export_jvd2015 321 bilgic feline scc Flashcards
Feline Oral squamous cell carcinoma: clinical manifestations and literature review
JVD2015 32(1), Bilgic O, Duda L, Sanchez MD, Lewis JR
most common oral tumor type in cat
SCC
Oral tumors account for what percentage in cats?
10% of all feline tumors, 90% malignant
Squamous cell carcinoma accounts for what percentage of oral tumors in cats
60-70%
most common location of SCC in cats
sublingual/lingual, maxilla, mandible, buccal mucosa, lip, caudal pharynx/tonsillar region
Metastatic rate of SCC in cats
35.7%
Where does it metastasize to?
mandibular lymph nodes and lungs
most cats succumb to the what effects of SCC?
local aggressive growth of primary tumor
Environmental factors contibuting to SCC in Cats
- environmental smoke (2X increased risk)
- flea collars (5.3x increased risk)
- canned food (3.6x increased risk)
- Canned tuna (4.7x increased risk)
Human papillomavirus has been implicated as risk factor for SCC in humans. IN cats…
more investigation warranted
Altered epidermal growth factor receptor (EGFR) may play a key role in feline oral SCC, true or false
True, 69% samples of feline oral SCC were reactive to EGFR
Cox-1
constitutive form, catalyzes synthesis of prostaglandins involved in homeostatic functions of GI, vasodilation of kidneys, synthesis of thromboxane
Cox - 2
inducible form, sites of inflammation. Proinflammatory cytokines, carcinogens, oncogenes, and mitogens can induce Cox-2 activiaton
cox-2 immunoreactivity in feline oral SCC
9% of samples positive in one study, 67% in another study, also observed in normal feline oral tissue (80%)
clinical signs of oral feline SCC
hyporexia, anorexia, lethargy, wt loss, decreased grooming, ptyalism, halitosis
Lingual/sublingual SCC in cats
- common
- frenulum/sublingual mucosa
- quickly invades tongue
- ulceration
- sloughing of tongue
maxillary feline scc
- invade bone
- osteolysis
- crater-like lesion
- destruction of palantine process
- caudal masses are ulcerative
- inability to retropulse globe
mandibular feline oral SCC
- similar to maxillary lesions
- mobile teeth
- ulceration
- periosteal proliferation
Neoplasia that may mimic oral SCC
FSA, peripheral nerve sheath tumors, lymphoma, melanoma, OSA, Chond, adenocarcinoma, granular cell tumor, HSA, MCT, Plasma cell tumor, ectopic thyroid tissue
What percentage of change in mineral content is needed before bone loss is appreciated on radiographs?
30 - 50 %
What type of imaging modality is best for diagnosing oral SCC?
FDG-PET, or FDG-CT, Fluorodeoxyglucose positron emission tomography
How should you assess tumor staging in feline oral scc?
regional lymph node aspirates, three view thoracic rads, hypercalcemia
Recurrence rates of surgically treated feline oral scc
38% in one study of rostral mandible, another study had 80% recurrence, within 5 - 12 mo of surgery
Median STT in cats with oral SCC, treated with surgery
< 6 months
Median STT with cats treated with surgery and radiation
14months
How do cats do with a mandibulectomy?
not well, function is affected, 12% unable to eat for up to 813 days
complications of mandibulectomy of SCC in cats
mandibular drift, decreased prehension, ptyalism, tongue protrusion, decreased ability to groom
Curative intent radiation treatment for feline oral SCC
- many sml doses for 5 days each week for several weeks
- 2 doses per day or try 7 days per week
Palliative radiation treatment for oral SCC in cats
-few large, weekly doses of radiation, hypofractionation
What was the median STT in cats with partial response to radiation tx?
60 days
what was the median STT in cats with complete response to XRT?
298 days
What is the median STT in all cats with SCC treated with XRT
86 days
Study looking at hypofractionization treatment in cats with oral scc and melanoma
median ST was 60 days and did not result in palliation
does chemotherapy work in oral SCC in cats?
not as a solo treatment, efficacy poor,
What treatment has improved stt in cats with oral SCC
curative intent surgery plus radiation tx, combination treatments work best
What chemotherapy radiation combo improved STT
11 cats, concurrent xrt with chemo: mitoxantrone, 10 - 15 fx over 3 weeks, 8 cats went into remission for median time of 170 days
Can Cox-2 inhibitors or NSAIDs help cats with oral SCC?
maybe beneficial, but COX-2 expression in feline oral SCC is less than in human and canine oral SCC.
Palliative treatments
analgesia, nutritional supplements, infection control, opiods,
dose of buprenorphine
0.02 mg/kg recommended
Tramadol
synthetic aminocyclohexanol opioid analgesic acting on neurotransmission of noradrenaline and seratonin, dosing is lower, and longer interval than dogs
Meloxicam dose
Cox-2 inhibitor, 0.1 mg/cat or 0.025 mg/kg either twice weekly or EOD.
