Cancer of the GI tract: Oral tumors Flashcards by Aimee Soileau

Combining RT with zoledronate in tumor-bearing (ie, OSCC) cats results in a partial remission rate of ___% and decreases serum ____, a bone resorption marker. The combination is well tolerated.

44%
CTx

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The sentinel lymph node of head and neck tumors in dogs does not correspond to the regional lymph node in ___% of cases in one study.

52%

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In a recent large study evaluating outcome in 123 dogs with tonsillar carcinoma, the MST was ________. The MST in dogs without metastasis was _______. Name the 3 positive prognostic factors found in this study.

MST: 4 months
MST no met: 13 months
positive prog: tonsillectomy, adjuvant chemo, asymptomatic at diagnosis

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Feline OSCC treated with anti-angiogenic therapy (bleomycin, piroxicam, thalidomide) w/ concurrent accelerated hypofractioned RT results in significantly longer DFI and MST compared to anti-angiogenic therapy alone (DFI _______ vs. _____; MST ______ vs. ______); however, a high occurrence rate of acute severe toxicity at ___% with combined treatment is seen.

DFI RT + med: 6 months
DFI med only: 1 month
MST RT + med: 5 months
MST med only: 1 month
30%

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Cats with OSCC treated with accelerated hypofractionated RT (10 x 4.8Gy) have a CR rate of ___%, PR rate of ___%, and metastatic rate of ___%. The PFS is ______, the local PFS is ______, and the MST is ______. Cats with T1 tumors have a PFS of _____.

CR 41%
PR: 29%
19%
PFS: 4 months
local PFS: 7 months
MST: 6 months
T1 PFS: 20 months

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The post-op complication rate for maxillectomy in cats is ___%. What were the 2 most common post-op complications? Local recurrence rate of ___%. What is the median PFI and MST? What is the 1-year and 2-year survival rates for cats with FSA, SCC and OSA?

57%
hyporexia and dehiscence
18%
PFI and MST not reached
1- and 2-year survival FSA: 94%
1- and 2-year survival SCC: 83%
1- and 2-year survival OSA: 80%

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A recent retrospective study evaluated clinicopathologic features of 25 cats with maxillary sarcoma found a MST of _____ following histologic diagnosis.

2 months

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A recent retrospective study evaluating 83 dogs with oral SCC or FSA treated with adjunctive hypofractionated RT following surgery reported post-operative RT did not appear to be protective for _______. What were the MSTs for dogs that were treated with adjunctive RT vs. surgery alone for both tumor types?

oral FSA

MST
- FSA w/ RT: 10mo
- FSA w/out RT: 23mo

MST
- SCC w/ RT: 5.6 years
- SCC w/ out RT: 6mo

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Canine oral SCC regional LN metastatic rate is ____% and distant metastatic rate is ____%. For tonsillar SCC, regional LN metastatic rate is ___%.

RLN: <40%
Distant: <36%
tonsillar RLN: 73%

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The local recurrence rate following surgery for canine SCC ranges from ____-___%. Following RT, LR ranges from ____-____%.

Surgery LR: 0-50%
RT LR: 31-42%

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The 1-year survival rate for canine oral SCC following surgery is ____ - ____%. For RT, it is ___%.

Sx 1 year: 57-91%
RT 1 year: 72%

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The best treatment for canine oral SCC is ________ with a _______ prognosis, MST of ____ - _____, and ______ or _____ being the cause of death.

Surgery and/or RT
Good to excellent
MST 26-36mo
local or distant disease

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Site predilection for canine oral FSA is ________.

maxillary gingiva and hard palate

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Canine oral FSA regional LN metastatic rate is ___ - ___% and distant metastatic rate is ___ - ____ %.

RLN: 9-28%
distant: 0-71%

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The local recurrence rate for canine oral FSA following surgery ranges from ___ - ___%. The LR rate following RT ranges from ___-___%.

Sx LR: 31-60%
RT LR: 32%

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The MST for canine oral FSA following surgery ranges is ______ while the MST following RT ranges from ____ - ______.

Sx MST: 12mo
RT MST: 16-36mo

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The 1-year survival rate for canine oral FSA following surgery is ___ - ___% while the 1-year survival rate following RT is ___%.

SX 1 year: 21-50%
RT 1 year: 76%

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The best treatment for canine oral FSA is ________, prognosis is _____, MST is ____ - _____ and the cause of death is _____.

Surgery and/or radiation
good prognosis
MST 18-26mo
local disease

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The local recurrence rate for canine AA following surgery ranges from ___ - ___%, and the LR rate following RT ranges from ___ - ____%.

SX LR: 0-11%
RT LR: 8-18%

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The MST for canine AA treated with surgery ranges from ____ - ____ while the MST for RT is ______.

Sx MST: >28-64mo
RT MST: 37mo

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The best treatment for canine AA is _______ with a ______ prognosis, MST of _____, and cause of death is _____.

surgery
excellent
MST >34mo
rarely tumor related

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The site predilection for feline oral SCC is ______, ______, and ______.

tongue, tonsils, and pharynx

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***In a series of 52 cats with oral SCC treated with various therapies, 1-year survival was ____%, MST was ____, and 42% of cats had SCC involving the ____, ____, or ____.

<10%
</= 3 months
tongue, pharynx, or tonsils

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Feline oral SCC response to radiation is ____ with a MST of ____.

- poor - MST 3mo

The best treatment for feline oral SCC is ______, the prognosis is _____, the MST is ____, and the cause of death is ____.

- surgery and radiation +/- sensitizer - poor to fair - MST 14mo - local disease

In one study, ____ and ____ had a DECREASED risk of developing oral melanoma.

- GSDs and Boxers

Papillary SCC has been shown to occur in younger dogs _____ with a site predilection for the ____.

- < 9 months - rostral oral cavity

The reported metastatic rate of feline oral SCC to mandibular lymph nodes is ___% and lungs is ___%.

- Mandibular LN: 30% - Lungs: 10%

_____ and _____ are dog breeds predisposed to oral FSA.

Goldens and Labs

Where is the most common location for high-low FSA?

hard palate and maxillary arcade between canine and carnassial teeth

______ is the fourth most common oral tumor in dogs.

OSA

Peripheral odontogenic fibromas have a predilection for what site?

maxilla rostral to 3rd premolar

What breeds are predisposed to AA?

- Sheltie, Old English Sheepdog, Akita, and Goldens

AA occurs at the _____ in 51% of cases.

rostral mandible

Only ____% of 31 cats and dogs with metastasis to the regional lymph node had metastasis to the mandibular LNs.

55%

Accuracy of LN aspirates for detection of metastatic cancer in dogs and cats is ___%.

77%

Difficulty prehending food after surgery for oral tumors is more common after bilateral mandibulectomy caudal to the ______ teeth.

2nd premolar

___% of cats never eat voluntarily after mandibulectomy.

12%

Tumor-related deaths are ___ - ___x more likely with malignant tumors.

10-21x

Local tumor recurrence of oral tumors is more frequent after incomplete excision. LR rates for complete excision range from ___ - ___% whereas incomplete excision is ____ - ____%.

Complete: 15-22% Incomplete: 62-65%

***The metastatic rate of oral canine SCC to regional lymph nodes is up to ___% and lungs is ___ - ___%. The tonsillar and tongue base metastatic rate is up to ___%.

- RLN: 10% - Lungs: 3-36% - Tonsillar or tongue base: 73%

***The overall recurrence rates of canine oral SCC are ___ - ___%. For mandibulectomy, the recurrence rate is ___ - __% and for maxillectomy, the recurrence rate is ___-___%

- overal LR: 18-23% - Mandibulectomy: 0-10% - Maxillectomy: 15-30%

The MST following mandibulectomy for canine oral SCC is ___ - ____, and the MST following maxillectomy is ___ - ___.

- mandibulectomy: 19-43 mo - maxillectomy: 10-39mo

***Untreated dogs with oral SCC have a MST of ____ and 1-year survival rate of ___%. Surgical excision in this study reported a 1-year survival rate of ___%, and stage was associated with MST. Stage 1 MST was ___, stage 2 was ____, stage 3 was ___, and stage 4 was ____.

- MST no tx: 2mo - 1 year no tx: 0% - 1 year sx: 94% - stage 1 MST: not reached - stage 2 MST: 14mo - stage 3 MST: 12mo - stage 4 MST: 2mo

The median DFS was significantly shorter for dogs with grade ____ oral SCC and SCCs with a PCNA > ____%. What were the different DFS?

- grade 3 - PCNA >65% DFS: - grade 3: 5mo - PCNA >65%: 5mo - Grade 2 or PCNA <65%: not reached

In one study of dogs with oral SCC, incomplete histologic margins were associated with a significantly worse outcome. MST for incomplete margins was ___ and for complete was ____.

- MST incomplete: 38mo - MST complete: not reached

Full-course RT either alone or as an adjunct for incompletely excised oral SCC in dogs has reported a local recurrence rate of ___%, a MST for RT alone as ___, and a MST for surgery and RT as ____.

- LR: 18% - MST RT alone: 15-16mo - MST Sx + RT: 34mo

***In a series of 39 dogs with oral SCC treated with radiation therapy, the overall PFS was ____. Local tumor control was more successful with smaller lesions. The PFS for T1 tumors is _____, T2 tumors is ____, and T3 tumors is ______.

- overall PFS 36mo - T1 PFS: not reached and >68 months - T2 PFS: 28months - T3 PFS: 8 months

Young age is also prognostic for dogs with oral SCC treated with MV RT. For dogs > 9 years old, MST was ____ compared to ____ for dogs <9 years old.

- MST >9yrs: 11mo - MST <9 yrs: 36mo

***In a series of 17 dogs with oral SCC treated with piroxicam alone, the response rate was ___%. The median PFI for responders was ___ and ____ for dogs with stable disease.

- RR 17% - PFS responders: 6mo - PFS stable dz: 3mo

***In a series of 9 dogs with oral SCC treated with piroxicam and cisplatin, the overall MST was ____, the response rate was ____%, and renal toxicity occurred in ___%. The MST for responders was ____ and ____ for non-responders.

- oMST: 8mo - RR: 56% - Renal toxicity: 41% - MST responders: 9mo - MST nonresponders: 4mo

***In a series of 7 dogs with T3 oral SCC treated with piroxicam and carboplatin, the CR rate was ___% and response was maintained in all dogs at a median follow up of ___.

- CR: 57% - Median 18mo

***Outcome may be better for mandibular SCC. In a study of 7 cats with mandibular SCC treated with mandibulectomy and RT, the MST was ___, the 1-year survival was ___%, and the local recurrence rate was ___%, which occurred 3-36 months after surgery.

- MST 14mo - 1 year: 57% - LR 86%

***In a series of 22 cats treated with mandibulectomy alone for oral SCC, the DFI was ___, the MST for rostral mandibulectomy was ___, ____ for hemi-mandibulectomy, and ____ when >50% of the mandible was resected.

- DFI: 11mo - MST rostral: 30mo - MST hemi: 7mo - MST >50%: 6mo

***RT alone for cats with oral SCC is ineffective. In 9 cats treated with accelerated RT (14 x 3.5Gy twice daily for 9 days), the oMST was ____.

3mo

***The combination of RT with sensitizers or chemotherapy _____ response rates for cats with oral SCC.

improves

A study evaluating an accelerated RT protocol (14 x 3.5Gy twice daily for 9 days) with carboplatin in 31 cats with oral SCC was performed. CR rate was ___%, PR was ___%, and MST was ____.

- CR: 52% - PR: 22% - MST 5mo

***Gemcitabine was evaluated as a radiosensitizer in 9 cats with oral SCC. The ORR was ___% for a median duration of ____, the MST was ____, and this protocol was NOT recommended given the severe _____ and _____ toxicity.

- ORR: 75% - Median: 1mo - MST 4mo - severe hematologic and local tissue toxicity

The combination of RT with mitoxantrone was evaluated in 2 series of 18 cats. The CR rate was ____%, the median duration of response was ___, and MST was ____.

- CR: 73% - median duration: 6 months - MST 6mo

***One study found that cats with oral SCC of the ____ and ___ had significantly longer MSTs than other locations. What were the MSTs of these two locations? A CR at 30 days was also associated with a significantly longer ST than non- or partial-responders (____ vs. ____).

- cheek and tonsil - MST for both cheek and tonsil: not reached - CR at 30 days MST: 13mo - MST partial or non-responders: 4mo

***In a study 54 cats with oral SCC treated with 8-10 Gy weekly fractions, the overall MST was ___, cats with sublingual location had an improved MST of ___ vs. mandibular at ____.

- oMST 3mo - MST sublingual: 5mo - MST mandibular: 3mo

***In a study of 23 cats with oral SCC with no previous treatment, Palladia and/or NSAID was evaluated. The biologic response rate was ___%, the CR rate was __%, PR ___%, and SD ___%. MST with Palladia was ____ and MST without Palladia was ____. Cats treated with an NSAID also had significantly improved MST of ____ vs. no NSAID at ___.

- Biologic response: 57% - CR: 4% - PR: 9% - SD: 43% - MST with Palladia: 4mo - MST without Palladia: 1mo - MST with NSAID: 6mo - MST without NSAID: 2mo

***Pamidronate has been shown to reduce proliferation of feline cancer cells in vitro. A pilot study of 5 cats with oral SCC were reported to have a PFS of ____ and MST of ____.

- PFS: 2mo - MST: 6mo

***The local recurrence of oral FSA in dogs after surgery is up to ___%. Following mandibulectomy, LR is ___% and following maxillectomy, LR is ___%.

- overall LR up to 54% - mandibulectomy LR: 59% - maxillectomy LR: 40%

***In a recent retrospective study of 29 dogs with oral FSA, recurrence was significantly associated with _______ and ______.

incomplete excision and breed (Golden or Golden-mix)

The median DFI for 5 cats with oral FSA treated with mandibulectomy was ____.

DFI 29mo

More recent retrospective series of dogs with oral FSA treated with surgery alone report an improved survival compared to before. The PFI was ___ and the MST was ____.

- DFI: >22mo - MST: 25mo

Canine oral FSA is radiation resistant in the gross disease setting. A study of 17 dogs treated with RT alone reported a MST of ____. As an adjunct to surgery, tumor recurrence is ___% and MST ranges from ___ - ____.

- MST RT alone: 7mo Sx + RT: - LR: 30% - MST: 18-26mo

***A smaller tumor size improves outcomes after RT for dogs with oral FSA. T1 tumors have a PFS of ___, ____ for T2 tumors, and ____ for T3.

- T1 PFS: 45mo - T2 PFS: 31mo - T3 PFS: 7mo

For dogs with mandibular OSA treated with mandibulectomy alone, the MST is ____ - ____, local recurrence is __-__%, metastasis in ___-___%, median metastasis-free interval is ____, and MST was _____.

- MST 14-18mo - LR: 15-30% - Metastasis: 35-60% - metastasis free interval: 21mo - MST 18mo

For dogs with maxillary OSA treated with maxillectomy, local recurrence occurs in ___%, metastasis occurs in ___%, and MST ranges from ____ - ____.

- LR: 60% - Metastasis: 32% - MST: 5-10mo

Reported 3-year progression-free survival rate for T1 and T2 AAs treated with RT is ___% whereas for T3 tumors it is ___%.

- T1 and T2: 86% - T3: 30%

In a retrospective study of 57 dogs with acanthomatous ameloblastomas treated with RT, the overall time to first event was ____, the overall MST was ____. What were 2 positive prognostic factors and their respective MST?

- oTTE: 40mo - oMST: 48mo - dogs younger than 8 years and dogs that received RT dose > 40Gy had significantly longer survival times - MST <8yrs: 6 years vs >8 yrs 3yrs - MST >40Gy: 8 yrs vs. <40Gy 5 mo

Tumor control with acanthomatous ameloblastoma with RT can be close to ___%.

90%

Marginal excision of AA in dogs results in a LR rate of ___% whereas mandibulectomy or maxillectomy result in a LR of ___%. The overall LR of RT is ___-___%.

- Marginal: 91% - Mand/maxillectomy: <5% - RT: 8-18%

Intralesional bleomycin has been reported in 2 studies of dogs with AA. The CR rate was ___%. No evidence of recurrence was seen at 1 year after a median follow-up of 28mo.

100% CR

In a study of 44 dogs with tonsillar SCC treated with surgery, RT, and/or chemotherapy, MST was ____ and dogs presenting with ____ or ____ had shorter STs.

- MST: 6mo - anorexia or lethargy

The lung metastatic rate at presentation for dogs with tonsillar SCC is ___%.

20%

____ and ____ are predisposed to developing lingual HSA and FSA.

Bordier collie and Golden

____ is predisposed to developing lingual PCT.

Cocker spaniel

Tumor size is associated with prognosis in dogs with lingual tumors. Tumors <2cm have a MST of ____ compared to tumors >2cm at ____.

MST <2cm: 27mo MST >2cm: 7mo

Local tumor recurrence after glossectomy is ___-___%.

26-28%

Dogs with recurrence of their lingual tumors are ___x more likely to die as a result of their tumor.

33x

Grade is associated with survival time in dogs with lingual SCC. What is the MST of grade 1, 2 and 3 after glossectomy?

- Grade 1 MST: 16mo - Grade 2 MST: 3mo - Grade 3 MST: 3mo

***The overall MST for dogs with lingual HSA is ____. Two prognostic factors are tumors causing clinical signs and large tumors. The MST for dogs with clinical signs is _____ compared to those without at ____. The MST for dogs with tumors <2cm was ____ compared to those with tumors 2-4cm at _____.

- MST 18mo - MST clinical signs: 5mo - MST no clinical signs: 21mo - MST <2cm: 21mo - MST >2cm: 5mo

The overall recurrence rate of MLO after surgery is ___-___%, which depends on grade and completeness of excision. DFI for completely resected tumors is ____, and is ____ for incompletely resected tumors. What is risk of recurrence for each grade?

- overall LR: 47-58% - DFI complete: 44mo - DFI incomplete: 11mo - LR grade 1: 30% - LR grade 2: 50% - LR grade 3: 80%

The metastatic rate for MLO is ____% and is dependent on grade. What is the risk of metastasis for each grade? The median time to metastasis is ____ - _____. Metastasis is more likely to occur with incomplete resection (____% vs. ___%).

- overall met rate: 58% - grade 1: 30% - grade 2: 60% - grade 3: 80% - median time: 14-18mo - metastasis incomplete: 75% - metastasis complete: 25%

The overall MST for MLO is ____, which is grade dependent. What is the MST for each grade? Outcome for dogs with mandibular MLO is significantly better (_______ vs. ______).

- oMST: 21mo - grade 1: 50mo - grade 2: 22mo - grade 3: 11mo - mandibular MST: 50mo - non-mandibular MST: 20mo

The most common odontogenic tumor in cats is _________, which occurs in cats <18 months.

inductive fibroameloblastoma

Cancer of the GI tract: Oral tumors Flashcards

(90 cards)