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Ovarian Cancer

Oncology Registrars’ Forum. “Best of Five”. Ovarian Cancer. May 2007 Dr Anna Winship Guy’s & St. Thomas’ NHS Trust. Click Here For First Question. Question 1.

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Ovarian Cancer

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  1. Oncology Registrars’ Forum “Best of Five” Ovarian Cancer May 2007 Dr Anna Winship Guy’s & St. Thomas’ NHS Trust Click Here For First Question

  2. Question 1 • A 66 year old women underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. What is the most likely diagnosis? Serous cystadenocarcinoma Endometrioid adenocarcinoma Mucinous cystadenocarcinoma Clear cell cystadenocarcinoma Transitional cell carcinoma Click Here For Answer

  3. Question 1 • A 66 year old women underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. What is the most likely diagnosis? Serous cystadenocarcinoma Endometrioid adenocarcinoma Mucinous cystadenocarcinoma Clear cell cystadenocarcinoma Transitional cell carcinoma Click Here For Next Question

  4. Question 2 • A 66 year old women underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. What is the most important risk factor for the development of ovarian cancer? Infertility Oestrogen replacement therapy Diet / obesity Family history Talcum powder (perineal application) Click Here For Answer

  5. Question 2 • A 66 year old women underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. What is the most important risk factor for the development of ovarian cancer? Infertility Oestrogen replacement therapy Diet / obesity Family history Talcum powder (perineal application) Click Here For Next Question

  6. Question 3 • A 35 year old women complained of right sided pelvic pain and was found to have an adnexal mass. Her risk of malignancy index (RMI) was calculated. What is the correct formula? U = Ultrasound results; M = menopausal status U x M x age U x M x Ca125 M x age x Ca125 U x age x Ca125 U x age x M x Ca125 Click Here For Answer

  7. Question 3 • A 35 year old women complained of right sided pelvic pain and was found to have an adnexal mass. Her risk of malignancy index (RMI) was calculated. What is the correct formula? U = Ultrasound results; M = menopausal status U x M x age U x M x Ca125 M x age x Ca125 U x age x Ca125 U x age x M x Ca125 Click Here For Next Question

  8. Question 4 • A 35 year old women complained of right sided pelvic pain and was found to have an adnexal mass. Her RMI was calculated at 225. Which investigation (if any) should be performed next? No further investigation Fine needle aspirate of adnexal mass Trucut biopsy of adnexal mass CT scan of abdomen / pelvis Staging laparotomy Click Here For Answer

  9. Question 4 • A 35 year old women complained of right sided pelvic pain and was found to have an adnexal mass. Her RMI was calculated at 225. Which investigation (if any) should be performed next? No further investigation Fine needle aspirate of adnexal mass Trucut biopsy of adnexal mass CT scan of abdomen / pelvis Staging laparotomy Click Here For Next Question

  10. Question 5 • A 50 year old nurse underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. She was found to have a large right ovarian mass with cystic and solid elements, rupture of the capsule, omental deposits measuring <2cm in diameter, liver capsule deposits, a small amount of ascites and a small pleural effusion. From the information given her FIGO stage is: Stage IIB Stage IIIA Stage IIIB Stage IIIC Stage IV Click Here For Answer

  11. Question 5 • A 50 year old nurse underwent a staging laparotomy, TAH, BSO and omentectomy for ovarian cancer. She was found to have a large right ovarian mass with cystic and solid elements, rupture of the capsule, omental deposits measuring <2cm in diameter, liver capsule deposits, a small amount of ascites and a small pleural effusion. From the information given her FIGO stage is: Stage IIB Stage IIIA StageIIIB Stage IIIC Stage IV Click Here For Next Question

  12. Question 6 • A 42 year old accountant underwent a staging laparotomy, TAH, BSO and omentectomy for a poorly-differentiated serous cystadenocarcinoma. The operation note stated that “optimal” cytoreduction was obtained. The accepted definition of “optimal” encompasses patients in whom there remain no tumour nodules greater than: 0.2cm in diameter 0.5cm in diameter 0.7cm in diameter 1.0cm in diameter 1.5cm in diameter Click Here For Answer

  13. Question 6 • A 42 year old accountant underwent a staging laparotomy, TAH, BSO and omentectomy for a poorly-differentiated serous cystadenocarcinoma. The operation note stated that “optimal” cytoreduction was obtained. The accepted definition of “optimal” encompasses patients in whom there remain no tumour nodules greater than: 0.2cm in diameter 0.5cm in diameter 0.7cm in diameter 1.0cm in diameter 1.5cm in diameter Click Here For Next Question

  14. Question 7 • A 63 year old civil servant underwent a staging laparotomy, TAH, BSO and omentectomy and was found to have a stage IIC mucinous cystadenocarcinoma of the ovary. She was offered adjuvant chemotherapy. Which drug or drug-combination is most likely to cause peripheral neuropathy? Single agent carboplatin Carboplatin / paclitaxel Carboplatin / docetaxel Cisplatin / docetaxel Cisplatin / pactitaxel Click Here For Answer

  15. Question 7 • A 63 year old civil servant underwent a staging laparotomy, TAH, BSO and omentectomy and was found to have a stage IIC mucinous cystadenocarcinoma of the ovary. She was offered adjuvant chemotherapy. Which drug or drug-combination is most likely to cause peripheral neuropathy? Single agent carboplatin Carboplatin / paclitaxel Carboplatin / docetaxel Cisplatin / docetaxel Cisplatin / pactitaxel Click Here For Next Question

  16. Question 8 • A 48 year old teacher underwent a staging laparotomy, TAH, BSO and omentectomy for suspected ovarian cancer. A large right ovarian mass with solid and cystic elements was found. Histopathology showed a clear cell carcinoma of the right ovary with a small focus of disease in the left ovary. What is the most appropriate management? Observation with serial Ca125 Adjuvant chemotherapy with 6 cycles of carboplatin Adjuvant chemotherapy with 8 cycles of carboplatin Adjuvant chemotherapy with 6 cycles of carboplatin / paclitaxel Adjuvant chemotherapy with 8 cycles of carboplatin / paclitaxel Click Here For Answer

  17. Question 8 • A 48 year old teacher underwent a staging laparotomy, TAH, BSO and omentectomy for suspected ovarian cancer. A large right ovarian mass with solid and cystic elements was found. Histopathology showed a clear cell carcinoma of the right ovary with a small focus of disease in the left ovary. What is the most appropriate management? Observation with serial Ca125 Adjuvant chemotherapy with 6 cycles of carboplatin Adjuvant chemotherapy with 8 cycles of carboplatin Adjuvant chemotherapy with 6 cycles of carboplatin / paclitaxel Adjuvant chemotherapy with 8 cycles of carboplatin / paclitaxel Click Here For Next Question

  18. Question 9 • A 40 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for stage IIIB clear cell carcinoma of the ovary. What is the most appropriate management? Observation with serial Ca125 Adjuvant chemotherapy with 6 cycles of carboplatin Adjuvant chemotherapy with 8 cycles of carboplatin Adjuvant chemotherapy with 6 cycles of carboplatin / paclitaxel Adjuvant chemotherapy with 8 cycles of carboplatin / paclitaxel Click Here For Answer

  19. Question 9 • A 40 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for stage IIIB clear cell carcinoma of the ovary. What is the most appropriate management? Observation with serial Ca125 Adjuvant chemotherapy with 6 cycles of carboplatin Adjuvant chemotherapy with 8 cycles of carboplatin Adjuvant chemotherapy with 6 cycles of carboplatin / paclitaxel Adjuvant chemotherapy with 8 cycles of carboplatin / paclitaxel Click Here For Next Question

  20. Question 10 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is the most appropriate management? Repeat Ca125 in 8 weeks Repeat Ca125 in 6 months Repeat CT scan Chemotherapy with single agent carboplatin Chemotherapy with carboplatin / paclitaxel Click Here For Answer

  21. Question 10 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is the most appropriate management? Repeat Ca125 in 8 weeks Repeat Ca125 in 6 months Repeat CT scan Chemotherapy with single agent carboplatin Chemotherapy with carboplatin / paclitaxel Click Here For Next Question

  22. Question 11 • A 40 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for stage IIIB clear cell carcinoma of the ovary. Which trial(s) may she be eligible for? ICON4 ICON5 ICON4, SCOTROC4 ICON5, SCOTROC4 ICON4, ICON5, SCOTROC4 Click Here For Answer

  23. Question 11 • A 40 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for stage IIIB clear cell carcinoma of the ovary. Which trial(s) may she be eligible for? ICON4 ICON5 ICON4, SCOTROC4 ICON5, SCOTROC4 ICON4, ICON5, SCOTROC4 Click Here For Next Question

  24. Question 12 • A 57 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for suspected ovarian cancer. Which FIGO stage is she most likely to have? I then II then III then IV II then III then I then IV III then IV then I then II III then I then IV then II IV then III then I then II Click Here For Answer

  25. Question 12 • A 57 year old woman underwent a staging laparotomy, TAH, BSO and omentectomy for suspected ovarian cancer. Which FIGO stage is she most likely to have? I then II then III then IV II then III then I then IV III then IV then I then II III then I then IV then II IV then III then I then II Click Here For Next Question

  26. Question 13 • A 59 year old woman underwent transvaginal ultrasound scanning which confirmed the presence of a semi-cystic, semi-solid mass arising from the left ovary. Her Ca125 was 70. What is her RMI from the information given? 70 210 630 4130 None of the above Click Here For Answer

  27. Question 13 • A 59 year old woman underwent transvaginal ultrasound scanning which confirmed the presence of a semi-cystic, semi-solid mass arising from the left ovary. Her Ca125 was 70. What is her RMI from the information given? 70 210 630 4130 None of the above Click Here For Next Question

  28. Question 14 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. How would you define her disease? Chemo-refractory Chemo-resistant Partially chemo-resistant Partially chemo-sensitive Chemo-sensitive Click Here For Answer

  29. Question 14 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. How would you define her disease? Chemo-refractory Chemo-resistant Partially chemo-resistant Partially chemo-sensitive Chemo-sensitive Click Here For Next Question

  30. Question 15 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is the most important prognostic factor? Ca125 Age Extent of debulking surgery Response to platinum Stage of disease Click Here For Answer

  31. Question 15 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is the most important prognostic factor? Ca125 Age Extent of debulking surgery Response to platinum Stage of disease Click Here For Next Question

  32. Question 16 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is her overall 5-year survival rate? 50% 40% 30% 20% 10% Click Here For Answer

  33. Question 16 • A 40 year old woman receives chemotherapy for stage IIIB clear cell carcinoma of the ovary. 6 weeks following completion of ther treatment a CT scan shows no evidence of residual disease. She remains well for 9 months but her Ca125 rises from 19 to 65. She is asymptomatic. What is her overall 5-year survival rate? 50% 40% 30% 20% 10% Click Here For Next Slide

  34. The End

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