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OVARIALCANCER – ÖKAD KUNSKAP OM
BIOLOGI OCH GENETIK SKRIVER OM
KARTAN
KARIN SUNDFELDT1,
1INSTITUTE OF CLINICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY,
SAHLGRENSKA CANCER CENTER, UNIVERSITY OF GOTHENBURG, S-41345 GOTHENBURG,
SWEDEN.
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Disclosure Information
Karin Sundfeldt
I have
I have no financial relationships to disclose.
I will not discuss off label use and/or investigational use in
my presentation.
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Heterogen cancersjukdom
•
Adenocarcinoma
•
5 histological phenotypes
•
•
•
•
•
•
60%
15%
12%
8%
5%
Microscopic resemblance to
•
•
•
•
Karst and Drapkin reviewed 2010
Serous
Mucinous
Endometrioid
Clear cell
Undifferentiated
90%
Fallopian tube
Gastrointestinal tract
Endocervical epithelium
Endometrium – uterus
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Ovarialcancer – Ny indelning – Typ 1 och 2
• FIGO 2014
– Serös ovarialcancer delas upp i 2 sorter
– Låggradig (low grade) och höggradig (high grade)
• Svensk förening för patologi (SvFP)
– Kvalitets- och standardiseringskommittén (KVAST)
11-2015
– Typ 1 (låggradiga) och Typ 2 (höggradiga)
20%
80%
Robert Kurman and Le-Ming Shih 2004
20%
80%
Robert Kurman and Le-Ming Shih 2004
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STIC – Serös tubar Intraepitelial neoplasi
HGSC
High-grade serous
Modified from Le-Ming Shih,
Johns Hopkins, Baltimore,
USA
Kindelberger DW et al. Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: Evidence
for a causal relationship. Am J Surg Pathol. 2007
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Opportunistisk Salpingektomi
Vetenskapligt bevisat – Har det effekt/nytta för patienten
• 2008 Brittish Colombia ovarian cancer research team
(OVCARE) cancer prevention strategy.
• In September 2011, the The Society of Gynecologic Oncology of
Canada (GOC) endorsed OVCARE’s cancer prevention strategy
by issuing a statement recommending that “physicians discuss
the risks and benefits of bilateral salpingectomy with patients
undergoing hysterectomy or requesting permanent, irreversible
contraception,” and that an “ovarian cancer prevention
(research) study focused on fallopian tube removal is a GOC
priority.” www.g-o-c.org
