Devita, Hellman, and Rosenberg's Cancer

LWBK1006-23 LWW-Govindan-Review December 12, 2011 19:10

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

Question 23.1.10.Oral contraceptive use for≥5 years is associated with what percentage

decrease in the incidence of ovarian cancer?

A. 5%

B. 10%

C. 20%

D. 50%

E. 80%

Question 23.1.11.A 25-year-old woman has her left ovary removed because of an ovarian

mass. The final pathology shows that this is a moderately differentiated

papillary serous cancer. There was no other evidence of disease in the

abdominal cavity. What is the likelihood that this patient has a positive

pelvic or para-aortic lymph node metastasis?

A. 5%

B. 15%

C. 30%

D. 50%

Question 23.1.12.Patients with high-risk early ovarian cancer should generally be treated:

A. By observation

B. With platinum-based chemotherapy

C. With whole abdominal radiation therapy

D. BorC

Question 23.1.13.A 55-year-old woman who has just achieved a complete clinical remis-

sion (normal CT scan, pelvic examination, and CA-125) after six cycles

of chemotherapy for stage IIIC optimally debulked serous ovarian cancer

presents to you for a second opinion regarding her prognosis and treat-

ment options at this point. She is in excellent general health and tolerated

chemotherapy well except for some numbness in her fingers and toes,

which caused her treating oncologist to switch her treatment from pacli-

taxel/carboplatin to docetaxel/carboplatin after cycle three. You should

advise her that:

A. The risk of eventual relapse for an optimally debulked patient with

a complete clinical remission is approximately 30%; no therapy is

proven to be of any further survival benefit at this point.

B. She should have second-look surgery; if residual disease is found,

she should have four to six cycles of intraperitoneal platinum-based

therapy because this can improve survival in patients with platinum-

sensitive, minimal residual disease.

C. She should have a PET scan; if residual disease is found, she should

have four to six cycles of a non–cross-resistant drug, such as topotecan.

D. Her risk of eventual relapse is approximately 70%; she should

be offered consolidation therapy with paclitaxel 175 mg/m^2 every

3 weeks for 12 months with the expectation of a 30% improvement

in survival.

E. Her risk of relapse is approximately 70%; no therapy is proven to be

of any survival benefit at this point.