Iindidi / i-ovari / isigulana / i-ovarian-germ-cell-treatment-pdq

Inguqulelo yonyango lwe-Ovarian Germ Cell Tumors

Ulwazi ngokubanzi malunga nee-Ovarian Germ Cell Tumors

IINGONGOMA EZIPHAMBILI

• Ithumba lesibeleko se-Ovarian sisifo apho iiseli ezibi (zomhlaza) zenza intsholongwane (iqanda) iiseli ze-ovary.

• Iimpawu zesisu seentsholongwane zesibeleko kukudumba kwesisu okanye ukopha kwilungu lobufazi emva kokuyeka ukuya exesheni.

• Uvavanyo oluvavanya ii-ovari, indawo ye-pelvic, igazi, kunye nezicubu ze-ovari zisetyenziselwa ukubona (ukufumana) kunye nokufumanisa isifo se-ovarian germ cell.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona kunye nokhetho lonyango).

Ithumba lesibeleko se-Ovarian sisifo apho iiseli ezibi (zomhlaza) zenza intsholongwane (iqanda) iiseli ze-ovary.

Izidumba zeseli zeGerm ziqala kwiiseli zokuzala (iqanda okanye isidoda) somzimba. Iimvumba zentsholongwane yesibeleko zihlala zenzeka kumantombazana akwishumi elivisayo okanye kubafazi abancinci kwaye zihlala zichaphazela i-ovary enye.

Ii-ovari zizibini zamalungu kwinkqubo yokuzala yabasetyhini. Zikwisinqe, elinye kwicala ngalinye lesibeleko (umngxunya, ilungu elimile okwepeyari apho kukhula umbungu). Isibeleko ngasinye simalunga nobukhulu kunye nokumila kweamangile. Ii-ovari zenza amaqanda kunye neehomoni zabasetyhini.

I-Anatomy yenkqubo yokuzala yabasetyhini. Amalungu kwinkqubo yokuzala yabasetyhini afaka isibeleko, amaqanda, imibhobho yesibeleko, umlomo wesibeleko, kunye nelungu lobufazi. Isibeleko sinomaleko ongaphandle wemisipha obizwa ngokuba yi-myometrium kunye nelining yangaphakathi ebizwa ngokuba yi-endometrium.

Ithumba lesibeleko se-Ovarian ligama eliqhelekileyo elisetyenziselwa ukuchaza iintlobo ezahlukeneyo zomhlaza. Esona sifo siqhelekileyo sesibeleko se-ovari sibizwa ngokuba yi-dysgerminoma. Jonga ezi zishwankathelo zilandelayo ze- zolwazi malunga nezinye iintlobo zamathumba e-ovari:

• I-Ovarian Epithelial, iTropopian Tube, kunye nonyango lweCeritoneal Cancer

• Unyango lwe-Ovarian ephantsi enobungozi

Iimpawu zesisu seentsholongwane zesibeleko kukudumba kwesisu okanye ukopha kwilungu lobufazi emva kokuyeka ukuya exesheni.

Izilonda zentsholongwane yesibeleko kunokuba nzima ukuba zichongwe (ukufumana) kwangethuba. Rhoqo akukho zimpawu kumanqanaba okuqala, kodwa amathumba anokufumaneka ngexesha leemviwo zesibeleko (zokuhlola). Jonga ugqirha wakho ukuba unayo yezi zinto zilandelayo:

• Isisu esidumbileyo ngaphandle kokufumana ubunzima kwamanye amalungu omzimba.

• Ukopha kwilungu lobufazi emva kokuyeka ukuya exesheni (xa ungasayi exesheni).

Uvavanyo oluvavanya ii-ovari, indawo ye-pelvic, igazi, kunye nezicubu ze-ovari zisetyenziselwa ukubona (ukufumana) kunye nokufumanisa isifo se-ovarian germ cell.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwePelvic: Uvavanyo lwelungu lobufazi, umlomo wesibeleko, isibeleko, iityhubhu zesibeleko, ii-ovari, kunye neethanga. I-speculum ifakwe kwilungu lobufazi kwaye ugqirha okanye umongikazi ujonga kwilungu lobufazi kunye nomlomo wesibeleko ngeempawu zesifo. Uvavanyo lomlomo womlomo wesibeleko luqhele ukwenziwa. Ugqirha okanye umongikazi ukwengeza into enye okanye emibini ethanjisiweyo, iminwe egotyiweyo yesandla esinye kwilungu lobufazi aze abeke esinye isandla phezu kwesisu esisezantsi ukuva ubungakanani, imilo, kunye nokuma kwesibeleko kunye namaqanda. Ugqirha okanye umongikazi ukwangenisa umnwe othanjisiweyo, ofakwe iglavu kwi-rectum ukuze uve amaqhuma okanye iindawo ezingaqhelekanga.

Uvavanyo lwePelvic. Ugqirha okanye umongikazi ufaka i-lubricated, iiglavu zeminwe yesandla esinye kwilungu lobufazi kwaye ucinezela emazantsi esisu ngesinye isandla. Oku kwenzelwa ukuziva ubungakanani, imilo, kunye nokuma kwesibeleko kunye namaqanda. Ilungu lobufazi, umlomo wesibeleko, imibhobho yesibeleko, kunye nomqolo nawo ayajongwa.

• I-Laparotomy: Inkqubo yotyando apho kusikwa khona (ukusikwa) eludongeni lwesisu ukujonga ngaphakathi esiswini ukuba akukho zimpawu zezifo. Ubungakanani bokubanjwa kuxhomekeke kwisizathu sokuba kwenziwe i-laparotomy. Ngamanye amaxesha amalungu ayasuswa okanye kuthathwe iisampulu zeethishu ze zihlolwe ngemicroscope kukhangelwe iimpawu zesifo.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yicompography tomography, ikhompyuter yeTomography, okanye ikhompyuter ye-axial tomography

• Uvavanyo lwe-serum tumor marker: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu, izicwili, okanye iiseli zethumba emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo egazini. Oku kubizwa ngokuba kukuphawula amathumba. Inqanaba elonyukayo le-alpha fetoprotein (AFP) okanye i-chorionic gonadotropin (HCG) egazini inokuba luphawu lwe-ovarian germ cell tumor.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona kunye nokhetho lonyango).

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Uhlobo lomhlaza.

• Ubungakanani bethumba.

• Inqanaba lomhlaza (nokuba ichaphazela inxenye ye-ovary, ibandakanya i-ovary yonke, okanye isasazekile kwezinye iindawo emzimbeni).

• Indlela iiseli zomhlaza ezijonga ngayo phantsi kwemicroscope.

• Impilo yomguli ngokubanzi.

Izilonda zentsholongwane yesibeleko zihlala zinyangwa ukuba zifunyenwe kwaye zanyangwa kwangoko.

Amanqanaba ee-Ovarian Germ Cell Tumors

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo se-ovarian germ cell, kuvavanywa ukwenziwa ukufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwi-ovary okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa i-ovarian germ cell tumors:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

Emva kokuba kufunyaniswe isifo se-ovarian germ cell, kuvavanywa ukwenziwa ukufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwi-ovary okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwe-ovary okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Ngaphandle kokuba ugqirha uqinisekile ukuba umhlaza usasazekile ukusuka kwii-ovari ukuya kwamanye amalungu omzimba, kwenziwa utyando olubizwa ngokuba yi-laparotomy ukuze kubonwe ukuba umhlaza usasazekile na. Ugqirha kufuneka asike esiswini kwaye ajonge ngononophelo kuwo onke amalungu ukuze abone ukuba unawo na umhlaza kuwo. Ugqirha uya kunqunqa izicwili ezincinci ukuze zijongwe phantsi kwemicroscope xa zineempawu zomhlaza. Ugqirha unokuhlamba isisu esiswini kunye nolwelo, olujongwa phantsi kwemicroscope ukubona ukuba inazo iiseli zomhlaza kuyo. Ngokwesiqhelo ugqirha uya kuwususa umhlaza kunye namanye amalungu anomhlaza kuwo ngexesha le-laparotomy.

Uninzi lweemvavanyo ezisetyenziselwa ukufumanisa isifo se-ovarian germ cell cell zikwasetyenziselwa ukuqokelela. Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziselwa ukuqaphela:

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Uvavanyo lweTransvaginal ultrasound: Inkqubo esetyenziselwa ukuvavanya ilungu lobufazi, isibeleko, iityhubhu zesibeleko, kunye nesinyi. I-ultrasound transducer (iprobe) ifakwa kwilungu lobufazi kwaye isetyenziselwa ukubetha amaza esandi aphezulu (i-ultrasound) kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Ugqirha unokuchonga amathumba ngokujonga kwi-sonogram.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo ne-tumor njenge-tumor yokuqala. Umzekelo, ukuba ithumba le-ovarian germ cell lisasazeka esibindini, iiseli zesisu esibindini eneneni ziiseli zentsholongwane yomhlaza. Esi sifo sisifo se-metastatic ovarian germ cell tumor, hayi umhlaza wesibindi.

La manqanaba alandelayo asetyenziselwa i-ovarian germ cell tumors:

Inqanaba I

Kwinqanaba le-IA, umhlaza ufunyanwa ngaphakathi kwi-ovary enye okanye ityhubhu ye-fallopian. Kwinqanaba le-IB, umhlaza ufumaneka ngaphakathi kuwo omabini amaqanda okanye kwimibhobho yesibeleko. Kwinqanaba le-IC, umhlaza ufunyanwa ngaphakathi kwesinye okanye zombini ii-ovari okanye iityhubhu ze-fallopian kwaye enye yezi zinto ziyinyani: (a) i-capsule (isimbozo sangaphandle) se-ovary siphukile, (b) umhlaza ufumaneka kumphandle wangaphandle enye okanye zombini ii-ovari okanye i-fallopian tubes, okanye (c) iiseli zomhlaza zifunyenwe kwi-pelvic peritoneum.

Kwinqanaba I, umhlaza ufumaneka kwi-ovari enye okanye zombini. Inqanaba I lahlulwe laba ligaba IA, inqanaba IB, kunye nenqanaba IC.

• Isigaba IA: Umhlaza ufunyanwa ngaphakathi kwi-ovary enye.

• Isigaba IB: Umhlaza ufumaneka ngaphakathi kuwo omabini amaqanda.

• Isigaba se-IC: Umhlaza ufunyanwa ngaphakathi kwesinye okanye zombini ii-ovari kwaye enye yezi zinto ziyinyani:

• umhlaza ufumaneka nakumphezulu ongaphandle wenye okanye zombini ii-ovari; okanye

• I-capsule (isimbozo sangaphandle) se-ovary siphukile (siphukile); okanye

• iiseli zomhlaza zifunyanwa kulwelo lwe-peritoneal cavity (umzimba) oqulethe uninzi lwamalungu esiswini) okanye ekuhlambeni i-peritoneum (izicwili ezigubungele umngxunya we-peritoneal).

Inqanaba II

Kwinqanaba IIA, umhlaza ufunyanwa kwelinye okanye zombini ii-ovari okanye i-fallopian tubes kwaye isasazeke kwisibeleko kunye / okanye kwimibhobho yesibeleko kunye / okanye kwii-ovari. Kwinqanaba le-IIB, umhlaza ufumaneka kwelinye okanye zombini amaqanda okanye kwimibhobho ye-fallopian kwaye isasazekile kwikholoni. Kumhlaza wokuqala we-peritoneal, umhlaza ufumaneka kwi-pelvic peritoneum kwaye awusasazekanga apho usuka kwelinye ilungu lomzimba.

Kwinqanaba lesibini, umhlaza ufunyenwe kwelinye okanye kuzo zombini ii-ovari kwaye uye wasasazeka kwezinye iindawo zesisu. Inqanaba II lahlulwe laba linqanaba IIA, inqanaba IIB, kunye nenqanaba IIC.

• Isigaba IIA: Umhlaza usasazekile esibelekweni kunye / okanye kwimibhobho yesibeleko (iityhubhu ezinde ezibhityileyo ezidlula kuwo amaqanda ukusuka kumaqanda kuye esibelekweni).

• Isigaba IIB: I-Cancer isasazeke kwezinye izicubu ngaphakathi kwe-pelvis.

• Isigaba se-IIC: I-Cancer ifunyenwe ngaphakathi kwelinye okanye zombini ama-ovari kwaye isasazeka kwisibeleko kunye / okanye kwiibhubhu ze-fallopian, okanye kwezinye izicubu ngaphakathi kwesikhumba. Enye yezi zinto ziyinyani:

• umhlaza ufumaneka kumphezulu ongaphandle wesinye okanye zombini ii-ovari; okanye

• I-capsule (isimbozo sangaphandle) se-ovary siphukile (siphukile); okanye

• iiseli zomhlaza zifunyanwa kulwelo lwe-peritoneal cavity (umzimba) oqulethe uninzi lwamalungu esiswini) okanye ekuhlambeni i-peritoneum (izicwili ezigubungele umngxunya we-peritoneal).

Ubungakanani beethumba zihlala zilinganiswa ngeesentimitha (cm) okanye ii-intshi. Ukutya okuqhelekileyo okunokusetyenziselwa ukubonisa ubungakanani bethumba nge-cm kubandakanya: ipea (1 cm), ipeanut (2 cm), umdiliya (3 cm), i-walnut (4 cm), ikalika (5 cm okanye 2) I-intshi), iqanda (i-6 cm), ipesika (i-7 cm), kunye ne-grapefruit (i-10 cm okanye ii-intshi ezine).

Inqanaba III

Kwinqanaba le-III, umhlaza ufumaneka kwelinye okanye zombini ama-ovari kwaye usasazeke ngaphandle kwe-pelvis kwezinye iindawo zesisu kunye / okanye kwiindawo ezikufutshane. Inqanaba III lahlulwe laba linqanaba IIIA, inqanaba IIIB, kunye nenqanaba IIIC.

• Isigaba IIIA: Ithumba lifumaneka esinqeni kuphela, kodwa iiseli zomhlaza ezinokubonakala kuphela ngemicroscope zisasazekile kumphezulu we-peritoneum (izicwili ezibeka udonga esiswini kwaye zigubungela uninzi lwamalungu esiswini), i amathumbu amancinci, okanye isicwili esidibanisa amathumbu amancinci kudonga lwesisu.

Kwinqanaba IIIA, umhlaza ufunyanwa kwenye okanye zombini ii-ovari okanye i-fallopian tubes kwaye (a) umhlaza usasazeke kwii-lymph node kwindawo engaphandle okanye ngasemva kwe-peritoneum kuphela, okanye (b) iiseli zomhlaza ezinokubonakala kuphela ngemicroscope isasaze kwi-omentum. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Isigaba IIIB: Umhlaza usasazekile kwi-peritoneum kwaye umhlaza kwi-peritoneum ziisentimitha ezi-2 okanye zincinci.

Kwinqanaba IIIB, umhlaza ufunyanwa kwelinye okanye zombini ii-ovari okanye i-fallopian tubes kwaye isasazeke kwi-omentum, kwaye umhlaza kwi-omentum ziisentimitha ezi-2 okanye zincinci. Umhlaza unokuthi usasazeke kwii-lymph node emva kweperitoneum.

• Isigaba IIIC: Umhlaza usasazeke kwi-peritoneum kwaye umhlaza kwi-peritoneum mkhulu kune-2 cm kunye / okanye umhlaza usasazeke kwii-lymph node esiswini.

Kwinqanaba le-IIIC, umhlaza ufunyanwa kwenye okanye zombini ii-ovari okanye kwimibhobho kwaye usasazeke kwi-omentum, kwaye umhlaza kwi-omentum mkhulu kune-2 cm. Umhlaza usenokusasazeka kwii-lymph node emva kwe-peritoneum okanye kumphezulu wesibindi okanye udakada.

Umhlaza osasazeke ngaphezulu kwesibindi uthathelwa ingqalelo kwinqanaba lesithathu lomhlaza wesibeleko.

Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke ngaphaya kwesisu ukuya kwamanye amalungu omzimba. Kwinqanaba le-IVA, iiseli zomhlaza zifumaneka kulwelo olongezelelekileyo olwakha malunga nemiphunga. Kwinqanaba le-IVB, umhlaza usasazeke kwizitho kunye nakwizicubu ngaphandle kwesisu, kubandakanya umphunga, isibindi, ithambo, kunye ne-lymph node kwindawo yokugcuma.

Kwinqanaba IV, umhlaza usasazeke ngaphaya kwesisu ukuya kwamanye amalungu omzimba, anje ngemiphunga okanye izicwili ngaphakathi kwesibindi.

Iiseli zomhlaza kulwelo olujikeleze imiphunga lukwaqwalaselwa kwinqanaba lesine umhlaza we-ovari.

Ukuphindaphinda ii-Ovarian Germ Cell Tumors

Isisu esosulelayo se-ovarian germ cell ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuya ubuye kwenye i-ovary okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo seentsholongwane.

• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Ukujonga

• Unyango ngamayeza

• Unyango ngemitha

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa komongo wethambo

• Unyango olutsha

• Unyango lwezihlunu zentsholongwane yesibeleko kunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo seentsholongwane.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-ovarian germ cell cell. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Utyando lolona nyango luxhaphake kakhulu kwi-ovarian germ cell cell. Ugqirha angawukhupha umhlaza esebenzisa olu hlobo lunye lotyando.

• Unilateral salpingo-oophorectomy: Inkqubo yotyando lokususa i-ovary enye kunye netyhubhu enye ye-fallopian.

• I-hysterectomy iyonke: Inkqubo yotyando lokususa isibeleko, kubandakanya umlomo wesibeleko. Ukuba isibeleko kunye nomlomo wesibeleko ukhutshiwe kwilungu lobufazi, utyando lubizwa ngokuba yi-hysterectomy yelungu lobufazi. Ukuba isibeleko kunye nomlomo wesibeleko ukhutshwa ngokusikwa okukhulu (okusikiweyo) esiswini, utyando lubizwa ngokuba sisisu esiswini sisonke. Ukuba isibeleko kunye nomlomo wesibeleko zithathwa ngokusikwa kancinane (okusikiweyo) esiswini kusetyenziswa i-laparoscope, utyando lubizwa ngokuba yi-laparoscopic hysterectomy iyonke.

Uhlobo lweHysterectomy. Isibeleko siyasuswa ngotyando kunye okanye ngaphandle kwamanye amalungu okanye izicwili. Kwi-hysterectomy iyonke, isibeleko kunye nomlomo wesibeleko ziyasuswa. Kwi-hysterectomy iyonke ene-salpingo-oophorectomy, (a) isibeleko kunye nesinye (unilateral) isibeleko kunye ne-fallopian tube ziyasuswa; okanye (b) isibeleko kunye (zombini) iiqanda kunye nemibhobho yesibeleko iyasuswa. Kwi-hysterectomy egqibeleleyo, isibeleko, umlomo wesibeleko, omabini amaqanda, zombini ii-fallopian tubes, kunye nezicubu ezikufutshane ziyasuswa. Ezi nkqubo zenziwa kusetyenziswa ukusika okunqamlezayo okuphantsi okanye ukusikwa okuthe nkqo.

• I-Bilal salpingo-oophorectomy: Inkqubo yotyando lokususa ii-ovari kunye zombini iityhubhu ze-fallopian.

• I-Tumor debulking: Inkqubo yotyando apho kususwe khona ithumba elininzi kangangoko kunokwenzeka. Amanye amathumba awanakususwa ngokupheleleyo.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango lweradiation emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Emva kwekhemotherapy yesifo se-ovarian germ cell tumor, ukubonakala kwesibini kwe-laparotomy kunokwenziwa. Oku kuyafana ne-laparotomy eyenziwayo yokufumana inqanaba lomhlaza. Ukujonga okwesibini i-laparotomy yinkqubo yotyando yokufumanisa ukuba iiseli zesisu zishiyekile emva konyango lokuqala. Ngexesha lale nkqubo, ugqirha uya kuthatha iisampulu zee-lymph node kunye nezinye izicwili esiswini ukujonga ukuba ngaba umhlaza ushiyekile na. Le nkqubo ayenzelwanga idysgerminomas.

Ukujonga

Ukujongwa kujonge imeko yesigulana ngaphandle kokunika naluphi na unyango ngaphandle kokuba iimpawu okanye iimpawu zivela okanye zitshintshe.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza. Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Jonga iziyobisi ezivunyiweyo kwi-Ovarian, iTopopian Tube, okanye iPeritoneal Cancer yolwazi oluthe kratya.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga ii-ovarian germ cell cell tumors.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

I-dose ephezulu ye-chemotherapy kunye nokufakelwa komongo wethambo

I-high-dose chemotherapy kunye nokufakelwa komongo wethambo yindlela yokunika amanani aphakamileyo kakhulu ekhemotherapy kunye nokutshintsha iiseli ezenza igazi ezichithwe ngumhlaza. Iiseli zesinti (iiseli zegazi ezingafakwanga) zisuswe kumongo wethambo lesigulana okanye umnikeli kwaye ziyabanda zigcinwe. Emva kokuba i-chemotherapy igqityiwe, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Unyango olutsha

Ukudityaniswa kwe-chemotherapy (ukusetyenziswa kwesiyobisi esingaphaya kwesinye somhlaza) kuvavanywa kwizilingo zonyango.

Unyango lwezihlunu zentsholongwane yesibeleko kunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukhetho lonyango ngeSigaba

Kweli Candelo

• Isigaba I-Ovarian Germ Cell Tumors

• Isigaba II se-Ovarian Germ Cell Tumors

• Isigaba III se-Ovarian Germ Cell Tumors

• Isigaba IV Ovarian Germ Cell Tumors

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Isigaba I-Ovarian Germ Cell Tumors

Unyango luxhomekeke ekubeni ithumba yi-dysgerminoma okanye olunye uhlobo lwe-ovarian germ cell cell.

Unyango lwe-dysgerminoma lunokubandakanya oku kulandelayo:

• Unilateral salpingo-oophorectomy kunye okanye ngaphandle kwe-lymphangiography okanye i-CT scan.

• Unilateral salpingo-oophorectomy elandelwa kukujonga.

• Unilateral salpingo-oophorectomy elandelwa ngonyango lwemitha.

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

Unyango lwezinye iiseli zentsholongwane ye-ovari inokuba:

• unilateral salpingo-oophorectomy elandelwa kukuqwalaselwa ngononophelo; okanye

• i-unilateral salpingo-oophorectomy, ngamanye amaxesha ilandelwa ngokudibanisa i-chemotherapy.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Isigaba II se-Ovarian Germ Cell Tumors

Unyango luxhomekeke ekubeni ithumba yi-dysgerminoma okanye olunye uhlobo lwe-ovarian germ cell cell.

Unyango lwe-dysgerminoma inokuba:

• iyonke isisu esisisu kunye nesalpingo-oophorectomy yamazwe amabini elandelwa lonyango ngemitha okanye indibaniselwano ngekhemotherapy okanye

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

Unyango lwamanye amathumba wesibeleko se-ovari unokubandakanya oku kulandelayo:

• Unilateral salpingo-oophorectomy elandelwa ngokudityaniswa kweekhemotherapy.

• Ukujonga okwesibini i-laparotomy (utyando olwenziwe emva konyango lokuqala ukubona ukuba iiseli zethumba zihlala).

• Uvavanyo lweklinikhi yonyango olutsha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Isigaba III se-Ovarian Germ Cell Tumors

Unyango luxhomekeke ekubeni ithumba yi-dysgerminoma okanye olunye uhlobo lwe-ovarian germ cell cell.

Unyango lwe-dysgerminoma lunokubandakanya oku kulandelayo:

• Iyonke isisu esisisu kunye nesalpingo-oophorectomy yamazwe amabini, kunye nokususwa komhlaza omninzi kwi-pelvis kunye nesisu ngangokunokwenzeka.

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

Unyango lwamanye amathumba wesibeleko se-ovari unokubandakanya oku kulandelayo:

• Iyonke isisu esisisu kunye nesalpingo-oophorectomy yamazwe amabini, kunye nokususwa komhlaza omninzi kwi-pelvis kunye nesisu ngangokunokwenzeka. I-Chemotherapy iya kunikwa ngaphambi kunye / okanye emva kotyando.

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

• Ukujonga okwesibini i-laparotomy (utyando olwenziwe emva konyango lokuqala ukubona ukuba iiseli zethumba zihlala).

• Uvavanyo lweklinikhi yonyango olutsha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Isigaba IV Ovarian Germ Cell Tumors

Unyango luxhomekeke ekubeni ithumba yi-dysgerminoma okanye olunye uhlobo lwe-ovarian germ cell cell.

Unyango lwe-dysgerminoma lunokubandakanya oku kulandelayo:

• Iyonke isisu esiswini kunye ne-salpingo-oophorectomy yamazwe amabini elandelwa yi-chemotherapy, ngokususwa komhlaza omninzi kwi-pelvis kunye nesisu ngangokunokwenzeka.

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

Unyango lwamanye amathumba wesibeleko se-ovari unokubandakanya oku kulandelayo:

• Iyonke isisu esisisu kunye nesalpingo-oophorectomy yamazwe amabini, kunye nokususwa komhlaza omninzi kwi-pelvis kunye nesisu ngangokunokwenzeka. I-Chemotherapy iya kunikwa ngaphambi kunye / okanye emva kotyando.

• Unilateral salpingo-oophorectomy elandelwa yichemotherapy.

• Ukujonga okwesibini i-laparotomy (utyando olwenziwe emva konyango lokuqala ukubona ukuba iiseli zethumba zihlala).

• Uvavanyo lweklinikhi yonyango olutsha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango kwiindlela eziqhelekileyo ze-Ovarian Germ Cell Tumors

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango luxhomekeke ekubeni ithumba yi-dysgerminoma okanye olunye uhlobo lwe-ovarian germ cell cell.

Unyango lwe-dysgerminoma inokuba:

• I-Chemotherapy kunye okanye ngaphandle kwonyango lwe-radiation.

Unyango lwamanye amathumba wesibeleko se-ovari unokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Ugqirha kunye okanye ngaphandle kwe-chemotherapy.

• Uvavanyo lweklinikhi yonyango lweedosi ephezulu elandelwa kukufakwa komongo wethambo.

• Uvavanyo lweklinikhi yonyango olutsha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga ne-Ovarian Germ Cell Tumors

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nesisu seentsholongwane zentsholongwane, bona oku kulandelayo:

• I-Ovarian, iTyhubhu yeFallopian, kunye neKhaya laseKhaya lePeritoneal Cancer

• Iziyobisi ezivunyiweyo kwi-Ovarian, Tube ye-fallopian, okanye iPeritoneal Cancer

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli