Introduction: Non-epithelial is a rare type of ovarian cancer but the most common ovarian neoplasm in reproductive age. This study analyzed the correlation of clinical characteristics to disease-free survival (DFS) and 3-year survival in non-epithelial ovarian cancer. Methods: A cohort analysis of medical records of 30 patients with non-epithelial ovarian cancer from 2016 to 2017 at Dr. Soetomo General Academic Hospital. Survival analysis was performed using Kaplan–Meier test, log-rank test, and Cox regression to determine the correlation of characteristics including age, stage, tumor size, tumor residue, histopathology type and chemotherapy status as prognostic factors for recurrence and mortality. Results: DFS was significantly affected by stage (p=0.049), tumor residue (p<0.0001), and chemotherapy (p=0.005). Stage I, no residual disease, and adequate chemotherapy had the highest DFS and mean DFS rates (94.1% and 35.6 months; 95.5% and 35.7 months; 75% and 31.94 months, respectively). Highest recurrence rates were found in patients with unstaged disease (hazard ratio [HR]=10.08), residue >0 cm (HR=23.13), and inadequate chemotherapy (HR=6.55). Three-year survival was significantly affected by stage (p=0.001), tumor residue (p<0.0001), and chemotherapy (p<0.0001). Stage I, no residual disease, and adequate chemotherapy had the highest 3-year survival rate and mean survival time (94.1% and 35.47 months; 95.5% and 35.7 months; 87.5% and 33 months). The highest mortality were found in patients with unstaged disease (HR=19.99), residue >0 cm (HR=11.33), and inadequate chemotherapy (HR=11.71). Conclusion: Stage, tumor residue, and chemotherapy status in patients with non-epithelial ovarian cancer are significant prognostic factors for DFS and 3-year survival.
Objective:Rare disease Background:Huge ovarian tumors are rare. In developing countries, many women with huge ovarian tumors only seek consultation when the tumor has become very large. Most cases are benign, and only a few cases were reported to be malignant. This case report presents a case of huge malignant ovarian tumor with a final diagnosis of stage III epithelial ovarian cancer. The tumor was completely removed. The huge malignant ovarian tumor in this case report was completely excisable. Case Report:A 43-year-old woman visited the tertiary hospital in Surabaya Indonesia in early September 2020 with a complaint of an enlarged abdomen. The patients had 3 children and normal menstrual periods. Her bowel function was normal. The patient started to notice the abdominal enlargement at 3 months prior to seeking treatment. Ultrasound examination showed a unilocular cystic mass with a diameter of >25 cm, and a solid nodule with normal vascularity was seen. No ascites was noted. Histopathologic examination showed an ovarian mass weighing 9700 g with a size of 30×28×14 cm. The final result showed that the tumor was malignant; specifically, the tumor was a sero-mucinous adenocarcinoma of the left ovary, grade II, which had metastasized to the omentum. Conclusions:Huge malignant ovarian tumors tend to be at an early stage when the diagnosis is made, and they are completely excisable.
Recently, the high rate of C-section is caused by obstetric indications and large number of elderly pregnant patients with maternal complications and fetal continuous monitoring use. C-section has higher risk of complication than vaginal delivery. Some post obstetric surgery complications require aggressive measures such as relaparotomy on critical conditions that cause morbidity.This retrospective study will analyze the profile of post-obstetric surgery referrals with surgical complications to Dr. Soetomo General Teaching Hospital. The records were total sampling according to inclusion and exclusion criteria using medical record data in 2019-2020.There were 27 cases of post-obstetric surgery referrals with surgical complications from all 70 post-obstetric surgery referrals (38.5%)-most referrals from outside Surabaya by private hospitals. Most patients were in 21-35 years (74%), 51.85% multiparity, only 18.5% with obesity. Most of the patients came with hypovolemic shock and complications of thrombocytopenia, prolonged haemostasis, and acute renal impairment. Most common indications for referrals are internal bleeding and postpartum hemorrhage. Operations at the referring hospital were performed emergency in 77.7% of cases. The most indications for surgery that increased the risk of relaparotomy were previous C-sections and the arrest of labors. Relaparotomy was performed in 23 cases (83.1%), most common findings were bleeding from the corner stitch of uterine incision and retroperitoneal hematoma. Most common procedures during relaparotomy were hysterectomy 42.42% and vascular ligation 30.3%.Relaparotomy on post obstetric surgery referrals was performed in patients with suspicion of internal bleeding due to bleeding from corner stitch of uterine incision and indications for surgery that were risk factors for relaparotomy were previous caesarean section and arrest of labors
Ovarian cancer is often asymptomatic, grows rapidly and most diagnosed at advanced stage.Till now there is no method for early detection. Its incidence and mortality rate are increasing. Actually, non-epithelial type of ovarian cancer most found in young women and has better prognosis with adequate therapy. The main therapy for non-epithelial ovarian cancer is surgery, both radical and conservative (fertility sparing). Postoperative chemotherapy depends on the type and stage, although platinum-based chemotherapy regimens are used in almost all cases because of their chemosensitivity. The first-line regimens used are bleomycin, etoposide and cisplatin. Some clinical characteristics could affect prognosis including recurrence and survival rate. They include patient's age, cancer stage, tumor size, tumor marker, post-operative tumor residue, histopathological type of cancer, and chemotherapy. Better knowledge of those prognostic factor will lead to better management of patients with non-epithelial ovarian cancer and increase survival rate.
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