STUDY OF AGE, PERFORMANCE STATUS, PERITONEAL CARCINOMATOSIS INDEX, BOWEL RESECTION AND HISTOPATHOLOGY IN ADVANCED EPIHELIAL OVARIAN CANCER.
Authors: Saha Bijan Kumar , S. Zaveri Shabber 
Published: January 2022

Objective –To study the Age, Peritoneal Carcinomatosis Index, Visceral Resection and Histopathology in FIGO stage III epithelial ovarian cancer.
Methodology – A retrospective cross-sectional study was conducted at a tertiary hospital in Bangalore, India. All patients diagnosed with FIGO
stage III epithelial ovarian cancer who underwent cytoreductive surgery (primary, interval or secondary cytoreductive surgery) between April 2017
to April 2019 were included in the study. Parameters noted were 1) Age at presentation 2) ECOG performance status 3) Peritoneal Carcinomatosis
Index (PCI) 4) Visceral resection done 5) Histopathology report. Performance status was calculated according to European Co-operative Oncology
Group (ECOG) grade. Histopathology report was grouped into four types. 1) Endometroid type 2) Low grade serous type 3) High grade serous type
4) Mucinous type. Histopathology reported as high-grade serous carcinoma with clear cell changes or high-grade dysplasia were included in high
grade serous carcinoma type. Histopathology reported as high-grade serous carcinoma with clear cell changes or high-grade dysplasia were
included in high grade serous carcinoma type.
Results- A total of 84 patients were included in the study. 45 patients underwent interval, 25 patients underwent primary and 14 patients underwent
secondary cytoreductive surgery. Most patients diagnosed with epithelial ovarian cancer was between age 50-70 years (65.46%). Maximum age
noted was 82 years and minimum age noted was 36 years in this study. Most of the patients had ECOG performance status 1. 29.76% of patients had
ECOG performance status 0, 65.47 % of patients had ECOG performance status 1 and 4.76% of patients had ECOG performance status 2. 45
patients underwent interval, 25 patients underwent primary and 14 patients underwent secondary cytoreductive surgery. Maximum PCI score
noted was 36 and minimum PCI score noted was 3. Most of the patients had PCI score between 11-20 (66.66%) who underwent surgery. 26 patients
out of 84 patients required bowel resection (30.95%). Most common bowel resection performed was anterior resections / low anterior resections
followed by limited right hemicolectomy. 17.85% of patients underwent anterior resection and 5.95% of patients underwent limited right
hemicolectomy. Other visceral resection done were limited left hemicolectomy (3.57%), transverse colectomy (1.19%), distal gastrectomy
(1.19%), low anterior resection + limited right hemicolectomy (1.19%). None of the patients required diverting stoma. Anastomotic leak was noted
in 3 patients (3.57%). Most common histopathology reported was high grade serous (71.44%) followed by low grade serous type (19.04%).
Endometroid type and mucinous type was least common (4.76% each).
Conclusion – Epithelial ovarian cancer was most common between age group 50-70 years in this study. Most patients had ECOG performance
status 1. PCI score between range 11-20 was noted for majority of patients who underwent cytoreductive surgery. Most common bowel resection
performed was low anterior resection/ anterior resection followed by limited right hemicolectomy. None of the patients required diverting stoma.
Anastomotic leak was noted in 3.57% of patients. Most common histopathology reported was high grade serous (71.44%) followed by low grade
serous type (19.04%). Endometroid type and mucinous type were least common (4.76% each)