consenso-venezolano-en-cc3a1ncer-epitelial-de-ovario-2013
consenso-venezolano-en-cc3a1ncer-epitelial-de-ovario-2013
consenso-venezolano-en-cc3a1ncer-epitelial-de-ovario-2013
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240<br />
Primer Cons<strong>en</strong>so Nacional <strong>de</strong> cáncer <strong>epitelial</strong> <strong>de</strong> <strong>ovario</strong><br />
intersticial <strong>de</strong> la trompa. La histerectomía<br />
aum<strong>en</strong>ta la morbilidad operatoria pero facilita<br />
el manejo hormonal posterior y evitaría el riesgo<br />
<strong>de</strong> <strong>de</strong>sarrollo <strong>de</strong> una neoplasia <strong>en</strong> la trompa<br />
reman<strong>en</strong>te a nivel intersticial (24) . Se requiere<br />
una evaluación histopatológica exhaustiva <strong>de</strong><br />
los <strong>ovario</strong>s y trompas obt<strong>en</strong>idos <strong>en</strong> el marco <strong>de</strong><br />
una cirugía profiláctica con el fin <strong>de</strong> <strong>de</strong>scartar un<br />
cáncer oculto, cuya ocurr<strong>en</strong>cia se estima <strong>en</strong> un<br />
3 % <strong>en</strong> las paci<strong>en</strong>tes con mutaciones BRCA (35,36) .<br />
La edad recom<strong>en</strong>dada para la anexectomía<br />
bilateral es <strong>en</strong>tre 35 y 40 años o al completar<br />
la paridad (36) . El lavado peritoneal durante la<br />
anexectomía bilateral <strong>en</strong> paci<strong>en</strong>tes <strong>de</strong> alto riesgo<br />
permite id<strong>en</strong>tificar carcinoma peritoneal oculto,<br />
si<strong>en</strong>do es<strong>en</strong>cial la evaluación exhaustiva <strong>de</strong> la<br />
pelvis y <strong>de</strong> todas las superficies peritoneales;<br />
sin embargo, se necesitan más estudios para<br />
recom<strong>en</strong>dar la citología peritoneal como parte<br />
<strong>de</strong>l protocolo <strong>de</strong> cirugía <strong>de</strong> interv<strong>en</strong>ción <strong>de</strong><br />
riesgo (36-38) .<br />
No hay evid<strong>en</strong>cia convinc<strong>en</strong>te <strong>de</strong> un efecto<br />
prev<strong>en</strong>tivo <strong>de</strong> la actividad física <strong>en</strong> el <strong>de</strong>sarrollo<br />
<strong>de</strong> cáncer <strong>de</strong> <strong>ovario</strong> (39) . El uso <strong>de</strong> f<strong>en</strong>retidina,<br />
retinoi<strong>de</strong> sintético, como quimioprev<strong>en</strong>ción no<br />
hormonal <strong>en</strong> paci<strong>en</strong>tes <strong>de</strong> alto riesgo se <strong>en</strong>cu<strong>en</strong>tra<br />
aún <strong>en</strong> etapa experim<strong>en</strong>tal (40,41) .<br />
La dieta rica <strong>en</strong> fécula (OR:1,2) y la ingesta<br />
<strong>de</strong> carnes rojas (OR:1,5) aum<strong>en</strong>tan el riesgo <strong>de</strong><br />
cáncer <strong>de</strong> <strong>ovario</strong>. Los alim<strong>en</strong>tos <strong>de</strong> orig<strong>en</strong> animal,<br />
el pescado, vitaminas, vegetales crudos, y con<br />
alto cont<strong>en</strong>ido <strong>de</strong> fibra no aum<strong>en</strong>tan el riesgo <strong>de</strong><br />
cáncer <strong>de</strong> <strong>ovario</strong>. Una dieta baja <strong>en</strong> grasa, podría<br />
disminuir la incid<strong>en</strong>cia <strong>de</strong> cáncer <strong>de</strong> <strong>ovario</strong> (41-43) .<br />
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