Which Histopathologic Subtype of Ovarian Cancer is Most Common?

Which Histopathologic Subtype of Ovarian Cancer is Most Common?

September 1, 2017

Do you know which histopathologic subtype of ovarian cancer is most common? Or the appropriate management of a patient with clear cell carcinoma confined to the left ovary? Take this quiz to test your knowledge on the management of ovarian cancer.

Do you know which histopathologic subtype of ovarian cancer is most common? Or the appropriate management of a patient with clear cell carcinoma confined to the left ovary? Take this quiz to test your knowledge on the management of ovarian cancer.

Question 1

Answer and Question 2 on Next Page »

Answer

D. Malignant epithelial tumors. Ovarian neoplasms consist of several histopathologic entities and treatment depends on the specific tumor type. Epithelial ovarian cancer comprises the majority (90%) of malignant ovarian neoplasms.

Reference: Kurman RJ, Carcangiu ML, Harrington CS, et al. WHO classification of tumors of female reproductive organs, 4th edition. WHO/IARC Classification of tumors. Vol 6. Lyon:IARC Publications; 2014.

Question 2

Answer and Question 3 on Next Page »

Answer

C. Adjuvant chemotherapy with taxane/carboplatin 3–6 cycles. Clear cell carcinoma is a subtype of epithelial ovarian carcinoma with a high incidence of stage I presentation. Recurrences are more frequent with this subtype. The clinical management includes maximal cytoreduction and platinum plus paclitaxel–based chemotherapy. Ovarian clear cell carcinomas have poor response rates to platinum-based regimens, which may be related to the intrinsic chemoresistance of these tumors. Despite their aggressive clinical course, clear cell carcinomas are still treated similarly to other epithelial ovarian cancers. The rarity of these tumors prevents the conduction of randomized studies.

Reference: Pectasides D, Pectasides E, Psyrri A, Economopoulos T. Treatment issues in clear cell carcinoma of the ovary: a different entity? Oncologist. 2006;11:1089-94.

Question 3

Answer and Question 4 on Next Page »

Answer

C.Combination of intraperitoneal and intravenous taxane and platinum. Based on the results of several randomized phase III trials a combination of intravenous and intraperitoneal chemotherapy has been shown to convey a significant survival advantage among women with optimally debulked epithelial ovarian cancer compared to intravenous administration alone. The three largest studies with the greatest survival advantage delivered cisplatin 100 mg/m2 intraperitoneally. The two most recent trials also included taxanes.

Reference: Chan DL, Morris DL, Rao A, Chua TC. Intraperitoneal chemotherapy in ovarian cancer: a review of tolerance and efficacy. Cancer Manag Res. 2012;4:413-22.

Question 4

Answer and Question 5 on Next Page »

Answer

B. Delay treatment until clinical relapse. Results of a multi-institutional European trial on the utility of CA 125 in monitoring ovarian cancer after completion of primary therapy have previously reported by the Society of Gynecologic Oncology. Women with relapsed ovarian cancer did not live longer if chemotherapy was started earlier based on a rising CA 125, as opposed to delaying treatment until symptoms developed. It was found that the group undergoing CA 125 monitoring received 5 more months of chemotherapy overall, whereas quality of life measures were higher in women who were treated at the time of clinically evident recurrence.

Reference: Clarke T, Galaal K, Bryant A, Naik R. Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev. 2014;(9):CD006119.

Question 5

Answer on Next Page »

Answer

B. Fertility sparing surgery and resection of residual disease. Surgery is the primary treatment of borderline epithelial tumors including standard ovarian cancer debulking surgery or fertility sparing surgery.

Reference: Harter P, Gershenson D, Lhomme C, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian tumors of low malignant potential (borderline ovarian tumors). Int J Gynecol Cancer. 2014;24(9 suppl 3):S5-S8.