Oral medicine and oral cancer: adjuvant therapy with extracapsular spread: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral medicine and oral cancer: adjuvant therapy with extracapsular spread

Sample item

A man undergoes resection and neck dissection for a buccal mucosa carcinoma. Histology shows extracapsular extension of nodal disease with close margins. Which adjuvant treatment is recommended?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Radiotherapy with concurrent cisplatin

Postoperative concurrent chemoradiotherapy, with cisplatin acting as a radiosensitiser, improves outcome in patients with extracapsular nodal spread or positive margins. Radiotherapy alone is used for other intermediate-risk features.

Option by option

  • A. Observation with regular follow-up

    Observation would undertreat a high-risk pathological finding.

  • B. Radiotherapy with concurrent cisplatin (correct)

    Correct. Extracapsular spread is a high-risk feature that calls for chemoradiation.

  • C. Induction chemotherapy before further surgery

    Induction chemotherapy before surgery is irrelevant after the tumour has already been resected.

  • D. Radiotherapy alone

    Radiotherapy alone is used for intermediate-risk features and gives poorer control than chemoradiation here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is B, Radiotherapy with concurrent cisplatin. Postoperative concurrent chemoradiotherapy, with cisplatin acting as a radiosensitiser, improves outcome in patients with extracapsular nodal spread or positive margins.

Why is "Observation with regular follow-up" not the answer?

Observation would undertreat a high-risk pathological finding.

Why is "Induction chemotherapy before further surgery" not the answer?

Induction chemotherapy before surgery is irrelevant after the tumour has already been resected.

Why is "Radiotherapy alone" not the answer?

Radiotherapy alone is used for intermediate-risk features and gives poorer control than chemoradiation here.

What concept does this question test?

It tests Oral medicine and oral cancer: adjuvant therapy with extracapsular spread in Dentistry. Radiotherapy alone is used for other intermediate-risk features.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral medicine and oral cancer: adjuvant therapy with extracapsular spread?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.