Publication:

Demographic and clinicopathologic profile of malignant epithelial ovarian tumors: an experience from a tertiary cancer care centre in Bangalore, South India

Background Ovarian cancer is fast emerging as the leading cancer of the female genital tract. It is the second most common gynecological malignancy in India, but has poor outcomes making it the leading cause of gynecologic cancer related deaths. There is a paucity of data regarding demographic details, patterns of care and outcomes of ovarian epithelial malignancies in India. This is a study to evaluate the demographic details, clinical profile and pathology details of epithelial ovarian cancer registering in atertiary cancer center in Bangalore, Karnataka, India.

Methods This is a retrospective study of the case records of patients diagnosed with epithelial ovarian cancer from January 2012 to December 2014.

Results Malignantovarian tumors constituted 5.6% of all malignancies in women. 84 cases were of epithelial origin constituting 64.4% of all malignant ovarian tumors. 58% of patients were from Karnataka and 25% were from West Bengal. 27% underwent suboptimal surgery outside at presentation. The median age at presentation was 51 years. Most of the patients were parous (25% were para 2 and 3). 5% patients were nulliparous. Pain abdomen (39%) and abdominal distension/ bloating (16%) were the most common symptoms. 75% of these cases presented in III-IV stage. Method of diagnosis was: primary surgery and Biopsy of mass (50%), fine needle aspiration cytology of mass or ascites/ pleural effusion (40%), and diagnostic laparoscopy in (9.5%) of the patients. The most common histological variants were serous cystadenocarcinoma (32%) and mucinous adenocarcinoma (15%).

Conclusions Majority of the patients presented with vague nonspecific abdominal complaints which leads to delay in diagnosis. Most of the patients presented in advanced stage of the disease. Delay in diagnosis and improper management prior to registering in tertiary cancer centre was common. There is a need to improve awareness regarding ovarian cancer in general population and also primary care physician.