Citation
Mokhtarudin, Rusinahayati and Vallipuram, Sivanesaratnam and Pailoor, Jayalakshmi and Mohd Nordin, Noraihan
(2010)
Clinical behaviour, pathological findings, survival and
prognostic factors in young woman in comparison to
menopausal women with epithelial ovarian malignancy.
Malaysian Journal of Medicine and Health Sciences, 6 (1).
pp. 19-32.
ISSN 1675-8544
Abstract
Objective: The purpose of this study was to evaluate the clinical behaviour, pathological
findings, survival and prognostic factors in young women in comparison to menopausal
women with epithelial ovarian malignancy. Methods: A retrospective analysis of 141
patients (67 for age below 40 years and 74 menopausal) treated between 1980 and 2000
was conducted. Results: Irrespective of the stage, the most common clinical presentation
was abdominal distension in both young (78%) and menopausal women (66%). In young
women, 52% presented at an early stage of the disease and in menopausal women this was
seen in 22% (p-value <0.05). The most common histological type of carcinoma in young
women was mucinous cystadenocarcinoma (36%) and in menopausal women, it was serous
cystadenocarcinoma (47%) (p<0.05).The overall 5-year survival rates in each group were
54% in young women and 41% in menopausal women. The 5-year survival rate appeared
to be influenced by the stage of disease and tumour debulking surgery from univariate
analysis in both young and menopausal women. In the final multivariate Cox proportional
hazard model analysis, the optimal tumour debulking surgery was a significant (0.25; 95%
CI (0.1-0.3) p <0.01) independent prognostic factor for survival probability in both young
and menopausal women Conclusion: There are limited reports in the literature comparing
the outcomes of younger and menopausal women with epithelial ovarian malignancy treated
by any gynaecology oncologist from a single academic institution. Our results showed that
the proportion of epithelial ovarian malignancy in young women was 30% from the total
identified numbers of patients treated for epithelial ovarian malignancy. Although different
types of carcinoma occurred in the young and menopausal women, the stage of the disease
at presentation and optimal debulking surgery are important prognostic factors to ensure
better survival rate.
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