Management, Clinical follow-up and Outcome
The clinical management and follow-up information was available in a total of 50 patients. The cohort consisted predominantly of high-risk cases with varied management as feasible in a low income setting. A total of 14 patients received a complete protocol of high-risk treatment regimen (including induction chemotherapy, surgery, autologous stem cell transplantation, and radiation); 13 patients received chemotherapy followed by surgery, and 12 patients received only chemotherapy. Further in 4 patients debulking surgery was followed by adjuvant chemotherapy, only surgery was done in 2 patients and 1 patient underwent spontaneous remission without surgery. No treatment was given to 4 patients owing to the advanced stage of disease and/or complications due to disease per se. The duration of follow-up ranged from 7 days to 1200 days with a mean follow-up of 450 and a median of 480 days. Out of the 50 patients, 22 patients (44%) were alive without disease and 28 patients (56%) were dead at the end of follow-up period. Out of the 28 deceased patients, 10 suffered relapse post-treatment, 14 patients died due to progressive disease or complications related to therapy and 4 died without adequate therapy.