Bone Tumors Flashcards
Boston, Vet Surg, 2017:
SRT + surgical stabilization for appendicular bone tumors
Complication rate?
MST?
Boston, Vet Surg, 2017:
94% complication rate - unacceptably high, not recommended
MST: 344 days
Seguin, Vet Surg, 2017:
Ulnar rollover transposition for limb-sparing surgery
What % of tumor excisions were complete?
Tumor recurrence rate?
What was the median proportion of radius removed?
What proportion of radius removed was associated with greater risk of fracture of the radial remnant?
What % of ulnar grafts remained viable?
What % developed infection and was infection a prognostic factor?
Median DFI?
MST?
Functional outcomes?
Seguin, Vet Surg, 2017:
85% complete excision
7% recurrence rate
Median proportion of radius removed was 52%
Limbs that had 54% or more of the radius removed were more likely to fracture the radial remnant
63% of ulnar grafts remained viable
44% developed infection, and infection was not a prognostic factor
Median DFI: 245 days
MST: 277 days
11% excellent limb function, 52% good limb function, 15% fair limb function and 7% poor limb function
Wustefeld-Janssens, Vet Surg, 2018:
Modification of the metal endoprosthesis limb-salvage procedure by addition of a SOP plate
What was absent post-op and why?
What was compromised post-op and why?
Post-op functional outcome?
Wustefeld-Janssens, Vet Surg, 2018:
Deep pain sensation was absent post-op, likely due to inadvertent neurectomy during dissection
Perfusion to the skin immediately surrounding the surgical incision was compromised, likely due to compromised venous and lymphatic drainage and/or damage to subdermal plexus vessels during dissection
Post-op functional outcome was acceptable
Hans, Vet Surg, 2018:
Limb amputation and post-op SSI for appendicular OSA
What % developed a SSI?
Did SSI have any effect(s) on DFI and MST?
Risk factor for disease progression and death?
Hans, Vet Surg, 2018:
10% developed a SSI
SSI had no effect on DFI and MST
Failure to complete chemotherapy was associated with increased risk of disease progression and death
Turner, JAVMA, 2017:
Stage III OSA
How did metastasectomy affect MST?
In what situation(s) did pulmonary metastasectomy provide a survival advantage?
What tumor location was associated with a shorter DFI and overall survival time?
Turner, JAVMA, 2017:
Metastasectomy was associated with a longer MST
Pulmonary metastasectomy offered a survival advantage if there were <3 nodules on thoracic radiography and a DFI of >275 days, but not if there was metastasis to viscera other than lungs
Tumor location in the proximal humerus was associated with a shorter DFI and overall survival time
Matsuyama, JAVMA, 2018:
Limb amputation + carboplatin chemotherapy + metronomic cyclophosphamide chemotherapy for appendicular OSA
What did 58% of the dogs that received metronomic cyclophosphamide chemotherapy develop?
What effect did metronomic cyclophosphamide chemotherapy have on median DFI and overall survival time?
Matsuyama, JAVMA, 2018:
58% developed cystitis
No effect on median DFI or overall survival time
Santamaria, JAVMA, 2019:
Limb amputation + single subcutaneous infusion of carboplatin for appendicular OSA
MST?
DFI?
What adverse effect(s) of chemotherapy did 7% of the dogs develop?
Any benefit over limb amputation alone?
Santamaria, JAVMA, 2019: MST 196 days DFI 197 days GI signs in 7% of the dogs No benefit in MST over limb amputation alone
Parachini-Winter, JVIM, 2019:
Cutaneous and subcutaneous metastasis of appendicular OSA
What % had incidental finding of cutaneous and subcutaneous metastasis?
What % developed pulmonary metastasis and what % developed bone metastasis?
Median cutaneous and subcutaneous metastasis-free interval?
Median cutaneous and subcutaneous metastasis survival time?
Prognosis after diagnosis of cutaneous and subcutaneous metastasis?
Parachini-Winter, JVIM, 2019:
95% incidental finding of cutaneous and subcutaneous metastasis
85% developed pulmonary metastasis and 5% developed bone metastasis
Median CSM-free interval: 160 days
Median CSM survival time: 55 days
Grave prognosis
Giuffrida, Vet Surg, 2018:
Primary appendicular HSA vs telangiectatic OSA (tOSA)
Distribution of HSA vs tOSA?
Risk factor(s) for tOSA?
Which tumor is more likely to cause lameness and which tumor is more likely to cause limb swelling?
Rate of pulmonary metastasis for HSA vs tOSA?
Overall survival time for tOSA treated with local treatment + chemo vs local treatment alone vs no treatment?
Overall survival time for HSA treated with local treatment + chemo vs local treatment alone?
More aggressive treatment with associated with longer survival time in dogs with which tumor?
Giuffrida, Vet Surg, 2018:
HSA: 78% in the hindlimbs - proximal tibia > mid-tibia > proximal femur
tOSA: 83% in the forelimbs - proximal humerus > distal radius
Odds of tOSA increased 1.6-fold for each 5kg increase in body weight
HSA was more likely to cause lameness but tOSA was more likely to cause limb swelling
Pulmonary metastasis: 20% of HSA vs 7% of tOSA
Overall survival times for tOSA: 7 months for local treatment + chemo vs 4.5 months for local treatment alone vs 3 months for no treatment
Overall survival times for HSA: 10 months for local treatment + chemo vs 3.5 months for local treatment alone
More aggressive treatment was associated with longer survival in dogs with HSA but not tOSA
Turner
OSA prognosis
JAVMA 2017
No tx for metastasis
MST 49d
Metastasectomy alone
MST 232d
No affect
preceding DFI
Leeper
Cholesterol Concentrations in OSA
JSAP 2017
Elevated total cholesterol
45% OSA dogs
10% fracture control
associated with a reduced hazard ratio for overall mortality in dogs with osteosarcoma
Turner, JAVMA, 2017:
Stage III OSA
How did metastasectomy affect MST?
In what situation(s) did pulmonary metastasectomy provide a survival advantage?
What tumor location was associated with a shorter DFI and overall survival time?
Turner, JAVMA, 2017:
Metastasectomy was associated with a longer MST
Pulmonary metastasectomy offered a survival advantage if there were <3 nodules on thoracic radiography and a DFI of >275 days, but not if there was metastasis to viscera other than lungs
Tumor location in the proximal humerus was associated with a shorter DFI and overall survival time
Matsuyama, JAVMA, 2018:
Limb amputation + carboplatin chemotherapy + metronomic cyclophosphamide chemotherapy for appendicular OSA
What did 58% of the dogs that received metronomic cyclophosphamide chemotherapy develop?
What effect did metronomic cyclophosphamide chemotherapy have on median DFI and overall survival time?
Matsuyama, JAVMA, 2018:
58% developed cystitis
No effect on median DFI or overall survival time
Santamaria, JAVMA, 2019:
Limb amputation + single subcutaneous infusion of carboplatin for appendicular OSA
MST?
DFI?
What adverse effect(s) of chemotherapy did 7% of the dogs develop?
Any benefit over limb amputation alone?
Santamaria, JAVMA, 2019: MST 196 days DFI 197 days GI signs in 7% of the dogs No benefit in MST over limb amputation alone
Parachini-Winter, JVIM, 2019:
Cutaneous and subcutaneous metastasis of appendicular OSA
What % had incidental finding of cutaneous and subcutaneous metastasis?
What % developed pulmonary metastasis and what % developed bone metastasis?
Median cutaneous and subcutaneous metastasis-free interval?
Median cutaneous and subcutaneous metastasis survival time?
Prognosis after diagnosis of cutaneous and subcutaneous metastasis?
Parachini-Winter, JVIM, 2019:
95% incidental finding of cutaneous and subcutaneous metastasis
85% developed pulmonary metastasis and 5% developed bone metastasis
Median CSM-free interval: 160 days
Median CSM survival time: 55 days
Grave prognosis
