Ovarian Tumors, November 26, 2004

Ovarian Tumors, November 26, 2004

Among benign ovarian tumors, ovarian cysts are the most common, typically classified as serous cystadenomas, mucinous cystadenomas, and corpus luteum cysts, accounting for about 90% of all benign ovarian tumors. Peritoneal mucinous tumors often arise secondary to ruptured ovarian cysts.

Ovarian cancer is the third most common gynecological malignancy, following cervical and uterine cancers. Approximately 35% of ovarian cancers originate from serous cystadenomas, while 5–10% stem from mucinous cystadenomas. Additionally, endometrioid carcinoma accounts for 10% of ovarian cancers, and clear cell carcinoma also makes up 10%. Benign teratomas and germ cell tumors have a malignant transformation rate of less than 4%.

Secondary ovarian tumors can metastasize from the gastrointestinal tract, breast, uterus, fallopian tubes, and other sites. Krukenberg tumor is a special type of metastatic tumor originating from the gastrointestinal tract.

Staging of ovarian cancer:

Stage I: Tumor confined to the ovary.

Ia: Unilateral, capsule intact, no ascites.

Ib: Bilateral, capsule intact, no ascites.

Ic: Unilateral or bilateral, capsule breached.

Stage II: Associated with pelvic spread.

IIa: Involvement of uterus and fallopian tubes.

IIb: Involvement of other pelvic tissues.

IIc: Presence of ascites containing malignant tumor cells.

Stage III: Metastasis to extra-pelvic organs.

IIIa: Histologically confirmed peritoneal surface metastasis.

IIIb: Histologically confirmed peritoneal lymph nodes ≤2cm.

IIIc: Histologically confirmed peritoneal lymph nodes >2cm.

Stage IV: Enlarged inguinal lymph nodes.

Chemotherapy: CTX, TSPA, DDP, ADM, CBP.

CTX regimen: CTX 800mg, once weekly, TSPA 20mg intravenously, every other day, eight sessions per cycle, total dose not exceeding 300mg.

FAC regimen: 5-FU 15mg/kg, ACD 6μg/kg, both administered intravenously for 1–5 days, CTX 400mg, every other day, four weeks per cycle. COA regimen: CTX 800mg, once weekly, VCR 2mg, once weekly, ACD 0.5mg, 1–3 times per week, one week per cycle.