P

p53 tumor suppressor gene mutations in pathogenesis, 23f, 24, 24f as prognostic factor, 13 in type I vs. type II tumors, 22t Paclitaxel for advanced ovarian carcinoma, 155f, 157, 158f intraperitoneal, 158, 158f maintenance, 159 for clear cell carcinoma, 151f for early-stage cancer benefits of, 153t choice of, 150-151, 151f intraperitoneal, 152, 152t for germ cell tumors, 216

for recurrent ovarian cancer, 166t, 167f, 168, 168t, 169 Palliative surgery, 125-127 Papillary projections, imaging of, 71

PARP (poly-AD-ribose polymerase) inhibitor, for recurrent and resistant ovarian cancer, 175 Pathogenesis, of ovarian cancer, 52-53 Patient characteristics, as prognostic factors, 9-10 Peak systolic velocity (PSV), on spectral Doppler, 65-67 Pedigree, in genetic counseling, 47, 47f Pelvic resection, en bloc, 113-117, 114f, 115f, 116f Pelvic sidewall recurrence, 80-81 Peritoneal carcinomatosis, imaging of, 76, 76f PET. See Positron emission tomography (PET). Peutz-Jeghers syndrome (PJS), sex cord tumors with annular tubules in, 208-209 PI (pulsatility index), on spectral Doppler, 65-67 Platinum-based chemotherapy for advanced ovarian carcinoma, recommendations on, 155f

Platinum-based chemotherapy (Continued) for borderline tumors, 198 for clear cell carcinoma, 151f for early-stage cancer benefits of, 148, 148f, 148t, 153t choice of, 150-151, 150t, 151f intraperitoneal, 152, 152t evolution of, 156 for granulosa cell tumors, 205 for recurrent ovarian cancer combination vs. single-agent, 167-170, 167f, 168t, 169f considerations in selection of, 165, 165b goals of, 165, 165b vs. non-platinum regimen, 166, 166t, 167f reactions to, 166-167, 168, 168f, 169f reasons for not using, 166, 166b sequential delivery of, 170

treatment-free interval and response to, 164, 164f, 164t

Platinum-resistant ovarian cancer chemotherapy for, 174

chemoresistance and chemosensitivity testing in selection of, 175 potential agents for, 171b ongoing research on, 175-176 radiation therapy for, 174 recurrent vs., 163-165, 165b PLCO (Prostate, Lung, Colorectal and Ovarian) cancer screening trial, 92-93, 92t Ploidy, as prognostic factor, 13 Poly-AD-ribose polymerase (PARP) inhibitor, for recurrent and resistant ovarian cancer, 175 POMB-ACE regimen, for germ cell tumors, 216 Positive predictive value (PPV), 90

of transvaginal ultrasound, 91 Positron emission tomography (PET) for recurrent disease, 81-82, 82f for secondary cytoreduction, 186 for specific tumor characterization, 68-69, 69f for staging, 78, 78f PPV (positive predictive value), 90

of transvaginal ultrasound, 91 Predictive test, of chemoresistance and chemosensitivity, 175

Predictive values, of screening test, 89, 90 Predisposition syndromes. See Hereditary cancer predisposition syndrome(s). Prevalence, of ovarian cancer, 90 Prevention, 51-61 chemo-defined, 52

in general population, 53-54, 55t for women with increased risk, 55-56, 56t genetic predisposition and, 52, 53f pathogenesis and, 52-53 prophylactic surgery for defined, 52

in general population, 56-57, 57t in high-risk population, 57-60, 61t procedure for, 58, 58f-59f and risk reduction, 60-61, 61t Progesterone, for granulosa cell tumors, 205 Prognostic factor(s), 9-13 age as, 9-10 CA-125 as, 12-13

HER2/neu proto-oncogene amplification as, 13 histology and grade as, 10-11 p53 tumor suppressor gene mutations as, 13 patient characteristics as, 9-10

Prognostic factor(s) (Continued) ploidy as, 13

residual disease after cytoreductive surgery as, 11-12,

12f, 13t stage as, 9, 10b, 11f tumor biology as, 13 Prognostic test, of chemoresistance and chemosensitivity, 175

Prophylactic surgery for BRCA mutations, 42 defined, 52

in general population, 56-57, 57t for hereditary nonpolyposis colorectal cancer, 46 in high-risk population, 57-60, 61t procedure for, 58, 58f-59f and risk reduction, 132-133, 132f vs. screening, 102, 104, 104b Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial, 92-93, 92t Protective factors, for ovarian cancer, 4 Proteomic techniques, for screening, 96-101, 99t, 100t Pseudo-Meigs syndrome, 205-206

PSV (peak systolic velocity), on spectral Doppler, 65-67 PTEN mutations, in endometrioid carcinoma, 27 Pulsatility index (PI), on spectral Doppler, 65-67 PVB regimen, for germ cell tumors, 215

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