PAEA Surgery End Of Rotation (EOR) Practice Exam

What is considered the surgical response for advanced disease of small intestine malignancies?

1. Localized excision of the tumor

2. Adjuvant chemotherapy

3. Wide resection with adjuvant therapy

4. Routine monitoring without intervention

The correct answer is: Wide resection with adjuvant therapy

For advanced disease of small intestine malignancies, wide resection with adjuvant therapy is considered the optimal surgical response. This approach addresses the tumor more comprehensively, removing not only the primary malignancy but also surrounding tissues that may contain micro-metastatic disease. Wide resection is not limited to simply excising the visible tumor but typically involves removing a section of the affected segment of the small intestine along with any regional lymph nodes that could harbor cancer cells. This surgical method is crucial in managing advanced cancer, as it can help achieve clear margins and minimize the risk of recurrence. Adjuvant therapy, which may include chemotherapy, is often administered postoperatively to target any residual microscopic disease and reduce the risk of metastasis. This combination enhances overall survival rates and decreases the likelihood of cancer returning, making it a comprehensive approach to treating advanced small intestine malignancies. Localized excision of the tumor alone would not adequately manage advanced disease due to the potential for undetected spread, while routine monitoring without intervention would not address the immediate need for managing the malignancy effectively. Thus, the combination of wide resection and adjuvant therapy is the most effective approach for this condition.