gynae onc Flashcards
1
Q
AFP raised in
A
Immature teratoma
Sertoli leydig
Yolk sac tumor
Embryonal carcinoma
2
Q
hcG raised in
A
dysgerminoma
embryonal carcinoma
3
Q
LDH raised in
A
dysgerminoma
immature teratoma
4
Q
ca125 raised in
A
epithelial tumors
5
Q
CEA raised in
A
epithelial tumors
6
Q
estradiol raised in
A
juvenile granulosa cell tumor
7
Q
testosterone raised in
A
sertoli-leydig cell tumors
8
Q
what tumor markers raised in IMMATURE TERATOMA
A
AFP
LDH
9
Q
what tumor markers raised in SERTOLI LEYDIG TUMOR
A
AFP
Testosterone
10
Q
what tumor markers raised in YOLK SAC TUMOR
A
AFP
11
Q
what tumor markers raised in EMBRYONAL CARCINOMA
A
AFP
hCG
12
Q
what tumor markers raised in DYSGERMINOMA
A
hCG
LDH
13
Q
What tumor markers raised in EPITHELIAL TUMORS
A
CA125
CEA
14
Q
what tumor markers raised in JGCT?
A
estradiol
15
Q
major complication rate for cervical ca
A
27%
16
Q
adverse long term bowel QoL effects reported in __% od RT pts?
A
50%
17
Q
obstruction presents in __% RT for cervical ca
A
14.%%
18
Q
fistula present in ___% of women undergoing single or combined treatment for cervical ca
A
8%
19
Q
radiation cystitis incidence
A
26%
20
Q
bladder atony - % requiring ISC
A
2-3%
21
Q
urinary/vaginal fistula after radical hysterectomy
A
<2%
22
Q
RT dose that may induce menopause
A
10Gy
23
Q
dyspareunia reported in __% after RT for cervical ca
A
55%
24
Q
endometrial ca 1y survival overall
A
90%
25
endometrial ca 5y survival overall
75%
26
endometrial ca 10y survival overall
70%
27
ovarian ca 1y survival overall
71%
28
ovarian ca 5y survival overall
42%
29
ovarian ca 10y survival overall
35%
30
cervical ca 1y survival overall
81%
31
cervical ca 5y survival overall
61%
32
cervical ca 10y survival overall
50%
33
vulval ca 1y survival overall
86%
34
vulva ca 5y survival overall
67%
35
vaginal ca 1y survival overall
90%
36
vaginal ca 5y survival overall
70%
37
endometrial ca 5y survival by stage
92, 74, 47, 15
38
ovarian ca 5y survival by stage
93, 67, 27, 13
39
cervical ca 5y survival by stage
87, 67
40
incidence endometrial ca
28/100 000
41
lifetime risk of endometrial ca
3%
| 10-15% for obese patients
42
tamoxifen increases risk of endometrial ca by
3-6x
43
bariatric surgery decreases risk of endometrial ca by
70-80%
44
NPV of ET<4mm on TVS for endo ca
>99%
45
positive findings on hysteroscopy, what chance of EC
70%
46
negative findings on hysteroscopy, what chance of EC
2.5%
47
failure rate of OPD EB
7%
48
inadequate sample on EB
1% have EC
| 10% have EH or polyps
49
ovarian cancer incidence
9-17/100 000
50
lifetime risk of ovarian cancer
2%
51
most important prognostic indicator for ovarian cancer
volume of residual disease
52
staging laparotomy for ovarian cancer
1) evaluate peritoneal surfaces
2) washings or retrieve ascites
3) infracolic omentectomy
4) selective lymphadenectomy of pelvic and para-aortic nodes
5) Bx or resection of suspicious lesions
6) random peritoneal Bx
7) TAHBSO
53
platinum sensitive ovarian disease
relapse >12/12
54
platinum partially sensitive ovarian disease
relapse 6-12/12
55
platinum resistant ovarian disease
relapse <6/12
56
platinum refractory ovarian disease
does not respond
| use pegylated liposomal doxurubicin, topetocan, or etoposide
57
ovarian staging: disease confined to ovaries or tubes
Stage I
58
ovarian staging: one or both ovaries or tubes, pelvic extension, or peritoneal cancer
Stage 2
59
ovarian staging: one or both ovaries or tubes, spread to peritoneum outside the pelvis or metastasis to retroperitoneal nodes
Stage 3
60
ovarian staging: pleural effusion with positive cytology
Stage 4a
61
ovarian staging: parenchymal mets , inguinal nodes, or extra-abdominal organs
stage 4b
62
ovarian staging: surgical spill
stage IC1
63
ovarian staging: capsule rupture
stage 1C2
64
ovarian staging: cells in washings or ascites
stage 1C3
65
ovarian staging: extension or implants onto uterus, tubes or ovaries
stage 2a
66
ovarian staging: extension to other pelvic intraperitoneal tissues
stage 2b
67
ovarian staging: positive retroperitoneal nodes only
stage 3a1
68
ovarian staging: peritoneal mets beyond pelvis up to 2cm in diameter
stage 3B
69
ovarian staging: peritoneal mets >2cm
stage 3C
70
ovarian staging: capsule of liver or spleen
stage 3c
71
endometrial staging: <50% myometrial invasion
stage 1A
72
endometrial staging: >50% myometrial invasion
stage 1B
73
endometrial staging: extension to cervix
stage 2
74
endometrial staging: spread to serosa/adnexa
stage 3a
75
endometrial staging: spread to vagina or parametrium
stage 3b
76
endometrial staging: pelvic nodes
stage 3C1
77
endometrial staging: para-aortic nodes
stage 3C2
78
endometrial staging: spread to bowel or bladder
stage 4a
79
endometrial staging: spread to groin nodes
stage 4b
80
cervical ca 1y survival by stage
96, 92, 74, 50
81
ovarian ca 1y survival by stage
98, 90, 73, 54
82
uterine ca 1y survival by stage
99, 95, 83, 46
83
vulval ca 1y survival by stage
96, 89, 78, 43
84
lifetime risk of cervical ca
1/135
85
HPV type most common in cervical ca
16 (and 18, together 75%)
86
age group with highest incidence of cervical ca
25-34
| 25-29 especially?
87
age group with highest incidence of endometrial ca
70-74
88
age group with highest incidence of ovarian ca
75-79
89
cervical staging: confined to cervix/uterus, <3mm in depth
IA1
90
cervical staging: confined to cervix/uterus, 3-5mm in depth
IA2
91
cervical staging: confined to cervix, uterus, >5mm in depth and <2cm in dimension
IB1
92
cervical staging: confined to cervix/uterus, 2-4cm in dimension
IB2
93
cervical staging: confined to cervix/uterus, >4cm in dimension
IB3
94
cervical staging: involvement of upper 2/3 vagina, <4cm
IIA1
95
cervical staging: involvement of upper 2/3 vagina, >4cm
IIA2
96
cervical staging: parametrial involvement
IIB
97
cervical staging: lower third of vagina involved
IIIA
98
cervical staging: extension to pelvic wall
IIIB
99
cervical staging: hydronephrosis
IIIB
100
cervical staging: pelvic lymph nodes
IIIC1
101
cervical staging: paraaortic lymph nodes
IIIC2
102
cervical staging: growth to mucosa of bladder or rectum
IVA
103
cervical staging: spread to distant organs
IVB
104
cervical ca: management for stage IA1
local excision
105
cervical ca: management of stage IA2-2A, <4cm
radical hysterectomy and lymphadnectomy
106
cervical ca: management of stage IA1-2A, >4cm
chemoradiation
107
cervical ca: management of stage IIB-IVA
chemoradiation
108
cervical ca: management of stage IVB
combined chemotherapy
109
vulval ca: 5y survival if no nodes involved
>80%
110
vulval ca: 5y survival if inguinal nodes involved
<50%
111
vulval ca: 5y survival if iliac or other pelvic nodes involved
10-15%
112
vulval staging: confined to vulva, <2cm in size and <1mm deep
IA
113
vulval staging: confined to vulva, >2cm in size or >1mm deep
IB
114
vulval staging: extension to adjacant perineal structures
II
| lower third of urethra, lower third of vagina, anus
115
vulval staging: 1 lymph node >5mm
IIIA
116
vulval staging: 1-2 lymph nodes <5mm
IIIA
117
vulval staging: 2+ lymph nodes >5mm
IIIB
118
vulval staging: 3+ lymph nodes <5mm
IIIB
119
vulval staging: positive nodes with extracupsular spread
IIIC
120
vulval staging: invasion of upper urethra, vaginal mucosa, bladder, rectum
IVA
121
vulval staging: fixed or ulcerated inguinofemoral nodes
IVA
122
vulval staging: distant mets, including pelvic nodes
IVB
123
1 year survival rates range, overall
72-89%
| worst to best: ovarian, cervical, vulval, endometrial
124
5 year survival rates range, overall
42-75%
| worst to best: ovarian, cervical, vulval, endometrial
125
going from 1 year to 5 year overall stats, whats the pattern
worst = -30,
| worst ovarian at 1y becomes best endometrial at 5y
126
1 year - stage 1 survival range across all cancers
96-99
127
1 year - stage II survival range across all cancers
89-95
| -10 from stage 1
128
1 year - stage III survival range across all cancers
73-83
| -15 from stage 2
129
1 year - stage IV survival range across all cancers
43-54
| -30 from stage 3
130
5 year - stage 1 survival range across all cancers
87-93
| *highest = ovarian, lowest = cervical
131
5 year - stage II survival range across all cancers
67 and 74
| ovarian = cervical
132
5 year - stage III survival range across all cancers
27 and 47
| ovarian and endometrial only
133
5 year - stage IV survival range across all cancers
13 and 15
| ovarian and endometrial only
