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Gynecologic Oncology > Cervical Cancer > Flashcards

Cervical Cancer Flashcards

1
Q

Cervical cancer is the ___ most common type of gyn cancer

A

third

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2
Q

What is the average length of time from a normal pap to cervical cancer?

A

10 years

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3
Q

what percentage of invasive cervical cancers are visible lesions (stage 2)

A

50%

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4
Q

What is the most common type of cervical cancer?

A

Squamous cell adenocarcinoma (90%)

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5
Q

What is the second most common type of cervical cancer?

A

Adenocarcinoma 15 - 20%

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6
Q

What tests/procedures should be done to completely stage a patient with cervical cancer?

A

EUA, Cystoscopy, proctoscopy, CXR, IV pyelogram

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7
Q

What imaging modality should you use to evaluate for concerning nodal metastasis in a patient with cervical cancer?

A

PET- CT

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8
Q

What imaging modality should you use to evaluate for local recurrence, size of lesion or extend of local invasion?

A

MRI

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9
Q

Criteria for conservative management of cervical cancer (CKC or observation)

A
  1. desired fertility
  2. Stage IA1 disease (< 3mm depth of invasion)
  3. negative conization margins
  4. no LVSI
  5. No small cell or neuroendocrine histology
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10
Q

Management of IA1 cervical cancer

A

Conization or extrafascial hysterectomy

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11
Q

Management of stage 1 A2 cervical cancer

A

Modified radical hysterectomy + Lymph node dissection

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12
Q

Management of stage IB1- IB2 cervical cancer

A

Radical hysterectomy + RT

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13
Q

Management of stage IB3 cervical cancer

A

ChemoRT + Brachytherapy

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14
Q

Management of stage II - Stage IV cervical cancer

A

ChemoRT + Brachytherapy

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15
Q

What are the components of a radical hysterectomy?

A
  1. Removal of parametria, upper vagina and lymphnodes
  2. Dissection of the ureters to the bladder
  3. Dissection of rectum off of posterior vagina
  4. Ligation of uterine arteries at their origin
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16
Q

True or false: Disease Free survival at 4.5 years for a minimally invasive hysterectomy for cervical cancer was inferior to an open approach

A

True

17
Q

Indications for primary radiotherapy in the treatment of cervical cancer?

A

Stage IB3
tumor size > 4 cm
LVSI
stromal invasion

18
Q

Indications for primary radiotherapy AND chemosensitization?

A

Stage Stage IIB and up
parametrial involvement
positive lymph nodes
positive surgical margins

19
Q

External beam radiation: Total dose of radiation

A

5000 - 6000 rads

20
Q

External beam radiation: How many weeks of treatment?

A

5-6 weeks

21
Q

External beam radiation: How many days per week of treatment?

A

5 days per week

22
Q

External beam radiation: How much radiation treatment per dose

A

180 rads

23
Q

Follow up for Cervical Cancer

A

Pap smear and exam
Every 3 months for 2 years.
Every 6 months for 3 years.
Yearly after 5 years.

24
Q

How do you treat recurrent cervical cancer after previous hysterectomy? (Central recurrence)

A

Radiation therapy

25
Q

How do you treat recurrent cervical cancer after previous radiation therapy ? ( Central recurrence)

A

Pelvic Exenteration

26
Q

How do you treat recurrent cervical cancer that has distant recurrence or recurrence at the pelvic side wall?

A

Chemotherapy: Taxol/Cisplatin + Bevacizumab

27
Q

How do you treat cervical cancer in pregnancy if < 24 wga and undesired pregnancy?

A

Treat as non pregnant

28
Q

How do you treat cervical cancer if < 24 weeks, desired or > 24 weeks undesired with CIS/Microinvasion

A

Vaginal delivery

29
Q

How do you treat cervical cancer if < 24 weeks, desired or > 24 weeks undesired with stage IA2 - IB disease < 2 cm

A

CKC or trachelectomy

30
Q

How do you treat cervical cancer if < 22 weeks, desired or > 22 weeks undesired with stage IB disease > 2 cm

A

Neoadjuvant chemotherapy followed by CS and radical hysterectomy for stage I disease

Neoadjuvant chemotherapy and chemo + RT for stage II - IV disease

Gynecologic Oncology (11 decks)

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