SESAP Questions

Category 2, Items 17 and 18

A 66-year-old otherwise healthy man undergoes esophagogastroduodenoscopy for progressive dysphagia. He has no other complaints. Endoscopy reveals a fungating partially obstructing lesion 30 cm beyond the incisors. Microscopic examination of a biopsy from the mass reveals adenocarcinoma, and an additional biopsy 4 cm proximal to the gastroesophageal junction shows Barrett’s esophagitis without dysplasia. The esophagogram and computed tomogram (CT) shown are obtained.

Item 17. Development of the malignancy is most likely related to

1. smoking

2. lye exposure

3. gastroesophageal reflux disease

4. heredity

5. esophageal diverticula

Item 18. Evaluation shows no sign of metastatic disease and the patient completes a preoperative program of two cycles of cisplatinum and fluorouracil (5-FU) with 45 Gy of radiation therapy.

After complete resection, the patient’s five-year survival would be

1. 5%

2. 10%

3. 35%

4. 50%

5. 75%

For each of the incomplete statements above, select the one answer that is best of the 5 given.

For the critique of this item see page 474.