Glomerular Filtration rate and its determinants.pptx
Â
05052008OvarianTelehealth
1. Ovarian Cancer Treatment & Management Karen A. Zempolich, M.D. Monarch Women’s Cancer Center Utah Cancer Action Network May 5, 2008
2.
3.
4.
5. Ovarian Cancer: Risk Factors Hysterectomy/Removal of Both Ovaries Personal breast cancer history Infertility / low parity Pregnancy and Breastfeeding Family history Oral Contraceptives (50% decrease) Age Decrease Increase
6.
7.
8.
9.
10.
11.
12.
13. Ovarian Carcinoma Comprehensive surgical treatment- Hospital Goff et al, Cancer 2007 57% Low (1-9) Annual cases 69% Urban 56% Large rural 46% Small rural Location 74% High (>20) 69% Medium (10-19) Rate of Comprehensive Surgery
14. Ovarian Carcinoma Comprehensive surgical treatment- Surgeon Goff et al, Cancer 2007 55% Very Low (1) Annual cases 76% Gyn Onc 37% OB/ Gyn (Maine only) 38% Gen Surgeon Location 75% High (>10) 65% Medium (2-9) Rate of Comprehensive Surgery
15. Ovarian Carcinoma Comprehensive surgical treatment- Patient Goff et al, Cancer 2007 0.54 (0.41-0.72) >80 0.79 (0.64-0.97) 71-80 0.88 (0.74-1.05) 61-70 1.07 (0.92-1.26) 51-60 1.00 21-50 Age OR (95% CI)
16. Ovarian Carcinoma Comprehensive surgical treatment- Patient Goff et al, Cancer 2007 0.66 (0.44-0.99) Asian/ Islander 0.76 (0.60-0.95) Hispanic 0.66 (0.52-0.83) African American 1.00 Caucasian Race OR (95% CI)
17.
18. Ovarian Carcinoma Primary Management—Debulking Baker et al, Cancer 1994 13% > 2 cm 20% 1 to 2 cm 50% < 1 cm 5 yr survival Residual Disease
19. Ovarian Carcinoma Primary Management—Debulking Hacker N, Ob & Gyn 1983 6 months > 1.5 cm 18 months 0.5 to 1.5 cm 40 months < 0.5cm Median survival Residual Disease