Deck 15: Cancer Staging, Treatment, and Prognosis

Question 1

Which stage is most appropriate for a patient who has testicular seminoma involving the spermatic cord with multiple 2- to 5-cm paraaortic lymph nodes?

A)Stage IB
B)Stage IIB
C)Stage IIC
D)Stage IIIA

Answer 1

Stage IIB

Question 2

Which of the following statements about malignant mesothelioma is true?

A)Chemoradiation therapy alone offers promising results.
B)Most patients die of metastatic disease and not of local recurrence.
C)Patients who have the epithelial subtype have a worse prognosis.
D)Mediastinal lymph node involvement affects the prognosis.

Answer 2

Mediastinal lymph node involvement affects the prognosis.

Question 3

Hodgkin lymphoma most commonly occurs during which decade of life?

A)Second
B)Third
C)Fourth
D)Fifth

Answer 3

Third

Question 4

BRCA2 is responsible for breast cancer and characterized by:

A)Chromosomal 17 is the location
B)It is less common than BRCA1 in risk of breast cancer
C)Its mutation can be present in sporadic breast cancer
D)It is not responsible for breast cancer in men.
E)It is one of oncogenes

Question 5

Soft tissue sarcoma most commonly arises from what site?

A)Head and neck
B)Retroperitoneum
C)Lower extremity
D)Upper extremity

Question 6

Which of the following adjuvant systemic therapies would be most appropriate to recommend for an otherwise healthy patient who has HER-2/neu-positive (FISH) ER/PR-negative breast cancer with positive axillary lymph nodes?

A)Four cycles of dose-dense doxorubicin and cyclophosphamide (AC) in conjunction with four cycles of paclitaxel.
B)Four cycles of AC, four cycles of paclitaxel with concurrent trastuzumab, and continuation of trastuzumab for 1 year.
C)Four cycles of paclitaxel, four cycles of AC with concurrent trastuzumab, and continuation of trastuzumab for 1 year.
D)Six cycles of docetaxel, doxorubicin, and cyclophosphamide.

Question 7

Which histology is most likely in men older than 60 years with testicular cancer?

A)Yolk sac tumor
B)Classical seminoma
C)Choriocarcinoma
D)Lymphoma

Question 8

Which of the following factors is NOT typically associated with improved overall survival for patients who present with unknown primary tumors of the head and neck region?

A)Radiation doses of >50 Gy
B)Complete resection of the involved lymph nodes
C)Subsequent presentation of the primary tumor
D)Stage N1 versus stage N2 lymph node involvement

Question 9

Which of the following conditions should be treated like small cell lung cancer?

A)Combined small cell lung cancer and non-small cell lung cancer
B)Non-small cell lung cancer with neuroendocrine features
C)Large cell neuroendocrine tumors
D)Atypical carcinoid tumors

Question 10

The basal molecular phenotype of breast cancer most commonly is:

A)ER-positive, PR-positive, HER-2/neu-negative.
B)ER-positive, PR-positive, HER-2/neu-positive.
C)ER-negative, PR-negative, HER-2/neu-negative.
D)ER-negative, PR-negative, HER-2/neu-positive.

Question 11

A 22-year-old man with Hodgkin disease has adenopathy of the right cervical and right supraclavicular regions and weight loss of >10% of his baseline body weight. Which of the following cancer stages is most likely to be associated with this patient's condition?

A)Stage IA
B)Stage IB
C)Stage IIA
D)Stage IIB

Question 12

A 72-year-old man was found to have an anterior rectal cancer at 2 cm from the anal verge. A CT scan of chest, abdomen and pelvis showed no evidence of metastatic disease. An MR scan of pelvis showed an anterior tumour abutting the prostate gland, radiologically staged as a T3, N1, M0 cancer. What is the most appropriate next step in management?

A)abdominoperineal resection
B)chemotherapy
C)long-course chemoradiation
D)short-course radiotherapy
E)total mesorectal excision

Question 13

Which of the following statements about pancreatic cancer is FALSE?

A)Approximately 10% to 20% of pancreatic cancers are associated with hereditary factors.
B)New-onset diabetes mellitus may be the first clinical feature in 10% of patients.
C)Tumors of the pancreatic head arise to the right of the superior mesenteric vein- portal vein confluence and include tumors of uncinate origin.
D)The most common physical finding at initial presentation is Courvoisier's sign.

Question 14

Which of the following statements about unknown primary head and neck tumors is true?

A)PET imaging is able to detect the primary tumor in 60% of cases.
B)Random biopsies will reveal the primary lesion in 40% of cases.
C)Chest imaging will reveal a primary lung tumor in 20% of cases.
D)Tonsillectomy may reveal the occult primary tumor in 20% of cases.

Question 15

Taxane derivatives elicit cytotoxic effects mainly by which of the following mechanisms?

A)Stabilization of microtubules and prevention of their disassembly
B)Intercalation into DNA and inhibition of DNA replication
C)Inhibition of topoisomerases
D)Inhibition of DNA repair

Question 16

Which of the following statements about patients who are diagnosed with breast cancer and have supraclavicular lymph node involvement is true?

A)The diagnosis should be classified as stage M1 breast cancer.
B)Approximately 30% of patients will have clinically detectable internal mammary lymph nodes on CT scan of the chest.
C)Over 20% of patients will have lymphedema and brachial plexopathy.
D)Over 20% of patients will survive 10 years with aggressive trimodality therapy.

Question 17

Bladder cancer associated with hydronephrosis and invasion limited to the outer half of the bladder muscle layer corresponds to which T stage?

A)T2
B)T3
C)T4a
D)T4b

Question 18

A 42-year-old man presented with a 1-month history of altered personality and increased seizure frequency. An MR scan of brain demonstrated an enhancing lesion in the right frontal lobe. Histology revealed a grade 3 oligodendroglioma, with loss of heterozygosity of 1p/19q. What is the most appropriate treatment?

A)chemoradiation with temozolomide
B)cranial irradiation
C)craniospinal irradiation
D)procarbazine, vincristine and lomustine (PCV)
E)temozolomide

Question 19

Which of the following Hodgkin lymphoma subtypes is most closely associated with the development of non-Hodgkin lymphoma?

A)Nodular sclerosis
B)Lymphocyte depleted
C)Lymphocyte predominant
D)Lymphocyte rich

Question 20

Which of the following primary sites is most commonly involved in patients who are diagnosed with Ewing sarcoma?

A)Pelvis
B)Humerus
C)Fibula
D)Tibia

Question 21

During gene therapy, genes are most commonly transferred into cells by:

A)viral vectors.
B)bacterial plasmids.
C)synthetic oligonucleotide primers.
D)small-interfering RNA (siRNA).

Question 22

Which of the following statements about desmoid tumors is true?

A)They commonly metastasize to the lungs.
B)They commonly metastasize to the bones.
C)Surgical excision is the most common treatment of choice.
D)Definitive radiation therapy can achieve local control in 25% of cases.

Question 23

Multidrug resistance in tumor cells is often attributed to extrusion of drugs mediated by overexpression of which of the following proteins?

A)P-glycoprotein
B)Bcl-2
C)BAX
D)TP53

Question 24

Which of the following lymph node chains is most commonly involved in patients who present with Hodgkin lymphoma?

A)Inguinal
B)Paraaortic
C)Mediastinal
D)Cervical

Question 25

Which of the following cell cycle phases is most radiosensitive?

A)M
B)S
C)G1
D)G0