Clinicopathological Spectrum of Indian Adolescent and Young Adults (AYA) Gynecological Tumors: A Retrospective Analysis

Abstract

Background: Cancers in adolescents and young adults (AYA) represents a bridge between childhood and elderly incidence curves of cancers demanding tailored approaches and management of their distinct presentations. The literature on Indian gynecological cancer patients aged 15 to 39 years is limited. Thus, our study aims to determine the distribution of gynecological tumors, modalities of diagnosis, and treatment employed in managing these patients. Methods: A retrospective cross-sectional analysis of patients from 15 to 39 years of age who presented with gynecological tumors was done. The data of all the patients during the study period was recorded and statistically analyzed. Results: The study included 50 patients. The tumors observed were ovarian (78%), cervical (16%) and uterine (6%) in origin. Histopathological diagnosis was benign (46%), malignant (50%) and borderline tumor (4%). CA125 was the most frequently done tumor marker and was raised in 17 cases (34%), of which 13 were malignant. The tumor size was greater than 10 cm in 56% of cases. Definitive management strategies included cystectomy/ salpingo-oopherectomy (44%), total hysterectomy and salpingo-oopherectomy (38%), chemoradiation (14%), and conization (2%). The most common benign and malignant ovarian tumors were serous cystadenoma and serous cystadenocarcinoma, respectively. All uterine malignancies were sarcomas. Conclusion: Ovarian tumors are the most common gynecological malignancies in adolescents and young adults. Timely diagnosis and comprehensive and multidisciplinary management can improve survival and preserve future fertility in these young patients.