Devita, Hellman, and Rosenberg's Cancer

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

366 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 26.5. In addition to site, which of the following variables is used to estimate

the risk of sarcoma-specific death for a given patient?

A. Tumor grade and histology

B. Tumor size and depth

C. Age

D. All of the above

Question 26.6. Which of the following is NOT true regarding the staging of soft tissue

sarcomas?

A. Stage II includes small (<5 cm) high-grade tumors without metas-

tases.

B. Stage IV includes distant but not nodal metastases.

C. All low-grade tumors are classified as stage I if not metastatic.

D. Histologic grade, size, depth, and presence or absence of nodal and

distant metastases are variables used to determine tumor stage.

Question 26.7. A 52-year-old man underwent resection of a 3-cm mass from the lateral

left thigh. Pathology revealed a high-grade leiomyosarcoma, and the lat-

eral surgical margin was positive. The most appropriate next step in the

treatment of this patient’s cancer would be:

A. Radiation

B. Adjuvant chemotherapy

C. Re-resection

D. Observation

Question 26.8. A 68-year-old woman presented with a purplish nodular lesion in the

occipital scalp. Resection revealed an angiosarcoma measuring 3 cm. Sur-

gical margins were negative. What is the most appropriate next step in

the treatment of this patient’s cancer?

A. Radiologic imaging to look for nodal metastases and referral for adju-

vant radiation

B. Monitoring

C. Adjuvant chemotherapy with an anthracycline

D. Adjuvant chemotherapy with paclitaxel

Question 26.9. A 65-year-old woman presented with abdominal pain and iron-deficiency

anemia. Workup revealed a gastric mass and multiple large intra-

abdominal masses and liver hypodensities. Biopsy of the gastric mass

revealed a spindle cell neoplasm thought to be a leiomyosarcoma. After

three cycles of doxorubicin and ifosfamide, imaging showed disease pro-

gression. The appropriate next step in the management of this patient’s

cancer would be:

A. Docetaxel and gemcitabine

B. Dacarbazine

C. Request the pathologist to perform a CD117 (c-Kit) stain

D. Palliative radiation