Ovarian cancer in Ibadan: characteristics and management

Abstract

Ovarian cancer has the highest case fatality rate among gynaecological cancers worldwide because of lack of effective screening methods and non-specific early warning symptoms with late presentation. A reinvigorated study is necessary in the developing countries because of a projected increase in its incidence. The decreasing fertility rate and increasing use of ovulation induction drugs are some of the reasons. The Ovarian Cancer Service of the Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria commenced the first longitudinal study of this malignancy from 1 December 1998 in order to establish a regional management and research centre. It is a questionnaire survey detailing the demography, clinical and staging laparotomy findings and histology of all confirmed cases. Twenty-one staging laparotomy and histologically confirmed ovarian cancer cases were managed from 1 December 1998 to 31 July 2002, about 1.5% of the 1387 gynaecological admissions. It is the third most common of the gynaecological cancers, representing 9.8% of the 214 cases. More than 60% of the patients were 50 years or younger. Only 19% were nulliparous, with 47.6% having had five or more deliveries. Only two patients (9.5%) had used the oral contraceptive pill, for a maximum period of 1 month. Only one patient (4.8%) had a positive family history of cancer. Abdominal swelling was the most common presenting symptom. Eighty-one per cent of the patients presented in Stages III and IV. Epithelial ovarian cancer constituted about 76.2% of the cases. Only 23.8% had adjuvant therapy, consisting of combination chemotherapy using cisplatin-based regimes. The case fatality rate 6 months after surgery was 76%. The ovarian cancer patients in this environment are younger and of higher parity than expected. The risk factors for this disease require further study.

Gynecological Malignancies: Epidemiological Characteristics of the Patients in a Tertiary Care Hospital in India

“…The proportion of patients with cervical malignancy increased with increasing parity. (17) 18 (16) The observation of the present study, that most of the patients with gynecological malignancies were multiparous, corroborates with the studies done in different parts of the world (Chhabra et al, 2002;Nkyekyer, 2000;Were and Buziba, 2001;Kidanto et al, 2002;Rashid et al, 1998;Odukogbe et al, 2004). The studies from the developing countries along with the observations in the present study indicate that the patients with ovarian malignancy may also be multiparous alike the patients with cervical malignancy.…”

“…In this study, only three patients (11.1%) with ovarian malignancy had ever used oral contraceptive pills. Similarly, Odukogbe et al (2004) from Nigeria reported that only two patients with ovarian cancer (9.5%) had used the oral contraceptive pills.…”

“…In a similar study done by Nigam et al (2005) in India, 12.5% patients had given a family history of cancer. Though, Odukogbe et al (2004) reported that only one patient with ovarian cancer (4.8%) had a positive family history of cancer.…”

Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

“…Were and Buziba (2001) reported that 80.9% of the tumors were squamous cell carcinoma and 11.9% were adenocarcinoma histopathologically in a study done on cervical cancer patients in a hospital in Kenya. According to Odukogbe et al (2004), epithelial ovarian cancer constituted about 76.2% of the ovarian cancer cases in a study done in a hospital of Nigeria in comparison to 88.9% in the present study. In an institution-based study done by Kamal et al (2003) in Pakistan, endometrial adenocarcinoma was the most common uterine malignant tumor.…”

“…Odukogbe et al (2004) reported abdominal swelling as the most common presenting symptom among the patients of ovarian cancer in a hospital of Nigeria. A recently published study from a tertiary care hospital of Pakistan (Saeed and Akram, 2012) had reported abdominal pain (74.6%) and distension (76.0%) as the most common presenting symptoms of patients with epithelial ovarian cancer.…”