Ovatian cancer , screening staging and investigations

1. Aparna.D.S
OVARIAN CANCER
GYNECOLOGY
Roll No - 9

2. .
INRODUCTION
.
STAGING
.
SCREENING
.
INVESTIGATIONS
.
RESOURCES
Table of contents
01
02
03
04
05

3. 01
Screening
Ovarian Cancer

4. 314,000
Women are diagonosed globally per year
WHY ?

5. Most common
cancer in the
world
Most common
cause of
Women are
in the risk
.
death .
7 th 8 th 1 in 78

6. Neptune is far
Tickets
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7. 02
STAGING
TNM Staging of Ovarian Cancer

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10. STAGE 1 : Confined to ovaries
One ovary Both ovaries
One or both ovaries
A B C
 C1 – Surgical spillage
 C2 – Before surgery
 C3– Malignant cells in Ascitic
fluid or peritoneal washing

11. STAGE 2 : PELVIC EXTENSION
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2A – Extension and / implants on
UTERUS AND FALLOPIAN
TUBE
2B – Extension to other pelvic organs

12. .
STAGE 3 – EXTRA PERITONEAL EXTENSION
3A: Positive retroperitoneal lymphnodes/
Micrometastasis beyond pelvis
A1:Positive lymphnodes only (metastatisis less
. than or more than 10mm
A2: Microscopic extrapelvic with or without
. nodal involvement
.

13. 3B: Macroscopic peritoneal metastasis
beyond pelvis up to 2 cm in greatesest
dimenslon,
3C: Macroscopic peritoneal metastasis
beyond pelvis up to 2 cm with extension
of tumour to capsule of liver and spleen

14. 4A :Pleural effusion with positive cytology
4B :Hepatic or splenic
parenchymal metastasis
to extra abdominal organs.
STAGE 4 : DISTANT METASTASIS

15. .

16. ABC DUBMASH / INTRA / EXTRA/
META

17. INVESTIGATIONS
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1. ULTASOUND
 Solid tumour
 Thick capsule
 Papilary projections
 Thick septum (> 5mm)
 Enlarged paraaortic nodes Ascitis
and metastasis can be evaluated

19. .
a. Carcino embroyonic antigen
b. Ca 125
c. Alfa feto protein
d. Placental alkaline phosphate
e. Alkaline phosphate
f . LDH
2 TUMOUR MARKERS
g. CA 19-9
h. Inhibin B

20. Ca 125
 It is a glycoprotein antigen
 Sensititivity Is very high
 Used for
EARLY DIAGONOSIS
RECURENCE
RESPONSE TO THERAPY
Differentiating BENINGN and MALIGNANT
 Also raised in abdominal TB and Endometriosis

21. DOPPLER ULTASOUND
 Pulsatality index - <1
 Resistance index - <0.4

22. .
FEATURES OF ADVANCED STAGE DISEASE

23. Guess who!
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