The Fellowship of the European Board of Surgery in Surgical Oncology (FEBS-SO) is the benchmark European qualification in surgical oncology. Practise with thousands of FEBS-SO-mapped clinical vignettes, each referenced to ESSO, ESMO and NCCN guidelines, and built to mirror the structure and difficulty of the written examination.
Content reviewed 26 August 2026 against current guidelines.
Start practising freeTaken from the bank, not written for this page. Answer it in your head, then open the explanation.
A 52-year-old man presents with a firm, palpable 3 cm groin node eighteen months after excision of a thigh melanoma. Core biopsy confirms metastatic melanoma, and positron emission tomography with computed tomography together with brain magnetic resonance imaging show no other disease. The node is mobile, technically resectable, and the tumour is BRAF wild-type. His performance status is 0 with no autoimmune history. The multidisciplinary team debates whether to operate first and give pembrolizumab afterwards, or to give part of the pembrolizumab before surgery. What does randomised evidence show about this decision?
Correct answer: A
SWOG S1801 randomised patients with resectable clinically detectable stage III to IV melanoma to surgery followed by adjuvant pembrolizumab, or to three cycles of pembrolizumab before surgery followed by the remainder afterwards. The neoadjuvant-plus-adjuvant sandwich arm had significantly better event-free survival with the same total drug exposure, the biological rationale being that priming the immune system while the tumour and its antigen are still in situ generates a broader T-cell response. Option B: surgery was not compromised and outcomes were better, not worse. Option C: the trial was not restricted by BRAF status, and the neoadjuvant principle applies to immunotherapy regardless of mutation. Option D: surgery remained part of the protocol for every patient; omitting resection outside a trial is not supported. Option E: benefit was not limited to radiological responders, and radiological response correlates imperfectly with pathological response.
Teaching point. Same drug, same dose, different order — giving immunotherapy while the tumour is still in the patient beats giving all of it after you have removed it.
Referenced to NCCN Cutaneous Melanoma v2.2026; ESMO Cutaneous Melanoma Clinical Practice Guidelines
Every question is explained like this — start with 50 free ›Every question is written by Pablo Lozano Lominchar, MD, PhD, and mapped to this board’s published syllabus. Before it enters the bank it has to pass an automated check: five options, a written explanation, and a citation — a named society guideline or a named trial. Benign and functional topics cannot be published without a society guideline; oncological ones cite NCCN, ESMO or AJCC, and the classification systems that govern a topic — Bethesda, TIRADS, Atlanta, Prague, Chicago — have to appear where they apply. The author has audited the full active bank against current guideline versions: what fails is re-cited, rewritten or withdrawn. 650 questions are currently withdrawn and are served to nobody.
Work through board-style questions across every tumour site, prioritise the ESSO core curriculum topics, and use timed practice to sharpen recall. Cross-reference each explanation with the current ESSO/ESMO guideline so you can defend your reasoning in the oral component.
SurgBoardsQ&A offers more than 7,400 FEBS Surgical Oncology practice questions, each with a full explanation and guideline citation, covering the complete FEBS-SO syllabus.
FEBS-SO combines a written multiple-choice paper with an oral/viva component assessing clinical decision-making across the breadth of surgical oncology, from staging principles to multidisciplinary management.
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