scholarly journals The Challenges of Managing Ovarian Cancer in the Developing World

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Olivier Mulisya ◽  
Franck K. Sikakulya ◽  
Mbusa Mastaki ◽  
Tambavira Gertrude ◽  
Mathe Jeff
Keyword(s):  
Ovarian Cancer ◽  
Relative Survival ◽  
High Morbidity ◽  
Ovarian Mass ◽  
Cancer Awareness ◽  
Cancer Treatments ◽  
Palpable Mass ◽  
Relative Survival Rate ◽  
Loss Of Weight ◽  
One Year

Ovarian cancer has high morbidity and mortality rates among cancers of the reproductive system. The disease typically presents at late stage when the 5-year relative survival rate is only 29%. Similarly, access to prevention, early diagnosis, treatment, and palliative care for cancer-related disease is insufficient. The availability of cancer treatments in Africa is especially poor. Case. A 17-year-old lady, nulliparous, was admitted with complaint of abdominal swelling and loss of weight and a huge left ovarian cyst revealed by ultrasound scan. Laparotomy was done, and a mass which resembled a hemorrhagic solid tumor was found. Grossly, the left ovarian mass measured 15.0×20.0×8.0 cm and a left salpingectomy was performed. Two months later, she came back with lower limb swelling progressively increased in a week with vulvar edema, with a palpable mass. She was discharged on request by her relatives for traditional medicine. One year later, she passed on in an unrevealed picture. The management of ovarian cancer is too challenging in low-resource countries, from hospital settings to the communities with poor cancer awareness. It is therefore imperative that healthcare resources, policies, and planning focus to be coordinated in a rational way.

scholarly journals Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Shin ◽  
Jaeman Bae ◽  
Johyun Ha ◽  
Kyu-Won Jung
Keyword(s):  
Ovarian Cancer ◽  
Cancer Registry ◽  
Excess Mortality ◽  
Social Deprivation ◽  
Relative Survival ◽  
First Year ◽  
Relative Survival Rate ◽  
Probability Of Death ◽  
Central Cancer Registry ◽  
Over Time

ObjectiveConditional relative survival (CRS) rates, which take into account changes in prognosis over time, are useful estimates for survivors and their clinicians as they make medical and personal decisions. We aimed to present the 5-year relative conditional survival probabilities of patients diagnosed with ovarian cancer from 1997–2016.MethodsThis nationwide retrospective cohort study used data from the Korean Central Cancer Registry. Patients diagnosed with ovarian cancer between 1997 and 2016 were included. CRS rates were calculated stratified by age at diagnosis, cancer stage, histology, treatment received, year of diagnosis, and social deprivation index.ResultsThe 5-year relative survival rate at the time of diagnosis was 61.1% for all cases. The probability of surviving an additional 5 years, conditioned on having already survived 1, 2, 3, 4, and 5 years after diagnosis was 65.0, 69.5, 74.6, 79.3, and 83.9%, respectively. Patients with poorer initial survival estimates (older, distant stage, serous histology) generally showed the largest increases in CRS over time. The probability of death was highest in the first year after diagnosis (11.8%), and the conditional probability of death in the 2nd, 3rd, 4th, and 5th years declined to 9.4%, 7.9%, 6.1%, and 5.2%, respectively.ConclusionCRS rates for patients with ovarian cancer increased with each year they survived, but this did not reach the level of ‘no excess mortality’ even 5 years after diagnosis. The largest improvements in CRS were observed in patients with poorer initial prognoses. Our findings provide updated prognosis to ovarian cancer survivors and clinicians.

scholarly journals Treatment of advanced-stage ovarian cancer including combination of intra-abdominal chemotherapy

2021 ◽  
Vol 20 (2) ◽  
pp. 28-35
Author(s):  
V. V. Saevets ◽  
A. V. Privalov ◽  
A. V. Vazhenin ◽  
Y. A. Semenov ◽  
A. V. Shmidt
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
Abdominal Cavity ◽  
Relative Survival ◽  
Study Groups ◽  
Stage Iiia ◽  
Results Of Treatment ◽  
Significant Difference ◽  
One Year ◽  
The One

Introduction. Ovarian cancer is the leading cause of death from gynecological malignancies: the one-year relative survival rate with stages 3 and 4 of the disease is 20%. The results of treatment remain unsatisfactory, which dictates the need to find new methods of treatment. The aim of the study was to evaluate the effectiveness of the use of HIIH (hyperthermic intraperitoneal intraoperative chemoperfusion, HIPEC) in patients with the diagnosis of: ovarian cancer IIIA-From the stage of the disease.Materials and methods. 117 cases of stage IIIA-C ovarian cancer treated at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from January 2014 to March 2021 were retrospectively studied. All patients underwent 3 cycles of neoadjuvant chemotherapy (NAPHT) according to the paclitaxel+carboplatin (PCb) scheme, followed by surgical treatment to the extent of maximum cytoreductive surgery. Two study groups were formed: 1 — cases with GIIH (N=57), 2-without GIIH (N=60). On the 14-16 day after the operation, all patients underwent 3 cycles of adjuvant chemotherapy according to the PCb scheme.Results. A significant increase in overall survival was found in the first group of patients with HIPEC. This technique allows to increase the survival rate of patients for 14 months at stage IIIA-B (p<0.05). At stage IIIC, there was no statistically significant difference in the survival rate of patients. There was a tendency to increase the survival rate by 5 months (p>0.05), which is associated with the pronounced prevalence of the tumor process and the technical impossibility of removing the tumor. Discussion. The concentration of drugs in the abdominal cavity and in the blood plasma significantly differs due to the functioning of the peritoneal-plasma barrier, which leads to a lower toxicity in comparison with systemic chemotherapy, and therefore allows you to give a large dose of the drug with fewer adverse events, and the fact of hyperthermia (42°C) has a positive effect on the effectiveness of intraperitoneal chemotherapy. To date, this method has not been included in the clinical recommendations on the territory of the Russian Federation, but data from foreign literature, including randomized trials, have shown the high effectiveness of this method.Conclusion. The results obtained in the course of our study demonstrate the effectiveness of this technique, in the form of an increase in overall and relapse-free survival with acceptable toxicity.

A CLINICAL STUDY ON VARIOUS MODES OF PRESENTATION OF PANCREATOBILIARY MALIGNANCIES

2021 ◽  
pp. 62-64
Author(s):  
Ashwini Sheorain ◽  
Nibedita Sen ◽  
Swapnil Sen ◽  
Sushpa Das
Keyword(s):  
Early Diagnosis ◽  
Obstructive Jaundice ◽  
Tertiary Care ◽  
Experimental Studies ◽  
High Morbidity ◽  
Malignant Obstructive Jaundice ◽  
Palpable Mass ◽  
Diagnosis And Management ◽  
Modes Of Presentation ◽  
Loss Of Weight

Obstructive Jaundice is an important surgical problem that occurs when there is an obstruction to the passage of conjugated bilirubin from liver cells to intestine. It is among the most challenging conditions managed by general surgeons and results in high morbidity and mortality. Hence, early diagnosis of the cause of obstruction is very important especially in malignant cases, as resection is only possible at an early stage. Signicant 3 advances have been made over the past 30 years in understanding pathophysiology, diagnosis and management of obstructive jaundice. Biliary obstruction effects the bile ducts and leads to disturbed liver function and widespread systemic effects. Jaundice patients are at high risk for developing hepatic and renal dysfunction, cardiovascular problems, nutritional deciencies, bleeding problems, infections, and wound 4 complications, and higher perioperative mortality. There is usually an overlap of features among different obstructive pathologies, for example uctuating icterus is present in both common bile duct stone and periampullary carcinoma. AIM:To study the clinical spectrum of the patient with malignant obstructive jaundice. MATERIALS AND METHODS: The study has been carried out on 48 patients with clinical presentation of suspected malignant obstructive jaundice over a period of 13 months who were seen in general surgery department of a tertiary care centre of Eastern India. A detailed history and relevant information were collected from the patient and relatives like mode of onset, duration, progression, loss of weight and substance abuse. Besides, information like place of residence, family history, personal history, drug intake etc. were recorded. RESULTS: The mean age (mean ± s.d.) of the patients was 66.27±5.85 years with range 52 - 78 years and the median age was 67.0 years. 81.3% of patients had signicant loss of weight which was signicant. 75.0% of patients had palpable mass abdomen and it was signicant. There was neither any signicant association between habit of alcohol intake nor the habit of smoking with cancer of the patients. CONCLUSION: The descriptive study on malignant obstructive jaundice patients demonstrated the various modes of presentation. Obstructive jaundice is a multi spectrum disease, in terms of organ involvement, local spread and resectability. Analytical and experimental studies done for each of the etiologies separately will throw more light on the possible evolution of early diagnosis and management.

scholarly journals Period Analysis of Intraracial Differences in Incidence and Survival Rates in Epithelial Ovarian Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Lili Han ◽  
Sulaiya Husaiyin ◽  
Jing Liu ◽  
Miherinisha Maimaiti ◽  
Mayinuer Niyazi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
Epithelial Ovarian Cancer ◽  
Median Survival ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Relative Survival Rate ◽  
Kaplan Meier ◽  
The Difference

Background. To explain the difference in the incidence and relative survival in a population-based cohort of women with epithelial ovarian cancer (EOC) postdiagnosis in the last forty years. EOC is the most common type of all ovarian cancers, but there is inadequate information about the variations related to long-term EOC survival. Methods. We acquired the incidence and relative survival rate data from the Surveillance, Epidemiology, and End Results (SEER) registries to analyze the epidemiological variations from 1974 to 2013 in EOC-affected individuals. The survival disparities in EOC-specific individuals due to age, race, and socioeconomic status (SES) were performed by Kaplan-Meier analysis. The Results. The overall incidence of EOC progressively declined to 9.0 per 100,000 from 11.4 in the last forty years. The median survival rate improved to 48 months in the first decade from a previous of 27 months in the fourth decade. The 5-year relative survival rate (RSR) increased to 44.3% that was previously 32.3% at the same time. However, between whites and blacks, an increase from 11 to 18 months was observed in the median survival differences. Between the low and high poverty groups, it was increased from 7 months to 12 months, respectively. Conclusions. The incidence rate of RSR and EOC-specific individuals in the last forty years was improved. However, the survival rates among different races and SES differed over time.

AGE-RELATED FEATURES OF ANNUAL MORTALITY AND SURVIVAL OF PATIENTS WITH THYROID CANCER (C73) IN SAINT-PETERSBURG (POPULATION STUDY)

2021 ◽  
pp. 507-515
Author(s):  
В.М. Мерабишвили
Keyword(s):  
Thyroid Cancer ◽  
Survival Rate ◽  
Relative Survival ◽  
Population Level ◽  
First Year ◽  
Relative Survival Rate ◽  
Age Related ◽  
One Year ◽  
Objective Indicators

Ежегодно в России регистрируют более 13 тыс. (13 250 - 2018 г.) новых случаев рака щитовидной железы (РЩЖ), в Санкт-Петербурге - около 1 тыс. (975 - 2018 г.), 150 у мужчин и 825 у женщин. В России практически не проводят исследования по анализу выживаемости больных РЩЖ на популяционном уровне. Такие разработки проводятся нами с 1998 г. Было установлено, что уровень пятилетней наблюдаемой и относительной выживаемости больных РЩЖ в нашем городе был заметно ниже среднеевропейского (программа Eurocare-4). Планируется проанализировать динамику объективных показателей деятельности онкологической службы на основе базы данных популяционного ракового регистра СанктПетербурга. Установлено значительное снижение показателей погодичной летальности, летальности больных на 1-м году наблюдения, однолетней с 2000 по 2018 г., наблюдаемой выживаемости - с 74,7 до 97,5 %, пятилетней - с 71,2 до 76,2 %. Относительная выживаемость была на 1-5 % больше. Пятилетняя выживаемость больных РЩЖ младше 60 лет была заметно выше, чем у лиц 60 лет и старше (92,2 и 62,7 % соответственно). Учитывая низкий уровень летальности у больных РЩЖ, медиана выживаемости исчислена только для 2004 г., она составила 14,8 года. Every year in Russia, more than 13 thousand (13 250 - in 2018) new cases of thyroid cancer are registered, in St. Petersburg about 1 000 (975 - in 2018) (150 among men and 825 among women). In Russia, almost no studies are conducted to analyze the survival rate of patients with thyroid cancer at the population level. Such developments have been carried out by us since 1998. It was found that the level of 5-year observed and relative survival of patients with thyroid cancer in our city was significantly lower than the European average (Eurocare-4 program). It is planned to analyze the dynamics of objective indicators of the activity of the cancer service based on the database of the population cancer register of St. Petersburg. There was a significant improvement in the indicators of partial mortality, mortality of patients in the first year of follow-up, one-year survival from 2000 to 2018 from 74,7 to 97,5 %, and five-year survival from 71,2 to 76,2 %. The relative survival rate was 1-5 % higher. The five-year survival rate of patients with thyroid cancer was significantly higher among patients under 60 years of age than among those aged 60 years and older (92,2 and 62,7 %, respectively). Given the low mortality rate among patients with thyroid cancer, the median survival rate is calculated only for 2004. It was 14,8 years.

scholarly journals Osteopontin as a Tumor Marker in Ovarian Cancer

2022 ◽  
Author(s):  
Shikha Rani ◽  
Alka Sehgal ◽  
Jasbinder Kaur ◽  
Dilpreet Kaur Pandher ◽  
RPS Punia
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Test ◽  
Ca 125 ◽  
Tumor Biomarker ◽  
Screening Methods ◽  
High Morbidity ◽  
Ovarian Mass ◽  
Likelihood Ratios ◽  
Median Plasma ◽  
Sensitivity Specificity

Abstract Introduction: Ovarian cancer is associated with high morbidity and mortality. This is due to the nonspecific symptoms and no effective screening methods. Currently CA 125 is used as a tumor biomarker for the diagnosis of ovarian cancer, but it has its own limitations. So, there is need for other tumor biomarkers for the diagnosis of ovarian cancer. To determine the diagnostic test characteristics of plasma osteopontin (OPN) in detecting ovarian malignancy and comparing its performance with carbohydrate antigen-125 (CA 125). Methods: This is a prospective cross-sectional diagnostic test evaluation. Women with adnexal mass detected by clinical or radiological examination were enrolled as suspected cases. Women who presented with other gynecological conditions were enrolled as controls. OPN and CA 125 levels were measured in all enrolled subjects. Results: Among 106 women enrolled, 26 were ovarian cancer, 31 had benign ovarian masses and 49 were controls. Median plasma CA 125 levels were higher in subjects with ovarian cancer (298 U/ml; IQR 84-1082 U/ml vs. 37.5U/ml; IQR 17.6-82.9U/ml; P<0.001).CA 125 sensitivity, specificity, positive and negative likelihood ratios were 88.5%, 61.3%,2.10 and 0.19 respectively. Median plasma OPN levels were higher in subjects with ovarian cancer (63.1 ng/ml; IQR 39.3-137 ng/ml vs. 27ng/ml; IQR 20-52ng/ml; P=0.001). Sensitivity, specificity, positive and negative likelihood ratios of OPN were 50%,87%,2.58 and 0.62, respectively. Conclusion: OPN levels were higher in ovarian cancer than in the benign ovarian mass and had better specificity than CA125. OPN can better differentiate between benign and malignant ovarian mass as compared to CA125.

scholarly journals Future Healthcare Workers and Hepatitis B Vaccination: A New Generation

2021 ◽  
Vol 18 (15) ◽  
pp. 7783
Author(s):  
Andrea Trevisan ◽  
Paola Mason ◽  
Annamaria Nicolli ◽  
Stefano Maso ◽  
Marco Fonzo ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Antibody Titer ◽  
Healthcare Workers ◽  
Lower Percentage ◽  
Hepatitis B Vaccination ◽  
High Morbidity ◽  
One Year ◽  
Mandatory Vaccination ◽  
University Of Padua ◽  
The University

Before the introduction of universal vaccination, hepatitis B caused high morbidity and mortality, especially among healthcare workers. In the present study, the immune status against hepatitis B was assessed in a cohort of 11,188 students of the degree courses of the School of Medicine of the University of Padua (Italy) who had been subjected to mandatory vaccination in childhood or adolescence and who will be future healthcare workers. The variables that influence the antibody response to vaccination are mainly the age at which the vaccine was administered and sex. If vaccination was administered before one year of age, there is a high probability (around 50%) of having an antibody titer lower than 10 IU/L compared to those vaccinated after one year of age (12.8%). The time between vaccine and analysis is not decisive. Furthermore, female sex, but only if vaccination was administered after one year of age, shows a significant (p = 0.0008) lower percentage of anti-HBs below 10 IU/L and a greater antibody titer (p < 0.0001). In conclusion, the differences related to the age of vaccination induce more doubts than answers. The only plausible hypothesis, in addition to the different immune responses (innate and adaptive), is the type of vaccine. This is not easy to verify because vaccination certificates rarely report it.

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