OVARIAN TUMORS

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 factor
A 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 population
Her life time risk approx. 5%
5-10% of ov.ca are linked to identifiable, inherited
mutations in certain genes
Families 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 1015% 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

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Ovarian Cancer

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