Association between therapeutics outcomes and histological types of ovarian cancer in KNH

Abstract

Background: Ovarian cancer is the third commonest cause of cancer death from gynaecologic tumours in Kenya. Early disease causes minimal, nonspecific, or no symptoms therefore, most patients are diagnosed when the disease is at an advanced stage. Treatment involves surgery and chemotherapy. Overall, prognosis for these patients remains poor but has not been described in Kenya. This study was conducted to describe the histological types of disease treated at the national referral hospital, the adverse effects of treatment and the survival rate of patients with cancer of the ovary. Objectives: To describe the histological types, therapeutic methods used, survival rate at 2 years and determine the association between histological type, and survival. Methods: : A 10-year review of medical record files of patients treated for cancer of the ovary between 1998 and 2008 was undertaken at Kenyatta National Hospital. Structured questionnaires were used to collect data. Histology reports were read to describe the type of tumour. The type of surgery done and the chemotherapy regimen used was described. Surgical complications and adverse effects of chemotherapy was also recorded. Survival was determined from death certification, verbal autopsies and telephone calls to locate participants. Results: In this study patients with cancer of the ovary presented at advanced stages (73.3 %) of disease ( stages III & IV ). Epithelial tumours (86.2 %) are the commonest histological type with 45.7% of them being serous type. Chemotherapy (46.0 %) was the most used therapeutic option, with vomiting and diarrhoea being the leading morbidity associated with it. Survival at 2 yrs from diagnosis was 0.50 as per the Kaplan-Meier time surviva

estimate. There was lack of documentation of vital information at all stages of management (indicated as Nl). Conclusion: There is need for emphases on community awareness of ovarian cancer as a killer disease and for regular medical check-ups as the disease has no symptoms in early stages hence presenting at very late stages. There is need for complete documentation in patient’s files of all aspects of management.