Table Of ContentW
TUMOR BOARD REVIEW O
R
D An Imprint of Springer Publishing
E
N
Evidence-Based Case Reviews and Questions •
M
IM
Third Edition S
•
C
FRANCIS P. WORDEN, MD H
E
MARTHA P. MIMS, MD, PhD W
HELEN K. CHEW, MD
Now in its third edition, Tumor Board Review: Evidence-Based Case Reviews and TUMOR
Questions is the most comprehensive clinical case review book in the field. With
hands-on input from current fellows and oncologists, this new edition has been
enhanced and reformatted for greater efficiency and practicality.
T
The review covers all disease-site areas in oncology and features a wide variety of U BOARD REVIEW
board-style questions pivotal in helping fellows and oncologists prepare for both M
the American Board of Internal Medicine (ABIM) medical oncology board exam and
O
maintenance of certification (MOC) assessments. Evidence-based discussions of
difficult patient cases offer an in-depth and accurate depiction of what is discussed at R
Evidence-Based
tumor boards and foster critical thinking essential for clinical practice. Patient cases also
B
highlight impactful treatment decisions that include newly approved immunotherapies
O
and targeted therapies. Each chapter contains digestible essentials for each case,
including a summary of diagnosis, molecular and genomic testing, treatment options, A Case Reviews and
toxicity considerations, follow-up, and survivorship. Each chapter ends with high-yield R
multiple-choice questions, corresponding answers, and detailed rationales, ensuring D
readers are well-equipped with the knowledge they need to make well-informed,
Questions
individualized treatment decisions. Tumor Board Review: Evidence-Based Case Reviews R
and Questions is an essential case-based reference for anyone working in oncology. E
V
FRANCIS P. WORDEN
Key Features: I
E
Third Edition
n D escribes more than 120 patient cases, including locally advanced and W MARTHA P. MIMS
metastatic cases for each major disease site
n Contains 300 board-style questions and answers related to case reviews HELEN K. CHEW
n I ncludes new advances in diagnosis and therapy, with a greater emphasis on
immunotherapies, cancer genomics, and precision-based targeted therapies
n P rovides essentials for toxicity considerations, follow-up, and survivorship
considerations Third
Edition
Recommended
Shelving: Oncology
An Imprint of Springer Publishing
11 W. 42nd Street
New York, NY 10036-8002
www.springerpub.com
Tumor Board Review
Tumor Board Review
Evidence-Based Case Reviews
and Questions
Third Edition
Editors
Francis P. Worden, MD
Professor of Medicine
Director of the Hematology/Oncology Fellowship Program
University of Michigan Medical School
Ann Arbor, Michigan
Martha P. Mims, MD, PhD
Professor
Chief of Hematology-Oncology
Baylor College of Medicine
Houston, Texas
Helen K. Chew, MD
Professor of Medicine
Director of the Clinical Breast Cancer Program
University of California Davis
Davis, California
Copyright © 2023 Springer Publishing Company, LLC
Demos Medical Publishing is an imprint of Springer Publishing Company.
All rights reserved.
First Springer Publishing edition 2011 (978-1-6170-5046-6); subsequent edition 2015.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or
by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permis-
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Springer Publishing Company, LLC
11 West 42nd Street, New York, NY 10036
www.springerpub.com
connect.springerpub.com/
Acquisitions Editor: David D’Addona
Compositor: Exeter Premedia Services Private Limited
ISBN: 978-0-8261-4597-0
ebook ISBN: 978-0-8261-4598-7
DOI: 10.1891/9780826145987
22 23 24 25 26 / 5 4 3 2 1
Medicine is an ever-changing science. Research and clinical experience are continually expanding our
knowledge, in particular our understanding of proper treatment and drug therapy. The authors, editors,
and publisher have made every effort to ensure that all information in this book is in accordance with the
state of knowledge at the time of production of the book. Nevertheless, the authors, editors, and publisher
are not responsible for any errors or omissions or for any consequence from application of the informa-
tion in this book and make no warranty, expressed or implied, with respect to the content of this publi-
cation. Every reader should examine carefully the package inserts accompanying each drug and should
carefully check whether the dosage schedules therein or the contraindications stated by the manufacturer
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Library of Congress Cataloging-in-Publication Data
Names: Worden, Francis P., editor. | Mims, Martha Pritchett, editor. |
Chew, Helen K., editor.
Title: Tumor board review : evidence-based case reviews and questions /
editors, Francis P. Worden, Martha Pritchett Mims, Helen K. Chew.
Description: Third edition. | New York, NY : Springer Publishing Company,
[2023] | Includes bibliographical references and index.
Identifiers: LCCN 2022019636 (print) | LCCN 2022019637 (ebook) | ISBN
9780826145970 (paperback) | ISBN 9780826145987 (ebook)
Subjects: MESH: Neoplasms | Evidence-Based Medicine | Practice Guideline |
Case Reports
Classification: LCC RC254 (print) | LCC RC254 (ebook) | NLM QZ 200 | DDC
616.99/4--dc23/eng/20220624
LC record available at https://lccn.loc.gov/2022019636
LC ebook record available at https://lccn.loc.gov/2022019637
Publisher’s Note: New and used products purchased from third-party sellers are not guaranteed for q uality,
authenticity, or access to any included digital components.
Printed in the United States of America.
Contents
Contributors xv
Preface xxi
1. Head and Neck Cancer 1
Irene Tsung, Samuel B. Reynolds, and Paul L. Swiecicki
Introduction 1
Case Summaries 1
Case 1.1: Locally Advanced Cancer of the Oropharynx 1
Case 1.2: Locally Advanced Nasopharyngeal Cancer 4
Case 1.3: Metastatic Adenoid Cystic Carcinoma 7
Case 1.4: Metastatic Squamous Cell Carcinoma 9
Review Questions 12
Answers and Rationales 15
References 16
2. Thyroid Cancer 19
Kamya Sankar and Francis P. Worden
Introduction 19
Case Summaries 21
Case 2.1: Locally Advanced Anaplastic Thyroid Cancer 21
Case 2.2: Metastatic Medullary Thyroid Cancer 22
Case 2.3: Metastatic Radioactive Iodine Refractory Differentiated Thyroid Cancer 24
Review Questions 29
Answers and Rationales 31
References 32
3. Non-Small Cell Lung Cancer 35
Natalie Chen, Cyrus A. Iqbal, Omayra Gonzalez-Pagan, Meera Patel, Daniel Wang, and
Quillan Huang
Introduction 35
Case Summaries 36
Case 3.1: Early-Stage Resectable Lung Cancer 36
Case 3.2: Locally Advanced Unresectable Lung Cancer 38
Case 3.3: Metastatic Lung Can cer Without Driver Mutations 40
Case 3.4: Metastatic Lung Adenocarcinoma With a Targetable Driver Mutation 43
Case 3.5: Metastatic Non-Small Cell Lung Cancer in the Second Line 45
Review Questions 47
Answers and Rationales 49
References 50
v
vi Contents
4. Small Cell Lung Cancer 53
Ebaa Al-Obeidi and Karen Kelly
Introduction 53
Case Summaries 53
Case 4.1: Newly Diagnosed Extensive-Stage Small Cell Lung Cancer 53
Case 4.2: Relapsed Small Cell Lung Cancer 56
Case 4.3: Limited-Stage Small Cell Lung Cancer and the Role of Prophylactic Cranial
Irradiation Versus MRI Brain Surveillance 57
Review Questions 61
Answers and Rationales 64
References 65
5. Hormone Receptor-Positive Breast Cancer 67
Katherine Sanchez, Jennifer Collins, Sudha Yarlagadda, Jingxin Sun, Sarah Premji,
Maryam Nemati Shafaee, and Julie Nangia
Introduction 67
Case Summaries 67
Case 5.1 : Early-Stage Breast Cancer 67
Case 5.2 : Early-Stage Hormone-Positive Breast Cancer 71
Case 5.3 : Locally Advanced Breast Cancer 73
Case 5.4 : Stage IV Breast Cancer 75
Case 5.5 : Recurrent Stage IV Breast Cancer 78
Review Questions 81
Answers and Rationales 83
References 84
6. Triple-Negative Breast Cancer 87
Richard Benjamin Young and Helen K. Chew
Introduction 87
Case Summaries 87
Case 6.1: Localized Triple-Negative Breast Cancer 87
Case 6.2: Locally Advanced Triple-Negative Breast Cancer 89
Case 6.3: Metastatic Triple-Negative Breast Cancer 92
Review Questions 96
Answers and Rationales 98
References 98
7. Esophageal Cancer 101
Kamya Sankar, Charles B. Nguyen, and Bryan J. Schneider
Introduction 101
Case Summaries 103
Case 7.1: Locally Advanced, Resectable Esophageal Adenocarcinoma 103
Case 7.2: Locally Advanced Esophageal Squamous Cell Carcinoma 106
Case 7.3: Locally Advanced Cervical Esophageal Squamous Cell Carcinoma 106
Case 7.4: Metastatic Esophageal Adenocarcinoma 107
Case 7.5: Human Epidermal Growth Factor Receptor 2-Positive Metastatic Esophageal
Cancer 110
Review Questions 112
Answers and Rationales 115
References 116
Contents vii
8. Gastric Cancer 119
Karen Riggins and Huili Zhu
Introduction 119
Case Summaries 119
Case 8.1: Resectable Gastric Cancer 119
Case 8.2: Unresectable Locally Advanced Gastric Cancer 123
Case 8.3: Metastatic Gastric Adenocarcinoma 125
Review Questions 131
Answers and Rationales 134
References 135
9. Pancreatic Cancer 139
Huili Zhu, Zachary Phillip Yeung, Benjamin Musher, and Shalini Makawita
Introduction 139
Case Summaries 139
Case 9.1: Resectable Pancreatic Cancer 139
Case 9.2: Borderline Resectable Pancreatic Cancer 143
Case 9.3: Locally Advanced Pancreatic Cancer 145
Case 9.4: Metastatic Pancreatic Cancer 146
Review Questions 149
Answers and Rationales 151
References 152
10. Neuroendocrine Cancer 155
Tannaz Armaghany and Zachary Phillip Yeung
Introduction 155
Case Summaries 156
Case 10.1: Gastric Neuroendocrine Neoplasm 156
Case 10.2: Pancreatic Neuroendocrine Neoplasm 159
Case 10.3: Midgut Neuroendocrine Tumor and Carcinoid Syndrome 165
Case 10.4: Poorly Differentiated Neuroendocrine Carcinoma 170
Review Questions 173
Answers and Rationales 176
References 177
11. Hepatobiliary Cancer 181
Brian Pham and Edward J. Kim
Introduction 181
Case Summaries 181
Case 11.1: Metastatic Hepatocellular Carcinoma 181
Case 11.2: Locally Advanced Cholangiocarcinoma 184
Case 11.3: Metastatic Cholangiocarcinoma 186
Review Questions 188
Answers and Rationales 190
References 190
12. Colorectal Cancer 193
Brian Pham and Edward J. Kim
Introduction 193
Case Summaries 194
viii Contents
Case 12.1: Locally Advanced Colon Adenocarcinoma 194
Case 12.2: Locally Advanced Rectal Cancer 196
Case 12.3: Unresectable Metastatic Colon Adenocarcinoma 197
Review Questions 200
Answers and Rationales 203
References 204
13. Anal Cancer 207
Arathi Mohan and John C. Krauss
Introduction 207
Case Summaries 208
Case 13.1: Locally Advanced Anal Cancer 208
Case 13.2: Very Early-Stage Anal Cancer Requiring Surgery Alone 210
Case 13.3: Metastatic Anal Cancer 211
Review Questions 212
Answers and Rationales 214
References 214
14. Prostate Cancer 217
Monica Tamil, Nagaishwarya Moka, Aihua Edward Yen, and Arpit Rao
Introduction 217
Case Summaries 217
Case 14.1: Localized Prostate Cancer 217
Case 14.2: Biochemically Recurrent Prostate Cancer 220
Case 14.3: Metastatic Hormone-Sensitive Prostate Cancer 222
Review Questions 225
Answers and Rationales 228
References 229
15. Testicular Cancer 231
Thomas C. Westbrook, Eric B. Schwartz, and Zachery R. Reichert
Introduction 231
Case Summaries 231
Case 15.1: Localized Testicular Cancer—Seminoma 231
Case 15.2: Advanced Testicular Cancer—Seminoma 233
Case 15.3: Locally Advanced Nonseminoma Testicular Cancer 236
Case 15.4: Metastatic Nonseminoma Testicular Cancer 237
Review Questions 240
Answers and Rationales 243
References 244
16. Renal Cancer 245
Eric Granowicz and Mamta Parikh
Introduction 245
Case Summaries 245
Case 16.1: Early-Stage Renal Cell Carcinoma 245
Case 16.2: Metastatic Renal Cell Carcinoma 248
Case 16.3: Oligometastatic Disease 251
Review Questions 253
Contents ix
Answers and Rationales 256
References 257
17. Bladder Cancer 259
Eric Granowicz and Mamta Parikh
Introduction 259
Case Summaries 259
Case 17.1: Muscle-Invasive Bladder Cancer in a Surgical Candidate 259
Case 17.2: Muscle-Invasive Bladder Cancer in a Nonsurgical Candidate 262
Case 17.3: Metastatic Bladder Cancer 263
Case 17.4: Platinum-Refractory Metastatic Bladder Cancer 265
Review Questions 267
Answers and Rationales 270
References 271
18. Cervical Cancer 273
Alli M. Straubhar and Jean H. Siedel
Introduction 273
Case Summaries 274
Case 18.1: Early Cervical Cancer 274
Case 18.2: Locally Advanced Cervical Cancer 277
Case 18.3: Distant Metastatic and Recurrent Cervical Cancer 278
Review Questions 281
Answers and Rationales 284
References 285
19. Uterine Cancer 289
Claire Hoppenot
Introduction 289
Case Summaries 289
Case 19.1: Type 1 Endometrial Cancer 289
Case 19.2: Advanced Type 2 Endometrial Cancer 292
Case 19.3: Leiomyosarcoma 294
Review Questions 298
Answers and Rationales 300
References 300
20. Ovarian Cancer 303
Katelyn Tondo-Steele and Jean H. Siedel
Introduction 303
Case Summaries 304
Case 20.1: Early Ovarian Cancer 304
Case 20.2: Borderline Ovarian Tumor 306
Case 20.3: P rimary Treatment: Neoadjuvant Treatment Versus Primary Cytoreductive
Surgery 308
Case 20.4: Recurrent Ovarian Cancer 310
Case 20.5: Malignant Germ Cell Tumor 311
Review Questions 313
Answers and Rationales 316
References 318
