Clinicopathologic features of epithelial ovarian cancer

Abstract

Objectives: This retrospective study was conducted at the Clinical Oncology Department of Mayo Hospital with the objectives to find out the frequency of different clinicopathologic features and to see the pattern of treatment and its outcome. Patients and methods: From 2000 to 2004, 375 patients were seen at the Department of Clinical Oncology, Mayo hospital, Lahore. A proforma was designed to document the age, parity, histopathology, stage, grade, clinical features, and family history. The information was obtained from the medical record section. Stage was assigned according to FIGO staging system. All patients with histopathologically proven epithelial ovarian cancer were included. Results: Epithelial ovarian cancer constituted 8.4 % of all female cancers. The median age at presentation was 51 years (range, 21-75 years). All patients were symptomatic before the diagnosis, with ascites being the most common single manifestation (38.4 %) and in patients with multiple signs and symptoms abdominal sym ptoms were most commonly seen (71.5 %). Median pre operative CA125 level was 218 U/ml. ).Optimal cytoreduction was seen in 36.5 % only, and 63.5% patients presented after sub-optimal cytoreduction. Majority of the patients (82.7%) presented in late stages (III & IV) and only 17.3 % in early stages (I&II). Most common histopathologic type of invasive cancer was serous cystadenocarcinoma , seen in 247(72.4%) patients. Endometrioid tumors were seen in very few (3.8 % ).High grade tumors were the most common. Most women were multiparous and only 16.5% were nulliparous. Post operative treatment primarily included cisplatin based combination chemotherapy. One hundred and twenty seven patients were re treated for recurrent or residual disease and 68 were referred for secondary cytoreduction and were given second line therapy subsequently. Conclusion: Epithelial ovarian cancer is not a silent disease, most patients are symptomatic and present in an advanced stage. In majority of the patients optimal cytoreduction is not achieved. Cystadenocarcinoma is the predominant histology and the endometrioid variety is seen only in few.