Devita, Hellman, and Rosenberg's Cancer

LWBK1006-22 LWW-Govindan-Review December 12, 2011 19:7

Chapter 22•Cancer of the Testis 299

Question 22.11. Which of the following defines a seminoma with poor prognosis?

A. Mediastinal primary site

B. Brain metastases

C. A and B

D. None of the above

Question 22.12. Which of the following may be present in patients with intermediate-risk

nonseminoma?

A. Alpha-fetoprotein (AFP) of 20,000 ng/mL

B. HCG of 35,000 mIU/mL

C. Primary mediastinal site

D. None of the above

Question 22.13. Which of the following patients has good-risk metastatic seminomatous

germ cell tumor?

A. A 23-year-old man with testicular seminoma, elevated AFP and hep-

atic metastases.

B. A 38-year-old man with testicular seminoma, elevated AFP and pul-

monary metastases.

C. A 19-year-old man with primary mediastinal seminoma, normal AFP

and hepatic metastases.

D. A 28-year-old man with primary mediastinal seminoma, normal AFP

and pulmonary metastases.

Question 22.14. What is the standard chemotherapy regimen for patients with poor-risk

germ cell tumors?

A. Three cycles of BEP

B. Four cycles of EP

C. Four cycles of BEP

D. AorB

Question 22.15. Which of the following treatments have shown improved survival com-

pared with BEP in patients with poor-risk germ cell tumors in a random-

ized phase III trial?

A. Four cycles of etoposide, ifosfamide, and cisplatin (VIP)

B. Two cycles of BEP followed by high-dose chemotherapy and stem cell

support

C. A and B

D. None of the above

Question 22.16. What is the best treatment for a patient with poor-risk germ cell tumor

and compromised pulmonary function?

A. Four cycles of EP

B. Four cycles of VIP

C. Three cycles of BEP

D. Four cycles of bleomycin, vincristine, and cisplatin (BOP)