Prevalence and Management of Nonepithelial Ovarian Cancer in a Sub‐Saharan African Setting

TL;DR

This study examines the prevalence and treatment of rare nonepithelial ovarian cancers in Ethiopia, finding a higher rate than previously reported.

Contribution

The study provides new prevalence data and insights into management practices for nonepithelial ovarian cancers in Sub-Saharan Africa.

Findings

The prevalence of nonepithelial ovarian cancer was 17.3% in the studied population.

Yolk-sac tumors were the most common histologic subtype among germ cell tumors.

Staging surgery was performed in 65% of cases, while fertility-sparing surgery was done in 27%.

Abstract

Nonepithelial ovarian cancers (NEOCs) comprise a group of uncommon malignancies which can be challenging to treat. This broad term includes germ cell tumors, sex cord–stromal tumors, and rare types of ovarian cancer, such as small‐cell carcinomas and sarcomas. It is imperative that these rare tumors are managed with accurate diagnosis, staging, and treatment in order to optimize patient outcomes. The aim of this study was to describe the prevalence, pathology, and therapeutic interventions for NEOC in a Sub‐Saharan African setting.

This is a 5‐year retrospective review of NEOC cases managed at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia, from September 2016 to September 2020. Data on NEOCs including clinical presentation, pathology, therapeutic interventions, staging status, type of surgery, histological subtype, and current disease status were extracted from patients’ records. Data were collected using a structured data extraction format. Data were analyzed using Stata release 15 (College Station, TX: StataCorp LLC).

The prevalence of NEOC was 17.3% (80 out of 264 cases of ovarian cancer). Among the types of NEOC, sex cord–stromal tumors were most common (46.2%) followed by germ cell tumors (43.8%). Of the germ cell tumors, yolk‐sac tumor was the common histologic subtype, representing 15% of all NEOC cases. Sixty‐five percent of cases were managed with staging surgery while 27% underwent fertility sparing surgery. There was no statistically significant association between patients’ age and type of tumor (p = 0.08).

In this study, the prevalence of NEOC was 17.3%, which is higher than in other previous reports in the literature. Yolk‐sac tumor was the most common histologic subtype among germ cell tumors.