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41 Cards in this Set
- Front
- Back
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Rate of HSIL/cancer with HSIL pap |
70% |
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Rate of HSIL/cancer with LSIL pap |
15-20% |
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Rate of HSIL/cancer with AGC based on HPV |
all comers- 13% Hpv +45% Hpv- 2% |
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Rate of HSIL/cancer with ascus based on hpv |
All comers- 7% HPV - 1% Hpv + 18% |
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Rate of nodal disease by 1/3 stromal invasion (gog49 delgado) |
1/3= 5% 2/3= 13% 3/3= 26% |
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Rate of nodal disease with + parametria (gog 49 delgado) |
43% |
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Rate of nodal disease with grade 1? grade 2? Grade 3? Lvi? (Gog 49 delgado) |
10% 14% 22% 25% |
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Sedlis criteria and rate of recurrence with or without rads? (Gog92) |
Lvi+ 2/3 3/3 invasion >4cm Need 2 of 3 15% recur with rads and 28% withour |
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Peter's criteria for chemorads in adjuvant cervix? PFS and OS at 4 yrs? (Gog 109) |
+parametria Positive margin Positive nodes 81% vs 71% OS favouring chemo 80% vs 63% PFS favouring chemo |
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How big of cone should you do? |
20mm to get neg margin |
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Detection rate of ct and MRI for positive nodes? (Gog 183) |
37% MRI 31% CT |
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Spread pattern of cervical verrucous carcinoma? |
Local spread but not mets |
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Other than HPV, list a virus associated with cervical cancer |
EBV causes lymphoepithelioma-like carcinoma of the cervix |
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What proportion of cervical cancers are adenocarcinoma? |
25% |
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Which strain of HPV causes the majority of adenocarcinoma? |
18 |
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To distinguish endocervical adenocarcinoma, endometrioid variant, from endometrial cancer, what IHC helps? |
CEA +, ER -, vimentin - is hallmark of endocervical. Hpv markers like p16 also support endocervical. Opposite is true for endometrial |
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Which IHC stains most readily distinguish a tumor as neuroendocrine (except small cell which is different)? |
Chromogranin Synaptophysin |
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What subtype of neuroendocrine tumor is most common? |
Small cell |
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What features of mesenchymal tumors are associated with worse prognosis? (Prog usually good) |
Deep invasion Sarcomatous overgrowth |
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During radiation treatment, which clinical feature/lab result is indicative of progression? |
Low hemoglobin levels |
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How is anemia treated in cervical cancer- transfusion or EPO? |
Transfusion Cx cancer cells have EPO receptor and may be stimulated by EPO admin |
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Standards of evaluation of response to treatment on PET? |
>25% increased FDG uptake = progression >15% decrease uptake = partial response No uptake = complete response Between progression and increase is stable disease |
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What's the rate of nodal mets in stage 1a2 disease? |
5-13% |
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Which mode of treatment for CIN is associated with higher persistence and recurrence? |
Cryotherapy |
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What's the rate of nodal spread in stage 1a1 disease? |
<5%, especially if LVI neg |
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What is the 5 year survival after surgery for a non- bulky stage 1b/2a cervical cancer? (Same with rads) |
83-92% (landoni) |
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5 yr OS for pts with <4cm tumor |
80% (landoni) |
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5yr OS for patients with >4cm tumor |
60% (landoni) |
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What proportion of relapsed early stage disease are pelvic? |
60% (landoni) |
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What is the rate of ovarian mets in SCC of the cervix? What about adenocarcinoma? |
<0.5% 3-5% |
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For pts meeting sedlis criteria, what are the local and distant recurrence rates with and without radiation? |
21% local, 9% distant without radiation 14% local and 3% distant with rads |
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With Peters' criteria, what are the rates if distant and local relapse with CRT vs RT? |
9% local, 10% distal with CRT 22% local, 16% distant with RT Biggest benefit when chemo added for tumors >2cm or with 2 or more + nodes |
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What is the dose of cisplatin used in chemorads? |
40-50mg/m2 weekly |
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What is the 5yr survival rates with stage 2b, 3b and 4a cervical cancer post radiation treatment? |
60%, 45%, 30% |
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Which nodal basin has unusually high involvement in stage 3a cervical cancer? |
Inguinal nodes They should be included in the radiation field |
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What is the most active chemo in stage 4b cervical cancer and what is the response rate? |
Cisplatin 50mg/m2 50% 6mo duration of response |
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What are the most common toxicities and rates of each for cis-taxol in cervical cancer? |
Grade 3 or 4 Anemia- 28% Thrombocytopenia- 4% Leukopenia 55% |
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How is cis- topo given in advanced cervical cancer? |
Day 1 topo 0.75mg/m2 then 50mg/m2 cis Day 2 and 3 topo again RR 27% |
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Describe GOG 240- tawari 2017 |
452 pts with advanced/recurrent cx ca Cis-taxol-bev vs cis-taxol-topo RR with bev 48% vs 36% without 3.7mo increased os (17 vs 13.3mo) More gi, neutropenia and fistula with bev |
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GOG 92 |
Sedlis 1999 - all stage 1b, rads vs obs 277pts total Intermediate risk factors 2of 3- >4cm, lvsi, deep stromal invasion Rads decreased recurrence 47% |
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Who published GOG 92 (sedlis) long term data and what did they find? |
ROTMAN 2006 RT reduced risk for progression and death by 42% |
