GYN Flashcards
Cervical cancer staging FIGO
I - cervix only
II - upper 2/3 vagina
III - lower vagina, parametric, sidewall
IIIc - nose positive
IVA - nearby organs
IVB - distant Mets
Thresholds to change cervical cancer treatment (3)
IA1 - IB1 - surgery alone
(upper vagina, <5mm invasion, <2cm)
IB2 - IVA - cisplatin/RT + brachytherapy
Distant Mets / respectability
IVB - > surgery alone
IVB -> cis taxol
+ pembro if CPS 1+
FIGO Staging ovarian
1 a/b - ovaries only
1c - Hugh risk (surgical spill/rupture)
2 - pelvic implants
3 - implants above the pelvis or N+
4 - Mets
Non epithelial ovarian CA types (3)
- low malignant potential tumor
- sex cord / strongly
Tx both with surgery - Dysgerminoma
- surgery, consider adj BEPx3
Tx of ovarian CA
- resection
- carbo taxol x6 +/- Bev
Bev in ovarian cancer
Increased EFS with same OS
Role of PARPi in ovarian CA adjuvant
1) if BRCA or HRD - one year of Palpatine
2 all comers modest benefit of niraparib
Second line ovarian cancer tx (2)
1 >6m - platinum rechallange
2 - doxil
FIGO stages for endometrial cancer
IA - <50%
IB - > 50%
II - cervix
III - vagina, adenexa, parametria
IVA - bladder
IVB - distant / omental / ascites
Stage IA endometrial tx
Surgery then
G1/2 observation
G3 brachytherapy
Stage IB endometrial tx
Surgery then
G1/2 brachytherapy
G3 EBRT +/- carbo taxol
Stage II endometrial tx
Surgery then
EBRT +/- carbo taxol
Stage III endometrial tx
Carbo taxol +/- EBRT
Carcinosarcoma tx
Surgery then
Adjuvant carbo taxol regardless of stage
Uterine LMS tx
Surgery then… if stage …
I - observe
2+ - doxorubicin OR gem/docetaxel
