This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
A 25 year old married nullipara undergoes laproscopic cystectomy for ovarian cyst which on histopath reveals ovarian serous cisadenocarcinoma. What should be the next management ? 
Select and explain. 
A. Serial Ca 125 measurement and follow up, B. Hysterectomy and bilaterals alpingoophorectomy, C. Unilateral salpingoophorectomy, D. Radiotherapy
C: Unilateral salpingoophorectomy
Answer: C: Unilateral salpingoophorectomy 
Explanation: Unilateral salpingoophorectomy Cystadenocarcinoma is an epithelial ovarian carcinoma. All patients with epithelial ovarian carcinoma require surgery i.e., B/L salpingophorectomy with hysterectomy. But the patient in question is quite young and nulliparous. She needs feility sparing surgery. There have'nt been enough successful trials on feility sparing surgery in ovarian carcinoma. Currently two surgical options are available in patients with epithelial ovarian carcinoma who desires to retain the feility. - Simple unilateral salpingoophorectomy - Staging procedure (unilateral salpingoophorectomy, bilateral pelvic and paraaoic lymphoadenectomy and multiple biopsies). Simple unilateral salpingoophorectomy is done in patients with early stage disease whereas staging procedure is done in patients with advanced disease. Stage of the cancer is not mentioned in the question. But, staging procedure is not mentioned as an option. Thus, the answer is obvious i.e., unilateral salpingoophorectomy. Management of epithelial ovarian tumour. The initial management of patient with epithelial ovarian tumour is surgery. Surgery is almost always performed in women suspected of epithelial ovarian cancer. The procedure is necessary to : ? Obtain tissue at diagnosis Assess the extent of the disease Attempt optimal cytoreduction which is crucial for successful treatment. Treatment in patients with Early stage disease Patients with stage I or II disease (Tumour confined to the ovary and pelvis). These patients require ? B/L salpingoophorectomy with hysterectomy. For management purpose early stage disease can be divided into two categories : -Patients with low risk. Patients with early stage disease and well differentiated encapsulated tumour -- They do'nt need any. .fuher t/t after surgery. Patients with high risk Patients with early stage disease with poorly differentiated tumours, those with pelvic extension, capsular rupture or involvement ascites or high grade lesions. These patietns require Surgery with postoperative chemotherapy Patients with advanced disease (stare III or IV) (Distant metastasis, peritoneal implants). - In these patients surgery is not enough. But still they need surgery for debulking of the tumour. - They require postoperative chemotherapy (Platinum based chemotherapy).