Skeletal System Flashcards
1
Q
What’s the most common primary bone tumour of the dog? What’s the %?
A
OSA, 85%
2
Q
What’s the likelihood of OSA in small dogs (<15kg)? What’s the most common location?
A
5% of OSA can be found in small dogs, but 59% would be in the axial skeleton
3
Q
Where is OSA most commonly found in the dog?
A
75% in the appendicular skeleton.
- thoracic limbs 2x as likely as pelvic limbs
- Proximal humerus & distal radius = 2 most common locations
- in the pelvic limbs, more even distributed with proximal femur slightly less common
4
Q
What’s the distribution of OSA in the axial skeleton in the dog?
A
- 27% mandible, 22% maxilla
- 15% spine, 14% cranium
- 10% ribs, 9% nasal/ paranasal, 6% pelvis
5
Q
How often is multicentric OSA noted in the dog?
A
10%
6
Q
Is OSA due to multiple micro-trauma of physeal region?
A
A cadaver study didn’t find a difference in incidence of microdamage in radius of small vs large breed dogs
7
Q
What’s a common genetic mutation found in canine OSA?
A
loss of p53 function via missense mutation in exons 4-8 (found in 24-47% of spontaneous arising OSA samples)
8
Q
What are two other suspected genetic factors in OSA in dogs?
A
pRB-E2F dysregulation and PTEN mutations
9
Q
Which breed has shown strong inheritable factor for OSA?
A
Scottish deerhound
10
Q
What are some pathways that have been implicated in canine OSA?
A
- MET/HGF (esp. in Rotties)
- IGF-1/IGF-1R; subsequent MAPK and Akt activation
- possible HER2 overexpression
- mTOR
- Hedgehog & Notch
11
Q
What’s the MST for amputation only for canine OSA?
A
19 weeks
12
Q
What’s the MST for small dogs (<15kg) with appendicular OSA treated with amputation only vs amputation plus adjuvant chemotherapy?
A
Sx only MST = 257 days
Sx + Chemo MST = 415 days
BUT - they are not statistically different!
13
Q
What’s the diagnostic yield of trephine and Jamshidi biopsy for canine OSA?
A
Trephine: 93.8% accuracy
Jamshidi: 91.9% for tumour detection (vs. other disorders) and 82.3% accuracy for specific tumour subtype
14
Q
What’s the likelihood of pulmonary metastases on presentation for canine OSA?
A
<10%
15
Q
What’s the best imaging modality to detect concurrent bone metastasis in canine OSA?
A
1 study compared scintigraphy, CT , and x-rays and found scintigraphy to be the best. BUT, the lesions were not confirmed histologically
16
Q
What’s the surgical staging system for sarcoma in people?
A
Stage I: low grade (G1), no mets
Stage II: high grade (G2), no mets
Stage III: regional or distant mets, any grade
Substage A (T1): intracompartmental
substage B (T2): extracompartmental
most dogs with OSA = stage IIB
17
Q
Which anatomical location for canine OSA carries poor DFI and ST?
A
proximal humerus
18
Q
How does histological grade of canine OSA affect the prognosis?
A
the prognostic value = controversial
19
Q
How does canine OSA of the head fare compared to other sites?
A
- locally aggressive but maybe with a lower metastatic rate
- one study found local recurrence rate of 51.3% with a metastatic rate of 38.5%
20
Q
Which anatomical location has a better prognosis in the dog - maxillary or mandibular OSA?
A
- Mandibular OSA: 1 year survival rate = 71%; still had a 58% metastatic rate and ST improved with adjuvant chemo
- Maxillary OSA: MST = 5m
21
Q
What’s the prognosis of canine rib OSA?
A
- Chest wall excision alone - MST = 3m
Sx + chemo MST = 8m
22
Q
What’s the prognosis of scapular OSA in dogs?
A
guarded, with scapulectomy:
- DFI = 210 days
- MST = 246 days
Use of adjuvant chemo improves both DFI and ST
23
Q
What’s the prognosis of canine OSA distal to the antebrachium or tarsocrural joints?
A
MST = 466 days
but still aggressive with high metastatic potential
24
Q
What’s the prognosis of vertebral OSA in dogs?
A
MST = 4m with Sx + RT + chemo
25
What's the prognosis of pelvic OSA in dogs?
With hemipelvectomy:
- local recurrence rate = 21%
- metastatic rate = 46%
- mean ST = 533 days
26
What's the outcome of canine extraskeleetal OSA?
aggressive with high metastatic rate
- Sx only MST = 1m
- Sx + chemo MST = 5m
27
What's the outcome of dogs with stage III OSA?
- can be ok with appropriate treatment
- Stage III on presentation MST = 76 days
- bone mets: 132 days > lung mets (60 days) > lung + other soft tissue mets (19 days)
- LN metastasis: 318 days
28
How do dogs with stage III OSA do with metastaectomy?
MST = 232 days vs 49 days (for those that did not have metastasectomy)
29
What are the theories behind how ALP influences prognosis in canine OSA?
- ALP level is associated with disease burden (both the size of the primary tumour as well as macrometastasis)
- ALP is a byproduct of osteoblastic properties of endothelin-1 signaling (pro-tumorigenic advantage)
30
What's the cutoff value for bone ALP or total ALP for canine OSA?
Bone ALP @ 23 U/L
or total ALP @ 110 U/L
31
What's the significance of ezrin in canine OSA?
Ezrin mediates early metastatic survival
- it's a negative prognostic factor: DFI 116 days vs 188 days
32
What's the significance of MET and RON in canine OSA?
MET and RON are tyrosine kinase receptors that are capable of forming heterodimers --> protumorigenic effects
- high RON expression = significant decrease ST compared to absent, low or intermediate expression
- MET was not found to be prognostic
33
What's the role of survivin and its significance in canine OSA?
Survivin is an anti-apoptotic protein that participates in the processes of cell division as well as apoptosis inhibition
- survivin inhibits both caspase-dependent and -independent mediated apoptosis, and its expression can promote tumorigenesis
- survivin levels affects DFI: 331 days (low survivin) vs 173 days (high survivin)
34
What's the significance of VEGF and COX-2 expression in canine OSA?
- VEGF expression is associated with DFI, but not ST: 356 days vs 145 days
- COX 2 expression is associated with MST: 86 days (high) vs 423 days (negative) vs 399 days (poor staining) vs 370 days (moderate)
- COX-2 expression may play a role in tumour initiation and progression
35
What's the role of heat shock protein and its significance in canine OSA?
HSP is involved in cellular responses to stress and aid in appropriate protein folding and protection cells after endoplasmic reticulum stressors --> avoids apoptosis
- HSP60 found to be associated with reduced DFI and STs
36
How does Treg influence OSA outcome in dogs?
- Treg #'s on its own did not have differences in DFI or ST
- but CD8:Treg ratio does:
low CD8/Tregs = significantly shorter ST compared to high CD8/Tregs
37
What parameters on the CBC is prognostic for canine OSA?
Shorter DFI with:
- relative lymphocytosis (> 1000 cells/ uL) and
- relative monocytosis (>400 cells/ uL)
- due to presence of myeloid-derived suppressor cells?
- the monocytes also have down regulation of surface receptors (ex. CCR2, CXCR2 chemokines receptors) and other functional impairments
38
What's the role of tumour-infiltrating macrophages in canine OSA?
Dogs with more than 4.7% surface area infiltrate with CD204+ macrophages experienced a significantly longer DFI.
39
What are some criteria for limb sparing surgery for canine OSA?
- <50% involvement of the bone
- no fracture
- less than 360 degree soft tissue involvement
- firm/definable soft tissue mass rather than edematous lesion
- no mets
40
What's the infection rate for limb sparing surgery for canine OSA?
40-50%
41
What's the complication rate of endoprosthesis for canine OSA?
- overall complication rate = 96%
- 78% implant infection
- 36% implant complication
- 24% recurrence
42
What are the pros and cons of distraction osteogenesis for canine OSA?
Pros:
- can weight bear in 48h after Sx
- no exercise restriction after the skin incision heals
- much less risk of infection compared to other limb spare techniques
Cons:
- extensive client involvement
- extended amount of time that the fixator remains in place
43
What are the pros and cons of ulna transposition for canine OSA?
Pros:
- no distant donor site morbidity
- the bone is autologous & vascularized --> improves healing and reduces risk of infection
Cons:
- poor biomechanical in post-op period --> ulna is much smaller than the radius
- permanent internal hardware
44
Describe intracorporeal and extracorporeal intrapoerative RT?
for intracorporeal:
- the bone if reflected out (after making one cut, and pivots from the joint that is still attached) for RT
for extracoproeal:
- 2 cuts are made in the bone and the diseased bone is removed completely for RT
IORT:
- 70Gy is given to the diseased bone
- complication rate = 69% within 5-9 months
- most common complication = fracture
- local recurrence and infection also possible
45
What's the outcome of IORT with adjuvant chemo for canine appendicular sarcoma?
- MST = 298 days (~10m)
46
What's the outcome of SRT for canine OSA?
Single fraction SRS with adjuvant chemo:
- MST 9.8-12 months
- 63% developed pathologic fracture around 6m
- Acute skin toxicity = 58%
- Late skin toxicity = 16%
47
What can be an indicator of increased risk of fracture post SRT for canine OSA?
- subchondral bone involvement
- increasing CT grade (based on degree of lysis, length of identified full cortical lysis, subchondral bone lysis, and ratio of length of affected bone to normal bone.)
48
What's the fracture rate of canine OSA treated with 10 Gy x 2 daily fractions?
35.7%
49
Describe isolation of limb circulation and perfusion for canine OSA?
Technique for local delivery of treatments that would be too toxic for systemic administration, and/or to improve tumour penetration
50
What's the significance of tumour necrosis post treatment for canine OSA?
the more tumour necrosis induced by treatment, the better the outcome
51
Generally speaking, what's the 1-year local recurrence-free rate and survival rate for dogs treated with limb sparing surgery?
76% recurrence-free at 1 year
60% alive at 1 year
52
What's are the general 3 major complications of limb sparing surgery?
- infection
- implant complications
- local recurrence
53
What's the outcome of CFRT + chemotherapy for canine OSA?
- median local disease control: 202 days (~7m)
- MST = 209 days (~ 7m)
- median time to metastasis = 314 days (~10.5m)
54
What's the general MST in dogs with OSA using adjuvant doxorubicin cisplatin concurrent chemo? Which had unacceptable toxicity?
MST 300 days; median DFI = 240 days
- concurrent doxorubicin @ 25mg/m2 and cisplatin at 60mg/m2 = unacceptable toxicity
- much better if doxorubicin in given 1 day later @ 12.5mg/m2
- or do alternating cisplatin/ doxorubicin q3w at MTD
55
What's the general outcome of adjuvant cisplatin for canine OSA?
MST = 262-325 days (~7-8m)
56
What's the outcome of carboplatin + gemcitabine concurrent combo for canine OSA?
median DFI = 203 days, MST = 279 days
57
What's the general outcome (DFI and MST) of single agent carboplatin post surgery for canine OSA?
DFI: 123; 137; 196; 256; 257 (~ 4-8.5m)
MST: 207; 230; 277; 307; 383 (~ 8-12m)
58
In the one study comparing Carbo4, Carbo6, and Carbo/Dox for canine OSA, what's the final conclusion?
Selmic et al 2014 (470 dogs!)
- The overall median DFI = 291 days (~10m)
- MST = 284 days (9.5m)
- no significant difference in any of the protocols in the risk of met development or death
- Carbo6 had the lowest AE
59
What's the outcome of single agent doxorubicin for canine OSA?
- 2-3 doses pre-op and continued every 2 weeks for total of 5 doses post-op
- 1 year survival rate = 50%, 2 year = 9.7%
60
What's the outcome of carbo/doxo concurrent chemo for canine OSA?
Carbo @ 175mg/m2 and doxo @ 15mg/m2 1 day later, every 3w x 4 treatments
- well tolerated
- median DFI = 195 days (6.5m)
- MST = 235 (~8m)
- so not better than single agents
61
What's the outcome of MTD carboplatin alternating with MTD doxorubicin for canine OSA?
- generally well tolerated
- median DFI = 202- 227 days (6.7m - 7.5m)
- MST = 320 days (~ 8.6 -10.6m)
- 18% grade III or IV hematological AE
- 12% grade III or IV GI AE
62
What's the outcome with doxorubicin MTD followed by carboplatin MTD for canine OSA?
Similar to other combination protocols
- median DFI = 232 (~8m)
- MST = 247-317 (8-11m)
63
In a head-to-head comparison of MTD carbo vs MTD carbo alternating with MTD doxo, what was the conclusion?
- Carboplatin single agent DFI = 425 days (14m)
- which is significantly longer than alternating with doxorubicin, DFI = 135 days (4.5m)
- the MST = 479 days (16m) vs 287 days (9m) not statistically significant
64
What's the outcome of carboplatin MTD with cyclophosphamide metronomic dosing for canine OSA?
- 1 study didn't find a significant difference
- another study found a different PFS (244 vs 480 days) and MST (458 vs 480 days), but 58% of the dogs developed SHC, and the difference was also not significant
65
What's the utility of immunotherapy for canine OSA?
stimulation of the innate immune system has beneficial outcome for canine OSA
66
What's the role of growth hormone and insulin-like growth factor in canine OSA?
- aberrant GH and IGF-1 overexpression has been hypothesized as a tumorigenesis for canine OSA
- but using a somatostatin + carbo did not improve DFI or MST compared to placebo + carbo post amputation
67
What's the role of metalloproteases in canine OSA?
- MMP-2 and MMP-9 is associated with invasion and metastasis
- inhibitors of MMP did not improved DFI or MST compared to placebo in a post-op setting
68
What's the outcome of using Palladia as maintenance after MTD carboplatin?
no difference in DFI or MST
69
What's the criteria of pulmonary metastasectomy for canine OSA?
1. primary tumour in remission > 300 days
2. limited to 1 to 2 nodules on CXR
3. metastasis confined to the lungs (bone scan negative)
4. long doubling time (> 30 days)
70
What's the outcome of pulmonary metastasectomy for canine OSA?
additional MST of 176 days! (~6m) for an overall MST of 487 days (16 months)
71
What's the effectiveness of toceranib for macroscopic pulmonary metastasis in dogs with OSA?
- overall response rate = low --> 10-17.6% RR
- median PFS: 36-57 days (~1-2m), MST 89-90 days (~3m)
72
Which aerosolized drug delivery has shown some benefits for pulmonary mets for canine OSA?
- Paclitaxel, 1 dog had CR for more than 325 days
- Doxorubicin also showed PR, but lung toxicities noted on necropsy
- no DLT hematologic or biochemical activities
- Gemcitabine didn't work (in theory would induced Fas receptor in tumour cells)
73
What are some immunomodulating treatments tried for canine OSA with pulmonary metastasis?
- nebulizing IL-2 or IV liposome DNA complexes coding IL-2
- had 1 CR and 2 PR (IV liposome DNA_)
- attenuated Salmonella typhimurium vaccine --> 1 PR for 68 days --> significantly longer time to met (308 vs 240 days [10 vs 8 m) and MST (621d vs 278d [20m vs 9m)
74
What's the response rate and duration of response (analgesia) for palliative RT for canine OSA?
RR = 74 - 93%
Duration of response = 53 - 130 days (2-4m)
- no limiting acute or late toxicity
- adding carboplatin may improve analgesic response and ST
75
What's the utility of 153Sm-EDTMP or 177LU-DETMP
Radioisotope tagged with a bisphosphonate for osteotropism.
- improved analgesia noted
- some also had improved c/s and reduced tumour size
76
What's the MOA of bisphosphonates?
- it preferentially deposit in area of active bone mineral remodeling
- it's taken up by osteoclasts --> inhibits post-translational prenylation of small GTP-binding proteins (Ras, Rho, and Rac) --> failure of normal intracellular signaling and extracellular interactions with the matrix --> apoptosis
77
Which bisphosphonates have been used in canine OSA and what's the benefit?
- originally most studies were done with pamidronate
- as single agent, helps with pain
- 28% of dogs for > 4m
- also effective when used with PRT
- in PRT with doxorubicin, didn't perceive additional analgesia, but helped with bone biologic effects within the bone tumour microenvironment
- zoledronate also shown beneficial effect (100x more potent than pamidronate)
- pain alleviation in 50% of dogs for >4m
78
What's the difference between parosteal and periosteal OSA in dogs?
- they both arise from the periosteum of the bone, but parosteal is much less aggressive than periosteal
- parosteal tend to be well circumscribed with minimal cortical involvement (grows outward, board pedicle) and histologically looks less aggressive than the typical intraosseous OSA
- periosteal OSA is still just as aggressive as intraosseous OSA and often has cortical lysis with extension into the one and surrounding soft tissue
79
What's the 2nd most common primary bone tumour in the dogs?
chondrosarcoma (5-10% of all bone tumours)
80
What's the most common breed for chondrosaroma?
Golden Retrievers
81
Where is chondrosarcoma most commonly found in the dogs?
nasal cavity
82
What's the biological behaviour of canine chondrosarcoma?
- typically less aggressive/ metastatic than OSA, but a variant of de-differentiated chondrosarcoma has been reported
- prognosis can depend on location and grade
83
What's the MST for nasal chondrosarcoma in dogs?
210-580 days (7-19m), treated with RT and/or Sx
84
What's the MST for rib chondrosarcoma in dogs?
>1800 to > 3820 days (5-10y)
85
What's the MST for appendicular chondrosarcoma in dogs?
with surgery alone, MST = 979 days (2.6y)
- grade is an important prognostic factor for metastasis
- grade 1 = 0% @ 6y
- grade 2 = 31% @ 2.7y
- grade 3 = 50% @ 0.9 y
86
How common is primary bone hemangiosarcoma and what's the biological behaviour?
- rare, <5% of all primary bone tumours
- aggressive, metastasis within 6m
- need thorough staging
- predilection for distal tibia
- MST = 299 days (10m) with amputation and chemotherapy
- ddx: telangiectatic OSA
87
How common is primary bone fibrosarcoma and what's the biological behaviour?
- rare, <5% of all bone tumours
- ddx: fibroblastic OSA
- can do well with amputation alone, but metastatic rate is still considerable
- postulated to met to heart, pericardium, skin and bones rather than lungs
- no good evidence of adjuvant chemo in preventing metastasis
88
What is MLO?
MLO = multilobular osteochondrosacoma, aka. multilobular tumour of the bone
- predilection for the skull
- long term survival possible, esp with low grade and complete resection
- metastatic rate 56%, but median time to metastasis = 542 days (1.57)
- local recurrence rate = 47%, median DFI = 797 days (2y)
- MST = 800
- even with pulmonary metastasis, can still remain asymptomatic for lung disease for 1+ y
89
What's multiple cartilaginous exostosis (MCE)?
MCE = most commonly incidentally found in growing dogs
- typically palpable with no or minimal pain
- lesion from on bone that form from endochondral ossification
- lesion stops growing when animal reaches skeletal maturity (so benign neglect is ok if it's not causing the patient any concerns)
- otherwise conservative surgery can remove the lesion
- malignant transformation later on as has reported
- genetic component -- affected dogs should be neutered
90
What's the biological behaviour of bone cysts?
- benign
- typically found in young animal with mild to moderate lameness
- may be due to trauma to the growth plate interfering with proper endothelial ossification
- tx = curettage and packing with autogenous bone graft
91
What's the biological behaviour of aneurysmal bone cysts?
- a proposed mechanism is trauma or benign bone tumour causing vascular disruption --> rapidly enlarging lesion with anomalous blood flow --> damages bone mesenchyme --> will eventually be stabilized and the reactive bone becomes more consolidated and matures
- tx = en bloc resection and reconstruction or curettage and packing with autogenous bone graft
92
Which IHC can be used to differentiate histiocytic sarcoma vs synovial cell sarcoma vs myxosarcoma?
- Histiocytic sarcoma: vimentin (+), cytokeratin (-), CD18 (+)
- Synovial cell sarcoma: vimentin (+), cytokeratin (+), CD 18 (-)
- Myxosarcoma: vimentin (+), cytokeratin (-), HSP (+), variable CD 18
93
What's the MST of periarticular histiocytic sarcoma in dogs?
Adjuvant CCNU post amputation greatly improves ST:
568 days vs 161 days (1.5y vs 5m)
94
What's the MST of periarticular synovial cell sarcoma in dogs?
With amputation alone MST = 455-967 days (1.2 - 2.6y)
- depends on grade
- grade I = 365-1460 days (1-4y)
- grade II = 156 -1095 days (5m - 3y)
- grade III = 183 days (~6m)
95
What's the MST of periarticular myxosarcoma in dogs?
- tx = amputation or local resection (synovectomy)
- prolonged ST still possible with incomplete excision (>2y)
96
What's the most common primary bone tumour in the cat?
OSA, accounts for 70-80% of all bone tumorus
- but bone tumours in general is rare in cats
97
What's the biological behaviour of OSA in cats?
- more common in appendicular vs axial skeleton (one study reported 2:1, but some 1:1)
- predilection of pelvic limbs (distal femur and proximal tibia)
- if in axial skeleton, skull (esp oral cavity) and pelvis = most common
- locally aggressive but metastatic rate is low (5-10%)
- rare to see metastasis on presentation
98
What's the biologic behabviour of osteochondroma in cats?
- can continue to develop after skeletal maturity (unlike the dog) in sites not associated with endochondral ossification (ex. skull)
- also has the potential for malignant transformation
99
What's the biological behaviour of MCE in cats?
- unlike the dogs, MCE in cats can develop after skeletal maturity
- may have a viral origin
- seldom affect long bones, rarely symmetric
100
What are some molecular differences between feline and canine OSA?
- MMP-2 and MMP-9 have greater expression in canine vs feline OSA
- KIT IHC positive in 79% of canine OSA but none in feline OSA
- cats more commonly express phosphorylated form of ezrin, dogs more commonly express in a membranous location (more biologically active)
101
What's the most common site of MCE in cats?
- scapula, vertebrae, and mandible
- rapidly progressing, conspicuous, hard swelling
- pain, loss of function
102
What's the outcome of feline appendicular OSA?
- MST = 22-44m with amputation alone
- 1- and 2-y survival rate = 66% and 55%
- adjuvant chemo is not recommended
- complete surgical excision is prognostic for DFI, PFS, and ST
- Young age negatively impacted local tumour progression
103
What's the outcome of feline axial OSA?
MST = 6.7m, worse than extraskeletal OSA
- mostly a reflection of inability to obtain complete margin rather than a more aggressive biological behaviour
104
What's the prognosis of MCE in cats?
guarded
- recurrence or new lesion development = common
- no effective treatment protocol
105
What's the significance of grade or histological subtypes of OSA in cats?
- grade is prognostic
- subtype is not
106
What are the top 3 bone tumours in the cat?
bone tumours are rare in cats
1. OSA
2. fibrosarcoma
3. chondrosarcoma
4. hemangiosarcoma
Tx = aggressive resection, met rate is likely low, but mets also reported with CSA and HSA
107
What's the likelihood of cutaneous/ SQ metastasis for canine OSA?
- in this cohort, 19/20 with cutaneous/ SQ mets were found incidentally
- there were also 17/20 lung mets and 1/20 bone mets
- median time to cutaneous mets = 160 days
- ST after cutaneous mets = 54 days --> Sx + chemo = 94 days vs no tx = 11 days
108
How can IHC differentiate between hemangiosarcoma and telangiectatic OSA?
HSA: ALP (-), factor VIII (+)
Telangiectatic OSA: ALP (+), factor VIII (-)
109
What's the prognostic implication of different subtypes of canine OSA?
fibroblastic = 546 days (18m)
- osteoblastic = 257 days (8.5m)
- chondroblastic = 170 days (5.6m)
110
What's the outcome of SRT (9Gy x 3) for canine OSA?
- fracture rate = 41%
- max. lameness improvement median 3 weeks post
- median time to first event = 143 days
- MST = 233 days (with chemo)
111
What's the "optimal" time to initiate chemotherapy post OSA amputation in dogs?
within 5 days
Median OST = 445 days vs 239 days (14m vs 8m)
- didn't seen increased in incidence of grade III or IV AE
112
What's the rationale behind high dose losartan and toceranib for canine stage III OSA and what's the response outcome?
- inhibition of the CCL2-CCR2 axis reduced monocyte migration
- ORR = 25% of the dogs
- SD more than 8 weeks in another 25%
113
What's the reported outcome of OSA dogs receiving amputation, carboplatin chemotherapy (4–6 doses), and EGFR vaccine?
1y survival rate = 65%
114
What's the outcome of cranimaxillofacial OSA in dogs treated with SBRT?
- median time to first event (TFE) of 171 days,
- MST of 232 days. (~8m)
- Cause of death was local progression for 22/35 (63%) patients, metastasis for 9/35 (26%) patients and unknown for four
- administration of chemotherapy along with five fractions of SBRT was associated with increased survival time
115
What's the pre- and post- treatment (SBRT + chemo) PET-CT difference for canine OSA?
- significant reduction in avidity
- metabolic tumor volume and total lesion glycolysis both showed a significant reduction of -99.8%.
- post-tx PET SUV max was predictive of metastasis
116
What's the significance of circulating tumour cells in canine OSA?
12/15 dogs had a pre-metastatic CTC spike, and these patients had a median survival time of 301 days, significantly shorter than the 626 days for those without a spike.
117
What's the fracture rate and most common site of fracture for canine OSA treated with 12Gy x 3 daily fractions?
50/127 ~ 40%
- most common site = distal tibia
118
How common is a secondary cancer found on necropsy for canine OSA treated with standardized therapy?
12% (HSA was the most common 2nd tumour)
- most common met = lungs, followed by bone, kidney, liver and heart
119
What was the outcome of 18F-FDG for staging for canine OSA?
Of the 71 dogs assessed,
- 23.9% were identified with a high suspicion or confirmation of a metastatic neoplasm,
- 16.3% had comorbid malignant neoplasms
- 8/71 (11.3%) having both metastatic and comorbid lesions.
120
What's the outcome of autologous cancer cell vaccination, adoptive T-cell transfer, and interleukin-2 administration for canine OSA?
- DFI = 231 days
MST = 415 days (13m)
121
What's the outcome of dogs with OSA undergoing a secondary amputation?
Dogs originally had limb-spare surgery that required an implant to reconstruct the osseous defect.
- 31/192 had a secondary amputation (14%)
- median disease specific survival = 604 days (20m)
- lived for a median of 205 days (7m) after secondary amputation
122
What's the outcome of canine MLO treated with 10Gy x 3 SRT?
- median PFI = 223 days (~7m)
- MST = 329 days (~11m)
123
What's the difference in outcome between SRT vs palliative RT with adjuvant chemo for canine OSA?
SRT MST = 350d (~1y)
PRT MST = 147d (5m)
124
What's the metastatic rate of feline appendicular or scapular OSA?
- 46.3%; 41.9% developed metastasis after amputation
- median time to metastasis = 235 days (~8m)
- MST = 527 days (1.4y)
- Humerus location was significantly associated with a higher rate of distant metastasis.
125
What's the outcome of amputation followed by single SQ carboplatin for canine OSA?
MST = 196 days (6.5m)
median met free interval = 197 days
3/45 (7%) hospitalized for GI AE
