User:PriceDL/Notes/Ovarian Cancer


 * 95% epithelial
 * Others germ cell or stromal
 * Risk of developing epithelial ovarian cancer (EOC) increases with length and duration of ovulation
 * Associated with BRCA1 and BRCA2
 * Risk reduced by early pregnancy and us of oral contraceptive pill
 * Most patients present with pelvic mass in advanced stage III or IV

Symptoms

 * Abdominal distension
 * Loss of apetite
 * Pelvic/abdominal pain
 * Increased urinary urgency/frequency

Investigations

 * Serum CA125
 * Transvaginal ultrasound
 * MRI
 * CT-PET for staging
 * Assess BRCA in family history

Prognosis

 * Significantly better 5-year survival for BRCA-positive than BRCA-negative

Management

 * Surgery and chemotherapy - which, both and order depend on staging
 * In advanced chemo may be used to shrink tumour before surgery. Mortality is same but better surgical morbidity if tumour shrunk prior to surgery
 * Carboplatin and caplitaxel preferred
 * Hysterectomy and bilateral salpingo-oophorectomy with pelvic and paraaortic lymph node dissection preferred