Chapter 120 - Esophageal Cancer | Attempts: 907

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| By Ryan Palmer

Ryan Palmer

Community Contributor

Quizzes Created: 6 | Total Attempts: 19,017

Questions: 8 | Attempts: 907 | Updated: Mar 22, 2023

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Cancer is a very tough subject to talk about and an even harder mountain to climb if you happen to suffer from it, but this quiz aims to at least spread awareness about one particular strand of the terrible illness – dealing with the oesophagus. Do you know as much as you should?

Questions and Answers

1.

Which of the following statements regarding the treatment of SCCa esophagealcancer is not true?
- A.
  
  In locally advanced operable cancer responding to chemoradiation, the continuation of chemoradiation is an alternative to surgery
- B.
  
  Preoperative chemoradiation improves the disease free survival in operable cancer
- C.
  
  Definitive chemoradiation increases survival compared with radiation alone
- D.
  
  In metastatic disease, chemotherapy provides a slight but significant increase in survival v best supportive care
Correct Answer
D. In metastatic disease, chemotherapy provides a slight but significant increase in survival v best supportive care

Explanation
Chemotherapy does not provide a significant increase in survival compared to best supportive care in metastatic disease.

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2
0
2.

Which of the following procedures has the highest morbidity and mortality rates?
- A.
  
  Tubed pec major myocutaneous flap
- B.
  
  Gastric pull up
- C.
  
  Colon transposition graft
- D.
  
  Free radial forearm fasciocutaneous graft
Correct Answer
C. Colon transposition graft

Explanation
A colon transposition graft is a surgical procedure where a segment of the colon is used to replace or reconstruct a damaged or diseased part of the urinary tract. This procedure involves significant risks and potential complications, leading to higher morbidity and mortality rates compared to the other options listed. The surgery carries the risk of infection, anastomotic leaks, bowel obstruction, and other complications associated with major abdominal surgery. Therefore, the colon transposition graft has the highest morbidity and mortality rates among the given procedures.

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3.

Which of the following reconstruction methods gives the highest rate of return tooral feeding?
- A.
  
  Tubed pec major myocutaneous flap
- B.
  
  Gastric pull up
- C.
  
  Colonic transposition flap
- D.
  
  Free radial forearm fasciocutaneous graft
- E.
  
  Free jejunum interposition graft
Correct Answer
B. Gastric pull up

Explanation
Gastric pull up is the reconstruction method that gives the highest rate of return to oral feeding.

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4.

Which of the following flaps is the most susceptible to ischemic injury?
- A.
  
  Deltopectoral flap
- B.
  
  Pec major myocutaneous flap
- C.
  
  Radial forearm free flap
- D.
  
  Lateral thigh free flap
- E.
  
  Jejunal free flap
Correct Answer
C. Radial forearm free flap

Explanation
The radial forearm free flap is the most susceptible to ischemic injury. This is because the flap relies on the radial artery as its main blood supply, which is a small vessel with limited collateral circulation. If there is any compromise to the radial artery, such as thrombosis or spasm, it can lead to inadequate blood flow to the flap and subsequent ischemic injury. Additionally, the radial forearm flap has a relatively thin and delicate skin paddle, making it more prone to ischemic damage compared to other flaps.

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5.

Which of the following has the greatest risk of esophageal cancer?
- A.
  
  Recently diagnosed tylosis in a 45 yr old
- B.
  
  Recently diagnosed Barrett’s
- C.
  
  Long-standing history of ETOH and tobacco with mild dysphagia
- D.
  
  Long history of achalasia
Correct Answer
C. Long-standing history of ETOH and tobacco with mild dyspHagia

Explanation
A long-standing history of ETOH (alcohol) and tobacco use with mild dysphagia poses the greatest risk of esophageal cancer. Both alcohol and tobacco are known risk factors for developing esophageal cancer. Dysphagia, or difficulty swallowing, can also be a symptom of esophageal cancer. Therefore, the combination of these factors increases the likelihood of developing esophageal cancer compared to the other options provided.

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1
0
6.

A circumferential esophageal tumor that is 3 cm is at what tumor stage?
- A.
  
  Tis
- B.
  
  T1
- C.
  
  T2
- D.
  
  T3
Correct Answer
C. T2

Explanation
A circumferential esophageal tumor that is 3 cm in size is classified as T2 stage. In the TNM staging system for cancer, T2 stage indicates that the tumor has invaded the muscularis propria layer of the esophageal wall. This means that the tumor has grown beyond the inner lining of the esophagus and into the deeper layers of the organ. The size of the tumor (3 cm) is also a factor in determining the stage, with T2 stage typically indicating tumors larger than 2 cm but not larger than 5 cm.

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7.

An esophageal tumor measuring 4cm with vocal cord paralysis and unilateralpalpable lymphadenopathy is clinically staged at what level?
- A.
  
  T2N1
- B.
  
  T2N2
- C.
  
  T3N1
- D.
  
  T3N2
- E.
  
  T1N1
- F.
  
  T1N2
Correct Answer
C. T3N1

Explanation
The correct answer is T3N1. This is because the tumor is measuring 4cm, which indicates a T3 stage. The presence of unilateral palpable lymphadenopathy suggests regional lymph node involvement, leading to an N1 stage.

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8.

An esophageal tumor measuring 5cm in its greatest dimension with involvementof the postcricoid mucosa is best treated by which surgical modality?
- A.
  
  Total larygopharyngectomy with cervical esophagectomy
- B.
  
  Wide excision with negative margins
- C.
  
  Cervical esophagectomy and wide excision of the postcricoid region
Correct Answer
A. Total larygopHaryngectomy with cervical esopHagectomy

Explanation
The correct answer is Total laryngopharyngectomy with cervical esophagectomy. This surgical modality involves the removal of the entire larynx and pharynx, along with the cervical esophagus. Since the tumor involves the postcricoid mucosa, which is located in the laryngopharynx, this surgical approach is the most appropriate. Wide excision with negative margins may not be sufficient to remove the entire tumor, and cervical esophagectomy alone may not address the involvement of the postcricoid region.

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Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Nov 09, 2010

Quiz Created by
Ryan Palmer

Chapter 120 - Esophageal Cancer

Which of the following statements regarding the treatment of SCCa esophagealcancer is not true?

Which of the following procedures has the highest morbidity and mortality rates?

Which of the following reconstruction methods gives the highest rate of return tooral feeding?

Which of the following flaps is the most susceptible to ischemic injury?

Which of the following has the greatest risk of esophageal cancer?

A circumferential esophageal tumor that is 3 cm is at what tumor stage?

An esophageal tumor measuring 4cm with vocal cord paralysis and unilateralpalpable lymphadenopathy is clinically staged at what level?

An esophageal tumor measuring 5cm in its greatest dimension with involvementof the postcricoid mucosa is best treated by which surgical modality?