Y5 - Ovarian tumour (benign and malignant) Flashcards
what provides a definitive diagnosis of ovarian cancer
surgery
def of an epithelial ovarian cancer
a malignant transformation of the ovarian capsule epithelium
what are different sub-types of ovarian cancer
epithelial, germ cell, and sex-cord tumours
aetiology
genetic causes implicated
- BRCA1/2
- HNPCC mutations
where do ovarian cancers often originate
the fallopian tubes at the distal fimbral portion
does epithelial ovarian cancer invade organ space
normally no, usually attaches to the surface of organs
epi
most lethal gynaecological cancer
elderly
is ovarian cancer more common in white women or black women
white women
RFs
increasing age
FHx of ovarian/breast cancer
never used OCP
what does OCP protect against
ovarian cancer
signs and symptoms
RFs pelvic mass -adnexal mass GI symptoms > 3 months -bloading -nausea -dyspepsia -urinary incontinence
features of BRCA1 mutation
found on chr 17q
autosomal dominant
what is the increased risk of ovarian cancer with a BRCA1 mutation
35% increased lifetime risk
features of BRCA2 mutation
found on chr 13q
what is the increased risk of ovarian cancer with a BRCA2 mutation
30%
first line investigation
pelvic ultrasound
- solid mass
- high blood flow (doppler)
what cancer antigen marker is raised in ovarian cancer
CA 125
what is the definitive test for ovarian cancer
surgery and histopathology
why do patients commonly present at late stages of ovarian cancer
due to vague and non-specific symptoms
what are the four stages of ovarian cancer
Stage 1 - confined to ovaries
Stage 2 - involves pelvic extension or primary peritoneal cancer
Stage 3 - spread to the peritoneum outside the pelvis or metastasis to retroperitoneal lymph ndoes
stage 4 - distant metastasis
what are the cornerstones of ovarian cancer treatment
surgery and chemotherapy
what is standard therapy for ovarian cancer
maximal surgical debulking and chemotherapy
management for stage I ovarian cancer
surgery
management for stages II-IV ovarian cancer with optimal debulking
IV and intraperitoneal chemotherapy with paclitaxel and cisplatin
management for stages II-IV ovarian cancer with sub-optimal debulking
IV chemotherapy with carboplatin and paclitaxel OR docetaxel
management for platinum sensitive recurrent disease
carboplatin and paclitacel or doxorubicin liposomal
management for platinum resistant recurrent disease
doxorubicin liposomal
prevention for ovarian cancer
OCP
complications
intraperitoneal therapy failure
plantar-palmar erythrodysaesthesia
alopecia
what causes plantar-palmar erythrodysaesthesia
doxorubicin liposomal
what is plantar-palmar erythrodysaesthesia
paraesthesia with painful redness of palms and soles
prognosis
majority of patients have remission after first line therapy
what is the most important prognostic factor for relapse
treatment-free interval or time from completion of first line therapy to reoccurrance
what has worse prognosis, platinum sensitive or platinum resistant ovarian cancer
platinum resistant
