A retrospective analysis to reveal the patient characteristics, disease burden, treatment patterns and outcomes of epithelial ovarian cancer

Abstract

Background: In India, ovarian cancer is 3^rd most common gynecologic malignancy. The majority of patients are diagnosed in advanced stage (70-80%), where the long-term (10 years) survival rate is poor, estimated at 15-30%.

Objectives: This study aims to evaluate clinical epidemiology, treatment patterns, and survival outcomes in patients with epithelial ovarian cancer.

Methods: This was a retrospective analysis of epithelial ovarian cancer patients who were treated at SKIMS, Srinagar, over a period of 9 years, from January 2010 to December 2018.

Results: Ovarian cancer constituted 2.94% of all cancers registered. Epithelial ovarian cancer constituting 88.4% of all ovarian cancers. The median age of the patients was 50 years. More than two-thirds of patients belonged to the rural background. More than 76.0% of the patients were in stage III/IV at the time of diagnosis. The most common presenting symptoms were abdominal distension/bloating (46.5%), abdominal pain (21%). The most common histological types were serous cystadenocarcinoma (65.9) followed by mucinous cystadenocarcinoma 15%). Median overall survival for whole study cohort was 30 months (95% confidence interval [CI]: 28.0–31.9). Median overall survival for stage I, II, III, and IV was 72, 60, 30, and 20 months. Early-stage at diagnosis, optimal cytoreduction, and operation by onco-surgeon significantly improved OS.

Conclusion: Delay in diagnosis, improper management before referral, and lack of tertiary care facilities are the root cause of the poor outcome.

Implications: This data will serve as a benchmark over which we can further improve outcomes of epithelial ovarian cancer patients.