Deck 13: Cancer Staging, Treatment, and Prognosis

Question 1

What is the risk of metastasis to the lymph nodes in a patient with stage T2N0 squamous cell carcinoma of the lateral aspect of the oral tongue?

A)There is a greater risk of metastasis to the retropharyngeal nodes than to the mid-jugular nodes.
B)There is a greater risk of metastasis to the superior jugular nodes than to the submandibular nodes.
C)There is a similar risk of metastasis to the retropharyngeal nodes as to the mid- jugular nodes.
D)There is a similar risk of metastasis to the submandibular nodes as to the mid-jugular nodes.

Answer 1

There is a similar risk of metastasis to the submandibular nodes as to the mid-jugular nodes.

Question 2

Which of the following factors is included in the international prognostic index (IPI) for non-Hodgkin lymphoma?

A)Histology
B)Weight loss
C)Lactate dehydrogenase (LDH) level
D)Erythrocyte sedimentation rate (ESR)

Answer 2

Lactate dehydrogenase (LDH) level

Question 3

Which of the following factors most adversely affects patients receiving radiation therapy for squamous cell carcinoma of the head and neck?

A)Concurrent HPV infection
B)Concurrent tobacco use
C)Gender of the patient
D)Grade of the cancer

Answer 3

Concurrent tobacco use

Question 4

Which of the following pathological findings is associated with patients who have meningioma?

A)Verocay bodies
B)Psammoma bodies
C)Small, round blue cells
D)Flexner-Wintersteiner rosettes

Question 5

According to Intergroup Trial 0116, adjuvant chemotherapy and radiation therapy after gastrectomy were more likely than gastrectomy alone to:

A)result in an unacceptable level of toxicity in the majority of patients.
B)result in a statistically significant decrease in the rate of distant metastases.
C)result in a statistically significant improvement in overall patient survival.
D)be most beneficial after D2 lymph node dissections.

Question 6

Which of the following statements about post-prostatectomy radiation therapy used in the EORTC 22911 Trial is true?

A)It resulted in more frequent grade 2 or grade 3 late effects.
B)It improved local control, biochemical progression-free survival, and overall patient survival.
C)It was beneficial for patients who had prostate cancer with positive lymph nodes.
D)Hormone therapy was added to the treatment regimen for patients with positive lymph nodes.

Question 7

Which of the following symptoms is most common in patients who present with endometrial cancer?

A)Pelvic pain
B)Low back pain
C)Vaginal bleeding
D)Hematuria

Question 8

Which of the following stages of oropharyngeal squamous cell carcinoma is associated with the lowest risk of contralateral cervical lymph node metastases?

A)T2N1 with the primary tumor confined to the tonsillar fossa
B)T1N1 involving the most lateral section of the soft palate
C)T1N1 confined to the glossal-tonsillar sulcus
D)T1N0 involving the lateral aspect of the base of tongue

Question 9

Which of the following equations is used to determine a positive predictive value?

A)True positive / (True positive + false negative)
B)True positive / (True positive + false positive)
C)True negative / (True negative + false negative)
D)True negative / (True negative + false positive)

Question 10

Which of the following treatment outcomes is associated with patients who have DCIS, according to prospective randomized trials?

A)In NSABP B-17, the actuarial rate of breast cancer recurrence after 12 years in patients who received surgery only was 24%.
B)In NSABP B-17, the actuarial rate of breast cancer recurrence after 12 years in patients who received surgery plus breast irradiation was 16%.
C)In NSABP B-24, breast irradiation reduced the risk of breast cancer recurrence in all subgroups except for the patients with positive surgical margins.
D)In EORTC 10853, the subtype of DCIS histology had no effect on patients' risk for breast cancer recurrence.

Question 11

Which of the following lymph nodes is NOT commonly associated with prostate cancer metastases?

A)Inguinal
B)External iliac
C)Presacral
D)Obturator

Question 12

Which of the following FIGO stages is associated with a patient who has endometrial cancer with extension through the entire myometrium and involvement of the surface of the uterine serosa?

A)IC
B)IIB
C)IIIA
D)IIIC

Question 13

Which of the following histologic subtypes of rhabdomyosarcoma has the worst prognosis?

A)Alveolar
B)Embryonal
C)Spindle cell
D)Botryoid

Question 14

Primary surgery is most appropriate for patients with which of the following types of squamous cell carcinoma?

A)Stage T1N0 of the oropharyngeal portion of the posterior pharyngeal wall
B)Stage T1N0 of the floor of mouth
C)Stage T1N0 of the soft palate
D)Stage T2N0 of the base of tongue

Question 15

Which of the following statements about radiation-induced fibrosis is true?

A)It is usually irreversible.
B)It can be easily managed by surgical excision.
C)It can be effectively treated using hyperbaric oxygen.
D)The severity is reduced with concurrent chemotherapy.

Question 16

Median survival is defined as the:

A)most prevalent time to death in the sample population.
B)point in time a survival probability on a Kaplan-Meier curve is 50%.
C)median of the survival-time intervals.
D)mean of the survival-time intervals.

Question 17

A 43-year-old man presented with vomiting and 4-kg weight loss. His performance status was 1. He was found to have a pre-pyloric gastric carcinoma gastric outlet obstruction. A CT scan showed no metastases. What is the most appropriate next step?

A)chemo-radiation
B)neoadjuvant chemotherapy
C)palliative bypass
D)radical resection
E)self-expanding stent

Question 18

What is the stage of a 5-cm gastric tumor that extends into, but not through, the muscularis propria with 16 of 23 positive lymph nodes?

A)I
B)II
C)III
D)IV

Question 19

Which of the following chemotherapy agents recently has been shown to be effective in treating hormone-refractory prostate cancer?

A)Docetaxel
B)Gemcitabine
C)Oxaliplatin
D)Topotecan

Question 20

Which of the following tumor stages is associated with a patient who has vulvar cancer arising on the labia minora with involvement of the lower urethra?

A)T1
B)T2
C)T3
D)T4

Question 21

Which of the following statements about staging for non-small cell carcinoma of the lung is true?

A)CT scan provides approximately 95% sensitivity and specificity.
B)Screening tests have reduced the mortality rate for high-risk patients.
C)PET scanning has replaced mediastinoscopy for determining cancer staging.
D)Positive PET scan findings require pathological confirmation.

Question 22

What is a major criterion for the diagnosis of multiple myeloma?

A)Calcium level of >12 mg/dL
B)Hemoglobin level of 8.5 g/dL
C)Plasmacytoma on tissue biopsy
D)Lytic bone lesions on skeletal survey

Question 23

Which of the following body sites is most commonly involved in patients with rhabdomyosarcoma?

A)Thorax
B)Extremities
C)Head and neck
D)Genitourinary tract

Question 24

Which of the following statements about the management of brain metastases secondary to breast cancer is true?

A)Prednisone therapy should be initiated with a loading dose of 20 mg, followed by 10 mg four times daily.
B)Symptomatic improvement is expected between 24 to 72 hours after initiation of therapy.
C)Treatment is more effective for focal neurological deficits than for headaches.
D)Dexamethasone must be administered four times daily because of its half-life properties.

Question 25

What is the most common histology of tumors involving the terminal ileum?

A)Sarcoma
B)Carcinoid
C)Lymphoma
D)Adenocarcinoma