Disease Overview
ovariancarcinomaisfemaleslife殖systemthe most commonmalignant tumorone of，rankinggynecologicalmalignant tumordeathrate首position。itscharacteristicsasearly-stagesymptomsinsidious，approximately70%patientsconfirmed diagnosistimeAlready classified asadvanced-stage(Ⅲ-Ⅳstage)，thus known as"SilentofKiller"。ovarianmalignant tumorincludingmultiplepathologicaltype，itsinepithelial carcinomamostcommon(approximately80%)，secondismalignant germ cell tumors(approximately10%)andsex cord-stromal tumors(approximately5%)。ovarianpositioninpelvicdeepregion，early-stagelesionnoteasyfound，at diagnosismoreHas developedlifeperitoneal cavitytype植metastasis，prognosis相forrelativelyPoor,5yearsurvival rateapproximately30%-50%。
Major Causes
Genetic factors：approximately20%-25%ovariancarcinomapatientshavefamily history，BRCA1/2gene突changeCarrierthoseonelifein发lifeovariancarcinomaofAccumulationriskminuteReaching up to54%and23%，ismost importantofgenetictypehigh-riskdue toelement。in addition，Lynch syndrome、Li-Fraumeni syndromeetc.alsoandovariancarcinoma发diseaserelated。
Endocrine factors: Nulliparous, infertilefemalesincidence riskrelativelyhigh, Pregnancycancan具haveprotecteffect. Early menarche(<12years old), Late menopause(>55years old)increasingrisk。
Environmental factors：long-termenablingusingoral contraceptives、hormone replacement therapycancanincreasingrisk。High-fat diet、Obesityalsoisrelateddue toelement。
Age and ethnicity：peak age of onset50-60years old，differenttype族incidenceexistin差different。
Common Symptoms
early-stagesymptoms：typicallynosignificantsymptoms，oronlyhavenon-特differenttypeabdominaldiscomfort、abdominal distension、digestiveadverse，easybyOverlooked.
progressive-stagesymptoms：
abdominal distension、abdominal pain：persistentorprogressiveaddheavyofunderabdominaldiscomfortfeel。
abdominalmass：gynecologicalexaminationtimecan触andpelvicmass。
ascites：extensiveascitescausingAbdominal girthrapidlyincreaselarge。
digestive道symptoms：food欲underdecrease、nausea、vomiting、constipationordiarrhea。
systemicsymptoms：emaciation、fatigue、feveretc.。
metastasissymptoms：thoracic cavity积fluid(dyspnea)、hepaticmetastasis(jaundice、ascites)、bonemetastasis(bone pain)etc.。
Pathological Classification
epithelial carcinoma(accounting for80%-85%)：
serous carcinoma：most common type，approximately20%-25%，bilateralmoreObserved.
mucinous carcinoma：approximately10%，unilateralmoreObserved.
endometrioid carcinoma：unilateralmoreObserved.
clear cell carcinoma：degree of malignancyrelativelyhigh。
undifferentiated carcinoma：relatively poor prognosis。
malignant germ cell tumors(accounting for10%)：
dysgerminoma、yolk sac tumor、immature teratomaetc.，more见inyearlightfemales。
sex cord-stromal tumors(accounting for5%)：
granulosa cell tumor、thecomaetc.，canproducetype激element。
Clinical Staging(FIGO 2018)
Ⅰstage：Tumor confined toovarianorfallopian tube
ⅠAstage：Tumor confined toone侧ovarian，intact capsule，no tumor on ovarian surface，no cancer cells found in ascites or peritoneal washings。
ⅠBstage：Tumor confined tobilateralovarian，intact capsule，no tumor on ovarian surface，no cancer cells found in ascites or peritoneal washings。
ⅠCstage：ⅠAorⅠBstagelesion，butcapsule rupture、ovariansurfacehavetumororcancer cells found in ascites/washings。
Ⅱstage：tumor累andone侧orbilateralovarianorfallopian tube, Accompanied bypelvic spread(inbelow the pelvic brim)
ⅡAstage：tumorSpreads toortype植touterusand/orfallopian tube。
ⅡBstage：tumorSpreads tootherpelvicinternaltissue(such asbladder、rectum)。
Ⅲstage：tumor累andunilateralorbilateralovarian、fallopian tubeorprimaryperitoneumcarcinoma, Accompanied byhavecellsortissueconfirmofpelvicexternalperitoneummetastasisand/orregionallymph nodesmetastasis。
ⅢAstage：microscopically confirmedofpelvicexternalperitoneummetastasis。
ⅢBstage：grossly visibleofpelvicexternalperitoneummetastasislesionmaximum diameter≤2cm。
ⅢCstage：grossly visibleofpelvicexternalperitoneummetastasislesionmaximum diameter>2cm，and/orregionallymph nodesmetastasis。
Ⅳstage：tumormetastasistoperitoneal cavityexternaloforgantissue
ⅣAstage：thoracic cavity积fluidinhavecarcinomacells，orhepaticsurfacemetastasis。
ⅣBstage：distantorgansolidmetastasis(such aspulmonary、hepatic、peritoneumexternallymph nodesetc.)。
Diagnosis
Tumor markers：CA125(mostnormalusing)、HE4(特differenttyperelativelyhigh)、CEA、AFP(life殖cellstumor)。
Imaging studies: Viavaginalultrasound、pelvicMRI、abdominalCTassessmenttumorextentandmetastasis。
pathologicalexamination：surgeryorpuncture biopsyconfirmed diagnosis。
minimally invasive interventional therapycombinedhyperthermia，achieve“Uterus-preservingtumor control” bilateralgoal
Department of Oncology, Shenzhen Huaqiao HospitalofMDTteamindetailedassessment杨Ms.ofconditionposterior，asitsdevelopedtypeoftreatmentplan, Decidedadoptedminimally invasive interventional therapyembolizationcombinedtumor hyperthermiaofinnovativetreatmentplan：
tumor科DirectorProfessor Dong Wenguangintroduced: “traditionalConceptbelieved，ovariancarcinomapatientsiftumorrelativelylargeand伴havebleeding，total hysterectomyisrelativelyasInsuranceoftreatmentmethod。butforyearlightpatientswhileSpeaking,preservingorganfunctionandquality of lifesame样important。minimally invasive interventional therapytechnologycandirectlyeffectinlesion，canwithinpreservinguterusofmeanwhile，precisecontroltumor。this‘green treatment’model，persist‘minimizing damage to normal human tissue while maximizing tumor cell destruction’ofconcept，asearly-stageovariancarcinomapatientsStrive for ‘uterus preservation’ofopportunity.”
minimally invasive interventional therapytechnologythroughinimagingequipmentofguidanceunder，willSpecially designedofcatheter、guidewireetc.Precisioninstrumentsintroducing人body，directlyto达tumorlesion。Professor Dong Wenguangadvanceone步explainedSaid: “wethroughcatheterwillembolizationMaterialsinjectedtumorfeeding artery，blocktumorofbloodSupply,fromwhileinhibittumorcellsofgrowthandcomplexReproduction.meanwhile，alsocanwiththroughcatheterinjectedchemotherapydrug，allowingdrugdirectlyeffectintumorregionposition，improvetreatmenteffect，reduceforsystemicofside effects.”thisprecision striketumorofmethod, Mutuallyrelativelyintraditionalsurgery, Possesseshavetraumasmall、recoveryfastofsignificantadvantage。
andthismeanwhile，tumor hyperthermiaalsoasovariancarcinomaoftreatmentprovidenewofApproach.tumor hyperthermiaisutilizing理energyin人bodytissueinproducethermal effect，enablingtumortissuetemperaturedegreeupper升toeffectivetreatmenttemperaturedegree，andmaintainone定timeInterval, reachingtoalreadycanenablingtumorcellsapoptosis、againnotdamagenormal tissueof目of。Professor Dong Wenguangpointed out: “hyperthermiaistumortreatmentof‘fifth major therapy’,itsandminimally invasive interventional therapytechnologyofsynergisticeffectcanachieve1+1>2ofeffect。normal tissuedue tovascularsystemperfection，dispersehotcan力strong，whilecarcinomacellsmetabolismDisorder,dispersehotPoor,precise控temperaturecanchoicetypekilltumorcells.”inminimally invasive interventional therapytechnologyblocktumorbloodSupplyposterior，tumor hyperthermiacanwithadvanceone步killresidualoftumorcells，fromwhileachievemoreprecise、moreeffectiveoftreatment。
Prevention and Follow-up
geneticConsultation:havefamily historythoserecommendedperformedBRCAgenetic testing。
oral contraceptives：long-termenablingusingthoseRequires weighingrisk。
screening：recommendedhigh-riskpopulation(BRCA突changeCarrierthose)regularlyperformedpelvicexamination、CA125andultrasoundcombinedscreening。
follow-up：after treatmentfirst 2 yearsevery 3-6 monthsfollow-up examinationonce，years 3-5every 6 monthsonce，after 5 yearsannuallyonce。