Kindly advise which course of chemotherapy to follow for the patient with following history: myomectomy-----2007 small rt. ovarian cyst was draind histopathalogical report-------no malignancy 6-7 months after surgery pt. felt rapidly growing mass in lower abdomen CT SCAN---CYST--10*9cm in diameter with 2-3cm irregular solid nodule inside mild hydronephrosis mild fatty liver CA125 62u/ml operated---cystectomy with Rt ovarotomy,cyst got ruptured during surgery Histopathological report--moderately differnciated adenocarcinoma of Rt ovary(grade II) Repeat histopathology report of same slide-----moderately differentiated adenocarcinoma of Rt ovary (gradeII)--at other institution CA125----decrease to 32 u/ml after surgery PET-CT---NO ABNORMALITY,nO PICK UP Scan---no abnormality Pt was reopened---oct.2009--Rt saphinggo-oopharotomy B/L PLND,supracolic omentectomy,RPLL,excision of node in sigmiod ,Bx from B/L dome of diaphram,peritonial washings were taken Histopathological report---moderately differentiated adenocarcinoma (grade 11)of rt ovary ramnent with sorroundig soft tissue involement omentum/nodes/nodules--- all free Chemotherapy----Received 3 courses of at 3 wkly interval with Paelitaxel 300 mg and carboplastin 400mg, last cycle on 19/12/2009 After 3 cycles--- Scan abdomen---lymphocele in rt side of abdomen.No other abnormality Scan lungs --Normal CA 125 ----88U/ml on 6/1/2010 CA 125----- 214U/ML------ 21 01 2010 USG Abd----solid nodule-2*3cm in lower rectus abdominus muscle No other abnormality FNAC---presence of malignant cells MRI Head and Neck-- insignificant 2010-22 jan.-----operated again panhysrtrectomy done and two nodules removed from anterior rectus muscle ,one on each side near incisiom. one node between uterus and rectum removed histopathological report----. Uterus---serosal deposits of 1.4 x1x0.4 cm deposits extends into myometrium Rt. rectus sheath node-- tumor deposits with tubuloglandular architechture.High grade nuclear cytology with focal mucinous differenciation.Tumour close to cut margin.cut margin is free Left rectus sheath nodule--- tumour deposits.Tumour abuts the cut margin Nodule on rectum----shows muscularis propria only CA 125 - 22.9 U/ mL Date 13.02.2010 (After Surgery) Please advise if we must follow the same chemotherapy or change the line? Thanks and regards,
Hi, As there the replace duration is more than six months, same chemotherapy is indicated. However, I am not sure from the details provided that she received only three cycles or after the response evaluation further three cycles were completed.