Endometrial_Hyperplasia_Cancer_Flashcards
What is the management for endometrial hyperplasia without atypia?
Management for endometrial hyperplasia without atypia includes addressing risk factors (e.g., obesity, HRT, tamoxifen therapy, anovulation), considering observation, using LNG-IUS, or oral progestogen (continuous).
What is the surveillance protocol for endometrial hyperplasia without atypia?
Surveillance for endometrial hyperplasia without atypia includes endometrial biopsy at 6 months.
What are the management options for atypical hyperplasia?
Management options for atypical hyperplasia include total hysterectomy with bilateral salpingo-oophorectomy for non-fertility preserving cases, and LNG-IUS or oral continuous progestogen for fertility-preserving cases.
What is the surveillance protocol for atypical hyperplasia?
Surveillance for atypical hyperplasia includes endometrial biopsy at 3 months.
What is the management for FIGO stage 1 endometrial cancer?
Management for FIGO stage 1 endometrial cancer includes total hysterectomy with bilateral salpingo-oophorectomy.
What is the management for FIGO stage 2 endometrial cancer?
Management for FIGO stage 2 endometrial cancer includes radical hysterectomy with lymph node assessment and possibly adjuvant radiotherapy.
What is the management for FIGO stage 3 endometrial cancer?
Management for FIGO stage 3 endometrial cancer includes maximal debulking surgery, chemotherapy, and radiotherapy if possible.
What is the management for FIGO stage 4 endometrial cancer?
Management for FIGO stage 4 endometrial cancer includes maximal debulking surgery if possible, or a palliative approach with low dose radiotherapy and high dose progesterone.
What are the adjuvant treatment options for endometrial cancer?
Adjuvant treatment options for endometrial cancer include postoperative radiotherapy to reduce local recurrence rates (but does not improve survival), local radiotherapy or brachytherapy, and chemotherapy for advanced or metastatic disease.
What hormone treatment is useful for women with complex atypical hyperplasia and low-grade stage 1A endometrial tumors?
High-dose oral or intrauterine progestins (LNG-IUS is preferred) are useful for women with complex atypical hyperplasia and low-grade stage 1A endometrial tumors.
What is the risk factor for pre-menopausal endometrial cancer related to fertility?
Primary infertility due to PCOS is a risk factor for pre-menopausal endometrial cancer.
What are the alternatives to hysterectomy for pre-menopausal women with endometrial cancer?
Alternatives to hysterectomy for pre-menopausal women with endometrial cancer are possible only for pre-cancer or early-stage low-grade endometrial cancers and include hormone therapy (oral progestogens or LNG-IUS).
What should be discussed with women facing the loss of fertility due to endometrial cancer treatment?
Women facing the loss of fertility due to endometrial cancer treatment should be referred to a specialist to discuss ovarian conservation and/or stimulation for egg retrieval and surrogacy.
What is the summary of management for localized endometrial cancer?
Management for localized endometrial cancer includes total abdominal hysterectomy with bilateral salpingo-oophorectomy, radiotherapy for high-risk patients, and progestogen therapy for frail elderly women not suitable for surgery.
What is the risk of malignancy index (RMI) for ovarian cancer and how is it calculated?
The risk of malignancy index (RMI) for ovarian cancer is calculated using the formula RMI = U x M x Ca125, where M = menopausal status (1 for pre-menopausal, 2 for post-menopausal), U = ultrasound score (0 for no features, 1 for 1 feature, 2 for ≥2 features), and Ca125 = units/ml. An RMI > 250 warrants referral to gynecology.
What is the management for stage 1 ovarian cancer?
Management for stage 1 ovarian cancer includes total hysterectomy with bilateral salpingo-oophorectomy, with adjuvant systemic chemotherapy if needed. If fertility needs to be preserved, only the affected ovary can be removed (only for stage 1a).
What is the management for stage 2 ovarian cancer?
Management for stage 2 ovarian cancer includes debulking surgery to remove as much of the cancer as possible, with chemotherapy given as neo-adjuvant or adjuvant.
What is the management for stage 3 ovarian cancer?
Management for stage 3 ovarian cancer includes similar steps as stage 2, with the addition of targeted treatment with bevacizumab (targets VEGF-A). If surgery is not possible, chemotherapy (platinum-based) and symptomatic treatment (e.g., ascitic drain, constipation treatment) are given.
What is the management for stage 4 ovarian cancer?
Management for stage 4 ovarian cancer is similar to stage 3, but palliative care is more likely.
What are the options for chemotherapy in ovarian cancer?
Options for chemotherapy in ovarian cancer include primary treatment, adjunct treatment following surgery, or for relapse of disease. The first-line combination is a platinum compound with paclitaxel, usually given as an outpatient treatment every 3 weeks for 6 cycles.
What is the first-line chemotherapy combination for ovarian cancer?
The first-line chemotherapy combination for ovarian cancer is a platinum compound with paclitaxel.
Why is carboplatin preferred over cisplatin in ovarian cancer treatment?
Carboplatin is preferred over cisplatin in ovarian cancer treatment because it is less nephrotoxic and causes less nausea.
What is the mechanism of action of paclitaxel in chemotherapy?
The mechanism of action of paclitaxel in chemotherapy is to cause microtubular damage, preventing replication and cell division.
