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Smith-Oskrochi L, Wustefeld-Janssens BG, Hollenbeck D, Stocks C, Deveau M. Safety and feasibility of short course pre-operative radiation therapy followed by surgical excision for canine solid tumours. Vet Comp Oncol 2023; 21:82-90. [PMID: 36271481 DOI: 10.1111/vco.12864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
Surgical resection of solid tumours, especially in early stages of disease, remains a cornerstone of cancer treatment in dogs and cats. There are numerous publications that show a strong association between local tumour control and outcome. To achieve local control in some cases radiation therapy and surgery are combined, with radiation therapy being delivered in the neoadjuvant or adjuvant setting. The objective of the study was to report acute toxicity and surgical site complication data in dogs that received a short-course pre-operative (SCPO) radiation therapy protocol, followed by surgical excision for various solid tumours. Medical records were reviewed, and data was analysed retrospectively. Dogs were included if a dermal or subcutaneous solid tumour was treated with SCPO radiation therapy and then was resected on the last day of radiation or 2-3 weeks later. A total of 34 dogs with 35 primary tumours were included. Acute radiation toxicity was diagnosed in 14 sites (40%). VRTOG scores were grade 1 in 50%, grade 2 in 43%, and grade 3 in 7%. Surgical site complications were identified in 17% of dogs with an overall surgical site infection rate of 11%. According to the Clavien-Dindo classification, two dogs required medical intervention (grade 2), 1 dog required surgical intervention under general anaesthesia (grade 3b), and 1 dog died as a result of complications (grade 5). Logistic regression analysis found that anatomic site was significantly associated with complications, where tumours located on the extremity was protective (P = .02; OR 0.06).
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Affiliation(s)
- Lauren Smith-Oskrochi
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Brandan G Wustefeld-Janssens
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.,Flint Animal Cancer Center, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
| | - Danielle Hollenbeck
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Christian Stocks
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Michael Deveau
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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2
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Surgical Excision of Intramuscular Sarcomas: Description of Three Cases in Dogs. Animals (Basel) 2023; 13:ani13020218. [PMID: 36670758 PMCID: PMC9854821 DOI: 10.3390/ani13020218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Compartmental excision consists of the complete resection of an anatomic district in which specific structures act as a barrier to local tumour invasion. It is a well-established procedure in human medicine, while only a few reports are available in veterinary medicine. The aim of this study was to describe complete muscle resection in 3 dogs affected by different intramuscular sarcomas. The clinical outcome was also reported. Medical records were searched, including preoperative diagnostic findings, compartmental excision, histologic diagnosis, and outcome. Three dogs fit the inclusion criteria, which had a sarcoma confined to a single muscular belly (semitendinosus, biceps, and splenius capitis muscles). Complete excision of the affected muscle was performed in all cases. One dog showed moderate lameness in the immediate postoperative period, resulting from the dorsal lifting of the scapula due to serratus ventralis tenotomy performed to remove the caudal insertion of the splenius capitis muscle. All the dogs recovered fully within one month, experiencing good clinical function. Histopathology showed complete tumour removal with no neoplastic fascial disruption in all cases. Compartmental excision provides effective local tumour control, representing an alternative to limb amputation or more radical excision if adjuvant radiotherapy is not an option for owners.
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3
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Successful Treatment of Vertebral Osteosarcoma in a Cat Using Marginal Surgical Excision and Chemotherapy. Vet Sci 2022; 9:vetsci9070315. [PMID: 35878332 PMCID: PMC9317830 DOI: 10.3390/vetsci9070315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
A three-year-old male neutered Norwegian Forest cat was referred for bilateral ambulatory paraparesis and spinal pain. On magnetic resonance imaging (MRI), a mass involving the right epaxial muscles with vertebral canal invasion and causing marked extradural spinal cord compression was identified. At surgery, the mass was debulked and a right hemilaminectomy was performed. Histopathology was diagnostic of fibroblastic osteosarcoma. Residual osteolytic lesions of the osteosarcoma were present at the level of the spinous process of the second lumbar vertebra. Four cycles of adjuvant doxorubicin chemotherapy were administered followed by oral toceranib phosphate. Neurological signs improved gradually over weeks to months and the lesion in the spinous process was no longer visible on radiographs. At one year from diagnosis, an MRI of the T3-L3 (3rd thoracic vertebra to the 3rd lumbar vertebra) spinal region and a whole-body computer tomography (CT) scan found no evidence of the osteosarcoma in the spine or of any metastasis. All medications were stopped and, at the time of writing 16 months later, the patient is neurologically normal with no signs of cancer recurrence. This is the first case report documenting the complete resolution of vertebral osteosarcoma lesions after treatment with doxorubicin followed by toceranib phosphate. The treatment also prevented tumor recurrence and was associated with an exceptionally long-term survival time.
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4
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Wustefeld-Janssens B, Smith L, Wilson-Robles H. Neoadjuvant chemotherapy and radiation therapy in veterinary cancer treatment: a review. J Small Anim Pract 2020; 62:237-243. [PMID: 33305431 DOI: 10.1111/jsap.13245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/20/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022]
Abstract
Multi-modality treatment strategies are more becoming commonplace in veterinary oncology practice yet the evidence base is far inferior to what has been generated in people. Surgery is unquestionably the cornerstone of most solid tumour treatment plans but certain scenarios dictate combining surgery with systemic chemotherapy and radiation therapy as an adjunct. By using these in the neoadjuvant setting, one can leverage certain effects of the treatment to improve local disease control, improve overall survival, gain insight into drug efficacy, reduce surgical morbidity and reduce long-term complications. An unintended consequence of combining therapies is an increased flow of information between members of the care team upfront that in almost all cases leads to improved patient outcomes albeit a difficult metric to quantify. This review sets out to explore some of the principles of neoadjuvant therapies and discuss potential opportunities to expand the evidence base in veterinary medicine.
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Affiliation(s)
- B Wustefeld-Janssens
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77845, USA
| | - L Smith
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77845, USA
| | - H Wilson-Robles
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77845, USA
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5
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Spugnini EP, Vincenzi B, Carocci F, Bonichi C, Menicagli F, Baldi A. Combination of bleomycin and cisplatin as adjuvant electrochemotherapy protocol for the treatment of incompletely excised feline injection-site sarcomas: A retrospective study. Open Vet J 2020; 10:267-271. [PMID: 33282697 PMCID: PMC7703611 DOI: 10.4314/ovj.v10i3.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022] Open
Abstract
Background fFeline injection-site sarcomas (FISSs) are mesenchymal tumors that can occur in cats after injections of different medical agents and are easily prone to recurrence. Aim The aims of this study were to report treatment outcomes for cats with feline injection-site sarcomas (FISSs) treated with both bleomycin and cisplatin, per adjuvant electrochemotherapy (ECT) protocol. Methods The medical records of cats with a diagnosis of FISS that were treated with ECT using both bleomycin and cisplatin were retrospectively evaluated. A total of 27 cats were available for statistical evaluation of their response. The cats received intravenous 20 mg/m2 bleomycin, and the tumor bed and margins were infiltrated with cisplatin at the dose of 0.5 mg/cm2. Then, the trains of permeabilizing biphasic electric pulses lasting 50 + 50 µseconds each were delivered in bursts of 1,300 V/cm using caliper electrodes under sedation. A second session was performed 2 weeks later. Results Side effects were limited to local inflammation in three cats. Three cats developed local tumor recurrence at days 180, 180, and 545 after surgery, two cats developed recurrence and metastases at 100 and 505 days after surgery, and two cats experienced distant metastases. A median time to recurrence could not be calculated as over 80% of the study population remained disease free or were censored due to death from other causes. Mean survival time was 985 days, and median cumulative survival for all cases was 1,000 days. Conclusion When compared to historical controls, the results of this study demonstrate the superior rates of tumor-free survival and disease-free interval. This adjuvant therapy could be a useful addition to the current options for FISS in consideration of its efficacy, limited toxicity, and ease of administration.
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Affiliation(s)
| | | | | | | | | | - Alfonso Baldi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies Campania University "Luigi Vanvitelli", Caserta, Italy.,Institute of Biosciences and BioResources, CNR, Naples, Italy
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Chiti LE, Martano M, Ferrari R, Boracchi P, Giordano A, Grieco V, Buracco P, Iussich S, Giudice C, Miniscalco B, Zani DD, Proverbio D, Morello E, Stefanello D. Evaluation of leukocyte counts and neutrophil-to-lymphocyte ratio as predictors of local recurrence of feline injection site sarcoma after curative intent surgery. Vet Comp Oncol 2019; 18:105-116. [PMID: 31441996 DOI: 10.1111/vco.12534] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Local recurrence (LR) is the major concern in the treatment of feline injection-site sarcoma (FISS). Pretreatment leukocyte counts and ratios have been reported as diagnostic and/or prognostic markers in human and canine oncology. The aim of this retrospective study was to explore the prognostic impact on LR and overall survival time (OST) of pretreatment neutrophil-to-lymphocyte ratio (NLR), white blood cell count (WBCC), neutrophil count (NC) and lymphocyte count (LC) in cats with surgically excised FISS. Eighty-two cats with histologically confirmed FISS at first presentation, without distant metastases, and with available pretreatment haematological analyses were retrospectively enrolled. The correlation of NLR, WBCC, NC, LC with tumour variables and patient variables was explored. NLR was correlated with tumour size (P = .004), histological pattern of tumour growth (P = .024) and histotype (P = .029), while WBCC and NC were associated with ulceration (P = .007, P = .011) and pattern of growth (P = .028, P = .004). No significant relationships emerged between LC and any of the considered variables. The impact of NLR, WBCC, NC, LC on LR and OST was then estimated in univariate and multivariate analysis. In univariate analysis, NLR, WBCC and NC were significant prognostic factors for both LR and OST. NLR, WBCC and NC remained prognostic in multivariate analysis for LR but not for OST. When NLR, WBCC and NC were jointly analysed, WBCC was the marker with the greater impact on LR. Preoperative NLR, WBCC and NC may aid in identifying cats at higher risk of LR.
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Affiliation(s)
- L E Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - M Martano
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - R Ferrari
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - P Boracchi
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - A Giordano
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - V Grieco
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - P Buracco
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - S Iussich
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - C Giudice
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - B Miniscalco
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - D D Zani
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - D Proverbio
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - E Morello
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - D Stefanello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
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7
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Torrigiani F, Romanelli G, Roccabianca P, Treggiari E. Neoadjuvant and adjuvant doxorubicin chemotherapy in a case of feline soft tissue sarcoma. JFMS Open Rep 2019; 5:2055116919857870. [PMID: 31308956 PMCID: PMC6607568 DOI: 10.1177/2055116919857870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 7-year old male neutered domestic shorthair cat was presented with a 2
month history of a slow-growing mass on the right zygomatic area. A CT scan
revealed a soft tissue mass in the right zygomatic region with no
alterations of the underlying bone and features of local invasiveness.
Cytology was suggestive of a mesenchymal tumour and histopathology from an
incisional biopsy was consistent with a soft tissue sarcoma (STS). The cat
was treated with neoadjuvant intravenous doxorubicin chemotherapy at a dose
of 25 mg/m2, every two weeks. The patient experienced a partial
response and underwent surgical excision of the tumour. Doxorubicin was
continued as an adjuvant treatment for three further chemotherapy sessions,
at a dose of 25 mg/m2 every 21 days. Local tumour recurrence was
detected on clinical examination and cytologically confirmed 259 days
following surgery. Relevance and novel information Treatment with neoadjuvant doxorubicin can be considered in cases of
inoperable STSs in order to cytoreduce the tumour and improve the chances of
achieving complete surgical margins. The role of adjuvant chemotherapy in
this setting remains unclear.
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Affiliation(s)
- Filippo Torrigiani
- Centro Specialistico Veterinario (Specialist Veterinary Centre), Milan, Italy
| | - Giorgio Romanelli
- Centro Specialistico Veterinario (Specialist Veterinary Centre), Milan, Italy
| | - Paola Roccabianca
- Department of Veterinary Medicine (DIMEVET), University of Milan, Lodi, Italy
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8
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Photodynamic Surgery for Feline Injection-Site Sarcoma. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8275935. [PMID: 31360726 PMCID: PMC6644288 DOI: 10.1155/2019/8275935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/04/2019] [Accepted: 06/27/2019] [Indexed: 12/14/2022]
Abstract
Musculoskeletal sarcomas are rare and aggressive human malignancies affecting bones and soft tissues with severe consequences, in terms of both morbidity and mortality. An innovative technique that combines photodynamic surgery (PDS) and therapy (PDT) with acridine orange has been recently suggested, showing promising results. However, due to the low incidence of sarcoma in humans, this procedure has been attempted only in pilot studies and stronger evidence is needed. Naturally occurring tumors in cats are well-established and advantageous models for human cancers. Feline injection-site sarcoma (FISS) shares with human musculoskeletal sarcomas a mesenchymal origin and an aggressive behavior with a high relapse rate. Furthermore, wide surgical excision is not always possible due to the size and site of development. We assessed the feasibility and the effectiveness of PDS and PDT with acridine orange to prevent FISS recurrence by treating a short case series of cats. For PDS, the surgical field was irrigated with an acridine orange solution and exposed to UV light to enlighten the residual tumor tissue, and the resultant fluorescent areas were trimmed. For PDT, before wound closure, the field was again irrigated with acridine orange solution and exposed to visible light to get the antitumoral cytocidal effect. The procedure was easy to perform and well tolerated, we did not observe any major complications, and all the surgical resection margins were free of disease. Finally, at follow-up, all treated patients did not show evidence of tumor recurrence and had a significantly higher event-free survival rate in respect to a control group treated only by surgery. In conclusion, by this study we demonstrated that, in FISS, PDS and PDT with acridine orange may improve local tumor control, granting a better outcome, and we laid the foundation to validate its effectiveness for the treatment of human musculoskeletal sarcomas.
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9
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Müller N, Kessler M. Curative-intent radical en bloc resection using a minimum of a 3 cm margin in feline injection-site sarcomas: a retrospective analysis of 131 cases. J Feline Med Surg 2018; 20:509-519. [PMID: 28696150 PMCID: PMC11104078 DOI: 10.1177/1098612x17717882] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives Owing to its highly infiltrative growth, feline injection-site sarcoma (FISS) carries a significant risk of local tumour recurrence. Parameters of possible prognostic significance (eg, tumour size and location, resection of de novo vs recurrent tumours, and achievement of tumour-free surgical margins) were examined with regard to their influence on recurrence rate (RR), disease-free interval (DFI) and survival time (ST). Methods This was a retrospective analysis of cats with FISSs located on the chest or abdominal wall or the interscapular region treated in a single institution using a standardised radical resection technique with 3 cm lateral margins and full-thickness body wall resection (tumours over chest/abdominal wall) or a minimum of two fascial planes (interscapular tumours). Results Median postoperative DFI and ST of 131 cats with FISSs was 21 and 24 months, respectively. Patients operated on for recurrent tumours were significantly more likely to die from tumour-related reasons compared with patients with de novo tumours ( P <0.001). RR and DFI in the different tumour locations were comparable ( P = 0.544 and P = 0.17, respectively). Local tumour recurrence occurred in 38.1% of the cats. Cats operated on for tumour recurrences had a significantly higher chance of another recurrence (RR 55.5% vs 33.3%; P = 0.005). Completeness of excision was determined by taking tumour bed biopsies. Tumour bed biopsies that did not contain tumour cells were associated with a significantly lower RR compared with those with tumour cells (30.5% vs 76.2%). Conclusions and relevance Depending on prognostic factors such as surgery for primary vs recurrent tumour, tumour-free resection margins and tumour location, the RR in FISS ranges from 33-55%, despite curative intent radical surgery. This study may help in identifying patients at risk for recurrence.
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Affiliation(s)
- Nina Müller
- Hofheim Small Animal Clinic, Hofheim, Germany
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10
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Longo M, Zani DD, Ferrari R, Bassi J, Andreis ME, Stefanello D, Giudice C, Grieco V, Liuti T, Handel I, Di Giancamillo M. Dynamic tomographic studies of interscapular feline injection-site sarcoma: essential or useless practice? J Feline Med Surg 2018; 20:502-508. [PMID: 28665170 PMCID: PMC11104069 DOI: 10.1177/1098612x17717176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives Feline injection-site sarcomas (FISSs) are soft tissue tumours typically characterised by an interscapular location and highly infiltrative behaviour. CT is considered the modality of choice for FISS staging and double positioning (dynamic approach) was reported to successfully detect the exact extent of infiltration into the muscles. The aim of the present study was to investigate the utility of the dynamic approach in feline patients referred for preoperative staging of interscapular FISS. Methods Tumour volume estimates were compared between the ellipsoid and the semi-automated segmentation methods. Two radiologists blinded to the patient coding used images from each position to assess the extent of muscular infiltration. The distance between the neoplasm and the adjacent skeletal structures (scapulae, spinous processes) was recorded in both positions by a single radiologist. Results Fifty-nine of 84 neoplasms invaded the adjacent muscular structures, with up to 15 muscles infiltrated. Between the extended and flexed position the average estimated numbers of muscles infiltrated were 1.9 (extended) and 1.84 (flexed) for observer A and 1.89 (extended) and 1.85 (flexed) for observer B. Good agreement between observers was established, with higher tumour volumes detected via the ellipsoid method. Moreover, tumours with smaller volumes showed slightly decreased muscular infiltration. Marked difference in the recorded distance between the skeletal structures and the neoplasm in the two different positions was established (mean ± SD difference spinous processes: 9.74 ± 9.57 mm; mean ± SD difference scapulae: 15.15 ± 11.76 mm). Conclusions and relevance A dynamic approach should be used for a complete evaluation of the invasiveness of FISS along with appropriate methodology for tumour volume measurement, which could potentially alter the tomographic estimation of the real dimension of the neoplasms.
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Affiliation(s)
- Maurizio Longo
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, UK
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | | | - Roberta Ferrari
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Jessica Bassi
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | | | | | - Chiara Giudice
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Valeria Grieco
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Tiziana Liuti
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, UK
| | - Ian Handel
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, UK
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11
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Elliott J, Finotello R. A dexamethasone, melphalan, actinomycin-D and cytarabine chemotherapy protocol as a rescue treatment for feline lymphoma. Vet Comp Oncol 2017; 16:E144-E151. [DOI: 10.1111/vco.12360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/19/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- J. Elliott
- Willows Veterinary Centre and Referral Service; Solihull UK
| | - R. Finotello
- Small Animal Teaching Hospital; University of Liverpool; Neston UK
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12
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Bray JP, Kersley A, Downing W, Crosse KR, Worth AJ, House AK, Yates G, Coomer AR, Brown IWM. Clinical outcomes of patient-specific porous titanium endoprostheses in dogs with tumors of the mandible, radius, or tibia: 12 cases (2013–2016). J Am Vet Med Assoc 2017; 251:566-579. [DOI: 10.2460/javma.251.5.566] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Zabielska-Koczywąs K, Wojtalewicz A, Lechowski R. Current knowledge on feline injection-site sarcoma treatment. Acta Vet Scand 2017; 59:47. [PMID: 28716129 PMCID: PMC5513368 DOI: 10.1186/s13028-017-0315-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 07/09/2017] [Indexed: 12/25/2022] Open
Abstract
Feline injection-site sarcomas (FISS) are malignant skin tumours of mesenchymal origin, the treatment of which is a challenge for veterinary surgeons. The role of surgery, radiotherapy and chemotherapy in FISS treatment has been studied, and a correlation between “clean” surgical margins and disease-free survival has been shown. In addition, clean surgical margins are one of the most important factors for achieving a low recurrence rate. The most effective method of FISS treatment includes combining radical surgery with pre- or postoperative radiotherapy. Chemotherapy may be used as a palliative method of treatment or may be considered an adjunctive therapy for surgery and radiotherapy. In cats with FISS without metastasis, the use of immunostimulant treatment with Oncept IL-2, intended as a complementary immunotherapy in association with surgery and brachytherapy, may also be considered to reduce the risk of relapse and increase the time to relapse. Additionally, this review focuses on recent advances in FISS treatment, including the use of novel compounds, such as doxorubicin conjugated to glutathione-stabilized gold nanoparticles, liposomal doxorubicin or tyrosine kinase inhibitors.
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14
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Bray JP. Soft tissue sarcoma in the dog - Part 2: surgical margins, controversies and a comparative review. J Small Anim Pract 2017; 58:63-72. [DOI: 10.1111/jsap.12629] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 07/07/2016] [Accepted: 08/08/2016] [Indexed: 12/12/2022]
Affiliation(s)
- J. P. Bray
- Companion Animal Clinical Studies, Head of Companion Animal Group, IVABS; Massey University; Palmerston North 4442 New Zealand
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15
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Porcellato I, Menchetti L, Brachelente C, Sforna M, Reginato A, Lepri E, Mechelli L. Feline Injection-Site Sarcoma. Vet Pathol 2016; 54:204-211. [DOI: 10.1177/0300985816677148] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Feline injection-site sarcoma (FISS) is an aggressive tumor believed to arise from the proliferation of fibroblasts and myofibroblasts in areas of chronic inflammation, particularly at sites of injection. Local recurrence is frequent after surgical excision. Gelatinases (MMP-2 and MMP-9) and their inhibitor (TIMP-2) are endopeptidases pivotal in extracellular matrix remodeling and therefore in tumor invasiveness. The aim of this study was to investigate the immunohistochemical expression of MMP-2, MMP-9, and TIMP-2 in FISS to assess their usefulness as prognostic factors. Size, soft tissue sarcoma (STS) grading system, depth of infiltration, surgical margins, and Ki-67 index were evaluated as additional prognostic markers. Twenty-four cases of primary FISS were classified according to clinical follow-up as nonrecurrent (NR, n = 14; 58.3%) and recurrent (R, n = 10; 41.7%). MMP-2, MMP-9, and TIMP-2 were variably expressed in the FISS examined, confirming their role in tumor invasiveness, yet they did not show significant differences between the R and NR groups. These results could be due to different tumor stages or to the multiple activities of these enzymes, not limited to ECM remodeling. The immunohistochemical expression of these enzymes considered alone does not seem to be useful as a prognostic marker. STS grading system, depth of infiltration, surgical margins, and Ki-67 index did not relate to recurrence. Instead, the size of the tumor, measured after formalin fixation, with an optimal cutoff of 3.75 cm (accuracy = 86%; P < .05), and the mitotic count, with an optimal cutoff of 20 mitoses/10 HPF (accuracy = 80%; P < .05), could be evaluated as useful prognostic markers.
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Affiliation(s)
- I. Porcellato
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - L. Menchetti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - C. Brachelente
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - M. Sforna
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - A. Reginato
- CDVet Diagnostic Laboratory, Via Ugo Guattari, Rome, Italy
| | - E. Lepri
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - L. Mechelli
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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Kang S, Southard T, Hume KR. DNA damage is a feature of feline injection-site sarcoma. Vet Comp Oncol 2016; 15:518-524. [PMID: 26781433 DOI: 10.1111/vco.12195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/27/2015] [Accepted: 10/18/2015] [Indexed: 12/11/2022]
Abstract
Feline injection-site sarcoma (FISS) is commonly treated with surgery and radiation therapy. Despite aggressive therapy, FISS has a high recurrence rate. The true benefit of adjuvant chemotherapy is not known. DNA damage response mechanisms help protect against genomic instability but can also promote chemoresistance. In order to determine whether DNA damage is a feature of FISS, we evaluated tumour tissues with γH2AX immunohistochemistry. H2AX is phosphorylated to form γH2AX following DNA double strand breaks. Seventeen FISS specimens were evaluated prospectively. DNA damage ranged from 2.18 to33.7%, with a median of 16.2%. Significant differences were noted between cats (P < 0.0001). Mitotic index ranged from 0 to 57 with a median of 13 and did not correlate with γH2AX positivity (P = 0.2). Further studies are needed to determine if γH2AX expression may predict chemosensitivity and have independent value as a prognostic factor.
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Affiliation(s)
- S Kang
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - T Southard
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - K R Hume
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Hartmann K, Day MJ, Thiry E, Lloret A, Frymus T, Addie D, Boucraut-Baralon C, Egberink H, Gruffydd-Jones T, Horzinek MC, Hosie MJ, Lutz H, Marsilio F, Pennisi MG, Radford AD, Truyen U, Möstl K. Feline injection-site sarcoma: ABCD guidelines on prevention and management. J Feline Med Surg 2015; 17:606-13. [PMID: 26101312 PMCID: PMC11148925 DOI: 10.1177/1098612x15588451] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OVERVIEW In cats, the most serious of adverse effects following vaccination is the occurrence of invasive sarcomas (mostly fibrosarcomas): so-called 'feline injection-site sarcomas' (FISSs). These develop at sites of previous vaccination or injection. They have characteristics that are distinct from those of fibrosarcomas in other areas and behave more aggressively. The rate of metastasis ranges from 10-28%. PATHOGENESIS The pathogenesis of these sarcomas is not yet definitively explained. However, chronic inflammatory reactions are considered the trigger for subsequent malignant transformation. Injections of long-acting drugs (such as glucocorticoids, and others) have been associated with sarcoma formation. Adjuvanted vaccines induce intense local inflammation and seem therefore to be particularly linked to the development of FISS. The risk is lower for modified-live and recombinant vaccines, but no vaccine is risk-free. TREATMENT AND PREVENTION Aggressive, radical excision is required to avoid tumour recurrence. The prognosis improves if additional radiotherapy and/or immunotherapy (such as recombinant feline IL-2) are used. For prevention, administration of any irritating substance should be avoided. Vaccination should be performed as often as necessary, but as infrequently as possible. Non-adjuvanted, modified-live or recombinant vaccines should be selected in preference to adjuvanted vaccines. Injections should be given at sites at which surgery would likely lead to a complete cure; the interscapular region should generally be avoided. Post-vaccination monitoring should be performed.
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