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Week 32 (Cervical Cancer) > Cervical Cancer > Flashcards

Cervical Cancer Flashcards

1
Q

Incidence

A

7:100000

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2
Q

Mortality rate

A

50%

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3
Q

Risk factors for cerv cancer

A 
Smokin
Immunosuppression
Age - bimodal
Parity
Partners
OCP use (not an independent risk factor)
DES exposure
HPV exposure - essential requirement
Inadequate screening
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4
Q

How to stage cervical cancer

A

Pre op MRI or EUA & cystoscopy

FIGO says:
Cool
EUA
Endocervical curettage
Hysteroscopy
Cystoscopy
Proctoscopy
IV urography
XRay of lungs and skeleton
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5
Q

FIgo stage 1 cerv ca

A

Cancer confined to the cervix

IA:dx only by microscopy; stromal invasion with a max depth of 5.0mm and largest extension of < or =7mm
Ia1: measured stromal invasion <3.0mm
1A2: measured stromal invasion > or = 3 and <5mm

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6
Q

Figo stage IB

A

Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a/IA2 (depth > or =5mm)

IB1: < or =4
IB2: >4cm, clinically visible

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7
Q

Figo stage 2 (a-B)

A

Cancer invades beyond uterus but not to pelvic wall or to lower third of vagina

IIA: no parametrial invasion
IIA1: clinically visible lesion < or =4cm
IIA2: clinically visible lesion >4cm
IIB: tumour with parametrial invasion

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8
Q

Stage III

A

Tumor extends to pelvic wall and/or involves lower third of vagina and or causes hydronephrosis or nonfunctional kidney

IIIA: tumor involves lower third of vagina, no extension to pelvic wall
IIIB: Tumor extend to pelvic wall or affects kidney
IIIB pelvic and para-aortic nodes

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9
Q

Figo stage 4

A

Tumour invades mucosa of bladder or rectum and or extends beyond true pelvis

IVA: local spread (bladed, rectum)
IVB: spread beyond pelvis

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10
Q

Treatment for stage 1AI

A

Can be treated conservatively with cone biopsy or LLETZ

LN risk <1.5%

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11
Q

Radical hysterectomy

A

Resection distant from edge of cervix
Uterine arteries are divided at the source
Vaginal cuff 1-2cm
Lymphadenectomy (not always)

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12
Q

Treatment for figo stage IB2 and IIa1

A

Surgery or RT

Both have similar outcomes

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13
Q

Treatment for 1B3 and IIA2

A

Radical hysterectomy with lymphadenectomy

Concurrent platinum-based chemoradiation (prognosis more favorable)

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14
Q

FIGO stage IIB to IVA or recurrence treatment

A

RT with chemo OR

Exteneration in medically fit patients

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15
Q

Treatment stage IVB/distant Mets

A

Chemoradiation

Cisplatin

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16
Q

Median time to recurrence

A

7-36 months

17
Q

Follow up

A

Every 3-4 months for the first 2-3 years
6 monthly until 5 years
Annual for life

18
Q

Pelvic lymphadenectomy

A

Parametrial nodes
Obturator nodes
Internal, external, and common iliac nodes

19
Q

Paraaortic node dissection

A

Resection of nodal tissue over the distal IVC from the level of the inferior mesenteric artery to the mid R common iiiac artery and b/w the aorta and left ureter from the inferior mesenteric after to the L mid common iliac artery

20
Q

Oncogenes

A

E5,6,7

21
Q

Cells infected by HPV

A

Parabasal cells

22
Q

Koliocytes presence

A

HPV infected cells

23
Q

Percentage of HPV infections that spontaneously resolve

A

80%

24
Q

How HPV infects

A

Genome integrates into host genome
E6 & E7 proteins over-expressed
P53 and PRB inactivated
Arrest of cell division PREVENTED

25
Q

Swede score for colposcopy findings

A 
Uptake of acetic acid
Margins and surface
Vessels
Lesion size
Iodine staining

Score 0-2 for each, total score of 10
<5 normal, CIN1, HPV
5-7 CIN2
8-10 CIN3

26
Q

Types of treatment

A 
Ablative
Cryotherapy
Cold coag
Diathermy
Laser 
Thermal ablation

Excisional
LLETZ
Come biopsy

27
Q

Ablation guidelines

A

Dx agreement
Absence of endocervical canal neoplasia
Cancer excluded
Adequate coloposcopy

28
Q

Advantages of laser therapy

A 
Painless
Minimal side effects
Concomitant haemostasis
High success rate
Easily identifiable residual disease
Easy re-treatment
29
Q

Complications of treatment

A

Cervical stenosis
Increased risk of Caesarean section
Preterm labour

NO affect on fertility

30
Q

Risk of PTB

A

RR 4.52 CKC <28 weeks

31
Q

NNTH for labour

A

1:8

Week 32 (Cervical Cancer) (2 decks)

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