LWBK1006-40 LWW-Govindan-Review December 12, 2011 20:33
Chapter 40•Treatment of Metastatic Cancer 513ANSWERS
Answer 40.1. The answer is D.
In patients with metastases to the lungs, complete resection of the tumor
nodules in the lung, when feasible, was associated with improved over-
all survival when compared to patients with unresectable metastasis or
partial resection of lung metastasis.Answer 40.2. The answer is B.
Synchronous liver metastases are slightly less frequent in females than
males. Similarly they are less frequent in patients older than 75 years old
compared to younger age patients.Answer 40.3. The answer is D.
Age and sex of the patient did not have an impact on survival outcome
whereas performance status, tumor grade, lymph node involvement, and
extrahepatic disease are independent prognostic factors for survival. Also
percentage of liver replaced by tumor (less than 25% vs. greater than
25%) was prognostic for survival.Answer 40.4. The answer is D.
Subtrochanteric segment extends from lesser trochanter to the junction
of the proximal and middle-thirds of the diaphysis, and is subject to very
high axial loads of weightbearing and tremendous bending forces. All
these features make it appropriate for operative management.Answer 40.5. The answer is D.
Prostate cancer along with oropharyngeal and non-melanoma skin can-
cers are rarely associated with tumor metastases to the brain. Lung, breast,
colorectal cancers along with melanomas, kidney, and thyroid cancers
have higher rates of metastases to brain.Answer 40.6. The answer is D.
The international registry of lung metastases notes up to 60% survival at
10 years for patients with germ cell tumors who underwent resection of
their lung metastases, whereas the survival with the other listed cancers
is not so good.Answer 40.7. The answer is A.
The hippocampus is the most sensitive area of the brain to whole brain
radiation. With newer techniques it is possible to minimize the dose to the
hippocampus while delivering the full dose to the brain. Treatment with
WBRT is associated with a complete response rate of 37% in patients
with small cell lung cancer and brain metastases.