Ovarian Cancer Flashcards
EOC per 100,000
a) Mortality rate
b) age standardised incidence
a) 7.4
b) 12.6
Lifetime risk of being diagnosed with ovarian cancer
1-1.5%
Risk of ovarian malignancy based on RMI?
<25 = <3% 25-250 = 20% >250 = 75% (sens 70%, spec 90%)
cut off 200 increased sensitivity (78%, 87%)
Most common type of epithelial ovarian cancer?
serous cystadenocarcinoma
Proportion of EOC caused by endometriod cell carcinoma?
10%
What type of cell is Brenne’s cell tumor derived from?
Transitional cell
Clear cell carcinoma is derived from what type of cell?
Mullerian
Normal ovarian volume in pre and post-menopausal women?
<20cm3 premenopausal
<10cm3 postmenopausal
List 7 criteria for a screening programme
- Condition: suitable for screening
- Test: suitable
- Treatment: effective + accessable
- Mortality/Morbidity reduced
- Benefit>Harm
- Sustainable
- Social/Ethics/Cost considered
Proportion of ovarian cancer diagnosed in late stages?
75%
Inheritance of BRCA?
Chromosome 17
Autosomal dominant
BRCA 1 80y cumulative risk
a) breast cancer
b) ovarian cancer
a) 72%
b) 44%
BRCA 2 80y cumulative risk
a) breast cancer
b) ovarian cancer
a) 69%
b) 17%
Frequent histological finding of serous tumor?
psammoma bodies
Tumor marker secreted by serous EOC?
Ca125
Risk factors for serous ovarian cancer?
caucasian nulliparous chronic ovulator nil COCP HRT Fanconi Ashkenazi Jew Icelandic BRCA hx
Common USS findings serous ovarian cancer?
mixed solid/cystic
thick septations
calcification uncommon
frequently bilateral
Most important prognostic factor of serous adenocarcinoma?
stage at diagnosis
High grade serous ovarian cancer 5yr survival?
40%
Low grade serous ovarian cancer 5 year survival, advanced stage.
80%
Epithelial ovarian cancer low grade, early stage- should they receive chemotherapy?
No- does not improve survival.
Ca125 is elevated in what types of ovarian cancer?
80% of EOC, particularly non-mucinous tumors.
Mucinous tumors have elevation of what markers?
CEA, Ca199, +/- Ca125
Histology difference borderline vs. malignant mucinous tumor
> 10mm2 stromal invasion = malignant
Grading mucinous tumors is dependent on what histological features?
% of solid component
Grade I= no solid
Grade II= <50% solid
Grade III = >50% solid
severe nuclear atypic can increase the grade
Mean age of diagnosis of mucinous adenocarcinoma of ovary?
60yo
Mucinous adenocarcinoma of the ovary is confirmed to the ovary in what proportion of cases?
95-98%
Proportion of mucinous adenocarcinoma found in ovary that is primary vs. secondary?
primary ~20%
secondary ~80%
USS appearance of mucinous cystadenocarcinoma
mural thickening
solid/cystic components
95% unilateral
areas of haemorrhage
MRI T1 appearance of mucinous cystadenocarcinoma
mucin = higher signal than water
Prognosis of stage I mucinous adenocarcinoma?
95%
Prognosis mucinous cystadenocarcinoma stage II or worse?
32%
Clear cell carcinoma histology of cells?
hobnail
clear
Risk factors for clear cell carcinoma of the ovary?
Lynch Syndrome Endometriosis Family history of ovarian cancer chronic ovulates (early menarche, late menopause, no COCP)