AGASACA Flashcards
T/F: plain radiographs can both under- and over-estimate lymph node disease.
True
T/F: cytology is a reliable way to differentiate perianal adenomas versus adenocarcinomas in male dogs.
False; usually requires biopsy
What is the most important histologic criteria to support a diagnosis of peri-anal sebaceous gland adenocarcinoma (as opposed to benign tumor)?
Invasiveness of tumor cells into surrounding tissue. Also, disorderly cellular arrangement, nuclear pleomorphism, and increased numbers of mitotic figures.
Which of the following can be used on ultrasound to distinguish neoplastic from benign nodes? Contour/shape Cavitation Parenchymal uniformity Size
Size only
T/F: For peri-anal tumors that require aggressive unilateral resection, incontinence is fairly common post-operatively.
False: “very rare” per Withrow text
Which anti-cytokeratin antibody was found to react positively in cats with anal sac adenocarcinoma?
CAM 5.2
What % of intact male dogs will be cured of their perianal adenomas by castration and removal of the mass?
> 90%
What is the ORR and CR for perianal adenomas treated with electrochemotherapy? What was a prognostic factor affecting response?
ORR >90%
CR 65%
Tumors <5 cm more likely to respond
Larger tumors more likely to develop necrosis, erythema, inflammation
What immunosuppressive (non-chemo) drug gave a measurable reduction in tumor size in a dog with multiple perianal adenomas?
Cyclosporine
T/F: perianal sebaceous adenocarcinomas are typically cured with the first surgical removal.
False; requires planned aggressive removal with adequate margins (usually not done the first time).
What are negative prognostic factors for perianal sebaceous adenocarcinomas?
Stage/size
Metastasis
What is the 2 year control rate for a perianal sebaceous adenocarcinoma <5 cm removed with surgery?
> 60%
What % of dogs with perianal sebaceous adenocarcinomas have mets at diagnosis? What is the MST for these dogs?
15%
MST with mets: 7 months (but 5/6 were not treated aggressively)
What % of dogs with AGASACA have mets at diagnosis?
50-80%
What are negative prognostic indicators for dogs with AGASACA?
increased primary tumor size lymph node mets distant mets advanced stage lack of surgery treatment with chemo alone lack of any treatment \+/- E-cadherin
T/F: For dogs without distant metastasis, removal of metastatic nodes improves survival for dogs with AGASACA relative to surgical removal of only the primary tumor
True
What was the median duration of response for dogs with relapsed/resistant AGASACA treated with Palladia?
19-25 weeks (4.75-6.25 months)
Through what receptor is AGASACA thought to respond to Palladia?
PDGFR-a.
In one study, 19.5% of tumors were positive for it (Brown 2012). In another, PDGFR-a was found in all tumors, and the stroma of all was positive for PDGFR-b. (Urie 2012)
What is the MST for AGASACA treated with surgery and melphalan?
20 months (1.7 years)
What is the event-free survival and MST for AGASACA treated with surgery (tumor +/- metastatic nodes), definitive RT (3.2Gy x 15), and mitoxantrone?
EFS 9 months
MST 31 months
What can be done to minimize the risk of acute RT effects during treatment of the perineal and pelvic regions?
<3 Gy per fraction
Is hypercalcemia a negative prognostic indicator for dogs with AGASACA?
Controversial. One study says yes; others have not supported it.
What are the best and worst MST reported for cats with AGASACA treated with surgery +/- multimodal therapy?
One study: 3 months (included some with incisional bx).
Another more recent study: >300 days
