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24 Cards in this Set

  • Front
  • Back
what is the median age in cervix carcinoma at diagnosis?
45 years
what are the common high-risk subtypes for cervical carcinoma?
subtype 16 and 18, 31
where do CIN typically arise?
transformation zone from squamous to glandular zone
what percentage of CIN I progress to invasive carcinoma?
<1%
what percentage of CIN I progress to CIN III?
5-10%
what are the two types of invasive cervical carcinoma?
85% squamous cell carcinoma

15% adenocarcinoma
what is the basic pathogenesis of cervical carcinoma?
HPV infection with oncogenic types --> persistence of infection due to failure to clear infection --> CIN II/III --> possibly malignant transformation
in what time range does a CIN II/III possibly transform into invasive carcinoma?
2 years
what percentage of cervical carcinoma are linked to persistence of HPV infection?
99.7%
where can HPV DNA be found in oncogenic and non-oncogenic HPV subtypes, respectively?
non-oncogenic subtypes stay epigenetic

oncogenic subtypes are integrated into the DNA
what are important viral pathogenetic mechanisms responsible for malignant transformation of CIN?
overexpression of viral oncogenes E6 and E7 with inactivation of tumor suppressor genes (notably p53 and RB)
what percentage of women will have a HPV infection in their lifetime?
80%
what percentage of precancerous lesions of the cervix, vulva/anus and suspect cytology findings can be avoided with HPV vaccination?
70% of cervical precancerous lesions

70% of precancer of vulva/anus

50% of suspect cytologies
what percentage of patients with cervical cancer can be cured?
two thirds
what is the stage cutoff for surgical intervention
greater stage IIa

stage IIa beyond cervix, with vaginal involvement (but not lower third)

stage IIb parametrium affected
what are the therapy principles for microcarcinoma of the cervix?
stage Ia1
conisation with curettage of cervix
preferably simple hysterectomy

stage Ia2
limited radical hysterectomy, ie pelvic lymphadenectomy
what stages comprise microcarcinoma of the cervix?
stage Ia
what stages comprise macrocarcinoma of the cervix?
stage Ib-IV
what are the therapy principles for carcinoma in situ of the cervix?
knife conisation and endocervical curettage
what are the therapy principles for macrocarcinoma stage Ib of the cervix?
Wertheim operation
=
extended radical hysterectomy
what is surgically removed in extended radical hysterectomy
uterus, parametria, pelvic lymph nodes and vaginal cuff
what stages of cervical carcinoma are treated with combined radiochemotherapy?
stages IIb and greater
what is the chemotherapeutic agent in cervical carcinoma?
low dose cisplatin acting as radiosensitizer
what is the staging system for cervical carcinoma?
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