Term
| What are the components of an oncology surgical approach to a physical exam? |
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Definition
-history
-visual inspection
-mass palpation
-evaluate: gross appearance, consistency, size, mobility
-palpation of regional lymph nodes
-secondary effects of a tumor present |
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Term
| What do you find out on a fine needle aspiration? |
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Definition
-cytological evaluation: cellularity
-definitive diagnosis: lymphoma, melanoma, mast cell tumor
-supportive information
-inflammation often accompanies tumors |
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Term
| What is the purpose of a biopsy? |
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Definition
-obtain a diagnosis
-need to know tumor behavior: degree of local invasion, metastatic potential, biologic activity |
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Term
| What are the major considerations that go along with a biopsy? |
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Definition
-invasiveness of the procedrure
-potential for intrarcavitary hemorrhage
-potential to seed tumor cells |
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Term
| What are the two types of biopsies? |
|
Definition
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Term
| What is an incisional biopsy? Advantages/disadvantages? |
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Definition
-removal of part of the tumor (specific behavior of tumor may affect treatment plan/decision)
-Disadvantage: requires a second surgery, seed tumor cells if not careful |
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Term
| What is an excisional biopsy? Advantages/disadvantages? |
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Definition
-remove an entire tumor with normal tissue, allows for a single procedure
-disadvantage: surgical excision may not be complete, may remove too much tissue |
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Term
How do the following relate to the selction of biopsy method?
a) size of skin mass
b) location of skin mass
c) fixed vs movable mass
d) musculoskeletal in origin |
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Definition
a)large = I & small = E
b) fixed = I & movable = E
c) near important structures = I & internal organs = E
d) musculoskeletal = I |
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Term
| Why do we bother with tumor staging? |
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Definition
| -to evaluate for progression/extent of sidease |
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Term
| What diagnostics do we do for tumor stagin? |
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Definition
-Bloodwork: CBC, serum biochem, UA
-Rads: three-view thoracic
-Ultrasound: abdomen to ID masses
-LN aspiration: enlarged/draining nodes
-Computed tomography
-MRI |
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Term
| What are the general surgical principles for surgical oncology? |
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Definition
| -one and done: normal anatomy, less chance of tumor metastasis, easier closure, less chance of surgical spread of tumor, excise all neopalstic tissue |
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Term
| What is the margin of excision dependent of? |
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Definition
-tumor type
-tumor grade
-location of tumor |
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Term
| What surgical principles define the margi of excition? |
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Definition
|
|
Term
| What are intralesional margins of excision? |
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Definition
| -leave gross tumor behind |
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Term
| What are marginal margins of excision? What are they used for? |
|
Definition
-just peripheral to pseudocapsule, reactive zone
-used for benign |
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Term
| When do we use wide and radical margins of excisions? |
|
Definition
-curative-intent recommended for solid tumors
-excise a margin of normal tissue
-1 or 2 facial planes deep |
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|
Term
| What are some forms of radical morgins? |
|
Definition
-entire tissue compartment
-splenectomy
-amputation
-mammary chain |
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|
Term
| Describe the techniques necessary for oncology surgery? |
|
Definition
-sharp dissection
-gentle tissue handling
-hemostasis: prevent release of tumor emboli
-ligate vein first
-minimal handling of tumor itslef
-use appropriate suture
-lavage
-avoid drain use if possible
-change istruments, gloves, drapes for closure |
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Term
| What is the purpose of painting the edges of a tumor biopsy? |
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Definition
| -allows for margin assessment |
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Term
| What should we evaluate of lymph nodes? |
|
Definition
-enlargement
-symmetry
-degree of fixation |
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Term
| True or False: Lymph node size indicates metastasis. |
|
Definition
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Term
|
Definition
-controversia
-ease of removal
-lymph nodes are a poor barrier to disease
-cytoreduction of tumor volume: for adjunctive therapy
-improve survival rates/ palliation:; reducing paraneopasti syndromes |
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Term
| When do we use palliative therapy/surgery? What is the goal of such treatments? |
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Definition
-used when cancer is not curable
-Goal: to improve quality of life |
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Term
| What are a few examples of palliative therapy/surgery? |
|
Definition
-upper airway obstruction
-non-resectable mass
-bone tumor, amputation not possible
-hemoabdomen |
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Term
| Describe oncology supportive therapy. |
|
Definition
-vascular access prots for chemo
-PleuroPort: access to a body cavity for intracavitary admin of chemo
-feeding tube
-pain management |
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Term
| What are some prophylactic surgeries we do for oncology? What types of neoplasia are they intended to prevent? |
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Definition
-ovariecetomy/ovariohysterectomy: mammary & ovarian/uterine neoplasia
-orchidectomy: testicular, perianal, prostatic neoplasia
-rectal polyp: often transform into malignancy |
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