The diagnostic yield of preoperative screening for oral cancer in dogs over 15 years, part 2: distant screening

Stephanie Goldschmidt Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Maria Soltero-Rivera Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Adrian Quiroz College of Agriculture and Environmental Sciences, University of California-Davis, Davis, CA

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Kristen Wong College of Agriculture and Environmental Sciences, University of California-Davis, Davis, CA

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Robert Rebhun Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Allison Zwingenberger Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Yunyi Ren Department of Biostatistics, Epidemiology, and Research Design, Clinical and Translation Science Center, University of California-Davis, Davis, CA

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Sandra Taylor Department of Biostatistics, Epidemiology, and Research Design, Clinical and Translation Science Center, University of California-Davis, Davis, CA

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Boaz Arzi Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Abstract

OBJECTIVE

Determine diagnostic yield of chest, abdomen, and 4-site screening to diagnose metastatic disease and secondary diseases of prognostic significance in dogs with oral cancer.

SAMPLE

Medical records from 381 dogs with histologically confirmed oral tumors that underwent preoperative screening were retrospectively reviewed.

RESULTS

Thoracic metastasis was diagnosed in 4.9% (0.9% odontogenic, 6.5% nonodontogenic) of oral tumors. Oral malignant melanoma and multilobular osteochondrosarcoma were most at risk. Abdominal metastasis was diagnosed in 2% of oral tumors (0% odontogenic, 3.1% nonodontogenic) and cytologically confirmed in 2 cases (0.6% [2/295)] of all abdominal ultrasounds (AUS) 5.5% [2/36] of all AUS that had cytology). Both cases had oral malignant melanoma. Incidental disease was diagnosed in 53.1% and 81.3% of thoracic and abdominal screenings, respectively. Major findings were more common in AUS (7.8%) compared to thoracic screening (1.9%). The prevalence of incidental findings was similar for odontogenic and nonodontogenic tumors. Both metastasis and major findings were diagnosed more commonly with thoracic CT compared to radiographs. Metastasis or a major finding of prognostic significance was diagnosed in at least 1 test in 27.8% of patients that had head CT, lymph node cytology, thoracic screening, and AUS (n = 115).

CLINICAL RELEVANCE

Major incidental findings were more commonly detected with AUS and were diagnosed in 1 in every 12 patients. However, metastatic disease was most commonly detected with thoracic screening. When all 4 screening tests are performed, there is an approximately 1 in 4 chance of diagnosing metastasis or major significant disease regardless of tumor type.

Abstract

OBJECTIVE

Determine diagnostic yield of chest, abdomen, and 4-site screening to diagnose metastatic disease and secondary diseases of prognostic significance in dogs with oral cancer.

SAMPLE

Medical records from 381 dogs with histologically confirmed oral tumors that underwent preoperative screening were retrospectively reviewed.

RESULTS

Thoracic metastasis was diagnosed in 4.9% (0.9% odontogenic, 6.5% nonodontogenic) of oral tumors. Oral malignant melanoma and multilobular osteochondrosarcoma were most at risk. Abdominal metastasis was diagnosed in 2% of oral tumors (0% odontogenic, 3.1% nonodontogenic) and cytologically confirmed in 2 cases (0.6% [2/295)] of all abdominal ultrasounds (AUS) 5.5% [2/36] of all AUS that had cytology). Both cases had oral malignant melanoma. Incidental disease was diagnosed in 53.1% and 81.3% of thoracic and abdominal screenings, respectively. Major findings were more common in AUS (7.8%) compared to thoracic screening (1.9%). The prevalence of incidental findings was similar for odontogenic and nonodontogenic tumors. Both metastasis and major findings were diagnosed more commonly with thoracic CT compared to radiographs. Metastasis or a major finding of prognostic significance was diagnosed in at least 1 test in 27.8% of patients that had head CT, lymph node cytology, thoracic screening, and AUS (n = 115).

CLINICAL RELEVANCE

Major incidental findings were more commonly detected with AUS and were diagnosed in 1 in every 12 patients. However, metastatic disease was most commonly detected with thoracic screening. When all 4 screening tests are performed, there is an approximately 1 in 4 chance of diagnosing metastasis or major significant disease regardless of tumor type.

Supplementary Materials

    • Supplementary Table S1 (PDF 185 KB)

Contributor Notes

Corresponding author: Dr. Goldschmidt (sgoldschmidt@ucdavis.edu)
  • 1.

    Congiusta M, Lawrence J, Rendahl A, Goldschmidt S. Variability in recommendations for cervical lymph node pathology for staging of canine oral neoplasia: a survey study. Front Vet Sci. 2020;7:506. doi:10.3389/fvets.2020.00506

    • Search Google Scholar
    • Export Citation
  • 2.

    Arzi B, Verstraete F. Clinical staging and biopsy of maxillofacial tumors. In: Verstarete F, Lommer M, Arzi B, eds. Oral and Maxillofacial Surgery in Dogs and Cats. 2nd ed. Elsevier; 2020:415422.

    • Search Google Scholar
    • Export Citation
  • 3.

    Gibson M. Head and neck cancer. HemOnc.org LLC. Accessed July 19, 2023. https://hemonc.org/wiki/Head_and_neck_cancer

  • 4.

    Pflister D, Spencer S, Adkins D, et al. NCNN guidelines, head and neck cancer. Version 1.2023 – December 20, 2022. National Comprehensive Cancer Network; 2023.

  • 5.

    Liptak JM. Cancer of the gastrointestinal tract: oral tumors. In: Vail, DM, Thamm DM, Liptak JM, eds. Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed. Elsevier; 2019:432448.

    • Search Google Scholar
    • Export Citation
  • 6.

    Soukup J, Lewis J. Oral and maxillofacial tumors, cysts, and tumor-like lesions. In: Lobprise H, Dodd J, eds. Wiggs's Veterinary Dentistry: Principles and Practice. 2nd ed. Wiley Blackwell; 2019:131153.

    • Search Google Scholar
    • Export Citation
  • 7.

    Sacornrattana O, Dervisis NG, McNiel EA. Abdominal ultrasonographic findings at diagnosis of osteosarcoma in dogs and association with treatment outcome. Vet Comp Oncol. 2013;11(3):199207. doi:10.1111/j.1476-5829.2011.00312.x

    • Search Google Scholar
    • Export Citation
  • 8.

    Tong NM, Zwingenberger AL, Blair WH, Taylor SL, Chen RX, Sturges BK. Effect of screening abdominal ultrasound examination on the decision to pursue advanced diagnostic tests and treatment in dogs with neurologic disease. J Vet Intern Med. 2015;29(3):893899. doi:10.1111/jvim.12602

    • Search Google Scholar
    • Export Citation
  • 9.

    Bigio Marcello A, Gieger TL, Jiménez DA, Granger LA. Detection of comorbidities and synchronous primary tumours via thoracic radiography and abdominal ultrasonography and their influence on treatment outcome in dogs with soft tissue sarcomas, primary brain tumours and intranasal tumours. Vet Comp Oncol. 2015;13(4):433442. doi:10.1111/vco.12063

    • Search Google Scholar
    • Export Citation
  • 10.

    Bryson GL, Wyand A, Bragg PR. Preoperative testing is inconsistent with published guidelines and rarely changes management. Can J Anaesth. 2006;53(3):236241. doi:10.1007/BF03022208

    • Search Google Scholar
    • Export Citation
  • 11.

    Owen LN. TNM Classification of Tumors in Domestic Animals. WHO; 1980.

  • 12.

    Mattoon J, Nyland T. Small Animal Diagnostic Ultrasound. 3rd ed. Saunders; 2015.

  • 13.

    Straw RC, LeCouteur RA, Powers BE, Withrow SJ. Multilobular osteochondrosarcoma of the canine skull: 16 cases (1978–1988). J Am Vet Med Assoc. 1989;195(12):17641769.

    • Search Google Scholar
    • Export Citation
  • 14.

    Dernell WS, Straw RC, Cooper MF, Powers BE, LaRue SM, Withrow SJ. Multilobular osteochondrosarcoma in 39 dogs: 1979–1993. J Am Anim Hosp Assoc. 1998;34(1):1118. doi:10.5326/15473317-34-1-11

    • Search Google Scholar
    • Export Citation
  • 15.

    Leonardi L, Carrano A, Stoppini L, Floris M. Multilobular tumor of the zygomatic bone in a dog. Open Vet J. 2014;4(1):911.

  • 16.

    Nemanic S, London CA, Wisner ER. Comparison of thoracic radiographs and single breath-hold helical CT for detection of pulmonary nodules in dogs with metastatic neoplasia. J Vet Intern Med. 2006;20(3):508515. doi:10.1892/0891-6640(2006)20[508:cotras]2.0.co

    • Search Google Scholar
    • Export Citation
  • 17.

    Armbrust LJ, Biller DS, Bamford A, Chun R, Garrett LD, Sanderson MW. Comparison of three-view thoracic radiography and computed tomography for detection of pulmonary nodules in dogs with neoplasia. J Am Vet Med Assoc. 2012;240(9):10881094. doi:10.2460/javma.240.9.108877

    • Search Google Scholar
    • Export Citation
  • 18.

    Lexander K, Joly H, Blond L, et al. A comparison of computed tomography, computed radiography, and film-screen radiography for the detection of canine pulmonary nodules. Vet Radiol Ultrasound. 2012;53(3):258265. doi:10.1111/j.1740-8261.2012.01924.x

    • Search Google Scholar
    • Export Citation
  • 19.

    Eberle N, Fork M, Von Babo V, Nolte I, Simon D. Comparison of examination of thoracic radiographs and thoracic computed tomography in dogs with appendicular osteosarcoma. Vet Comp Oncol. 2011;9(2):131140. doi:10.1111/j.1476-5829.2010.00241.x

    • Search Google Scholar
    • Export Citation
  • 20.

    Wright JM, Vered M. Update from the 4th edition of the World Health Organization classification of head and neck tumours: odontogenic and maxillofacial bone tumors. Head Neck Pathol. 2017;11(1):6877. 10.1007/s12105-017-0794-1

    • Search Google Scholar
    • Export Citation
  • 21.

    Blackford Winders C, Bell CM, Goldschmidt S. Case report: amyloid-producing odontogenic tumor with pulmonary metastasis in a Spinone Italiano-proof of malignant potential. Front Vet Sci. 2020;7:576376. doi:10.3389/fvets.2020.576376

    • Search Google Scholar
    • Export Citation
  • 22.

    Dank G, Rassnkic K, Sokolovsky Y, et al. Use of adjuvant carboplatin for treatment of dogs with oral malignant melanoma following surgical excision. Vet Comp Oncol. 2014;12(1):7884. doi:10.1111/j.1476-5829.2012.00338.x

    • Search Google Scholar
    • Export Citation
  • 23.

    Brockley LK, Cooper MA, Bennett PF. Malignant melanoma in 63 dogs (2001–2011): the effect of carboplatin chemotherapy on survival. NZ Vet J. 2013;61(1):2531. doi:10.1080/00480169.2012.699433

    • Search Google Scholar
    • Export Citation
  • 24.

    Boston SE, Lu X, Culp WT, et al. Efficacy of systemic adjuvant therapies administered to dogs after excision of oral malignant melanomas: 151 cases (2001–2012). J Am Vet Med Assoc. 2014;245(4):401407. doi:10.2460/javma.245.4.401

    • Search Google Scholar
    • Export Citation
  • 25.

    Tuohy JL, Selmic LE, Worley DR, Ehrhart NP, Withrow SJ. Outcome following curative-intent surgery for oral melanoma in dogs: 70 cases (1998–2011). J Am Vet Med Assoc. 2014;245(11):126671173. doi:10.2460/javma.245.11.1266

    • Search Google Scholar
    • Export Citation
  • 26.

    Iacobino D, Camerino M, Riccardo F, et al. Difference in outcome between curative intent vs marginal excision as a first treatment in dogs with oral malignant melanoma and the impact of adjuvant CSPG4-DNA electrovaccination: a retrospective study on 155 cases. Vet Comp Oncol. 2021;19(4):651660. doi:10.1111/vco.12690

    • Search Google Scholar
    • Export Citation
  • 27.

    Piras LA, Riccardo F, Iussich S, et al. Prolongation of survival of dogs with oral malignant melanoma treated by en bloc surgical resection and adjuvant CSPG4-antigen electrovaccination. Vet Comp Oncol. 2017;15(3):9961013.

    • Search Google Scholar
    • Export Citation
  • 28.

    Turek M, LaDue T, Looper J, et al. Multimodality treatment including ONCEPT for canine oral melanoma: a retrospective analysis of 131 dogs. Vet Radiol Ultrasound. 2020;61(4):471480. doi:10.1111/vru.12860

    • Search Google Scholar
    • Export Citation
  • 29.

    Sarowitz BN, Davis GJ, Kim S. Outcome and prognostic factors following curative-intent surgery for oral tumours in dogs: 234 cases (2004 to 2014). J Small Anim Pract. 2017;58(3):146153. doi:10.1111/jsap.12624

    • Search Google Scholar
    • Export Citation

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