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Heme/Onc Boards > Gynecologic Oncology > Flashcards

Gynecologic Oncology Flashcards

1
Q

First line chemo in uterine cancer

A

Carboplatin + paclitaxel (+trastuzumab in HER2 positive serous carcinoma)

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2
Q

What non-chemotherapy regimen may be superior to tamoxifen/megace in endometrial cancer?

A

everolimus/letrozole

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3
Q

What defines high-risk early stage ovarian cancer?

A

Stage IC or II; clear cell histology (any stage); Grade 3 tumors (any histology)

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4
Q

Which gene is thought to play a role in small-cell carcinoma hypercalemia-type ovarian cancer?

A

SMARCA4 (occ SMARCA2 as well)

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5
Q

How are Stage IA, IB, and IC ovarian cancer defined?

A

IA = Tumor limited to one ovary with capsule intact; IB = Tumor involves both ovaries, but capsules are intact; IC = tumor involves one or both ovaries with either surgical spill, capsule ruptured before surgery or tumor on ovarian or fallopain tube surface, or malignant cells in ascites or peritoneal washing

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6
Q

How is platinum sensitive vs. insensitive defined in ovarian cancer?

A

Recurrence in less than or greater than 6 months

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7
Q

What are genetic changes characteristic of Type 1 endometrial cancer?

A

K-Ras, PTEN, beta-catenin mutations

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8
Q

What are genetic changes characteristic of Type 2 endometrial cancer?

A

p53, HER2 amplificaiton, Bcl2 amplification

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9
Q

What is chemotherapy choice for platinum-resistant ovarian cancer?

A

Doxil + bevacizumab

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10
Q

How are borderline ovarian tumors (tumors of low malignant potential) defined?

A

Epithelial proliferation with absence of stromal invasion

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11
Q

What stages of dysgerminoma is chemotherapy recommended?

A

Stages II-IV

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12
Q

What stages of granulosa cell tumors should receive chemotherapy?

A

Stage IC-IV (Carbo/taxol or BEP)

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13
Q

Which type of endometrial cancer is estrogen dependant?

A

Type 1

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14
Q

What is stage IA ovarian cancer?

A

cancer only within one ovary and no cancer on surface

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15
Q

What is stage IB ovarian cancer?

A

Cancer in both ovaries, but no cancer on the surface

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16
Q

What is stage IC ovarian cancer?

A

Cancer in on or both ovaries, plus cancer has spread to surface of one or both ovaries or cancer cells are in abdominal fluid

17
Q

What is stage II ovarian cancer?

A

Cancer has spread to nearby organs in the pelvis

18
Q

What is stage III ovarian cancer?

A

Cancer has spread to the peritoneum

19
Q

What is stage IV ovarian cancer?

A

Cancer has spread outside the pelvis and peritoneum

20
Q

When can you observe ovarian cancer after surgery?

A

IA or IB if grade 2 endometroid (NOT high grade serous or grade 3 endometrois)

21
Q

What is stage IA endometrial cancer?

A

Less than half myometrial invasion

22
Q

What is stage IB endometrial cancer?

A

More than half myometrial invasion but does not extend past the uterus

23
Q

What is stage II endometrial cancer?

A

Invades cervical stroma

24
Q

Adjuvant treatment for Stage I endometrial cancer?

A

Observation for G1/G2 stage IA. RT +/- systemic therapy for IB G3. Otherwise vaginal bracytherapy.

25
Q

Adjuvant treatment for Stage II endometrial cancer?

A

EBRT and/or vaginal brachytherapy +/- systemic therapy

26
Q

Adjuvant treatment for Stage III/IV endometrial cancer?

A

Systemic therapy +/- EBRT +/- vaginal brachytherapy

27
Q

What is stage IIIA endometrial cancer?

A

Tumor invades the serosa of the uterus and/or adnexae

28
Q

What is Stage IIIB endometrial cancer?

A

Vaginal and/or parametrial involvement

29
Q

What is Stage IIIC endometrial cancer?

A

Metastases to pelvic and/or para-aortic lymph nodes

30
Q

What are risk factors of uterine carcinosarcomas?

A

Similar to type 1- unopposed estrogen exposure

31
Q

What treatment is recommended to women with resected uterine carcinosarcoma?

A

Ifosfamide, msna, and cisplatin

32
Q

What is the treatment for low-risk gestational trophoblastic neoplasia?

A

Single agent methotrexate or dactinomcyin

33
Q

What is the treatment for high-risk gestational trophoblastic neoplasia?

A

Combination chemotherapy with methotrexate and etoposide and actinomycin alternating with cyclophosophamide and vincristine

34
Q

What is the criteria for high-risk gestational trophoblastic neoplasia?

A

hcg >40,000, non-pulmonary visceral metastases, and >4 months to the diagnosis of malignant transformation

35
Q

When is chemotherapy not required for ovarian germ cell tumors?

A

Stage 1 dysgerminomas, or grade 1, stage IA immature teratomas

Heme/Onc Boards (4 decks)

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