Devita, Hellman, and Rosenberg's Cancer

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

Chapter 23•Gynecologic Cancers 319

Question 23.2.21.Which of the following histologic features does not predict the outcome

for a patient with vulvar cancer?

A. Presence of lymphovascular invasion

B. Tumor grade

C. Depth of invasion and tumor thickness

D. Number of positive lymph nodes

Question 23.2.22.Her final pathology reveals a 3.3-cm invasive squamous cell carcinoma

with two involved (positive) lymph nodes in the right inguinal/femoral

lymph node dissection of 12 removed. The contralateral node dissec-

tion was negative. Margins around the primary tumor were negative and

greater than 1 cm. Her appropriate International Federation of Obstetri-

cian & Gynecologist (FIGO) and TNM stage are:

A. IVA and T2N1M0

B. II and T2N2M0

C. III and T3N1M0

D. III and T2N1M0

Question 23.2.23.The most appropriate therapy for this patient after she recovers from

surgery is:

A. Close observation

B. Chemotherapy with cisplatin plus 5FU

C. Referral for consideration of radiation therapy

D. Exploration with dissection of the pelvic lymph nodes

Question 23.2.24.Unfortunately, despite the use of adjuvant therapy, this patient’s cancer

recurs locally on the vulva, and a 2-cm recurrence is documented. You

advise which of the following:

A. Repeat resection

B. Chemotherapy with bleomycin

C. Best supportive care

D. Chemotherapy with cisplatin plus 5FU

Question 23.2.25.A 62-year-old woman has been diagnosed with a uterine corpus (body)

cancer. You have not received her records for review, but she is seen in

your office for consultation and asks many general questions. You tell her

all of the following are true, EXCEPT:

A. Approximately 90% of these cancers arise from the endometrial lin-

ing and are typically managed with hysterectomy and staging.

B. Most of these cancers are caused by exogenous estrogen use.

C. Uterine sarcomas are less common than endometrial cancers and rep-

resent approximately 10% of corpus cancers.

D. Endometrial cancer typically presents at an early stage with patients

having abnormal uterine bleeding.