LWBK1006-20 LWW-Govindan-Review December 12, 2011 19:4
Chapter 20•Cancer of the Gastrointestinal Tract 233Question 20.1.6. Which of the following statements is TRUE about molecular genetic alter-
ations in gastric cancer?
A. Many sporadic diffuse gastric cancers display altered E-cadherin, a
transmembrane, calcium-dependent adhesion molecule important in
epithelial cell homophilic and heterophilic interactions.
B. The p53 tumor suppressor gene is consistently altered in most gastric
cancers.
C. Microsatellite instability has been found in 13% to 44% of sporadic
gastric carcinomas.
D. All of the above.Question 20.1.7. A 72-year-old man diagnosed with squamous cancer of the esophagus
has questions regarding the benefit of chemoradiation plus surgery for
his locally advanced cancer. He would like to know about the natural
history of his disease and the expected benefit of combined modality
therapy. Which of the following statements best describes the likely out-
come/prognosis of his cancer?
A. In patients with cancers of the upper and middle thirds of the esoph-
agus, which are predominately squamous cell carcinomas, distant
recurrence predominates over locoregional recurrence.
B. Preoperative radiotherapy and chemoradiotherapy may reduce the
rate of locoregional recurrence but have no obvious effect on the rate
of distant metastases.
C. Two recent prospective randomized trials evaluating chemoradiother-
apy alone or chemoradiotherapy followed by surgery in squamous
cancer indicate that improvement in local control with the addition
of surgery also resulted in improved survival.
D. Concurrent administration of chemotherapy and radiotherapy pro-
vides better local control than radiotherapy alone, and the admin-
istration of chemotherapy has been shown in follow-up studies to
reduce systemic recurrence.Question 20.1.8. Which of the following statements about the role of fluorodeoxyglucose
positron emission tomography (FDG-PET) use in the diagnosis and man-
agement of esophageal cancers is TRUE?
A. In the detection of distant metastases, FDG-PET is superior to com-
puted tomography (CT), with sensitivity, specificity, and accuracy all
in the range of 80% to 90%.
B. PET in combination with CT (PET/CT fusion or hybrid FDG-
PET/CT) further improves specificity and accuracy of noninvasive
staging.
C. FDG-PET seems to have value in evaluating response to chemother-
apy and radiotherapy.
D. All of the above.