Introduction: Ovarian cancer continues to present significant therapeutic challenges in sub-Saharan Africa, where late diagnosis and limited resources often compromise outcomes. This study examines the management and survival outcomes of ovarian cancer patients at a major referral center in Cameroon. Methods: We conducted a retrospective cohort analysis of 72 ovarian cancer patients treated between 2015 and 2024 at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Data encompassing demographic characteristics, clinical presentation, treatment modalities, and survival outcomes were meticulously extracted from medical records. Survival analysis was performed using Kaplan-Meier curves and Cox regression models to identify prognostic factors. Results: The majority of patients (40.3%) were aged 40 - 59 years, with a mean age of 48.7 years. Most women (56.9%) identified as housewives. Alarmingly, 73.6% presented with advanced-stage disease (FIGO stages III/IV). Epithelial ovarian cancer predominated (86.1%), with high-grade serous carcinoma being the most frequent. Primary debulking surgery followed by adjuvant chemotherapy was the most common treatment approach (62.5%), though optimal cytoreduction was achieved in only 46.9% of cases. The median overall survival was 29 months, with 5-year survival reaching 25%. Multivariate analysis revealed that neoadjuvant chemotherapy followed by interval debulking surgery independently predicted improved survival (HR = 0.18, p = 0.037), while suboptimal debulking significantly compromised outcomes (HR = 8.86, p = 0.043 for progression-free survival). Conclusion: Our findings paint a sobering picture of ovarian cancer management in Cameroon, characterized by late presentation and suboptimal surgical outcomes. The demonstrated survival benefit of neoadjuvant chemotherapy approaches suggests a promising pathway for improving outcomes in resource-constrained settings where achieving optimal cytoreduction remains challenging.
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