CTR Staging & Prognostic Factors 3 — Questions and Answers
Question 1: In prostate cancer staging, what Gleason score range indicates Grade Group 5 (the highest grade)?
- Gleason 6
- Gleason 7 (3+4)
- Gleason 7 (4+3)
- Gleason 9-10 (Correct answer)
Correct answer: Gleason 9-10
Grade Group 5 encompasses Gleason scores 9 and 10, representing the most poorly differentiated prostate tumors.
Question 2: Which SEER summary stage category is used when cancer has spread only to regional lymph nodes with no distant spread?
- In situ
- Localized
- Regional (Correct answer)
- Distant
Correct answer: Regional
SEER 'Regional' stage is assigned when cancer has spread to nearby lymph nodes or tissues but not to distant sites.
Question 3: A tumor registrar is abstracting a case where pathology shows extension of the tumor into but not through the serosa of the colon. Which T category applies in AJCC 8th edition?
- T1
- T2
- T3 (Correct answer)
- T4a
Correct answer: T3
T3 colon tumors invade through the muscularis propria into pericolorectal tissues but do not penetrate the visceral peritoneum.
Question 4: Which receptor status combination confers the best prognosis in breast cancer?
- ER-/PR-/HER2-
- ER+/PR+/HER2- (Correct answer)
- ER-/PR-/HER2+
- ER+/PR-/HER2+
Correct answer: ER+/PR+/HER2-
ER+/PR+/HER2- tumors are hormone receptor-positive and HER2-negative, associated with the best overall prognosis among the major subtypes.
Question 5: In the AJCC staging system, clinical staging (cTNM) is based on information available before which event?
- First recurrence
- First definitive treatment (Correct answer)
- Pathologic examination of the primary tumor
- Death of the patient
Correct answer: First definitive treatment
Clinical staging uses all information obtained before the first definitive treatment, including physical exam, imaging, and biopsy results.
Question 6: For melanoma, which prognostic factor is most important for T category assignment in AJCC 8th edition?
- Tumor diameter
- Breslow thickness and ulceration (Correct answer)
- Clark level of invasion
- Satellite lesion count
Correct answer: Breslow thickness and ulceration
Breslow thickness (measured in millimeters) and presence of ulceration are the primary determinants of the T category in AJCC 8th edition melanoma staging.
Question 7: What does 'resection margin status' (R classification) describe in surgical pathology reports?
- Depth of tumor invasion into the wall
- Presence of residual tumor after surgical resection (Correct answer)
- Number of lymph nodes removed
- Lymphovascular invasion status
Correct answer: Presence of residual tumor after surgical resection
The R classification documents whether residual tumor remains after surgery: R0 (no residual), R1 (microscopic residual), or R2 (macroscopic residual).
CTR Staging & Prognostic Factors 3
In prostate cancer staging, what Gleason score range indicates Grade Group 5 (the highest grade)?