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A Detailed Study of Patients and Tumor Characteristics of Epithelial Ovarian Cancer in Saudi Women

Al-Badawi, Ismail A. MD, MBChB, FRCSC*; Munkarah, Adnan R. MD; Tulbah, Asmaa MD; Babic, Inas I. MD*; Al Husaini, Hamed MD§; Ahmad, Sarfraz PhD

International Journal of Gynecological Cancer: March 2013 - Volume 23 - Issue 3 - p 456–460
doi: 10.1097/IGC.0b013e318284aafe
Ovarian Cancer

Background The Saudi population is characterized by high parity and intermarriages that may impact ovarian carcinogenesis. Herein, we analyzed the tumor characteristics and outcomes in Saudi patients with epithelial ovarian cancer (EOC).

Methods Patients with EOC treated at King Faisal Specialist Hospital and Research Center during 1995–2007 were identified retrospectively through a review of their medical records. Patients’ and tumor characteristics were collected including age at diagnosis, marital status, parity, histology, stage, treatment rendered, and follow-up data.

Results One hundred-ninety-three patients with EOC were identified in this cohort. The mean age of the patients was 55 ± 15 years, the mean ± SD body mass index was 27.0 ± 5.6 kg/m2, and the median parity was approximately 7.0. Whereas 4 patients reported a family history of cancer, 164 women reported negative family history; and it was unknown in 27 cases. Tumor distribution by International Federation of Gynecology and Obstetrics stage was the following: 12 patients (6.2%) had stage I disease at diagnosis, 1 patient (0.5%) stage II disease, 130 patients (67.4%) stage III disease, 39 patients (20.2 %) stage IV disease, and that of 11 patients (5.7%) was unknown. Information on residual disease after surgery was available on 98 patients with optimal debulking (<1 cm) achieved in 61 cases. Median progression-free survival from end of chemotherapy to recurrence/progression was 11.9 months (95% confidence interval, 9.4–15.2). Tumor histology, size of residual disease, and stage at diagnosis were significant prognostic factors. The patients’ age, body mass index, tumor histology, and grade had no impact on survival.

Conclusions Patients presenting with advanced-stage disease are higher among Saudis than those reported in global literature. Despite high intermarriage rates, reported family history for related cancers was quite low in this cohort. Notably, this is the first study evaluating EOC in Saudi patients.

*Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; †Department of Women’s Health Services, Henry Ford Hospital, Detroit, MI 48202; ‡Department of Anatomical Pathology, and §Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; and ∥Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL.

Address correspondence and reprint requests to Ismail A. Al-Badawi, MD, MBChB, FRCSC, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital & Research Center, PO Box 3354, Riyadh 11211, MBC-52, Saudi Arabia. E-mail:

The authors declare no conflicts of interest.

Received August 2, 2012

Accepted December 24, 2012

Copyright © 2013 by IGCS and ESGO