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GI Flashcards

1
Q

T staging for gastric cancer

A

T1a: lamina propria or muscularis mucosa, T1b: invades submucosa, T2: invades muscularis propria, T#: invades subserosa, T4a: invades serosa, T4b: invades adjacent structures

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2
Q

Management of cT1-2N0 anal

A

chemoradiation 42/5040

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3
Q

Liver mean constraint during gastric RT

A

mean <25 Gy

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4
Q

femoral heads constraint

A

V40<40%, V45<25%, Max , 50 Gy

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5
Q

management for resectable panc

A

whippe, adj chemo, adj CCRT for positive margin or N+ disease.

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6
Q

Which surgery spares sphincter

A

LAR

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7
Q

Lab workup for gastric

A

CBC, CMP, H. pylori, CEA

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8
Q

management of T2N0 esophagus

A

esophagectomy for select candidates, primary <3cm, well-differentiated

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9
Q

management of cT2+ or N+ gastric cancer

A

periop chemo, FLOT gastrectomy FLOT, adj CCRT if positive margin or poor responder.

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10
Q

Management for T1N0 rectal

A

Transanal excision

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11
Q

What nodes to treat in extrahepatic HCC

A

RPLN, celiac, SM, PH, Gastrohepatic

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12
Q

Anal canal superior edge

A

palpable upper border of anal sphincter

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13
Q

management of extrahepatic HCC

A

surgery, LND, adj cape x 6 months, adjuvant CCRT for margin positive, llT2-T4 or any N1, 54 in 30 45 to nodes.

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14
Q

constraints for liver for liver sbrt

A

Spare 700 cc to < 15 Gy, Mean < 15 Gy

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15
Q

Bladder constraint during rectal rt

A

V40<40%, V45<15%, Max , 50 Gy

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16
Q

N staging for pancreas

A

N1: 1-3 LN, N2: 4+ LN

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17
Q

anal margin distance

A

5 cm from anal verge

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18
Q

labs for pancreatic cancer workpu

A

CBC/CMP, CA19-9, glucose, amylase, lipase, LDH, CEA

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19
Q

N staging for gastric cancer

A

N1:1-2LN, N2: 3-6 LN, N3a: 7-15 LN, N3b: 16+ LN

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20
Q

T staging for rectal cancer

A

T1: invasion of submucosa, T2: muscularis propria, T3: into perirectal tissue, T4a: through visceral peritoneum, T4b: organ invasion

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21
Q

Kidney constraint during panc radiation

A

V18<30%, if only 1 kidney V18%<10%

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22
Q

lower thoracic esophagus location

A

30-40 cm

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23
Q

Siewert III

A

2-5 cm into stomach, treat like gastric.

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24
Q

Anal canal inferior edge

A

anal verge

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25
Q

cervical esophagus lengths

A

15-20 cm

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26
Q

Concurrent chemo for anal

A

CI 5-Fu 1000mg/m2 D1-4 D29-32 + MMC 10 mg/m2 D1 D29 q4w x2. (cisplatin to replace MMC if can’t tolerate)

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27
Q

SB constraint during 5 fraction rectal

A

Max<25 Gy

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28
Q

High risk colonoscopy screening

A

q5y starting at age 40

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29
Q

What imaging is needed for pancreas

A

triphasic CT

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30
Q

SBRT dose for HCC

A

50 in 5

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31
Q

GE junction location

A

40-45 cm, GEJ to 5 cm into stomach.

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32
Q

management of T3+ N+ esophagus

A

preop CCRT

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33
Q

Rectal SB constraint

A

V35<180 cc, V40<100cc, V45<65cc

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34
Q

workup for T1b+ gastric cancer

A

diagnostic laparoscopy

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35
Q

Concurrent chemo for rectal

A

cape: 825 mg/m2 PO BID 5 days/week during RT

36
Q

Layers of rectum

A

muscularis mucosa, submucosa, muscularis propria, perirectal fat

37
Q

T stage for pancreatic cancer

A

T1a: <=0.5mm, T1b: 5-10mm, T1c: 1-2 cm, T2: 2-4 cm, T3: >4 cm, T4: involves CA, SMA, or CHA

38
Q

Lab workup for anal

A

CBC, CMP, HPV, HIV, pregnancy

39
Q

management of oligometastatic rectal cancer

A

chemo then short course, restage at 8 weeks and resect primary, SBRT to mets, then additional chemo

40
Q

Siewert I

A

1-5 cm above

41
Q

Stomach max during panc rt

42
Q

mid thoracic esophagus location

43
Q

Average risk colonscopy screening

A

age 50 q10 years

44
Q

management for cTis-T1a gastric cancer

A

endoscopic resection or gastrectomy, if R0: observe, if R1: adj CCRT, R2: adj CCRT

45
Q

What is resected in whipple?

A

panc head and body, distal stomach, duodenum, proximal jejunum, gallbladder, distal CBD.

46
Q

What are N1 sites for gastric cancer

A

Lesser curv, greater curv, left/right cardia, suprapyloric, infrapyloric

47
Q

N stage for anal cancer

A

N1a: inguinal, perirectal, or internal iliac LN, N1b: external iliac LN, N1c: N1a+N1b

48
Q

Do you treat common iliac with rectal

A

only if T4

49
Q

Management of HCC

A

resect if possible, ClassA/B no portal HTN

50
Q

management of cT1b gastric cancer

A

gastrectomy, R0: observe, R1-R2: adj ccrt (45Gy in 25)

51
Q

Management of T2N0 rectal

52
Q

postop treatemnt T4 or N+ after APR/LAR

A

FOLFOX then CCRT

53
Q

Mangement of Intrahepatic cholangio

54
Q

managemenet of unrsectable panc

A

neoadj folfirinox, restaging, defintive CCRT if needed

55
Q

What do you need to calculate child’s pugh score

A

total bili, serum albumin, PT INR, Ascites, Encephalopathy, A5-6, B 7-9, C10-15

56
Q

T stage anal

A

T1: <=2cm, T2 2-5, T3: >5, T4: invasion of organs

57
Q

N2 sites for gastric cancer

A

Celiac, Left gastric, common hepatic, splenic hilum, splenic artery

58
Q

management of T1bN0 esgphagus

A

esophagectomy

59
Q

T stage for esophagus

A

T1a: lamina propria or muscularis mucosa, T1b: invades submucosa, T2: invades muscularis propria, T3: invades adventitia, T4a: invades pleura, pericardium, diaphragm, azygos vein, or peritoneum, T4b: invades aorta, vert body, or airway

60
Q

Do you treat external iliac with rectal

A

only if T4

61
Q

upper thoracic esophagus location

62
Q

Nonoperative approach for rectal

A

T1-2N): ccrt, T3 or N+: CCRT then chemo. cCR can observe

63
Q

Rectal length

64
Q

Siewert II

A

1 to -2 cm around GEJ

65
Q

What are criteria for no further tx after transanal resection for rectal cancer?

A

<3cm, margins>3mm, <30% lumen circumference, G1, No LVSI, mobile

66
Q

Treatment for Tis esophagus

A

endoscopic resection preferred over esophagectomy

67
Q

M staging rectal

A

M1a: 1 DM, M1b: 2+ DM without peritoneal mets, M1c: peritoneal mets

68
Q

management for borderline resectable pancreas

A

neoadj folfirinox, restaging, neoadj ccrt if needed

69
Q

Anal canal length

70
Q

chemo for ccrt of esophagus

A

carboplatin AUC=2, paclitaxel 50 mg/m2 q1w x5

71
Q

When do you treat nodes for pancreatic

72
Q

N3 sites for gastric

A

hepatoduodenal, retropanc, pancreaticoduodenal, peripanc, superior mesenteric, middle colic (N4), para-aortic (N4)

73
Q

MRI T staging for rectum

A

T3a<1mm, T3b: 1-5mm, T3c: 5-15 mm, T3d >15 mm

74
Q

postop treatemnt T1-2N0 after APR/LAR

75
Q

Liver mean during panc RT

A

Mean <30 Gy

76
Q

What LNs to cover when doing RT for gastric cancer

A

perigastric, celiac, left gastric, splenic artery, common hepatic artery/porta hepatis, suprapyloric/infrapyloric, pancreaticoduodenal

77
Q

N stage for esophagus

A

N1: 1-2 LN, N2: 3-6 LN, N3: 7+ LN

78
Q

Management of cT3-4 or N+ anal

A

CCRT 45/50.4/54/54, elective, <3cm LN, >3cm LN, primary

79
Q

postop treatemnt T3N0 after APR/LAR

A

CCRT then folfox or capeox, consier obs for low grade upper rectum, minimal invasion, no LVSI

80
Q

Management of T3N0 or higher rectal cancer

81
Q

management of T1aN0 esophagus

A

endoscopic resection preferred over esophagectomy

82
Q

N staging for rectal cancer

A

N1a: 1 LN, N1b: 2-3 LN, N1c: No regional LN but tumor deposits in subserosa, mesentery, or non-peritonealized perirectal/mesorectal tissues., N2a: 4-6 LN, N2b: 7+ LN

83
Q

What if you have high risk features after Transanal excision for rectal cancer

A

finish with LAR or APR

84
Q

Heart mean and V30 during panc rt

A

Mean<30 Gy and V30<20%

85
Q

Rectal lateral field posterior border

A

T4: 1 cm behind sacrum T3: 2 cm into sacrum

86
Q

Rectal lateral field anterior border:

A

T4: anterior to pubic symphysis, T3: posterior to pubic symphysis

Constraints (10 decks)

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