Ch. 33 Colorectal Cancer PP

Question 1

most common histology type

Answer 1

adenocarcinoma

Question 2

2nd most common histologic type

Answer 2

mucinous adenocarcinoma

Question 3

histologic types with the worst prognosis

Answer 3

signet ring cell and squamous cell carcinoma

Question 4

most common staging system for colorectal cancer

Answer 4

TNM

Question 5

two most important prognostic indicators for survival

Answer 5

# of positive nodes
depth of penetration through the bowel wall

Question 6

classification according to the level of invasion into bowel wall and absence or presnece of positive nodes

Answer 6

Dukes staging

Question 7

describe dukes A to C

Answer 7

A: not penetrated through bowel wall
B: penetrated through bowel wall, negative nodes
C: positive nodes

Question 8

colorectal routes of spread

Answer 8

direct extension,
lymphatics,
blood, and
peritoneal seeding

Question 9

most come site of blood borne distant spread

Answer 9

liver

Question 10

second most common distant spread

Answer 10

lung

Question 11

two most comes rectal cancer surgeries

Answer 11

low anterior resection

abdominoperineal resection

Question 12

• removal of tumor plus a margin and immediately adjacent lyph nodes
• bowel reanastomsed, no colostomy

Answer 12

low anterior resection

Question 13

• Performed if cancer located in lower 1/3 of rectum (distal 5cm)
• Requires a colostomy
• Rectum, anus, and draining lymphatics pulled out through perineal opening
• Requires a reconstruction of the pelvic floor using absorbable mesh, omentum or peritoneum

Answer 13

abdominoperineal resection

Question 14

OAR when treating the pelvis

Answer 14

small bowel

Question 15

OAR when treating ascending or descending colon

Answer 15

kidney