Tumors of the Skeletal System Flashcards
(128 cards)
1
Q
A necropsy study of 83 dogs with OSA evaluated the patterns of metastatic progression. A total of 20 different sites of metastasis were identified. The most common site of metastasis was _____, followed by ______, _____, ______, and _______.
A
- lung
- bone, kidney, liver, and heart
2
Q
Outcomes of 35 dogs with craniomaxillofacial OSA treated with SRT +/- chemotherapy were assessed. Median time to first event (TTFE) was ____ and MST was ____. MST for mandible was ____, ____ for calvarium, and ____ for maxilla. The overall metastatic rate was ___%. ____% developed grade 3 AE’s. ______ and _______ was associated with increased survival time.
A
- TTFE: 6mo
- oMST: 8mo
- MST mandible: 5mo
- MST calvarium: 8mo
- MST maxilla: 8mo
- met rate: 34%
- grade 3 AEs: 23%
- Administration of chemotherapy and 5 fractions (vs. single fraction)
3
Q
A retrospective Italian Society of Veterinary Oncology study of 56 cats with appendicular OSA was performed. Metastatic rate was ____%. Among the 49 cats that underwent surgery, median time to local progression, time to distant progression, and tumor specific survival were ___________. 1-year survival rate was ____% and 2-year survival rate was ___%
A
- 30%
- not reached
- 66%
- 55%
4
Q
The outcome of 35 dogs with craniomaxillofacial OSA treated with SBRT was evaluated. Median time to first event was ______ and oMST was ______. Site-specific MSTs were _____ for mandible, ______ for maxilla, and ______ for calvarium. Pulmonary metastasis was found in ____%. Cause of death was local progression in ___% and metastasis in _____%. What 2 factors were associated with increased survival time?
A
- TTFE: 6 months
- oMST: 8 months
- mandible MST: 5 months
- maxilla MST: 8 months
- calvarium MST: 8 months
- 34% pulm mets overall
- 63% (local progression)
- 26% (metastasis)
- administration of chemotherapy and 5 fractions of SBRT (vs. single fraction)
5
Q
*** A recent retrospective study of 11 dogs with surface OSA reported an over PFI of _____ and MST of _____. ___% were diagnosed with metastasis at diagnosis and ___% later developed metastasis for a total metastatic rate of ____%. The PFI for periosteal OSA was _____ and _____ for parosteal OSA in this study.
A
- DFI: 14mo
- MST: 19mo
- met at dx: 18%
- met later: 36%
- overall met: 65%
- PFI periosteal: 15mo
- PFI parosteal: 12mo
6
Q
A recent retrospective study of 22 dogs with vertebral OSA after palliative decompression surgery alone or combined with RT and/or chemotherapy was evaluated. The MST for dogs treated with surgery alone was ________, surgery and chemotherapy was _______, and surgery, RT, and chemotherapy was ______. Cause of death in all cases that survived surgery was _______.
A
- MST (Sx alone): ~1 month
- MST (sx + chemo): ~3 months
- MST (sx + RT + chemo): 9 months
- tumor regrowth
7
Q
***A recent retrospective study of 15 dogs evaluated the biologic behavior of primary OSA of the digits, metacarpus, and metatarsus. What was the overall PFS and MST following curative - intent treatment (surgery or SRT) +/- chemotherapy?
A
PFI: 13 months
MST: 23 months
8
Q
Dogs with a history of TPLO are ___ times more likely to develop OSA of the proximal tibia. Each 1 kg increase in body weight was associated with an ___% increase risk of OSA.
A
40x
11%
9
Q
A study evaluating macrophage infiltration of OSA as a prognostic factors in dogs undergoing amputation followed by 6 doses of carboplatin found a DFI of _____ and MST of ________.
A
DFI: 13 months
MST: 15 months
10
Q
What are the mean average survival times for dogs with appendicular OSA of the fibroblastic, chrondroblastic, and osteoblastic histologic subtypes treated with amputation and adjuvant platinum-based chemotherapy?
A
- Fibroblastic: 18 months
- Chondroblastic: 6 months
- Osteoblastic: 9 months
11
Q
The MST of dogs with appendicular OSA treated with definitive intent local therapy and adjuvant carboplatin and an SUVmax of >7.4 is ______ and an SUVmax <7.4 is _______.
A
- SUVmax >7.4 MST: 9 months
- SUVmax <7.4 MST: 23 months
12
Q
A study evaluating the clinicopathological features and prognosis in 153 dogs with appendicular OSA found _______ to be the most common subtype, a lymph node metastatic rate of ____%, and dogs with proximal extremity tumors had a lower 1-year survival rate (______) compared to those with distal extremity tumors (_______).
A
- Osteoblastic
- 14%
- proximal OSA 1-year: 14%
- distal OSA 1-year: 40%
13
Q
______ is a thioredoxin reductase 2 inhibitor and has been shown to improve survival in a pilot study when combined with standard of care (amputation + carboplatin) for male dogs with OSA.
A
Auranofin
14
Q
What was the TTP and MST in dogs treated with chemotherapy within 5 days after amputation for OSA compared to > 5 days.
A
- TTP </= 5 days: 12 months
- MST </= 5 days: 15 months
- TTP > 5 days: 7 months
- MST > 5 days: 8 months
15
Q
___% of dogs with appendicular OSA treated with SBRT have maximum lameness improvement at a median of 3 weeks for a median of ______ duration. The fracture rate is ___%. The TTFE is ______ and MST is _______. The MST of dogs with salvage limb amputation is _____ compared to those without at _____.
A
- 84%
- 6 months
- 41%
- TTFE: 5 months
- MST 8 months
- MST salvage amp: 12 months
- MST no amp: 7mo
16
Q
***In a recent study evaluating the configuration of pathologic fractures in dogs with OSA treated with SBRT, ______ was the most common location to develop a fracture. The ____ was more likely to develop a transverse fracture than other fracture types.
A
- distal tibia
- distal radius
17
Q
Dogs with appendicular OSA treated w/ SBRT that have <40% of bone affected have a MST of ____ compared to those with >/= 40% of _____. ______ was significantly correlated with fracture rate based off CT.
A
- <40% MST: 9 months
- > /= 40% MST: 6 months
- subchondral bone lysis
18
Q
Dogs that undergo secondary amputation after complications related to limb salvage surgery for dogs with OSA have a MST of _____ compared to those that do not (_____). The MST after amputation was _____.
A
- MST secondary amp: 20 months
- MST no amp: 13 months
- MST after amp: 7mo
19
Q
What is the DFI and MST in dogs with appendicular OSA treated with autologous cancer cell vaccination, adoptive T-cell transfer, and IL-2 following amputation? What is the 2-year survival rate?
A
- DFI: 7 months
- MST: 14 months
- 2 year survival: 36%
20
Q
What is the median PFS and MST in dogs with multilobular osteochondrosarcoma treated with SBRT? ___% developed late AEs and ___% showed response on CT.
A
- PFS: 7 months
- MST: 11 months
- Late AEs: 38%
- RR 80%
21
Q
78% of primary bone HSA in dogs occurs in _________, particularly the ____. Overall survival with amputation + chemotherapy for primary bone HSA is _______ and for primary bone telangiaectic OSA is __________. One year survival rates did not differ b/w dogs with HSA (______%) vs. those with tOSA (_____%). Dogs with tOSA weigh a median of ___ kg more than dogs with HSA.
A
- hind limbs
- tibia
- HSA MST: 10 months
- tOSA MST: 7 months
- HSA 1-year: 28%
- tOSA 1-year: 7%
- 10kg
22
Q
In dogs with appendicular OSA, survival times are significantly longer when treated with SRT + chemotherapy (_______) vs. conventionally hypofractionated RT + chemotherapy (______).
A
SRT + chemo MST: 12 months
CHRT + chemo MST: 5 months
23
Q
For appendicular OSA, males are slightly more affected than females EXCEPT for what breeds?
A
St. Bernard, Great Dane, and Rottie
24
Q
Axial OSA occurs slightly more in female dogs EXCEPT for what locations?
A
rib and spine - males predominate
25
p53 is the most thoroughly described gene mutation contributing to OSA formation and progression. The most common abnormality is ________ mutations. Overexpressions of p53 in appendicular OSA was identified in ___% compared to axial OSA at ____%. A homolog within the p53 family, ________, has been identified to be involved in canine OSA cellular survival and metastasis.
- missense point mutations
- appendicular: 84%
- axial: 56%
- deltaNp63
26
Besides p53, what are other gene mutations found in OSA?
- Rb (loss/hyperphosphorylated)
- PTEN (loss)
- RHOC (overexpression)
- RUNX2 (overexpression)
- TUSC3 (loss)
- ADAM15, CTC1, MEN1, CDK7 (CNVs)
27
Evidence of breed-associated inheritance have been found in what 6 breeds? Which of these breeds have we identified 33 genetic loci? Which breed has a narrow heritability trait?
- Greyhounds (genetic loci)
- Rotties (genetic loci)
- Irish wolfhounds (genetic loci)
- Scottish Deerhound (narrow heritability)
- Great Danes
- St. Bernards
28
Scottish Deerhound has a ___% incidence of OSA.
15%
29
Which miRNAs have been found to be associated with OSA?
- miR-334 (decreased)
- miR-544 (decreased)
- miR34a (decreased)
- miR-9 (overexpression)
- miR-214 (overexpression)
- miR-126 (overexpression --> improved prognosis)
30
What signaling pathways have been identified in canine OSA?
- MET/HGF
- IGF-1 --> MAPK and AKT signaling
- EGF --> HER2
- mTOR
- HH
- Notch
31
_____ and ____ are specific proteins that have been identified to participate in the progression of canine OSA metastasis.
- ezrin and CXCR4
32
***A novel germline mutation resulting in enhanced receptor phosphorylation and aberrant MET signaling has been identified in the ______ breed.
Rottie
33
Diagnostic accuracy of biopsy biopsy with a trephine is ___%. Accuracy for neoplasia with Jamshidi bone marrow biopsy is ____% and accuracy for tumor subtype is ____%.
Trephine:
- diagnostic accuracy: 94%
Jamshidi
- diagnostic accuracy: 92%
- accuracy of tumor subtype: 82%
34
Describe the staging scheme for OSA. According to this system, most dogs present with what stage?
- Stage I: Low grade (G1) lesions without metastasis
- Stage II: High grade lesions (G2) without metastasis
- Stage III: Lesions with regional or distant metastasis regardless of grade
- Substage A: Intracompartmental
- Substage B: Extracompartmental
- most dogs are stage IIB
35
***Up to ___% of dogs with appendicular OSA are lame for a period before presentation.
60%
36
For OSA arising from flat bones, ______ and _____ were positive prognostic factors.
- small dog size and completeness of excision
37
OSA of the head is locally aggressive but has a lower metastatic rate. In a study of 138 dogs treated with various therapies, local recurrence or progression occurred in ___%, distant metastasis occurred in ___%, and oMST was ____. Dogs who underwent surgery had a MST of _____. Dogs with mandibular OSA treated with surgery alone had a 1-year survival rate of ____%. ________ was associated with decreased hazard of LR or death and ____ location had significantly greater hazard of LR.
- LR: 51%
- Met: 39%
- oMST: 8mo
- MST sx: 11mo
- mandible 1 year: 71%
- histologically free margins
- calvarium
38
***Maxillary OSA has a MST of _____ with surgery alone. Rib OSA has a PFI of ____ and MST of _____ with surgery alone and a PFI of ____ and MST of ____ with surgery and chemotherapy. Scapular OSA treated with subtotal scapulectomy and chemotherapy has a DFI of ____ and MST of _______. OSA distal to antebrachiocarpal and tarsocrural joints has a MST of ______. Vertebral OSA treated with combination of surgery, RT, and chemotherapy has a MST of ______. Pelvic OSA treated with hemipelvectomy has a LR of ___%, metastatic rates of ____%, mean ST of ____, and 2 year survival rate of ____%.
Maxillary:
- MST sx alone: 5mo
Rib:
- PFI sx alone: 2mo
- PFI sx + chemo: 8mo
- MST sx alone: 3mo
- MST sx + chemo: 8mo
Scapular:
- DFI sx + chemo: 7mo
- MST sx+ chemo: 8mo
Distal to antebrachiocarpal or tarsocrural joints:
- MST: 16mo
Vertebral:
- MST sx + RT + chemo: 4mo
Pelvic:
- LR: 21%
- Met: 46%
- MST: 18mo
- 2 year: 35%
39
One report of extraskeletal OSA reported a MST of _____ with surgery alone and _____ with surgery + chemo. A larger study separated soft tissue and mammary OSA and reported a MST of non-mammary gland soft tissue OSA of _____ aft er surgery and a MST of ____ for mammary gland OSA after surgery. The major cause of death for non-mammary gland OSA was ______ (___%) and ______ for mammary OSA (___%).
- MST sx alone: 1mo
- MST sx + chemo: 5mo
- MST non mammary sx: 1mo
- MST mammary sx: 3mo
- cause of death non mammary: LR 92%
- cause of death mammary: pulmonary metastasis 63%
40
***What entails a good candidate for metastasectomy for OSA?
- tumor control >300 days (>10mo)
- < 3 pulmonary nodules
- Long doubling time (>30 days) with no new visible lesions within this time
- metastasis confined to lungs
41
In a study of 90 dogs with stage 3 OSA, oMST was ____. Dogs with bone metastasis have a MST of ____, lung metastasis ______, and other soft tissue metastasis ______.
MST:
- Bone met: 4mo
- lung met: 2mo
- soft tissue met: <1mo
42
Dogs with LN metastasis from OSA have a MST of _____.
2mo
43
In dogs with stage III OSA treated with metastasectomy, MST was ____ compared to dogs with no surgery at ____. In another study, dogs with metastasectomy had an oMST of _____ and a MST of ____ after surgery.
MST:
- Metastasectomy: 8mo
- No sx: 2mo
2nd paper
- oMST: 16mo
- MST after sx: 6mo
44
A pre-operative elevation of either total ALP > _____ or bone isoenzyme ALP > _____ is associated with shorter DFI and ST in dogs with OSA.
- total ALP > 110
- Bone isoenzyme ALP > 23
45
In dogs with OSA, high ezrin staining is associated with a shorter DFI of ____ compared to low stating at ____.
DFI
- High ezrin: 4mo
- Low ezrin: 6mo
46
What molecular, genetic, and immunologic indices have been associated with prognosis in canine OSA? There are 12 negative prognostic indices and one positive.
Negative prognosis:
- Ezrin (high tumor staining)
- RON (high tumor expression)
- Survivin (high tumor expression)
- VEGF (elevated serum levels)
- COX-2 (strong staining intensity)
- HSP60 (high)
- IGF-II (down regulation)
- alcohol dehydrogenase (down regulation)
- low CD8/Treg ratio
- lymphocytosis
- monocytosis
- CCR2 and CXCR2 (down regulation on monocytes)
Improved prognosis:
- Increased macrophage (CD204+) infiltrate
47
Dogs with OSA whose primary tumors express low survivin immunoreactivity scores achieved longer DFI of ____ compared with high scores at ____.
DFI
- low survivin: 11mo
- high survivin: 6mo
48
Dogs with OSA who have elevated serum VEGF concentrations have shorter DFI of ______ compared to lower concentrations at _____.
DFI:
- Lower 50th percentile: 12mo
- Higher 50th percentile: 5mo
49
***In dogs with OSA treated with amputation and DOX, COX-2 immunoreactivity score (intensity x percentage positive) was correlated with disease outcome. MST for strong intensity was _____ compared to MST for negative, poor, and moderate staining ranging from ____-____.
MST:
- Strong COX-2 intensity: 3mo
- Negative, poor, moderate: 12-14mo
50
In a study of 69 dogs with OSA treated with amputation and chemotherapy, baseline lymphocytosis of ______ and monocytosis of ______ were associated with shorter DFI.
- lymphocytosis >/= 1000 cells/uL
- monocytosis >/= 400 cells/uL
51
Dogs with OSA who had > ___% surface area infiltrate with CD204+ macrophages experienced significantly longer DFIs. TILs (CD3+ and FoxP3+) did NOT influence outcome in this study.
>4.7%
52
For LSS, suitable candidates are when the primary tumor affects ____% of the bone on radiographs and tumors in the _____ or _____ are best.
- <50%
- distal radius or ulna
53
The infection rate of LSS is ___-___%. For metal endoprosthesis, the infection rate has been reported to be ___%.
- 40-50%
- 78%
54
Metal endoprosthesis has an overall complication rate of ___% and LR of ____%.
- complication rate: 96%
- LR: 24%
55
For intraoperative RT, a single dose of ___ Gy is delivered to the tumor.
70Gy
56
The MST for appendicular OSA in dogs treated with exracorporeal intraoperative RT is ____.
10mo
57
In a retrospective study of 46 dogs with OSA receiving SRS (30Gy) and chemotherapy, MST was ____, pathologic fracture rate was ___% at a median time of ____. Acute skin toxicity occurred in ___% and late skin toxicity occurred in ___%. ________ was predictive for shortened time to fracture.
- MST: 10mo
- fracture: 63% at median 6mo
- Acute skin AE: 60%
- Late skin AE: 15%
- Involvement of subchondral bone
58
In 7 dogs with OSA that underwent surgical stabilization for fractures at the time of SRT and 11 dogs were stabilized beforehand, ___% developed major infection, resulting in amputation or euthanasia. Therefore, the authors did NOT recommend stabilization concurrently with SRT.
- 72%
59
In a study of accelerated palliative RT protocol using manual planning in dogs with OSA (2 daily fractions of 10Gy), rate of fracture post-RT was ___%.
36%
60
In a review of 220 LSSs, 1 year local recurrence rate was ____%, 1 year survival was ___%, local disease control was improved with _________, _____, and ______. ________ is predictive of outcome.
- 1 year LR: 76%
- 1 year survival: 60%
- pretreatment with moderate doses of RT, intra-arterial cisplatin, local implantation of cisplatin polymer
- % of tumor necrosis
61
In a surgery of owners of dogs undergoing partial mandibulectomy or maxillectomy, ___% were satisfied with outcome and ___% cited difficulty eating as a complication.
- 84%
- 44%
62
In a study of 48 dogs with OSA treated with amputation and 4 doses of carboplatin, overall DFI was _____, and ____ for dogs receiving all 4 doses. Overall MST was ____, and _____ for dogs receiving all 4 doses.
DFI:
- oDFI: 9mo
- DFI all 4: 11mo
MST:
- oMST: 11mo
- MST all 4: 13mo
63
DFI's for dogs with OSA receiving single-agent carboplatin after amputation range from ____-____ and MST's range from ____-____.
- DFI: 4-9mo
- MST: 7-11mo
64
In a study of 24 dogs with OSA treated with definitive surgery followed by combination chemotherapy consisting of carboplatin (175mg/m2) administered on day 1, followed by DOX (15mg/m2) on day 2, repeated every 21 days for 4 treatment cycles, mild GI toxicity occurred in ___%, DFI was ____, and MST was _____, which was not superior to historical single-agent studies.
- Mild GI toxicity: 50%
- DFI: 7mo
- MST: 8mo
65
In a study of 32 dogs with OSA treated with amputation or LSS and then adjuvant carboplatin followed 21 days later with DOX for up to 3 treatment cycles reported a DFI of ____, MST of _____, 1 year survival of ___%, and 2 year survival of ___%. In a second study of 50 dogs with amputation and alternating therapy (3 cycles), grade 3 and 4 hematologic toxicity occurred in ___%, grade 3 and 4 GI toxicity occurred in ___%, DFI was ____, and MST was _____.
- DFI: 8mo
- MST: 11mo
- 1 year: 48%
- 2 year: 18%
- Hematologic: 18%
- GI: 12%
- DFI: 8mo
- MST: 9mo
66
In a study of 33 dogs with OSA treated with adjuvant chemotherapy consisting of 2 doses of DOX given 2 weeks apart followed by 4 doses of carboplatin, DFI was _____ and MST was _____.
- DFI: 8mo
- MST: 8mo
67
In a study of 38 dogs with OSA treated with amputation and 3 doses of DOX followed by 3 doses of carboplatin, hospitalizations occurred in ___% and MST was ____.
- hosp: 5%
- MST: 11mo
68
***In a large retrospective study of 470 dogs with OSA compared carboplatin and DOX-based chemotherapy following amputation - 5 different protocols were compared (carboplatin x 4, carboplatin x 6, DOX q2 weeks, DOX q3 weeks, alternating carboplatin/DOX). Overall DFI was ____ and overall MST was ____. NO chemotherapy protocol proved superior, but a lower proportion of dogs treated with _____ experienced AEs (____% vs. ____%).
- DFI: 10mo
- MST: 10mo
- 6 cycles of carboplatin
- 48% vs. 60-75%
69
***In a randomized, open-label trial study of dogs with OSA comparing carboplatin x 6 to alternating carboplatin and DOX reported that dogs treated with carboplatin alone had a significantly longer DFI of _____ compared to dogs treated with alternating protocol at _____.
DFI:
- carbo alone: 14mo
- alternating: 5mo
70
In an initial clinical study of 27 dogs with OSA evaluated single-agent activity of L-MTP-PE after amputation. Dogs treated with L-MTP-PE had significantly longer DFI of ____ compared to placebo at _____. Dogs also had significantly prolonged STs with L-MTP-PE at _____ compared to placebo at ______. Two subsequent randomized, double-blind studies were conducted to determine effectiveness of combining L-MTP-PE with cisplatin. In one study, dogs treated with amputation followed by cisplatin x 4 were then randomized to receive L-MTP-PE or placebo. Dogs treated with L-MTP-PE had a significantly prolonged MST of ____ compared to placebo at ____. The second study evaluated concurrent cisplatin and L-MTP-PE and NO improvement in DFI or MST was observed compared to placebo.
1st study DFI:
- L-MTP-PE: 6mo
- placebo: 2mo
1st study MST:
- L-MTP-PE: 7mo
- placebo: 3mo
2nd study MST:
- L-MTP-PE: 14mo
- placebo: 10mo
71
In an open-label clinical trial, 52 dogs with OSA were treated with intra-tumoral adenoviral vector FasL and carboplatin followed by amputation for histologic evaluation. Dogs with greater inflammation and lymphocyte infiltration scores had improved outcome. MST for low score was ____ compared to high score at ____.
- MST low: 7mo
- MST high: 12mo
72
***An intravenous, highly attenuated recombinant Listeria monocytogenes expressing chimeric HER2/neu fusion protein (ADXS31-164), a.k.a. the Listeria vaccine, was given to dogs with OSA for 3 consecutive doses every 3 weeks after completion of conventional therapy. _____ was used as a biomarker to measure immune reaction. This biomarker did NOT correlate with outcomes, but the magnitude of ______, ______, and ______ elevations 24 hours after treatment were significantly greater in dogs with STs exceeding 18mo. Overall, the vaccine was well tolerated and DFI was ____ and MST was _____.
- T cell IFNg secretion
- WBC, neutrophil, and monocyte elevations
- DFI: 21mo
- MST: 32mo
73
In a randomized, prospective clinical trial of 126 dogs with OSA treated with amputation and 4 doses of carboplatin followed by either metronomic chemotherapy alone or metronomic chemotherapy and Palladia did NOT find statistical difference in DFI between groups. The DFI for control group was _____ compared to _____ for Palladia group, and the MST for control group was _____ compared to ____ for the Palladia group.
DFI:
- Control: 7mo
- MST: 8mo
MST:
- Control: 8mo
- MST: 11mo
74
***Concurent suramin and DOX for dogs with OSA reported a DFI of ____ and MST of ____.
DFI: 7mo
MST: 12mo
75
Concurrent carboplatin and gemcitabine for dogs with OSA following surgery report a DFI of _____ and MST of _____.
- DFI: 7mo
- MST: 9mo
76
Adjuvant cisplatin +/- DOX for dogs with OSA have reported DFI ranging from _____ - ____, and MST ranging from ____-____.
- DFI: 5mo - 8mo
- MST: 9mo - 12mo
77
Paclitaxel has a PR rate of ____% for dogs with measurable OSA.
PR 22%
78
In a retrospective study of 23 dogs with measurable OSA metastasis treated with Palladia, PR rate was ___% and SD was ____%. In a second retrospective study of 20 dogs, overall clinical benefit was ___% with a PFS of ____ and MST of _____. In a prospective study of 22 dogs, dogs were evaluated at 8 weeks for treatment response. SD was reported in ____% and PD was reported in ____%. PFS was ____ and MST was _____.
1st retrospective:
- PR: 4%
- SD: 44%
2nd retrospective:
- CB: 10%
- PFS: 1mo
- MST: 3mo
Prospective study:
- SD: 18%
- PD: 83%
- PFS: 2mo
- MST: 3mo
79
Alleviation of bone cancer pain with palliative RT occurs in ____-____% of dogs for a median of ____ - ____.
- 74-93%
- 2-4mo
80
***153-Sm is a radioisotope that undergoes ____ and _____ decay. When conjugated to EDTMP (bisphosphonate) in dogs, improved lameness scores were seen in ____% and improved activity levels were seen in ____%.
- gamma and beta
- improved lameness: 63%
- improved activity: 83%
81
_____ is an isotope that emits gamma photons and beta particles and may offer greater bone marrow sparing effects in comparison to 153-Sm due to lower soft tissue penetration of 670um.
177-Lutetium (177-Lu)
82
Aminobisphosphonates interfere with post-translational prenylation of small GTP- binding proteins -- ____, ____, and ____.
Ras, Rac, Rho
83
Pamidronate results in pain alleviation for >4 months in ___% of dogs, and zoledronate results in pain alleviation for >4 months in ____%.
- PAM: 28%
- ZOL: 50%
84
Zoledronate has ___ - fold greater anti-resorptive potency than pamidronate.
100-fold
85
_______ breed is at highest risk for chondrosarcoma.
Golden retrievers
86
***Chondrosarcoma occurs in flat bones at a rate of ____%. The most common location is _____.
- 61%
- nasal cavity
87
Dedifferentiated chondrosarcoma has a metastatic rate of ____%. A recent study reported a PFS of ____ and MST of ____.
- 63%
- PFS: 5mo
- MST: 8mo
88
The MST for nasal chondrosarcoma ranges from _____ - ____ with various treatments.
MST: 7-19mo
89
In more contemporary reports, rib chondrosarcoma has a MST of ____ - _____.
MST: 3 years - > 10.5 years
90
***Appendicular chondrosarcoma has a MST of ____ following amputation alone. Outcomes are dependent on histologic grade. For grade 1 tumors, MST is _____ and metastatic rate is ____%. For grade 2 tumors, MST is _____ and metastatic rate is ____%. For grade 3 tumors, MST is ____ and metastatic rate is ____%.
- oMST: 33mo
Grade 1:
- MST: 6 yrs
- met: 0%
Grade 2:
- MST: 2.7 yrs
- Met: 31%
Grade 3:
- MST 0.9 yrs
- met: 50%
91
Most dogs with HSA of the bone will develop metastasis within _____ from diagnosis.
within 6 months
92
In a study of 41 dogs with primary appendicular HSA treated with surgery and chemotherapy, oMST was _____. Predilection for the ____ limb was noted - especially the ____.
MST: 10mo
- pelvic, tibia
93
What are more common metastatic sites for primary bone FSA?
- heart, pericardium, skin, and bones (Rather than lungs)
94
In a report of 39 dogs with multilobular osteochondrosarcoma (MLO), LR occurred in ___% at a median of _____ and metastasis occurred in ____% at a median of _____. oMST was _____. Local recurrence and metastasis were predicted by _____ and ______.
- LR: 47% at median 27mo
- met: 56% at median 18mo
- oMST: 27mo
- tumor grade and ability to obtain histologically complete resection
95
What are the most common sites of bone metastasis?
pelvis, lumbar vertebrae, ribs, femur, humerus
96
A familial tendency in bone cysts have been identified in ______ and ______ breeds.
- Dobies and Old English Sheepdog
97
***What is the difference in IHC staining for periarticular HS and synovial cell sarcoma?
- PAHS: Vimentin+, CD18+, cytokeratin -
- SCS: Vimentin +, CD18-, cytokeratin +
98
The oMST of synovial cell sarcoma following amputation ranges from ____ - _____. Survival depends on histologic grade. The MST of grade 1 tumors ranges from ____-____, grade 2 tumors ____-_____, and grade 3 tumors _____.
- oMST: 15-32mo
- Grade 1: 12-48mo
- Grade 2: 5-36mo
- Grade 3: 6mo
99
The metastatic rate of synovial cell sarcoma is ___-___%.
8-32%
100
The metastatic rate for PAHS is up to ___%. Treatment with amputation alone results in MST of _____ compared to _____ for amputation + adjuvant CCNU.
- Met: 91%
- MST sx alone: 5mo
- MST sx + CCNU: 19mo
101
What is the IHC staining for myxoma sarcoma?
vimentin +, HSP+, +/-CD18, cytokeratin-
102
The most common location for myxoma sarcoma is the _____ and ____.
stifle and digits
103
The MST of myxoma sarcoma of the joint is _____ even with incomplete excision.
> 2 years
104
______ and ______ are the most common locations for axial OSA in cats.
skull (oral cavity) and pelvis
105
Appendicular OSA in cats occurs more often in the _____ limb with ____ and ____ being most common.
- pelvic
- distal femur and proximal tibia
106
Virtually all cats with MCE are _____ positive.
FeLV+
107
A feature of feline OSA on histology is the presence of ________.
multinucleate giant cells
108
___% of canine OSA is KIT+ and ___% of feline OSA is KIT+.
- canine: 79%
- feline: 0%
109
The most common sites for MCE in cats is the ______, _____, and _____.
scapula, mandible, vertebrae
110
The MST of appendicular OSA for cats is ____-____ with amputation alone and the metastatic rate is ___-___%.
- MST: 24-44mo
- Met: 5-10%
111
The MST of axial OSA in cats is ____.
MST 7 months
112
_____ is the second most common primary bone tumor in cats.
FSA
113
A recent retrospective study evaluated the effects of pain severity and periperative analgesia on outcome in dogs with OSA. Pain severity had NO effect, but peri-operative analgesia did. The MST for dogs who received high-intensity peri-operative analgesia was significantly longer (_____) than those who received low-intensity analgesia.
MST:
- high intensity: 13mo
- low intensity: 8mo
114
The ORR of ifosfamide salvage therapy for metastatic canine OSA is ___% with a MST of ____.
- ORR: 12%
- MST: 3mo
115
The impact of radiation dose and pre-treatment pain levels on survival in dogs undergoing RT +/- adjuvant chemotherapy for OSA was recently evaluated. In dogs receiving combinations of both chemotherapy and radiotherapy, survival was significantly longer with SRT at ____ compared to conventionally hypofractionated radiotherapy at ____. _____ and _____ were significantly associated with improved survival in dogs treated with RT and chemotherapy.
MST:
- SRT + chemo: 12mo
- CHRT + chemo: 5mo
- low pain score and high RT dose significantly improved survival
116
_____ and ____ were the DLT of Sm-153-DOTP in a phase 1 evaluation of dogs with OSA. The MTD was _____.
- DLT: neutropenia and thrombocytopenia
- MTD: 1.75mCi/kg
117
Combination therapy of Losartan and Palladia for metastatic OSA in dogs results in a clinical benefit rate of ___%. Losartan inhibits the _________, which inhibits _______ recruitment. A ____ - fold higher dose than typical anti-hypertensive dosing is needed for blockage.
- CB: 50%
- CCL2-CCR2 axis
- monocyte
- 10 fold
118
The most sensitive IHC marker for distinguishing OSA from other primary bone tumors is _____ at 100% and the most specific marker is _____ at 78%. A combination of these markers elicits a sensitivity of ___% and specificity of ___%.
- sensitive: ALP
- specific: runx2
- Se: 87%, Sp: 85%
119
_____ is an IHC marker that can differentiate osteogenic hemangiosarcoma from telangiectatic osteosarcoma in dogs. ____% were reclassified based on this staining, mostly from an original diagnosis of tOSA to HSA.
VIII-RAg/vWF
20%
120
A study evaluated the incidence of pulmonary metastasis on thoracic radiographs versus CT. What percentage of dogs with osteosarcoma had evidence on the respective modalities?
- TXR: 5%
- CT: 28%
121
What antibiotic has been shown to reduce OSA cell viability in vitro?
Enrofloxacin
122
What was the median duration of pain control in a study of dogs with appendicular OSA that were treated with two 10Gy fractions delivered over two consecutive days?
~3mo
123
***The safety and efficacy of an accelerated coarsely fractionated RT protocol (10Gy x2 over 2 consecutive days) for treatment of canine appendicular OSA in 14 dogs was assessed. Most patients received pamidronate and NSAID and most patients underwent carboplatin following the RT protocol. Within 14 days, ___% of patients had pain control for a duration of ____ with ___% developing fracture.
- 93% pain control
- duration of 3mo (80 days)
- fracture rate: 35%
124
Results of a retrospective study indicated that dogs with an initial diagnosis of osteosarcoma that lived > 1 year had a median survival time beyond the initial year of approximately ______. What was noted to have improved prognosis?
- MST 8mo beyond 1 year
- surgery site infection
125
In a retrospective study of 39 dogs with primary chest wall tumors treated with curative-intent therapy, rib OSA was the most common tumor with a DFI of _____ and MST of _____. Increased ALP was associated with worse outcome (______ vs. _____). Metastasis occurred in ___%. Chondroblastic OSA had an improved MST of ______ compared to osteoblastic at ______. 6-month survival rate was ___% and 12 month survival rate was ____%. The DFI for rib chondrosarcoma was _____ and the MST was _____. Metastasis and LR occurred in ____%. 1-year survival was ___% and 2-year survival was ____%.
OSA
- DFI: 5mo
- MST: 10mo
- MST elevated ALP: 7mo
- MST normal ALP: 23mo
- metastasis 75%
- MST chondroblastic: >6 years
- MST osteoblastic: 10mo
- 6 month survival: 68%
- 12 month survival: 32%
CSA
- DFI: 11mo
- MST: not reached at >3.5 years
- met/LR: 17%
- 1 year survival: 75%
- 2 year survival: 50%
126
In a retrospective study of 50 dogs with mandibular OSA, metastasis occurred in ____% at a median of _____. The overall MST was _____. On univariate analysis, a MI of ____ was associated with decreased outcome. Grade also influenced outcome. Dogs with grade II/III tumors had a 1 year metastasis-free rate of ___% and 1 year survival rate of ____%. Dogs with grade I tumors had a metastasis-free rate of ___% and 1 year survival rate of ___%. On multivariate analysis, grade and adjuvant chemotherapy were associated with outcome. Dogs not treated with chemotherapy had a ___x greater HR of metastatic disease than dogs treated with chemotherapy. MFI for dogs treated with chemotherapy was _____ compared to _____ for those not treated with chemotherapy.
- metastasis: 60% at median 21mo
- oMST: 18mo
Univariate:
- MI >40/10hpf
- Grade II/III 1 year MF rate: 24%
- Grade II/III 1 year survival: 24%
- Grade I 1 year MF rate: 72%
- Grade I 1 year survival: 77%
Multivariate:
2.6x
- MFI chemo: 31mo
- MFI no chemo: 17mo
127
In a study evaluating 30 dogs with ulnar OSA, _______ was the most common breed. DFI was _____ and MST was _____, improved compared to prior studies. On multivariate analysis, tOSA subtype was associated with worse ST of ____. Dogs with tOSA were ____x more likely to die from disease. Distant metastasis occurred in ____%.
- Rottie
- DFI: 15mo
- MST: 15mo
- MST tOSA: 7mo
- 6.99x
- 50%
128
In a study of 26 dogs with OSA who underwent ulnar rollover transposition LSS, ____% developed complications. DFI was _____ and MST was _____.
- 77%
- DFI: 8mo
- MST: 9mo
