Cancer of the GI tract: Salivary Gland, Esophageal, GI, Pancreas, Hepatic Flashcards
(97 cards)
1
Q
In a retrospective study of cats and dogs treated with surgery +/- adjuvant RT or chemotherapy for salivary gland carcinoma, MST for dogs was _____ and MST for cats was ____.
A
- MST dog: 18mo
- MST cat: 17mo
2
Q
Spondylitis on ventral aspect of the vertebral body ______ was detected radiographically in ___% of dogs with Spirocercosis-associated esophageal sarcoma.
A
- T7-12
- 80%
3
Q
In a study of 17 dogs with Spirocercosis-associated esophageal sarcoma, 5 dogs were treated with partial esophagectomy and adjuvant doxorubicin and survived _____.
A
9 months
4
Q
***In cats, a ____ solitary mass is suggestive of pancreatic cancer over hyperplasia.
A
> 2cm
5
Q
What are 2 IHC markers that can be used for dogs with pancreatic carcinoma? Which one can differentiate between well differentiated and poorly differentiated carcinoma?
A
- Claudin-4: can differentiate
- Claudin-5: lost for both
6
Q
***In a recent study of 34 cats with pancreatic carcinoma, overall MST was ____, cats treated with either chemotherapy or surgery had a MST of _____, cats with abdominal effusion at diagnosis had a MST of ____, cats treated with an NSAID only had a MST of ____, and 1-year survival rate was ___%.
A
- oMST: 3mo
- MST chemo/sx: 6mo
- MST effusion: 1mo
- MST NSAID: <1mo
- 1 year: <10%
7
Q
Name two breeds predisposed to gastric carcinoma.
A
collie and standard poodle
8
Q
For dogs with gastric carcinoma, metastasis to ____ is common with a reported ___% at presentation and ___% at necropsy.
A
- RLN
- 30% presentation
- 77% necropsy
9
Q
Gastric carcinoma tends to arise from what location?
A
pylorus or lesser curvature
10
Q
Gastric leiomyoma, leiomyosarcoma, and GIST tend to arise from what location?
A
- cardia or pylorus
11
Q
Squash preparation cytology with assessment for the presence of ____ and/or ______ has high sensitivity (94%) and specificity (94%) for gastric carcinoma.
A
- signet rings and/or cytoplasmic micro-vacuolation
12
Q
FNA cytology of gastric masses has POOR agreement (____%) with definitive histopathology.
A
50%
13
Q
Treatment of gastric carcinoma in dogs with gastrojejunostomy (Billroth 2) has been performed in more advanced disease and resulted in survival times of ____.
A
poor survival ~1mo
14
Q
Expression of _____ is found in 60% of canine gastric carcinoma and expression of _____ is found in 42%.
A
HER-2: 58% Give Lapatinib??
EGFR: 42%
15
Q
Canine gastric carcinoma has a poor prognosis. Long-term survival is possible after partial gastrectomy but STs are typically ______.
A
<6 months
16
Q
Reported MST for gastric GIST is ___.
A
MST 37mo
17
Q
Reported MST for gastric leiomyosarcoma is ___ - ___.
A
8-12mo
18
Q
Reported MST for undifferentiated sarcoma of the stomach is ____.
A
MST 3mo
19
Q
Reported MST for gastric MCT in dogs is ____ and ____ in cats.
A
- MST dog: <1mo
- MST cat: 18mo
20
Q
Expression of ___ is associated with more aggressive histologic findings and poorly differentiated tumors in dogs with HCC.
A
keratin-19
21
Q
HCC is the most common primary liver tumor in dogs with a rate of ___%.
A
77%
22
Q
HCC is diagnosed in 34% of _____ with progressive vacuolar hepatopathy.
A
Scotties
23
Q
_____ and _____ dogs are over-represented in some studies of HCC.
A
Miniature Schnauzer and MALE dogs
24
Q
Metastatic rates for massive HCC in dogs are ___-___% and for nodular and diffuse forms are ___-___%.
A
- Massive: 0-37%
- Nodular/diffuse: 93-100%
25
50% of all feline hepatobiliary tumors are ______.
biliary cystadenoma
26
What is the most common malignant hepatobiliary tumor in cats?
cholangiocarcinoma
27
______ and _____ dogs may be predisposed to cholangiocarcinoma.
Labs and FEMALE dogs
28
The morphologic distribution of cholangiocarcinoma is ______ in 37-46% , ______ in up to 54% of cases, and _____ in 17-54%.
- Massive
- nodular
- diffuse
29
What is the metastatic rate of cholangiocarcinoma in dogs and cats?
- dogs: 90%
- cats: 70-80%
30
The most common morphologic types of carcinoids are what?
- nodular (30%) and diffuse (70%)
31
What are the 3 most common primary hepatic sarcomas? What is the most common in cat and dog?
- HSA, leiomyosarcoma, and FSA
- Dog: leiomyosarcoma
- cat: HSA
32
What are the morphologic types of primary hepatic sarcoma and their frequency?
- massive: 36%
- nodular: 64%
33
What is the metastatic rate of primary hepatic sarcomas in dogs?
86-100%
34
An AST:ALT ratio of <1 is consistent with ______ or _____, and an AST:ALT ratio of >1 is consistent with _____ or _____.
- <1: HCC or biliary carcinoma
- >1: neuroendocrine tumor or sarcoma
35
Hyperferritinemia can be seen in dogs with _____ and _____ and may help differentiate from other liver disease.
- Histiocytic sarcoma
- IMHA
36
Hepatic aspirates may correctly diagnose liver tumors in up to ___% of cases. What are useful cytological features for diagnosing well-differentiated HCC?
- 60%
- dissociation of hepatocytes, acinar or palisading arrangement, naked nuclei, capillaries, mild anisocytosis, anisokaryosis, mutlinuclearity, and increased N:C ratios
37
Needle-core biopsies of hepatic tumors can obtain correct diagnosis in up to ___% of cases with a ___% risk of mild to moderate hemorrhage.
- 90%
- 5%
38
Preoperative helical contrast CT was evaluated in hepatic lesions. What findings were consistent with HCC, nodular hyperplasia, and metastatic liver lesions? What was the reported accuracy in differentiating benign from malignant masses?
HCC
- heterogenous; hyper-, iso-, and hypoenhancement in both arterial and portal venous phases (85%)
Nodular hyperplasia
- homogenous; hyper- and isoenhancement in both portal venous and delayed phases (93%)
Metastasis
- homogenous; hypoenhancement in both arterial and portal venous phases (89%); 55% also had homogenous hypoenhancement in delayed phase
>90% accuracy
39
***In a report of 42 dogs with massive HCC treated with liver lobectomy, intra-operative mortality rate was ___% and complication rate was ____%.
- mortality: 5%
- complication: 30%
40
The overall local recurrence rate of massive HCC is ___-___%. In a study evaluating completeness of excision in 37 dogs with massive HCC, complete excision resulted in recurrence rate of ___%, PFS of ___, and MST of ____. Incomplete excision resulted in a recurrence rate of ___%, PFS of ____, and MST of ____.
- overall LR: 0-13%
Complete:
- LR: 12%
- PFS: 33mo
- MST: 5 years
Incomplete:
- LR: 60%
- PFS: 17mo
- MST: 26mo
41
The overall reported survival time for dogs with massive HCC following surgery is ___-____ with most dogs not dying of HCC.
- 4-5 years
42
The overall survival time for cats with massive HCC is _____ following surgery.
2.4 years
43
In a study of 6 dogs treated conservatively for massive HCC, the MST was ____ and dogs were ____x more likely to die of tumor-related causes than dogs treated with surgery.
- MST: 9mo
- 15.4x
44
Canine liver cannot tolerate cumulative doses of RT greater than ___ Gy.
30 Gy
45
3D-CRT was described in 6 dogs with non-resectable HCC and reported a PR of ___% and MST of ____.
PR: 83%
MST: 19mo
46
Single-agent gemcitabine was investigated in 18 dogs with unresectable HCC. Most dogs had nodular or diffuse well-differentiated disease. The overall MST was _____. The MST for massive HCC was ____, nodular HCC was _____, and diffuse HCC was ____. The MST for incompletely excised tumors was ____ and ___ for non-resectable HCC.
- oMST: 33mo
- Massive MST: 45mo
- Nodular MST: 33mo
- Diffuse MST: 4mo
- Incompletely excised MST: 44mo
- Non-resectable MST: 7mo
47
Survival time for dogs with bile duct carcinomas (cholangiocarcinomas) is poor following liver lobectomy due to local recurrence and metastasis in the majority of patients within _______ of surgery.
- within 6 months
48
The metastatic rate for hepatic carcinoids is ___%, which is typically early in the course of disease.
93%
49
>50% of reported cases in 2 series of intestinal MCT in dogs were ______ dogs with a ____ predominance.
- Maltese
- MALE
50
When leiomyosarcomas were stratified by KIT reactivity, ___% were reclassified as GISTs. It was found that dogs with GIST lived longer than dogs with leiomyosarcoma. ___% of GISTs metastasized. GISTs were significantly more likely to occur in ________ whereas leiomyosarcomas were significantly more likely to occur in _____ and ______. A recent study reported a higher rate of metastasis (___%) for GISTs and ___% of metastasis for leiomyosarcoma.
- 67%
- 7%
- large intestine (cecum)
- stomach and small intestine
- recent study: GIST met 30%, Leiomyosarcoma met 0%
51
Nephrogenic diabetes insipidus has been documented in 1 dog with ________.
intestinal leiomyosarcoma
52
Hypoglycemia is seen in ____% of patients with intestinal smooth muscle tumors.
55%
53
***_____ cats are 1.8x more likely to develop intestinal neoplasia.
Siamese
54
_______ are over-represented for inflammatory colorectal polyps.
Miniature dachshunds
55
What are reported paraneoplastic syndromes with intestinal neoplasia?
- alopecia
- nephrogenic diabetes insipidus
- hypoglycemia
- erythrocytosis
- hyperviscosity syndrome
- hyper-eosinophilia and eosinophilic tumor infiltrates
- neutrophilic leukocytosis
56
***In one study, ___% of dogs with neoplasia had loss of wall layering on ultrasound, which was associated with a ___ x greater likelihood of neoplasia than enteritis. Dogs with walls thicker than _____ are nearly ___ x as likely to have a tumor. Dogs with focal lesions are ___ x more likely to have a tumor.
- 99%, 50x
- >1 cm, 4x
- focal lesions, 20x
57
In a series of 14 cats with carcinomatosis, the hallmark US findings was the presence of masses in the:
presence of masses in the double sheet portion of the peritoneum that connects the visceral and parietal portions (100% of cats)
58
The risk of GI perforation for dogs and cats undergoing GI biopsies is ___% for dogs and ___% for cats.
- dog: 1%
- cat: <3%
58
In one study, ___% of dogs had different colonoscopy biopsy results compared with final histopathology results with a tendence to over or under-diagnose malignancy?
- 30%
- underdiagnose
59
In cats with small intestinal adenocarcinoma, ___% have regional LN metastasis, ___% have peritoneal cavity metastasis, and ___% have lung metastasis.
- RLN: 50%
- Peritoneal cavity: 30%
- Lung: < / = 20%
60
For small intestinal adenocarcinoma in dogs, prognosis is guarded. Mean ST without treatment is ____, after surgery is ____ - _____.
- MST no tx: 12 days
- MST sx: 4-10mo
61
Small intestinal leiomyosarcoma in dogs have reported MST of ____ - _____. One series of 28 dogs with GISTs found a MST of _____. If post-operative deaths were included, MST was ____. In this same study, MST for dogs with leiomyosarcoma was ____. Another study found no difference in survival between dogs with GIST and leiomyosarcoma with 1-year survival rates for both tumor types to be ___%.
- MST leiomyosarcoma: 1-2 years
- MST GIST: 38mo
- MST post op death: 12 months
- MST leiomyosarcoma: 8months
- 1-year survival: 80% for both
62
Feline small intestinal adenocarcinoma carry a significant perioperative risk. In 2 series, 50% of cats in 1 report, and ALL cats in another report were euthanized or died within ____ of surgery. For the cats that survived beyond this time point, their MST was ____. In another report, MST was _____.
- within 2 weeks
- MST beyond 2 weeks: 15mo
- MST another report: 3mo
63
What is the most common complication from rectal-pull through surgeries? What is the % frequency?
fecal incontinence occurs in 57%, 40% permanent
64
For canine rectal polyps and carcinoma in situ, local recurrence of clinical signs occurs in ___% after surgery and malignant transformation associated with tumor recurrence occurs in ___%.
- 41%
- 18%
65
For canine colorectal adenocarcinoma, MST after local excision is ___-____, and MST has been reported to be ____ with stool softeners alone.
- MST local excision: 2-4+ years
- MST SS: 15mo
66
For colorectal EMPs in dogs, MST is reported to be ____ following surgical excision.
15mo
67
The MST for feline large intestinal adenocarcinoma is _____ after surgery alone. Adjuvant chemotherapy with doxorubicin has improved STs in cats following subtotal colectomy to ____ vs. ____ without doxorubicin.
- MST 4.5months
- MST DOX: 9mo
- MST no DOX: 2mo
68
In a study of cats with colonic adenocarcinoma treated with surgery and adjuvant carboplatin, DFI was reported to be ____ and MST was ____. Negative prognostic factors were the presence of metastasis (local or distant). MST for metastasis was _____ and ____ for no metastasis.
- DFI: 8mo
- MST: 9mo
- MST met: 6-7mo
- MST no met: 11mo
69
For dogs with colorectal tumors, gross appearance may determine outcome. Mean ST for annular, obstructing masses was ____, ____ for nodular/cobblestone masses, and ____ for single pedunculated masses.
- MST annular: 2mo
- MST cobblestone/nodular: 12mo
- MST pedunculateD: 32mo
70
For dogs with non-lymphomatous small intestinal tumors, 1-year survival with LN metastasis is ___% compared to ___% without LN metastasis. In another study, dogs with and without visceral metastasis from leiomyosarcoma survived equally as long after surgical resection (_____).
- 1 year LN met: 20%
- 1 year no LN met: 67%
- MST leio with/without met: 21mo
71
For cats with intestinal adenocarcinoma, what 3 factors are associated with significantly longer survival times and list the differences in survival?
1. Subtotal colectomy
- ST: 5mo vs. 2mo with mass excision
2. Post-operative doxorubicin
- ST: 9mo vs. 2mo
3. No LN metastasis at surgery
- ST: 9mo vs. 2mo
72
APC gene was found to be altered in about ___% of dogs with colorectal tumor samples, similar to familial polyposis syndrome in humans.
70%
73
What LN is the primary lymphatic drainage center of the salivary glands in dogs and cats with salivary gland neoplasia?
- Medial retropharyngeal
74
What is the most common complication after surgical removal of parotid gland adenocarcoma?
facial paralysis (decreased ability to blink)
75
Metastasis to regional lymph nodes has been reported in ___% of cats and ___% of dogs with salivary gland neoplasia.
- met cat: 39%
- met dog: 17%
76
What is the sensitivity of fecal floatation test for diagnosis of Spirocercosis-associated esophageal sarcoma?
25%
77
What are the histologic types reported of Spirocercosis-associated sarcomas in the esophagus in decreasing frequency?
OSA > FSA > undifferentiated sarcoma
78
_____ can differentiate non-neoplastic and neoplastic Spirocercosis.
Elevated VEGF (neoplastic)
79
Treatment with transendoscopic esophageal mass ablation for dogs with Spirocercosis-associated esophageal sarcomas has a reported MST of _____.
MST 7mo
80
Name negative prognostic indicators for canine HCC.
1. Right sided tumor
2. High ALT, AST
3. Increased ALP:AST ratio
4. Incomplete excision
81
What is the reported clinical benefit of Palladia in 7 dogs with GIST? What was the PFS in gross disease vs. microscopic? What two factors decreased PFS?
- CB: 71%
- PFS (gross): 27mo
- PFS (microscopic): 17mo
- mets and increased mitotic index
82
A recent paper of dogs with colorectal lymphoma treated with mostly chemotherapy +/- surgery reported a PFS of _____ and MST of ____. What were positive prognostic factors?
- PFS: 3.6 years
- MST: 5 years
- positive prog: presence of hematochezia, younger age (<7yrs), and substage b
83
A small study of 8 dogs treated with Palladia for exocrine pancreatic carcinoma found an overall clinical benefit of ___% (4 dogs evaluated) and palladia-specific median overall survival time of _______.
- 75%
- 3 months
84
The postsurgical outcome of 9 cats with localized pancreatic carcinoma was evaluated. The median postsurgical survival time was _______.
11 months
85
oMST of dogs with salivary gland carcinoma treated with surgery is _____ with a recurrence rate of ____% and metastatic rate of _____%. LR occurred at a median of _____ while metastasis occurred at a median of _____.Dogs in which lymph node metastasis was detected at the time of surgery and lymphadenectomy was performed, the DFI is ____ and MST is _____.
- oMST: 5.1 years
- 42% at median 6mo
- 32% at meadian 10mo
- LN met DFI: 3 months
- LN met MST: 8 months
86
A recent case-control study of 75 dogs with HCC who developed recurrence following surgery were compared to those who did not develop recurrence. The median time to recurrence was _____. No significant risk factors were found with no difference in outcome for dogs who developed recurrence, incomplete excision, or lung metastasis.
- Median time to recurrence: 12mo
87
The sensitivity and specificity of cytology for diagnosis of liver masses in dogs in _____ and _____, respectively, according to recent study. ____% of neoplastic masses were correctly diagnosed.
- Se: 60%, Sp: 70%
- 20%
88
14 dogs with combined hepatocellular-cholangiocarcinoma were recently evaluated for outcome. Intrahepatic metastasis was found in ___% at surgery and the oMST was ____.
- met: 14%
- oMST: 23mo
89
The outcome of 200 dogs undergoing a liver lobectomy for spontaneous hemoabdomen secondary to a ruptured liver mass was recently evaluated. ____% were diagnosed with HCC or benign tumors and with a long-term survival of ____. _____ was the third most common tumor with a MST of _____.
- 64%
- MST HCC or adenoma: 30mo
- HSA, MST: 2mo
90
A recent retrospective study evaluating feline nonhematopoietic malignant liver tumors was performed. What were the 3 most common tumors in decreasing frequency? Metastasis was found or suspected in ___% at diagnosis. Intra-operative complications were ___% and mortality rate was ___%. Local recurrence was ___% at a median of ______. Post-operative metastasis occurred in ____% at a median of ____. MST with surgery was ______, which was significantly longer than without surgery at ____. MST for HCC was ____ and bile duct carcinoma was _____.
- HCC (43%) > Bile duct carcinoma (33%) > mesenchymal (15%)
- Met at dx: 10%
- Intra-op comp: 12%
- mortality rate: 15%
- LR: 30% at median of 5mo
- post-op met 21% at median of 6mo
- MST w/ surgery: 12mo
- MST w/ out surgery: <1mo
- MST HCC: 29mo
- MST bile duct carcinoma: 9mo
91
Perioperative complications and outcome after surgery for gastric carcinoma in 40 dogs was retrospectively evaluated recently. Surgical treatment included partial gastrectomy > Billroth I > subtotal gastrectomy > and submucocal resection. Major complication rate was ___% with ___% developing septic peritonitis, comparable to previous reports. The PFS was ___ and the MST was ____, improved from previous reports. ______ was a negative prognostic factor and ______ was a positive prognostic factor.
- Major comp: 20%
- 10% septic
- PFS: 2mo
- MST: 6mo
- neg prog: intraoperative complication
- positive prog: received adjuvant chemotherapy
92
A retrospective study of outcome for dogs with small intestinal adenocarcinoma treated with tumor excision +/- adjuvant chemotherapy reported a oMST of ____. The only predictor of outcome was age. Dogs who were < 8 years had a MST of ____ compared to >8 years at ____. LN mets and adjuvant chemotherapy were not prognostic in this study.
- oMST: 18mo
- MST <8y: 3.3 years
- MST >8yr: 16mo
93
Comparison of ultrasound and CT in 13 dogs with gastric neoplasia was recently performed. CT identification rate was ___% compared to ___% for ultrasound.
- CT: 90%
- US: 70%
94
A recent retrospective study evaluating 42 dogs with gastrointestinal sarcoma was performed. The MST for GISTs and leiomyosarcoma was ____ with no significant difference between the two. The metastatic rate did not differ between the two histologic types, ranging from ___-___%. MC _____ for GIST and _____ for all tumor types resulted in improved survival. Intensity of c-kit staining also improved survival for dogs with GIST. The MST for low staining was ____ compared to high staining at _____.
- oMST: 34mo
- 15-30%
- MC <9 for GIST and complete excision for both
- MST low c-kit: 8mo
- MST high c-kit: 47mo
95
Submucocal resection via a transanal approach for epithelial rectal tumors in 93 dogs resulted in a local recurrence rate of ___%, ___% complication rate, and 5-year survival of ___%.
- LR 20%
- 30% Complication rate
- 5 year: 73%
96
Feline minor salivary gland adenocarcinoma mean survival time was _____ in a recent case series.
26mo
