H

P-hCG (P-human chorionic gonadotropin), in germ cell tumors, 213 Hepatic metastases, resection of, 118, 118f Hepatocyte nuclear factor-1b, in clear cell carcinoma, 27 HER2/neu proto-oncogene amplification, as prognostic factor, 13

Hereditary breast and ovarian cancer (HBOC), 35-43 BRCA genes in, 5-7, 35-36, 37f features and risks of, 7t, 36-39 genetic testing for, 39-41, 39b, 40f, 41f and lifetime risk of ovarian cancer, 52, 53t screening and risk reduction for, 42-43 Hereditary cancer predisposition syndrome(s), 33-49 and autosomal dominant inheritance, 34-35, 35f epidemiology of, 33, 34f, 52, 53t genetic assessment for, 47 and DNA banking, 49 genetic counseling process in, 47-48, 47f and genetic discrimination, 48 of minors, 48 referral for, 39b, 49 hereditary breast and ovarian cancer as, 35-43 BRCA genes in, 5-7, 35-36, 37f

Hereditary cancer predisposition syndrome(s) (Continued) features and risks of, 7t, 36-39 genetic testing for, 39-41, 39b, 40f, 41f and lifetime risk of ovarian cancer, 52, 53t screening and risk reduction for, 42-43 hereditary nonpolyposis colorectal cancer as, 44-46 features and risks of, 44 genetic testing for, 44-46, 44b, 45b and lifetime risk of ovarian cancer, 52, 53t management of, 46 and prevention, 52 Hereditary nonpolyposis colorectal cancer (HNPCC), 44-46 features and risks of, 44 genetic testing for, 44-46, 44b, 45b and lifetime risk of ovarian cancer, 52, 53t management of, 46 and ovarian cancer, 7 High-risk population prophylactic surgery in, 57-60, 61t vs. screening, 102, 104, 104b screening for, 102-105 CA-125 and transvaginal ultrasound for, 103-105 vs. prophylactic surgery, 102, 104, 104b recommendations on, 102 Risk of Ovarian Cancer Algorithm in, 105, 105b UKFOCSS trial of, 105 HIPEC (hyperthermic intraperitoneal chemotherapy), for recurrent ovarian carcinoma, 188-189 Histology, as prognostic factor, 10-11 HLA-G (human leukocyte antigen G) overexpression, in carcinogenesis, 22t, 25 HNPCC. See Hereditary nonpolyposis colorectal cancer (HNPCC).

Hormonal therapy, for granulosa cell tumors, 205 Hormone replacement therapy in BRCA mutation carriers, 42-43 and ovarian cancer, 4-5, 6t P-Human chorionic gonadotropin (P-hCG), in germ cell tumors, 213

Human leukocyte antigen G (HLA-G) overexpression, in carcinogenesis, 22t, 25 Hyperthermic intraperitoneal chemotherapy (IPHC, HIPEC), for recurrent ovarian carcinoma, 188-189 Hysterectomy for advanced-stage epithelial cancer, 113, 114 for borderline tumor, 197 for granulosa cell tumors, 202 prophylactic for BRCA mutations, 42

for hereditary nonpolyposis colorectal cancer, 46

in high-risk population, 58-59

for risk reduction in general population, 57, 57t

ICON-3 (International Collaborative Ovarian Neoplasm 3) trial, 157

ICON-4 (International Collaborative Ovarian Neoplasm 4) trial, 168

IHC (immunohistochemistry) analysis, in hereditary nonpolyposis colorectal cancer, 45

Imaging, 63-82

overview of role of, 63-64 for recurrent disease, 79-82, 79f, 80f CT for, 79-81, 79f FDG-PET for, 81-82, 82f MRI for, 79-81, 79f, 80f

Imaging (Continued) for screening, 64-65 for secondary cytoreduction, 185-186 for specific tumor characterization, 70-76 ancillary findings in, 71 of clear cell carcinomas, 71, 71f of collision tumor, 74-75 CT for, 68 of dysgerminoma, 72 of endometrioid carcinomas, 71-72, 72f of epithelial tumors, 70-71, 70f FDG-PET for, 68-69, 69f of fibrous tumors, 73-74, 73f, 74f of granulosa cell tumors, 73 of metastasis to ovaries, 75-76, 75f MRI for, 66f, 67-68 papillary projections in, 71 of sex cord-stromal tumors, 73 of teratoma immature, 72 mature, 71-72, 72f ultrasound for, 65-67, 66f for staging, 76-79 CT for, 77-78 distant metastases in, 77 FDG-PET for, 78, 78f fused PET-CT for, 78 intraperitoneal dissemination in, 76, 76f lymph node metastases in, 76-77 MRI for, 77-78 Immunohistochemistry (IHC) analysis, in hereditary nonpolyposis colorectal cancer, 45 Immunostaining, for screening, 97f Implants, of borderline tumors, 194 In vitro fertilization (IVF), and ovarian cancer, 4 Incidence, of ovarian cancer, 1

by race, 3, 3t Infertility, as risk factor for ovarian cancer, 4 Inhibin, in granulosa cell tumors, 204 International Collaborative Ovarian Neoplasm 3 (ICON-3) trial, 157

International Collaborative Ovarian Neoplasm 4 (ICON-4) trial, 168

International Federation of Gynecology and Obstetrics

(FIGO) staging system, 9, 10b, 11f Interval cytoreduction, 122-123, 123t, 124f Intraoperative frozen section analysis of, 131-132 of borderline tumor, 196-197 Intraperitoneal (IP) chemotherapy for advanced ovarian carcinoma, 155f, 158-159, 158f for early ovarian carcinoma, 152, 152t, 153f, 153t hyperthermic, for recurrent ovarian carcinoma, 188-189

Intraperitoneal (IP) dissemination, imaging of, 76, 76f IPHC (hyperthermic intraperitoneal chemotherapy), for recurrent ovarian carcinoma, 188-189 Irinotecan, for clear cell carcinoma, 151f IVF (in vitro fertilization), and ovarian cancer, 4

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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