Gastrointestinal Flashcards
Percentage of dogs with cecal GISTs that show signs of acute abdomen secondary to perforation?
AH
25%-32%
Withrow 2019 - Ch 23 - GI
What percentage of cats with clinical signs of chronic small bowel disease have IBD or neoplasia?
AH
Almost all of them!
95-99% had IBD or neoplasia (LSA, MCT, ACA) on biopsy
Withrow 2019 - Ch 23 - GI
Which intestinal cancers are associated with each of these paraneoplastic syndromes?
- Alopecia
- Neutrophilic leukocytosis
- Hypereosinophilia
- Hyperviscosity syndrome
- Erythrocytosis
- Hypoglycemia
- Nephrogenic diabetes insipidus
AH
- Alopecia: carcinoma (+ Cheyletiella) in a dog, metastasizing colonal carcinoma in a cat
- Neutrophilic leukocytosis (monocytosis and eosinophilia): rectal tumors dog
- Hypereosinophilia: T-LSA; a cat and several dogs
- Hyperviscosity syndrome: EMP dog
- Erythrocytosis: cecal LMS dog
- Hypoglycemia: smooth muscle tumors dog
- Nephrogenic diabetes insipidus: LMS dog
Withrow 2019 - Ch 23 - GI
In what percentage of dogs with intestinal lymphoma and non-lymphomatous solid tumors and abdominal mass could be palpated?
AH
Lets say up to half of them:
LSA - 20-40%
Non-LSA - 20-50%
Withrow 2019 - Ch 23 - GI
What proportion of dogs and cats with intestinal tumors have hypoproteinemia?
AH
1/4 - 1/3
Withrow 2019 - Ch 23 - GI
What percentage of cats with intestinal smooth muscle tumors are hypoglycemic?
AH
up to 55%
Withrow 2019 - Ch 23 - GI
Why it may be difficult to distinguish intestinal LSA and MCT in cats?
AH
eosinophilia with LSA
MCT with concurrent small T-cell LSA
Withrow 2019 - Ch 23 - GI
Percentage of dogs and cats with intestinla tumors that show an abdominal mass on plain radiographs?
What percentage shows an obstructive pattern?
AH
~40%
higher for solid tumors, lower for LSA
10-75% show obstructive pattern
Withrow 2019 - Ch 23 - GI
The normal appearance of intestine does not rule out the presence of LSA. What percentage of dogs with GI LSA does not show sonographic abnormalities?
AH
About 1/4 (26%)
Withrow 2019 - Ch 23 - GI
How much each of these signs on ultrasound increase the likelihood of having an intestinal neoplasia in dogs?
loss of wall layering
Wall thickness > 1cm
AH
loss of wall layering: 50X more, almost all (99%) of dogs in one study had loss of wall layering.
Wall thickness > 1cm: 20X more
Withrow 2019 - Ch 23 - GI
Colonoscopical biopsy results tend to underdiagnose dogs with malignancy. What percentage of dogs had a different colonoscopy biopsy results vs final histopathology?
AH
Around 1/3 (31%)
Withrow 2019 - Ch 23 - GI
What is the risk of dehiscence after GI biopsy via ex lap in dogs and cats?
Which population is more at risk?
AH
Very low risk (1% dogs, <3% cats)
Cats with neoplasia and hypoalbuminemia
Withrow 2019 - Ch 23 - GI
Why carcinomatosis in cats should not always be seen as an indication of euthanasia?
AH
Two cats with maliganant effusion lived 2.5 and 28 mo after removal of the primary intestinal ACA.
Withrow 2019 - Ch 23 - GI
Most common non-hematopoietic gastric tumor in dogs?
Gastric carcinoma
Most common gastric cancer in cats?
Lymphoma
Most common subtype of canine gastric carcinoma?
Diffuse (either undifferentiated or glandular subtype); other subtype is intestinal (papillary, acinar, or solid subtype)
Which gastric tumor(s) has been associated with paraneoplastic hypoglycemia? And what is the mechanism?
Leiomyoma and leiomyosarcoma, suspected to be due to excessive release of IGF-2.
Cell of origin of GISTs?
Interstitial cells of Cajal
IHC markers for GISTs
C-Kit (CD117) and CD34.
Mutations in exon 11 are common and sometimes exon 9 too.
IHC is required to differentiate between GISTs and leiomyosarcomas
Incidence (percent) of HER-2 expression in canine gastric carcinoma?
58%
(~60%)
Median survival times for dogs vs. cats with gastrointestinal MCTs
Dogs: <1 month
Cats: 531 days (barrett et al 2018)
Is primary or metastatic liver cancer more common in dogs? Cats?
Dogs: Metastatic (2.5x more)
Cats: Primary
Four categories of primary malignant hepatobiliary tumors in dogs and cats
Hepatocellular, bile duct, neuroendocrine (carcinoid), and mesenchymal
Most common malignant hepatobiliary tumor in cats?
Bile duct carcinoma (cholangiocarcinoma)
Silver stains are used to differentiate what two broad types of hepatobiliary tumors?
Carcinoids (positive) vs. carcinomas
Most common hepatic sarcoma in dogs? Cats?
Dogs - leiomyosarcoma
Cats - HSA
What is the hepatic enzyme elevation trends for primary vs. metastatic liver tumors in dogs?
Primary - more often ALP and ALT
Metastatic - more often AST (and bilirubin)
Hyperferritinemia is common in dogs with what kind of cancer?
Histiocytic sarcoma
Maximum cumulative RT dose the liver can tolerate?
30Gy
Most common intestinal tumor in dogs and cats? Second most? Third most?
Dogs - lymphoma, adenocarcinoma, leiomyosarcoma/GISTs
Cats - lymphoma, adenocarcinoma, MCT
Most common breed of cat to develop intestinal neoplasia?
Siamese (1.8x as likely)
Most common anatomical location for intestinal adenocarcinoma in dogs and cats?
Dogs - colon and rectum (Rectum > colon)
Cats - small intestine
Define carcinoid
Refers to tumors that arise from the diffuse endocrine system rather than the epithelium, despite histologic similarity to carcinomas
What is the 1-year survival rate for dogs with solid small intestinal tumors?
AH
~40%
Withrow 2019 - Ch 23 - GI
What are the three most common sites of metastasis in cats with intestinal adenocarcinoma, and what percentage of cases metastasize to each site?
AH
Local LNs: 50%
Peritoneal cavity (carcinomatosis): 30%
lungs: 20%
Withrow 2019 - Ch 23 - GI
What are the two most common sites of metastasis in dogs with intestinal adenocarcinoma or LMS?
AH
Local LNs: Similar to cats (50%)
liver
Withrow 2019 - Ch 23 - GI
Perioperative mortality for intestinal tumors?
What are the reasons?
AH
30-50%
Sepsis, peritonitis, owners decision for euthanasia when nonresectable tumors are present
Withrow 2019 - Ch 23 - GI
Prognosis for canine small intestinal adenocarcinoma:
Survival with and without surgery
AH
Guarded prognosis
without treatment: 12 days
Surgical resection: ~4months (114 days). Althogh others report 7-10 months
Withrow 2019 - Ch 23 - GI
Survival times for dogs with intestinal LMS who survive the perioperative period?
AH
1.1 to almost 2 years
Withrow 2019 - Ch 23 - GI
Compare survivals for dogs with intestinal GIST vs LMS?
AH
If the dog survives perioperative period:
LMS: 1.1 to almost 2 years
GIST: >3yrs (38mo)
Total:
LMS: 8mo
GIST: 1 yr
No difference in a study. 1-yr survival ~80% for both tumors
Withrow 2019 - Ch 23 - GI
Comment on surgery for dogs with intestinal MCTs?
AH
The benefit is questionable
In two case series, most died within the first month.
Only 2/49 dogs lived past 180 days.
Prednisone was not helpful in most cases.
Withrow 2019 - Ch 23 - GI
Comment on benefits of surgery for cats with small intestinal ACA?
AH
Significant perioperative risk. If they live >2 weeks after surgery they may experience long-term control with surgery alone.
Withrow 2019 - Ch 23 - GI
What is the most common complication of surgical removal of rectal malignancies via rectal-pull through?
AH
Fecal incontinence
57% total with 40% permanent fecal incontinence
Withrow 2019 - Ch 23 - GI
Survival times after surgery alone for cats with large intestinal neoplsia after surgery alone?
Benefits of chemotherapy?
AH
LSA: 3.5 mo
ACA: 4.5 mo
MCT: 6.5
Adjuvant chemo improves ST for ACA but not LSA.
Withrow 2019 - Ch 23 - GI
MST with vs without chmo in cats with colonic ACA and subtotal colectomy?
AH
Significant advantage for DOX: ~9mo vs 2mo
Carbo: ~9mo (no control group)
Withrow 2019 - Ch 23 - GI
Possilbe mechanism of resistance to TKIs in GIST patients?
AH
Second site mutation in c-kit
Withrow 2019 - Ch 23 - GI
duration of response when using TKIs to treat dogs with GISTs in the settings of metastatic dz, nonresectable dz, or recurrent dz:
AH
PR or CR for
~5mo: metastatic
>9mo: nonresectable
>4 yrs: recurrent
Withrow 2019 - Ch 23 - GI
What is the percentage of dogs with mets with tonsillar SCC?
75%
What is the overall local recurrence rate for dogs with oral SCC surgically excised? Based on site?
Overall - 20-25%
Mandibulectomy - 0-10%
Maxillectomy - 15-30%
What is the MST and survival rates for mandibular and maxillary SCC in dogs?
Mandibular: MST 19 - 43 mos; 1 yr 90-100%; 2 yr 80%; 3 yr 60%
Maxillary: 10 - 39 mos; 1 yr 60-95%; 2 yr 70%; 3 yr 40%
What is the MST for oral SCC in dogs based on stage after surgical excision?
Stage II - 14 mos
Stage III - 12 mos
Stage IV - 2 mos
What is the local tumor recurrence rate for canine oral SCC after full course RT? MST for RT alone?
Recurrence - 31%
MST - 15 - 16 mos (RT+Sx = 34 mos)
What is the overall median PFS for dogs with oral SCC?
36 mos
What are prognostic factors for oral SCC in dogs treated with orthovoltage RT?
Rostral tumor location
Non-recurrent tumors
Portal size <100 cm2/m2
Age <6 yrs
What is the duration of response to radiation therapy in a gross disease setting for dogs with oral SCC?
2-3 mos
What is the response to piroxicam alone for the treatment of oral SCC in dogs?
RR - 17%
PFI - 3.5 - 6 mos
What is the complete response rate to treatment with carboplatin + piroxicam in dogs with oral SCC?
57%
What is the overall MST for cats with oral SCC regardless of treatment pursued?
3 mos or less
What is the most common cause of treatment failure for cats with oral SCC?
Local recurrence - almost 90%
What are prognostic factors for survival in cats with oral SCC?
Tumor location
Extent of resection
What is the complete and partial response rate for cats treated with RT + carboplatin for oral SCC?
CR - 52%
PR - 22%
What is the response rate for cats with oral SCC treated with RT + mitoxantrone?
73% (CR)
What are the locations of feline oral SCC associated with a positive prognosis with RT + chemo?
Tonsils
Cheek
What is the ORR for cats treated with pRT with oral SCC?
81%, MST ~6 mos
What location for cats treated with pRT are associated with a better outcome for oral SCC?
Sublingual (4.5 mos) better than mandibular (3 mos)
What are the outcomes associated with SRT for treatment of feline oral SCC?
ORR - 39%
PFI - 3 mos
MST - 3.5 mos
What are the complications associated with SRT for treatment of feline oral SCC?
Mandibular fx (~50%)
Fibrosis (~33%)
Oronasal fistula
What is the most common oropharyngeal cancer in cats?
- Squamous cell carcinoma
- Fibrosarcoma
Besides, melanoma, SCC, and fibrosarcoma, what other malignant oral tuors occur in dogs?
OSA, chondrosarcoma, anaplastic sarcoma, multilobular osteochondrosarcoma, intraosseous carcinoma, myxosarcoma, hemangiosarcoma, mast cell tumor, and TVT
Common breeds for oral malignant melanoma?
cocker spaniel, miniature poodle, anatolian sheepdog, gordon setter, chow, golden retriever
What % of oral malignant melanoma are amelanotic?
38%
What IHC antibodies can differentiate melanoma from other poorly differentiated tumors?
PNL2, Melan A, TRP-1, TRP-2
Metastatic rate of oral malignant melanoma in dogs?
up to 80%
Five histological types of oral SCC?
conventional, papillary, basaloid, adenosquamous, spindle cell
What is the metastatic rate for oral, non-tonsillar scc in dogs?
5-29%
Which site of oral SCC has a higher rate of metastasis: caudal tongue and tonsil or rostral oral cavity?
caudal tongue and tonsil
Risk of oral SCC in cats is increased 4x by exposure to what? 2x by exposure to what?
4x: flea collars, high intake of canned food or canned tuna fish
2x: tobacco smoke
What is the rate of metastasis of oral scc in cats to the mandibular lymph nodes? Lungs?
Mandibular lymph nodes - 31%
Lungs - 10%
What dog breeds have a higher rate of oral fibrosarcoma?
labs, goldens
Oral fibrosarcoma that appears histologically benign but behaves aggressively is termed?
histologically low grade, but biologically high grade
What is the rate of metastasis to lungs/regional LN of oral fibrosarcoma in dogs?
30%
What percent of axial OSA are located in the maxilla? mandible?
Maxilla - 27%
Mandible - 16-22%
Is the metastatic potential of axial OSA higher or lower than appendicular OSA?
lower
What are the four canine types of epulides?
acanthomatous
fibromatous
ossifying
giant cell
What are peripheral odontogenic fibroma?
- benign gingival proliferation arising from the periodontal ligament similar to focal fibrous hyperplasia
-slow growing - preferred term for epulides that includes fibromatous and ossifying epulides
What site do peripheral odontogenic fibromas have a predilection for?
maxilla rostral to the third premolar teeth
Describe acanthomatous ameloblastoma.
- preferred term for acanthomatous epulides
- benign tumor that has an aggressive local behavior and frequently invades bone of the underlying mandible or maxilla
What is the most common site for acanthomatous ameloblastoma in dogs?
rostral mandible (51% of cases)
caudal mandible (22%)
rostral maxilla (22%)
caudal maxilla (6%)
What paraneoplastic syndrome has been reported in two cats with oral SCC?
hypercalcemia
Diagnostic accuracy of FNA for oral masses?
98% in dogs
96% in cats
Accuracy of radiographs to detect oral mass bone invasion of nearby structures? CT w/contrast?
30%
90%
% of dogs with Oral MM with metastatic lymph nodes that were normal size?
40%
% of dogs with Oral MM without metastatic lymph nodes that were abnormal size?
49%
Size of margins recommended for malignant oral tumors?
> 2cm
What is the rate of metastasis for oral MM to lungs in dogs?
14% to 67%
What oncogene is a positive predictive indicator at low percentages and is associated with suppression of cell-cycle inhibitors and confers resistance to chemo and RT in cats with oral SCC treated with SRT?
Bmi-1
What is the biologic response rate in cats with oral SCC treated with toceranib and/or NSAID?
57%
CR - 4%
PR - 9%
SD - 43%
Median survival time for untreated oral MM in dogs?
65 days
(~2 mos)
Overall local tumor recurrence rate for oral MM after surgery in dogs?
45% (22% after mandibulectomy, 48% after maxillectomy)
1 year survival rate for oral MM treated with surgery alone?
<35%
Variables known to have prognostic significance for oral MM in dogs?
age, tumor size, clinical stage, ability of 1st tx to gain local contrl, histologic and IHC criteria (defree of differentiation, MI, nuclear atypia, pigment quantification), COX-2 expression, PDGFR expression, Ki67 exprewssion, c-kit expression
Which drug has shown effective in treatment of cats in a palliative setting with bone invasive SCC?
Pamidronate - PFS 2.5 mos, MST ~6 mos
What percentage of dogs are noted to have metastasis of oral FSA and to what locations?
regional lnn - 19-22% (~20%)
lungs - 27% (~30%)
What is the local recurrence rate in dogs with oral FSA treated with surgery? By site?
24-54% (~25-50%)
Mandibular - 59% (~60%)
Maxillary - 40%
What are significant indicators of local recurrence after surgery for canine oral FSA?
Incomplete excision
Breed – goldens
What is the outcome for dogs treated with surgery for oral FSA overall?
MST - 25 mos
PFI - 22 mos
1 yr 88% (~90%)
2 yr 58% (~60%)
What is the outcome for RT alone for the treatment of gross oral FSA in dogs?
7 mos
Breeds at an increased risk of AGASACA
Spaniels, particularly English cocker spaniels, German shepherds, Alaskan malamutes, and dachshunds
Mean age of dogs diagnosed with AGASACA
9-11 years
Age and breed of cat AGASACA
13 years
Siamese
Histologic patterns of tumor cell arrangement in AGASACA (3)
Which 2 are most common accounting for 95%
- Solid (closely packed neoplastic cells in lobules or nests with minimal stroma)
- Tubules/rosettes/pseudorosettes (cells are radially arranged around a central tubule or a collection of cytoplastic processes or a small blood vessel)
- Papillary (elongated tree-like projections with a
fibrovascular stalk)
Solid and tubules/rosettes/pseudorosettes patterns
Are unilateral or bilateral AGASACA more common?
Unilateral
Overall incidence of bilateral - 14%
What percentage of dogs with AGASACA have hypercalcemia?
16-53%
Metastatic rates and locations of AGASACA
Reported in 26% to 96% of dogs at the time of diagnosis
26% to 89% of dogs having metastasis to the regional LNs
0% to 42% with metastasis to distant sites (lungs, liver, spleen, bone, and, less commonly, heart, adrenal glands, stomach, omentum, pancreas, kidneys, urinary bladder, and the mediastinum)
The medial iliac and internal iliac LNs and sacral LNs are the most common sites of metastasis.
Response rates of oral MM to hypofractionated RT? CR rate?
RR 81-100%
CR 70%
Rate of local recurrence in dogs who obtain a CR? Median time to recurrence?
15 - 26% recurrence rate
median time to recurrence 139 days
Clinical signs in dogs with AGASACA
perianal discomfort, swelling, discharge, bleeding, scooting, perianal licking, tenesmus,
abnormal stool shape, constipation, anorexia, polyuria, polydipsia, hyporexia, lethargy, vomiting
What is the DFI for cats with oral FSA treated with mandibulectomy?
29 mos
What is the outcome for dogs with oral FSA treated with Sx + RT?
Local recurrence - 32% (~30%)
MST - 18 - 26 mos
1 yr PFS - 76% (~75%)
PFS - 7 mos (T3) - 45 mos (T1) (31 mos T2)
Median time to metastasis in dogs with oral malignant melanoma treated with RT?
311d
What percentage of osteosarcoma cases are axial?
25%
Clinical signs in cats with AGASACA
perineal ulceration or discharge, tenesmus,
constipation, scooting, and excessive grooming of the perineal area
What variables increase local tumor control and survival time for dogs with oral malignant melanoma?
rostral tumor location, smaller tumor volume, no radiographic evidence of bone lysis, post-operative irradiation of microscopic disease, megavoltage irradiation
Of axial OSAs, what percentage are maxillary? Mandibular?
Maxillary - 16 - 22% (~15-20%)
Mandibular - 27% (~30%)
cytologic appearance of AGASACA
characteristic “neuroendocrine” cytologic appearance consisting of polyhedral to roundish epithelial cells with uniform round nuclei and light blue-gray, slightly granular cytoplasm
What percentage of dogs had evidence of metastatic disease at the time of diagnosis with axial OSA? After definitive treatment?
At diagnosis - 4%
After treatment - 32-46% (~30-50%)
Staging for AGASACA
assessing the size of the anal sac mass, evaluating for hypercalcemia, and investigating the abdomen and thorax for metastatic disease.
MST for dogs w/oral malignant melanoma treated with RT based by stage?
Stage 1 - 758 days
Stage 2 - 278 days
Stage 3 - 163 days
Stage 4 - 80 days
What is the outcome for oral OSA after mandibulectomy? Maxillectomy?
Mandibulectomy - MST 14 - 18 mos; local recurrence 15-28% (~15-30%); metastasis 35-58% (35-60%)
Maxillectomy - MST 5-10 mos; local recurrence 58% (~60%); metastasis 32% (~30%)
IHC markers for the diagnosis of GIST
AH
KIT
DOG1
In humans and dogs, there is a subset of GIST that are KIT negative.
Withrow 2019 - Ch 23 - GI
mainstay of treatment for dogs with nonmetastatic AGASAC or AGASAC metastatic to the regional
LNs
Surgery
Complication rate and common complications after surgical excision of AGASACA
5-24%
wound dehiscence, rectal perforation, rectocutaneous fistulation, incisional infection, and transient fecal incontinence
Response rate of cats with oral malignant melanoma treated with hypofractioned RT? MST?
60%, 146 days
MST for dogs w/oral malignant melanoma treated with surgery w/ vs w/out adjuvant chemotherapy?
335 vs 352 (no benefit)
MST of dogs w/advanced stage oral malignant melanoma treated with tyrosinase vaccine?
224-389d
What are poor prognostic factors for oral OSA for dogs?
Serum ALP >140 u/L
Increased monocyte counts
Telangiectatic OSA
MI
Grade
Local tumor recurrence
What is the recurrence rate for canine peripheral odontogenic fibroma after sx without bone removal? With bone removal?
Without - 0-17%
With - 4%
What is the recurrence rate for cats with peripheral odontogenic fibromas?
73% (~75%)
MST for dogs w/OMM treated with surgically excised stage 2 or 3 treated w/vaccine vs without?
not reached vs 324d
What is the local recurrence rate for acanthomatous ameloblastoma with surgery alone? RT?
Sx - 0-91%
RT - 8-18% (10-20%)
MST of dogs with oral malignant melanoma of lip and tongue when treated with combination of sx, rt, chemo, and vaccine?
lip 580d
tongue >551d
Any relationship between history of NSAID use and incidence of cancer in dogs?
AH
A study found a significantly reduced risk in dogs with a history of NSAID use (71% reduced risk)
Withrow 2019 - Ch 23 - GI
Where are perianal (hepatoid) glands located?
AH
In the dermis in a circular fashion around the anus
scattered on the prepuce, tail, pelvic limbs, and trunk
Withrow 2019 - Ch 23 - GI
Hormones affecting perianal adenoma?
AH
androgenic hormones - stimulate
estrogen - supress
Withrow 2019 - Ch 23 - GI
Where are the majority of canine lingual tumors located? Feline?
Canine - Dorsal surface
Feline - Ventral surface near frenulum
What percentage of dogs and people have a secondary tumor when there is evidence of a lingual tumor?
Dogs - 16% (~15%)
People - 29% (~30%)
What are the breed predilections for the different lingual tumors in dogs?
MM - Chow, Shar Pei
SCC (most common) - poodle, lab, Samoyed
HSA and FSA - Border collie, golden
Plasma cell tumor - Cocker spaniel
What is the rate of local tumor recurrence after glossectomy for dogs with lingual tumors?
26-28% (~25-30%)
What is the MST for dogs with metastatic disease at the time of diagnosis for lingual tumors? Without mets?
Mets - 8 mos
Without - 22 mos
What is a negative prognostic indicator associated with lingual HSA?
Clinical signs
Size (2-4 cm)
What is the typical age of dogs with undifferentiated malignancy?
<2 yo
What are the common locations of undifferentiated malignancy of young dogs?
Hard palate
Upper molar teeth
Maxilla
Orbit
What is the typical appearance of MLO on imaging?
“Popcorn” bony lesion
What is the rate of metastasis for dogs with MLO?
58% (~60%)
- 25% completely excised
- 75% incompletely excised
What is the MST for MLO in dogs?
11 - 50 mos
overall: 21 mos
What location of MLO is associated with a better outcome in dogs?
Mandibular
What are the two broad categories of odontogenic tumors and which species are they more common in?
Inductive and noninductive
Cats
What is the most common odontogenic tumor in cats and what is the classic radiographic appearance? Location?
Inductive fibroameloblastoma
Radiolucent halo
Upper canine teeth and maxilla
What types of osteomas have been described in dogs?
Peripheral
Central
What is the second most common diagnosis associated with a salivary gland tumor in pets?
Sialadenitis (~30%)
What are clinical signs associated with salivary gland neoplasia in pets?
Halitosis, weight loss, anorexia, dysphagia, exophthalmos, Horner’s, sneezing, dysphonia
What salivary gland is most commonly affected for neoplastic conditions in cats? Dogs?
Cats - mandibular
Dogs - parotid
What infectious agent is associated with esophageal neoplasia?
Spirocerca lupi
Which breed and sex of dogs are predisposed to exocrine pancreatic neoplasia?
Female
Spaniels
What is a paraneoplastic condition associated with exocrine pancreatic neoplasia in cats specifically?
paraneoplastic alopecia
What is the size cutoff for a mass in the pancreas in cats which is associated more likely with neoplasia rather than hyperplasia?
> 2 cm, solitary
Which tight junction molecule expression pattern may be helpful in diagnosis of pancreatic carcinoma?
Claudin-4
What is the overall MST for cats with pancreatic carcinoma? Chemo and/or Sx?
MST - 3 mos
Chemo and/or Sx - 5.5 mos
What is a poor prognostic indicator for cats with pancreatic carcinoma?
Abdominal effusion - MST 1 mo
Chemotherapies that have demonstrated antitumor activity in the gross disease setting for AGASACA
carboplatin, cisplatin, and actinomycin D
Chemotherapies used in the post-op setting for AGASACA
mitoxantrone and melphalan
MST of surgery alone vs surgery and chemotherapy for AGASACA
~16 months for both
no significant difference in outcome between dogs treated with surgery alone and dogs treated with surgery and chemotherapy
Surgery alone - 500 days
Surgery and chemotherapy 540 days
Response rates of dogs with gross disease treated with hypofractionated or fractionated
protocols for AGASACA
38% to 75%
Response of dogs with AGASACA treated with palliative RT protocols
Improvement of CS - 63%
Hypercalcemia - 31%
PFI and MST in dogs with AGASACA treated with palliative-intent hypofractionated protocols
PFI: 10-11 months
MST: 8-15 months
Overall MSTs for dogs with AGASACA
1 to 2.5 years
Poor prognostic factors for AGASACA
Primary tumor size
Presence of clinical signs
Presence of LN metastasis
Size of LN metastasis
Presence of distant metastasis
Nonpursuit of surgery
Treatment with chemotherapy alone
Lack of any therapy at all
Histologic features of the primary tumor
E-cadherin immunoreactivity,
Hypercalcemia