ovarian cancer
DESCRIPTION
Ovarian Cancer. Dr . Saadeh Jaber OBGYN consultant 2010. Epidemiology. Second most common gynecological cancer . >35 , median 70 It accounts for deaths more than cancer of cervix and uterus together. Etiology. The ovulation theory Genetics others. Risk factors and Prevention. - PowerPoint PPT PresentationTRANSCRIPT
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Dr . Saadeh JaberOBGYN consultant
2010
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EpidemiologySecond most common gynecological
cancer .
>35 , median 70
It accounts for deaths more than cancer of cervix and uterus together
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EtiologyThe ovulation theoryGeneticsothers
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Risk factors and PreventionRisk factors
Number of life time ovulationsage > 35 InfertilityNulliparity Late menopasueFamily historyBRCA 1 +2
PreventionUse of OCPBreastfeedingMultiparityTubal sterilization
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GeneticsFamilial Ovarian cancer5-10% of epithelial cancers (usually serous
adencarcinoma)1 relative ---- 2.5% 2 relatives 30-40 %Most have breast and colorectal cancerBRCA 1 & BRCA 2 HNPCC
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Primary vs Secondary
Histological type
Classification
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Primary Vs SecondarySecondary : 7%Common primary cancers are breast cancer
and gastrointestinal cancer “Krukenberg tumour”
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Histological origin
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Epithelial Cell tumor85 % of malignant tumors
60-70 yrs
Worst prognosis
CEA , CA-125
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Brenner
Clear cell
Endometroid
Mucinous
Serous
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Borderline epithelial tumors10% of the epithelial cellsAtypia, mitotic activity , but no invasion of
the stromaGood prognosisMost are serous or mucinous
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Germ Cell tumorSecond most common type of ovarian cancer5-10%20-40 yrsBetter prognosisLDH, AFP,B-HCG
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Sex Cord TumorsLeast common ovarian neoplasm5-8 % of ovarian cancers and 30 % of all
tumorsLow grade malignancyHormonally active
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Clinical findingsUsually absent or nonspecific GI symptomsUrinary symptomsPostmenopausal bleedingVirilizationAcute abdomen
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Diagnosis – InvestigationsU\STumor markersBariun enemaIVPChest X-ray, abdominal X-rayCT/PET
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U/S
Solid and cystic, septation, irregularly shaped
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Diagnosis – Markers
Ovarian Tumor Serum markerDysgerminoma LDHEndodermal sinus
AFP
Choriocarcinoma B-HCGGranulosa tumor InhibinSertoli-leydig cell
Testosterone
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MetastasisMainly through the peritoneal fluid
Lymphatic spread
Least common hematogeneous
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ManagementSurgery: TAH/BSO Pelvic and aortic lymph node dissection OmentectomyAppendectomy Washings Biopsies
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PrognosisThe five-year survival rate for all stages of
ovarian cancer is 45.5%.
Germ cell tumors of the ovary have a much better prognosis than other ovarian cancers, in part because they tend to grow rapidly to a very large size, hence they are detected sooner.
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Incidence Mortality