Ovarian cancer: an analysis of forty-four patients at the National Radiotherapy Centre, Accra--Ghana.

BACKGROUND: The median age for ovarian cancer is 60-65 years. Greater than 70% present with advanced disease but recent treatment advances have resulted in modest improvement in treatment outcome over the past decade.
OBJECTIVE: To evaluate the median age, time of presentation, histology and treatment outcome of 44 cases referred to us for management.
METHODS: We studied 44 cases of ovarian cancer. Chemotherapy consisted of 3 weekly cycles of Cisplatin at 75mg/m2 and Cyclophosphamide at 750mg/m2 or Paclitaxel at 175mg/m2. Parameters documented included age, histology, time of presentation stage and treatment response. These were obtained from clinical examination, operation notes, pathology reports, radiological exams and Cancer Antigen 125 tumor marker levels.
RESULTS: Age range was 12-64 years with a median of 45 years. Thirty-seven (82%) had stage 3 or 4 disease. Thirty-seven (82%) presented after four months of which two-thirds presented more than one year after initial symptoms. Thirty-seven (82%) had epithelial ovarian cancer, four (9%) had germ cell tumours and three (7%) stromal tumors. Only twenty five patients could be assessed for treatment response. Twenty (80%) out of these 25 patients received Cyclophosphamide and Cisplatin chemotherapy. Total clinical response rate was 52%, with only four patients (16%) achieving complete clinical response and nine patients (36%), a partial response.
CONCLUSION: Our patients presented with a median age of 45 years which is lower than what is reported for most countries. A large majority present with advanced disease and presented more than four months after initial symptoms. The response rate of cyclophosphamide/Platinum chemotherapy in this group with epithelial cell type was relatively low.