Izinhlobo / i-ovarian / isiguli / i-ovarian-germ-cell-treatment-pdq

Inguqulo Yokwelashwa Kwe-Ovarian Germ Cell Tumors

Imininingwane ejwayelekile Mayelana Ne-Ovarian Germ Cell Tumors

AMAPHUZU ASEMQOKA

• Isimila segciwane lesandulela ngculaza yisifo lapho amangqamuzana abulalayo (umdlavuza) akha amangqamuzana egciwane (amaqanda) esibelethweni.

• Izimpawu zesimila segciwane lesandulela ngculaza ukuvuvukala kwesisu noma ukopha kwesitho sangasese sowesifazane ngemuva kokunqamuka kokuya esikhathini.

• Ukuhlolwa okuhlola ama-ovari, indawo ye-pelvic, igazi, nezicubu zama-ovari kusetshenziselwa ukuthola (ukuthola) nokuxilonga isimila segciwane lesandulela ngculaza.

• Izici ezithile zithinta ukubikezela (ithuba lokuthola kabusha nezindlela zokwelashwa).

Isimila segciwane lesandulela ngculaza yisifo lapho amangqamuzana abulalayo (umdlavuza) akha amangqamuzana egciwane (amaqanda) esibelethweni.

Izimila zamangqamuzana egciwane ziqala kumaseli okuzala (iqanda noma isidoda) somzimba. Izicubu zesifo segciwane le-ovari zivame ukwenzeka emantombazaneni asakhula noma kwabesifazane abasebasha futhi zivame ukuthinta i-ovary eyodwa kuphela.

Ama-ovari ayizitho zombili ohlelweni lokuzala lwabesifazane. Zisemathangeni, eyodwa ohlangothini ngalunye lwesibeletho (isitho esime, esinamapheya lapho kukhula umbungu). I-ovary ngayinye icishe ilingane nobukhulu be-alimondi. Amaqanda enza amaqanda namahomoni abesifazane.

I-anatomy yohlelo lokuzala lwabesifazane. Izitho ezisehlelweni lokuzala labesifazane zifaka phakathi isibeletho, amaqanda, amashubhu e-fallopian, umlomo wesibeletho, kanye nesitho sangasese sowesifazane. Isibeletho sinolwelwesi olungaphandle lwemisipha olubizwa ngokuthi i-myometrium nolwelwesi lwangaphakathi olubizwa ngokuthi i-endometrium.

Isimila segciwane lesandulela ngculaza ligama elijwayelekile elisetshenziselwa ukuchaza izinhlobo ezahlukahlukene zomdlavuza. Isimila segciwane lesandulela ngculaza esivame kakhulu sibizwa nge-dysgerminoma. Bona izifinyezo ezilandelayo ze- ngolwazi mayelana nezinye izinhlobo zamathumba ama-ovari:

• I-Ovarian Epithelial, Fallopian Tube, kanye ne-Primary Peritoneal Cancer Treatment

• Ukwelashwa Kwe-Ovarian Low Malignant Potential Tumors

Izimpawu zesimila segciwane lesandulela ngculaza ukuvuvukala kwesisu noma ukopha kwesitho sangasese sowesifazane ngemuva kokunqamuka kokuya esikhathini.

Izicubu zesifo segciwane le-ovarian kungaba nzima ukusheshe sikuhlolisise (thola). Imvamisa azikho izimpawu ezigabeni zokuqala, kepha izicubu zingatholwa ngesikhathi sezivivinyo ezijwayelekile zabesifazane (ukuhlolwa). Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Isisu esivuvukele ngaphandle kwesisindo kwezinye izingxenye zomzimba.

• Ukopha ophuma esithweni sangasese sowesifazane ngemuva kokunqamuka kokuya esikhathini (lapho ungasayi esikhathini).

Ukuhlolwa okuhlola ama-ovari, indawo ye-pelvic, igazi, nezicubu zama-ovari kusetshenziselwa ukuthola (ukuthola) nokuxilonga isimila segciwane lesandulela ngculaza.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• Ukuhlolwa kwe-pelvic: Ukuhlolwa kwesitho sangasese sowesifazane, umlomo wesibeletho, isibeletho, amashubhu e-fallopian, ama-ovari, ne-rectum. Kufakwa i-speculum esithweni sangasese bese udokotela noma umhlengikazi ebheka esithweni sangasese kanye nomlomo wesibeletho ukuthola izimpawu zesifo. Kuvame ukwenziwa ukuhlolwa kwesibeletho sePap. Udokotela noma umhlengikazi uphinde afake umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ebeka esinye isandla phezu kwesisu esingezansi ukuze ezwe ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Udokotela noma umhlengikazi uphinde afake umunwe othanjisiwe, ofakwe igilavu ​​ku-rectum ukuzwa izigaxa noma izindawo ezingejwayelekile.

Ukuhlolwa kwepelvic. Udokotela noma umhlengikazi ufaka umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ucindezela esiswini esingezansi ngesinye isandla. Lokhu kwenzelwa ukuzwa ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Isitho sowesifazane sangasese, umlomo wesibeletho, amashubhu okuya emithanjeni, kanye nengxenyenamba iyahlolwa.

• I-Laparotomy: Inqubo yokuhlinza lapho kwenziwa ukusikeka (ukusika) odongeni lwesisu ukubheka ngaphakathi kwesisu ukuthi asinazo yini izimpawu zesifo. Ubukhulu bokusikwa buxhomeke ekutheni kungani i-laparotomy yenziwa. Kwesinye isikhathi izitho ziyasuswa noma amasampula wezicubu athathwe ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zesifo.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computer ene-tomography, noma i-computer axial tomography.

• Isivivinyo se-serum tumor marker: Inqubo lapho kuhlolwe khona isampula legazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila. Izinga elikhulisiwe le-alpha fetoprotein (AFP) noma i-chorionic gonadotropin (HCG) egazini kungaba uphawu lwe-ovarian germ cell tumor.

Izici ezithile zithinta ukubikezela (ithuba lokuthola kabusha nezindlela zokwelashwa).

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Uhlobo lomdlavuza.

• Usayizi wesimila.

• Isigaba somdlavuza (noma ngabe sithinta ingxenye ye-ovary, sithinta i-ovary yonke, noma sisabalalele kwezinye izindawo emzimbeni).

• Indlela amangqamuzana omdlavuza abukeka ngayo ngaphansi kwesibonakhulu.

• Impilo ejwayelekile yesiguli.

Izimila zamangqamuzana e-Ovarian ngokuvamile ziyelapheka uma zitholakale futhi zilashwe kusenesikhathi.

Izigaba Zama-Ovarian Germ Cell Tumors

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwesimila segciwane le-ovarian germ cell, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-ovary noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa ama-ovarian germ cell tumors:

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

Ngemuva kokutholakala kwesimila segciwane le-ovarian germ cell, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-ovary noma kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usabalale ngaphakathi kwe-ovary noma kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Ngaphandle kokuthi udokotela abe nesiqiniseko sokuthi umdlavuza ususabalele kusuka esibelethweni uye kwezinye izingxenye zomzimba, kwenziwa umsebenzi obizwa nge-laparotomy ukubona ukuthi umdlavuza ususabalele yini. Udokotela kufanele asike esiswini bese ebheka ngokucophelela zonke izitho ukuthi unomdlavuza yini kuzo. Udokotela uzosika izicucu ezincane ukuze zihlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza. Udokotela angageza futhi umgodi wesisu ngoketshezi, olubuye lubhekwe ngaphansi kwesibonakhulu ukubona ukuthi lunamaseli omdlavuza yini ngaphakathi. Imvamisa udokotela uzowususa umdlavuza nezinye izitho ezinomdlavuza phakathi ne-laparotomy.

Ukuhlolwa okuningi okusetshenziselwa ukuxilonga i-ovarian germ cell tumor nakho kusetshenziselwa ukubeka esiteji. Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziselwa ukubeka esiteji:

• I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• Ukuhlolwa kwe-Transvaginal ultrasound: Inqubo esetshenziselwa ukuhlola isitho sangasese sowesifazane, isibeletho, amashubhu ezulu, nesinye. I-ultrasound transducer (iphenyo) ifakwa esithweni sangasese futhi isetshenziselwe ukubhebhethekisa amaza omsindo aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni bese yenza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Udokotela angabona izimila ngokubheka i-sonogram.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

• Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

• Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lwesimila njengesimila sokuqala. Isibonelo, uma isimila segciwane lesandulela ngculaza sisakazekela esibindi, amangqamuzana wesimila esibindini empeleni angamaseli wegciwane lomdlavuza we-ovarian. Lesi sifo yisigaxa segciwane lesandulela ngculaza se-ovarian, hhayi umdlavuza wesibindi.

Lezi zigaba ezilandelayo zisetshenziselwa ama-ovarian germ cell tumors:

Isiteji I

Esigabeni IA, umdlavuza utholakala ngaphakathi kweshubhu elilodwa le-ovary noma le-fallopian. Esigabeni IB, umdlavuza utholakala ngaphakathi kwawo womabili amaqanda noma amashubhu e-fallopian. Esigabeni IC, umdlavuza utholakala ngaphakathi kowodwa noma womabili amaqanda noma amashubhu we-fallopian futhi okunye kwalokhu okuyiqiniso: okukodwa noma womabili amaqanda noma amashubhu e-fallopian, noma (c) amangqamuzana omdlavuza atholakala ku-pelvic peritoneum.

Esigabeni I, umdlavuza utholakala ku-ovari eyodwa noma womabili. Isigaba I sihlukaniswe isigaba IA, isigaba IB, nesigaba IC.

• Isigaba IA: Umdlavuza utholakala ngaphakathi kwe-ovary eyodwa.

• Isigaba IB: Umdlavuza utholakala ngaphakathi kwawo womabili amaqanda.

• Isigaba IC: Umdlavuza utholakala ngaphakathi kwesinye noma womabili amaqanda futhi okukodwa kokulandelayo kuyiqiniso:

• umdlavuza utholakala nangaphandle kwendawo eyodwa noma womabili amaqanda; noma

• i-capsule (isembozo sangaphandle) se-ovary idabukile (iphukile); noma

• amangqamuzana omdlavuza atholakala kuketshezi lwe-peritoneal cavity (umgodi womzimba oqukethe izitho eziningi esiswini) noma ekuhlanzweni kwe-peritoneum (izicubu ezifaka umgodi we-peritoneal).

Isigaba II

Esigabeni IIA, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya esibelethweni kanye / noma kumashubhu we-fallopian kanye / noma kuma-ovari. Esigabeni IIB, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu e-fallopian futhi usabalalele kukholoni. Emdlavuzeni oyinhloko we-peritoneal, umdlavuza utholakala ku-pelvic peritoneum futhi awusakazekanga lapho kusuka kwenye ingxenye yomzimba.

Esigabeni II, umdlavuza utholakala kwelinye noma kuwo womabili amaqanda futhi usabalele nakwezinye izindawo zokhalo. Isigaba II sihlukaniswe isigaba IIA, isigaba IIB, nesigaba IIC.

• Isigaba IIA: Umdlavuza usabalalele esibelethweni kanye / noma kumashubhu we-fallopian (amashubhu amade amade adlula kuwo amaqanda kusuka esibelethweni aye esibelethweni).

• Isigaba IIB: I-Cancer isakaze kwezinye izicubu ngaphakathi kwesikhumba.

• Isigaba IIC: Umdlavuza utholakala ngaphakathi kowodwa noma womabili amaqanda futhi usabalalele esibelethweni kanye / noma kumashubhu we-fallopian, noma kwezinye izicubu ngaphakathi kwesikhumba. Futhi, okunye kokulandelayo kuyiqiniso:

• umdlavuza utholakala engxenyeni engaphandle yesinye noma womabili amaqanda; noma

• i-capsule (isembozo sangaphandle) se-ovary idabukile (iphukile); noma

• amangqamuzana omdlavuza atholakala kuketshezi lwe-peritoneal cavity (umgodi womzimba oqukethe izitho eziningi esiswini) noma ekuhlanzweni kwe-peritoneum (izicubu ezifaka umgodi we-peritoneal).

Osayizi bezicubu bavame ukulinganiswa ngamasentimitha (cm) noma amasentimitha. Izinto zokudla ezijwayelekile ezingasetshenziswa ukukhombisa usayizi wesimila ngo-cm zifaka: ipea (1 cm), iphenathi (2 cm), umvini (3 cm), i-walnut (4 cm), umcako (5 cm noma 2) amasentimitha), iqanda (6 cm), ipentshisi (7 cm), ne-grapefruit (10 cm noma 4 inches).

Isigaba III

Esigabeni III, umdlavuza utholakala kwelinye noma kuwo womabili amaqanda futhi usabalale ngaphandle kwesikhumba kwezinye izingxenye zesisu kanye / noma ama-lymph node aseduze. Isigaba III sihlukaniswe isigaba IIIA, isigaba IIIB, nesigaba IIIC.

• Isigaba IIIA: Isimila sitholakala okhalweni kuphela, kepha amangqamuzana omdlavuza angabonakala nge-microscope asabalale ebusweni be-peritoneum (izicubu ezibeka udonga lwesisu futhi zimboze izitho eziningi esiswini), amathumbu amancane, noma isicubu esixhuma amathumbu amancane nodonga lwesisu.

Esigabeni IIIA, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi (a) umdlavuza usabalalele kuma-lymph node endaweni engaphandle noma ngemuva kwe-peritoneum kuphela, noma (b) amangqamuzana omdlavuza angabonakala nge-microscope kuphela isakaze ku-omentum. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

Isigaba IIIB: Umdlavuza usabalalele ku-peritoneum kanti umdlavuza ku-peritoneum ungamasentimitha ama-2 noma amancane.

Esigabeni IIIB, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya ku-omentum, kanti umdlavuza ku-omentum ungamasentimitha ama-2 noma amancane. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum.

• Isigaba IIIC: Umdlavuza ususabalele kwi-peritoneum kanti umdlavuza ose-peritoneum mkhulu kunamasentimitha ama-2 kanti / noma umdlavuza usabalalele kuma-lymph node esiswini.

Esigabeni IIIC, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya ku-omentum, kanti umdlavuza ku-omentum mkhulu kunamasentimitha ama-2. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum noma ebusweni besibindi noma ubende.

Umdlavuza osabalalele ebusweni besibindi ubhekwa njengomdlavuza wesigaba III se-ovarian.

Isigaba IV

Esigabeni IV, umdlavuza usabalalele ngaphesheya kwesisu waya kwezinye izingxenye zomzimba. Esigabeni se-IVA, amangqamuzana omdlavuza atholakala kuketshezi oluthe xaxa olwakha azungeze amaphaphu. Esigabeni IVB, umdlavuza ususabalele ezithweni nakwizicubu ezingaphandle kwesisu, kufaka phakathi iphaphu, isibindi, ithambo nama-lymph node emgodini.

Esigabeni IV, umdlavuza usabalalele ngaphesheya kwesisu waya kwezinye izingxenye zomzimba, njengamaphaphu noma izicubu ezingaphakathi kwesibindi.

Amaseli womdlavuza kuketshezi oluzungeze amaphaphu nawo abhekwa njengomdlavuza wesigaba IV ovarian.

Izimila Ezivamile Zase-Ovarian Germ Cell

Isimila segciwane lesandulela ngculaza esivele njalo ngumdlavuza ophindaphindiwe (wabuya) ngemuva kokuba welashwe. Umdlavuza ungabuya ubuye kwesinye isibelethwane noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinezicubu zesifo segciwane esivela esibelethweni.

• Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukuqaphela

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• I-chemotherapy ephezulu ene-bone marrow transplant

• Izinketho ezintsha zokwelashwa

• Ukwelashwa kwezimila zamangqamuzana ama-ovarian germ kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinezicubu zesifo segciwane esivela esibelethweni.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-ovarian germ cell tumor. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa ukwelashwa okuvame kakhulu kwesisu se-ovarian germ cell. Udokotela angawukhipha umdlavuza esebenzisa eyodwa yalezi zinhlobo zokuhlinzwa.

• Unilateral salpingo-oophorectomy: Inqubo yokuhlinza ukususa i-ovary eyodwa kanye ne-fallopian tube eyodwa.

• I-hysterectomy ephelele: Inqubo yokuhlinza ukususa isizalo, kufaka phakathi umlomo wesibeletho. Uma isibeletho nomlomo wesibeletho kukhishwa ngesitho sangasese sowesifazane, ukuhlinzwa kubizwa nge-hysterectomy yesitho sangasese sowesifazane. Uma isibeletho nomlomo wesibeletho kukhishwa ngokusebenzisa ukusikeka okukhulu esiswini, ukuhlinzwa kubizwa ngokuthi yi-hysterectomy ephelele yesisu. Uma isibeletho nomlomo wesibeletho kukhishwa ngesikezi esincane (esisikiwe) esiswini kusetshenziswa i-laparoscope, ukuhlinzwa kubizwa ngokuthi yi-laparoscopic hysterectomy ephelele.

I-Hysterectomy. Isibeletho sisuswa ngokuhlinzwa noma ngaphandle kwezinye izitho noma izicubu. Ku-hysterectomy ephelele, isibeletho nomlomo wesibeletho kuyasuswa. Ku-hysterectomy ephelele ene-salpingo-oophorectomy, (a) kukhishwa isibeletho kanye ne-one (unilateral) ovary kanye ne-fallopian tube; noma (b) kukhishwe isibeletho kanye nawo womabili (amabhilidi) amaqanda kanye namashubhu e-fallopian. Ku-hysterectomy enamandla, kukhishwa isibeletho, umlomo wesibeletho, womabili amaqanda, amashubhu womabili, nezicubu eziseduze. Lezi zinqubo zenziwa kusetshenziswa imbobo ephansi enqamulelayo noma imbobo ebheke phezulu.

• I-Bilateral salpingo-oophorectomy: Inqubo yokuhlinza ukususa womabili amaqanda kanye namashubhu womabili.

• I-tumor debulking: Inqubo yokuhlinza lapho kukhishwa khona isimila esiningi ngangokunokwenzeka. Ezinye izimila azikwazi ukususwa ngokuphelele.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy noma i-radiation therapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ngemuva kwamakhemikhali we-ovarian germ cell tumor, kungenziwa i-laparotomy ebukeka okwesibili. Lokhu kufana ne-laparotomy eyenziwayo ukuthola isigaba somdlavuza. I-laparotomy ebukeka okwesibili iyinqubo yokuhlinzwa yokuthola ukuthi amaseli we-tumor asele ngemuva kokwelashwa okuyisisekelo. Phakathi nale nqubo, udokotela uzothatha amasampula ama-lymph node nezinye izicubu esiswini ukuze abone ukuthi awukho yini umdlavuza osele. Le nqubo ayenzelwanga ama-dysgerminomas.

Ukuqaphela

Ukuqaphela kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa ngaphandle uma kuvela izimpawu noma izimpawu noma zishintsha.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa izidakamizwa ezingaphezu kwesisodwa ze-anticancer. Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa ezivunyelwe i-Ovarian, i-Fallopian Tube, noma i-Primary Peritoneal Cancer ukuthola eminye imininingwane.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha izicubu zesifo segciwane esivela esibelethweni.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

I-chemotherapy ephezulu ene-bone marrow transplant

I-chemotherapy ephezulu ene-bone marrow transplant iyindlela yokunikeza imithamo ephezulu kakhulu ye-chemotherapy nokufaka amaseli akha igazi abhujiswa ukwelashwa komdlavuza. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa emnkantsheni wethambo lesiguli noma kumnikeli futhi afriziwe agcinwe. Ngemuva kokuthi ukwelashwa ngamakhemikhali kuqediwe, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Izinketho ezintsha zokwelashwa

Inhlanganisela yamakhemikhali (ukusetshenziswa kwezidakamizwa ezingaphezu kweyodwa ze-anticancer) iyahlolwa ekuhlolweni kwemitholampilo.

Ukwelashwa kwezimila zamangqamuzana ama-ovarian germ kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho zokwelashwa ngesiteji

Kulesi Sigaba

• Isigaba I Ovarian Germ Cell Tumors

• Isigaba II Ovarian Germ Cell Tumors

• Isigaba III Ovarian Germ Cell Tumors

• Isigaba IV Ovarian Germ Cell Tumors

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Isigaba I Ovarian Germ Cell Tumors

Ukwelashwa kuya ngokuthi i-tumor iyi-dysgerminoma noma olunye uhlobo lwesimila segciwane lesandulela ngculaza.

Ukwelashwa kwe-dysgerminoma kungafaka okulandelayo:

• Unilateral salpingo-oophorectomy nge noma ngaphandle kwe-lymphangiography noma i-CT scan.

• I-unilateral salpingo-oophorectomy elandelwa ukubuka.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngemisebe.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngamakhemikhali.

Ukwelashwa kwamanye ama-tumor ama-ovarian cell tumors kungaba:

• i-unilateral salpingo-oophorectomy elandelwa ukuqaphela ngokucophelela; noma

• unilateral salpingo-oophorectomy, kwesinye isikhathi kulandelwa inhlanganisela yamakhemikhali.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Isigaba II Ovarian Germ Cell Tumors

Ukwelashwa kuya ngokuthi i-tumor iyi-dysgerminoma noma olunye uhlobo lwesimila segciwane lesandulela ngculaza.

Ukwelashwa kwe-dysgerminoma kungaba:

• i-hysterectomy yesisu ephelele kanye ne-bilpal salpingo-oophorectomy elandelwa ukwelashwa ngemisebe noma inhlanganisela yamakhemikhali noma

• unilateral salpingo-oophorectomy elandelwa ngamakhemikhali.

Ukwelashwa kwezinye izicubu zesifo segciwane esibelethweni kungafaka okulandelayo:

• Unilateral salpingo-oophorectomy elandelwa inhlanganisela yamakhemikhali.

• Ukubukeka kwesibili kwe-laparotomy (ukuhlinzwa okwenziwe ngemuva kokwelashwa okuyisisekelo ukubona ukuthi amaseli we-tumor ahlala yini).

• Isivivinyo somtholampilo sokwelapha okusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Isigaba III Ovarian Germ Cell Tumors

Ukwelashwa kuya ngokuthi i-tumor iyi-dysgerminoma noma olunye uhlobo lwesimila segciwane lesandulela ngculaza.

Ukwelashwa kwe-dysgerminoma kungafaka okulandelayo:

• Ingqikithi yesisu esiswini kanye ne-bilpal salpingo-oophorectomy, nokususwa komdlavuza omningi okhalweni nasesiswini ngangokunokwenzeka.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngamakhemikhali.

Ukwelashwa kwezinye izicubu zesifo segciwane esibelethweni kungafaka okulandelayo:

• Ingqikithi yesisu esiswini kanye ne-bilpal salpingo-oophorectomy, nokususwa komdlavuza omningi okhalweni nasesiswini ngangokunokwenzeka. I-Chemotherapy izonikezwa ngaphambi kanye / noma ngemuva kokuhlinzwa.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngamakhemikhali.

• Ukubukeka kwesibili kwe-laparotomy (ukuhlinzwa okwenziwe ngemuva kokwelashwa okuyisisekelo ukubona ukuthi amaseli we-tumor ahlala yini).

• Isivivinyo somtholampilo sokwelapha okusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Isigaba IV Ovarian Germ Cell Tumors

Ukwelashwa kuya ngokuthi i-tumor iyi-dysgerminoma noma olunye uhlobo lwesimila segciwane lesandulela ngculaza.

Ukwelashwa kwe-dysgerminoma kungafaka okulandelayo:

• Ingqikithi yesisu esiswini kanye ne-bilpal salpingo-oophorectomy elandelwa yi-chemotherapy, ngokususwa komdlavuza omningi ethangeni nasesiswini ngangokunokwenzeka.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngamakhemikhali.

Ukwelashwa kwezinye izicubu zesifo segciwane esibelethweni kungafaka okulandelayo:

• Ingqikithi yesisu esiswini kanye ne-bilpal salpingo-oophorectomy, nokususwa komdlavuza omningi okhalweni nasesiswini ngangokunokwenzeka. I-Chemotherapy izonikezwa ngaphambi kanye / noma ngemuva kokuhlinzwa.

• I-unilateral salpingo-oophorectomy elandelwa ukwelashwa ngamakhemikhali.

• Ukubukeka kwesibili kwe-laparotomy (ukuhlinzwa okwenziwe ngemuva kokwelashwa okuyisisekelo ukubona ukuthi amaseli we-tumor ahlala yini).

• Isivivinyo somtholampilo sokwelapha okusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho zokwelashwa zama-Ovarian Germ Cell Tumors Aphindaphinda

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Ukwelashwa kuya ngokuthi i-tumor iyi-dysgerminoma noma olunye uhlobo lwesimila segciwane lesandulela ngculaza.

Ukwelashwa kwe-dysgerminoma kungaba:

• I-Chemotherapy noma ngaphandle kwemithi yokwelashwa ngemisebe.

Ukwelashwa kwezinye izicubu zesifo segciwane esibelethweni kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali.

• Ukuhlinzwa nge-chemotherapy noma ngaphandle kwayo.

• Isivivinyo somtholampilo samakhemikhali aphezulu we-chemotherapy alandelwa ukufakelwa umnkantsha wethambo

• Isivivinyo somtholampilo sokwelapha okusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukuze ufunde kabanzi mayelana nama-Ovarian Germ Cell Tumors

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nezicubu zamagciwane esibelethweni se-ovari, bheka okulandelayo:

• I-Ovarian, iThubhu le-Fallopian, nekhasi lasekhaya lomdlavuza oyinhloko we-Peritoneal

• Izidakamizwa zivunyelwe i-Ovarian, Fallopian Tube, noma i-Primary Peritoneal Cancer

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli