Devita, Hellman, and Rosenberg's Cancer

LWBK1006-26 LWW-Govindan-Review December 12, 2011 19:29

Chapter 26•Sarcomas 367

Question 26.10. A 55-year-old man presented with a 10-cm mass in the medial left thigh.

Biopsy revealed a high-grade liposarcoma. Imaging revealed no evidence

of distant metastases. The most appropriate treatment of this patient’s

cancer would be:

A. Definitive radiation

B. Definitive radiation and concurrent doxorubicin

C. Limb-sparing resection followed by adjuvant radiation

D. Preoperative chemotherapy followed by resection

Question 26.11. A 52-year-old man with metastatic unresectable gastrointestinal stromal

tumor (GIST) was treated with imatinib (400 mg/d). Imaging showed

initial disease response; however, the disease progressed after 28 months

on therapy. The most appropriate treatment would be:

A. Erlotinib

B. Sunitinib

C. Doxorubicin

D. Imatinib 600 or 800 mg/d

Question 26.12. The following factors are independent predictors of poorer disease-

specific survival in patients with nonmetastatic soft tissue sarcoma,

EXCEPT:

A. Large tumor size (>10 cm)

B. High-grade histology

C. Extremity site

D. Older age (>60 years)

Question 26.13. A 48-year-old woman underwent complete resection of a 9-cm high-grade

leiomyosarcoma arising in the lower extremity. Postoperative adjuvant

radiation was administered. Two years later, a chest computed tomogra-

phy (CT) scan revealed a new single 3-cm, round, noncalcified pulmonary

nodule. What is the most appropriate next treatment?

A. Complete resection of the lung nodule

B. Radiation

C. Ifosfamide and doxorubicin

D. Docetaxel and gemcitabine

Question 26.14. Which of the following are FALSE about patients with metastatic or

locally recurrent soft tissue sarcoma?

A. Median survival is 12 months, although 20% to 25% of patients are

alive 2 years after diagnosis.

B. Complete resection of oligometastases to the lung can result in 5-year

survivorship in 20% to 30% of patients.

C. Re-resection is the preferred treatment of a locally recurrent sarcoma.

D. Combination chemotherapy improves overall survival compared

with single-agent chemotherapy.