Devita, Hellman, and Rosenberg's Cancer

LWBK1006-20 LWW-Govindan-Review December 12, 2011 19:4

232 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 20.1.3. Which of the following statements about Barrett’s esophagus is TRUE?

A. The prevalence of Barrett’s esophagus in the general population

undergoing endoscopy is approximately 5%.

B. Both medical and antireflux therapies are associated with reduced

risk of developing esophageal cancer.

C. Patients with low-grade dysplasia should undergo surveillance annual

endoscopy.

D. Patients with Barrett’s esophagus have a 5- to 10-fold higher risk of

developing esophageal carcinoma compared to the normal popula-

tion.

Question 20.1.4. Which of the following statements about the role of trastuzumab in the

treatment of gastroesophageal cancers is FALSE?

A. The percentage of patients with overexpression of HER2 by FISH or

immunohistochemistry is approximately 10%.

B. The addition of trastuzumab to cisplatin-based chemotherapy has

been shown to improve response rates compared to chemotherapy

alone.

C. The addition of trastuzumab to cisplatin-based chemotherapy has

been shown to improve overall survival rates compared to chemother-

apy alone.

D. None of the above.

Question 20.1.5. A 22-year-old woman is diagnosed with metastatic gastric cancer, with

diffuse involvement of the stomach and linitis plastica. Her father died of

the same cancer at age 42 years. Her mother is concerned about famil-

ial gastric cancer and is asking for information about hereditary gastric

cancer and appropriate screening for her other children. Which of the fol-

lowing would be the most appropriate recommendation to this family?

A. Hereditary gastric cancer is rare and unlikely. She may just have some

environmental exposures or DNA mismatch repair gene mutations

that cannot be screened for.

B. She may very well have hereditary early-onset diffuse gastric cancer,

but no surveillance or workup is recommended because this has yet

to be confirmed in larger studies.

C. E-cadherin mutation testing should be considered here, and, in fact,

prophylactic gastrectomy should be considered strongly for her sib-

lings if a germ line E-cadherin mutation is confirmed and mucosal

abnormality can be documented by endoscopic examination of the

stomach.

D. E-cadherin mutation testing should be considered, and, in fact, pro-

phylactic gastrectomy should be considered strongly for her sib-

lings if a germ line E-cadherin mutation is confirmed even if no

mucosal abnormalities are seen by endoscopic examination of the

stomach.