PAEA Surgery End Of Rotation (EOR) Practice Exam

Which of the following conditions commonly indicates the need for chemotherapy?

1. Node negative disease

2. Tumors less than 1cm

3. Node positive disease

4. Localized tumors

The correct answer is: Node positive disease

Chemotherapy is often indicated in node positive disease because the presence of cancer cells in the lymph nodes suggests that the cancer has a greater likelihood of spreading beyond the primary tumor site. This significantly raises the risk of metastasis, making adjuvant chemotherapy a critical component of treatment to target any residual microscopic disease that may not be detectable. In contrast, conditions such as node negative disease, tumors less than 1cm, and localized tumors often exhibit a lower risk of metastasis and may not require chemotherapy as part of the treatment plan. Node negative disease indicates that there are no cancer cells in the lymph nodes, suggesting a lower overall risk, while smaller tumors and localized tumors typically present a better prognosis and may be adequately treated with less aggressive interventions like surgery or localized radiation therapy. Thus, chemotherapy is generally reserved for cases where there is evidence of spread or a higher risk of recurrence, as seen in node positive disease.