The New Indian Journal of OBGYN. 12(1):126-131

Evaluation of inadequately staged ovarian cancer patients referred to gynaecologic oncology center

Faraz Sarvar Vali, Pariseema Dave, Bijal M Patel, Shilpa M Patel, Chetna D Parekh, Anshul T Bansal

ABSTRACT

Objectives: To analyse the factors associated with lack of comprehensive surgical staging (CSS) for early stage ovarian cancers performed at non-oncological centers. Materials and methods: A total of 50 patients with histologically proven ovarian cancer, operated elsewhere and underwent completion surgery (CS) or interval debulking surgery (IDS) at our institute were included. Demographic characteristics, preoperative evaluation, operative notes and histopathology reports of other centers were collected. Investigations and management done at our institute were analysed. Results: Out of the 50 patients included in our study, 38 (76%) patients were operated by gynaecologist and 7 (14%) by general surgeons. Preoperatively, ultrasonography was done in 35 (70%), CT scan in 19 (38%) and tumor markers in 19 (38%) patients. Thirty five (70%) patients had complex and solid lesions. 31 (62%) patients were histologically proven epithelial ovarian cancers. None of the patients had undergone CSS and operative notes of 37 (74%) patients could not be retrieved. Only 12 (24%) patients presented to our institute within 2 weeks of primary surgery. At our institute, 26 (52%) patients underwent completion surgery and 23 (46%) underwent NACT followed by IDS. Out of 26 CS patients, there was upstaging of disease in 6 (23%) patients and 15 (57%) required adjuvant chemotherapy. Conclusion: Our study confirms the adverse impact of inadequate staging and management of oncological patients operated in a non-oncological center by general gynaecologists and surgeons. There is need of awareness among general gynaecologists and surgeons regarding importance of CSS and timely referral to oncological center.