Saira Yunus, Amtullah Zarreen, Farhat Naz, Shahnaz Kauser, Shazia Ali.
Pattern of gynaecological malignancies in tertiary hospital.
Pak J Med Res Jan ;50(2):64-6.

Objectives: To analyze the pattern of genital tract tumour in terms of their age, mode and stage of presentation, histological subtypes and treatment modalities. Settings and duration: Gynae Unit-1 Jinnah Hospital/Allama Iqbal Medical College, Lahore from Oct 2007 to Oct 2009. Patients and Methods: All cases of genital tract malignancy admitted through OPD, emergency or referred to the unit were included in the study. A proforma was designed for each type of genital tract cancer and its details entered through history, examination and investigations. The staging and grading systems as designed by FIGO7 were used. The data was collected and analysed through SPSS version 10. Results: During the two years, 63 cases of genital tract malignancies were recorded. The most frequent cancer was ovarian seen in 35(55.6%) with mean age 48 years. Among them two third of cases were with stage 3 and 4 disease. Epithelial ovarian cancer was seen in 26(41.3%) and abdominal hysterectomy and bilateral salpingoophrectomy and nodal dissection was carried out in 16 patients. Fertility preserving surgery was done in young patients with germ cell tumors and were given chemotherapy post-operatively. Cervix cancer was seen in 14(22.2%), with mean age of 45 years. Among them five patients (35.7%) presented with stage 3 and seven (50%) with stage 1 and 2 of disease. Only five underwent radical surgery and patients with disease beyond stage 2 were given radio chemotherapy. Endometrium cancer was seen in 12(19%), with mean age of 50 years. Among them nine patients (75%) presented with stage 1 and 2, and were treated by radical surgery followed by radiotherapy and three patients (25%), in stage 3 and 4 were treated with radiotherapy. One patient (1.6%) of vulval carcinoma was 55 years of age with stage 2 squamous cell carcinoma. She was given radiotherapy. One patient (1.6%) of choriocarcinoma was 40 years of age and was given chemotherapy. Conclusions: Ovarian cancer was the most frequent gynaecological malignancy, which presented at an advanced stage due to late referral. Policy Message: A strong referral system should be developed between primary, secondary and tertiary health centres for screening of general population and high risk group and treatment of affected cases. Awareness about modification of risk factors, and management guidelines also need to be adopted.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com