export_jvd2015 321 bilgic feline scc

Question 1

Feline Oral squamous cell carcinoma: clinical manifestations and literature review

Answer 1

JVD2015 32(1), Bilgic O, Duda L, Sanchez MD, Lewis JR

Question 2

most common oral tumor type in cat

Answer 2

SCC

Question 3

Oral tumors account for what percentage in cats?

Answer 3

10% of all feline tumors, 90% malignant

Question 4

Squamous cell carcinoma accounts for what percentage of oral tumors in cats

Answer 4

60-70%

Question 5

most common location of SCC in cats

Answer 5

sublingual/lingual, maxilla, mandible, buccal mucosa, lip, caudal pharynx/tonsillar region

Question 6

Metastatic rate of SCC in cats

Answer 6

35.7%

Question 7

Where does it metastasize to?

Answer 7

mandibular lymph nodes and lungs

Question 8

most cats succumb to the what effects of SCC?

Answer 8

local aggressive growth of primary tumor

Question 9

Environmental factors contibuting to SCC in Cats

Answer 9

1. environmental smoke (2X increased risk)
2. flea collars (5.3x increased risk)
3. canned food (3.6x increased risk)
4. Canned tuna (4.7x increased risk)

Question 10

Human papillomavirus has been implicated as risk factor for SCC in humans. IN cats…

Answer 10

more investigation warranted

Question 11

Altered epidermal growth factor receptor (EGFR) may play a key role in feline oral SCC, true or false

Answer 11

True, 69% samples of feline oral SCC were reactive to EGFR

Question 12

Cox-1

Answer 12

constitutive form, catalyzes synthesis of prostaglandins involved in homeostatic functions of GI, vasodilation of kidneys, synthesis of thromboxane

Question 13

Cox - 2

Answer 13

inducible form, sites of inflammation. Proinflammatory cytokines, carcinogens, oncogenes, and mitogens can induce Cox-2 activiaton

Question 14

cox-2 immunoreactivity in feline oral SCC

Answer 14

9% of samples positive in one study, 67% in another study, also observed in normal feline oral tissue (80%)

Question 15

clinical signs of oral feline SCC

Answer 15

hyporexia, anorexia, lethargy, wt loss, decreased grooming, ptyalism, halitosis

Question 16

Lingual/sublingual SCC in cats

Answer 16

• common
• frenulum/sublingual mucosa
• quickly invades tongue
• ulceration
• sloughing of tongue

Question 17

maxillary feline scc

Answer 17

• invade bone
• osteolysis
• crater-like lesion
• destruction of palantine process
• caudal masses are ulcerative
• inability to retropulse globe

Question 18

mandibular feline oral SCC

Answer 18

• similar to maxillary lesions
• mobile teeth
• ulceration
• periosteal proliferation

Question 19

Neoplasia that may mimic oral SCC

Answer 19

FSA, peripheral nerve sheath tumors, lymphoma, melanoma, OSA, Chond, adenocarcinoma, granular cell tumor, HSA, MCT, Plasma cell tumor, ectopic thyroid tissue

Question 20

What percentage of change in mineral content is needed before bone loss is appreciated on radiographs?

Answer 20

30 - 50 %

Question 21

What type of imaging modality is best for diagnosing oral SCC?

Answer 21

FDG-PET, or FDG-CT, Fluorodeoxyglucose positron emission tomography

Question 22

How should you assess tumor staging in feline oral scc?

Answer 22

regional lymph node aspirates, three view thoracic rads, hypercalcemia

Question 23

Recurrence rates of surgically treated feline oral scc

Answer 23

38% in one study of rostral mandible, another study had 80% recurrence, within 5 - 12 mo of surgery

Question 24

Median STT in cats with oral SCC, treated with surgery

Answer 24

< 6 months

Question 25

Median STT with cats treated with surgery and radiation

Answer 25

14months

Question 26

How do cats do with a mandibulectomy?

Answer 26

not well, function is affected, 12% unable to eat for up to 813 days

Question 27

complications of mandibulectomy of SCC in cats

Answer 27

mandibular drift, decreased prehension, ptyalism, tongue protrusion, decreased ability to groom

Question 28

Curative intent radiation treatment for feline oral SCC

Answer 28

- many sml doses for 5 days each week for several weeks | - 2 doses per day or try 7 days per week

Question 29

Palliative radiation treatment for oral SCC in cats

Answer 29

-few large, weekly doses of radiation, hypofractionation

Question 30

What was the median STT in cats with partial response to radiation tx?

Answer 30

60 days

Question 31

what was the median STT in cats with complete response to XRT?

Answer 31

298 days

Question 32

What is the median STT in all cats with SCC treated with XRT

Answer 32

86 days

Question 33

Study looking at hypofractionization treatment in cats with oral scc and melanoma

Answer 33

median ST was 60 days and did not result in palliation

Question 34

does chemotherapy work in oral SCC in cats?

Answer 34

not as a solo treatment, efficacy poor, 

Question 35

What treatment has improved stt in cats with oral SCC

Answer 35

curative intent surgery plus radiation tx, combination treatments work best

Question 36

What chemotherapy radiation combo improved STT

Answer 36

11 cats, concurrent xrt with chemo: mitoxantrone, 10 - 15 fx over 3 weeks, 8 cats went into remission for median time of 170 days

Question 37

Can Cox-2 inhibitors or NSAIDs help cats with oral SCC?

Answer 37

maybe beneficial, but COX-2 expression in feline oral SCC is less than in human and canine oral SCC. 

Question 38

Palliative treatments

Answer 38

analgesia, nutritional supplements, infection control, opiods, 

Question 39

dose of buprenorphine

Answer 39

0.02 mg/kg recommended

Question 40

Tramadol

Answer 40

synthetic aminocyclohexanol opioid analgesic acting on neurotransmission of noradrenaline and seratonin, dosing is lower, and longer interval than dogs

Question 41

Meloxicam dose

Answer 41

Cox-2 inhibitor, 0.1 mg/cat or 0.025 mg/kg either twice weekly or EOD.