Abstract
Background: Ovarian cancer is the third commonest cause of cancer death from gynaecologic tumors in Kenya. Early disease causes minimal, nonspecific, or no symptoms therefore, most patients are diagnosed when the disease is at an advanced stage. Overall, prognosis for these patients remains poor but has not been described in Kenya. Objectives: To describe the histological types, therapeutic methods used, therapeutic outcome and the survival rate at 2 years. Methods: This was a retrospective cross-sectional descriptive study undertaking a 10-year review of case records of patients treated for cancer of the ovary between 1998 and 2008 in Kenyatta National Hospital. Results: Majority of the patients (73.3%) presented with advanced stage of disease (stages III & IV). Epithelial tumors (86.2%) are the commonest histological type, with 45.7% of them being serous type. Chemotherapy was the most (46.0%) used therapeutic option, with vomiting and diarrhea being the leading morbidity associated with it. Survival at 2 yrs from diagnosis was 50% as per the Kaplan-Meier time survival estimate. Conclusion: There is need to improve the quality of data on cancer care and information systems in general to provide a reliable source of information to guide research and policy in oncology. Further, the late presentation to hospital calls for innovative strategies to improve ovarian cancer awareness and uptake of screening tests. There is need to lobby Governments in resource limited setting to subsidize cancer of the ovary care and invest in lower level health facilities to promote early diagnosis and decongest the referral hospital.
Highlights
Ovarian cancer is the third most frequent cause of death from gynaecological cancers worldwide
This poor prognosis is further worsened by lack of trained Gynaecologic Oncologist in resource limited settings, which culminates to sub-optimal treatment to these patients
The study was undertaken at Kenyatta National Hospital (KNH) by reviewing case records of patients treated with cancer of the ovary
Summary
Ovarian cancer is the third most frequent cause of death from gynaecological cancers worldwide. More than half of the women with ovarian cancer are diagnosed in the advanced stages of the disease with overall poor prognosis [3] This poor prognosis is further worsened by lack of trained Gynaecologic Oncologist in resource limited settings, which culminates to sub-optimal treatment to these patients. There is limited information on epidemiology of reproductive cancers including ovarian cancer from developing countries, and where available it is mostly from institutional-based data and is of poor quality This is largely from lack of standardized encounter form, a robust data base and absence of a national data registry. Nonspecific, or no symptoms most patients are diagnosed when the disease is at an advanced stage Overall, prognosis for these patients remains poor but has not been described in Kenya. There is need to lobby Governments in resource limited setting to subsidize cancer of the ovary care and invest in lower level health facilities to promote early diagnosis and decongest the referral hospital
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