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USMLE cancer stag

QuestionAnswer
MC type of colon cancer and risk factors adeno; >50, polyps, IBD (esp UC), FMH, high fat/low fiber
grading colon cancer Dukes: A=mucosa, B=through musoca, C=regional LN, D=mets
MC type of liver cancer and risk factors hepatocell; smoking, cirrhosis, hemochromo, Wilson, AAT, glycogen storage dz I, schisto, chemicals (VAT=aflatoxin, vinyl Cl, thorotrast)
MC type of GB cancer and risk factors adeno; assoc w gallstones, cholecystenteric fistula, porcelin GB
MC type of cholangiocarcinoma (bile duct) cancer and risk factors adeno of prox bile duct; 4Cs: 1ry sclerosing cholangitis (MC), UC, choledochal cysts, clonorchus infxn in Hong Kong
risk factors pancreatic cancer inSPECt the Death Order: smoking, heavy EtOH, chronic pancreatitis, DM, hi fat/obesity, chemicals (benzidine dyes, azo dyes), CDKN2A mutation (familial melanoma)
risk factors for squa cell eso cancer smoking, EtOH, nitrosamines, betel nuts, achlasia, Plummer-Vinson
risk factors for adeno eso cancer GERD, Barretts
grading eso cancer I=lamina propria or submucosa, II=muscul propria or adventitia, IIb=muscul propria + regional LN, III=adventi+region LN or local invasion, IV=mets
MC type of gastric cancer and risk factors GAP in the HAMPer: Gastritis, H Pylori, Salts/nitrites/smoked foods, Pernicious anemia, Menetrier, antrectomy, blood type A
grading Hodgkins Ann Arbor: I=single LN, II=2 LN same side diaphragm, III=both sides diaphragm, IV=extralymph
grading CLL 0=lymphocyt, 1=lymphocyt + LAD, 2=lymphocyt + splenomegal, 3=lymphocyt + anemia, 4=lymphocyt + decrsd plts
MC type of thyroid cancer, risk factor generally for thyroid cancer papillary; Risk factors for papillary: radiation, Cowdens, Gardners; MENII,III at risk for medullary
MC type prostate cancer, risk factors adeno; AGE, AA, high fat, fam hx, herbicies/pesticides
grading prostate cancer A=nonpalp,B=palp within prostate, C=beyond prostate, D=mets
MC type bladder cancer, risk factors transitional; smoking, dyes (aniline, azo), radiation, coffee, sweeteners, cyclophosphamide, schistosomiasis haemo (sq cell)
grading bladder cancer 0=mucosa, A=lamina propria, B=mscl invasion, C=perivesicular fat, D=mets to LN
tx difft stages prostate cancer A,B=radical prostatectomy; C=radiation + anti-androgen; D=anti-androgen
tx difft stages bladder cancer 0=intravesicular chemo, A=resxn (but recur); B,C=cystectomy and LN, D=cystectomy and chemo
MC type renal cancer, risk factors renal cell; smoking, phenacetin analgesics, PCKD, VHL, Hg&Cd exposure
MC type of testicular cancer, general risk factors germ cell seminoma; cryptorchidism, Klinefelter
grading testicular cancer A=testicle, cord; B=LN below diaphragm; C=distant mets
tx difft stages testicular cancer orchiotomy, seminoma=also f/u radiation; nonseminoma=also +/- chemo
MC type penile cancer, risk factors SCC; HSV, HPV18, (circumcision may protect)
MC type skin cancer, risk factor basal cell; sun, coal tar, arsenic, familial melanoma/dysp nevi, BC nevus syn, albinism, Xeroderma pigmentosum, III=distant met
MC type lung cancer, general risk factors NSCLC adeno; smoking, asbestosis, COPD
risk factors breast cancer BRAC1,2; prolonged unopposed estrogen (early menarche, late menopause, nulliparity, late age 1st pregnancy, >40yo), high fat intake, obesity
tx breast ca Lumpectomy if <4cm, simple mastectomy if widespread DCIS or LCIS; modified radial mastectomy (where also remove breast and axillary nodes) for larger tumors
risk factors ovarian ca BRCAI gene predisposes, FMH, grtr
staging ovarian ca I limited to ovaries, II beyond ovaries, (uterus, tubes, + pelvic cytology), III within pelvis, (peritoneal mets or LN), IV distant mets, involves bladder or rectum
tx ovarian ca cytoreductive debulking surgery: TAH-BSO, omentectomy, bowel resxn as nec. Given post op chemo (carboplatin&Taxol)
risk factors cervical ca early age of coitus, mltpl sex partners, smoking, immunosuppress, HPV16,18, OCP>10yrs
staging cervical ca 0=CIS (Within epithelium), I=within cervix (MC), Ia1=depth 3mm (minimally invasive), Ia2=depth >3mmIb=depth >5mm, IIa=beyond cervix, upper 2/3 vagina, IIb=parametria involved, III=pelvic wall or 1/3 vagina, IV=bladder, rectum, mets
tx cervical ca IA1=simple hysterectomy, IA2=modified radical hysterectomy w upper 1/3 vagina, IB/IIa=radial hysterectomy+LN dissection OR radiation; IIb,III,IV=radiation. Adjuvant given as nec
when adjuvant tx given for cervical ca after surgical tx Adjuvant (radiation and chemo) given if: met to LN, tumor>4cm, poorly diffted lesion, + marg
risk factors endometrial ca nulliparity, late menopause, chronic anovulation (ie PCOS); DM, HTN, obesity
staging endometrial ca I=remains in uterus (endometrium and myometrium), II=cervical stroma, (endocervical glands, cervical stroma), III=serosa, adenxa, positive cytology, vagina, pelvic or para-aortic nodes, IV=bladder, rectum, distant mets [MC lungs]
tx endometrial ca Surgical: total abdominal hysterectomy and bilater salping (TAH-BSO), pelvic and para-aortic LN, peritoneal washings; Radiation post op as nec
when adjuvant tx given endometrial ca Radiation: based on post-op findings if have poor px get radiation: met to LN, >50% myometrium, positive surgical margins, poorly difftd histology Chemo: for metastatic dz
risk factors vulvar ca obesity, HTN, HPV16,18
staging vulvar ca Stage 0 (CIS): basement membrane intact, Stage I: <2cm, nodes not palpable, Stage II: >2cm, confined to vulva, Stage III: spread to lower urethra, vagina or anus, unilateral nodes, Stage IV: upper urethra, bladder or rectum bilateral nodes, distant mets
tx vulvar ca <2cm and invasion <1mm can have local excision, if >1mm need LN dissection
Created by: ehstephns on 2011-01-15



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