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  1. Article ; Online: Isolated tubal metastasis from an incidental HPV-associated endocervical adenocarcinoma presented as an adnexal mass: A case report.

    Aljhdali, Hessa / Balega, Janos / Williams, Anthony / Ganesan, Raji

    Case reports in women's health

    2023  Volume 39, Page(s) e00532

    Abstract: Tubal metastasis from endocervical adenocarcinoma is uncommon and is discovered as an incidental finding on routine sampling of fallopian tubes. In this paper, we present the case of an 81-year-old woman who presented with an adnexal mass during ... ...

    Abstract Tubal metastasis from endocervical adenocarcinoma is uncommon and is discovered as an incidental finding on routine sampling of fallopian tubes. In this paper, we present the case of an 81-year-old woman who presented with an adnexal mass during investigations of postmenopausal bleeding. Hysterectomy and bilateral salpingo-oophorectomy with excision of the left adnexal mass were performed, which led to the diagnosis of an incidental HPV-associated endocervical adenocarcinoma with secondary, macroscopic tubal involvement. The patient received adjuvant pelvic radiotherapy and remained well after three months of follow-up, with no evidence of recurrence. Only a few cases of endocervical adenocarcinoma with tubal metastasis have been reported in the literature, which are commonly associated with ovarian, uterine corpus, and/or parametrial tissue involvement. To date, there are only two reported cases of isolated tubal metastasis, and in both cases, tubal involvement was discovered microscopically. Data on the impact of secondary tubal involvement on patient outcomes are limited.
    Language English
    Publishing date 2023-08-03
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2800286-6
    ISSN 2214-9112 ; 2214-9112
    ISSN (online) 2214-9112
    ISSN 2214-9112
    DOI 10.1016/j.crwh.2023.e00532
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  2. Article: An unusual case of three concomitant primary solid cancers with unique histopathological characteristics.

    Shatila, Mohamed / Ahmad, Ijaz / Balega, Janos / Kalkat, Maninder S / Patel, Akshay J

    International journal of surgery case reports

    2023  Volume 113, Page(s) 109080

    Abstract: Introduction and importance: Struma Ovarii is a rare type of monodermal teratoma with at least 50 % of its mass being thyroid tissue. They make up <1 % of all ovarian tumours and 3 to 5 % of all ovarian teratomas. These tumours are usually benign but ... ...

    Abstract Introduction and importance: Struma Ovarii is a rare type of monodermal teratoma with at least 50 % of its mass being thyroid tissue. They make up <1 % of all ovarian tumours and 3 to 5 % of all ovarian teratomas. These tumours are usually benign but malignant transformation is seen in <5 % of cases.
    Case presentation: We present the case of a 45-year-old lady with three synchronous primary cancers on a background of Struma Ovarii; primary lung adenocarcinoma, papillary thyroid carcinoma and ovarian teratoma. Over the course of 18 months, this lady underwent full pelvic clearance of malignant Struma Ovarii and lymph nodes, total thyroidectomy, and an anatomical lung resection.
    Clinical discussion: This case represents an incredibly rare condition of Struma Ovarii for which there is no firm management consensus. Furthermore, the uniqueness of three separate primaries has to the best of our knowledge not previously been reported in the literature.
    Conclusion: This reinforces the notion that in select patients, radical management with curative intent is entirely possible but requires complete multi-disciplinary and multi-modal sub-specialty collaboration.
    Language English
    Publishing date 2023-11-20
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2023.109080
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  3. Article ; Online: Prevalence of computed tomography-based sarcopenia and the prognostic value of skeletal muscle index and muscle attenuation amongst women with epithelial ovarian malignancy: A systematic review and meta-analysis.

    Tranoulis, Anastasios / Kwong, Fong Lien Audrey / Lakhiani, Aarti / Georgiou, Dimitra / Yap, Jason / Balega, Janos

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2022  Volume 48, Issue 7, Page(s) 1441–1454

    Abstract: Background: Sarcopenia represents an index of frailty amongst cancer patients and it is associated with poor oncological outcomes and a higher risk of surgical complications in several types of malignancy.: Aim: To further delineate the impact of ... ...

    Abstract Background: Sarcopenia represents an index of frailty amongst cancer patients and it is associated with poor oncological outcomes and a higher risk of surgical complications in several types of malignancy.
    Aim: To further delineate the impact of sarcopenia assessed via computed tomography scan (CT) on oncological outcomes and post-operative complications amongst women with epithelial ovarian carcinoma (EOC). Our secondary objective was to quantify and understand the prevalence of sarcopenia in EOC.
    Design: We systematically searched MEDLINE, SCOPUS, ClinicalTrials.gov, and Cochrane Database, from inception up to August 2021. Quality assessment was performed using the Newcastle-Ottawa scale (NOS). Outcomes consisted of prevalence, overall survival (OS), progression-free survival (PFS) and post-operative complications. Pooled analyses of proportion estimates, hazard ratios (HRs) and odds ratios (ORs) were performed with STATA and Review Manager 5.3.
    Results: 21 studies were included in this meta-analysis. NOS scores ranged from six to nine. Pooled analysis yielded an overall sarcopenia prevalence of 41%. Pooled analysis of adjusted HRs demonstrated significant association between low muscle attenuation (MA) [aHR = 1.23, (95% CI 1.02-1.47), p-value = 0.03] and OS, whilst low skeletal muscle index (SMI) trended towards shorter OS [aHR = 1.37, (95% CI 0.99-1.90), p-value = 0.05. Low-SMI was also associated with higher risk of total post-operative complications [uOR = 1.56, (95% CI 1.16-2.11), p-value = 0.004].
    Conclusion: Our findings suggest that CT-assessed skeletal mass and radiodensity represent rather accurate indices of nutritional status and could prospectively be incorporated into the decision-making process in women with EOC.
    MeSH term(s) Carcinoma, Ovarian Epithelial/pathology ; Female ; Humans ; Muscle, Skeletal/diagnostic imaging ; Muscle, Skeletal/pathology ; Ovarian Neoplasms/complications ; Ovarian Neoplasms/diagnostic imaging ; Ovarian Neoplasms/surgery ; Postoperative Complications/pathology ; Prevalence ; Prognosis ; Sarcopenia/diagnostic imaging ; Sarcopenia/epidemiology ; Sarcopenia/etiology ; Tomography, X-Ray Computed
    Language English
    Publishing date 2022-02-24
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2022.02.024
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    Zs.A 1149: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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    Zs.MO 549: Show issues

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  4. Article ; Online: The value of magnetic resonance imaging in investigating complex atypical hyperplasia of the endometrium.

    Ofinran, Olumide / Balega, Janos

    Minerva ginecologica

    2016  Volume 68, Issue 4, Page(s) 400–404

    Abstract: Background: Magnetic resonance imaging (MRI) has been recommended to rule out myometrial invasion or distant metastasis before treatment for complex atypical hyperplasia (CAH). This study aimed to evaluate whether preoperative MRI in patients diagnosed ... ...

    Abstract Background: Magnetic resonance imaging (MRI) has been recommended to rule out myometrial invasion or distant metastasis before treatment for complex atypical hyperplasia (CAH). This study aimed to evaluate whether preoperative MRI in patients diagnosed with CAH on initial biopsy will have any impact on their management.
    Methods: A retrospective study of women diagnosed with CAH on initial endometrial biopsy that subsequently had hysterectomies. Definitive diagnosis was established at histology of the hysterectomy specimens and compared with preoperative MRI findings.
    Results: Preoperative MRI scan was performed in 33 of 106 patients and myometrial invasion was reported in 12 patients with final histology diagnosing endometrial cancer in 10 patients. Twenty-one out of 33 cases were reported as no invasion on MRI but nine patients were confirmed with endometrial cancer on histology. Of the thirty-three patients diagnosed with endometrial cancer, twenty had stage 1a cancer, eight had stage 1b and five had stage 2 cancer. Twenty-seven patients had grade 1 and six patients had grade 2 cancer with no high-grade subtypes.
    Conclusions: In our series, we found that MRI had no value in the management of CAH. Thirty-three endometrioid endometrial cancers (31%) were identified and we found no high-risk subtypes, and simple hysterectomy and bilateral salpingo-oophorectomy would be performed and the few stage 2 cases diagnosed were microscopic and would not have been diagnosed on MRI.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biopsy ; Endometrial Hyperplasia/diagnostic imaging ; Endometrial Hyperplasia/pathology ; Endometrial Hyperplasia/surgery ; Endometrial Neoplasms/diagnostic imaging ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/surgery ; Female ; Humans ; Hysterectomy/methods ; Magnetic Resonance Imaging/methods ; Middle Aged ; Neoplasm Staging ; Ovariectomy ; Retrospective Studies ; Salpingectomy ; Young Adult
    Language English
    Publishing date 2016-08
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 80159-8
    ISSN 1827-1650 ; 0026-4784 ; 0325-8793
    ISSN (online) 1827-1650
    ISSN 0026-4784 ; 0325-8793
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  5. Article ; Online: Serum Albumin as a Predictor of Survival after Interval Debulking Surgery for Advanced Ovarian Cancer (AOC): A Retrospective Study.

    Dai, Dairui / Balega, Janos / Sundar, Sudha / Kehoe, Sean / Elattar, Ahmed / Phillips, Andrew / Singh, Kavita

    Journal of investigative surgery : the official journal of the Academy of Surgical Research

    2020  Volume 35, Issue 2, Page(s) 426–431

    Abstract: Objective: To investigate the impact of serum albumin (at diagnosis and pre-operatively) on survival in patients undergoing cytoreductive surgery for advanced ovarian cancer(AOC) and whether improvement in albumin achieved following neoadjuvant ... ...

    Abstract Objective: To investigate the impact of serum albumin (at diagnosis and pre-operatively) on survival in patients undergoing cytoreductive surgery for advanced ovarian cancer(AOC) and whether improvement in albumin achieved following neoadjuvant chemotherapy (NACT) affects overall survival (OS).
    Methods: Outcomes of 441 patients who underwent cytoreduction for AOC were reviewed. Albumin was recorded at diagnosis and pre-operatively. Further analysis was performed if patients were hypoalbuminaemic at diagnosis.Analysis was stratified according to whether the patientreceived primary debulking surgery (PDS) or interval debulking surgery (IDS) and if their albumin was corrected.
    Results: 308 patients had a serum albumin level at diagnosis and 400 patients had a pre-operative albumin available for analysis. For patients with an albumin at diagnosis ≤ 35g/L and ≥36 g/L, median OS was 31.5 (95% CI 23.5-39.5) and 50.4 (95% CI 38.9-61.9) months respectively (P = 0.003). Followingmultivariate analysis (MVA), albumin at diagnosis remained statistically significant as an independent marker for survival, even after adjusting for cytoreductive outcome, stage and grade(p = 0.04, Hazard ratio 1.38, 95% CI 1.01-1.89).Hypoalbuminaemic patients at diagnosis achieved complete cytoreduction in 53% of cases.For PDS patients, median OS was 19.7 months (95% CI 11.5-27.9). For IDS patients, median OS was 27.9 months (n = 1).IDS patients with a corrected albumin had a median OS of 42.9 months (95% CI 31.5-54.3) (p > 0.05).
    Conclusion: Hypoalbuminaemia at diagnosis is a poor prognostic factor in AOC. Normalization of serum albumin after NACT is a potential predictor of survival.
    MeSH term(s) Cytoreduction Surgical Procedures ; Humans ; Neoplasm Staging ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Retrospective Studies ; Serum Albumin
    Chemical Substances Serum Albumin
    Language English
    Publishing date 2020-10-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639444-9
    ISSN 1521-0553 ; 0894-1939
    ISSN (online) 1521-0553
    ISSN 0894-1939
    DOI 10.1080/08941939.2020.1827314
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    Zs.A 2364: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  6. Article ; Online: Prolonged interruption of chemotherapy in patients undergoing delayed debulking surgery for advanced high grade serous ovarian cancer is associated with a worse prognosis.

    Searle, Gemma / Pounds, Rachel / Phillips, Andrew / Kehoe, Sean / Balega, Janos / Singh, Kavita / Yap, Jason

    Gynecologic oncology

    2020  Volume 158, Issue 1, Page(s) 54–58

    Abstract: Introduction: The current standard of care for advanced high grade serous ovarian cancer (HGSC) comprises a combination of debulking surgery and platinum-based chemotherapy given in the neoadjuvant or adjuvant setting. In the neoadjuvant setting, ... ...

    Abstract Introduction: The current standard of care for advanced high grade serous ovarian cancer (HGSC) comprises a combination of debulking surgery and platinum-based chemotherapy given in the neoadjuvant or adjuvant setting. In the neoadjuvant setting, patients usually undergo 3 cycles of chemotherapy followed by interval cytoreductive surgery (ICS), then 3 further cycles of chemotherapy. However, the optimum timeframe to administer chemotherapy before and after ICS remains unclear. We therefore examine the survival impact of the interval between pre- and post-operative chemotherapy in patients undergoing ICS in a well-established patient cohort. Factors leading to "delays" in recommencing post-operative chemotherapy were also examined.
    Methods: The study comprises of a retrospective cohort of 205 cases with FIGO stage III and IV HGSC undergoing ICS. The duration of the interval between pre-operative and post-operative chemotherapy was correlated with progression-free (PFS) and overall survival (OS). Univariate and multivariate analyses were constructed to identify factors associated with survival and prolonged chemotherapy interruption.
    Results: The median interval between pre-operative and post-operative chemotherapy was 63 days. Multivariate analyses revealed macroscopic residual disease (HR:2.280, 95% CI:1.635-3.177, p ≤ 0.001) and interruption of chemotherapy >10 weeks (HR:1.65, 95%CI:1.201-2.290, p = 0.002) were associated with poorer OS. Existing medical comorbidities and longer hospital stay were independent prognostic factors for prolonging the chemotherapy interruption.
    Conclusion: Our study recommends that interruption to chemotherapy to allow patients to undergo ICS should be ≤10 weeks; otherwise, OS is significantly impacted. Patients with pre-existing medical comorbidities should receive additional support pre- and post-operatively to keep the chemotherapy interruption to a minimum.
    MeSH term(s) Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Chemotherapy, Adjuvant ; Cohort Studies ; Cystadenocarcinoma, Serous/drug therapy ; Cystadenocarcinoma, Serous/surgery ; Cytoreduction Surgical Procedures ; Drug Administration Schedule ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Staging ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/surgery ; Prognosis ; Progression-Free Survival ; Retrospective Studies ; Time-to-Treatment
    Language English
    Publishing date 2020-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2020.04.048
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    Zs.A 885: Show issues Location:
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  7. Article ; Online: Glomangiomyoma of the Vagina: A Report of 2 Cases and Literature Review.

    Rahimi, Siavash / Marani, Carla / Balega, Janos / Hirschowitz, Lynn

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2017  Volume 36, Issue 4, Page(s) 334–338

    Abstract: We report 2 cases of vaginal glomangiomyoma in a 53-year-old who presented with a painful vaginal mass, and a 56-year-old who had postmenopausal bleeding and in whom an incidental vaginal mass was identified and resected at the time of hysterectomy. ... ...

    Abstract We report 2 cases of vaginal glomangiomyoma in a 53-year-old who presented with a painful vaginal mass, and a 56-year-old who had postmenopausal bleeding and in whom an incidental vaginal mass was identified and resected at the time of hysterectomy. Histologic examination of the resected masses showed solid, circumscribed, benign, smooth muscle-predominant tumors with interspersed small islands of epithelioid glomus cells. The glomus cells were intimately related to small-caliber blood vessels and showed no cytologic atypia or mitotic activity. The tumor cells showed diffuse expression of smooth muscle actin, CD34, and focal expression of h-caldesmon, vimentin, and estrogen receptor. No immunolabeling for calponin B or desmin was found. To our knowledge, there are only isolated reports of vaginal glomus tumors, and these are the first reported case of vaginal glomangiomyoma in the literature.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/PGP.0000000000000340
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    Zs.A 1814: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article ; Online: The impact on obstetric outcomes following complete amputation of the cervix uteri in fertility preservation surgery for cervical neoplasm.

    O'Neill, Danielle / Pounds, Rachel / Scully, Niall / Marriott, Natalie / Balega, Janos / Ganesan, Raji / Singh, Kavita / Yap, Jason

    European journal of obstetrics, gynecology, and reproductive biology

    2021  Volume 260, Page(s) 171–176

    Abstract: Objectives: Radical trachelectomy is offered to women with early-stage cervical neoplasia who desire fertility. The presence of isthmic glands within histological specimens suggests complete cervical amputation and as such, we examined if the presence ... ...

    Abstract Objectives: Radical trachelectomy is offered to women with early-stage cervical neoplasia who desire fertility. The presence of isthmic glands within histological specimens suggests complete cervical amputation and as such, we examined if the presence of these glands in surgical specimens adversely affects obstetric outcomes.
    Study design: The study cohort comprises 43 consecutive cases of early-stage cervical neoplasia. The presence of isthmic glands in pathological specimens was correlated with obstetric outcomes. Univariate and multivariate analyses were constructed to identify clinicopathological factors associated with adverse obstetric outcomes.
    Results: 43 patients underwent fertility sparing surgery; radical (30; 69.8 %) or simple trachelectomy (13; 30.2 %). Of these, 26 (60.5 %) had isthmic glands within the surgical specimen. Isthmic gland presence was not influenced by surgery radicality, disease stage, histological diagnosis, or surgical approach. Obstetric outcomes were available for 36 patients, with 27 attempting conception post-trachelectomy and 15 (55.6 %) achieving at least one pregnancy. Of 21 total pregnancies, the miscarriage and live birth rates were 7.4 % and 85.0 %, respectively. The presence of isthmic glands did not influence the overall conception rate, with 53.8 % of women with complete cervical amputation conceiving compared to 57.1 % of those without (p = 0.8632). Complete removal of the cervix did not increase premature deliveries <37 weeks gestation (p = 0.2521).
    Conclusions: The presence of isthmic glands in trachelectomy specimens provides a reliable surrogate marker for complete cervical amputation. In cases where complete cervical amputation is required to achieve maximum oncological outcomes, patients may be assured that there is little evident impact on fertility and obstetric outcomes.
    MeSH term(s) Amputation ; Cervix Uteri/pathology ; Cervix Uteri/surgery ; Female ; Fertility Preservation ; Humans ; Neoplasm Staging ; Pregnancy ; Trachelectomy/adverse effects ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/surgery
    Language English
    Publishing date 2021-03-26
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2021.03.032
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    Zs.A 837: Show issues Location:
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  9. Article ; Online: Friend or foe? The prognostic role of endometriosis in women with clear cell ovarian carcinoma. A UK population-based cohort study.

    Tranoulis, Anastasios / Buruiana, Felicia Helena / Gupta, Bindiya / Kwong, Audrey / Lakhiani, Aarti / Yap, Jason / Balega, Janos / Singh, Kavita

    Archives of gynecology and obstetrics

    2021  Volume 305, Issue 5, Page(s) 1279–1289

    Abstract: Purpose: The prognostic role of endometriosis amongst women with ovarian clear cell carcinoma (OCCC) remains debatable. The aim of this study was to ascertain the effect of endometriosis on the prognosis of OCCC.: Methods: A retrospective review of ... ...

    Abstract Purpose: The prognostic role of endometriosis amongst women with ovarian clear cell carcinoma (OCCC) remains debatable. The aim of this study was to ascertain the effect of endometriosis on the prognosis of OCCC.
    Methods: A retrospective review of the medical records of 94 women diagnosed and treated for OCCC at a tertiary gynaecological cancer centre in the UK, spanning the period 2010-2019. Women were divided into two groups according to the presence of endometriosis. Clinico-pathological characteristics, progression-free survival (PFS) and overall survival (OS) were collated between the two groups.
    Results: Forty-six cases of endometriosis-free OCCC (Ef-OCCC) were collated with 48 cases of endometriosis-related OCCC (Er-OCCC). There was no significant difference between the two groups regarding age (p-value = 0.2), FIGO stage (p-value = 0.8), residual disease (RD) (p-value = 0.07), adjuvant chemotherapy agent (p-value = 0.4) or chemo-resistance (p-value = 0.9). The presence of endometriosis did not significantly affect either OS or PFS. The median OS in the Ef-OCCC and Er-OCCC was 55.00 (95% CI 32.00-189.00) and 71.00 (95% CI 47.00-97.00; log rank = 1.35, p-value = 0.2) months. The median PFS in the Ef-OCCC and Er-OCCC group was 39.00 (95% CI 19.00-143.00) and 39.00 (95% CI 19.00-62.00; log rank = 0.7, p-value = 0.4) months. Survival differences between the two groups were not significant after stratification analysis for independent prognosticators.
    Conclusion: Endometriosis was not independently associated with the prognosis of OCCC either in crude analysis or after stratification for stage and RD. Further larger, well-designed prospective studies are warranted to draw firmer conclusions on the intrinsic link between endometriosis and OCCC.
    MeSH term(s) Adenocarcinoma, Clear Cell/pathology ; Cohort Studies ; Endometriosis/complications ; Endometriosis/pathology ; Female ; Humans ; Male ; Neoplasm Staging ; Neoplasm, Residual/pathology ; Ovarian Neoplasms ; Prognosis ; United Kingdom/epidemiology
    Language English
    Publishing date 2021-09-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-021-06191-8
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  10. Article: Analysis of Anxiety, Depression and Fear of Progression at 12 Months Post-Cytoreductive Surgery in the SOCQER-2 (Surgery in Ovarian Cancer-Quality of Life Evaluation Research) Prospective, International, Multicentre Study.

    Lakhiani, Aarti / Cummins, Carole / Kumar, Satyam / Long, Joanna / Arora, Vivek / Balega, Janos / Broadhead, Tim / Duncan, Timothy / Edmondson, Richard / Fotopoulou, Christina / Glasspool, Rosalind / Kolomainen, Desiree / Manchanda, Ranjit / McNally, Orla / Morrison, Jo / Mukhopadhyay, Asima / Naik, Raj / Wood, Nick / Sundar, Sudha

    Cancers

    2023  Volume 16, Issue 1

    Abstract: Patients with ovarian cancer (OC) often experience anxiety, depression and fear of progression (FOP); however, it is unclear whether surgical complexity has a role to play. We investigated the prevalence of anxiety, depression and FOP at 12 months post- ... ...

    Abstract Patients with ovarian cancer (OC) often experience anxiety, depression and fear of progression (FOP); however, it is unclear whether surgical complexity has a role to play. We investigated the prevalence of anxiety, depression and FOP at 12 months post-cytoreductive surgery and investigated associations with surgical complexity, patient (age, ethnicity, performance status, BMI) and tumour (stage, disease load) factors. One hundred and forty-one patients with FIGO Stage III-IV OC, who did not have disease progression at 12 months post-surgery, completed the Hospital Anxiety and Depression Scale and FOP short-form questionnaire. Patients underwent surgery with low (40.4%), intermediate (31.2%) and high (28.4%) surgical complexity scores. At 12 months post-surgery, 99 of 141 (70%) patients with advanced OC undergoing surgery experienced clinically significant anxiety, 21 of 141 (14.9%) patients experienced moderate to severe depression and 37 of 140 (26.4%) experienced dysfunctional FOP. No associations were identified between the three different surgical complexity groups with regards to anxiety, depression or FOP scores. Unsurprisingly, given the natural history of the disease, most patients with OC suffer from anxiety, depression and fear of progression after completion of first-line cancer treatment. Surgical complexity at the time of surgery is not associated with a deleterious impact on anxiety, depression or FOP for patients with OC. Patients with OC experience a profound mental health impact and should be offered mental health support throughout their cancer journey.
    Language English
    Publishing date 2023-12-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16010075
    Database MEDical Literature Analysis and Retrieval System OnLINE

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