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Abstract
Introduction/Background*Ovarian cancer is the eighth most frequent cancer worldwide. Although the vast majority of ovarian cancers are diagnosed in postmenopausal women and at advanced stage, a significant subset occurs in younger women. Our objective is to describe the diagnosis and treatment of ovarian cancer in young women in a tertiary Spanish hospital during a 7-year period.
Methodology Retrospective descriptive cohort study of patients aged between 18 and 45 years old diagnosed with ovarian cancer between 01/2012 and 12/2019 at University Hospital 12 de Octubre, Madrid, Spain.
Result(s)*A total of 34 women were included. The mean age at diagnosis was 35.9 years old and the mean body mass index (BMI) was 23.7 kg/m2. 22/34 (64.7%) women were nulligesta; 6/34 (17.6%) had a family history of breast/ovarian cancer; 7/34 (19.6%) were smokers and 3/34 (7.8%) were BRCA mutated.
The mean tumor’s size in presurgical imaging workup (ultrasound, CT or MRI scan) was 110.1 ± 68.5mm. The mean Ca-125 serum concentration was 128.4 U/mL in FIGO stages I-II and 393.7 U/mL in FIGO stages III-IV.
The diagnostic method was adnexectomy in 79.4% of the patients; 55.9% performed by laparotomy. 29/34 (85.3%) patients presented epithelial tumours (20.6% low-grade serous, 14.7% high-grade serous, 17.6% mucinous, 14.7% clear cells, 14.7% endometrioid) and 5/34 non epithelial (5.9% dysgerminoma and 11.8% other non epithelial histology). 23/34 (67.6%) patients were diagnosed at FIGO stages I-II.
In patients with FIGO stage III-IV, 4/11 (36.4%) of patients underwent primary cytoreductive surgery and 6/11 (54.5%) of patients underwent surgery after neoadjuvant chemotherapy. Complete tumor resection was obtained in 90.9% of all surgeries. Fertility preservation was possible in 7/34 patients (20.6%).
Mean follow up time was 48.4 ± 24.7 months. Five patients (14.7%) relapsed, one patient (3.4%) died because of disease and one patient (3.4%) died because other disease.
At the time of last follow up, 28/34 (82.4%) women were tumor free, 2/34 (5.8%) were alive with disease, 2/34 (5.8%) were lost in the follow up.
Conclusion*As reported in literature, women under 45 years old are often diagnosed with early stage ovarian cancer and present optimal survival results with low recurrence rate.