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13 Cards in this Set

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What percentage of patients with ovarian cancer are diagnosed as stage III or IV?
70%
Name the six subtypes of epithelial ovarian cancers and give their incidence.
1. serous: 50%
2. mucinous: 25%
3. endometrioid: 10%
4. clear cell: 6%
5. Brenner: 4%
6. undifferentiated: remaining 5%
Why is ovarian cancer typically diagnosed at a late stage?

What is the usual method of spread?
it is difficult to detect before dissemination

spreads by exfoliation into the peritoneal fluid
What are the signs and symptoms of ovarian cancer?
pelvic mass/pain
abdominal mass ("omental caking")
pleural effusion
ascites
ventral hernia (increased intra-ab pressure)
early satiety
nausea/vomiting
change in bowel habits
widening of abdominal girth
What are risk factors for ovarian cancer?
early menarche/late menopause
nulliparity
late childbearing
advanced age (50-70)
personal/family history of breast cancer
caucasian race
What is the clinical utility of CA-125?
elevated in 80% of ovarian ca cases useful for tracking disease progression, NOT as a screening tool
may be elevated in MANY premenopausal conditions
Name five factors protective against the development of ovarian cancer.,
breastfeeding
oral contraceptives
multiparity
tubal ligation
hysterectomy
What percent of ovarian cancer cases are associated with the so-called Hereditary Ovarian Cancer (HOC) syndromes?
10% to 15%
Name the three Hereditary Ovarian Cancer (HOC) syndromes.
breast-ovarian cancer syndrome
Lynch II syndrome--HNPCC
site-specific ovarian cancer
What are screening tools for women at high-risk for ovarian cancer (2+ affected first-degree relatives)?
annual CA-125 (poor)
annual transvaginal ultrasound
annual pelvic exam

consider BRCA screening +/- prophylactic oophorectomy if positive
By what process is ovarian cancer staged?
surgically:

peritoneal washings
total hysterectomy
bilateral salpingo-oophorectomy
omentectomy
pelvic and para-aortic lymphadenectomy
Name four poor prognostic indicators for ovarian cancer.
short disease-free interval
mucinous or clear cell tumor
multiple disease sites
high/rising CA-125
Name the two subtypes of nonepithelial ovarian cancer and give their incidence relative to all ovarian cancers.
germ cell tumors: 8%
sex-cord stromal tumors: 1%