Principles of Surgical Oncology Flashcards
What characteristic links all cancers?
Uncontrolled cell growth and proliferation
True or False:
Cancer is considered a genetic disease.
TRUE
What are other factors that could cause cancer?
Chemical: environment, tobacco, pesticides
Physical: sunlight, trauma, chronic inflammation, implants, magnets
Hormonal: estrogen/progesterone, testosterone
Viral: papillomavirus, retrovirus, FELV/FIV
What do you call the length of time from date of diagnosis or start of treatment that 1/2 of the patients with the disease are still alive?
Median survival time
What do you call the period from diagnosis until the 1st recurrance?
Disease free interval
What do you call obtaining tumor tissue for microscopic analysis?
Biopsy
What do you call the process of determining the extent of a tumor and the presence of regional and distant metastasis?
Staging
What 3 tests does staging ALWAYS include?
CBC/Chem/UA
Thoracic radiographs
Regional lymph node aspirates/biopsies
In the World Health Organization TNM Classification system, what do T, N, and M stand for?
T = tumor
N = node
M = metastasis
True or False:
Metastasis can be present despite a lack of lymph node enlargement.
TRUE
In evaluating the lymph nodes, what needs to be done at minimum?
Fine needle spirate
What is the ultimate diagnostic tool in oncology?
Histopathology
What 2 pieces of information can histopathology tell you?
Tumor type
Tumor grade
What is the guideline for formalin fixation?
1 part tissue to 10 parts formalin
Always change ____ and instruments when performing biopsy on multiple tumors.
Gloves
For which types of lesions can a punch biopsy be used?
Superficial lesions - skin, oral, perianal tumors, liver
Which biopsy technique is best for ulcerated and necrotic lesions?
Wedge biopsy
When can you use an excisional biopsy?
Small cutaneous mass reexcision with 2-3 cm margin in all directions
Cytology clearly indicates a benign lesion
Tumor type does not change treatment plan
Risk of biopsy equal or higher to surgical risk
Surgical emergencies
True or False:
Fine needle aspirate of lytic bone does not require anestesia.
TRUE
Trephine
Jamshidi
When should a regional lymph node be excised?
When known to contain tumor cells
When grossly abnormal
When in surgical margins
What are the 4 types of resection?
Intracapsular
Marginal
Wide
Radical
With which resection is macrscopic disease left behind?
Which which resection is microscopic disease potentially left behind?
Intracapsular resection
Marginal resection
Which type of resection is typically the most appropriate form of treatment?
Wide resection
What are the margins of a wide resection?
2-5 cm
What are the margins of a radical resection?
Margins extend beyond anatomical compartment
(Limb amputation, chain mastectomy)
What type of tumors might intracapsular excision be used for?
Thyroid
Parathryoid
Which excision is “just out the pseudocapsule”?
Marginal excision
What is an example of a tumor where marginal excision can be used?
Lipoma
What 4 things does a wide excision remove?
- En bloc removal of the mass
- Pseudocapsule
- Reactive zone
- Normal margin or tissue
What is a broad example of tumor where wide excision might be used?
Low grade, minimally invasive malignant tumor
What are your skin margins for a sarcoma?
3-5 cm on skin
1-2 fascial planes deep
What are your skin margins for a mast cell tumor?
1-3 cm on skin
1 fascial plane deep - ALWAYS
What is you minimal margin for an oral tumor?
1 cm minimum
Which tumor type might require a radical excision?
Highly invasive, poorly localized malignant tumor
True or False:
It is necessary to change ALL instruments and glove for wound closure.
True or False:
Primary closure is not always preferred in tumor removal.
FALSE
Close with primary repair whenever possible!
In closure of the wound after tumor removal, what are the 3 things that should be avoided?
Tension
Dead space
Drains
Samples should be allowed to dry. About how long should you wait before placing that sample in formalin?
About 20 minutes
Histopathology is NOT an ____.
Histopathology not only allows for a definitive diagnosis, it will also assist in the evaluation of what?
Margins
Adjuvant therapy is generally good in helping fight microscopic disease but is less effective for _____ disease.
Macroscopic
Where should vaccines be given in cats?
Where should vaccines NOT be given in cats?
Give as distal on limbs as possible
AVOID INERSCAPULAR AREA!!!
