Flashcards in Head and Neck Deck (20)
Patients with HPV-associated oropharyngeal cancer have higher survival rates compared with those with HPV-negative cancer. T or F?
Relationship between p16 expression and HPV?
p16 is unregulated when HPV E7 oncoprotein degrades the Rb protein, while p16 in HPV-negative tumors is silenced by epigenetic promoter methylation or genetic mutation.
Every year how many head/neck cancer patients develop a second primary?
What are the risk factors for head and neck cancer?
Tobacco, alcohol, HPV types 16 and 18 (oropharyngeal cancer), EBV (nasopharyngeal and paranasal sinus cancers)
Primary tumors of the oral cavity or oropharynx that are >= 4 cm are T4. T or F
F. They are T3. Those with massive local invasion of adjacent structures are classified as T4.
Vocal cord paralysis with a primary tumor in the larynx or hypopharynx indicates a T stage of no less than ---
What is the treatment for T1 or T2, N0 or N1, and M0 head/neck cancer?
Surgery or radiation (with salvage surgery as necessary). 5-yr OS can be 90%.
Treatment for higher volume stage III and stage IVA or IVB (without distant mets)?
Surgery followed by adjuvant radiation or chemorad OR definitive chemorad with surgery reserved for persistent disease or for recurrence of resectable disease. Cure rates range from 10% to 65%.
Treatment for cancer of unknown primary in the neck?
Neck dissection followed by XRT to include the likely primary sites and concurrent chemo if extracapsular extension of nodal disease is present.
When should metastatic adenoid cystic cancer and adenocarcinoma be treated?
Systemic treatment should be delayed until substantial to tumor growth can be appreciated on serial imaging studies within a six-month timeframe
What is the treatment for high-grade mucoepidermoid carcinoma
The same regimens used for squamous cell cancers from other sites
What are the different histologies of thyroid cancer?
Well differentiated thyroid cancer, anaplastic thyroid cancer, and medullary thyroid cancer
What are the etiologies for thyroid cancer?
The only well-documented etiology is radiation.
What is the treatment for thyroid cancer?
The mainstay of treatment is thyroid surgery. Radioactive iodine is used to ablate any normal thyroid remnant. If metastatic, radioactive iodine is the treatment of choice. Chemotherapy is reserved for disease that is refractory to radioactive iodine.
What I do chemo drugs used in thyroid cancer?
Doxorubicin with or without cisplatin.
Mutations in papillary carcinoma?
RET/PTC, BRAF, RAS
Treatment for locally recurrent or metastatic differentiated thyroid cancer?
Sorafenib, axitinib, pazopanib
Treatment for anaplastic thyroid cancer?
Resection if possible. Definitive or adjuvant chemorad with doxorubicin or doxo/cis. Radioactive iodine has no role.
Mutation in medullary thyroid cancer?