Exam 3-Oral Cancer Lecture 2

Question 1

Advanced clinical signs of SCC: Firm to hard (______)

Answer 1

indurated

Question 2

Advanced clinical signs of SCC: Non-______ (bound down to adjacent tissues)

Answer 2

movable

Question 3

Advanced clinical signs of SCC: Irregular, exophytic growth with poorly defined _______

Answer 3

margins

Question 4

Advanced clinical signs of SCC: Non-healing ulceration, ______ borders are particularly ominous

Answer 4

Rolled

Question 5

What are the two areas of the oral cavity that are rarely affected by SCC?

Answer 5

1.Dorsum of tongue 2.Anterior portion of the Hard Palate

Question 6

Again, what are the three high risk sites for SCC (very similar to Dr. W’s high risk sites for leukoplakia)

Answer 6

1.Lower Lip 2.Post/Lateral Border of the tongue 3.Floor of Mouth

Question 7

SCC occurs more in _____ than ______, but cases of the later sex are increasing.

Answer 7

males than females

Question 8

Cases of SCC in females are increasing, what are the two sites in the mouth that are increasing? (minimal assoc with HPV)

Answer 8

tonsillar pillars/soft palate margins

Question 9

SCC in the _______ region is increasing in frequency because of a strong relation to HPV…the typical risk factors of tobacco and EtOH are not applicable here, its more c/o ______ and ______

Answer 9

oropharynx…sex at early age, multiple oral sex partners

Question 10

SURVIVAL directly correlates with ______ of the primary tumor and whether it has ______ beyond the primary site

Answer 10

SIZE…SPREAD

Question 11

People under this age are seeing an ALARMING increase in incidence of SCC…the rate has increased 3x since the 1980’s and the most common site in the mouth is _______

Answer 11

young adults under 40 years (maybe 45)….lateral border of the tongue

Question 12

Staging systems: what does TNM stand for?

Answer 12

Tumor Size, Nodal Metastasis, Metastatic Spread

Question 13

T1 = Tumor less than __ cm. maximum size

Answer 13

2

Question 14

T2 = Tumor more than __ cm. but less than ___ cm.

Answer 14

2-4

Question 15

T3 = Tumor more than __ cm. in size

Answer 15

4

Question 16

T4 = Massive tumor more than __ cm in size and with involvement of antrum, skin, pterygoid muscles, and/or base of tongue

Answer 16

4

Question 17

N0 = ________

Answer 17

No lymph node involvement

Question 18

N1 = ____ lymph node(s) on the same side as the tumor, less than ___ cm. in size

Answer 18

1…3

Question 19

N2 = _____ lymph node on _____ side as the tumor, __-__ cm. in size or ______ lymph nodes on the SAME side as the tumor, all less than ___ cm.

Answer 19

1…same…3-6 cm…multiple…6cm

Question 20

N3 = ________ or bilateral lymph node involvement or lymph node involvement on the same side greater than ___ cm. in size

Answer 20

contralateral…6cm

Question 21

(M for Million dollar workup) M0 =

Answer 21

No evidence of distant metastatic spread

Question 22

M1 = ________

Answer 22

Distant metastatic spread is present

Question 23

T1, N0, M0 = Stage ___…. 5 year Survival rate =

Answer 23

1…77-85%

Question 24

T2, N0, M0 = Stage ___…5 year Survival rate =

Answer 24

2…66-76%

Question 25

Any T3 OR N1 involvement = Stage ___….5 year Survival rate =

Answer 25

3….41-44%

Question 26

ANY T4, N2/N3, or ANY M1 = Stage ___….5 year Survival rate =

Answer 26

4…9-20%