••• Chapter 46^ Epithelial and Nonepithelial Ovarian Tumors^459
❍ Surgical staging for ovarian cancer should involve what surgical steps?
Submitting any free fluid for cytology (or peritoneal washings), a systematic exploration of all intra-abdominal
surfaces and viscera, biopsy of multiple intraperitoneal sites, biopsy of the diaphragm, infracolic omentectomy, and
pelvic and para-aortic lymph node dissection.
❍ What percentage of patients with an ovarian epithelial cancer that appears to be confined to the ovary has
occult metastasis?
Approximately one-third of patients with early stage ovarian epithelial cancer will be upstaged following
comprehensive staging with 75% being restaged as having stage III disease.
❍ What are the theories to support the use of cytoreductive surgery for women with an advanced epithelial
ovarian?
Physiologic benefits include alleviation of nausea and early satiety, restoration of adequate intestinal function,
and improvement in nutritional status. Improved tumor perfusion and increased growth fraction are additional
theoretic benefits.
❍ What is the principal treatment of low malignant potential ovarian tumors?
Surgical resection alone.
❍ What is the chemotherapeutic treatment regimen of choice for patients with advanced epithelial ovarian cancer?
A combination of platinum and taxane.
❍ Which chemotherapy regimen recently showed a significant survival benefit among women with optimally
debulked epithelial ovarian cancer with a 65.6-month median survival?
A regimen consisting of intraperitoneal cisplatin and paclitaxel and intravenous paclitaxel demonstrated the longest
survival data from a randomized trial in advanced ovarian cancer.
❍ Nonepithelial tumors of the ovary account for what percentage of all ovarian cancers?
10%.
❍ In the first two decades of life, what percentage of ovarian tumors are germ cell?
70%
❍ Germ cell tumors commonly secrete what two hormones?
Alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG).
❍ What are the different histologic types of germ cell tumors?
(1) Dysgerminoma.
(2) Teratoma.
(3) Endodermal sinus tumor.
(4) Embryonal carcinoma.
(5) Polyembryoma.
(6) Choriocarcinoma.
(7) Mixed forms.