Incidence, pattern and management of ovarian cancer at a tertiary medical center in Enugu, South East Nigeria

Iyoke, Chukwuemeka Anthony; Ugwu, George Onyemaechi; Ezugwu, Euzebus Chinonye; Onah, N; Ugwu, Obinna J; Okafor, Okechukwu Charles

doi:10.4103/2141-9248.117947

Cited by 13 publications

(22 citation statements)

References 11 publications

(26 reference statements)

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“…However, after this time point, the patients from urban areas (median survival time, 121 months) survived longer compared with the patients from rural areas (median survival time, 96 months), although the difference was not significant (P=0.062). The 5-year cumulative survival rate of patients with ovarian cancer in Gezira State (38%) was an improvement compared with those reported for different parts of Nigeria (29)(30)(31)(32)(33). However, the 5-year survival rate was lower compared with the United States, which may be explained by a lack of awareness and timely access to health care.…”

Section: Discussionmentioning

confidence: 67%

Incidence and survival rates of ovarian cancer in low-income women in Sudan

Abuidris

Weng

Elhaj

et al. 2016

Molecular and Clinical Oncology

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Abstract. Ovarian cancer is the second most common gynecological cancer worldwide. Little is known about the disease in Sudan. The objective of the present study was to evaluate the incidence rate, age and stage at diagnosis, and median survival time of patients presenting at the National Cancer Institute-University of Gezira (NCI-UG), Sudan. Data were collected in a prospective study of women with ovarian cancer over a period of eleven years of follow-up (between 2000 and 2011). Descriptive statistics were used to summarize the distribution of the demographics of the sample. The direct method was used to compute the age-standardized rate (ASR) using data from the 1966 and 2000 World Standard Populations (WSPs). The Kaplan-Meier method was used to estimate survival functions and the median survival time. Log-rank tests were used to statistically compare between the survival functions. There were steady increases in ovarian cancer incidence rates between 2000 and 2009, with a slight decline noted in 2010 and 2011. The patients' age range was 9-90. The age-specific incidence rate increased greatly in women aged 55 years or older. The majority of the patients had stage III or IV disease. The annual ASR using WSPs 1966 and 2000 as standard populations were 3.3 and 3.7 per 100,000 women, respectively. The median survival time was 31 months (95% confidence interval, 19-43). The 5-year cumulative survival rate was 38%. In Sudan, ovarian cancer affects postmenopausal women, akin to what is reported in the developed world with high incidence rates. Presenting with advanced stage disease is the predominant factor that results in a short survival time for women.

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Section: Discussionmentioning

confidence: 67%

Incidence and survival rates of ovarian cancer in low-income women in Sudan

Abuidris

Weng

Elhaj

et al. 2016

Molecular and Clinical Oncology

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“…Ovarian cancer is a cosmopolitan disease as it occurs in every geographical location and in every race [1,30]. Epithelial ovarian cancer is the commonest subtype all around the world with high-grade serous accounting for 60-85% of cases [22,[35][36][37][38].…”

Section: Racial and Geographical Riskmentioning

confidence: 99%

“…From African subcontinent, findings contradict increasing age as a risk factor for EOC as reports show young premenopausal women to be mostly affected with serous cystadenocarcinoma, which is the most common histiotype. There is increasing report of rising incidence of ovarian cancer from Africa [38,[59][60][61].…”

Section: Age As a Risk Factormentioning

confidence: 99%

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Risk Factors for Ovarian Cancer

Zayyan¹

2020

Tumor Progression and Metastasis

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Ovarian cancers remain a perplexing group of diseases that continue to raise questions over their etiology and clinical behavior. They are the most fatal of gynecological cancers. Despite a global lifetime risk of only 1-2%, they contribute the highest mortality and the lowest 5-year (overall) survival rate of just 35%. The three broad histological groups: epithelial, sex cord-stromal and germ cell cancers have different biologic behavior and may constitute different clinical disease entities. Of the eight subtypes in the epithelial group, high-grade serous are universally the most common and have the worst prognosis. Globally making 65-85% of all ovarian cancers, most of the focus on risk factors has been directed on the epithelial group but the importance of other primary malignancies cannot be overemphasized as a step towards understanding their etiology and clinical behavior. The normal ovary has none of the epithelia that produce the range of epithelial ovarian cancers or there is an obvious premalignant stage, symptoms are very vague, screening and early diagnosis are difficult and indeed unrewarding. No specific etiology is known for any of the histologic groups. However, commonly mentioned risk factors like increasing age, genetics, nulliparity, prolonged infertility, use of fertility drugs, high animal fat, obesity, endometriosis, polycystic ovary syndrome, previous history of cancer, use of hormone replacement therapy, pelvic inflammatory disease and smoking may not apply to all the subtypes, while factors like increasing parity, breast feeding, use of oral contraceptive pills, hysterectomy, tubal ligation and use of antioxidants may differ in the degree of protection they provide. There may also be geographical and probably racial variations in the relevance of some of the risk factors. Thorough understanding of the predisposing and protective factors of the various histologic subtypes is an important step understanding the disease and therefore improving treatment outcome or providing effective prevention.

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“…1 The case-specific mortality rate of diagnostic ovarian cancer within one year is approximately 70%. 2 In patients with ovarian cancer undergoing laparotomy, only 30% of tumors were confined to the ovary, while the majority metastasized to the uterus, bilateral annex, peritoneum, and pelvic organs.…”

Section: Introductionmentioning

confidence: 99%

Hypoxia promotes HO-8910PM ovarian cancer cell invasion via Snail-mediated MT1-MMP upregulation

Sun

Lin

Zhuo

et al. 2015

Exp Biol Med (Maywood)

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The molecular mechanisms of ovarian cancer cell invasion under hypoxia remain unclear. Here we employed a 3D collagen model and chick chorioallantoic membrane (CAM) invasion assay to explore the influence of hypoxia on ovarian cancer cell invasion. Hypoxia (both 1% O 2 and CoCl 2 150 and 250 mM) induced HO-8910PM ovarian cancer cell invasion in 3D collagen and collagenolysis determined by hydroxyproline. Pretreatment with a hypoxia inducible factor-1a inhibitor, YC-1, or MMP inhibitor, GM6001, significantly inhibited 3D collagen invasion and degradation and cell proliferation. Hypoxia stimulated both mRNA and protein expressions of membrane-type 1 matrix metalloproteinase (MT1-MMP) and promoted MT1-MMP translocation to the cell surface in an YC-1 sensitive manner. MT1-siRNA transfection inhibited hypoxia-induced invasion, proliferation, and collagen degradation of cells in 3D collagen. Hypoxia stimulated Snail mRNA and protein expression as well as translocation to nucleus in an YC-1 sensitive manner. Overexpression of Snail with a recombinant plasmid in HO-8910PM cells resulted in an enhanced invasion in 3D collagen. Transfection with Snail-specific siRNA significantly decreased MT1-MMP expression and 3D collagen invasion. Hypoxia-treated cells significantly broke the upper CAM surface of 11-day-old chick embryos and infiltrated interstitial tissue, completely blocked in the presence of YC-1 or GM6001, or after MT1-MMP siRNA or Snail siRNA transfection. Together, these data suggest that hypoxia promotes HO-8910PM ovarian cancer cell traffic through 3D matrix via Snail-mediated MT1-MMP upregulation, a possible molecular mechanism of ovarian cancer cell invasion under hypoxia.

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Incidence, pattern and management of ovarian cancer at a tertiary medical center in Enugu, South East Nigeria

Cited by 13 publications

References 11 publications

Incidence and survival rates of ovarian cancer in low-income women in Sudan

Incidence and survival rates of ovarian cancer in low-income women in Sudan

Risk Factors for Ovarian Cancer

Hypoxia promotes HO-8910PM ovarian cancer cell invasion via Snail-mediated MT1-MMP upregulation

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