Incidence, characteristics, pattern and management of ovarian cancer in Abuja, Nigeria

Abstract

Background: The prevalence of ovarian cancer is thought to be increasing with huge burden of the disease with no comprehensive cancer center that can offer appropriate care in developing countries. However, little is known about the incidence, pattern and outcome of this disease in Abuja, Nigeria. Therefore, the aim of this study was to review the pattern of care offered to patients with ovarian cancer in our center and to evaluate patients’ outcome.Methods: This was a retrospective review of all the patients with histologically confirmed ovarian cancers admitted to the gynecological ward of the hospital over a period of 5 years. Relevant information was extracted from the ward register and patients medical case records. Data were analyzed using statistical package for social science version 23 and results were then presented in tables and chart.Results: Ovarian cancers constituted 19.6% and 5.6% of all gynecological cancers and all gynecological admissions respectively. The mean age at presentation was 50.2±8.5 years and premenopausal 32 (55%) constituting the majority. A large proportion 43 (74.1%) of the patients were parous. The commonest symptoms at presentation were abdominal swelling (86.2%), and abdominal pain (53.4%) with the majority 38 (65.5%) presenting in an advanced stage. The commonest histological type of ovarian cancers was epithelial accounting for 30 (51.7%) of all ovarian cancers. Common treatment modality was surgery and chemotherapy and majority 32 (55.3%) of the patients had cytoreductive surgery with 19 of them having optimum cytoreduction and 33 (57%) benefitted from chemotherapy. Lost to follow- up was significantly high (55%) and mortality rate was 15.5%.Conclusion: Cases of ovarian cancers are on the increase. Women presented at an advanced stage of the disease, which resulted in short survival times. Failure of optimal management was also worsened by poor compliance to treatment with high patients' default rate.

Clinical Characteristics and Outcome of Management of Ovarian Cancer in a Tertiary Hospital

“…The top three symptoms among patients from our study were abdominal swelling, abdominal pain, and weight loss. These are features of the advanced disease and similar presentations were seen in other studies (11,12,20). Patients with ovarian cancer hardly seek medical assistance early because symptoms are usually non-specific and will only present when the disease has become obvious and unbearable.…”

“…In a report from FIGO, ovarian cancer was seen more commonly among the age group of 60-64 years in developed countries, and the median age was about a decade earlier in low-income countries (6), which is consistent with what was found in this study. Other studies having similar mean ages include that which was carried out in Abuja (50.2±8.5 years), Kano (50.5 ± 13.5 years), and Kenya 49.8±15.7 years (11,18,19). Nulliparity has been known to be a strong risk factor for ovarian cancer (6,20), however, findings from this study showed a high incidence of ovarian cancer among parous women with a substantial contribution from multiparous women with a median parity (IQR) of 3(0-5).…”

“…This is a retrospective five-year study (2016)(2017)(2018)(2019)(2020), carried out at the Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. The names and hospital numbers of patients with histologically confirmed ovarian cancers from January 2016 to December 2020, were retrieved from the register at the Department of Pathology.…”

“…However, some risk factors have been shown to have some protection. They include conditions associated with reduced ovulatory cycles such as the use of combined oral contraceptive pills and breastfeeding, others are bilateral tubal ligation and late menarche (4,11,12). Surgical staging exploratory laparotomy for cytoreduction or tumour debulking remains the standard care for patients with ovarian cancer and this procedure should be performed by a gynecologic oncologist (10,13).…”