Ovarian

Question 1

What are the risk factors for ovarian Ca?

Answer 1

BRCA1

Lynch syndrome

Ovulations - early menarche, late menopause, nullip

Question 2

Outline the histology of ovarian Ca

Answer 2

Ep = serous/mucinous cystadenocarcinoma

Germ call/stromal

Question 3

What is the criteria for a 2WW referral for suspected ovarian cancer?

Answer 3

Vague bloating –> CA125 >35 –> TV US suggestive of ovarian Ca

Question 4

How should ovarian Ca in investigated?

Answer 4

Tumour marker = CA-125, carcinoembryonic antigen (CEA), CA 19-9
- if young = hCG, LDH, AFP, oestradiol

TV US (screen) –> CT TAP (staging) –> MRI pelvis (specialist)

Ascitic tap - malignant cells on cytology

Question 5

How should ovarian Ca be managed?

Answer 5

Surgical = staging laparotomy (total abdominal hysterectomy - TAH + bilateral salpingo-oophorectomy - BSO + omentectomy + peritoneal washing + LN)

Adjuvant chemo (platinum-based)

Tumour marker surveillance