Devita, Hellman, and Rosenberg's Cancer

LWBK1006-20 LWW-Govindan-Review December 12, 2011 19:4

Chapter 20•Cancer of the Gastrointestinal Tract 255

Question 20.3.11.Which of the following statements about adjuvant therapy for biliary

cancers is TRUE?

A. Although there is no clear evidence from one prospective randomized

trial, it appears patients treated in the adjuvant setting have a median

survival of approximately 2 years.

B. Adjuvant radiation is superior to chemotherapy alone.

C. Adjuvant therapy can improve overall survival for patients with R0

resections.

D. Fluoropyrimidine-based chemoradiation is standard because it is

superior to radiation alone.

Question 20.3.12.Which of the following statements regarding fibrolamellar HCC is

INCORRECT?

A. Fibrolamellar HCC occurs in equal frequencies in men and women.

B. This variant of HCC is uncommonly associated with prior cirrhosis

or viral hepatitis.

C. Lymph node metastases at the time of presentation are uncommon.

D. Most patients with fibrolamellar HCC present in their third decade

of life.

Question 20.3.13.You are consulted on a 50-year-old man with a history of chronic hep-

atitis B infection and Child-Pugh A cirrhosis, who presents with abdom-

inal pain. He is otherwise in good health. CT of the abdomen reveals

a cirrhotic liver with a 2.5 cm liver mass that rapidly enhances during

the arterial phase of contrast administration and “washout” during the

later venous phases. There is no involvement of the portal vein. AFP is

300 ng/mL. What is the next best step in his management?

A. Insist that he should get a biopsy.

B. Refer him to a hepatobiliary surgeon.

C. Start him on sorafenib.

D. Refer him to a radiation oncologist.

Question 20.3.14.Which of the following statements is NOT correct regarding hepatoblas-

toma?

A. This is the most common primary cancer of the liver in children.

B. Hepatoblastoma is a very chemosensitive tumor.

C. Patients with this tumor have a poor outcome after liver transplan-

tation, with a 5-year survival rate of 20%.

D. The peak incidence of hepatoblastoma is within the first 2 years of

life.