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Flashcards in Treatment of ovarian cancer (MF) Deck (21):
1

age for ovarian cancer
risk factors
FH
genetics

>50
nulliparity (or low parity), delayed pregnancy
FH of breast or ovarian cancer
BRAC1 (40%) and BRAC2 (18%)

2

when does ovarian cancer present

usually late - 60% late stage at diagnosis

3

how does ovarian cancer present

ascites/bloating
pelvic mass/bladder dysfunction
pleural effusion/SOB
incidental finding

4

which women should be offered BRAC1 and BRAC2 mutation testing

non mucinous ovarian or fallopian tube cancer

5

which women should have a genetic risk assessment

women with ovarian tumour who have a family history of breast, ovarian or colon cancer

6

ovarian cancer diagnosis

CA125 - can be raised in other conditions
US - transsvaginal/abdominal
cytology - pleural fluid/ascites
pathology - usually gold standard

7

US features

multilodular cyst
solid areas
bilateral lesions
ascites
intra abd mets

0=none
1=1
3=2 or more

8

score given for menopausal

pre 1
post 3

9

RMI score
when should be referred

US X menopausal score X CA123 U/ml
If over 200

10

FIGO
1
2
3
4

1 = confined to 1 or both ovaries
2=spread to other pelvic organs
3=spread beyond pelvis within the abdomen
4=spread into other organs eg. liver, lungs

11

prognosis of ovarian cancer 5 yr survival

1 80-90%
2 65%
3 15-35%
4 up to 15%

12

the three types of ovarian cancer spread

transcoelemic spread/peritoneal seeding within pelvis -> abd cavity

heat -> liver, lungs, brain (late and rare)

incident of brain mets in ovarian cancer is <2%

13

pathology of ovarian cancer

>90% epithelial cell tumours of ovary - serous, mucinous, endometriod, clear cell, undifferentiated

<10% germ cell, granulosa cell

14

ovarian cancer treatment

surgery - TAH, BSO, omentectomy, optimal bulking

surgery and chemo

chemo and surgery

timing and sequence

15

ovarian cancer chemo response rate
relapses?
palliative chemo?

response rates of 60-70% with carboplatin/paclitaxel

relapse rates are high

palliative - carboplantin, pac, etoposide, calyx, topotecan, gemcitabine, chlorambucil

16

hope for cure chemo/at presentation

platinum/paclitaxel

17

relapse chemo

caelyx, plat/pac, topotecan

18

chronic disease/multiple lines of therapy

etop, tam

19

what is given to women are are unfit for comb therapy

carboplantin

20

women with platinum sensative ovarian cancer who relapse

platinum based combination with paclitaxel, PLDH or gemcitabine

21

women wth recurrent plat resistant ovarian cancer

hormonal therapy with tamoxifen or an aromatose inhibitor