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ACVS Phase II > Bone Tumors > Flashcards

Bone Tumors Flashcards

1
Q

Sternberg, JVIM, 2013:
Appendicular OSA

Association between absolute tumor burden and serum bone-specific ALP (BALP)?

A

Sternberg, JVIM, 2013:

Tumor burden is a determinant of serum BALP activity

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2
Q

Amsellem, JAVMA, 2014:
Appendicular OSA in small breed dogs

  1. Overall MST?
  2. MST and DFI in amputation-only group vs curative-intent group?
  3. Is total serum ALP activity prior to treatment associated with outcome?
  4. Difference between appendicular OSA in small breed dogs and large breed dogs?
A

Amsellem, JAVMA, 2014:

  1. Overall MST: 263 days
  2. MST and DFI no different between amputation-only group and curative-intent group
  3. No
  4. Appendicular OSA in small breed dogs appeared to have lower mitotic index and grade
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3
Q

Culp, JAVMA, 2014:
OSA

  1. Most common tumor location?
  2. What % of dogs that developed SSI after limb-sparing surgery had a significantly improved prognosis?
  3. What % developed metastatic disease?
  4. If a dog with appendicular OSA survived >1 year, what was its MST?
  5. Was MST affected by the addition of chemotherapy or the type of surgery or both?
A

Culp, JAVMA, 2014:

  1. Most common tumor location was the distal radius (60%)
  2. 69% of dogs that developed a SSI after limb-sparing surgery had an improved prognosis
  3. 54% developed metastatic disease
  4. If a dog survived >1 year, its MST was 20 months
  5. MST was affected by the addition of chemotherapy but not the type of surgery
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4
Q

Talbott, Vet Surg, 2017:

What size of lesions were identified on CT but not on 3-view thoracic radiographs?

A

Talbott, Vet Surg, 2017:

Lesions 2-5mm in diameter were identified on CT but not thoracic radiographs

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5
Q

Steffey, Vet Surg, 2017:

  1. Mechanism of failure of OSA-affected antebrachia vs unaffected antebrachia?
  2. Mechanical properties of OSA-affected antebrachia vs unaffected antebrachia?
A

Steffey, Vet Surg, 2017:

  1. OSA-affected antebrachia failed by fracture at or adjacent to the OSA by crushing and/or bending, whereas normal antebrachia failed via mid-diaphysial fracture with a transverse cranial component and an oblique caudal component
  2. OSA-affected antebrachia were markedly weaker, more compliant and absorbed less energy to yield and failure compared to normal antebrachia
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6
Q

Turner, JAVMA, 2017:
Stage III OSA

  1. How did metastasectomy affect MST?
  2. In what situation(s) did pulmonary metastasectomy provide a survival advantage?
  3. What tumor location was associated with a shorter DFI and overall survival time?
A

Turner, JAVMA, 2017:

  1. Metastasectomy was associated with a longer MST
  2. 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
  3. Tumor location in the proximal humerus was associated with a shorter DFI and overall survival time
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7
Q

Matsuyama, JAVMA, 2018:
Limb amputation + carboplatin chemotherapy + metronomic cyclophosphamide chemotherapy for appendicular OSA

  1. What did 58% of the dogs that received metronomic cyclophosphamide chemotherapy develop?
  2. What effect did metronomic cyclophosphamide chemotherapy have on median DFI and overall survival time?
A

Matsuyama, JAVMA, 2018:

  1. 58% developed cystitis
  2. No effect on median DFI or overall survival time
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8
Q

Santamaria, JAVMA, 2019:
Limb amputation + single subcutaneous infusion of carboplatin for appendicular OSA

  1. MST?
  2. DFI?
  3. What adverse effect(s) of chemotherapy did 7% of the dogs develop?
  4. Any benefit over limb amputation alone?
A

Santamaria, JAVMA, 2019:

  1. MST 196 days
  2. DFI 197 days
  3. GI signs in 7% of the dogs
  4. No benefit in MST over limb amputation alone
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9
Q

Parachini-Winter, JVIM, 2019:
Cutaneous and subcutaneous metastasis of appendicular OSA

  1. What % had incidental finding of cutaneous and subcutaneous metastasis?
  2. What % developed pulmonary metastasis and what % developed bone metastasis?
  3. Median cutaneous and subcutaneous metastasis-free interval?
  4. Median cutaneous and subcutaneous metastasis survival time?
  5. Prognosis after diagnosis of cutaneous and subcutaneous metastasis?
A

Parachini-Winter, JVIM, 2019:

  1. 95% incidental finding of cutaneous and subcutaneous metastasis
  2. 85% developed pulmonary metastasis and 5% developed bone metastasis
  3. Median CSM-free interval: 160 days
  4. Median CSM survival time: 55 days
  5. Grave prognosis
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10
Q

Selmic, JAVMA, 2014:
OSA of the maxilla, mandible and calvarium

  1. What % were osteoblastic OSA and what % were chondroblastic OSA
  2. What was associated with a decreased hazard of developing progression or recurrence and death?
  3. Tumors arising from which location were associated with a greater hazard of developing progression or recurrence?
  4. What hematological finding was associated with an increased hazard of death?
  5. Did concurrent chemotherapy decrease the hazard of disease progression or death?
  6. What % developed local progression or recurrence of disease and what % of these also subsequently developed metastatic disease?
A

Selmic, JAVMA, 2014:

  1. 69% osteoblastic OSA, 18% chondroblastic OSA
  2. Complete excision was associated with a decreased hazard of developing progression or recurrence and death
  3. Tumors arising from the calvarium were associated with a greater hazard of developing progression or recurrence
  4. Monocytosis was associated with an increased hazard of death
  5. Concurrent chemotherapy did not decrease the hazard of disease progression or death
  6. 51% developed local progression or recurrence of disease and 39% of these also subsequently developed metastatic disease
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11
Q

Giuffrida, Vet Surg, 2018:
Primary appendicular HSA vs telangiectatic OSA (tOSA)

  1. Distribution of HSA vs tOSA?
  2. Risk factor(s) for tOSA?
  3. Which tumor is more likely to cause lameness and which tumor is more likely to cause limb swelling?
  4. Rate of pulmonary metastasis for HSA vs tOSA?
  5. Overall survival time for tOSA treated with local treatment + chemo vs local treatment alone vs no treatment?
  6. Overall survival time for HSA treated with local treatment + chemo vs local treatment alone?
  7. More aggressive treatment with associated with longer survival time in dogs with which tumor?
A

Giuffrida, Vet Surg, 2018:

  1. HSA: 78% in the hindlimbs - proximal tibia > mid-tibia > proximal femur
    tOSA: 83% in the forelimbs - proximal humerus > distal radius
  2. Odds of tOSA increased 1.6-fold for each 5kg increase in body weight
  3. HSA was more likely to cause lameness but tOSA was more likely to cause limb swelling
  4. Pulmonary metastasis: 20% of HSA vs 7% of tOSA
  5. 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
  6. Overall survival times for HSA: 10 months for local treatment + chemo vs 3.5 months for local treatment alone
  7. More aggressive treatment was associated with longer survival in dogs with HSA but not tOSA
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12
Q

Burton, JAVMA, 2015:
Implant-associated neoplasia

  1. Median time from surgical implant placement to diagnosis of neoplasia?
  2. What % experienced complications during healing of the initial surgery?
  3. What % of the implant-associated neoplasia were OSA?
  4. In what region of the bone were 81% of the tumors located?
A

Burton, JAVMA, 2015:

  1. 5.5 years from time of surgical implant placement to diagnosis of neoplasia
  2. 50% had experienced complications during healing of the initial surgery
  3. 81% were OSA
  4. 81% of the tumors were in the diaphysis
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13
Q 
Covey, Vet Surg, 2014:
Stereotactic radiotherapy (SRT) and fractures in dogs with appendicular OSA
  1. What % had pathological fractures before SRT and what % developed pathologic fractures after SRT?
  2. Metastatic rate?
  3. What % developed deep tissue infection?
  4. Survival time?
  5. On average, how long after SRT did fractures develop?
A

Covey, Vet Surg, 2014:

  1. 33% had fractures before SRT and 76% developed fractures after SRT
  2. 67% metastatic rate
  3. 83% developed deep tissue infection
  4. Survival time: 364-897 days
  5. Post-SRT fractures occurred an average of 6 months post-SRT, which corresponds to the expected peak time of increased bone porosity and loss of strength after a single high dose irradiation
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14
Q

Mitchell, Vet Surg, 2016:
2 generations of metal endoprosthesis for limb-sparing surgery

  1. Overall complication rate?
  2. Metastatic rate?
  3. MST?
A

Mitchell, Vet Surg, 2016:

  1. 96% overall complication rate
  2. 67% metastatic rate
  3. MST: 289 days
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15
Q

Petazzoni, VCOT, 2016:
Contralateral bone widening and transfer for limb-sparing surgery

  1. How much shorter than the contralateral tibia was the affected tibia?
  2. How was ROM in the stifle and tarsus affected?
A

Petazzoni, VCOT, 2016:

  1. The affected tibia was 11% shorter than the contralateral tibia
  2. 10 degree loss of passive ROM in the stifle and 12 degree loss of ROM in the tarsus
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16
Q

Boston, Vet Surg, 2017:
SRT + surgical stabilization for appendicular bone tumors

  1. Complication rate?
  2. MST?
A

Boston, Vet Surg, 2017:

  1. 94% complication rate - unacceptably high, not recommended
  2. MST: 344 days
17
Q

Seguin, Vet Surg, 2017:
Ulnar rollover transposition for limb-sparing surgery

  1. What % of tumor excisions were complete?
  2. Tumor recurrence rate?
  3. What was the median proportion of radius removed?
  4. What proportion of radius removed was associated with greater risk of fracture of the radial remnant?
  5. What % of ulnar grafts remained viable?
  6. What % developed infection and was infection a prognostic factor?
  7. Median DFI?
  8. MST?
  9. Functional outcomes?
A

Seguin, Vet Surg, 2017:

  1. 85% complete excision
  2. 7% recurrence rate
  3. Median proportion of radius removed was 52%
  4. Limbs that had 54% or more of the radius removed were more likely to fracture the radial remnant
  5. 63% of ulnar grafts remained viable
  6. 44% developed infection, and infection was not a prognostic factor
  7. Median DFI: 245 days
  8. MST: 277 days
  9. 11% excellent limb function, 52% good limb function, 15% fair limb function and 7% poor limb function
18
Q

Wustefeld-Janssens, Vet Surg, 2018:
Modification of the metal endoprosthesis limb-salvage procedure by addition of a SOP plate

  1. What was absent post-op and why?
  2. What was compromised post-op and why?
  3. Post-op functional outcome?
A

Wustefeld-Janssens, Vet Surg, 2018:

  1. Deep pain sensation was absent post-op, likely due to inadvertent neurectomy during dissection
  2. 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
  3. Post-op functional outcome was acceptable
19
Q

Boston and Skinner, Vet Surg, 2014:
Limb shortening as a strategy for limb-sparing treatment

  1. What was the estimated decrease in limb length?
  2. How much should limb shortening not exceed?
A

Boston and Skinner, Vet Surg, 2014:

  1. 14% decrease in limb length
  2. Limb shortening should not exceed 20%
20
Q

Hans, Vet Surg, 2018:
Limb amputation and post-op SSI for appendicular OSA

  1. What % developed a SSI?
  2. Did SSI have any effect(s) on DFI and MST?
  3. Risk factor for disease progression and death?
A

Hans, Vet Surg, 2018:

  1. 10% developed a SSI
  2. SSI had no effect on DFI and MST
  3. Failure to complete chemotherapy was associated with increased risk of disease progression and death
21
Q

Rubin, JAVMA, 2015:
Pathological fractures in dogs with appendicular primary bone neoplasia

  1. What % developed pathological fractures?
  2. Which bones were most commonly affected
  3. Tumors in which bone were less likely to fracture?
  4. What radiographic finding had 3 times the odds of eventual fracture?
A

Rubin, JAVMA, 2015:

  1. 38% developed pathological fractures
  2. The femur was most commonly affected (57% of femoral tumors) followed by the tibia (53% of tibial tumors)
  3. Tumors in the radius were 5 times less likely to fracture than tumors in other long bone locations
  4. Lytic tumors had 3 times the odds of eventual fracture compared to tumors that appeared plastic or mixed lytic-plastic

ACVS Phase II (53 decks)

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