John-Olabode et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PURPOSE This study was designed to investigate the clinicopathologic predictors of progression-free survival (PFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC) following primary treatment in Lagos, Nigeria. MATERIALS AND METHODS Using data from a retrospective cohort of 126 patients who received treatment for EOC between 2010 and 2018, we identified 83 patients with a complete clinical record for subsequent data analysis. Patients' demographics and updated 2-year follow-up status were abstracted from medical records. Kaplan-Meier survival curves were compared using the log-rank test, and Cox proportional hazard models were used for multivariate analysis to identify independent predictors of survivals following treatment in EOC patients. RESULTS The median PFS and OS were 12 and 24 months, respectively. After adjusting for covariates in the multivariate analysis, younger age ≤ 55 years (hazard ratio [HR] = 0.40; 95% CI, 0.22 to 0.74; P = .01) and International Federation of Gynecology and Obstetrics (FIGO) stage I/II (HR = 0.02; 95% CI, 0.01 to 0.08; P = .01) were independent predictors of improved PFS, whereas being premenopausal (HR = 2.34; 95% CI, 1.16 to 4.75; P = .02) was an independent predictor of reduced OS after 2-year follow-up. CONCLUSION PFS could be predicted by the age and FIGO stage of the disease, whereas menopausal status was predictive of OS in patients with EOC. This knowledge should form the basis for counseling patients with ovarian cancer during their primary treatment and lend support to the importance of aggressive follow-up and monitoring for the older, premenopausal patients and those with an advanced stage of epithelial ovarian cancer. However, robust longitudinal research should be carried out to provide additional reliable insight to this information.
Highlights Uptake of HPV vaccination & testing was abysmally low despite good knowledge of it. Unvaccinated and untested women were more willing to accept HPV test than vaccination. Knowing CC patient, being employed & unmarried predicted HPV vaccination & testing. Recommendation by HCP & friend/relative were motivators for HPV vaccination & test. Fear, cost & non-recommendation by HCP were barriers to HPV vaccination & testing.
Background: The timing of recurrence of epithelial ovarian cancer (EOC) after a standard primary treatment is an important indicator of the degree of response of the tumour to treatment. It, however, remains unclear if the timing of recurrence will predict survival outcomes. Aim: This study explored the impact of timing of recurrence after an initial response to standard primary treatment on the overall survival (OS) of patients with EOC. Methods: Data was extracted from the records of patients who underwent standard primary treatment and follow-up after EOC diagnosis between January 2011 and December 2020. The Kaplan-Meier survival estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Results: The risks of recurrence of EOC increased steadily with increasing time from the start of primary treatment from 13.6% in 6-months to 71.0% after 12-months. In the final multivariate analyses, recurrence within 6 months of treatment was a significant independent predictor of poor OS in EOC patients (hazard ratio=7.23, 95%CI: 3.87–13.51, P<0.01). Conclusion: Our study suggests that recurrence within 6-months is an important prognostic predictor of poor OS in EOC. Early tumour recurrence may be a useful surrogate of OS and thus this information should be considered in the design of future tailored randomized controlled trials. Future strategies to improve OS in EOC patients should focus on identifying effective measures to prevent early tumour recurrence.
Background To improve the overall survival of epithelial ovarian cancer (EOC) patients, a more precise risk identification after completion of standard treatment will enhance patients' follow‐up surveillance and the use of individualized targeted therapy. Aim This study explored the potential risk predictors of early mortality in EOC patients who had standard treatment with debulking surgery and chemotherapy. Methods The study included 93 EOC patients who had standard treatment and were followed up between January 2011 and December 2020. The sociodemographic, clinical, and laboratory data of patients with EOC including the update on their 3‐year follow‐up status were retrospectively collected and analyzed. Early mortality is defined as the death of a patient within 3 years of completion of standard treatment. Patients' data were computed using descriptive statistics and the associations between patients' factors and the risk of early mortality were tested using the binary logistic regression model. Results Early deaths occurred in 36 (38.7%) of patients with EOC. In the final multivariate analyses, early tumor relapse within 6‐months of treatment completion was the only independent risk factor that predicts early mortality in EOC patients (risk ratio = 8.6, 95% confidence interval: 3.3–24.5, p < 0.01). Conclusion Our study suggests that early tumor relapse may be a useful surrogate of early mortality in EOC. However, our findings should be interpreted with caution pending further corroboration through an adequately powered, prospective multicenter study.
BackgroundSeveral studies have shown that whether complete tumor resection can be achieved during debulking surgery depends on various patient-related factors. However, none of these studies was conducted among patients with epithelial ovarian cancer (EOC) in sub-Saharan Africa. In this study, we aimed to determine the preoperative predictors of optimal tumor resectability (OTR) during primary debulking surgery (PDS) in patients with EOC. MethodologyIn this study, we reviewed all patients with histologically diagnosed EOC who underwent PDS between January 2011 and December 2020. We included 83 patients with complete clinical records for subsequent data analysis. Descriptive statistics were computed for patients' data, and binary logistic regression analysis was used to assess the strength of associations between patients' preoperative characteristics and OTR. ResultsThe overall rate of OTR was 53.0%, while the rate in advanced EOC patients was 36.1%. In the univariate analyses, pleural effusion, ascites, tumor bilaterality, size of the largest tumor, retroperitoneal lymph nodes, omental caking, peritoneal thickening, significant extrapelvic tumor, serum cancer antigen-125 (CA-125) levels, and hemoglobin levels were recorded as the predictors of OTR. However, after adjusting for covariates in the final multivariate models, we found that the absence of moderate-to-large pleural effusion (odds ratio (OR) = 5.60; 95% confidence interval (CI) = 1.32, 23.71) and having serum CA-125 levels of ≤370
Background: Preterm birth is one of the major causes of neonatal morbidity and mortality worldwide. The association between occurrence of preterm birth and biomarkers measured in the maternal serum maybe helpful in predicting preterm birth especially in low resource settings. Aim: We aimed to examine the association between maternal serum leptin level and occurrence of preterm birth. Materials and Methods: This was an analytical cross-sectional study of women with preterm and term births in Lagos, Nigeria. One hundred and ninety women comprising of 95 women with preterm and term births respectively recruited. Maternal serum leptin levels were determined using Enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed by Stata version 16 (StataCorp, USA) statistical software with significance level set at p-value <0.05. Results: The mean serum leptin levels were significantly lower in women with preterm delivery compared to women with term delivery (1.48 ng/ml ± 0.72 vs. 1.75 ng/ml ± 0.67, p-value=0.007). On further analysis, women with very preterm birth had significantly lower serum leptin levels compared with women with moderate to late preterm and term births (1.28 ± 0.73 vs 1.55 ± 0.70 vs 1.75ng/ml ± 0.67, p-value=0.006). There was 57% reduction in the odds of having preterm delivery for every unit increase in serum leptin level on multivariate analysis (adjusted OR: 0.43, 95%CI: 0.26 – 0.71, P-value=0.001). Conclusion: Serum leptin concentration was significantly lower in women who had preterm births compared to women who had term births. Longitudinal studies are required to determine the predictive value of maternal serum leptin level with regards to preterm birth.
six series followed by six months of observation. After the observation, we determined the therapy's response with the RECIST Criteria (Response Criteria in Solid Tumors). Immunohistochemistry (retrospective) tests to ovarian cancer tissue and flow cytometry (prospective) blood tests then were performed to examine the expression of CD44 + /CD24 -, RAD6 and DDB2. Results There were significant overexpression of CD44 + / CD24 -, RAD6 and underexpression of DDB2 (p <0.05) in chemoresistance ovarian cancer tissue with significant AUC value (p<0.05). There were significant overexpression of CD44 + /CD24 -, and RAD6 (p <0.05) in blood circulation of chemoresistance ovarian cancer patients while CD44 + /CD24has significant AUC value (p<0.05) Conclusions We conclude that there were overexpression of CD44 + /CD24 -, RAD6, underexpression of DDB2 in ovarian cancer tissue, and overexpression of CD44 + /CD24in blood circulation and these proteins were good predictors of ovarian cancer chemoresistance.
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