Devita, Hellman, and Rosenberg's Cancer

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

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

SECTION 3 HEPATOBILIARY

RENUKA V. IYER•RAVI CHHATRALA

DIRECTIONS Each of the numbered items below is followed by lettered answers. Select the

ONE lettered answer that is BEST in each case unless instructed otherwise.

QUESTIONS

Question 20.3.1. A 52-year-old man is found to have abnormal liver function and an ele-

vated serum alpha-fetoprotein (AFP). Workup reveals prior hepatitis B

viral (HBV) infection, but it was not previously known or treated. An

ultrasound reveals a 4-cm lesion in the left hepatic lobe, and a computed

tomography (CT) scan reveals no evidence of metastatic disease or vascu-

lar involvement. A needle biopsy reveals hepatocellular carcinoma (HCC).

The patient undergoes successful partial hepatectomy, surgical margins

are clear, and the patient recovers from surgery. Which of the following

approaches should be followed?

A. Adjuvant chemotherapy with sorafenib

B. Combination chemotherapy that is doxorubicin based

C. Adjuvant radiation to surgical bed

D. None of the above

Question 20.3.2. Which of the following criteria are useful for selection of patients appro-

priate for liver transplantation?

A. Patients with solitary tumors≤5 cm, or patients with multifocal dis-

ease with≤3 tumor nodules each≤3 cm in size

B. Patients with Child-Pugh B or C cirrhosis

C. Tumors without evidence of macrovascular invasion and patients

who are not candidates for primary liver resection

D. All of the above

Corresponding Chapters inCancer: Principles & Practice of Oncology,Ninth Edition: 83 (Molecular Biology of

Liver Cancer), 84 (Cancer of the Liver), 85 (Cancer of the Biliary Tree).