Background: Treatment of ovarian cancer involves a combination of surgery with optimal debulking surgery followed by chemotherapy, because many women are diagnosed at an advanced stage. The optimal timing of postoperative chemotherapy for ovarian cancer remains poorly defined.
Objectives:To determine the proportion of patient with delayed chemotherapy, the time-to-commencement of adjuvant chemotherapy, and to identify the predictors of delayed chemotherapy among women with advanced ovarian cancer at the University of Port Harcourt Teaching Hospital (UPTH).
Material and Methods:This was a prospective cross-sectional study of 57 patients who underwent surgery for advanced ovarian cancer between January 1, 2018, and December 31, 2022. A proforma was used to obtain the socio-demographic and clinical characteristics of the participants. Chemotherapy delay was defined as initiation of multiagent chemotherapy >42 days from primary debulking surgery. Associations of sociodemographic and clinical characteristics with adjuvant chemotherapy delay were evaluated with multivariate logistic regression.Results: Most 20 (35.1%) were aged 45-54 years, with a mean age of 46.9 ± 11.3 years. Majority 37 (64.9%) were married and 31 (54.4%) had tertiary education. The most common histological type was serous 36 (52.6%) followed by mucinous 9 (15.8%). Almost all 55 (96.5%) the women had ascites on presentation, all the women were referred to the study centre, with many 33 (57.9%) of the referrals from private clinics. Many of these patients 46 (84%) had their adjuvant chemotherapy delayed, with 39 (69%) presenting with stage III disease. Financial constraint 35 (51.5%) was the main reason for delayed chemotherapy. Menopause was significantly associated with the delay in adjuvant chemotherapy (chi-square = 7.14, p = 0.01). However, multivariable logistic regression analysis did not identify any potential predictors as a factor for delay in commencing adjuvant chemotherapy. For every unit increase in age of these women, there was an insignificant 12% reduced odds of having delayed adjuvant chemotherapy.
Conclusion:Delay in starting adjuvant chemotherapy is known to be a risk factor for overall survival. Being able to identify the causes of these delays will assist healthcare professionals in understanding and mitigating the risk.