Research Paper
Year: 2020 | Month: August | Volume: 7 | Issue: 8 | Pages: 380-386
Management of Epithelial Ovarian Cancer in Older Patients in the Adam Malik Central Hospital of Medan
Dwi Faradina1, M. Rizki Yaznil2, Fachruroji3
1,2,3Universitas Sumatera Utara, Medan, North Sumatra, Indonesia
Corresponding Author: Dwi Faradina
ABSTRACT
Ovarian cancer is the eighth most common cancer in women and is ranked 18th most common cancer in the world. Based on SEER, 47% of ovarian cancers occur in women over 65 years of age. Decreased life expectancy in older ovarian cancer patients can be due to: more aggressive cancer cells at old age; resistance of cancer cells to chemotherapy; individual patient factors; inadequate surgery and suboptimal chemotherapy. As many as 75% of women with ovarian cancer are diagnosed at an advanced stage so the prognosis is poor. Consideration of chemotherapy doses, scheduling, route and time, is very important to determine the safest and most effective treatment with consideration of geriatric assessment, such as functional dependence, organ function, comorbidity, polypharmacy, social support, and cognition/psychosocial factors. The purpose of this study was to determine the characteristics and treatment of ovarian cancer in older patients, especially in H. Adam Malik General Hospital, Medan.
Data about ovarian cancer were obtained from the cancer registry, and through SIRS data (Hospital information system, Sistem informasi rumah sakit) with following keywords: ovarian cancer and malignant ovarian tumor corresponding to ICD10. After that, results search were filtered for patients older than 60 years old, and checked one by one to ensure that the patient was diagnosed with ovarian cancer. Then, the characteristics and management of the patient were obtained from the medical record.
This research was conducted at Haji Adam Malik Hospital which is a class A general hospital in Medan as well as a referral hospital of Development Area A which covers the provinces North Sumatra, Nanggroe Aceh Darussalam, West Sumatra, and Riau. Through SIRS data, we found that 132 patients were diagnosed with ovarian cancer and malignant ovarian tumor from 2016-2018. From the cases registered at H Adam Malik General Hospital, only 15 cases were in accordance with screening criteria, namely patients over the age of 60 years. Most patients were aged between 66-70 years (53.33%), histopathologically had the adenocarcinoma mucinous type (33.33%), and most were in stage IIIC (20%). For surgery, we found optimal primary debulking of 53.33%, suboptimal primary debulking of 33.33% and 13,345 primary debulking were not carried out. More patients had ASA scores with a range of 0-1 (53.33%) than patients with ASA scores of 2-3 (33.33%). 5 patients had good outcome (53.33%), 1 patient passed away (33.33%), and there was as much as 53.33% loss of follow-up with unknown outcome. Conclusion: the management of ovarian cancer in older patients in Dr. H. Adam Malik Hospital is in accordance with EBM.
Keywords: Epithelial Ovarian Cancer, Old Age
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