Saturday, April 03, 2021

Cancer Survival Rates

This is a quick post about one a very important frequently tested fact in the exam i.e. five year survival rates of different stages of gynaecology cancers. Recently there have been questions for the one year survival rates as well. I have compiled the rates in the form of tables for quick review.

I hope this is helpful.

Visit cancer research UK for updated information Click Here




Cervical Cancer


Overall 5 year survival 60%

Overall 1 year survival 80%


Stage

5 Yr Survival 

1 Yr Survival 

I

79%

96%

II

47%

92%

III

22%

75%

IV

7%

50%


Endometrial Cancer


Overall 5 year survival 77%

Overall 1 year survival 89%


Stage

5 Yr Survival

1 Yr Survival

I

76%

99%

II

56%

95%

III

30%

83%

IV

10%

46%


Ovarian Cancer


Overall 5 year survival 43%

Overall 1 year survival 72%


Stage

5 Yr Survival

1 Yr Survival

I

93%

98%

II

67%

89%

III

27%

73%

IV

13%

53%


Vulval Cancer


Overall 5 year survival 65%

Overall 1 year survival 86%


Stage

5 Yr Survival

1 Yr Survival

I

86%

96%

II

74%

89%

III

54%

78%

IV

15%

43%


According to groin node status 5 yrs survival

Groin Node Negative

92%

ipsilateral

75%

bilateral

30%

>2 nodes

25%

>6 nodes

0%


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Lynch Syndrome

Thursday, April 01, 2021

Lynch Syndrome

This post is about one of an important condition, we come across in gynaecology oncology and that is Lynch Syndrome. Recently there has been evidence found for it to be strongly associated with endometrial and ovarian cancer. NICE recommends to screen all women with endometrial cancer for Lynch syndrome. The points are taken from a recently published TOG which is free access.

To download the original article: Click Here

For infographic: Click Here



Introduction

  • Lynch syndrome (LS) → an autosomal dominant inherited condition
  • Predisposes to cancers which include colorectal, endometrial & ovarian
  • Most affected 95% people are unaware of their risk
  • Gynecological cancer → often the first cancer diagnosis in women

Epidemiology

  • Exact prevalence → unclear 1:278 to 1:440
  • LS is the most common inherited cancer predisposition syndrome 
  • Around 3% endometrial cancers are due to LS prognosis very good 10-yr survival ≥90%
  • Association with ovarian cancer less clear 1-2%
  • NICE recommends universal screening of individuals with colorectal cancer and endometrial cancer
  • Degree of penetrance, disease spectrum and age of cancer onset variable

Lynch Syndrome

  • Arises from inherited mutations in genes encoding proteins of highly conserved DNA mismatch repair (MMR) system MLH1, MSH2, MSH6 & PMS2
  • MMR system maintains genomic stability
  • Without functioning MMR→ uncorrected mutation rate by 1000-fold

How does it happen?

  • One pathogenic allele of an MMR gene is inherited & once second allele acquires somatic inactivating mutation→ as MMR system is non-functional which leads to widespread genomic instability as errors which occur during replication can not be corrected
  • Hypermutation leads to carcinogenesis
  • Incidence of endometrial cancer in (MSH6 = MLH1 & MLH2) > PMS2