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Papers > VCO 2021 > Flashcards

VCO 2021 Flashcards

1
Q

Prognostic value of sternal lymphadenopathy on malingancy and survival in dogs undergoing splenectomy
Author: Kelsey et al

A

No association sternal lymphadenomegaly and neoplasia
BUT - dogs with HSA and sternal lymphadenopathy had lower survival. May have predictive value to survival of dogs with splenic malignancy

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2
Q

Canine presumed glial brain tumors treated with radiotherapy: is there an inferior outcome in tumors contacting the subventricular zone?
Author: Bley et al

A

Yes, Glial tumors contacting the subventricular zone in dogs have a shorter tumor-specific survival and a higher rate of progression and CNS-metastasis.

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3
Q

Retrospective assessment of radiation toxicity from a definitive‐intent, moderately hypofractionated image‐guided intensity‐modulated protocol for anal sac adenocarcinoma in dogs.

Author: Korner

A

12 x 3.8 protocol =
70% grade 2 and 36% grade 1 acute tox. Late tox not observed. Median PFS 900 days.

Protocol considered safe

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4
Q

Feasibility and Safety of Whole Lung Irradiation in the Treatment of Canine
Appendicular Osteosarcoma
Author: Brehm

A

10 x 1.75Gy daily - to lungs = well tolerated

No prolonged survival compared to historic controls

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5
Q

What is the classification of thyroid carcinomas?

A

Follicular or parafollicular (medullary)

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6
Q

What is the reported metastatic rate at presentation for thyroid carcinomas and where do they metastasise to?

A

38% - distant mets, most commonly to the lungs. Regional to the medial retropharyngeal and deep cervical node

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7
Q

Outcome and post-operative complications in 73 dogs with thyroid carcinoma with gross vascular invasion managed with thyroidectomy
Aurthor; Latifi

A

Complication rate 25%, distant metastasis 12%, median OS 600 days, one-year disease specific survival was 82.5%. Sx remains valid treatment option for dogs with gross vascular invasion. No factors were identified to be associated with disease-specific survival

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8
Q

Is CT considered a sensitive way of assessing vascular invasion of thyroid carcinomas?

A

No - only identified in 50% of the cases in this paper

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9
Q

What was the most common and severe surgical complication associated with thyroidectomy?

A

Aspiration pneumonia

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10
Q

What was the finding of Henry et al regarding the effect of CBD on autophagy and apoptosis?

A

CBD significantly reduce cancer cell proliferation, and induce autophgy and apoptosis in rapidly dividing cells. It has synergistic effect with vincristine

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11
Q

Which cellular signalling effects were influenced by CBD in the paper of Henry et al?

A

increased phosphorylation of MAP kinase pathways, mainly suspected effect through induction of ERK and JNK phosphorylation prior to autophagy.

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12
Q

What is optical coherence tomography and what is it used for?

A

Imaging technique producing high resolution images using infra read light waves that penetrate non-transparent tissues up to 2 mm in depth. Can be used to identify areas of interest in surgically removed skin tumours.

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13
Q

According to Dornbusch et al, what was the sensitivity and specificity for optical coherence tomography for surgical margin assessment of canine mast cell tumours?

A

Sensitivity 90% and specificity 56%

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14
Q

What was the reported post-op complication rate in dogs after sx ASAC?

A

17%

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15
Q

What was the most common post-op complication after sx of ASAC?

A

Transient faecal incontinence, 7 of 161 dogs

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16
Q

What was intra-operative complications of ASAC associated with and what is the most common intra-operative complication?

A

It was associated with post-op complication and most common was anorectal wall perforation.

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17
Q

Which risks have been associated with local recurrence of ASAC after surgical removal?

A

Lymphatic or vascular invasion

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18
Q

Which histopathological factors have been associated with LN metastasis at presentation in dogs with ASAC?

A

Growth pattern (including solid, tubules, papillary), nuclear pleomorphism and lymphovascular invasion

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19
Q

Which histopathological factors have been associated with poorer outcome in dogs with ASAC?

A

Solid growth pattern, moderate or marked peripeheral infiltration, necrosis and lymphovascular invasion

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20
Q

How many owners adhere to the recommended restaging plan recommended by the vet post surgery for ASAC?

A

21%

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21
Q

Which factors have been deemed prognostic in ASAC by Tanis et al 2021?

A

Presence of multiple mLN (over 4 was negatively associated outcome)

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22
Q

Treatment with which Gy has be strongly associated with late toxicities when definitive intent protocols have been used?

A

3 Gy - commonly cause strictures

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23
Q

What was the reported acute and late toxicities for dogs treated with a moderate hypofractionated IMRT protocol 12 x 3,8 Gy?

A

100 % AE, but all grade 1 to 2. 0% late effect with median follow up for dogs alive 500 days.

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24
Q

Is there evidence for using toceranib as adjuvant treatment for carcinomas?

A

TTP longer for dogs with sx and adjuvant 360 vs. 300

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25
Q

Which changes to the microenvironment of carcinomas have been documented after use of toceranib as adjuvant treatment?

A

Lower VEGFR-2, reduced number of T-regs and lower HIF-1alpha expression in tissues sampled at the second surgery compared to the first, which could be a result of long term inhibition via TKIS

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26
Q

What was the total response rate to toceranib for dog with ASAC and what was PFS and OS?

A

client owned dogs, retrospective study, PFS and OST 313 (11 mnd) and 827 days (26 mnd), response to treatment 69% (20% PR and 48% SD)

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27
Q

What are the negative prognostic factors for ASAC?

A
  1. LN mets- some document size, other number but variable results. ST s 200 vs. 800 / 300 vs. 5002.
  2. Recurrence - shorter survival with recurrent disease. Longer survival if recurrent disease is surgically treated 300-400 days vs. 50
  3. stage- polton et al
  4. Size - variable cut offs found - 2.5 or 4 cm
  5. Clinical signs- systemic signs worse than local
  6. Distant mets
  7. No surgery, only chemo, no therapy
  8. histopathology features- solid pattern, infiltration and necrosis (associated negative outcome)
  9. Loss E-cadherin expression
  10. Hypercalcemia of malignancy - variable, not negative prognostic factor in all papers
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28
Q

Which % of sentinel LNs were identified with the use of indirect CT lymphography in dogs with ASAC?

A

12/13 - 92%

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29
Q

T or F: Indirect CT lymphography identified ipsilateral sentinel LN in all patient with ASAC?

A

No 4 of 12 were contralateral to the mass.

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30
Q

Which LN have been confirmed as a potential sentinel LN for ASAC in dogs?

A

Sacral, meal iliac and internal iliac

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31
Q

T/F; size of the primary anal sac tumour is indicative of regional metastasis?

A

False- likelihood of identifying metastatic iliosacral LNs is independent of the size of the primary tumour

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32
Q

Dogs with ASAC over XX cm are more likely to present with metastatic disease?

A

2.5 cm

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33
Q

Which breeds are predisposed for ASAC?

A

English cocker spaniel, GSD, dachs, Malamute (siamese cat)

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34
Q

How is the agreement between maximal dimension measurement of the primary tumour measured by CT compared to formalin and digital palpation?

A

No significant difference

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35
Q

which factors have been suggested to be associated with metastasis at presentation for dogs with ASAC?

A

Vascular invasion, primary tumour size and stage are strong predicators of metastasis at presentation. Dog with tumour over 2.5 cm - stage 2 were more likely to present with metastatic disease.

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36
Q

By using technetium-99 soulful colloid for identification of the sentinel LN for anal sacs- how many SLN were identified? was there difference detected between intramural and perimural injection?

A

100%, yes, there was poor concordance between the two techniques- so injection technique seem to have a significant effect on sentinel LN identified

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37
Q

Which imaging technique can be used to evaluate the surgeon cut margin real time in canine ASAC and STS?

A

Optical coherence tomography

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38
Q

What was PFI and MST for dogs with stage 4 ASAC treated with Toceranib ?

A

350 days for both

39
Q

What was the reported response rate for dogs with stage 4 ASAC treated with Toceranib?

A

No dog had complete or partial response, however 13 had signs of clinical benefint. No dogs had AE. PFI and MST 350 days

40
Q

which technique has recently been described as an alternative for removal of anal sac tumours? and what is the purposed benefit?

A

Modified closed anal sacculectomy

Lower risk of post op contamination, tumour dissemination and trauma to the external anal sphincter.

41
Q

What was the response to 3DCRT treatment for ASAC with a 20 x 2.5 Gy protocol as adjuvant treatment?

A

All dogs developed acute AE grade 3- colitis and anusitis. No late AE reported. MST was 770 days

42
Q

What was the outcome of SBRT treatment for ASAC?

A

100% acute toxicity. Some late toxicity reported including alopecia, and one stricture. MPS 550 days and MST 1000 days. The protocol was considered safe.

43
Q

What was the dose limiting toxicity in the combination protocol of toceranib and carboplatin?

A

Neutropenia

44
Q

What was the dose limiting factor in protocols combining doxorubicin and palladia?

A

Neutropenia

45
Q

What is histone lysine demethylase 2b, and how does its expression impact survival in dogs with HSA?

A

It is an enzyme involved in epigenetic regulation of gene expression and transcription- which in canine HSA improved tumour cell survival by increasing expression of DNA repair mechanisms.

Histone lysine demethylase 2B was highly expressed in stage 3 compared to stage 1 dogs and high expression was associated with shorter overall survival.

46
Q

Give examples on different mechanisms which may contribute to genomic instability?

A
  1. Enzymatic deamination
  2. Microsattelite instability- expansions of repeated sequences of DNA occur during replication - associated with mutation in MMR
  3. Macroscopic chromosome translocations
  4. Sporadic DNA damage lesions occurring during replication
  5. Somatic squired mutations
47
Q

What is the pricipal role of BRCA 1 and 2?

A

Maintain genomic stability by promoting error-free repair of DNA double strand breaks by homologous repair.

48
Q

BRCA 1 and 2 dys-reculation has been associated with which canine malignancy?

A

Mammary tumour

49
Q

Which findings on CT or thoracic rads are indicative of pulmonary HS?

A

Affected right middle lung lobe, intratumoural air bronchogram and consolidation of an entire lobe.

50
Q

What is the MST for dogs with primary, localised pulmonary HS?

A

430 days = 14 months

51
Q

Which negative prognostic factors were found for dogs with HS treated with curative intent by Murrey et al 2021?

A

High CCNU dose - significant longer survival if prescribed less than 66.6 mg/m2 (but very limited numbers).

52
Q

Which IHC-markers would you use to identify a pulmonary primary tumour?

A

Vimentin
Cytokeratin
CD18/CD204/Iba1

53
Q

Which new treatment technique has shown promising in vitro efficacy for killing canine melanoma cells?

A

Suicide gene therapy with the CDU/5-FC non-viral suicide system

54
Q

Explain suicide gene therapy?

A

a therapeutic strategy where cell suicide inducing transcends are introduced to cancer cells. The cytosine deaminase/5-fluorocytosine strategy induces enzyme activity which convert non-toxic fungal medication to the cytotoxic chemotherapeutic 5-FU. It is also based on a certain by-stander effect.

55
Q

What was the response rate for TC + RT vs. the modalities alone for nasal carcinoma in dogs?

A

RT + toceranib = 80%, RT = 70% and toceranib =20%

Use of the two modalities combined showed a marked improvement in both overall response rate 80% and clinical benefit 97%.

56
Q

T/F - concurrent use or RT and toceranib potentiate AE and is not recommended

A

F

57
Q

T/F - the use of TOC+ RT for nasal carcinoma did not have a significantly improve MST compared to TOC or RT alone.

A

T- HOWEVER it tended towards significance with 615 days vs. 387 and p = 0.502

58
Q

In a paper with canine oral melanoma, treated with surgery and anti-CSPG4 vaccination, what was the negative prognostic factor identified?

A

Bone invasion - 400 d vs. 1000 days

Dogs with soft tissue structures affected as primary site have better outcome than dogs with hard tissue sites affected.

59
Q

Why is CSPG4 an ideal tumour antigen for melanoma vaccine?

A

It is a cellular membrane antigen, which coordinates multiple intracellular pathways regulating proliferation, migration and survival. It is over expressed inhuman melanoma cancer stem cells and has bee associated with poor prognosis.

60
Q

What kind of vaccine is the melanoma oncept vaccine?

A

A xenogeneic DNA vaccine against human tyrosinase

61
Q

What was the MST for dogs treated with en bloc surgery and CSPG4-antigen electrovaccination?

A

680 days vs non vaccinated dogs which had a MST 200 days. For dogs over 20 kg- same effect was not documented in larger dogs.

62
Q

The protein SLUG play a role in which important process contributing to metastatic potential for neoplastic processes?

A

Epithelial to mesenchymal transition

63
Q

Upregulation and mutation of which protein/gene has been associated with increased ability to invade and promote cell migration in canine SCC?

A

SLUG encoded by Snai2 gene

64
Q

Name 4 proteins involved in EMT?

A

Snail, slug, TWIS, LEF

65
Q

Which method of SNL mapping of oral tumours gave the highest identification rate and what was the recommended regime by the author?

A

The use of indocyanine green identified 91% of the SLNs, compared to 50 % with MB and 40% with CT. The author recommended to use both a pre-op and peri-op method for identification of SNL in oral tumours.

66
Q

What was the accuracy and sensitivity for the proposed method a newly developed automatic diagnosis system using OCT for detection of unclean margins in dogs with STS?

A

97% and 94% - the method was deemed accurate and as it operates in real time and is non-invasive it can help in future surgical guidance.

67
Q

In the paper paper assessing impact of sentinel LN biopsy in dogs with head and neck tumours what was the agreement between SLN and RLN, and what did the histopath reveal?

A

The correspondence of SLN and RLN was 50%, with 40% of dogs having a positive LN for mets, 4/8 metastatic nodes were not the expected RLN

68
Q

T/F: Reduced viscosity of the contrast agent improves the success rate for SLN mapping.

A

F - no difference detected

69
Q

Which prognostic factors have been identified for canine gastrointestinal tumours?

A
  1. Complete removal- for all tumorus

2. MI less than nine and strong c-kit staining correlated positively with survival

70
Q

What was MST for canine GI sarcomas (including GIST and Leiomyosarcomas) ?

A

1000 days.

71
Q

What was the metastatic rate for GIST and leiomyosarcoma in the Alcazar et al 2021 paper from VCO?

A

Gist - 30%

LMSA - 15%

72
Q

Which IHC markers have been associated with an increased odds of death in canine mast cell tumours?

A

Increased expression of Ki-67, aberrant KIT-expression and elevated BAX expression.

73
Q

Which treatment target altering epigenetic expression of genes have shown promise in canine melanoma cell lines?

A

Histone demethylase inhibitors (specifically JARID1-targeted histone H3 demethylase inhibitors)

74
Q

Name two melanoma vaccines and their MOA

A
  1. Oncept - Xenogeneic DNA vaccine with human tyrosinase

2. CSPG4-DNA vaccine - Xenogenieic DNA vaccine with human CSPG4

75
Q

What was the MST for dogs treated with surgery (curative vs marginal) with or without immunotherapy with CSPG-4 in dogs with oral melanoma?

A
  1. Definitive sx + vaccine = 1300 d
  2. Palliative sx + vaccine = 500 d
  3. Definitive sx = 600 d
  4. Palliative sx = 450 d
76
Q

Which two biomarkers have been identified in feline oral SCC?

A

DNA methylation and TP53 mutations

77
Q

What was the sensitivity and specificity of the algorithm developed to diagnose FOSCC on cytobrush samples?

A

70% sensitivity and 97% specificity - accuracy 86%.

78
Q

What was the concordance in result between histopathological and cytobrush samples when assessing for methylation abnormalities and TP53 mutations in cats with FOSCC?

A

100%

79
Q

What are the pros and cons with laryngectomy and permanent tracheotomy in dogs?

A

Long term survival is possible as benign tumours are not unfrequent in the larynx
QoL considered acceptable
Permanent tracheostomy comes with some challenges

80
Q

What is the prognostic value of neutrophil to lymphocyte and lymphocyte to monocyte ration in dogs treated for oral MM?

A

No prognostic value identified.

81
Q

What was the rate of tumour infiltration to skin for scSTS in dogs?

A

50%

82
Q

T/F - Only high grade STS were found to infiltrate overlying dermis in dogs.

A

F- infiltration was found in 36% of low grade tumours.

83
Q

Which factors have been associated with local recurrence for perivascular wall tumours?

A
  1. WBCC, neutrophil to lymphocyte ration in univariate analysis,
  2. Ulceration and distal limb had higher risk LR
  3. Histo grade, necrosis, MI, iinfiltrated margins all associated LR in uni and multivariate
  4. Boxer, old age, ulceration, grade 3, Necrosis > 50% and high MI were correlated shorter survival
84
Q

What was the MOS for dogs with a heart base mass treated with conventional or SRT?

A

785 days = 26 months.

85
Q

Which AE were reported for SRT and conventional RT for dog treated for heart base mass?

A

Pneumonitits, pericardial effusion, arrhythmia

86
Q

What was the treatment success for papillary SCC in dogs treated with electron beam definitive intent RT?

A

9/10 dogs had CR. Progression reported in the dog with PR. All developed self limiting mucosist. DFI and OS not reached. It seems to result in good disease control and is an alternative to sx.

87
Q

Which type of cutaneous t-cell lymphoma has been associated with best outcome?

A

non-epitheliotrophic

88
Q

What could be a safe treatment-option for dogs with large cell lymphoma of presumed GI origin?

A

continous l-asparaginase weekly- 56% repose rate. ST 140 days (better than reported for multi drug protocol)

89
Q

How is the overall prognosis for surface OSA compared to those arising from the medullary cavity?

A

Paper from Cook et al described survival of 555 days in 11 dogs- with treatment. Seem like they have a slightly better outcome than medullary OSA

90
Q

What is the MST for dog with appendicular OSA undergoing SRT treatment, and what is the associated risk for pathological fracture?

A

MST was 7-8 mnd, and 40% of the dogs

91
Q

What are the reported complication rates with limb spare surgery?

A

Been reported complication rates between 50-95%.

92
Q

Which tumour sites of OSA are an option for limb-spare?

A

Distal radius, ulna and diaphysral lesions (poor results reported for humerus)

93
Q

Merkel cell carcinoma on IHC would be positive for?

A

Synaptophysin, NSE, cytokeratin 18, p63

Canine can also be KIT positive, and have chromogranin A expression

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