Panel: Innovations in AGASACA Care: A Multidisciplinary Approach to Diagnostics and Therapies

Apocrine gland anal sac adenocarcinoma (AGASACA) in dogs presents a unique clinical challenge due to its anatomical constraints, locally invasive behavior, and high metastatic potential. These complexities necessitate a thoughtful, coordinated approach across surgical, radiation, and medical oncology when evaluating disease stage and selecting treatment strategies. 
This panel will explore recent innovations and evolving strategies in the multidisciplinary care of dogs diagnosed with AGASACA, with a focus on advanced imaging and surgical, radiation and systemic therapies. 
The diagnostic imaging portion will highlight the role of computed tomography (CT) and sentinel lymph node mapping using CT lymphangiography to improve staging accuracy and guide therapeutic planning. 
The surgical segment will focus on evolving strategies for iliosacral lymphadenectomy, including open and minimally invasive techniques. It will also address surgical decision-making in the context of challenging advanced-stage disease.
The radiation therapy portion will discuss both definitive and palliative treatment protocols. It will emphasize conformal techniques such as stereotactic radiation therapy and intensity-modulated radiation therapy in managing unresectable disease, treating residual microscopic disease, and relieving clinical signs associated with large metastatic lymph nodes or paraneoplastic hypercalcemia.

Medical management will cover current evidence for chemotherapy and targeted therapies, as well as recent findings on immunologic markers, highlighting their therapeutic relevance and potential to shape future treatment paradigms. 
Through case-based discussion and highlighting clinical trials, this session will provide practical and clinically relevant insights and showcase how integrated multidisciplinary approaches are improving patient care and shaping the future of AGASACA management.