Hepatobiliary and pancreatic surgery: hepatocellular carcinoma: practice question

A General Surgery 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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General Surgery · Hepatobiliary and pancreatic surgery: hepatocellular carcinoma

Sample item

A patient with hepatitis B cirrhosis, Child-Pugh B, has a solitary 2 cm hepatocellular carcinoma and is unfit for resection or transplant. Which local treatment can achieve curative ablation?

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

The answer and the reasoning

C. Radiofrequency ablation

Small solitary hepatocellular carcinomas can be cured by percutaneous radiofrequency ablation in patients unfit for resection. Sorafenib and systemic chemotherapy are palliative, and the cirrhotic liver tolerates whole-liver radiation poorly.

Option by option

  • A. Systemic doxorubicin

    Systemic doxorubicin has little efficacy and high toxicity in cirrhosis.

  • B. Whole-liver external radiotherapy

    Whole-liver radiotherapy is poorly tolerated and non-curative.

  • C. Radiofrequency ablation (correct)

    Correct. Thermal ablation destroys a small tumour in situ.

  • D. Sorafenib

    Sorafenib is for advanced disease and does not cure.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Radiofrequency ablation. Small solitary hepatocellular carcinomas can be cured by percutaneous radiofrequency ablation in patients unfit for resection.

Why is "Systemic doxorubicin" not the answer?

Systemic doxorubicin has little efficacy and high toxicity in cirrhosis.

Why is "Whole-liver external radiotherapy" not the answer?

Whole-liver radiotherapy is poorly tolerated and non-curative.

Why is "Sorafenib" not the answer?

Sorafenib is for advanced disease and does not cure.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: hepatocellular carcinoma in General Surgery. Sorafenib and systemic chemotherapy are palliative, and the cirrhotic liver tolerates whole-liver radiation poorly.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Hepatobiliary and pancreatic surgery: hepatocellular carcinoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.