Flashcards in B18. Radiotherapy, surgical, and pharmacological treatment of uterine tumors Deck (11):
Which is the most important form of curative treatments for uterine tumors
Surgery, must be attempted in every case. Survival is worse with monotherapeutic (definitive) radiotherapy
What is the surgery option for uterine tumors
Hysterectomy usually paired with a salpingo-oophorectomy (ovaries and fallopian tubes)
What to do if the patient is younger that 40 years of age or if the tumor is well differentiated or of early infiltration.
The resection of ovaries might not be necessary but fallopian tubes need to be resected in order to decrease risk of ovarian cancer
When are the lymph nodes removed with endometrial carcinoma?
-In case of high risk tumors (stage 1b or higher)
-If the tumor infiltrates the endometrium deeper than 50%
-Tumor is grade 3
-Clear cell type
When is it appropriate to give radiotherapy for uterine tumors? Indications?
Postoperative EBRT. Indication include
-The infiltration of the myometrium
-The mitotic rate of the tumor
-Tumor differentiation (grading)
-and the number/status of dissected lymph nodes
Where are most of the local recurrences of uterine tumors? What is the treatment? For which stage?
Most often the recurrence is in the vagina so brachytherapy is needed for Stage I/A G3, I/B 1-2 and higher.
When to give preoperative radiotherapy for endometrial carcinoma? How is radiotherapy given?
If the endomterial tumor has spread to the cervix (stage II), or in the case of a histological type with poor prognosis (adenocarcinoma, G3, clear-cell carcinoma) then brachytherapy is given
When to give chemotherapy in endometrial carcinoma
-If patient is less than 40 years old
-has not yet given birth
-tumor is early invasion and well-differentiated (G1)
-tumor is confined to the endometrium
-hormone receptor positive
When is the neoadjuvant therapy given in endometrial carcinoma?
-if the tumor has disseminated (locally advanced and metastatic).
-pt is inoperable and the tumor is hormone receptor positive, then hormone therapy like progesterone is considered
When is adjuvant chemotherapy given?
-Tumorous lymph nodes
-Aggressive histological subtype (I.e. serous-papillary or clear cell endometrial cancer