Novel diagnostic and therapeutic approaches to the treatment of ovarian cancer (original) (raw)
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Practica medicală, 2021
Malignant ovarian neoplasms represent a public health issue, being one of the most frequent cancers among women, exhibiting the highest mortality rate. The general purpose of this study lays in the analysis of the metastasizing potential of malignant ovarian neoplasms, the correlation between the histological subtype and the genesis of the metastasis. We present an observational retrospective study spanning over 2 years, between 2018-2019, on 30 admitted patients who were treated for malignant ovarian neoplasms in the department of Obstetrics and Gynecology of Bucharest Emergency University Hospital. The most frequent histopathological subtype encountered in our study has been the high grade serous ovarian carcinoma 46,67%, with 30% presenting poorly differentiated neoplasms (G3), therefore having poor prognosis. A considerable number of patients 56,67% presented ascites (among which 43,33% of patients also exhibited peritoneal carcinomatosis, direct dissemination representing the main metastasizing pathway of malignant ovarian neoplasms in the patients included in our study.From our study we can conclude that patients with ovarian malignant neoplasms are diagnosed in an advanced stage of the disease, when metastasis are already present, with a poor prognosis. This is mainly due to the lack of regular gynecological checkups in menopausal womenand because it is considered that once past the fertile age the gynecological examination no longer represents a necessity.
International Journal For Multidisciplinary Research, 2023
Ovarian cancer is relatively common but serious and has a poor prognosis. The aim of this study is to highlight the epidemiological, diagnostic, therapeutic and evolutionary aspects of this malignant pathology managed at the Bejaia university hospital center. This is a retrospective and descriptive study over a period of 3 years (2019-2022) carried out on 20 patients who developed ovarian cancer. The average age of the patients was 50 years old, 53.23% of whom were over 45 years old. The CA-125 blood test was positive in 18 out of 20 patients. The tumors were discovered on ultrasound in 87.10% of cases and at laparotomy in 12.90%. Total hysterectomy with bilateral adnexectomy was the most performed procedure (64.52%). The early postoperative course was simple. 15 patients underwent second look surgery (16.13%) for locoregional recurrences. Epithelial tumors were the most frequent histological type (93.55%), including 79% in the advanced stage (IIIc-IV) and 21% in the early stage (Ia-Ib). Adjuvant chemotherapy was administered in 80% of patients. With a median follow-up of 36 months, 2 patients were lost to follow-up. The evolution was favorable in 27.42% and in 25.81% deaths occurred late postoperatively. Ovarian cancer is not common but serious given the advanced stages and the high rate of late postoperative deaths which were largely observed in patients deprived of adequate neoadjuvant or adjuvant chemotherapy.
Ovarian cancer is relatively common but serious and has a poor prognosis. The aim of this study is to highlight the epidemiological, diagnostic, therapeutic and evolutionary aspects of this malignant pathology managed at the Bejaia university hospital center. This is a retrospective and descriptive study over a period of 3 years (2019 - 2022) carried out on 20 patients who developed ovarian cancer. The average age of the patients was 50 years old, 53.23% of whom were over 45 years old. The CA-125 blood test was positive in 18 out of 20 patients. The tumors were discovered on ultrasound in 87.10% of cases and at laparotomy in 12.90%. Total hysterectomy with bilateral adnexectomy was the most performed procedure (64.52%). The early postoperative course was simple. 15 patients underwent second look surgery (16.13%) for locoregional recurrences. Epithelial tumors were the most frequent histological type (93.55%), including 79% in the advanced stage ( IIIc -IV) and 21% in the early stage (Ia- Ib ). Adjuvant chemotherapy was administered in 80% of patients. With a median follow-up of 36 months, 2 patients were lost to follow-up. The evolution was favorable in 27.42% and in 25.81% deaths occurred late postoperatively. Ovarian cancer is not common but serious given the advanced stages and the high rate of late postoperative deaths which were largely observed in patients deprived of adequate neoadjuvant or adjuvant chemotherapy.
Management of Ovarian Cancer: Experience of a single Institution
Research in Oncology, 2014
objectives: Retrospective review of total management and survival analysis of epithelial ovarian cancer patients in a single institution. Background: Epithelial ovarian cancer comprises the majority of ovarian neoplasms (about 80%). Predisposing factors may be Genetic, personal history of breast or endometrial, nulliparity, endometriosis and postmenopausal estrogen. Symptoms are often vague and till now there are no effective screening programs. Typically, treatment depends on a combination of surgery and chemotherapy in most of the patients. Methods: A retrospective review of medical files of all patients diagnosed and treated as epithelial ovarian cancer at clinical oncology department, Menoufia University from January 2006 till December 2011. The data collected included clinico-pathological characteristics, treatment modalities, response evaluation, progression free survival (PFS), and overall survival (OS). results: This study included 83 patients; the median age for patients was 55 years (18-72 years). 84.3% of the patients presented in advanced stages (Stages III and IV). Serous cystadenocarcinoma was the predominant pathologic subtypes in 68.7% of patients. Surgery was the initial treatment in 86.7% of the cases. All surgeries were done by Gyne-surgeons, Onco-surgeons, and General surgeons. Paclitaxel-carboplatin was the most commonly used regimen as first line chemo-therapy. Response rate to first line chemotherapy reached 80.2% (35% complete response). The median PFS and OS after first line chemotherapy were 17 and 45 months respectively. None of the patients was involved in clinical trials. conclusion: In our study, the age incidence of ovarian cancer was 55 years. 84.3% of the patients' typical presentation was advanced stage disease. The PFS was nearly the same as reported in the western literature. There was a significant correlation between response and stage and the same for OS and PFS with the type of debulking.
Journal of Obstetrics & Gynaecology of Eastern and Central Africa, 2019
Introduction: Ovarian cancer is the third most frequent cause of death amongst gynecological cancers both locally and globally. It presents with vague nonspecific symptoms and is histologically heterogeneous. Ovarian cancer management is primarily surgical followed by adjuvant chemotherapy depending on the histological type and the surgical stage. Objectives: To determine the clinical-pathological presentation, treatment and outcomes of ovarian cancer patients at Moi Teaching and Referral Hospital (MTRH), Eldoret. Methods: This was a retrospective chart review of ovarian cancer patients managed between January 2010 and August 2017 at MTRH. Data were analyzed using STATA version 15. Survival trends were generated using Kaplan Meier method. Results: A total of 124 medical charts of patients with ovarian cancer were retrieved, 29 had incomplete data and were excluded, and 95 were evaluable and included in this review. Over half, (63%) presented in stage 3 and 4 though there was no significant association between histology and stage of disease [X2(6) =4.72, p=0.58]. The median age at diagnosis was 47 years with 55-80 years being the modal age group (36%). Majority (57%) were married and 83.9% were unemployed. Only 66% had documented histopathology, with Epithelial Ovarian Cancer (EOC) being most common (70%), [serous (50%) and mucinous (11.4%)]. Sex cord stromal tumors 11%. Germ cell tumors amounted to 11% (dygerminomas 50%and Yolk sac tumors (25%) Bivariate analysis revealed significant association only between histology and parity [X2 (6) = 28.8, p<0.001]. Those reviewed contributed a total of 138.2 person-years to the study and 11(12%) died, giving a diseasespecific mortality rate of 79.6 per 1,000 person years (95% CI: 44.1-143.8). Mortality was highest among those with epithelial histology 109 (95% CI: 48.8-241.9) per 1,000 person years and those who had neoadjuvant chemotherapy then surgery as a treatment option, 373.1 (95% CI: 93.3-1491.8) per 1,000 person years. Those who underwent upfront surgery followed by adjuvant chemotherapy and sex cord stromal cancer had higher survival probability. Conclusion: Ovarian cancer at MTRH is diagnosed at advanced stages III and IV of disease and has a lower median age at presentation. EOC is the commonest histological type and serous subtype is the most lethal. Mortality was highest among those with EOC and those who underwent neoadjuvant chemotherapy. Granulosa cell tumor is the only sex cord stromal type reported in our setting and it exhibited a higher survival probability. Germ cell tumors were mainly found in nulliparous women.
Clinicopathological analysis of ovarian tumours: experience of 3 years in a cancer hospital
The New Indian Journal of OBGYN
Objective: The objective of this study was to study the distribution of ovarian tumors histopathologically in different age groups and their various clinical presentations. Methods: 100 patients who presented with 142 ovarian lesions on either or both sides were analyzed during a period of 3 years and a further two year follow-up of patients with malignant tumors were done in a tertiary cancer hospital. Results: There were 142 lesions comprising of 56% of neoplastic lesions, 30% of non-neoplastic lesions and 14% borderline lesions. Serous tumors were the commonest tumors (42%) followed by germ cell tumors. Serous cystadenoma (33.3%) was the commonest non-neoplastic lesion. The distribution of benign tumors in the reproductive age groups was more commonly seen. Malignant tumors were in the perimenopausal and postmenopausal age group (57.1%). Bilaterality of lesions was seen in 42 patients. Lump in abdomen was seen in 62.5% cases with benign lesions and vague discomfort was reported in all cases of malignant ovarian tumors. Out of 56 cases of malignant ovarian tumor, 34 patients presented in stage 1 and 10 patients presented in stage 4. Conclusions: Ovarian neoplasia is one of the most common and lethal malignancy in female reproductive tract in older age group. Since most of the ovarian cancer remain asymptomatic for prolong period so measures should be taken for early diagnosis for better outcome.
Clinicopathilogical study of ovarian tumors
The ovary is complex in its embryology, histology, and steroido-genesis and has the potential to develop malignancy. Ovarian cancer accounts for 3% of all the cancers in females. In the recent era also, there is still scarcity of simple, non invasive, reliable screening test for the diagnosis of ovarian tumors. As the ovarian tumors present at advanced stage, it increases the morbidity and mortality. In order to increase overall survival rate early diagnosis and staging is necessary, for which we have to depend on clinical and histopathological examination and its correlation. It was a prospective and descriptive study carried out over a period of two years in the department of pathology in the tertiary care teaching hospital. Total 100 cases were studied. The youngest case was 18 years old and the oldest one was 74 years. Maximum number of ovarian tumor was found in the 4 th decade of life. Pain in abdomen (71%) was the commonest clinical presentation in cases of ovarian tumors. It...
A Study on Clinicopathological Spectrum of Ovarian Tumours in a Tertiary Care Centre
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Ovarian cancer is the 6 th most common cancer in worldwide among female population, whereas in India, it is the third most common cancer among women, 1 in 70 women have their lifetime risk to develop this tumour. Survival rate depends on the stage of diagnosis. Although, geographic and racial differences in the incidence of ovarian tumours are well-recognised information regarding any dissimilarity in clinicopathological behaviour is scarce. In the present study, the clinicopathological features of patients with ovarian tumours are evaluated. MATERIALS AND METHODS In a series of 96 clinically and diagnostically-proved ovarian tumours, case history was taken and clinical examination was done. Surgical staging done according to laparotomy, gross morphology and histopathological study was done. Study Type-Observational study, done in between December 2015-March 2017 in Konaseema Institute of Medical Sciences and RF (Research Foundation). RESULTS Out of 96 cases are studied in Konaseema Institute of Medical Sciences and RF, 59 cases are benign and 32 cases are malignant tumour and 5 cases are borderline malignant potential tumours. Most of the tumour presented within 2 months of onset of symptoms, abdominal distension is commonest presentation in (51% of cases). Almost, 71% of the malignant tumour diagnosed at stage III/IV of the disease. CONCLUSION On histopathological study of these tumours, 73% are surface epithelial tumours. Among surface epithelial tumours, serous tumour is the commonest one. So, early diagnosis and prompt treatment (surgery and chemotherapy) definitely reduce the mortality from ovarian tumour.
Cureus, 2022
There are a minimum of five distinct sub-types of ovarian cancer based on histology, each of which has distinct factors of risk, types of cells, molecular makeups, clinical characteristics, and therapeutic approaches. Ovarian cancer is detected usually at later stages, and there is no reliable screening method. Cytoreductive surgery and chemotherapy which use platinum-containing drugs are the standard treatments used for freshly detected cancer. Chemotherapy, drugs that are anti-angiogenic, poly ADP-ribose polymerase inhibitors, and immunological treatments are all used to treat recurrent cancer. The most frequent type of ovarian cancer to be diagnosed is high-grade serous carcinoma (HGSC), which often responds well to platinum-based chemotherapy when discovered. However, HGSCs commonly relapse and develop increased treatment resistance in addition to the other histologies. As a result, ovarian cancer research is actively focused on understanding the processes causing platinum resistance and developing strategies to combat it. Serous tubal intraepithelial carcinoma is an HGSC precursor lesion. It is one of the early complications seen in ovarian carcinoma. It has been very useful in identifying the people who have a greater chance of developing ovarian cancer and development of strategies to prevent it. This has led to a significant progress for identification of the genes which are found in people with greater chances of development of ovarian carcinoma (for example, the BRCA1 and BRCA2).