ABOG ABOG Oncology & Gynecologic Cancers 2 — Questions and Answers
Question 1: Which vulvar cancer subtype is most common and most strongly associated with HPV infection?
- Verrucous carcinoma
- Melanoma
- Basaloid/warty squamous cell carcinoma (Correct answer)
- Keratinizing squamous cell carcinoma
Correct answer: Basaloid/warty squamous cell carcinoma
Basaloid and warty squamous cell carcinomas of the vulva are HPV-associated subtypes most commonly seen in younger women, whereas keratinizing SCC occurs in older women with lichen sclerosus.
Question 2: The International Federation of Gynecology and Obstetrics (FIGO) Stage IIIC1 ovarian cancer indicates tumor spread to which location?
- Retroperitoneal lymph nodes only (Correct answer)
- Liver parenchyma
- Pleural effusion with positive cytology
- Spleen surface implants
Correct answer: Retroperitoneal lymph nodes only
FIGO Stage IIIC1 ovarian cancer is defined by retroperitoneal lymph node metastasis only, without other peritoneal implants beyond the pelvis.
Question 3: Which chemotherapy regimen is the standard of care for primary treatment of advanced-stage epithelial ovarian cancer?
- Carboplatin + paclitaxel (Correct answer)
- Cisplatin + 5-fluorouracil
- Doxorubicin + cyclophosphamide
- Gemcitabine + bevacizumab
Correct answer: Carboplatin + paclitaxel
Carboplatin plus paclitaxel given every 3 weeks (or weekly) remains the standard first-line chemotherapy regimen for advanced epithelial ovarian cancer.
Question 4: A postmenopausal woman presents with vaginal bleeding. Endometrial sampling shows complex atypical hyperplasia. What is the recommended management?
- Levonorgestrel IUD placement
- Progestin therapy for 6 months then re-biopsy
- Total hysterectomy with bilateral salpingo-oophorectomy (Correct answer)
- Observation with annual sampling
Correct answer: Total hysterectomy with bilateral salpingo-oophorectomy
Complex atypical endometrial hyperplasia in a postmenopausal woman carries a ~25–40% risk of concurrent or subsequent endometrial carcinoma, making hysterectomy with BSO the definitive treatment.
Question 5: Which gestational trophoblastic neoplasm has the worst prognosis and requires combination chemotherapy?
- Complete hydatidiform mole
- Partial hydatidiform mole
- Invasive mole
- Choriocarcinoma with high-risk features (Correct answer)
Correct answer: Choriocarcinoma with high-risk features
High-risk choriocarcinoma (WHO score ≥7) requires multi-agent chemotherapy such as EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) due to resistance to single-agent therapy.
Question 6: What is the primary screening modality recommended by ABOG guidelines for cervical cancer in women aged 25–65?
- Annual Pap smear alone
- Co-testing (Pap + HPV) every 5 years or primary HPV testing every 5 years (Correct answer)
- HPV testing annually
- Colposcopy every 3 years
Correct answer: Co-testing (Pap + HPV) every 5 years or primary HPV testing every 5 years
Current guidelines recommend co-testing (Pap cytology plus HPV test) every 5 years or primary HPV testing every 5 years as preferred options for cervical cancer screening in women aged 25–65.
ABOG ABOG Oncology & Gynecologic Cancers 2
Which vulvar cancer subtype is most common and most strongly associated with HPV infection?