# Epidemiological Profile, Clinical Characteristics, and Management of Ovarian Cancer in Eastern India: A Hospital-Based Study

## TL;DR

This study examines the epidemiology, clinical features, and treatment of ovarian cancer in Eastern India, highlighting late-stage diagnoses and the need for improved early detection.

## Contribution

The study provides a detailed hospital-based analysis of ovarian cancer in Eastern India, emphasizing regional management patterns and socioeconomic influences.

## Key findings

- Most patients presented with advanced-stage ovarian cancer, particularly FIGO stages III and IV.
- Serous adenocarcinoma was the most common subtype, and elevated CA-125 and RMI levels were prevalent.
- Socioeconomic disparities were linked to delayed diagnosis and treatment patterns.

## Abstract

Introduction: Ovarian cancer (OC) remains a major global health burden. India reports the second-highest number of cases worldwide, with a steadily rising age-standardized incidence rate. Delayed diagnosis, often at advanced stages, is driven by socioeconomic disparities, limited awareness, and nonspecific early symptoms. This study aimed to describe the epidemiological profile, clinical characteristics, and management patterns of OC in Eastern India.

Methods: This retrospective, hospital-based epidemiological study was conducted at Tata Main Hospital, Jamshedpur, India, between January 2019 and December 2024. A sample of 130 patients with histopathologically confirmed primary OC was included. Sociodemographic variables, reproductive and medical history, clinical presentation (International Federation of Gynecology and Obstetrics (FIGO) stage, symptoms), tumor markers (cancer antigen-125 (CA-125), Risk of Malignancy Index (RMI)), histopathology, and treatment modalities were extracted from hospital records. Data were analyzed using descriptive statistics.

Results: The median age at presentation was 50.5 years. Half of the patients belonged to the lower-middle socioeconomic class (65/130, 50.0%). Nulliparity was observed in 13 patients (10.0%), and 62 patients (47.7%) were postmenopausal. A family history of malignancy was present in 11 patients (8.5%). Advanced disease at presentation was common, with FIGO stage III in 51 patients (39.2%) and stage IV in 28 patients (21.5%). Abdominal pain and distension were reported by approximately 94% of patients. Median CA-125 level was 552.5 U/mL, with elevated levels (>35 U/mL) in 95% of patients. Median RMI was 1881, and 93% had RMI >200. Epithelial OC constituted 114 cases (87.7%), with serous adenocarcinoma being the most frequent subtype (76/130, 58.5%). Cytoreductive surgery alone was performed in 25 patients (19.2%), neoadjuvant chemotherapy followed by interval debulking in 48 patients (36.9%), and palliative chemotherapy in 33 patients (25.4%). Fertility-sparing surgery was undertaken in 13 patients (10.0%).

Conclusion: Our findings highlight the high incidence of late-stage OC presentation in Eastern India, potentially linked to socioeconomic factors. The study confirms the utility and effectiveness of established diagnostic markers and adherence to standard management protocols. Future efforts should focus on targeted public health initiatives for early diagnosis, particularly among underserved socioeconomic groups, and multi-institutional studies to validate these regional findings and improve equitable care.