Accuracy: 73.6%. Conclusion: In a diagnostic test study to assess the accuracy of SLPI serum in supporting the diagnosis of ovarian cancer, it was found that SLPI serum had good sensitivity, specificity, PPV, NPV, and accuracy values. Latar Belakang: Kanker ovarium merupakan salah satu tumor ganas yang paling sering ditemukan pada organ reproduksi secara in vitro. Protein Secretory Leukocyte Protease Inhibitor (SLPI) sangat esensial untuk pertumbuhan sel kanker ovarium, protein yang menjaga kelangsungan hidup sel kanker ovarium, inhibisi efek antiproliferatif, dan membalikkan efek proapoptosis dari elastase. Penelitian ini bertujuan untuk mengevaluasi peran SLPI dalam mendiagnosis kanker ovarium. Metode: Penelitian dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar dan Laboratorium Prodia. Pengambilan sampel penelitian ini sudah dilakukan oleh peneliti sebelumnya pada penelitian tentang akurasi kadar serum insulin-like growth factor binding protein 2 dalam mendiagnosis kanker ovarium. Sampel penelitian (intended sample) adalah wanita berusia 18 tahun ke atas dengan tumor ovarium yang datang ke Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar. Hasil: Proporsi tipe epitelial secara signifikan lebih banyak pada kelompok kanker ovarium. Pada sampel kanker ovarium, didapatkan sampel paling banyak pada Stadium FIGO III. Median kadar CA125, skor RMI, dan kadar SLPI secara signifikan lebih tinggi pada kelompok dengan kanker ovarium. Nilai cut off serum SLPI yang digunakan pada penelitian ini adalah 54.000 pg/ml yang didapatkan dari analisa pendahuluan pada 26 training sample Sensitivitas:78,3; spesifisitas:66,7%; Nilai prediksi positif: 78,3%; Nilai prediksi negatif: 66,7% Akurasi: 73,6%. Kesimpulan: Pada penelitian uji diagnostik untuk menilai akurasi serum SLPI dalam menunjang diagnosis kanker ovarium didapatkan bahwa serum SLPI memiliki nilai sensitivitas, spesifisitas, PPV, NPV, dan akurasi yang baik.

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Death of 43 Indonesian women with ovarian cancer: A case series

Cited by 4 publications

References 20 publications

Advanced Stage Clear Cell Ovarian Carcinoma Mimicking Uterine Sarcoma Without Gross Residual Tumor During Primary Surgery: A Case Report

Advanced Stage Clear Cell Ovarian Carcinoma Mimicking Uterine Sarcoma Without Gross Residual Tumor During Primary Surgery: A Case Report

Correlation between clinicopathological factors and clinical outcomes of recurrent epithelial ovarian cancer at a tertiary hospital in Surabaya, Indonesia

Akurasi kadar serum Secretory Leukocyte Protease Inhibitor (SLPI) dalam menunjang diagnosis kanker ovarium: suatu uji diagnostik

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