Lecture 4 - Surgical Oncology

Question 1

What cancer treatment cure more cancer than any other single modality?

Answer 1

Surgery

Question 2

(T/F) Optimal treatment often requires multiple modalities

Answer 2

True
- Maximize benefit and potential for cure
- Minimize adverse effects

Question 3

List the roles of surgery:

Answer 3

1. Diagnose & treatment of solid tumors
2. Palliative treatment
3. Cancer prevention

Question 4

Definition:
Treatment given to help relieve the symptoms and reduce the suffering caused by cancer or other life-threatening diseases

Answer 4

Palliative treatment

Question 5

List the tumor diagnosis methods:

Answer 5

1. Fine needle aspiration
2. Needle core biopsy
3. Incisional biopsy
4. Excisional biopsy

Question 6

• Categorizes into epithelial, mesenchymal, or round cell
• Diagnostic for some tumor types (MCT)
  Advantages:
  
  • Economical
  • No sedation is needed
  • R/o non-neoplastic diseases
    Disadvantages:
  • 13-35% of samples are non-diagnostic

Which tumor diagnosis is this?

Answer 6

Fine needle aspirate

Question 7

• Tru-cut for soft tissues
• Jamshidi for bone (easier with diseased bone)
  Advs:
  
  • Often only requires sedation and local anesthesia
    Disadvs:
  • Small tissue sample so may be non-diagnostic or non-representative

Which tumor diagnosis is this?

Answer 7

Needle-core biopsy
(tip: obtain multiple samples to improve diagnostic accuracy)

Question 8

• Wedge or punch biopsy
• Need to plan where
  Advs:
  
  • Good for soft, friable or inflamed tissues
  • Can be performed with sedation and local anesthesia but may need general anesthesia
  • Oral tumor biopsy can be done without local anesthetic

Which tumor diagnosis is this?

Answer 8

Incisional biopsy

Question 9

• Common but controversial
• Diagnostic but the chance it will be therapeutic depends on the tumor type
• Preferable to FNA or needle core biopsy to plan a definitive surgical procedure OVER excisional biopsy

Which tumor diagnosis is this?

Answer 9

Excisional biopsy

Question 10

(T/F) Excisional biopsy is the best chance for cure, especially in cats with vaccine-associated sarcoma

Answer 10

False, initial surgical procedure = best chance for cure, excisional biopsy can be devastating

Question 11

The following is an example of what?
- Remove the tumor completely

Answer 11

Curative intent

Question 12

The following is an example of what?
- Remove the tumor to decrease symptoms

Answer 12

Palliative intent

Question 13

Definition:
Removal of a body part

Answer 13

Radical resection

Question 14

What surgical “dose” is the following describing?
- Precise amount of tissue depends on:
- Tumor type
- Biologic behavior (Histopathological grade)
- Tumor size: Larger tumors have greater microscopic extension

Answer 14

Wide margins

Question 15

What surgical “dose” is the following describing?
- Incomplete excision of a tumor with residual microscopic disease
- Planned or unplanned

Answer 15

Marginal resection

Question 16

What surgical “dose” is the following describing?
- Incomplete resection of the tumor with residual gross disease
- Rarely acceptable treatment for cancer as regrowth is usually rapid
- Presence of macroscopic tumor usually makes adjunctive treatments less effective

Answer 16

Debulking Surgery

Question 17

What helps determine tumor type, grade, and margins?

Answer 17

Histopathology results