Study of ovarian cancer at a tertiary care centre

Jayashree Mulik, Swapnil Khadse


Background: Despite major advances in case management, ovarian cancer continues to have the highest case fatality rate of all gynaecologic malignancies. There is paucity of meaningful screening and diagnostic protocols. Present study was planned with the objective of assessment of the prevalence of ovarian cancer and the associated risk factors at a tertiary care centre.

Methods: The present prevalence study was conducted at a tertiary care government hospital and entailed analysis of data of 73 patients of ovarian cancer. All the participants were subjected to comprehensive history taking, followed by general, systemic, per-speculum and per-vaginal examination. Serum tumour markers of the patients were assessed. Imaging studies including ultrasound, CT or MRI abdomen/pelvis were done as per need. Final diagnosis was confirmed on histopathology and the cases were classified according to histological classification of World Health Organization.

Results: Majority (41, 56.2%) were aged more than 45 years and above, most of them with one to two previous issues (64.3%). The disease was observed to be more common in postmenopausal women (65, 89%). Three fourth participants had negative family history of ovarian or breast cancer. Out of 73 patients, 31 had value of CA 125 between 150-400 U/mL and 42 had values >400 U/mL. Epithelial ovarian cancer (serous- 33, 45.2%, mucinous- 18, 24.7%) was observed to be the commonest histological type.

Conclusions: To diagnose ovarian tumours early using multipronged approach with focussed risk factor identification and screening with CA-125 is very important and is strongly recommended.


Mucinous, Ovarian cancer, Serous, Tumour marker, CA-125

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Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. Cancer J Clin. 2007;57(1):43-66.

Murthy NS, Shalini S, Suman G, Pruthvish S, Mathew A. Changing trends in incidence of ovarian cancer-the Indian scenario. Asian Pac J Cancer Prev. 2009;10(6):1025-30.

Ries LA. Ovarian cancer: survival and treatment differences by age. Cancer. 1993;71(S2):524-9.

Cramer DW, Hutchison GB, Welch WR, Scully RE, Ryan KJ. Determinants of ovarian cancer risk. I. Reproductive experiences and family History. J National Cancer Inst. 1983;71:711.

Cramer DW, Welch WR. Determinants of ovarian cancer risk. II. Inferences regarding pathogenesis. J National Cancer Inst. 1983;71(4):717-21.

Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohamed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130(1):107-14.

Scully RE. World Health Organization classification and nomenclature of ovarian cancer. Natl Cancer Inst Monogr. 1975;42:5-7.

Puri S, Chadha V, Pandey AK. Epidemiology of ovarian tumours in Northern India-A tertiary hospital based study. Indian J Comm Family Med. 2018;4(2):37.

Pradhan HK, Singh P, Ravikumar MS, Gothwal M. Study of risk factors and tumor markers in ovarian malignancy in western part of Odisha: a prospective observational study. Int J Reprod Contracept Obstet Gynecol. 2018;7(4):1572.

Mondal SK, Banyopadhyay R, Nag DR, Roychowdhury S, Mondal PK, Sinha SK. Histologic pattern, bilaterality and clinical evaluation of 957 ovarian neoplasms: a 10-year study in a tertiary hospital of eastern India. J Cancer Res Therapeut. 2011;7(4):433.

Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Women's Health. 2019;11:287.

Wernli KJ, Newcomb PA, Hampton JM, Trentham-Dietz A, Egan KM. Inverse association of NSAID use and ovarian cancer in relation to oral contraceptive use and parity. Br J Cancer. 2008;98(11):1781-3.

Whittemore AS, Harris R, Ltnyre J. Collaborative ovarian cancer group. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies: IV. The pathogenesis of epithlial ovarian cancer. Am J Epidemiol. 1992;136(10):1212-20.

Rice MS, Hankinson SE, Tworoger SS. Tubal ligation, hysterectomy, unilateral oophorectomy, and risk of ovarian cancer in the Nurses’ Health Studies. Fertil Steril. 2014;102(1):192-8.

Cornelison TL, Natarajan N, Piver MS, Mettlin CJ. Tubal ligation and the risk of ovarian carcinoma. Cancer Detect Prevent. 1997;21(1):1-6.

Hall JM, Friedman L, Guenther C, Lee MK, Weber JL, Black DM, et al. Closing in on a breast cancer gene on chromosome 17q. Am J Human Genet. 1992;50(6):1235.

Miki Y, Swensen J, Shattuck-Eidens D, Futreal PA, Harshman K, Tavtigian S, et al. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Sci. 1994:66-71.

Wooster R, Bignell G, Lancaster J, Swift S, Seal S, Mangion J, et al. Identification of the breast cancer susceptibility gene BRCA2. Nature. 1995;378(6559):789-92.

Nagle CM, Dixon SC, Jensen A, Kjaer SK, Modugno F, DeFazio A, et al. Obesity and survival among women with ovarian cancer: results from the ovarian cancer association consortium. Br J Cancer. 2015;113(5):817-26.

Basu P, De P, Mandal S, Ray K, Biswas J. Study of' patterns of care of ovarian cancer patients in a specialized cancer institute in Kolkata, eastern India. Indian J Cancer. 2009;46(1):28.

Yogambal M, Arunalatha P, Chandramouleeswari K, Palaniappan V. Ovarian tumours-Incidence and distribution in a tertiary referral center in south India. J Dent Med Sci. 2014;3(2):74-80.

Visintin I, Feng Z, Longton G, Ward DC, Alvero AB, Lai Y, et al. Diagnostic markers for early detection of ovarian cancer. Clin Cancer Res. 2008;14(4):1065-72.

Woolas RP, Xu FJ, Jacabs IJ, Yu YH, Daly L, Brechuck A, et al. Elevation of multiple serum markers in patients with stage I ovarian cancer. J National Cancer Inst. 1993;85(21):1748-51.