Cervical Cancer Flashcards

1
Q

Incidence rate in pregnancy

A

0.1-12 per 10000 pregnancies

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2
Q

Who should have cytology follow up during pregnancy

A

CGIN and CIN 2/3 with involved or uncertain margins

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3
Q

Progression rate from pre-invasive to invasive disease in pregnancy

A

0.04%

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4
Q

Risk of haemorrhage with loop diathermy in pregnancy

A

25%

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5
Q

First line imaging in pregnancy

A

MRI

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6
Q

FIGO stage 1A

A

Invasive carcinoma maximum depth <5mm on microscopy

1A1 - stromal invasion <3mm
1A2 - stromal invasion >3mm

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7
Q

FIGO stage 1B

A

Deepest measured invasion >5mm confined to cervix uteri
1B1 - >5mm stromal invasion and <2cm greatest dimension
1B2 - >2cm stromal invasion and <4cm greatest dimension
1B3 - Greatest dimension >4cm

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8
Q

FIGO stage 2A

A

Involvement limited to upper 2/3rds of vagina without parametrial involvement
2A1 - invasive carcinoma <4cm in greatest dimension
2A2 - invasive carcinoma >4cm in greatest dimension

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9
Q

FIGO Stage 2B

A

With parametrial involvement but not involving pelvic side wall

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10
Q

FIGO stage 3

A

Carcinoma invades pelvic side wall/lower third of vagina and/or causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or paraaortic lymph nodes

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11
Q

FIGO stage 2

A

Extends beyond uterus but is confined to upper 2/3rds of the vagina and does not involve the pelvic side wall

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12
Q

FIGO stage 3A

A

Involves lower third of vagina with no extension to pelvic side wall

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13
Q

FIGO stage 3B

A

Extension to pelvic side wall and/or hydronephrosis or non-functioning kidney

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14
Q

FIGO stage 3C

A

Involvement of pelvic or para aortic lymph nodes
3C1 - pelvic lymph nodes only
3C2 - para-aortic lymph nodes

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15
Q

FIGO stage 4

A

Carcinoma extends beyond true pelvis or involves bladder or rectal mucosa (biopsy proven)

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16
Q

FIGO stage 4A

A

Spread of the growth to adjacent organs

17
Q

FIGO stage 4B

A

Spread to distant organs

18
Q

Most common tumour type?

A

Squamous - 85%
Adenocarcinoma 2nd most common

19
Q

Treatment of 1A1 squamous cell

A

Total hysterectomy OR conisation to preserve fertility

20
Q

Treatment of 1A2 squamous cell

A

Radical hysterectomy +/- pelvic lymph node dissection
OR
Large cone biopsy + laparoscopic pelvic lymphadenectomy

21
Q

Treatment of stage 1A adenocarcinoma

A

Hysterectomy
OR
2.5cm deep conisation + 5mm clear margin

22
Q

Treatment of Stage 1B disease

A

Fertility sparing - radical vaginal trachectomy + laparoscopic lymphadenectomy with permanent suture at isthmus

Radical hysterectomy + bilateral pelvic lymphadenectomy + total pelvic radiotherapy + chemotherapy

23
Q

Stage IIA disease treatment

A

Intracavitary brachy + external beam radiotherapy + chemotherapy (cisplatin/5-FU)
Radiotherapy to para-aortic nodes if primary tumour >4cm

24
Q

Stage IIB treatment

A

Intracavitary radiotherapy + external beam therapy + chemo

25
Q

Stage III and IV treatment

A

Palliative radio-chemotherapy

26
Q

Risk of preterm birth after radical trachelectomy

A

25%

27
Q

HPV primary screening is ____ more sensitive and _____ less specific than cytology

A

25%
6%

28
Q

If endometrial cells are found on cervical screening, perform TV scan and endometrial biopsy in the following patients

A

> 40yo and more than 11 days from LMP

29
Q

Recommended Depth of removal of CIN by LLETZ

A

CIN I - 7-10mm
CIN II - 10-15mm
CIN III - 15-25mm

30
Q

HPV vaccination is predicted to have what effect on incidence of CIN and cervical cancer?

A

50% reduction in CIN
70% reduction in ca

31
Q

Risk of pelvic lymph node metastasis with 1A2 cancer

A

3-6%