Devita, Hellman, and Rosenberg's Cancer

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

Chapter 23•Gynecologic Cancers 317

Question 23.2.13.The patient has a 3-cm visible tumor found on her cervix that is biopsied

and is frankly invasive squamous cell carcinoma. She has several questions

regarding staging of her cancer. You advise the following, EXCEPT:

A. Staging for cervical cancer is clinical, involving pelvic exami-

nation.

B. If enlarged lymph nodes are seen on her computed tomography (CT)

scan, her cancer would be staged appropriately as at least stage III.

C. If hydronephrosis is demonstrated on her CT scan, her cancer would

be staged appropriately as at least stage III.

D. Positron emission tomography (PET) scanning appears to be the most

sensitive noninvasive method of detecting nodal involvement.

Question 23.2.14.The patient’s 3-cm visible tumor appears confined to the cervix and is

staged appropriately as stage IB1. Which of the following therapies is

most appropriate?

A. Radiation and chemotherapy with weekly cisplatin dosed at

40 mg/m^2

B. Simple hysterectomy with removal of fallopian tubes and ovaries

C. Radiation therapy or radical hysterectomy with lymphadenectomy

D. Brachytherapy radiation with a dose of 75 Gy

Question 23.2.15.A 40-year-old woman is diagnosed with invasive cervical cancer. She has

a 5-cm cervical tumor with parametrial involvement, and evidence of

hydronephrosis on imaging. Her cancer is staged appropriately as stage

IIIB. You elect to treat her with combined chemotherapy and radia-

tion. Which of the following is INCORRECT regarding the treatment

of locoregionally advanced cervical cancer?

A. Several randomized trials involving patients with locally advanced

cervical cancer have demonstrated a benefit to the addition of

chemotherapy to standard radiation therapy.

B. Carboplatin appears to be the most appropriate agent to combine

with radiation therapy for cervical cancer, and this should be followed

by hysterectomy.

C. 5FU with cisplatin is an acceptable regimen to combine with radiation

therapy and has demonstrated improved survival.

D. Weekly cisplatin with radiation therapy appears as active as other

regimen with manageable toxicity.

Question 23.2.16.After receiving definitive concurrent chemoradiotherapy for her stage IIIB

cervical cancer, she develops a recurrence in the cervix, 18 months from

the completion of therapy. Imaging studies suggest no extrapelvic disease.

You recommend the following:

A. Referral back to the radiation oncologist for consideration of further

radiation

B. Chemotherapy with combined cisplatin and topotecan

C. Chemotherapy with combined cisplatin and paclitaxel

D. Referral for consideration of further surgery