Over Cancer

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APPROACH TO SUSPECT OVER-TUBA-PERITONEAL CANCER

Often surgery for diagnosis in patients with ovarian-tuba-peritoneal cancer exploration is needed. Particularly in early stage patients, the removal of the tumor from disintegration will prevent the progression of the stage of the patient. Therefore, ovarian biopsy is not a recommended method to identify the disease.

In patients who are not suitable for surgical staging (prior to neoadjuvant chemotherapy due to the extent or general performance of the tumor) paracentesis, thoracentesis or tissue biopsies Suspicion of adnexal mass and demonstration by imaging is the most important part in the evaluation. Symptoms, laboratory findings and risk factors supporting clinical suspicion of malignancy. Transvaginal –transabdominal USG to describe adenxial mass abdoninopelvic tomography or magnetic resonance imaging. CA 125, HE4, CA19-9 can be used first as tumor marker. CEA to exclude adnexal metastasis from colon cancer In order to exclude tumors (germ cell-sex cord stromal), inhibin, LDH, hcg, AFP can be used.

Preoperative evaluation in patients suspected of over-tuba-peritoneal tumor by clinical examination, symptoms, tumor markers and imaging It should be done. During this assessment, the patient’s tolerance to staging surgery and the extent of the tumor should be evaluated. Sick if a possible If staging surgery will not benefit, biopsy from tumor tissue should be done and histopathological description should be made.

 

SURGICAL STAGING AND PROCEDURE

Over-tuba-peritoneal cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) 2013 staging system. This staging system, ovarian, tubal and peritoneal cancer staging in the same way and there is no difference in staging between histopathological subtypes

Total extrafacial hysterectomy, bilateral salpingo-oopherectomy, pelvic and paraaortic lymph node dissection, infracolic or infragastric omentectomy, abdominal washing fluid sampling is the standard staging procedure for ovarian-tuba-peritoneal cancer. Upper abdomen, all peritoneal surfaces, thin – thick evaluation of bowel mesentery should be added to the procedure. Appendectomy can also be added to the procedure.

Although laparotomy is generally used, laparoscopy can be performed in very special cases.

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