A. Laparoscopically assisted vaginal hysterectomy
B. Radical hysterectomy, radiotherapy and chemotherapy
C. External radiotherapy
D. TAH, BSO, peritoneal cytology, omentectomy, pelvic para-aortic lymphadenectomy.
E. Laparoscopic hysterectomy with bilateral salpingectomy
F. Laparotomy and bilateral salpingo-oophorectomy (BSO)
G. Presurgical radiotherapy followed by completion hysterectomy
I. Palliative care
J. Total abdominal hysterectomy (TAH) with BSO,
M. Annual follow-up
N. Optimal debulking surgery
O. Combined surgery and chemotherapy
P. No further therapy
Q. Laparoscopic hysterectomy with bilateral salpingo-oophorectomy
For each description below, choose the single most appropriate answer from the above list of options. Each option may be used once, more than once, or not at all.
1. A 52-year-old P1 woman was referred to the gynaecology clinic with irregular vaginal bleeding and abdominal pain lasting 2 months. Pelvic ultrasound showed an enlarged uterus with 13 mm thick endometrium and a10 cm complex adnexal mass on the right side. Outpatient Pipelle sampling has shown well-differentiated endometroid adenocarcinoma cells. Subsequent MRI has shown a three-quarters myometrial invasion. What is the most appropriate option?