Devita, Hellman, and Rosenberg's Cancer

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

Chapter 23•Gynecologic Cancers 321

Question 23.2.30.For this patient with three positive pelvic lymph nodes and a grade 2

endometrioid endometrial cancer, you recognize adjuvant therapy is con-

troversial but ultimately recommend:

A. Hormone therapy with a progestational agent

B. Referral for pelvic radiation therapy

C. Chemotherapy with combined paclitaxel, cisplatin, and doxorubicin

D. Combination of radiation and chemotherapy

Question 23.2.31.The patient completes your recommended adjuvant therapy. Unfortu-

nately, 18 months later she returns to your office with CT evidence of

liver and lung recurrent cancer that is biopsy proven. All of the following

are correct regarding recurrent endometrial cancer, EXCEPT:

A. Recurrence typically occurs within 3 years of the original diagnosis.

B. Approximately 50% of patients are symptomatic at the time of recur-

rence.

C. Serum CA-125 may be a useful surveillance marker for patients at

high risk for recurrence.

D. Isolated vaginal recurrence is rare in patients, and cure is only by

ultra-radical surgery.

Question 23.2.32.The most active (improved disease-free and overall survival) chemother-

apy regimen as determined in randomized clinical trials in women with

advanced or recurrent endometrial cancer with measurable disease is:

A. Doxorubicin plus paclitaxel

B. Cisplatin/doxorubicin

C. Cisplatin/doxorubicin/paclitaxel

D. Ifosfamide plus paclitaxel

Question 23.2.33.The following are true regarding uterine sarcomas, EXCEPT:

A. Represent approximately 10% of uterine corpus cancers.

B. The malignant mixed mullerian tumor is also known as uterine car-

cinosarcoma.

C. All different types of uterine sarcoma are treated similarly with resec-

tion followed by radiation therapy.

D. Uterine leiomyosarcoma is more chemoresponsive than most other

types of sarcomas.

Question 23.2.34.A 17-year-old female patient presents to your office with pelvic ultrasound

suggesting intrauterine gestational trophoblastic neoplasia (GTN). The

most common of the distinct clinicopathologic entities of GTN is:

A. Complete hydatidiform mole

B. Partial hydatidiform mole

C. Choriocarcinoma

D. Placental site trophoblastic tumor