Oncology

Question 1

What chemo for STS?

Answer 1

Doxorubicin. Multiple agent protocols haven’t been proven to be better than dox alone

Also try mitoxantrone and ifosfamide

Question 2

If STS can’t be excised w wide margins , what is recc therapy?

Answer 2

Marginal resection followed by adjuvant RT. Can also do RT before sx to shrink tumor

Question 3

Where does STS met to?

Answer 3

Lung. LN mets uncommon.

Question 4

What tumors comprise STS?

Answer 4

Malignant peripheral nerve sheath tumor, hemangiopericytoma, malignant schwannoma, neurofibrosarcoma, fibrosarcoma, undiff sarcoma, liposarcoma, leiomyosarcoma, myxosarcoma, rhabdomyosarcoma

Question 5

What biological behavior is common to all STS?

Answer 5

1. Ability to arise from any anatomic site but skin and SC more common. 2. Tendency to appear as a pseudo encapsulates soft to firm tumor. 3. High potential for local invasion 4. Local recurrence common 5. Low to mod metastatic rate. 6. Mets hematogenously to lungs 7. Rare regional LN mets (except synovial cell sarcoma and histiocytic sarcoma) 8. Similar histological appearance 9. Histological grade predictive of metastasis and surgical margins predictive of local tumor recurrence

Question 6

What tumors not included as STS?

Answer 6

OSA, Chondrosarcoma, HSA, synovial cell sarcoma, histiocytic sarcoma, mesothelioma, lymphangiosarcoma

Question 7

What percent of grade III STS mets to regional LN and lung

Answer 7

50%

Question 8

What’s the risk of shelling out a STS?

Answer 8

They appear to be well encapsulated but aren’t and the capsule is made up of tumor cells- these are the potentially more aggressive sub population of invasive cells= recurrent lesions may be more aggressive or higher grade

Question 9

Dogs with higher grade tumors warrant curative intent treatment as local recurrence is grade dependent. True or false?

Answer 9

True

Question 10

Why consider chemo for STS?

Answer 10

Intra abdominal STS, higher histological grade with tumors w higher rate of met. Incompletely resected tumors that you can’t to sx or rad on

Question 11

What do you do for metastatic dz?

Answer 11

Not surgery. Palliative care

Question 12

What are prognostic factors for local recurrence?

Answer 12

Tumors >5 cm more likely to recur. Superficial sites for STS and extremities easier to resect- better prognosis. Dogs w incomplete resection 10x more likely to develop recurrence. Tumors that are freely moveable have a more favorable prognosis, high grade and thickness of fascial plane deep to tumor neg prognostic indicators

Question 13

What’s expected survival time w no tx for nasal tumor?

Answer 13

3-6 months

Question 14

What nasal tumors have a worse prognosis

Answer 14

Anaplastic, SCC, undiff carcinoma worse prog compared to sarcomas. Dogs a unilateral nasal involvement w no bony destruction beyond turbinates had longest survival-23 months v dogs w cribiform plate lysis 6.7 months

Question 15

Treatment of choice for nasal tumor?

Answer 15

RT alone or with sx and chemo

Question 16

Side effects of RT on eye?

Answer 16

KCS, cataracts, retinal hemorrhage, corneal ulcer

Question 17

What’s the most common feline nasal tumor?

Answer 17

Nasal lymphoma

Question 18

Do cats w nasal LSA eventually have systemic spread of their disease?

Answer 18

YES

Question 19

What is the treatment of choice for STS?

Answer 19

Wide surgical excision- 3 cm margins and one fascial plane deep