Incidence of Ovarian Tumor in Last the Five Years in Al-Najaf City

Noorhan Shaker,Dalal Al-Jarah,Saliha Ali Hussain,Raghad Yas
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Keywords : Incidence,Ovarian,Tumor
Medical Journal of Babylon  6:1 , 2014 doi:1812-156X-6-1
Published :16 June 2014

Abstract

It is a retrospective and prospective study for ovarian neoplasm within five years in Al- Najaf city done in Al-Zahraa Teaching Hospital . The total number were 344 patients , 291 cases were benign ovarian tumors and 53 cases were malignant ovarian tumors analyzed according to their age groups and histopathological types of tumor .Young age groups were the most affected group with ovarian neoplasm in this study especially the benign type. Six histopathological types of benign and Six histopathological types of malignant were recorded; mature teratoma was more frequent for benign while serouscystadenocarcinoma was for malignant

Introduction

ovarian neoplasm is the most common tumors among women [1], fortunately 90% are benign. Malignant ovarian tumor is the 4th commonest malignant tumor in women and causes approximately 4000deaths each year in the UK [2]. Main risk factors are increasing age, +ve family history, increase age of reproduction , high socio-economic classes, nulliparity [3]. Ovarian tumors generally classified into 3 primary classes , epithelial tumors 90%, germ cell tumors 3% and sex cord / stromal tumors 6% depending on the type of the ovarian tissue were the neoplasm develops[4,5]. Diagnosis of ovarian tumor depends on signs and symptoms, abdominal and vaginal ultrasound,Doppler study of tumor vasculature[6], biochemical study (tumor markers) which are proteins associated with malignant tumors like CA125, B-hCG,?-fetoprotien [7,8], however the definitive diagnosis and staging done by surgery and histopathology . Treatment of benign ovarian tumors depends on age , presentation and fertility, while treatment of malignant tumors depends on type of tumor, stage, age and fertility [9],treatment includes surgery, chemotherapy , radiotherapy and hormonal [10,11] . Prognosis of malignant tumor depends on stage of tumor , grade, and size of residual tumor after surgery, there are 4stages of ovarian tumors according to tumor spread and 3 grades according to cell differentiation, unfortunately for most affected women the cancer has already spread beyond the ovaries by the time they present to specialist, this advanced stage means that the treatments are much less likely to be curative and approximately 30%survive 5years despite the widely introduction of new chemotherapy agents such as taxanes and increased interest in the screening for early stages[2,12] . Screening modalities are annual CA125 and transvaginal ultrasound [13].

Materials and methods

This is a retrospective and
prospective study carried out at Al-
Zahraa Teaching Hospital in Al-Najaf
city. In this study a number of
patients with benign and malignant
ovarian tumors in the last 5 years
(2000, 2001, 2002, 2003, 2004) had
been collected, the collected cases
were from Al-Zahraa and Al-Sader
Teaching Hospitals ,and Al-Forat
Center of Malignancy Research, and
private histopathological laboratories,
all cases undergone surgical resection
of tumors and sent for
histopathological study. The collected
data had been analysed, the tumors
divided as benign and malignant
types and found their incidence in
each studied year, also study the
relation of each type with patient age,
then classified each tumor according
to histopathological results of them
and found their relation with age .
Student t-test was used to
evaluate p-value significance between
benign and malignant ovarian tumors.
P-value of < 0.05 used as
significant .


Results

The total number of the collected cases was 344, benign ovarian tumors were 291 and malignant were 53 patients in these last 5 years The mean age of benign tumors was 32.3 and of malignant was 40 years, which is statistically significant ( p < 0.05 ) . as shown in Table 1.Table 3 shows the incidence of ovarian tumors ( benign and malignant ) in relation to different age groups. The higher incidence for benign tumors was 36.15% in the age group (20-29) and (30-39)years, while higher incidence for malignant tumors was 30.18% in the age group (30-39) years .Table 5 shows the histopathological types of malignant tumors by age group distribution . Six histological types were recorded (serouscystadenocarcinoma , mucinouscystadenocarcinoma , endometroid, granulosa cell tumor, dysgerminoma, immature teratoma ) , serouscystadenocarcinoma was more frequent tumor (37.8%) and was more frequent in age group (50-59) years .

Discussions

Ovarian cancers are potentially life-threatened malignancies that develop in one or both ovaries. Ovarian tumors are not only the most common of the gynecological tumor but are (for malignant) one the most lethal which is 4th or 5th most common cause of death from all cancer among women and the leading cause of death from gynecological malignancies , having over all 5 years survival only 30% in UK . [5,14] Mean age of benign and malignant cases in this study was lower than that reported in study done by Southwest Cancer Intelligence Service (2000) [7], which reveal mean age for benign 40 years and for malignant 60 years and also differ from Harvey Simon at 2003[5] who revealed average age of ovarian cancer 60 years, this difference may be due to many possible causes like environmental as wars , radiation, chemical pollutions and stress, or hereditary, or the cases reported in this study may not reflect all the cases of ovarian tumors because some prefer to be managed in more specialized centers outside the city ,or in our city older age groups usually not accept surgical interference . Regarding to histopathological types of benign and malignant tumors the incidence was benign teratoma more frequent of benign tumors (39.3%) , and serouscystadenocarcinoma was more frequent for malignant cases (37.8%) , these two results were in agreement with Stuart et al (2000) ,cancer research UK2002, and Harvey (2003) [5,15,16] , in which their studies reveal that benign teratoma was the most frequent (40%) and serouscystadenocarcinoma was more frequent malignant (40%) .

Conclusions

As ovarian tumor is 5th common tumor among women and for malignant is the most lethal one , we conclude that young age group was affected with ovarian tumors in the last 5 years in Al-Najaf city .

References

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