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Oncology Boards > Urogenital > Flashcards

Urogenital Flashcards

1
Q

Human glutathione S-transferase variants associated with increased risk for TCC? What about dogs? (JVIM 2019, Luethcke)

A

Human: GST theta, mu and pi, particularly null variant in GSTT1 Dogs - no correlation in 3 GST theta variants in Scotties or other dogs with TCC compared to controls (Scotties actually low)

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2
Q

Environmental risk for dogs with TCC (Luethcke, JVIM 2019

A

Household insecticide use, living farther away from farms

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3
Q

Rate of clinical improvement for dogs undergoing balloon dilation for obstruction for TCC? Average duration of improvement? (Kim JAVMA 2019)

A

9/12 dogs (75%), duration median 84 days 3 dogs with recurrent obstruction had 2nd procedure which lasted 41-70d

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4
Q

Dogs that had recurrent obstruction after urethral balloon dilation for TCC had what in common? (Kim JAVMA 2019)

A

All males, 2/3 = prostate the problem

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5
Q

What are the main ultrasound differences between feline and canine TCC on ultrasound (Hamlin VRU 2019)

A

Feline more likely to be mid-body or apex vs. canine usually trigonal

Feline less likely to have urethral extension

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6
Q

Describe the most common appearance for feline TCC on ultrasound (Hamlin VRU 2019)

A

singular, broad-based mass within the mid-body or apex of the urinary bladder w/o urethral extension

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7
Q

What % of invasive urothelial carcinoma is high grade?

A

70% (29% int, 1% low)

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8
Q

FOr dogs with iUC, what is the % met rate at dx?

A

nodal 16%, distant 14%

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9
Q

What are known risk factors for bladder cancer?

A

exposure to older generation flea control products

lawn chemicals

obesity

female gender

breed

+/- CTX exposure

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10
Q

The BRAF mutation has been found in more than ____% of canine iUC

A

80

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11
Q

What IHC can be used to determine urothelial origin (i.e. for bladder tumors)

A

uroplakin III and possibly GATA-3

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12
Q

Other than Scotties, what other breeds are at an increased risk of iUC?

A

eskimo dogs, shelties, westies, keeshonds, samoyed, beagle, dalmatian (in order of descending OR)

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13
Q

When is surgery indicated for iUC?

A
  1. obtain tissue for a definitive diagnosis
  2. eradicate lesion amenable to wide excision (tumors away from trigone)
  3. relieve urinary tract obstruction
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14
Q

What was the overall PFI and MST for dogs treated with partial cystectomy + COX inhibitors? Which group did better?

A

37 dogs - all gross tumor removed in 92% of dogs

overall PFI 235d (7.8mo), MST 348d (11.6mo)

22 dogs treated with surgery + daily piroxicam MST = 722d (24mo)

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15
Q

What is the range in MST after urethral stenting for iUC or prostatic carcinoma?

A

MST 20-78d (range 2-536d)

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16
Q

What is the rate of incontinence reported after urethral stent placement?

A

25-39%

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17
Q

iUC are considered sensitive to RT - what generally is their alpha/beta ratio like

A

usually considered low - suggests higher doses and less fractionation would be better

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18
Q

What were the late complications of IMRT for iUC?

A

urethral stricture (9%), ureteral stricutre (5%), rectal stricture (5%)

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19
Q

Doses of _____ of chlorambucil in dogs (for treatement of a variety of tumor types) was associated with more GI and bone marrow tox but no improvement in antitumor effects.

A

4mg/m2/day

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20
Q

Overall, COX inhibitors induce a remission (mostly PRs) in ____% of dogs with iUC and SD in up to _____%

A

PR 15-20%

SD 55%

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21
Q

If you suspect a dog with iUC has worsening clinical signs secondary to a UTI, while waiting for culture, what should your abx drug choice be like?

A

Treated for E. coli or Staph spp (most common in non-tumor and tumor dogs)

clavamox or TMS

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22
Q

What factors are associated with a mroe advanced TNM stage for canine iUC at diagnosis?

A

yonger age (associated with increased risk of nodal mets)

prostate involvement (increased risk of distant mets)

higher T stage (increased risk of nodal and distant mets)

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23
Q

What are the most frequently diagnosed feline urinary bladder tumors?

A

iUC (TCC)

mesenchymal

lymphoma

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24
Q

What was the MST of 111 cats with iUC treated with meloxicam?

A

311 d (10.4mo)

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25
Q

What was the MST for dogs with prostatic carcinoma treated with NSAIDs + chemo vs. NSAIDs alone? (Ravicini VCO 2018)

A

NSAIDs + Chemo = 106d

chemo alone 51d

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26
Q

What was associated with a significantly shorter MST for dogs with prostatic carcinoma? (Ravicini VCO 2018)

A

Intact dogs

Mets

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27
Q

What % of canine prostatic carcinoma expressed cox-1 and cox-2? (Sorenmo VCO 2004)

A

Cox-1: 94.1%

cox-2: 88.2%

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28
Q

What was the PPV and NPV for mineralization of the prostate in neutered dogs for predicting prostatic carcinoma? (Bradbury VRU 2009)

A

PPV 100%

NPV 50%

(sensitivity 84%, specificity 100%)

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29
Q

What was the PPV and NPV for prostatic mineralization predicting prostatic carcinoma in in tact male dogs? (Bradbury VRU 2009)

A

PPV 22%, NPV 96%

other things that caused it: BPH, prostatitis, paraprostatic cysts

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30
Q

What are the patterns of prostatic carcinoma in dogs?

A
  1. papillary
  2. cribriform
  3. solid
  4. small acinar/ductal
  5. signet ring
  6. mucinous

also preneoplastic: high grade prostatic intraepithelial neoplasia (HGPIN) and prostatic inflammatory atrophy (PIA)

31
Q

Expression of _____ changed from membranous to cytoplasmic in dogs with prostatic carcioma and was sig higher in cancer/mets vs. BPH. (Della Salda VCO 2019)

A

Nectin 4 (e-cadherin based adherens junction protein)

also looked at p63 - cancer had decreased nuclear p63 (transcription factor

32
Q

Similar to humans, what pathways are likely drivers for prostatic carcinoma in dogs? (Kobayashi Res Vet Sci 2018)

A

B-catenin, E-cadherin in WNT pathway, Caveolin-1

33
Q

What were the features of nuclei from neoplastic prostates vs. normal or hyperplastic? Combining this with what else helped to more precisely grade canine prostatic ca(Donato Res Vet Sci 2017)

A

Larger with greater nuclear size and shape

combined with Gleason score

34
Q

What were the IHC features of prostatic intrapeithelial neoplasia (PIN) in dogs?

A

increased # of basal epithelial cells

elevated expression of PCNA

heterogenous expression of androgen receptor

35
Q

Similar to people, overexpression of ____ and donregulation of ____ may be important steps in carcinogenesis of canine prostatic carcinoma (Lin J Comp Path 2016)

A

overexpression of stat3 (82% in prostatic ca vs. 25% of BPH)

downreg of PTEN

36
Q

What is the rate of permanent post-op urinary incontinence in dogs treated with total prostatectomy for prostatic carcinoma? (Bennett Vet Surg 2018)

A

35% (8/23)

37
Q

What was prognostic for MST in dogs with prostatic carcinoma treated with total prostatectomy? What was the OST and 1/2yr survival? (Bennet Vet Surg 2018)

A

MST shorter for dogs with extracapsular tumor extension vs. intracapsular tumors

mOST = 231d (7.7mo), 1yr 32%, 2yr 12%

38
Q

What was the rate of prostate adca being an incidental finding in dogs that were treated with IMRT? How did this impact MST? (Walz VCO 2019)

A

incidental in 40%

MST longer if incidental - 581d (19.4mo) than if symptomatic 220d (7.3mo)

39
Q

What was the rate of local LN mets in dogs treated with IMRT for prostatic carcinoma? Was this prognostic? (Walz, VCO 2019)

A

28% LN mets at dx

388d w/o mets (12.9mo) vs. 109d (3.6mo) w.

40
Q

What was the rate of AEs for dogs with prostatic carcnoma treated with IMRT? What protocol was used? (Walz VCO 2019)

A

2.5-2.8gy/fx to total median 50Gy

Acute AEs in 50% - mostly grade 1-2 diarrhea

suspect late tox in 3/18 (17%) - urethral stricture, ureteral stricture, hindlimb edema

41
Q

What was the mTTP and MST for dogs with prostatic carcinoma treated with IMRT? (Walze VCO 2019)

A

220d (7.3mo), MST 563d (18.8mo)

42
Q

What IHC markers were expressed in most feline renal cell carcinomas? (Matsumoto Vet Path 2018)

A

CK7, CK20, Kit, CD10

43
Q

What IHC marker is helpful in distinguishing feline tumors arising from kidney vs. other neoplasms? (Ramos-Vara J Comp. Path 2017)

A

Pax8

44
Q

What was the % of samples from renal FNA that were adequate for interpretation from dogs? What cancer type was this best for? (McAloney JAVMA 2018)

A

72% adequate

overall sensitivity 78% for neoplastic and 50% for nonneoplastic

sensitivity for LSA 100%

45
Q

For cats undergoing renal FNA< what was the diagnostic yield what changes on AUS made it more likely that a diagnostic sample would be obtained? (McAloney JFMS 2017)

A

diagnostic yield 68% (48% moderately cellular)

subcapsular renal infiltrate, diffuse renal enlargement w/o pelvic dilation and infiltrative/nodular change

46
Q

What gauge needle should be used for a renal core needle bx? (Crivellenti JAVMA 2018)

A

16ga - max dx quality of bx speciments from dogs with suspected kidney disease while avoiding apotential AEs caused by larger needles

47
Q

What Ki-67 proliferation found to be prognostic in canine renal cell carcinoma? (Suarez Bonnet Vet Path 2017)

A

Nope

48
Q

What were the IHC characteristics of canine renal cell carcinoma? (Gil da Costa Vet Path 2011)

A

All positive for uromodulin

12/13 positive for c-kit

11/13 positive for vimentin

9/13 positive for cytokeratin

49
Q

75% of renal cell carcinoma in people is _____ type and _____% of these are associated with _____ mutation. This mutation (was/was not) found in dogs with renal neoplasia (Pressler JVIM 2009)

A

people: renal clear cell carcinoma, 85% hav VHL mutation

NOT found in dogs

50
Q

What was the rate of bilateral renal tumors in dogs with renal neoplasia? (Bryan JVIM 2006)

A

4%

51
Q

What were the most common clinical signs and hematologic abnormalities in dogs with renal neoplasia? (Bryan JVIM 2006)

A

CS: hematuria, inappetence, weight loss, lethargy, palp abd mass

heme: neutrophilia, anemia, thrombocytopenia; 3 had polycythemia

52
Q

What was the rate of mets at dx and at death for dogs with renal neoplasia (Bryan JVIM 2006Z)

A

16% pulm mets at dx

77% at death

53
Q

What was the MST associated with the different types of renal neoplasia in dogs? (Bryan JVIM 2006)

A

Carinoma 16mo

Sarcoma 9mo

nephroblastoma 6mo

54
Q

What was the only independent prognostic factor found in canine renal cell carcinoma for dogs treated with nephrectomy? What other things were also prognostic (but not independent) (Edmondson Vet Path 2014)

A

Only independent: MI (>30 MST 187d vs. <10 1184 d. vs 10

Poorer prognosis with clear cell, hematuria, cachexia

55
Q

What are Call-Exner bodies and what cancer are they associated with? (Masserdotti Vet Clin Path 2008)

A

Central round areas of amporphous, deeply eosinophilic hyaline material surrounded by a rosette-like arrangement of rows of Sertoli cells

Sertoli cell tumors

56
Q

What marker can be used to distinguish between the two types of seminoma in dogs? (Grieco J Comp Path 2010)

A

kit

positive = classical seminoma

negative = spermatocytic seminoma

57
Q

In a Norweigian study, what was the proportion of testicular tumors reported for canine cancer and what was the breakdown of the types/prevalence? (Nodtvedt VCO 2011)

A

2.4% of all cancer

33% Leydig

26.4% Sertoli

33.9% seminoma/germ cell

58
Q

What was the average age for dogs with testicular tumors? (Nodtvedt VCO 2011)

A

10yrs

but lower for sertoli cell (8.6yrs)

59
Q

Which dog breeds were more likely to have testicular tumors and what type of tumors were more common in these breeds? (Nodtvedt VCO 2011)

A

Shelties and Collies 5x more likely

Sertoli cell tumors

60
Q

In one study, all testticular tumors in Norwegian elkhounds were _____ (Nodtvedt VCO 2011)

A

Seminoma

61
Q

What was the ORR, mTTP and MST for dogs with bladder tumors treated with palladia? (Gustafson JAAHA 2019)

A

ORR: PR 6.7%, SD 80%

mTTP 96d, MST post palladia: 150d

62
Q

What % of dogs with bladder tumors had progression of azotemia while taking palladia? (Gustafson JAAHA 2019)

A

56%

63
Q

What is Tavocept and what is it used for? (Henry JVIM 2018)

A

Tavocept = chemoprotectant that has mitigated cisplat toxicity and decreased require infusion/diuresis time in poeple

decreased in dogs as well - decreased from >6hrs to 90min and decreased occurrence of azotemia w/o changing ST (but RR was inferior to control group)

64
Q

What was found in dogs with lower urinary tract carcinoma treated with IV vs. intraarterial carboplatin? (Culp JVIM 2015)

A

IA had greater decrease in longest diameter of tumor, more likely to have a response and less likely to develop anemia, anorexia or lethargy

65
Q

What was the difference in response to mito + piroxicam or carbo + piroxicam for TCC in dogs? (Allstadt JVIM 2015)

A

No difference

mito: PR 8%, SD 69%

carbo PR 13%, SD 54%

PFI also not sig different

66
Q

What was the effect of combining toc/vbl for treatement of canine TCC? How was response to treatment measured in these dogs? (Rippy BMC 2016)

A

combination didn’t improve ORR (needed to decrease vbl to 1.6mg/m2 qwk, standard palladia)

AUS vs. CT - agreement greater in CT

67
Q

What was the ORR, MST and TTP for dogs with bladder cancer treated with 3mg/kg/day of deracoxib? (McMillan JAVMA 2011)

A

17% PR, 71% SD (13% PD)

MST 323d (10.8mo), TTP 133d (4.4mo)

Low tox - 4% (liver, kidney, GI)

68
Q

What is the response rate, mPFI and MST from first VBL for dogs with bladder cancer? (Arnold JVIM 2011)

A

3mg/m2 q2

36% PR, 50% SD

mPFI 122d (4mo)

MST from 1st vbl = 147d (5mo)

69
Q

What were imaging changes associated with prostatic LSA in dogs? (Donato VRU 2018)

A

78% = altered shape w/ rounded/irregular margins

NO MINERALIZATION

70
Q

Density of what tumor-infiltratig cells was shown to have a favorable prognosis in dogs with TCC? (Inoue Vet Immuno 2017)

A

CD3+ Granzyme B+ cells located in peritumoral stroma - independent prog indicator

71
Q

What subtype of TVT may be more chemoresistant and why?

A

Plasmacytoid - greater expression of p-gp

72
Q

What markers were expressed in canine TVT? (Stockmann VCO 2011)

A

92.3% expressed p53

p63 and Bcl-2 also in most

73
Q

All TVT has a re-arrangement of what oncogene?

A

c-my

re-arranged by insertion of a 1.5kbp transposable sequence known as the long interspersed element (LINE) 5 to the first exon

Oncology Boards (26 decks)

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