Risk predictors of early recurrence in women with epithelial ovarian cancer in Lagos, Nigeria

Abstract

Introduction epithelial ovarian cancer (EOC) is the most lethal gynaecological cancer with a recurrence rate as high as 85% after an initial treatment. However, there are currently no reliable means of predicting the risk of recurrence after first-line treatment. This study investigated the risk factors that predict early recurrence of EOC after primary treatment among women in Lagos, Nigeria. Methods this was a retrospective cohort study involving the review of all histologically confirmed EOC patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria over a 7-year period from January 2010 to December 2016. A study proforma was used to retrieve relevant information and descriptive statistics were computed for all data. The associations between variables were tested and multivariate analysis was done to adjust for all the possible characteristics that predict early EOC recurrence. Results the rate of recurrence of EOC was 76.4%. Suboptimal debulking surgery is the only independent predictor of early tumour recurrence. Conclusion women should be adequately counselled and encouraged to report their symptoms early to ensure optimal primary treatment. Strategic efforts should also be made to further improve subspecialty training programs and skills development in gynaecological oncology in Nigeria and sub-Saharan Africa.

Predictors of Survival Outcomes After Primary Treatment of Epithelial Ovarian Cancer in Lagos, Nigeria

“…The rate of tumor recurrence recorded in this study (76.4%) is almost similar to the rate recorded in the report from a previous study conducted in the same setting in Lagos, 18 whereas the high proportion of deaths recorded may be a reflection of the significantly large proportion of women (73.5%) who presented with an advanced stage disease together with its attendant poor survival outcome. Various studies outside SSA have focused on the identification of prognostic parameters for EOC, and several parameters that have been suggested to be predictive of survival in ovarian cancer include age, 19 FIGO stage, 20 postoperative residual tumor, 11 , 21 , 22 tumor histology, 23 histological grade, 24 presence of ascites, 25 and pretreatment serum concentrations of CA-125.…”

Predictors of early mortality risk in patients with epithelial ovarian cancer

“…An estimated 70% of the patients will have a relapse 32 with more than half of these occurring within 12 months of completion of treatment. 2 Relapsed EOC is not a curative disease and thus, strategies to reduce mortality due to EOC must focus on identifying effective measures to prevent its early relapse. This may be through prioritization of follow‐up surveillance and the introduction of a more aggressive individualized treatment plan that includes the use of maintenance therapy, especially in patients with tumor relapse.…”

“… 2 An estimated 90% of all ovarian cancer are of epithelial origin 3 with more than 70% of these cases diagnosed at the later stages of the disease. 2 The overall 5‐year survival rate of patients with epithelial ovarian cancer (EOC) is about 30%–48% despite the standard treatment of surgery and chemotherapy 4 , 5 with only a very modest increase of about 2%–4% since 1995. 6 Since the early 1970s, the prognosis of EOC has not improved substantially despite the substantial investments in the development of new cancer therapeutics.…”

An Assessment of Ovarian Cancer Histotypes Across the African Diaspora

“…Black women in the US have lower incidence of ovarian cancer but continue to experience worse outcomes. Smaller studies in West African countries such as Nigeria have documented similar poor survival in women diagnosed with cancer (20,21). Known factors that both modify and predict development of ovarian cancer include family history of breast and/or ovarian cancer; fertility factors such as decreased parity, earlier onset of menses, smaller family size, later age at time of first pregnancy, reproductive behavior; and environment.…”