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24 Cards in this Set
- Front
- Back
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what is the median age in cervix carcinoma at diagnosis?
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45 years
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what are the common high-risk subtypes for cervical carcinoma?
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subtype 16 and 18, 31
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where do CIN typically arise?
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transformation zone from squamous to glandular zone
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what percentage of CIN I progress to invasive carcinoma?
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<1%
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what percentage of CIN I progress to CIN III?
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5-10%
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what are the two types of invasive cervical carcinoma?
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85% squamous cell carcinoma
15% adenocarcinoma |
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what is the basic pathogenesis of cervical carcinoma?
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HPV infection with oncogenic types --> persistence of infection due to failure to clear infection --> CIN II/III --> possibly malignant transformation
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in what time range does a CIN II/III possibly transform into invasive carcinoma?
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2 years
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what percentage of cervical carcinoma are linked to persistence of HPV infection?
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99.7%
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where can HPV DNA be found in oncogenic and non-oncogenic HPV subtypes, respectively?
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non-oncogenic subtypes stay epigenetic
oncogenic subtypes are integrated into the DNA |
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what are important viral pathogenetic mechanisms responsible for malignant transformation of CIN?
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overexpression of viral oncogenes E6 and E7 with inactivation of tumor suppressor genes (notably p53 and RB)
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what percentage of women will have a HPV infection in their lifetime?
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80%
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what percentage of precancerous lesions of the cervix, vulva/anus and suspect cytology findings can be avoided with HPV vaccination?
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70% of cervical precancerous lesions
70% of precancer of vulva/anus 50% of suspect cytologies |
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what percentage of patients with cervical cancer can be cured?
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two thirds
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what is the stage cutoff for surgical intervention
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greater stage IIa
stage IIa beyond cervix, with vaginal involvement (but not lower third) stage IIb parametrium affected |
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what are the therapy principles for microcarcinoma of the cervix?
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stage Ia1
conisation with curettage of cervix preferably simple hysterectomy stage Ia2 limited radical hysterectomy, ie pelvic lymphadenectomy |
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what stages comprise microcarcinoma of the cervix?
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stage Ia
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what stages comprise macrocarcinoma of the cervix?
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stage Ib-IV
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what are the therapy principles for carcinoma in situ of the cervix?
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knife conisation and endocervical curettage
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what are the therapy principles for macrocarcinoma stage Ib of the cervix?
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Wertheim operation
= extended radical hysterectomy |
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what is surgically removed in extended radical hysterectomy
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uterus, parametria, pelvic lymph nodes and vaginal cuff
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what stages of cervical carcinoma are treated with combined radiochemotherapy?
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stages IIb and greater
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what is the chemotherapeutic agent in cervical carcinoma?
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low dose cisplatin acting as radiosensitizer
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what is the staging system for cervical carcinoma?
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stage I
limited to cervix stage II beyond cervix but not to pelvic wall not to lower third of vagina IIa only vagina, not parametrium stage III to pelvic wall and/or distal third of vagina and/or ureteral stenosis, hydronephrosis, silent kidney stage IVa beyond true pelvis and/or infiltration of bladder or rectum stage IVb distant metastasis |
