Upper tract TCC
Choose the best answer in each of the following questions:
1.
Which of the following statements is TRUE regarding flank pain in patients with upper tract
tumors?
a It is rare.
b It signifies invasive disease.
c It indicates invasion into adjacent structures.
d It correlates with stage.
e None of the above
2.
In patients with upper tract tumors, what is the most common finding on imaging studies of
the urinary tract?
a A mass
b A filling defect
c Hydronephrosis
d Nonfunction
e Delayed function
3.
The majority of renal pelvis tumors are:
a papillary and invasive.
b papillary and noninvasive.
c sessile and invasive.
d sessile and noninvasive.
e mixed papillary and sessile.
4.
Most ureteral tumors are:
a sessile.
b high grade and noninvasive.
c low grade and noninvasive.
d medium grade and low stage.
e low grade and invasive.
5.
What is the best predictor of outcome in patients with multifocal upper tract tumors?
a Stage
b Early radical surgery
c Grade
d Rate of recurrence
e Extent of surgery
6.
What is the single most important determinant of outcome in the treatment of upper tract
tumors?
a Grade
b Stage
c Early diagnosis
d Extent of surgery
e Size and focality of lesion
7.
After radical nephroureterectomy for a stage T3 TCC of the renal pelvis:
a local relapse is the main limitation to survival.
b adjuvant radiation decreases local relapse.
c adjuvant chemotherapy increases survival.
d adjuvant radiation does not improve survival.
e adjuvant radiation plus chemotherapy increases survival.
8.
A 46-year-old man is diagnosed with a 2-cm grade 3 tumor of the left renal pelvis. He is
otherwise healthy. Acceptable treatment options include which of the following?
a Ureteroscopic ablation of the tumor
b Percutaneous resection of the tumor followed by BCG therapy
c Laparoscopic nephroureterectomy
d Open nephroureterectomy
e Both c and d
9.
When endoscopic treatment of TCC of the upper urinary tract is used, ureteroscopy is best
employed for:
a small papillary tumors of the renal pelvis or ureter.
b large-volume tumors of the renal pelvis.
c small papillary tumors in the upper tracts of patients with previous urinary diversion.
d large bulky tumors of the lower pole of the kidney.
e large parenchymal invasive tumors of the renal pelvis.
10. A 60-year-old man who had undergone prior urinary diversion and a right
nephroureterectomy is diagnosed with a grade 1 tumor of the lower pole collecting system
of his solitary kidney. What is the optimal approach for this patient?
a Ureteroscopy with laser therapy of the lower pole tumor
b Nephroureterectomy
c Open lower pole partial nephrectomy
d Placement of a nephrostomy tube and BCG therapy
e Percutaneous access and resection of the lower pole tumor