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Repro II Exam I > Ovary and Uterine Cancer (Tieman) > Flashcards

Ovary and Uterine Cancer (Tieman) Flashcards

1
Q

most common genital tract malignancy in the US

A

carcinoma of the uterus

Most common clinical presentation is abnormal vaginal bleeding in perimenopausal or postmenopausal woman

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2
Q

risk factors for carcinoma of uterus

A 
Obesity
Unopposed estrogen stimulation (esp. 				postmenopausal)
Tamoxifen 
Nulliparity
Diabetes 
Late menopause
Polycystic ovary syndrome
Lynch syndrome
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3
Q

what decreases risk for getting carcinoma of uterus

A 
Ovulation
Progestin therapy
Combination BCP’s
Early menopause
Multiparity
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4
Q

what 4 tests can you do first for evaluation of abnormal vaginal bleeding

A

Pelvic exam/Pap smear

Endometrial samping

Transvaginal ultrasound

Fractional D&C

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5
Q

how is a uterine carcinoma staged

A

surgery

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6
Q

Stage 1 uterine carcinoma

1a
1 b
1c

A

confined to uterine corpus

1a—confined to endometrium
1b—invasion to < ½ of myometrium
1c—invasion to > ½ of myometrium

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7
Q

stage 2 uterine carcinoma

A

invaded endocervix or cervix

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8
Q

stage 3 uterine

A

tumor in peritoneum, vagina or lymph nodes

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9
Q

stage 4 uterine

A

distant mets, invasion of bladder or bowel mucosa, inguinal lymph node involvement

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10
Q

what affects the prognosis of a carcinoma

A

grade and histology

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11
Q

grade 1 5 year survival (endometrum)

A

95%

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12
Q

grade 2 5 year survival endometrial

A

85%

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13
Q

grade 3 endometrial carcinoma 5 yr survival

A

70%

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14
Q

what type of endometrial carcinomas have favorable histology? what type have unfavorable ?

A 
80% are favorable histology (Endometroid)
20% are unfavorable
Papillary serous carcinoma
Clear-cell carcinoma
Squamous cell carcinoma
Poorly differentiated carcinoma
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15
Q

Stage 1a and 1b,Grades I and II, favorable histology can be treated with what

A

TAH-BSO, peritoneal washings and removal of any enlarged lymph nodes

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16
Q

Grade 3 or unfavorable histology, stage 1c or stage 2 tumors require what treatment

A

TAH-BSO, cytology, and iliac/para-aortic node dissection +/- radiation

17
Q

stage 3 and 4 endometrial cancer treatment

A

Stages 3 & 4 require surgical debulking + radiation + chemotherapy

18
Q

stage 1 a endometiral and 1 b 5 year survival

A

90%

19
Q

stage 1 c uterine 5 year survival

A

80%

20
Q

stage 2 uterine surival 5 years

A

70-80%

21
Q

stage 3 endometrial 5 year survival

A

30-60%

22
Q

stage 4 endometrial 5 year

A

15%

23
Q

second most common but number 1 most lethal cancer of female genital tract

A

ovarian cancer

24
Q

increased risk for ovarian cancer>?

A 
White race/USA
Nulliparity/infertility
Late childbearing
Late menopause
Family history
BRCA genetic mutation
25
Q

decreased risk factors for developing ovarian cancer?

A 
Oral contraceptives
Multiparity
Breast feeding
Tubal ligation
hysterectomy
26
Q

which type of ovarian cancers produce elevated LDH

A

germ cell tumors

27
Q

stage 1 ovarian cancer

A

tumor confined to ovaries

1 c = cytology

28
Q

stage 2 ovarian

A

tumor spread confined to pelvis (2c=+cytology)

29
Q

stage 3 ovarian

A

Stage 3—tumor spread confined to abdominal peritoneal surfaces or retroperitoneal lymph nodes

30
Q

stage 4 ovarian cancer

A

distant mets

31
Q

what is the most important aspect for long term prognosis

A

Excision of any visible tumor
Most important aspect for long term prognosis
Bowel prep mandatory

32
Q

after excision of stage 1 low grade epithelial tumor what is done next

A

no further treatment

33
Q

stage 1 high grade epithelial tumor and beyond… after excision what is done

A

platinum-based chemotherapy +/- paclitaxel

34
Q

after gonadal stromal tumor is excised can you use chemo?

A

no relatively chemoresistant

35
Q

stage 1
stage 2
stage 3-4

5 year survival for epithelial cell tumors

A

Epithelial cell tumors
Stage 1—75-95% 5-year survival
Stage 2—65%
Stages 3 and 4—20%

36
Q

germ cell tumors

stage 1, 2, 3 five year survival

A

Stage 1—95%
Stage 2—80%
Stage 3—60-70%

37
Q

stage 1 gonadal stromal 5 year survival

A

90%

38
Q

why do a fractional D and C

A

b/c of staging purposes

send the endocervical curette separate from the corpus samples

if its in the endocervical canal its stage 2

Repro II Exam I (5 decks)

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