Clinico pathological features and treatment outcome of malignant epithelial ovarian tumour

Outcome of malignant epithelial ovarian tumours

Abstract

Background: Ovarian cancer is the ninth most common cancer in women and it ranks fifth as the cause of cancer death in women. Epithelial ovarian cancer (EOC) represents the most lethal malignancy of the female genital tract. EOC is typically diagnosed in advanced FIGO (Federation of International Gynaecology and Obstetrics) stages due to lack of symptoms in the earlier stages. So, the aim of this study was to determine the disease free survival (DFS) of EOC after treatment and also to find out the prognostic factors such as age, FIGO stage, histopathological subtypes   and grade for recurrence of disease.

Methods: A retrospective study was conducted in gynaecological oncology department of National Institute of Cancer Research and Hospital (NICRH), Dhaka. Study period was 02 years from January 2017 to December 2018.Histopathologically confirmed epithelial ovarian malignancy after completion of treatment was included in this study. Non-epithelial ovarian malignancy was excluded from this study.

Results: Mean age was 53 yrs (range 25-80 yrs).Final surgical staging (FIGO stage) of disease were as follows stage I; 24 (25.8%), stage II; 18 (19.4%), stage III; 45 (48.4%) and stage IV; 6 (6.5%). Mean follow-up time was 34 months (range 24-60 months). DFS according to FIGO stages were 35 months, 27 months,  25 months and 9 months respectively.  DFS based on the complete and incomplete surgical staging were 27 months and 22 months respectively. At univariate analysis, factors significantly associated with decrease DFS and increase recurrence which included age (HR- 1.39 95% CI), stage (HR- 1.22, 95% CI), histopathological type (HR-1.28, 95% CI) and grade of tumor (HR-1.65, 95% CI). At multivariate analysis, FIGO stage (HR-3.9, 95% CI), histopathological type (HR-1.86, 95% CI) and grade (HR-1.11, 95% CI) having an association with decease DFS.

Conclusion: Surgical stage was one of the strongest independent prognostic factors of DFS for EOC. Increasing age, histopathology and grade are also independent predictors of decrease DFS in patient with EOC treated with current standard therapy.

Bangladesh Med Res Counc Bull 2020; 46(2): 115-119