Embed Size (px)
Citation preview
/ /١٤٤٤ ٠٩ ٢٩
.AddarProfessorGyneoncologistOB/GYN Dept.KKUH and College of MedicineMKing Saud University
Professor Mohammed Hassan Addar
Introduction
It is the most lethal gynecological malignancy
>25,000 women in USA annually 14,000 deaths annually Incidence has increased by 30% over the
past decade Deaths from ovarian cancer increased by
18% 60% of patients present with advanced-stage
disease The overall survival rate is 38% at 5 years
Epidemiology
The etiologies of epithelial ovarian cancer are not known
Age The mean age at diagnosis is 59 years 15.7 per 100,000 women at age 40 years 54 per 100,000mwomen at age 79 years One women in 70 in the USA will develop
ovarian cancer Ov ca is a disease of postmenopausal
women, women with a family history of breast ca and ov.ca may be diagnosed with ov.ca up to 10 years earlier than the average women
Family history
The strongest risk factorA women with a single first-degree relative with ov.Ca has a relative risk (RR) of approximately 3.6 for developing ov.ca compared with general populationHer life time risk approx. 5%5-10% of ov.ca are linked to identifiable, inherited mutations in certain genesFamilies in which three or more first-degree relatives have ovarian or ovarian plus breast cancer are likley to have a cancer-susceptibility genetic mutation that is transmitted in an autosomal-dominant inheritance pattern
Family history
Three familial ovarian cancer syndromes: The site specific ovarian ov.ca syndrome # only ov.ca is seen # account for 10-15% of hereditary
ov.ca The hereditary breast/ovarian cancer
syndrome #associated with 65-75% of hereditary
ov.ca
Family history`
In the hereditary nonpolyposis colorectal cancer syndrome (HNPCC), affected individuals may have colon, endometrial, breast, ovarian or other cancers
HNPCC kindred's account for an additional 10-15% of hereditary ovarian cancer
The hereditary breast/ovarian cancer syndrome and perhaps less frequently the site –specific ovarian cancer syndrome are linked to mutations in the BRCA1 and BRCA2 genes
Ethnicity
Higher in white women Higher in north America and northern
Europe than Japan Difference related to genetics, diet, or
environmental exposure or a combination BRCA1 and BRCA2 genes are more
common among white women of Ashkenazi descent
Incidence of ov.ca is higher in countries with higher in countries with higher per capita consumption of animal fat
Reproduction factors
Nulliparous First childbirth after age 35 years Involuntary infertility Late menopause and early menarche RR (2.0-5.0) Pts. With prolonged period or
uninterrupted ovulation
Exogenous hormones
OCP decreased risk of epithelial tumors
RR 0.5 in 5 years or more users HRT
Hysterectomy Decrease the risk
Smoking no relation
Symptoms and Signs
Early stage asymptomatic 10-12 cm Bloating, abdominal discomfort,
pelvic pressure, urinary and rectal symptoms
Ascites , pleural effusion and shortness of breath
cashecsia
Ovarian Cancer
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
Ovarian Cancer
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
/ /١٤٤٤ ٠٩ ٢٩
