Oral

Question 1

Nemec et al. 2012. Histological subtype of oral non-tonsillar SCC in dogs

82% SCC were conventional SCC (CSS), 47.8% well-differentiated, 44.9% moderately-differrentiated and 7.3% poorly differentiated, 5.95% papillary SCC and basiloid SCC, 3.6% adenosquamous carcinoma, and 2.4% spindle cell carcinoma

Neutered female dogs, dogs aged 10-<15 years, English springer spaniel and Shetland Sheepdogs were overrepresentted

78% were proliferative with or without ulceration

71.4% located in dentate jaws, well differentiated CSCC more affected the tongue and othr non-dentate mucosal surfaces

No association was found between subtypes and TAI, perineural or lymphovascular invasion, or brtween gross appearance and tumor location

Question 2

Frazier et al. Outcome in dogs with surgically resected oral FSA (1997-2008)

Oral FSA treated with surgical excision with or without adjuvant RT

21 dogs treated with surgery alone and 8 dogs with surgery and RT

Median PFI?

MST?

1- and 2- year survival rates?

Local recurrence rate?

Metastasis?

Answer 2

>653 days (1.8 yr)

743 days (2.0 yr)

88% and 58%

24. 1%
25. 1%

Question 3

Gardner et al. Canine oral FSA: a retrospective analysis of 65 cases (1998-2010)

6 significant predictors of median survival were?

2 significant predictors of PFS were?

A combination of ___ and ___ was the strongest predictor of prolonged MS and PFS at ___ and ____ days

Answer 3

Location, tumor size and oral stage, type of surgery, margins, grade

Location, RT protocol

surgery and RT, 505 and 301 days

Question 4

Culp et al. Results of surgical excision and evaluation of factors associated with survival time in dogs with lingual neoplasia: 97 cases

Rate of tumor recurrence?

Most common histopath diagnosis?

Rate of metastatic disease? Overall MST?

MST for SCC? MM?

Which dogs had shorter survival time?

Answer 4

28%

SCC (32%) and malignant melanoma (30%)

19%, 483 days (16 months)

216 days (7.2 mo), 241 days (8 mo)

Lingual tumors >2 cm

Question 5

Fulton et al. Risk factors associated with survival in dogs with nontonsillar oral squamous cell carcinoma (OSCC):

Risk of death for the 21 dogs treated with surgery was?

1-year survival rate for dogs treated and not treated with surgery?

Risk of death increased with?

Tumor location, stage, and histologic subtype and survival time?

Answer 5

Decreased by 91.4% compared to dogs not treated with surgery

94% and 0%

Increasing TAI and increasing risk score (combination of TAI, PNI, LVI)

No association

Question 6

Martin et al. Combined zoledronic acid and meloxicam reduced bone loss and tumor growth in an orthotopic mouse model of bone-invasinve oral SCC

___ inhibited osteoclastic bone resorption at tumor-bone interface

____ was more effective than ___ at reducing xenograft growth but did not affect bone resorption

Synergistic effect betwen meloxicam and ZOL?

Answer 6

ZOL

Meloxicam than ZOL

Not observed - combination was well tolerated

Question 7

Delanet et al. Immunohistochemical and biochemical evidence of ameloblastic origin of amyloid-producing odeontogenic tumors (APOT) in cats

APOT are rare in cats

Antiameloblastine antibodies labeled neoplastic epithelial cells and amyloid in call cases

Neoplastic epithelial cells had strong, diffuse immunoreactivity to antibodies against AE1/AE3, cytokeratin 14, cytokeratin 19 and focal immunoreactivity to nerve growth factor receptor in 2 of 3 cases

Amyloid and some stromal cells weakly positive for laminin

Calretin, amelogenin, S100, GFAP did not label neoplastic epithelial cells

Feline APOTs and the amyloid are of ameloblastic lineage

Question 8

Nemec et al. Oral papillary SCC in 12 dogs

PSCC is a histological subtype of oral SCC

Considered oral tumor of young animals

Majority (>75%) were what age?

All tumors were derived from?

What % were advanced tumors (T2 and T3)?

Microscopically 2 patterns seen: 1) invasion of bone forming a cup-shaped indentation in bone or deeply cavitating cyst (cavitating pattern)

2) Histologically malignant growth but lack of bone invasion (non-cavitating pattern)

Features suggest 2 distinct biological behaivours of COPSCC

Answer 8

> 6 years (median 9 years)

Gingiva of dentate jaws with 67% affecting rostral location

92%

Question 9

Fulton et al. The expression of calretinin and cytokeratins in canine acanthomatous ameloblastoma and oral SCC

15 OSCC and 15 CAA, 6 tooth buds and 2 normal gingival tissues

CK expression?

Calretinin?

Answer 9

OSCC consistent with CAA and canine tooth bud tissue

10/15 OSCC and 2/15 CAA

Question 10

Armory et al. 2013. CT characteristics of odontogenic neoplasms of dogs

All tumor types were a direct association with or in the region of multiple teeth in 96.4% (27/28), contrast enhancement in 96.3% (26/27), alveolar bone lysis in 93.1% (27/29), and mass-associated tooth displacement in 85.2% (23/27).

Canine acanthomatous ameloblastomas (n = 15) appeared as extra-osseous (10/15) or intra-osseous (5/15) masses. Intra-osseuouc more aggressive.

Amyloid-producing odontogenic tumors (n = 3) had subjectively uniform CT imaging characteristics and consisted of round soft tissue and mineral attenuating masses with multiple associated cyst-like structures.

Fibromatous epulides of periodontal ligament origin (n = 4) were contrast enhancing extra-osseous masses that were rarely referred for CT examinations and 25% (1/4) were not visible with CT.

Question 11

Broome et al. Clincial feature and treatment outcomes of 41 dogs with sublingual ectopic thyroid neoplasia

Dogs with sublingual tumors were ___ and less likely to have ____ compared to eutopic thyroid carcinomas

21 dogs treated with surgery (partial hyoidectomy) 7 with radioiodine alone, 13 with surgery followed by radioiodine (radioiodine recommended for multifocal disease)

Overall MST?

Answer 11

Younger, metastatic disease (15% vs. 30%)

562 days (19 months)

Question 12

Suzuki et al. The origin and role of autophagy in the formation of cytoplasmic granules in canine lingual granular cell tumors

GCTs are characterized by polygonal neoplastic cells with eosinophilic cytoplasmic granules

Derived from Scwann cells in humans

Canine lingual GCT originate from ___ and develop cytoplasmic granules via ___

Answer 12

Neural crest, autophagy

Question 13

Soltero-Rivera et al. Benign and malignant proliferative fibro-osseous and osseous lesions of the oral cavity of dogs

Question 14

Mestrinho et al. PCNA and grade in 13 canine oral SCC: association with prognosis

Median DFS for grade 3 tumors? grade 2?

Grade __ tumors and PCNA labeling index ___ were related with shorter DFST

Mean PCNA labeling index was ___ in recurrent cases

Grade and PCNA may be important prognostic factors in canine OSCC

Answer 14

138 days, not reached

Grade 3 and >65%

Significantly higher

Question 15

Mestrinho et al. 2015. p63 and E-cadherin expression in canine oral SCC

All tumor cell has enhanced p63 expression

77% showed decreased E-cadherin immunoreactivity and 59% was cytoplasmic

Neither p63 nor E-cad were associated with tumor size, bone invasion, LN mets

p63 score was related to PCNA proliferative index

Aytpical p63 and cytoplasmic E-cad were related with higher tumor grade

Question 16

Sabhlok et al. 2014. Palliative RT outcomes for cats with oral SCC (1999-2005)

Overall mean and median ST?

Mean and median ST receiving palliative RT alone?

Mean and median ST receiving RT and chemotherapy?

MST for sublingual tumors? mandibular tumors?

Answer 16

4 months (127d) and 3 months (92d)

157 and 113 days

116 and 80 days

135 days and 80 days

Question 17

Munday et al. 2015. Molecular and IHC studies do not support a role for papillomavirus in canine oral SCC development

None of the primers amplified PV DNA but 4 had intense p16 staining - not due to PV infection

PVs are not significant cause of canine OSCCs

Question 18

Bonfanti et al. 2015. Diagnostic value of cytological analysis of tumors and tumor-like lesions of the oral cavity in dogs and cats: a prospective study on 114 cases

The diagnostic accuracy of FNA, FNI, IS for dogs were?

The diagnostic accuracy of FNA, FNI, IS for cats were?

High agreement with histopathology suggets cytological examination are all appropriate to correctly diagnose lesions of the oral cavity

Answer 18

98%, 98%, 91%

95%, 95%, 95%

FNI - fine needle insertion

IS - impression smear

Question 19

Milovancev et al. 2016. Antiproliferative effects of masitinib and imatinib against canine oral FSA in vitro

PDGFR-a and PDGFR-b

KIT and KDR?

The addition of ____ resulted in synergistic activity

Answer 19

Detected in neoplastic cells from most COF (5/6 and 6/6)

Not detected

Doxorubicin

Question 20

Meier et al. Hypoxia-related marker GLUT-1, CAIX, Proliferative index and MVD in canine oral malignant neoplasia

Question 21

Thierry et al. CT appearnce of canine tonsillar neoplasia: 14 cases

SCC>melanoma>LSA

Features associated with tonsillar neoplasia?

Medial retropharyngeal and mandibular lymphadenomegaly was ___

5 dogs had no enlargement of tonsil despit metastatic lymphadenomegaly

Consider tonsillar neoplasia with medial retropharyngeal lymphadenomegaly with normal sized tonsils

Answer 21

Marked enlargement, heterogeneity, loss of hypoattenuating hilus of medial retropharyngeal LN

ipsilateral to neoplastic tonsil 8/12 and 6/9 dogs

Question 22

Pisamai et al. 2017. Gene expression of cell adhesion molecules, MMP and their inhibitors in canine oral tumors

Decreased CDH1, SDC1, NECTIN4 were observed in OSCC and OM

Downregulation of MMP in late-stage OM

Enhanced TIMP1 in all tumor groups

MMP14 expression in early stage OM

Higher MMP9 and TIMP1 in AA

Altered expression of adhesion molecules, MMP7 and MMP correlated wtih clininopathologic features whereas TIMP1 and MMP14 was probably associated with early stage tumors

Question 23

Goldschmidt et al. 2017. Clinical characterization of canine AA in 263 dogs and the influence of postsurgical histopathological margin on local recurrence

Commonly presents where?

Breed overrepresented?

Local recurrence?

Raises question what the recommended margins should be

Answer 23

Rostral mandible in adult large breed dogs

Golden retrievers

None

Question 24

Reiec et al. 2017. Evaluation of CBC Indices (NLR, PLR, MPV/PLT, and PLCRi) in healthy dogs with periodontis, and dogs with oropharyngeal tumors as potential biomarkers of systemic inflammatory response

Association between CBC indices and PD?

Indices in OT dogs which were significant?

Answer 24

None

NLR and PLCRi significantly higher in OT than HD and dogs with OD

PLCRi - platelet large cell ratio index

Question 25

Cannon et al. 2017. Evaluation of protein kinase CK2 as therapeutic target for squamous cell carcinoma of cats

Expression of CK2a in feline oral mucosa samples and oral SCC samples?

Expression of CK2a and CK2a’ was downregulated with siRNA leading to?

Answer 25

Expressed in all mucosa samples and 7/8 SCC

decreased viability and apoptosis

Question 26

Walz et al. 2017. Fatty acid synthase as a potential therapeutic target in feline oral SCC

High FASN (fatty acid synthase) expression in feline OSS

Orlistat, FASHN inhibitor, reduced cell viability in feline and human OSCC cell lines

FASN inhibition is a viable therapeutic target for feline OSCC

Antagonistic with carboplatin

Question 27

van Ninwegen et al. 2017. Intratumoral injection of radioactive holmium (166 Ho) microspheres for treatment of oral SCC

Emit B-radiation

Local response rate?

MST?

Answer 27

55% - CR and PR allowing marginal resection

113 days and 296 days for patients with local response

Question 28

Giuliano et al. 2016. Quantitative expression and co-localization of Wnt signaling protein in feline SCC

Cyclin D1 (CCND1 or CD1), FRA1, c-Myc, and MMP7

Expression of CD1 was increased in FOSCC tissue by 2.3 to 3 fold compared to normal controls

There was significant change in co-localization for all permutations (CD1/FRA1 etc.) except for nuclear localization of CD1

Question 29

Supsavhad et al. 2016. p16, pRb, p53 in feline oral SCC

Majority of FOSCC have low p16 immunostaining intensity, therefore inactivation of CDKN2A may play a role in pathogenesis

A subset had increased p16 protein which supports an alternate pathogenesis

Question 30

Olmstead et al. 2017. Tolerability of toceranib phosphate when used in conjunction with other therapies in 35 cats with oral SCC: 2009-2013

2.75 mg/kg 3 days a week

Toxicity?

Median treatment duration

Well tolerated by majority of cats

Answer 30

Seen in 6 cats - grade 1 and 2 GI toxicity and 1 grade 4 metabolic toxicity

Discontinued in 1 cat and 2 cats dose reduction

77 days

Question 31

Wiles et al. 2017. Retrospective evaluation of Palladia in cats with oral SCC

Biological response rate?

MST with toceranib?

Cats achieving SD or better had significantly longer PFS and MST

Administration of NSAID?

Answer 31

56%

123 days vs. 45 days with no toceranib

Assciaited with significantly improved survival time

Question 32

Kiobukowska et al. 2016. High numbers of stromal cancer associated fibroblats are associated with shorter survival time in cats with oral SCC

CAF express a-SMA - associated with poor prognosis in human cancers such as SCC

CAF-positive stroma identified in? MST in these cats?

Median ST for oropharygeal vs. maxillary, mandibular, sublingual?

Median ST for sublingual SCC was shorter compared to maxillary SCC

Answer 32

75%, 35 days vs. 48.5 days (CAF-negative SCC)

Significantly longer 179 days vs. 43.5 days. vs. 42 days. vs. 22.5 days

Question 33

Brown et al. 2015. Characterization of STAT3 expression, signaling and inhibition in feline oral SCC

Question 34

Yoshokawa et al. 2016. Predicting clinical outcome in feline oral SCC: tumor initiating cells. telomeres, and telomerase

20 cats underwent SRT

Significant inverse correlation detected between treatment outcomes and Bmi-1 expression - negative prognostic indicator

Telomere lenght exhibited variability, many tumors had high levels of TA - correlated with high levels of Bmi-1, Ki67 and EGFR

Bmi-1 and telomerase may represent therapeutic targets

Question 35

Soltero-Rivera et al. 2014. Prevalence of regional and distant metastais in cats with advanced oral SCC: 49 cases (2005-2011)

Prevealence of LN metastasis?

Thoracic metastasis?

Patients with mandibulat LN mets, where were tumors located?

Pulmonary metastasis and tumor location?

Answer 35

31%

10%

53% maxillary, 27% mandibular, 13% sublingual, 7% caudal pharyngeal

3 mandibular, 1 maxillary, 1 sublingual mass

Question 36

Yoshikawa et al. 2016. Assessment of predictive molecular variables in feline oral SCC treated with SRT

Median ST and PFI

Overall response rate?

Patients with higher ___ or more ___ had shorter ST and PFI

Females had ___ PFI and ST than males

Answer 36

106 days and 87 days

38.5%

higher MVD or more keratinized SCC

significantly longer PFI and ST

Question 37

Randall et al. 2016. Evaluation of 18F-FDG PET/CT as a diagnostic imaging and staging tool for feline oral SCC

Question 38

Yoshikawa et al. 2013. Comparison between 18-F-FDG-PET and contrast enhanced CT for measuring gross tumors volume in cats with oral SCC

Mean gross tumor volume was significantly smaller than mean CT gross volume in mandibular/maxillary SCC but not in lingual/laryngeal group

Mismatch fraction analysis revealed that most of the lingual/laryngeal patients had large region of high 18-F-FDG activity outside of CT gross tumor volume

Mismath fraction was significantly greater in the lingual/laryngeal group than mandibular/maxillary group

Modality detected regions of possible tumor not detected on CT images

Question 39

Yoshikawa et al. 2012. Immunohistochemical characterization of feline oral SCC

22 tumor samples

Wide variation in Ki67 expression, MI, MVD, and EGFR expression

Tongue SCC has higher MVD than did mandibular or maxillary SCC

Tumor expression of EGFR was inversely proportional to survival time

Question 40

Poirier et al. 2013. Efficacy and toxicity of an accelerated hypofractionated RT protocol in cats with oral SCC

21 cats

10 once daily fractions of 4.8 Gy

Acute toxicity?

Late toxicity?

Response?

Metastatic disease?

Median PFS?

Median OS?

Prognostic?

Answer 40

Grade 2 mucositis in all cats

Alopecia (4 cats), leukotrichia (6), tongue ulceration (1), oronasal fistula

7 CR and 5 PR

19%

105 days (1 year PFS 23%)

174 days (1 year OS 29%)

Tumor stage was prognostic with PFS 590 days

Question 41

Pang et al. 2012. Identification of tumor initiating cells in feline head and neck SCC and evidence of gefitinib induced epithelial to mesenchymal transition

CD133 identified cells with sphere forming ability, reduced sensitivity to radiation and conventional chemotherpay and resistant to gefitinib (EGFR targeting drug)

Culture of cells in gefitinib causes change in cell morphology and gene expression reminiscent of epithelial to mesenchymal transition

Question 42

Riggs et al. 2018. Outcomes following surgical excision combined with adjunctive, hypofractionated radiotherapy in dogs with oral SCC or FSA

87 dogs undergone maxillectomy or mandibulectomy got SCC or FSA

MST for all 87 dogs? SCC? FSA?

What was signifciant predictor of survival time?

Dogs undergoing RT after incomplete excision of oral SCC?

Postoperative RT for FSA?

Answer 42

2,049 days and not reached for SCC, 557 for FSA

Tumor type

MST 2051 days vs. 181 with no RT

No protective value - 299 days with RT and 694 without RT

Question 43

MacLellan et al. 2018. Intraoperative and postoperative complications or partial maxillectomy for the treatment of oral tumors in dogs

Most common complication

Asscoaited with tumor size and location, maxillectomy type, surgical approach

Dogs treated with dorsolateral combined intraoral surgical approach were mor elikely to have bleding (83%) and longer mean duration of surgery than those treated with intraoral approach

Complication within 48 hours after surgery included?

Answer 43

bleeding 53% and 42.7% received blood transfusion

Epistaxis 51%, excesive facial swelling 37%, facial pawing 11%, difficulty eating 11.4%, wound dehiscence 11% and infection 8%

Question 44

Stathopoulou et al. 2018. Evaluation of analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease

Maximum buprenorphine plasma concentration was observed 30 minutes after adminitration and had low inter-individual variability

Significant difference between baseline pain scores compared with pain scores after buprenorphine

Significant effect on stomatitis index on pain score

Cats with stomatitis showed lower bioavailability and shorter half life after bucal administration

Question 45

Martano et al. 2018. Canine oral FSA: changes in prognosis over the last 30 years

Overall survival 247-743 days compared to 30-540 days before 2000

High local rate of recurrence 57%

Metastasis 10-14% and occurs late in disease course

Wide surgical excision, and combination of surgery and RT is best approach

Question 46

Flickinger et al. 2018. Evaluation of long-term outcome and prognostic factors of feline SCC treated with PDT using liposomal phosphorylated meta-tetra chlorine

Overall response rate

Mean PFI

MST

Invasiveness yielded significant worse outsomce

Progression at <6 months with invasive tumors

Larger lesions associated with inferior control and treatment intensity, and tumor location did not influence response and duration

Advanced lesions are not indications for PDT

Answer 46

84%

35 months

40 months

Question 47

Wainberg et al. 2018. Venteal cervical versus bilateral lateral approach for extirpation of mandibular and medial retropharyngeal lymph nodes in dogs

Sugical time for removal of all 4 LNs did not differ between the 2 approaches

Bilateral lateral approach was preferred by 62.5% of participants for visualization of mandibular LNs and ventral cervical approach was preferred by 87.5% for visualization of anatomy

Overall, 62.5% preferred the ventral apprach and 37.5% prefreed the bilateral lateral approach

Question 48

Winer et al. 2017. The application of 3-D printing for preoperative planning in oral and maxillofacial surgery in dogs and cats