Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UGI > CA Eso > Flashcards

CA Eso Flashcards

1
Q

Risk factors for SCC

A

Smoking
Alcohol
Caustic injury
Low socioeconomic status
Poor oral hygiene
Achalasia
Hx of thoracic radiation
Nutritional deficiencies
Non-epidermolytic palmoplatnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for adenocarcinoma

A

BE
Symptomatic GERD
Obesity
Tobacco
Male
Increased Age
Low diet of vegetables and fruit
History of thoracic radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Field change/ cancerization

1) Definition
2) Clinical implication

A

1) the process whereby cells in a particular tissue/organ are transformed due to prolonged exposure to carcinogens such that genetically altered but histologically normal appearing cells predate the development of neoplasia or coexist with malignant cells
2) synchronous tumor up to 17%, mainly in SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tis

A

high grade dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T1a

A

invades lamina propria or muscularis mucosae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T1b

A

invades submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T2

A

invades muscular propria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T3

A

invades adventitia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T4a

A

resectable tumor
invades pleura/pericardium/diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T4b

A

unresectable tumor
invades other adjacent structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Regional lymph nodes

1) N1
2) N2
3) N3

A

1) 1-2 LNs
2) 3-6 LNs
3) 7 or more regional LNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definitions of

1) cervical esophagus
2) upper thoracic
3) middle thoracic
4) lower thoracic

A

1) UES to sternal notch (15-20cm from incisor)
2) sternal notch to azygos vein (20-25)
3) azygos vein to inferior pulmonary vein (25-30)
4) inferior pulmonary vein to EGJ (30-40cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Risk of nodal metastasis for

a) T1a
b) T1b

A

a) 5%
b) 16%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T stage subclassification

a) mucosa
b) submucosa

A

a) invades
M1- epithelial layer = Ts
M2-lamina propria = T1a
M3- invades muscularis mucosae = T1b
b) penetrates
SM1: shallowest 1/3 submucosa
SM2: 2/3 submucosa
SM3: deepest 1/3 submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tumor features affecting risk of LN metastasis

A

macroscopic appearance of lesion (flat/depressed/ulceration)
tumor size (>2cm)
lymphovascular invasion
histologic differentiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Argument of esophagectomy over ER in early superficial eso cancer

1) ADV
2) DISDV

A

1)Precise pathological staging
Permanent removal of all Barrett’s mucosa
2)
Risk of major complication
Long hospital stay
Risk of preoperative death
Long recovery
LT problems of swallowing

17
Q

Treatment options of superficial oesophageal cancer (M1,M2, M3 w/o LN invasion)

A

Endoscopic resection (EMR, ESD
Endoscopic ablation (RFA, PDT, cryotherapy)
Esophagectomy
EBRT

18
Q

Staging for ca esophagus. Five year survival

1) I
2) IIa
3) IIb
4) III
5) IV

A

1) 50-80%
2) 30-40%
3) 10-30%
4) 10-15%
5) < 5%

19
Q

Criteria for resection

A

T1-T2N0M0
T3N0M0 after neoadj chemoRT
Selected T4a

20
Q

Surgical approaches for esophagectomy

A

1) transhiatal vs transthoracic
2) thoracoabdominal, 2 phase, 3 phase

21
Q

McKeown procedure

1) Defn
2) Indication

A

1) Tri-incisional oesophagectomy, 3 phase
1) Tri-incisional oesophagectomy, 3 phase
- Right thoracotomy: mobilise esophagus and tumor
- Laparoscopy (abdominal): creation of gastric conduit

  • Left neck incision: anastomosis of stomach to cervical oesophagus
    2) Middle or distal esophageal cancer
22
Q

Ivor Lewis procedure

1) Defn
2) Indication

A

1)2 phase oesophagectomy

Laparotomy: stomach mobilisation + creation of gastric conduit

Right thoracotomy: resection of tumour and anastomosis to proximal oesophagus

2)Low thoracic or EGJ cancers

23
Q

1FLND

A

“1 field lymph node dissection”
dissection of only abdominal field

24
Q

2FLND

A

abdominal + thoracic field

25
Q

3FLND

A

cervical + thoracic + abdominal fields

26
Q

Methods of oesophageal reconstruction

A

1) Presternal
2) Retrosternal
3) Posterior mediastinal (most preferred)

27
Q

Possible organs for reconstruction

A

Stomach
Colon
Jejunum

28
Q

Methods of stomach lengthening

A

Kocher maneuver
Excision of lesser curve of stomach
Incision of serosa on the gastric wall

29
Q

Two possibilities for effective isoperistaltic colon

A

1) transverse colon based on left colic vessels
2) right colon based on middle colic vessels

30
Q

Indications for colonic reconstruction

A

Previous gastric resection
Tumors with extensive gastric involvement
Failed gastric transposition

31
Q

Indications for jejunal reconstruction

A

after pharyno-laryngectomy performed for carcinoma of hypopharyx, postcricoid region and cervical oesophagus

32
Q

PLO

1) Defn
2) Indication

A

1) removal of larynx, lower pharynx, cervical trachea, one or both thyroid lobes and cervical oesophagus
2) ca eso or hypopharynx

33
Q

Grey Turner

A

Transhiatal oesophagectomy

for early stage tumours with low risk of LN metastasis

34
Q

Complications

A

Respiratory cx
Cardiac cx
Anastomotic leak (5%)
Chyle leak (3-4%)
Ischemic conduit
Wound problem (3%)
Reoperation (<10%)
GERD
Anastomotic stricture

35
Q

Palliative aims

A

Pain control
Symptomatic control
Nutrition
Luminal control of dysphagia (stent/RT/ndYAGlaser)
Control of distant disease (chemo, monoclonal antiB)

36
Q

Early complications of esophageal stenting

A

Chest pain
Bleeding
Perforation/fistulation
Aspiration
Malposition
Incomplete expansion

37
Q

Late complications of esophageal stenting

A

Food bolus obstruction
Migration
Overgrowth
Ulceration
Perforation
Fistula
Stent fracture

38
Q

LN involved in abdominal field dissection

A

1- right cardia

2-left cardia

3-lesser curvature

7- left gastric

8- common hepatic artery

9- celiac artery

11- splenic artery

19- infradiaphragmatic

20- paraesophageal

39
Q

LN involved in thoracic field dissection

A
  • R + L recurrent nerve
  • pretracheal
  • R + L tracheobronchial
  • R+ L main bronchus
  • subcarinal
  • upper + middle + lower thoracic paraesophageal
  • supradiaphragmatic
  • posterior mediastinal (include thoracic duct nodes)

UGI (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions