Ovarian Cancer (NICE) Flashcards
What level of CA125 would require an ultrasound scan?
35 or greater
What to do if ultrasound suggests ovarian cancer?
Urgent 2 week referral to gynaecological cancer service
What components are part of the risk of malignancy index?
Ultrasound scan
Menopausal status
CA125 level
How do you score the menopause status?
1 - pre-menopausal
3 - post-menopausal
What is the range of the ultrasound score?
1-3
When would a woman be classified as post-menopausal?
If not had a period for over 1 year
Or over 50 with hysterectomy
What RMI score should be referred to a specialist MDT?
> 250
What scan should be conducted in patients with an RMI score >250?
CT pelvis and abdomen (and thorax if clinically indicated)
When would you not require adjuvant chemo in ovarian cancer?
optimal surgical staging and have low-risk stage I disease (grade 1 or 2, stage Ia or Ib)
What adjuvant chemo should be offered to patients with grade 3 cancer (high grade)?
6 cycles of carboplatin
Should intraperitoneal chemo be used for ovarian cancer?
No unless part of trial (according to NICE)
What is stage 1A, B and C ovarian cancer?
1A: in one ovary and inside the ovary (or fallopian tube)
1B: in both ovaries or fallopian tubes but still inside
1C: cancer is on surface of ovaries OR capsule ruptured before or during surgery OR cells found in ascites or washings of peritoneum
What is stage 2 ovarian cancer?
Spread inside the pelvis or peritoneal deposits
What is stage 3 ovarian cancer?
Spread to retroperitoneal lymph nodes
What is stage 4A and B ovarian cancer?
4A - Malignant pleural effusion but no other organ spread
4B - spread to other lymph nodes or liver or spleen or outside abdomen
