Epidemiology of epithelial ovarian cancer: a tertiary hospital based study in Goa, India

Background: Ovarian malignancy is seventh most common cancer in women globally. With increase in longevity, the incidence of epithelial ovarian cancer is increasing and its etiopathology remains unknown. We present preliminary epidemiological findings to help prioritize research.Methods: Present epidemiological study is retrospective, descriptive study over two years. The collected data was analyzed using SPSS software for overall survival, with respect to stage of disease and histopathology type. Multivariate analysis was done to know independent risk factors.Results: 114 cases of primary ovarian epithelial cancer were analyzed. Patients' mean age at diagnosis was 52.1±8.96 years (median=52). 52.6% patients had stage III disease at first visit. Serous adenocarcinoma (85.05%) was the most prevalent type of histopathology followed by mucinous (7.1%), clear cell (6.1%) and Endometroid carcinoma (1.75%). Surgery followed by combination of taxane and platinum chemotherapy was first line treatment in 35%. The mean age at diagnosis was more with advancing stage (stage one 44±9.53 and stage four 55.35±9.74 years) but it was not statistically significant (p=0.098) Advancing age demonstrated poor survival (log-rank p=0.05) but survival was not significantly different in relation to histopathology (log-rank =0.629). On multivariate regression analysis age of patient (p=0.004), and stage of disease (p=0.005) were found to be independent risk factors while histopathology was not an independent risk factor (p=0.688) for survival.Conclusions: Research should be aimed to find tools for screening and early diagnosis as well as better therapeutic approaches for advanced epithelial ovarian cancer

Clinico-pathological study of ovarian tumors in Goa medical college: a tertiary care centre in Goa, India

Background: Ovarian neoplasms are a distinct entity in women health care and are increasingly contributing to morbidity and mortality among women. The burden is not only related to the increasing incidence but also to the varied pathological features depending on the tissue of origin and pathogenesis. The study was carried out to find the prevalence and determine the clinical presentation and histo-pathological distribution of ovarian neoplasms. Management options were also noted.Methods: It is a retrospective study carried out at Goa Medical College between January 2013 to December 2015. All patients diagnosed and treated for ovarian neoplasm were included in the study. Data was tabulated using Microsoft Excel and descriptive statistical analysis was carried out using SPSS version 23.Results: A total of 3111 patients were admitted in gynecology at Goa Medical College during the specified time period. Of these 358 cases were diagnosed with ovarian neoplasm. On histopathology 196 were benign tumors and 162 were reported to be malignant. Commonest presenting symptom was abdominal distention seen in 51.1% of the patients, pain in 44.4%, followed by dyspepsia in 26.85%. Epithelial tumors were most common (Benign - 39.3%, Malignant - 41%) followed by sex cord stromal tumors and germ cell tumors in 7.26% of cases.Conclusions: Surface epithelial tumors were most common neoplasm. An alarming high no. of malignant tumors (45.25%) was found in present study. 44.4% tumors presented in 41-50 years age group. Presenting complaints were vague and nonspecific leading to delay in diagnosis. Histological type correlates with prognosis; therefore, preponderance of histological type will guide treatment options and patient education with respect to epidemiology

Study on awareness, perceptions, experiences in decision process of hysterectomy in women presenting to Goa Medical College

Background: Hysterectomy (removal of uterus) has many indications like fibroids, dysfunctional uterine bleeding, uterine prolapse and chronic pelvic pain. The purpose of this study is to know the level of awareness of women about hysterectomy, to study their experiences, to assess their involvement in decision making process and to develop a suitable protocol, counselling and education material to ensure women’s involvement.Methods: This is a cross sectional study using validated semi-structured interview questionnaire over 6 months (1st December, 2018 to 31st May, 2019) in Goa Medical College. Data was entered in epidata manager and analysed using SPSS 22 version. Categorical variables were expressed in percentages and proportions and quantitative variables in mean±SD. Significance was checked using Chi square test and association between dependent and independent variables was assessed by using bivariate analysis. P value <0.05 was taken as significant.Results: A total of 149 women were recruited into the study who were admitted for hysterectomy. The mean age of women was 49.3 years. The awareness with respect to various aspects of hysterectomy was good in 23.4% subjects and poor in 76.6% subjects. The awareness was significantly related to level of education (p=0.002), urban location (p=0.016) and socioeconomic status (p=0.028). Education was significant factor in decision-making process (p< 0.05). It was observed that good experience had positive correlation to their perception about hysterectomy.Conclusions: It was concluded that awareness about hysterectomy was significantly related to education, urban location and socio-economic status of women. Pre-operative education would help to reduce the post-operative symptoms for a women undergoing hysterectomy