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Karalus W, Subharat S, Orbell G, Vaatstra B, Munday JS. Equine sarcoids: A clinicopathologic study of 49 cases, with mitotic count and clinical type predictive of recurrence. Vet Pathol 2024; 61:357-365. [PMID: 37937724 PMCID: PMC11067406 DOI: 10.1177/03009858231209408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Sarcoids are common mesenchymal neoplasms of horses. Although there are few studies in which sarcoids have been followed over a long period of time, sarcoids are considered locally invasive and have been reported to frequently recur following surgical excision. Currently, no histological features have been identified to predict which sarcoids will recur after excision. The present study comprised 49 sarcoids for which histology sections were available and in which the recurrence status of the case was known. Each sarcoid was excised from a different horse. Overall, 12 of the 49 (24%) sarcoids recurred after surgical excision. Mitotic count (MC), cellularity, necrosis, nuclear pleomorphism, and inflammation of the sarcoids were evaluated histologically. Of these, MC correlated with recurrence. Four of 5 (80%) sarcoids with an MC ≥ 20 in 2.37 mm2 recurred, which was a significantly higher recurrence rate than that of sarcoids with an MC < 20, 8 of 44 cases recurred (18%), P = .0051. Clinical type was also found to correlate with recurrence. Three of 4 (75%) fibroblastic types recurred, which was a significantly higher recurrence rate than that of sarcoids with other clinical types, 9 of 45 cases (18%), P < .001. In addition, univariate Cox regression analysis confirmed fibroblastic type and MC ≥ 20 as significant predictors for recurrence (P = .016 and P = .005, respectively). To the authors' knowledge, this is the first large study examining recurrence rates in sarcoids, and the first time that histological features have been correlated with recurrence.
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Affiliation(s)
| | | | - Geoff Orbell
- Gribbles Veterinary, Palmerston North, New Zealand
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Offer KS, Dixon CE, Sutton DGM. Treatment of equine sarcoids: A systematic review. Equine Vet J 2024; 56:12-25. [PMID: 36917551 DOI: 10.1111/evj.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/09/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND The sarcoid is the most common equine cutaneous neoplasm. Evidence-based treatment of this condition is often lacking, and selection of treatment modality based on clinical experience or anecdotal evidence. OBJECTIVES To assess the quality of the currently available best evidence regarding the treatment of the equine sarcoid. STUDY DESIGN Systematic review. METHODS In compliance with PRISMA guidelines, literature searches were performed in PUBMED, Web of Science, CAB Abstracts, EMBASE (Ovid) and Scopus in April 2021. Included papers were required to describe an interventional study examining sarcoid treatment strategy, of level 4 evidence or greater. The case definition required confirmation of at least some included lesions on histopathology, and a minimum of 6 months of follow-up was required on treated cases. Studies were assessed by two independent reviewers (KO, CD). Data extraction was performed manually, followed by risk of bias assessment. Methodological quality was assessed using the GRADE system. RESULTS In total, 10 studies were included in the review. Case definition was confirmed via histopathology in all included lesions in 60% of papers. Time to follow-up was variably reported. Overall risk of bias ranged from 'some concerns' to 'critical'. Reported sarcoid regression rate ranged from 28% to 100% on an individual sarcoid level, and 9%-100% on a whole horse level. Transient local inflammation was reported following most treatment strategies, with further adverse events reported infrequently. MAIN LIMITATIONS Review methodology excluded a large proportion of available literature regarding the equine sarcoid. Significant heterogeneity between included studies prevented quantitative synthesis and most included papers were at significant risk of bias, indirectness, and imprecision. CONCLUSIONS There is insufficient evidence currently available to recommend one sarcoid treatment over another. There is an urgent need for sufficiently powered, randomised, placebo-controlled trials in order to allow more definitive comparison of the efficacy of different treatment strategies.
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Affiliation(s)
- Katie S Offer
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Claire E Dixon
- Tufts Equine Center at the Hospital for Large Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - David G M Sutton
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Hollis AR. Management of equine sarcoids. Vet J 2023; 291:105926. [PMID: 36334801 DOI: 10.1016/j.tvjl.2022.105926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/19/2022] [Accepted: 10/29/2022] [Indexed: 12/12/2022]
Abstract
Sarcoids are the most common cutaneous neoplasm of the horse, arising as a result of a neoplastic proliferation of fibroblasts associated with infection with bovine papillomavirus, most notably types 1 and 2. Although they do not metastasise, they are locally invasive and aggressive, and can lead to important welfare concerns, interfere with tack and therefore impede athleticism, and undoubtedly lead to a reduction in the value of affected horses. This review discusses the evidence behind the most commonly used treatments for equine sarcoids. The most commonly used treatments are discussed. No one treatment is universally successful, and there are many treatments with varying level of scientific evaluation and reported success rates.
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Affiliation(s)
- Anna R Hollis
- Cambridge Equine Hospital, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
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Unger L, Jagannathan V, Pacholewska A, Leeb T, Gerber V. Differences in miRNA differential expression in whole blood between horses with sarcoid regression and progression. J Vet Intern Med 2018; 33:241-250. [PMID: 30506726 PMCID: PMC6335546 DOI: 10.1111/jvim.15375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background Currently no methods are available to predict the clinical outcome of individual horses with equine sarcoid (ES) disease. Objective To investigate if whole blood microRNA (miRNA) profiles can predict the long‐term development of ES tumors. Animals Five horses with regression and 5 with progression of ES lesions monitored over 5‐7 years and 5 control horses free of ES for at least 5 years. Methods For this cohort study, RNA extracted from whole blood samples from the regression, progression, and control groups was used for high throughput sequencing. Known and novel miRNAs were identified using miRDeep2 and differential expression analysis was carried out by the DESeq2 algorithm. Target gene and pathway prediction as well as enrichment and network analyses were conducted using TarBase, mirPath, and metaCore from GeneGo. Results Fourteen miRNAs were differentially expressed between regression and progression groups after accounting for the control condition: 4 miRNAs (28.6%) were upregulated and 10 miRNAs (71.4%) were downregulated with >2‐fold change. Seven of the 10 downregulated miRNAs are encoded in an miRNA cluster on equine chromosome 24, homologous to the well‐known 14q32 cluster in humans. Their target genes show enrichment for pathways involved in viral carcinogenesis. Conclusions and Clinical Importance Whole blood miRNA expression profiles are associated with long‐term ES growth in horses and warrant further validation as prognostic biomarkers in a larger study cohort. Deregulation of miRNAs on equine chromosome 24 might represent a trigger for ES development.
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Affiliation(s)
- Lucia Unger
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Vidhya Jagannathan
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Alicja Pacholewska
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.,Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Tosso Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Vinzenz Gerber
- Swiss Institute of Equine Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Haspeslagh M, Vlaminck LEM, Martens AM. Treatment of sarcoids in equids: 230 cases (2008-2013). J Am Vet Med Assoc 2017; 249:311-8. [PMID: 27439349 DOI: 10.2460/javma.249.3.311] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate outcomes following treatment of sarcoids in equids and to identify risk factors for treatment failure in these patients. DESIGN Retrospective case series. ANIMALS 230 equids with 614 sarcoids. PROCEDURES Records were searched to identify equids treated for ≥ 1 sarcoid between 2008 and 2013. A standardized protocol was used to determine treatment choice (electrosurgery, electrosurgery with intralesional placement of cisplatin-containing beads, topical administration of imiquimod or acyclovir, cryosurgery, bacillus Calmette-Guerin vaccine injection, or intralesional injection of platinum-containing drugs). Data regarding animal, tumor, treatment, and outcome variables were collected. Complete tumor regression without recurrence for ≥ 6 months was considered a successful outcome. Success rates were calculated; binary logistic regression analysis was used to identify risk factors for treatment failure and to compare effects of the 2 topical treatments. A χ(2) test was used to compare effects of the number of Bacillus Calmette-Guerin vaccine or cisplatin-containing drug injections on outcome. RESULTS The overall success rate was 460 of 614 (74.9%). Electrosurgical excision resulted in the highest treatment success rate (277/319 [86.8%]); odds of treatment failure were significantly greater for intralesional injection of platinum-containing drugs, cryosurgery, and topical acyclovir treatment. Odds of treatment failure were also significantly greater for sarcoids on equids with multiple tumors than for solitary lesions, and significantly lower for sarcoids on equids that received concurrent immunostimulating treatment for another sarcoid than for those on patients that did not receive such treatment. CONCLUSIONS AND CLINICAL RELEVANCE Selection bias for treatments was inherent to the study design; however, results may assist clinicians in selecting treatments and in determining prognosis for equids with sarcoids treated according to the described methods.
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Compston PC, Turner T, Wylie CE, Payne RJ. Laser surgery as a treatment for histologically confirmed sarcoids in the horse. Equine Vet J 2015; 48:451-6. [DOI: 10.1111/evj.12456] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 04/30/2015] [Indexed: 01/18/2023]
Affiliation(s)
| | - T. Turner
- Royal (Dick) School of Veterinary Studies; Easter Bush Veterinary Centre; Edinburgh UK
| | - C. E. Wylie
- Rossdales Equine Hospital; Newmarket Suffolk UK
| | - R. J. Payne
- Rossdales Equine Hospital; Newmarket Suffolk UK
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Mählmann K, Hamza E, Marti E, Dolf G, Klukowska J, Gerber V, Koch C. Increased FOXP3 expression in tumour-associated tissues of horses affected with equine sarcoid disease. Vet J 2014; 202:516-21. [DOI: 10.1016/j.tvjl.2014.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 09/01/2014] [Accepted: 09/03/2014] [Indexed: 12/19/2022]
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Taylor SD, Toth B, Baseler LJ, Charney VA, Miller MA. Lack of Correlation Between Papillomaviral DNA in Surgical Margins and Recurrence of Equine Sarcoids. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2013.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE To document the efficacy of intratumoural injections of 5-fluorouracil for the treatment of equine sarcoids. DESIGN A prospective study that included 13 horses and one donkey. PROCEDURE Sarcoids were confirmed by histological examination and treated with intratumoural 5-fluorouracil every 2 weeks. If the sarcoids did not resolve after seven treatments, treatment was considered a failure. All cases were re-examined 6 months after treatment commenced and owners were telephoned 3 years after commencement of treatment to report on tumour recurrence. Outcome comparisons were performed to determine the effect of previous treatment, tumour size and tumour location on sarcoid resolution. The efficacy of intratumoural 5-fluorouracil was compared with other previously documented treatments of equine sarcoids. RESULTS Sarcoids smaller than 13.5 cm3 were significantly (P = 0.032) more likely to resolve with treatment than larger sarcoids. Sarcoids that were not responsive to previous therapies were significantly (P = 0.007) more likely to recur after 3 years than sarcoids that had not been treated prior to this study. In this study, there were similar rates of resolution in cases with mutiple tumours (66.6%) when compared to cases with single tumours (60%). The numbers in this study were too small to properly evaluate the effect of tumour location on the success of treatment. Intratumoural 5-fluorouracil appeared to have resolved sarcoids in 9 of 13 cases (61.5%) as determined by follow up conversation with the owners 3 years after the initial treatment. CONCLUSION The use of intratumoural 5-fluorouracil compares favourably with other treatment modalities for sarcoids, with a long term successful resolution rate of 61.5%. Owners should be warned that resistant sarcoids and sarcoids larger than 13.5 cm3 have a poorer prognosis for resolution and more aggressive therapeutic options should be considered.
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Affiliation(s)
- A A Stewart
- Department of Veterinary Clinical Medicine, University of Illinois, 1008 W. Hazelwood Dr., Urbana-Champaign, IL 61802, USA.
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McCauley CT, Hawkins JF, Adams SB, Fessler JF. Use of a carbon dioxide laser for surgical management of cutaneous masses in horses: 32 cases (1993-2000). J Am Vet Med Assoc 2002; 220:1192-7. [PMID: 11990967 DOI: 10.2460/javma.2002.220.1192] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine outcome of horses in which cutaneous masses were removed with a carbon dioxide laser. DESIGN Retrospective study. ANIMALS 32 horses. PROCEDURE Medical records of horses with 1 or more cutaneous masses treated with a carbon dioxide laser were examined. Follow-up information was obtained through telephone interviews with owners and referring veterinarians. RESULTS Cutaneous masses were classified as sarcoids (15 horses), neoplastic masses other than sarcoids (squamous cell carcinoma [91; fibroma [1]; and melanoma [1]), and nonneoplastic masses (6). Minimum follow-up time was 6 months. Five sarcoids and 2 squamous cell carcinomas recurred. Seven (21%) horses had complications associated with dehiscence of wounds that had been closed primarily or failure of wound healing because of recurrence of the mass. Twenty-six (81%) owners were satisfied with the cosmetic appearance following surgery. CONCLUSION AND CLINICAL RELEVANCE Results suggest that a carbon dioxide laser may be effective for treatment of cutaneous masses in horses.
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Affiliation(s)
- Charles T McCauley
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907-1248, USA
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Martens A, De Moor A, Vlaminck L, Pille F, Steenhaut M. Evaluation of excision, cryosurgery and local BCG vaccination for the treatment of equine sarcoids. Vet Rec 2001; 149:665-9. [PMID: 11765322 DOI: 10.1136/vr.149.22.665] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Ninety-five horses with sarcoids were subjected to three types of treatment: surgical excision (conventional or carbon dioxide laser), cryotherapy or local BCG vaccination. The type of treatment was selected on the basis of the size, location and clinical appearance of the tumours. The choice between conventional and laser excision was empirical. A successful outcome was obtained in 11 of 14 (79 per cent) of the horses treated by cryosurgery, 18 of 27 (67 per cent) treated by BCG vaccination, 18 of 22 (82 per cent) treated by conventional excision, and 20 of 28 (71 per cent) treated with a carbon dioxide laser. For both excision methods, rigorous measures were taken to avoid autoinoculation and to ensure a wide margin of normal skin. The probability of local recurrence after excision was significantly higher for large sarcoids and sarcoids which had previously failed to respond to treatment. In 10 of the 31 horses with remaining sarcoids, some or all of the untreated sarcoids were observed to regress spontaneously.
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Affiliation(s)
- A Martens
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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