AGASACA

Question 1

Skorupski, JAVMA, 2018:
Dogs with early-stage anal sac adenocarcinoma
What % of dogs had local recurrence?
What % of dogs developed metastasis to regional lymph nodes?
What % of dogs developed both local recurrence and metastasis?
What histologic finding was associated with development of metastasis?
Many of the dogs survived for at least how many years after surgical excision without any additional treatment?

Answer 1

Skorupski, JAVMA, 2018:
21% had local recurrence
26% developed metastasis to regional lymph nodes
12% had both local recurrence and metastasis
Extent of cellular pleomorphism was associated with development of metastasis
Many of the dogs survived for at least 4 years after surgical excision without any additional treatment

Question 2

Amsellem, JAVMA, 2019:
Apocrine gland anal sac adenocarcinoma in cats
What were the most common clinical signs?
Risk factors for local recurrence?
What % of the cats developed local recurrence?

Answer 2

Amsellem, JAVMA, 2019:
Perineal ulceration or perineal discharge were the most common clinical signs
Risk factors for local recurrence were incomplete tumor margins and a high nuclear pleomorphic score
37% developed local recurrence

Question 3

Elliott, JAVMA, 2019:
Toceranib phosphate for stage 4 anal sac adenocarcinoma in dogs
What % of the dogs had stable disease?

Answer 3

Elliott, JAVMA, 2019:
87% had stable disease (some had reduction in tumor burden but not enough to classify as a partial response)

Question 4

Amsellem
AGASACA cats
JAVMA 2019

Answer 4

Median Disease Free interval 234d

Survival time 260d

Clinical Signs
~Perianal ulceration
~discharge

Recurrence at 96 days
~incomplete excision
~high nuclear pleomorphic score

Negative DFI
~high nuclear pleomorphic score

Risk of death
~Local recurrence
~High nuclear pleomorphic score

Question 5

Skorupski
AGASACA with surgery alone
JAVMA 2018

Answer 5

MST 1237d

Recurrence 354d
Metastatic disease 589d

Cellular pleomorphism associated with metastatic disease

Question 6

Barnes
Sx management of recurrent AGASACA
JSAP 2017

Answer 6

MST 2nd surgery 283d

Perianal surgery
~major complications 12%

Lyph node extirpation complications
~bleeding 5%

Recurrence 12%
Subsequent met 42%

Altered ultrasonographic appearance of LN consistent with metastatic disease

Question 7

Barnes et al JSAP 2017
A second surgery for metastasis related with anal sac adenocarcinoma prolonged MST by how long?

Answer 7

283 days
Median 247 days between surgical procedures

Question 8

Skorupski et al JAVMA 2018
What is the MST for non-metastatic AGASAC treated with surgery alone?

Answer 8

MST 1237 days