STS

Question 0

Dogs with microscopic STS treated w RT + Sx:

1. local recurrence rate
2. metastatic rate
3. median time to local recurrence is > ___ mos
4. dogs w MI > ___ are more likely to reoccur
5. does adding chemo improve local control or survival?

Answer 0

1. 15-20%
2. 8-15%
3. 24
4. 9
5. no

Question 1

Dogs treated with PRT for STS with gross disease live longer if they have which:
CR, PR, stable disease?
MST?

Answer 1

stable disease

10-11 mos

Question 2

In general regarding STS in dogs:

1. ____ _____ is predictive of metastasis
2. ____ __ _____ is predictive of local recurrence

Answer 2

1. histologic grade

2. completeness of excision

Question 3

In dogs with STS, histologic evidence of residual tumor is identified in only ____% of incompletely excised tumors.

Answer 3

22

Question 4

What are recurrence rates of incompletely excised STS in dogs for:
Gr I
Gr II
Gr III

Answer 4

7%
34%
75%

Question 5

When incompletely excised STS in dogs were treated w piroxicam + low-dose Cytoxan, what was the mDFI?

Answer 5

13 mos (v 7 mo w no further tx)

Question 6

In dogs with STS the median duration for local control was ___ mos for RT alone and ____ mos for RT + hyperthermia.

What was the difference in MST?

Answer 6

11….25

Hyperthermia does NOT increase MST

Question 7

The role of chemo is not known in canine STS - there is no documented increase in survival.
What are the metastatic rates for:
Gr I/II?
Gr III?
What is the median time to mets?

Answer 7

15%
41-44%
12 mos

Question 8

Name 3 negative prognostic factors for LOCAL CONTROL in STS in dogs.

Answer 8

1. large tumor size
2. incomplete surgical margins
3. high histologic grade (metastasis)

Question 9

Regarding canine STS:

1. Dogs are ___ x more likely to die of tumor related causes if > ___% tumor necrosis.
2. Dogs are ___ x more likely to die of tumor related causes if > ___ MI

Answer 9

2. 8 (3)….10

2. 6 (3)….20

Question 10

Regarding canine STS:

As _____ _____ increases, dogs were 77x more likely to die of their disease and the MST decreases.

Answer 10

AgNOR score

Question 11

Cats treated for STS with PRT ± Sx had a PFI of ____ mos and MST of ___ mos

Answer 11

10….24

Question 12

Was survival of cats with STS having gross disease treated with PRT affected by adjuvant chemotherapy?

Answer 12

Yes.
Sx+PRT+chemo = 29 mos
Sx + PRT = 5 mos

Question 13

Regarding cats treated pre-operatively with DRT for STS:

1. MST ___mos; mDFI ___-___ mos
2. ___-___% developed mets
3. Effect of incomplete resection?

Answer 13

1. 20; 13-20
2. 22 to 24
3. mDFI was sig shorter - 4 v 23 mos

Question 14

Cats treated with post-op DRT for STS:

1. MST?
2. mDFI?
3. ___-___% developed mets

Answer 14

1. 23-43 mos
2. 8-37 mos
3. 0 to 12%

Question 15

In cats with STS treated with post-op DRT:

1. Effect of local recurrence on mDFI?
2. cats w ____ ____ had 31% recurrence rate vs. cats w ____ ____ had a 55% recurrence rate.

Answer 15

1. 10 mos w recurrence, 20 mos w/o recurrence

2. one surgery….>1 surgery

Question 16

In cats with STS treated with post-op DRT, regarding the effect of marginal vs. wide resection studies have found that:

1. regarding local recurrence….
2. regarding MST….

Answer 16

1. no difference in 2 studies

2. conservative sx had longer MST (17 vs 16 mos), but RT was started w/in 2 days of sx (confounder)

Question 17

Cats with STS treated with pre-op vs post-op DRT, what was the difference in MST?

Answer 17

Pre-op sig shorter at 10 mos (vs 23 mos for post op)

Question 18

Cats treated for STS w post-op DRT, what was the effect of PCV on MST?

Answer 18

PCV < 25% 10 mos

PCV >25% 25 mos

Question 19

Does the difference in time between surgery and post-op DRT make a difference in PFI/MST for cats w STS?

Answer 19

Yes. Increased time between modalities causes lower PFI/MST.

Question 20

Expression of what marker decreases the time to recurrence of STS in cats treated w post-op DRT?

Answer 20

cytoplasmic p53 (mutated)

Question 21

VAS exhibit positive staining for what markers?

Answer 21

PDGF, EGF, TGF-ß, and c-jun

also PDF6R, EGFR

Question 22

Cats with suspected VAS should be treated under what 3 circumstances?

Answer 22

1. Mass growing > 1 mo post vax
2. Mass larger than 2 cm in diameter
3. Mass still present 3 mos post vax

Question 23

In general regarding VAS, mDFI & MST are decreased by what 3 things?

Answer 23

marginal resection
increased # of surgeries
surgery by rDVMs

Question 24

In one study of VAS, mDFI following marginal resection was ___mos vs ___-___mos following wide/radical sx.

Answer 24

2……10 to 14

Question 25

The mDFI for cats w VAS treated w surgery by rDVMs was ____mos vs ____ mos at referral institutions.

Answer 25

2…..9

Question 26

In one study of VAS, surgical margins of ___cm w ____ fascial plane(s) deep was achieved resulting in ____ mos MST and ____% recurrence rate.

Answer 26

5. ….2

30. ….14

Question 27

List 4 advantages of pre-op RT and one disadvantage.

Answer 27

Advantages:
1. fewer hypoxic cells
2. smaller RT field
3. shrinking tumor fascilitates surgical resection
4. less change of disseminating tumor during sx
Disadvantage: increased post-op infections

Question 28

Give 2 advantages and 3 disadvantages of pos-op RT.

Answer 28

Advantages: doesn’t delay sx, may provide better tumor control d.t. microscopic disease setting
Disadvantages: incr % of hypoxic cells, larger RT field, risk of repopulation bn sx & RT

Question 29

What is the effect of chemotherapy on MST of cats treated w Sx + post-op DRT w VAS?

Answer 29

Minimal effects

Question 30

In cats w VAS, tumors w incomplete martins are __x more likely to recur

Answer 30

10

Question 31

In cats w VAS treated w surgery alone, 3 prognostic factors were:

Answer 31

histologic grade
local tumor recurrence
distant metastasis