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

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.

A Survival Analysis of Patients with Recurrent Epithelial Ovarian Cancer Based on Relapse Type: A Multi-Institutional Retrospective Study in Armenia

“…In comparison, all other stage groups had similar survival rates (20–26 months). These data differ from the results of the article published by Rajendra Kumar Meena in 2022 in JCO Global Oncology, according to which stage I and II patients have better survival than more advanced-stage groups do [ 31 ]. An Italian study that was carried out by Gadducci et al also showed statistical significance between survival after recurrence and initial clinical stage (I, IIA vs. IIB–IV) [ 35 ].…”

“…This was probably because the median age of patients in Armenia was 55, which is considerably younger compared to statistics from the United States, where the median age for this disease is 63 [ 29 ], and also lower than that reported in Japanese studies, where the median age of patients at relapse was reported as 59 [ 30 ]. Conversely, in India, ovarian cancer is present in a younger age group, with a median age < 55 years reported by most studies, and even <50 years in some regions of the country [ 31 ]. This phenomenon might be attributed to underdiagnosis and undertreatment of ovarian cancer among the elderly population in limited-source settings.…”

Comparative study on the mutation spectrum of L‐MYC and C‐MYC genes of blood cfDNA in patients with ovarian cancer and healthy females

“…The present study reports a significant difference in the mean value of CA125 tumor marker between the cases and controls. Comparable results were reported by other studies 23–25 …”

“…Comparable results were reported by other studies. [23][24][25] Majority of cases belonged to stage III and stage IV of the disease at the time of diagnosis. Similar findings have been reported in other Indian studies.…”

“…Similar findings have been reported in other Indian studies. 23,26,27 Blood-based mutational profiling is suggested as a promising approach to provide a more comprehensive molecular profile of the disease in a minimally invasive manner. However, an increasing body of evidence from clinical and experimental studies suggests that surgical trauma caused by biopsies or resections gives rise to a series of local and systemic events that can potentially promote tumor progression and metastatic disease.…”