Gynecologic Cancers: Case 1 - Episode 9
Krishnansu S. Tewari, MD, FACOG, FACS says that s
ince this patient is platinum-sensitive, options include cisplatin, carboplatin, or oxaliplatin combined with either gemcitabine, pegylated liposomal doxorubicin, or topotecan. Although not FDA-approved for platinum- sensitive patients, bevacizumab at 15 mg/kg has been shown to improve PFS in platinum-sensitive patients in the OCEANS study when combined with carboplatin plus gemcitabine. Since she has had a long disease-free interval of 3 years and appears on imaging to only have surface liver metastasis and a solitary splenic nodule, a consideration for laparoscopy could be entertained with plans to perform a secondary cytoreductive surgery with or without heated intraperitoneal chemotherapy if limited disease is indeed encountered.
CASE 1: Epithelial Ovarian Cancer
Sarah W. is a 62-year-old Caucasian woman who works as a travel agent.
In June of 2013, the patient presented with bloating and abdominal distension. Prior medical history is notable for nulliparity, and medication-controlled hypertension.
In December of 2014, the patient presents for her 6-month evaluation with rising CA-125 level, mild abdominal distension and fatigue, and inability to work.