URO - TST TMR

Question 1

True about testicular cancer EXCEPT

a. What is the most common solid tumor in men between ages 25 and 35 years?
b. hCG, AFP, and LDH are helpful in establishing the correct diagnosis
c. scrotal utz is extremely accurate with >95% sensitivity and specificity
d. NOTA

Answer 1

A

Question 2

True about tumor markers EXCEPT
a. initial studies must include tumor markers including AFP, BhCG, LDH
b. elevated tumor markers are found almost exclusively in seminomatous germ cell tumors
c. 10% of px with localized seminomas and 25% with metastatic seminomas will have a modest rise in B human chorionic gonadotropin.
D. The presence of an increased AFP level ina patient whose tumor shows only seminoma, the patient should be treated for nonseminomatous GCT

Answer 2

B. nonseminomatous

Question 3

True about LDH

a. less specific than AFP or hCG as tumor marker
b. increased in 50-60% of the patients with metastatic nonseminoma
c. 80% of patients with advanced seminoma will have elevated LDH
d. AFP hCG and LDH levels should be determined before and after orchiectomy

Answer 3

D

Question 4

half life of AFP

Answer 4

5-7 days

Question 5

half life of hCG

Answer 5

36h

Question 6

what does reappearance of hCG and/or AFP or the failure of these tumor markers to decline according to the predicted half life is an indicator of

Answer 6

persistent or recurrent tumor

Question 7

True about management of testicular cancers EXCEPT

a. Patients suspected having a testicular neoplast should undergo a radcal inguinal orchiectomy with removal of tumor-bearing testis and preservation of the spermatic cord
b. After orchiectomy, CT scan o the chest, abdomen and pelvis is generally performed
c. Radical Inguinal Orchiectomy is curative in 80-85% of CS I seminoma and
d. Radical Inguinal Orchiectomy is curative in 70-80% of CS I NSGCT

Answer 7

A

spermatic cord is not preserved

Question 8

The landing zone for the left sided tumors is the

Answer 8

paraaortic and left renal hilar lymph nodes

Question 9

The landing zone of right sided tumors is the

Answer 9

interaortocaval and paracaval lymph nodes

Question 10

What are the acceptable staging modalities in the absence of retroperiteneal lymphadenopathy or elevated serum tumor marker levels

Answer 10

Chest radiography and CT

Question 11

Over 80% of patients with clinical stage IA nonseminoma are cured with

Answer 11

Orchiectomy alone

Question 12

T/F there is no survival advantage to RPLND or adjuvant chemo tx for Non seminomatous GCT stage IA

Answer 12

T; surveillance for LN

Question 13

Patient with testicular tumor, found out to be non-seminomanous GCT, with limited, ipsilateral retroperitoneal adenopathy <2cm in largest diameter, normal levels of AFP and hCG

Answer 13

Surveillancemodified bilateral nerve-sparing RLND or chemotx

Question 14

What is the treatment for Stage 1 seminoma

Answer 14

inguinal orchiectomy followed by immediate retroperitoneal radiation therapy or surveillance with treatment at relapse both result in cure in nearly 100% of patients with stage 1 seminoma

Question 15

Seminoma: Treatment of non bulky retroperitoneal disease (stage IIA or small Stage IIB)

Answer 15

retroperitoneal radiation

Question 16

Seminoma: What percentage of patients will have relapse-free survival with RT tx of retroperitoneal masses <3 cm in diameter?

Answer 16

90%

Question 17

Initial treatment for all stage IIC and some stage IIB seminoma

Answer 17

neoadjuvant chemotx

Question 18

What is the treatment of all Stage IIC and Stage III and most stage IIB GCT, regardless of histology?

Answer 18

chemotx