This discussion will review what I feel to be the top 10 clinically relevant advances in veterinary oncology over the last
~ 10 years. Topic #10 will be a "stinker topic" and will briefly summarize advances that have really NOT been advances. I
will post the abstracts from these publications and then summarize them in the lecture. It is important to point out that
major advances in surgical and radiation oncology have occurred over the last 30 years (e.g. hemipelvectomy, limb-sparing,
nasal planectomy, scapulectomy, etc.) but they will not be discussed here.
1. Six month chemo for lymphoma
The purpose of this study was to compare a maintenance-free chemotherapy protocol based on CHOP (H from hydroxydaunorubicin
= doxorubicin, O from Oncovin = vincristine) to a similar protocol with a maintenance phase for the treatment of canine lymphoma.
Fifty-three dogs with multicentric lymphoma were treated with a 6-month modified version of the University of Wisconsin (UW)-Madison
chemotherapy protocol (UW-25). Disease-free interval (DFI) and survival were compared to a historical control group of 55
dogs treated with a similar protocol with a prolonged maintenance phase. Remission rate for the study dogs was 94.2% (complete
remission = 92.3%, partial remission = 1.9%). DFI and survival between the 2 groups did not differ significantly, with median
DFI and survival of the study dogs equal to 282 and 397 days compared to 220 and 303 days for the control dogs (P = .2835
and .3365, respectively). Univariate analysis identified substage b (P = .0087), German Shepherd breed (P = .0199), and body
weight > 18 kg (P = .0016) as significant for worse survival. Longer survival was associated with thrombocytopenia (P = .0436).
Multivariate analysis revealed that substage (P = .0388) and weight (P = .0125) retained significance for DFI, whereas substage
(P = .0093), thrombocytopenia (P = .0150), and weight (P = 0 .0050) retained significance for survival. Overall, the protocol
was well tolerated by the dogs, with 41.5% (22/53) requiring a treatment delay or dose modification, but only 9.4% (5/53)
needing hospitalization. The 6-month chemotherapy protocol based on CHOP with no maintenance phase provides similar DFI and
survival times when compared to a similar protocol with a prolonged maintenance phase.
2. FNA of non-palpable LN's.
To determine sensitivity and specificity of physical examination, fine-needle aspiration, and needle core biopsy of the regional
lymph nodes for evidence of metastasis in dogs and cats with solid tumors. DESIGN: Case series. ANIMALS: 37 dogs and 7 cats.
PROCEDURE: Regional lymph nodes were evaluated by means of physical examination (palpation), fine-needle aspiration, and needle
core biopsy. Results were compared with results of histologic examination of the entire lymph node, the current standard.
RESULTS: Tumors included 18 sarcomas, 16 carcinomas, 7 mast cell tumors, and 3 other tumors. Carcinomas were more likely to
have metastasized to the regional lymph node (7/16 animals) than were sarcomas (2/18). Sensitivity and specificity of physical
examination were 60 and 72%, respectively. Sensitivity and specificity of cytologic examination of fine-needle aspirates were
100 and 96%, respectively. Sensitivity and specificity of histologic examination of needle core biopsy specimens were 64 and
96%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that fine-needle aspiration may be a sensitive and
specific method of evaluating the regional lymph nodes in dogs and cats with solid tumors, because results correlated well
with results of histologic examination of the entire lymph node. Physical examination alone was not a reliable method and
should not be used to decide whether to aspirate or biopsy the regional lymph nodes.