Morphology: A Keystone in Therapeutic Decision Making of Post Therapy Tumour Regression in Ovarian Tumours

摘要

Introduction: Ovarian carcinoma is one of the most common malignancies of the female genital tract. Treating ovarian cancer with Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) is said to reduce surgical morbidity and has equivalent survival times when compared with primary cytoreductive surgery followed by adjuvant chemotherapy.Aim: This study aims to evaluate the histomorphological changes induced by NACT and its influence on the progression free survival of patients with malignant ovarian neoplasms.Materials and Methods: A total of 52 patients who were operated in VS Hospital, Chennai, after administration of four cycles of platinum-based chemotherapy were included in this six year study from January 2011-December 2016. Various histomorphological changes caused by NACT were looked for and five parameters namely fibrosis, necrosis, inflammation, residual tumour and psammoma bodies were graded. Progression free survival was calculated after follow-up of patients for three years. The graded parameters were compared with the survival time and their effect on survival was estimated.Results: The age of the patients ranged from 34 to 80 years with a mean age of 52 years. Out of the 52 cases, 46 were serous cystadenocarcinoma, four were mucinous cystadenocarcinoma, one case each of endometrioid adenocarcinoma and malignant mixed mullerian tumour. On comparing features like presence of fibrosis, necrosis, inflammation, residual tumour and psammoma bodies with progression free survival period, necrosis was found to have statistically significant association with disease free survival. Median progression free survival estimated in this study was about 22 months.Conclusion: This study analysed the various histomorpholgical changes induced by NACT in malignant ovarian neoplasms and their influence on survival of the patients.