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Onco Board Review 2 > HSA > Flashcards

HSA Flashcards

1
Q

What is the staging scheme for cutaneous HSA?

A

Stage 1: confined to dermis
Stage 2: extends into SQ
Stage 3: extends into underlying muscle

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2
Q

What is the difference in metastatic potential between stage I and stage II/III cutaneous HSA?

A

Stage 1: 30% rate with only dermal mets (maybe new primaries and not mets)
Stage 2 and 3: 60% met rate to lungs, LN, distant dermal mets

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3
Q

Which IHC stains differentiate synovial cell sarcoma from histiocytic sarcoma?

A

Synovial: vimentin and cytokeratin
HS: CD18, CD204 (CD18 is sarcoma, CD204 specific among leukocytes for histolytic origin)

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4
Q

How do VEGF levels of splenic tumors compare to healthy dogs? Is there a difference between dogs with HSA vs. hematoma? (Frenz 2014)

A

VEGF levels higher in dogs with splenic tumors; no difference between HSA and hematoma

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5
Q

What % of canine splenic tumors are HSA?

A

45-51%

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6
Q

What % of canine splenic masses are associated with non-traumatic hemoabdomen are HSA?

A

63-70%

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7
Q

Which IHC markers identify HSA?

A

Factor VIII/vWF, CD31/PECAM

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8
Q

What % of dogs with HSA have criteria for DIC?

A

47-50%

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9
Q

Describe a T2 HSA.

A

tumor >/= 5cm or ruptured

invading SQ tissue

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10
Q

What was the MST for dogs with HSA treated with surgery, L-MTP-PE, and chemo?

A
  1. 1 months

5. 7 months with surgery and chemo alone

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11
Q

What is the MST for splenic HSA with surgery alone?

A

19-86d

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12
Q

Which visceral site HSA has the best prognosis?

A 
Renal
MST 278d (9.3 months) with surgery and chemo
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13
Q

T/F: Administration of DOX q2 weeks improves survival in HSA vs. 3 weeks.

A

False

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14
Q

How does Yunnan Baiyao affect HSA cell lines? (Wirth 2016)

A

caspase-mediated apoptosis

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15
Q

T/F: There was no significant difference to PFS/OST with addition of mCTX after DOX for HSA. (Matsayuma 2017)

A

True

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16
Q

Does metronomic chemo added to DOX improve outcome?

A

No, several studies (Matsuyama 2017, Alexander 2018)

Finotello 2016 suggested that it did, but not reproduced in future studies.

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17
Q

What histopath feature was associated with survival in multivariate analysis for HSA? (Moore JAVMA 2017)

A

mitotic index - MST was longer (292d) for dogs with mitotic score of 0 (< 11 mitoses/10 hpf)

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18
Q

What % of small breed dogs that underwent splenectomy for splenomegaly had a malignant process? What breed may have had higher incidence of neoplasia? (Corbin 2017)

A

47%
(67% of these were HSA)
Wheaten terriers

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19
Q

What were the results of single 12 Gy fraction for dogs with R atrial masses and hemorrhagic pericardial effusion? (Nolan 2017)

A

Decreased need for pericardiocentesis (did not improve overall MST)

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20
Q

How does FDG-PET compare to conventional staging for HSA? (Borgatti 2017)

A

Abnormalities were found in 2 dogs that were not on conventional staging (R atrial mass and a hepatic nodule)

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21
Q

What is eBAT? (Borgatti 2017)

A

biospecific angiotoxin that consists of truncated Pseudomonas exotoxin fused to EGF and the amino terminal of urokinase plasminogen activator

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22
Q

How did eBAT affect survival in HSA dogs? (Borgatti 2017)

A

improved 6 month survival from < 40% in comparison population to ~70%
- eBAT also had less tox than traditional EGFR targeting

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23
Q

What else was unique about survival in the eBAT study? (Borgatti 2017)

A

6 dogs survived > 450 days

24
Q

How did epirubicin compare to DOX for canine HSA (MST and toxicity)? (Kim 2007)

A
  • MST similar to DOX (Stage I did have significantly better MST at 345d)
  • 39% hospitalized for GI dox - higher incidence than DOX
25
Q

What was the response rate for DAV (DOX, DTIC, Vinc)? MST? (Dervisis 2011)

A

RR 47.4%

MST 125d

26
Q

What was the RR of VAC and MST? (Alvarez 2013)

A

RR 86%

MST stage III 195d (6.5 mo) same as stage I/II 189d

27
Q

What is the ORR for DOX for presumed cardiac HSA? (Mullin 2014)

A

41%

MST 116d

28
Q

What unusual nodal location of HSA has been reported in dogs and cats?

A

cervical LN

29
Q

Positive prognostic factors for cutaneous HSA? (Szivek 2011)

A

predisposed breed, ventral abdomen, solar induced

30
Q

% of patients with cutaneous HSA recurrence? (Szivek 2011)

A

77%

31
Q

What % of incidentally detected splenic masses were malignant? (Cleveland 2016)

A

30%

58% were cHSA

32
Q

What % of cardiac masses were successfully identified with FNA/cyto? (Pedro 2015)

A

6/6 - 100%

5/6 neoplastic, 1 was inflammation (confirmed on histo?)

33
Q

What % of dogs with cardiac HSA had concurrent splenic HSA? (Boston 2011)

A

29% (and 42% had metastasis to another site)

34
Q

What % of dogs with splenic HSA had concurrent cardiac masses? (Boston 2011)

A

8.7% (is this different than what Withrow states?)

35
Q

What was MST for surgery alone for cHSA? How did chemo affect survival? (Wendelburg 2015)

A

surgery alone - 1.6 months
any form of chemo extended survival (DOX, DOX + mCTX, mCTX alone all better than surgery alone) - initially not significantly different, but was after adjusting for stage and looking at early follow up period - concluded stage is important

36
Q

Does the use of Palladia after DOX prolong survival? (Gardner 2015)

A

No

37
Q

How did DOX/CTX compare to DOX/DTIC? (Finotello 2015)

A

TTM and MST longer with ADTIC (> 550 d vs. 100-150 d)

38
Q

What were the conclusions regarding IP Doxil? (Sorenmo 2008)

A
  • IP administered doxil result in effective drug concentration and comparable clearance with IV
  • Did not effectively prevent intra-abdominal recurrence
39
Q

Concentrations of ___ were higher in dogs with splenic masses compared to healthy controls. (Frenz 2014)

A

VEGF

Didn’t differentiate between malignant and benign, though.

40
Q

In dogs with confirmed splenic HSA, what % of dogs with grossly abnormal livers actually had HSA metastasis? (Clendaniel 2014)

A

50% (29/58)

Also noted that biopsy on liver that appeared normal was low yield

41
Q

The presence of a splenic mass > __ cm on AUS in cats is suggestive of malignancy. (Bertal 2017)

A 
1 cm
(a moth-eaten appearance of the spleen does not necessarily reflect a LSA or other malignant neoplastic process on cyto)
42
Q

What was the median PFS/MST for dogs with lingual HSA? (Burton 2014)

A

PFS 524d, MST 553d (18 months)

all were low or intermediate grade; most small and on ventral surface

43
Q

What % of cats with visceral HSA had lung metastasis at dx? (Culp 2008)

A

33%

44
Q

What % of cats with visceral HSA had multifocal involvement at diagnosis? (Culp 2008)

A

77%

45
Q

What was MST for cats with visceral HSA? (Culp 2008)

A

Majority euth within 1 day of dx; rest was MST 77d

46
Q

RR of hypofractionated RT for non-splenic HSA? MST? (Hillers 2007)

A

90%
MST 95d (3.2 months)
8 Gy x 3 or 6 Gy x 4

47
Q

RR of non-resectable SQ HSA to DOX? (Wiley 2007)

A

38.8%

48
Q

What are risk factors for perioperative death with splenectomy? (Wendelburg 2014)

A
  • thrombocytopenia (for each 10,000 decrease in PLT odds of death increase 6%)
  • anemia (if PCV < 30%, odds of death 2x higher)
  • intraoperative arrhythmia (increased by 2x)
49
Q

What is MTP-PE? (Vail 1995)

A

Synthetic lipophilic derivative of MDP, a component of bacterial cell wall – encapsulation within liposome greatly enhances endocytosis and tissue uptake.

50
Q

What cytokines were increased with L-MTP-PE treatment? (Vail 1995)

A

TNF-a, IL-6

51
Q

What % of dogs that received L-MTP-PE with DOX/CTX were disease free after 1 year? (Vail 1995)

A

37%

only 15% of placebo group

52
Q

Was there a significant difference in survival for dogs receiving L-MTP-PE vs. placebo? (Vail 1995)

A

There was for stage II, not stage I

53
Q

What was survival difference between stage I and II? (Vail 1995)

A

Stage I - 355
Stage II - 148
(this was statistically significant)

54
Q

How did masitinib affect HSA cell lines? (Lyles)

A

induced apoptosis in all lines via activation of caspase 3/7

55
Q

What IHC markers can distinguish lymphangiosarcoma from HSA?

A

PROX-1

LYVE-1

56
Q

Which is FALSE regarding feline hemangiosarcoma?

a. 77% of cats with visceral hemangiosarcoma have multifocal disease at diagnosis
b. The liver is the most common location for visceral hemangiosarcoma
c. A MI >3 is associated with a shorter survival time
d. Visceral locations are more common than skin/subcutaneous locations

A

D. Visceral locations are more common than skin/SQ - FALSE

Onco Board Review 2 (20 decks)

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