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WorksheetsLaryngeal and Hypopharyngeal Cancer
Total questions: 15
Worksheet time: 10mins
Which subsite of the larynx has the highest risk for distant metastasis?
Supraglottis
Glottis
Subglottis
What is the primary surgical treatment for subglottic SCC?
Endoscopic resection
Total laryngectomy with paratracheal node dissection
Vertical partial laryngectomy without neck dissection
Total laryngopharyngectomy
What percentage of patients who have failed radiation for advanced larynx cancer are suitable candidates for salvage surgery?
10%
25%
50%
67%
What lies just medial to the greater horn of the thyroid cartilage?
Vallecula
Laryngeal Vestibule
Piriform Sinus
Tonsillar Fossa
What percent of severely dysplastic carcinoma in situ progress to malignancy?
3%
24%
18%
34%
What was the key conclusion of the VA Laryngeal Cancer Study?
TL for stage IV laryngeal SCC provides best survival outcomes
Early stage laryngeal SCC can be treated with chemotherapy alone
Total laryngectomy is the ideal method of laryngeal preservation
ChemoRT can preserve larynx in 2/3 of late stage patients without compromising survival
Your VA patient was treated with XRT for T1bN0M0 SCCA left TVF. You find persistence of tumor. You are considering a hemilaryngectomy for him. What would make him a bad candidate for this procedure according to the Biller criteria?
No involvement of contralateral cord
Tumor has 7mm extension into the subglottis
Vocal cord process is involved
No cartilage involvement
Which of the following are risk factors for the development of a pharyngocutaneous fistula after TL?
Anemia
Prior radiation treatment
COPD
GERD
Which form of nonsurgical treatment in advanced laryngeal cancers has the highest 2 year survival rate?
Induction chemotherapy followed by radiation
Radiation
Concurrent chemoradiation
None of the above
Treatment options for management of the clinically node negative neck in hypopharyngeal SCCa
observation
elective neck dissection
radiation therapy
The rate of regional nodal metastasis of T1 hypopharyngeal SCCa
10-30%
30-50%
50-70%
70-90%
Which of the following indicate the need for level VI neck dissection in hypoopharyngeal cancers
vocal cord fixation
post-cricoid
pyriform sinus involving apex
lateral pharyngeal wall
For hypopharyngeal cancers, adjuvant RT or chemoradiotherapy is indicated after surgery for patients who have the following:
Positive resection margins
lymphovascular or perineural invasion
extranodal extension
pathologically positive lymph nodes identified after neck dissection.
The most common location of hypopharyngeal cancers
Pyriform Sinus
post cricoid
posterior pharyngeal wall
Would you get a total laryngectomy?
Yes
No
