1
|
Polton G, Borrego JF, Clemente-Vicario F, Clifford CA, Jagielski D, Kessler M, Kobayashi T, Lanore D, Queiroga FL, Rowe AT, Vajdovich P, Bergman PJ. Melanoma of the dog and cat: consensus and guidelines. Front Vet Sci 2024; 11:1359426. [PMID: 38645640 PMCID: PMC11026649 DOI: 10.3389/fvets.2024.1359426] [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: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 04/23/2024] Open
Abstract
Melanoma of the dog and cat poses a clinical challenge to veterinary practitioners across the globe. As knowledge evolves, so too do clinical practices. However, there remain uncertainties and controversies. There is value for the veterinary community at large in the generation of a contemporary wide-ranging guideline document. The aim of this project was therefore to assimilate the available published knowledge into a single accessible referenced resource and to provide expert clinical guidance to support professional colleagues as they navigate current melanoma challenges and controversies. Melanocytic tumors are common in dogs but rare in cats. The history and clinical signs relate to the anatomic site of the melanoma. Oral and subungual malignant melanomas are the most common malignant types in dogs. While many melanocytic tumors are heavily pigmented, making diagnosis relatively straightforward, melanin pigmentation is variable. A validated clinical stage scheme has been defined for canine oral melanoma. For all other locations and for feline melanoma, TNM-based staging applies. Certain histological characteristics have been shown to bear prognostic significance and can thus prove instructive in clinical decision making. Surgical resection using wide margins is currently the mainstay of therapy for the local control of melanomas, regardless of primary location. Radiotherapy forms an integral part of the management of canine oral melanomas, both as a primary and an adjuvant therapy. Adjuvant immunotherapy or chemotherapy is offered to patients at high risk of developing distant metastasis. Location is the major prognostic factor, although it is not completely predictive of local invasiveness and metastatic potential. There are no specific guidelines regarding referral considerations for dogs with melanoma, as this is likely based on a multitude of factors. The ultimate goal is to provide the best options for patients to extend quality of life and survival, either within the primary care or referral hospital setting.
Collapse
Affiliation(s)
- Gerry Polton
- North Downs Specialist Referrals, Bletchingley, United Kingdom
| | - Juan F. Borrego
- Hospital Aúna Especialidades Veterinarias IVC Evidensia, Paterna, Spain
| | | | | | - Dariusz Jagielski
- Veterinary Institute, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Martin Kessler
- Department of Clinical Oncology, Tierklinik Hofheim, Hofheim, Germany
| | | | | | | | | | - Péter Vajdovich
- Department of Physiology and Oncology, University of Veterinary Medicine, Budapest, Hungary
| | - Philip J. Bergman
- VCA Clinical Studies, Katonah-Bedford Veterinary Center, Bedford Hills, NY, United States
| |
Collapse
|
2
|
Bellamy E, Larsen Moberg H, Suárez-Bonnet A, Palma SD, Murgia D, Pittaway R, Verganti S. Feline ventral abdominal wall angiosarcoma: haemangiosarcoma or lymphangiosarcoma? Clinical and pathological characteristics in nine cases. J Feline Med Surg 2024; 26:1098612X231216636. [PMID: 38227337 PMCID: PMC10949878 DOI: 10.1177/1098612x231216636] [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] [Indexed: 01/17/2024]
Abstract
OBJECTIVES Angiosarcomas are rare malignant mesenchymal neoplasms of endothelial cell origin with a predilection to the ventral abdominal wall in cats. Larger case series describing this entity are lacking. METHODS Two referral centre laboratory databases were searched for angiosarcoma of the ventral abdominal wall. Nine cases with a histological diagnosis were included. Immunohistochemistry (factor VIII and PROX-1 antibodies) was used to phenotype them as haemangiosarcoma or lymphangiosarcoma. RESULTS All cats presented with a ventral abdominal mass, five of which were producing a serosanguinous discharge. Eight underwent tumour staging and pulmonary metastases were suspected in one cat (but not histologically confirmed). With histopathology alone, a diagnosis of angiosarcoma and lymphangiosarcoma was made in four and five cases, respectively. After immunohistochemistry, five cases had a haemangiosarcoma phenotype and four had a lymphangiosarcoma phenotype, including two cases of lymphangiosarcoma that were reclassified as hemangiosarcoma. Eight cats received treatment (either surgery with or without adjuvant therapies or medical management alone). Six cats were euthanased due to local disease progression. The median survival time for haemangiosarcoma was 166 days (range 137-381), and for lymphangiosarcoma it was 197 days (range 67-208). Two cats with haemangiosarcoma remained alive for a follow-up period of 329 and 580 days, respectively. CONCLUSIONS AND RELEVANCE Feline ventral abdominal angiosarcomas are rare locally aggressive neoplasms. While histology often provides a diagnosis of angiosarcoma, immunohistochemistry is ultimately required to differentiate between haemangiosarcoma and lymphangiosarcoma phenotypes. Further studies are required to evaluate whether the different phenotypes have an impact on treatment response and outcome.
Collapse
Affiliation(s)
- Edward Bellamy
- Animal Health Trust, Centre of Small Animal Studies, Newmarket, UK
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, Newmarket, UK
| | - Hanne Larsen Moberg
- Royal Veterinary College, University of London, Hatfield, UK
- Norwegian University of Life Sciences, Ås, Norway
| | | | - Stefano Di Palma
- Animal Health Trust, Centre of Small Animal Studies, Newmarket, UK
- IDEXX Laboratories Ltd, Wetherby, UK
| | - Daniela Murgia
- Animal Health Trust, Centre of Small Animal Studies, Newmarket, UK
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, Newmarket, UK
| | - Rachel Pittaway
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, Newmarket, UK
| | - Sara Verganti
- Animal Health Trust, Centre of Small Animal Studies, Newmarket, UK
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, Newmarket, UK
| |
Collapse
|
3
|
Kokkinos P, Elliott J, Almansa Ruiz JC. A modified full-thickness labial/buccal rotational flap reconstruction technique following bilateral rostral maxillectomy and nasal planectomy for resection of maxillary tumors: Technique and results in two dogs. Vet Surg 2023; 52:1191-1201. [PMID: 37649180 DOI: 10.1111/vsu.14018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 07/14/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To describe a naso-facial reconstruction technique following bilateral rostral maxillectomy and its functional and cosmetic outcomes. ANIMALS Two dogs. STUDY DESIGN Clinical case series. METHODS Two dogs were presented with a right rostral maxillary mass. Preoperative biopsy and staging revealed a biologically high-grade and histologically low-grade fibrosarcoma (Hi-Lo FSA). A combined nasal planectomy and radical bilateral rostral maxillectomy was performed sparing the labial/buccal mucocutaneous flaps bilaterally. Surgery resulted in asymmetry of the width of the flaps; the narrower flap was rotated medially to reconstruct the lip and create an oral vestibule. The wider flap was rotated medially to cover the remaining dorsolateral opening of the nasal conchae. The flaps overlapped in a parallel manner, discretely concealing the nasal passages, and separating them from the oral cavity. Hemorrhage occurred in both dogs, with one dog requiring a blood transfusion postoperatively. RESULTS Oral Hi-Lo FSA with tumor-free margins was confirmed in both dogs. Both dogs recovered uneventfully within 4 weeks. Owners reported being very satisfied with the functional (return to normal exercise/activities and uncompromised respiration) and cosmetic outcomes. Based on the owners' telephone follow up, no tumor recurrence was noted at 15 (Dog 1) and 6 (Dog 2) months postoperatively. CONCLUSION The full-thickness bilateral labial/buccal rotational flaps were used successfully to reconstruct the rostral maxilla, external nose and facial defects involving the nasal cavity. The technique resulted in acceptable functional and cosmetic outcomes and can be considered for naso-facial reconstruction in selected cases.
Collapse
Affiliation(s)
- Panagiotis Kokkinos
- Southfields Veterinary Specialists part of Linnaeus Veterinary Limited, Essex, UK
- Northwest Veterinary Specialists part of Linnaeus Veterinary Limited, Cheshire, UK
| | - James Elliott
- Southfields Veterinary Specialists part of Linnaeus Veterinary Limited, Essex, UK
| | - José C Almansa Ruiz
- Southfields Veterinary Specialists part of Linnaeus Veterinary Limited, Essex, UK
| |
Collapse
|
4
|
Ossowska M, Picornell JA, Finotello R, Amores-Fuster I, Tanis JB. Pre-operative neoadjuvant vinblastine-prednisolone in canine mast cell tumours: A single-centre retrospective cohort study. Vet Comp Oncol 2023; 21:447-459. [PMID: 37183272 DOI: 10.1111/vco.12904] [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: 01/22/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
Neoadjuvant chemotherapy can be used in canine mast cell tumours (MCTs) to optimise surgical margins or to enable marginal excision in challenging locations. The objective of this study was to describe the outcome of dogs with cutaneous and subcutaneous MCTs treated with neoadjuvant vinblastine-prednisolone (NA-VP). Records of treatment-naïve dogs with cutaneous/subcutaneous MCT that received NA-VP were reviewed including signalment, indication for NA-VP, staging results, clinical response, surgical data and histopathology reports. For dogs with post-operative follow-up ≥365 days, predictive factors for local recurrence (LR) were evaluated. Forty-four dogs were included. NA-VP was indicated to optimise surgical margins (group MARG) in 19 dogs (43.2%) and to enable surgery (group MORB) in 25 dogs (56.8%). Complete and partial response were documented in 40.9% of dogs and 30 dogs (68.2%) underwent surgery. The indication for NA-VP was significantly associated with undergoing surgery (p < .001) on multivariable analysis. Twelve (48%) and 18 dogs (94.7%) underwent surgery in the group MORB and MARG, respectively. Five dogs (16.7%) experienced wound dehiscence. Complete excision was achieved in 14 dogs (46.7%). In dogs undergoing surgery with ≥365 days of follow-up, LR was documented in five cases (20.8%). None of the factors analysed including mitotic count, completeness of excision and response to NA-VP were associated with LR; notably, LR occurred in 3/11 (27.2%) completely excised MCTs. In a pre-operative setting, NA-VP appears safe and could be beneficial in selected cases. Prognostic factors such as clinical response, mitotic count and completeness of excision should be interpreted with caution following NA-VP.
Collapse
Affiliation(s)
- Małgorzata Ossowska
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Jose Alvarez Picornell
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Riccardo Finotello
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Isabel Amores-Fuster
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Jean-Benoit Tanis
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
- Department of Molecular & Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| |
Collapse
|
5
|
Bray J, Eward W, Breen M. Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk. Vet Comp Oncol 2023; 21:145-158. [PMID: 36745110 DOI: 10.1111/vco.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/03/2022] [Accepted: 02/03/2023] [Indexed: 02/07/2023]
Abstract
Due to the complex nature of tumour biology and the integration between host tissues and molecular processes of the tumour cells, a continued reliance on the status of the microscopic cellular margin should not remain our only determinant of the success of a curative-intent surgery for patients with cancer. Based on current evidence, relying on a purely cellular focus to provide a binary indication of treatment success can provide an incomplete interpretation of potential outcome. A more holistic analysis of the cancer margin may be required. If we are to move ahead from our current situation - and allow treatment plans to be more intelligently tailored to meet the requirements of each individual tumour - we need to improve our utilisation of techniques that either improve recognition of residual tumour cells within the surgical field or enable a more comprehensive interrogation of tumour biology that identifies a risk of recurrence. In the second article in this series on defining the relevance of surgical margins, the authors discuss possible alternative strategies for margin assessment and evaluation in the canine and feline cancer patient. These strategies include considering adoption of the residual tumour classification scheme; intra-operative imaging systems including fluorescence-guided surgery, optical coherence tomography and Raman spectroscopy; molecular analysis and whole transcriptome analysis of tissues; and the development of a biologic index (nomogram). These techniques may allow evaluation of individual tumour biology and the status of the resection margin in ways that are different to our current techniques. Ultimately, these techniques seek to better define the risk of tumour recurrence following surgery and provide the surgeon and patient with more confidence in margin assessment.
Collapse
Affiliation(s)
| | - Will Eward
- Orthopedic Surgical Oncologist, Duke Cancer Center, Durham, North Carolina, USA
| | - Matthew Breen
- Oscar J. Fletcher Distinguished Professor of Comparative Oncology Genetics, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| |
Collapse
|
6
|
Haine DL, Pittaway R, Berlato D, Demetriou J. Incomplete histological margins following planned narrow excision of canine appendicular soft tissue sarcomas and mast cell tumors, using the residual tumor classification scheme. Vet Surg 2022; 51:1078-1086. [PMID: 35830150 PMCID: PMC9912198 DOI: 10.1111/vsu.13852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the frequency of incomplete histological margins following planned narrow excision (PNE) of mast cell tumors (MCTs) and soft tissue sarcomas (STSs), and to assess the residual tumor classification (R) scheme for reporting histological margins in clinical cases. STUDY DESIGN Retrospective clinical study. SAMPLE POPULATION Forty-four client-owned dogs with 47 masses. METHODS Medical records of dogs undergoing planned narrow excision of STSs and MCTs were reviewed (2016-2019). Histologic specimens were reviewed by a single pathologist and assigned R scoring (histologically incomplete/R1 margins defined as "tumor on ink"). RESULTS Six out of 23 (26%) MCT PNEs and 10/42 (42%) of STS PNEs resulted in R1 margins. R1 margins were more likely when performing PNE with 6-10 mm lateral measured surgical margins (LMSMs) versus 0-5 mm LMSM for MCTs (1/14 vs 5/9), but not STSs (3/7 vs 7/17) (P = .049). The R scheme resulted in higher retrospective percentage agreement in histological reporting than defining incomplete histological margin as tumor cells within ≤1 mm of the margin (83% vs 68% agreement). Complications occurred in 12/47 surgeries, with none requiring additional surgery. Tumors recurred in 3/18 (17%) STSs and 2/18 (11%) MCTs. CONCLUSION Fewer R1 margins were obtained when PNE with LMSM of 6-10 mm was performed for mast cell tumors. The use of the R scheme increased agreement in histopathological margin assessment. CLINICAL SIGNIFICANCE Planned narrow excision is a viable technique for histopathological diagnosis of appendicular soft tissue sarcomas and mast cell tumors for limb salvage.
Collapse
Affiliation(s)
- David L. Haine
- Cave Veterinary Specialists, part of Linnaeus Veterinary Limited
| | | | - Davide Berlato
- AniCura Animal Oncology and Imaging CenterHünenbergSwitzerland
| | | |
Collapse
|
7
|
Beer P, Rohrer-Bley C, Nolff MC. Near-infrared fluorescent image-guided lymph node dissection compared with locoregional lymphadenectomies in dogs with mast cell tumours. J Small Anim Pract 2022; 63:670-678. [PMID: 35815663 PMCID: PMC9542114 DOI: 10.1111/jsap.13529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/03/2022] [Accepted: 05/25/2022] [Indexed: 12/21/2022]
Abstract
Objectives Near‐infrared fluorescent imaging has been described for intraoperative mapping of the draining lymph nodes in human cancer and canine oral tumours. The aim of this study was to retrospectively describe the results of lymphadenectomies in dogs with mast cell tumours treated either by standard unguided locoregional lymph node dissection or near‐infrared fluorescent image‐guided lymph node dissection. Methods Medical records between 2012 and 2020 were reviewed for dogs that were presented for surgical resection of mast cell tumours with concurrent lymphadenectomy either with (near‐infrared fluorescent image‐guided lymph node dissection) or without near‐infrared fluorescence image guidance (lymph node dissection). The number and location of lymph nodes planned for surgical dissection and actually dissected nodes, presence of metastases and perioperative complications were recorded. Results Thirty‐five patients underwent near‐infrared fluorescent image‐guided lymph node dissection, and 43 lymph node dissections. The number of nodes preoperatively planned for resection were 70 and 68, respectively. Fifty‐eight of those (83%) were identified during near‐infrared fluorescent image‐guided lymph node dissection procedures, compared with 50 (74%) during lymph node dissection. near‐infrared fluorescent image‐guided lymph node dissection resulted in resection of additional fluorescent nodes not corresponding to locoregional nodes in 15 of 35 dogs. Using near‐infrared fluorescent image‐guided lymph node dissection, we identified at least one metastatic node in 68% of dogs (24 of 35) compared with 33% (14 of 43) when lymph node dissection was used without imaging. No complications related to near‐infrared fluorescent imaging were reported. Clinical Significance The present study suggests that near‐infrared imaging is a promising technique for intraoperative detection of the draining lymph nodes in dogs with mast cell tumours. Further validation of the technique is required to assess if near‐infrared fluorescent imaging can detect the true sentinel lymph node.
Collapse
Affiliation(s)
- P Beer
- Vetsuisse Faculty, Clinic for Small Animal Surgery, University of Zurich, Zurich, 8057, Switzerland
| | - C Rohrer-Bley
- Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, 8057, Switzerland
| | - M C Nolff
- Vetsuisse Faculty, Clinic for Small Animal Surgery, University of Zurich, Zurich, 8057, Switzerland
| |
Collapse
|
8
|
Chalfon C, Sabattini S, Finotello R, Faroni E, Guerra D, Pisoni L, Ciammaichella L, Vasconi ME, Annoni M, Marconato L. Lymphadenectomy improves outcome in dogs with resected Kiupel high-grade cutaneous mast cell tumours and overtly metastatic regional lymph nodes. J Small Anim Pract 2022; 63:661-669. [PMID: 35733233 DOI: 10.1111/jsap.13525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/12/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Historically, the prognosis for dogs with stage II Kiupel high-grade cutaneous mast cell tumours has been considered poor. OBJECTIVES The aim of this study was to explore the impact of lymphadenectomy on outcome in dogs with Kiupel high-grade cutaneous mast cell tumours and overt regional lymph node metastasis. MATERIAL AND METHODS Data from dogs with completely staged Kiupel high-grade cutaneous mast cell tumours with overt and/or certain regional lymph node metastasis undergoing excision of the primary tumours and adjuvant medical treatment were extracted. Dogs with a cytological diagnosis of regional lymph node metastasis that did not undergo lymphadenectomy were compared with dogs that underwent lymphadenectomy and had a histological diagnosis of overt lymph node metastasis. RESULTS Forty-nine dogs were included, 18 did not undergo lymphadenectomy while 31 underwent lymphadenectomy. Median time to progression was significantly shorter in dogs that did not undergo lymphadenectomy (150 days, 95% confidence interval: 129 to 170) compared to the other dogs (229 days, 95% confidence interval: 191 to 266). Median survival time was also shorter in dogs that did not undergo lymphadenectomy (250 days, 95% confidence interval: 191 to 308) compared to dogs that underwent lymphadenectomy (371 days, 95% confidence interval: 311 to 430). On multivariable analysis, lack of lymphadenectomy was associated with higher risk of overall tumour progression (hazard ratio: 2.05, 95% confidence interval: 1.02 to 4.13), nodal progression (hazard ratio: 3.4, 95% confidence interval: 1.65 to 7.02) and tumour-related death (hazard ratio 3.63, 95% confidence interval: 1.72 to 7.66), whereas tumour size was associated with higher risk of local recurrence (hazard ratio: 3.61, 95% confidence interval: 1.06 to 13). CLINICAL SIGNIFICANCE Regional lymphadenectomy may improve outcome in dogs with biologically aggressive cutaneous mast cell tumours.
Collapse
Affiliation(s)
- C Chalfon
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - S Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - R Finotello
- Depertment of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - E Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - D Guerra
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - L Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - L Ciammaichella
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - M E Vasconi
- Centro Veterinario Torinese, Turin, 10153, Italy
| | - M Annoni
- Clinica Veterinaria Tibaldi, Milan, 20141, Italy
| | - L Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| |
Collapse
|
9
|
Pazzi P, Steenkamp G, Rixon AJ. Treatment of Canine Oral Melanomas: A Critical Review of the Literature. Vet Sci 2022; 9:vetsci9050196. [PMID: 35622724 PMCID: PMC9147014 DOI: 10.3390/vetsci9050196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/09/2023] Open
Abstract
Critical appraisal of the available literature for the treatment of canine oral malignant melanoma (OMM) is lacking. This critical review aimed to evaluate the current literature and provide treatment recommendations and possible suggestions for future canine OMM research. PubMed, Web of Science and Google Scholar were searched in June 2021, for terms relevant to treatment of OMM. Inclusion and exclusion criteria were applied and information on clinical response and outcome extracted. Eighty-one studies were included. The overall level of evidence supporting the various canine OMM treatment options was low. The majority of studies included confounding treatment modalities and lacked randomization, control groups and consistency in reporting clinical response and outcomes. Within these limitations, surgery remains the mainstay of therapy. Adjunctive radiotherapy provided good local control and improved median survival times (MST), chemotherapy did not offer survival benefit beyond that of surgery, while electrochemotherapy may offer a potential alternative to radiotherapy. Immunotherapy holds the most promise in extending MST in the surgical adjunctive setting, in particular the combination of gene therapy and autologous vaccination. Prospective, randomized, double-blinded clinical trials, with a lack of confounding factors and reporting based on established guidelines would allow comparison and recommendations for the treatment of canine OMM.
Collapse
|
10
|
Paulos PE, Boston S, Skinner O, Liptak JM, Amsellem PM, Fournier Q, Wood CJ, Maurizio A, Murgia D, Oblak ML, Dean BL, Baird SD, Kulendra NJ. Outcome with Surgical Treatment of Canine Soft Tissue Sarcoma in the Region of the Ischiatic Tuberosity: A Veterinary Society of Surgical Oncology Retrospective Study. Vet Comp Oncol 2022; 20:669-678. [PMID: 35420253 DOI: 10.1111/vco.12821] [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: 01/20/2022] [Revised: 03/27/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the outcome of dogs with soft tissue sarcoma (STS) within the region of the ischiatic tuberosity (ITSTS) treated surgically. STUDY DESIGN Multi-institutional retrospective study ANIMALS: Fifty-two client-owned dogs with histologically confirmed STS in the region of the IT treated with surgical resection between March 1st, 2009, and March 1st, 2021, and a minimum follow-up time of six months. METHODS Data collected included signalment, preoperative diagnostics, surgical intent/method, complications, histopathology, margins, outcome, and cause of death. Statistical analyses were performed to determine significant factors in treatment and prognosis of ITSTS. RESULTS Fifty-two dogs with histopathologically-confirmed ITSTS included resulting in 24 grade I, 20 grade II, and seven grade III tumors. Overall survival time and disease progression were negatively associated with tumor grade while recurrence was positively associated with grade and incomplete margins. Overall survival time and progression-free survival time was not reached for tumors graded as I or II and was 255 and 268 days respectively for grade III. Median time to recurrence was not reached for tumors excised with complete margins and 398 days for incomplete margins. There was a 25% reported surgical complication rate. CONCLUSION Ischiatic tuberosity soft tissue sarcoma was not found to be a unique clinical entity in dogs. Treatment recommendations and prognosis were similar to STS in other locations. The outcome was influenced by histologic grade and margins. CLINICAL SIGNIFICANCE Ischiatic tuberosity soft tissue sarcoma of dogs does not behave more aggressively than those in other locations. Surgical complications were common but not life-threatening. Overall prognosis, including survival and disease recurrence, appears to depend on histological grade and surgical margins. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Patrisha E Paulos
- VCA Canada, Mississauga-Oakville Veterinary Emergency Hospital, Ontario, Canada
| | - Sarah Boston
- VCA Canada, Mississauga-Oakville Veterinary Emergency Hospital, Ontario, Canada
| | | | | | | | | | | | | | | | | | | | - Steven D Baird
- Earlswood Veterinary Referrals, Belfast, Northern Ireland
| | | |
Collapse
|
11
|
Mason SL, Pittaway C, Gil BP, Russak OM, Westlake K, Berlato D, Benoit J, Morris J, Dobson JM. Outcomes of adjunctive radiation therapy for the treatment of mast cell tumors in dogs and assessment of toxicity: A multicenter observational study of 300 dogs. J Vet Intern Med 2021; 35:2853-2864. [PMID: 34672378 PMCID: PMC8692218 DOI: 10.1111/jvim.16264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022] Open
Abstract
Background Radiation therapy is commonly used as an adjunct to incomplete surgical excision in dogs with mast cell tumors (MCT), but the optimal dose and fractionation regimen have yet to be determined. Hypothesis We assessed outcomes (time to local recurrence, patient survival and toxicity) of a large population of dogs with MCT that received adjunctive radiation therapy. Animals Three hundred dogs with 302 MCT treated using adjunctive radiation therapy. Methods Retrospective observational study. Clinical records of 4 veterinary radiation centers were reviewed. Results Local recurrence rates were similar regardless of radiation protocol with 6.6% of patients developing recurrent cutaneous MCT at a median of 526 days. Local recurrence rate was similar between high and low‐risk MCT. Mast cell tumor related death was reported in 19% of all dogs, with 13% of dogs with low‐risk MCT dying of their disease compared to 29% of dogs with high‐risk MCT. No SC MCT (SCMCT) recurred after radiation therapy and only 7% of dogs with SCMCT were reported to have died of their disease. Mild late toxicity was common in both protocols and severe late toxicity occurred in 1.9% of dogs many years after treatment. Conclusions and Clinical Importance Our study supports the use of adjunctive radiation for the long‐term control of incompletely or narrowly excised cutaneous and SCMCT in dogs. More moderate dose and fractionation protocols may be appropriate in the adjunctive treatment of low‐risk MCT in dogs. Large multicenter prospective studies are required to establish the optimal dose and fractionation for MCT of different risk categories.
Collapse
Affiliation(s)
- Sarah L Mason
- Southfields Veterinary Specialists, Basildon, United Kingdom.,Queens Veterinary School Hospital-Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Charles Pittaway
- Queens Veterinary School Hospital-Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.,Dick White Referrals, Cambridge, United Kingdom
| | - Begona Pons Gil
- Southfields Veterinary Specialists, Basildon, United Kingdom
| | - Onne-Marju Russak
- Dick White Referrals, Cambridge, United Kingdom.,Animal Health Trust, Newmarket, United Kingdom
| | - Katie Westlake
- Queens Veterinary School Hospital-Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Davide Berlato
- AniCura Animal Oncology and Imaging Center, Hünenberg, Switzerland.,Animal Health Trust, Newmarket, United Kingdom
| | - Jérôme Benoit
- Southfields Veterinary Specialists, Basildon, United Kingdom
| | | | - Jane Margaret Dobson
- Queens Veterinary School Hospital-Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
12
|
Bellamy E, Berlato D. Canine cutaneous and subcutaneous mast cell tumours: a review. J Small Anim Pract 2021; 63:497-511. [PMID: 34671978 DOI: 10.1111/jsap.13444] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/26/2021] [Accepted: 09/06/2021] [Indexed: 01/12/2023]
Abstract
Cutaneous and subcutaneous mast cell tumours are common neoplasms in the dog. While the majority can be treated with adequate local therapy alone, a subset demonstrates a biologically aggressive behaviour associated with local recurrence or metastasis. This article reviews the diagnosis and tumour staging of canine mast cell tumours alongside treatment options and the evidence supporting their use. In addition, prognostic markers are evaluated to highlight how one can recognise mast cell tumours that may behave in a biologically aggressive manner as well as the challenges of tumours that are large, infiltrative or in locations not amenable to wide surgical excision.
Collapse
Affiliation(s)
- E Bellamy
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - D Berlato
- AniCura AOI Center AG, Hünenberg, 6331, Switzerland
| |
Collapse
|
13
|
Chiti LE, Ferrari R, Roccabianca P, Boracchi P, Godizzi F, Busca GA, Stefanello D. Surgical Margins in Canine Cutaneous Soft-Tissue Sarcomas: A Dichotomous Classification System Does Not Accurately Predict the Risk of Local Recurrence. Animals (Basel) 2021; 11:ani11082367. [PMID: 34438827 PMCID: PMC8388623 DOI: 10.3390/ani11082367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Histological evaluation of surgical margins is crucial for correct prognostication and adjuvant treatment recommendation after excision of soft tissue sarcoma (STS) in dogs. Incompletely excised STS have a high risk of local recurrence (LR), while completely excised STS without other negative prognostic factors are generally associated with a good prognosis. However, guidelines are lacking on how to manage STS excised with clean but close margins (CbCM), although some authors advocated their inclusion in the tumor-free margin group. This retrospective study investigates the impact of CbCM on LR of canine STS. Ninety-eight surgical excised canine STS at first presentation were included. Cumulative incidence of LR was estimated for each category of margins (tumor-free, infiltrated, CbCM), and after grouping CbCM alternatively in the tumor-free and infiltrated category. Cumulative incidence of LR at three years differed significantly between the three categories, and it was estimated to be 42% with infiltrated margins, 23% with CbCM, 7% with tumor-free margins. Both when CbCM were grouped with infiltrated margins or with tumor-free margins, the incidence of LR was statistically different. The rate of LR with CbCm was greater than with tumor-free margins. The category CbCM may be considered as a separate prognostic category. Abstract Adjuvant treatments are recommended in dogs with incompletely excised cutaneous soft-tissue sarcoma (STS) to reduce the risk of local recurrence (LR), although guidelines are lacking on how to manage clean but close margins (CbCM). This retrospective study investigates the impact of CbCM on LR of canine STS. Ninety-eight surgically excised canine STS at first presentation were included. Tissue samples were routinely trimmed and analyzed. Cumulative incidence of LR was estimated for each category of margins (tumor-free, infiltrated, CbCM), and included CbCM in the tumor-free and infiltrated category, respectively. The prognostic impact on LR was then adjusted for relevant prognostic factors. Cumulative incidence of LR at three years differed significantly between the three categories (p = 0.016), and was estimated to be 42% with infiltrated margins, 23% with CbCM, 7% with tumor-free margins. Both when CbCM were grouped with infiltrated margins (p = 0.033; HR = 5.05), and when CbCM were grouped with tumor-free margins (p = 0.011; HR = 3.13), a significant difference between groups was found. STS excised with infiltrated margins had the greatest risk of LR. The rate of LR with CbCm was greater than recurrence rate of tumor-free margins. The category CbCM may be considered as a separate prognostic category.
Collapse
Affiliation(s)
- Lavinia Elena Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy; (L.E.C.); (P.R.); (F.G.); (D.S.)
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy; (L.E.C.); (P.R.); (F.G.); (D.S.)
- Correspondence:
| | - Paola Roccabianca
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy; (L.E.C.); (P.R.); (F.G.); (D.S.)
| | - Patrizia Boracchi
- Laboratorio di Statistica Medica, Biometrica ed Epidemiologia “A. Maccaro”, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122 Milan, Italy;
| | - Francesco Godizzi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy; (L.E.C.); (P.R.); (F.G.); (D.S.)
| | | | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy; (L.E.C.); (P.R.); (F.G.); (D.S.)
| |
Collapse
|
14
|
Meuten DJ, Moore FM, Donovan TA, Bertram CA, Klopfleisch R, Foster RA, Smedley RC, Dark MJ, Milovancev M, Stromberg P, Williams BH, Aubreville M, Avallone G, Bolfa P, Cullen J, Dennis MM, Goldschmidt M, Luong R, Miller AD, Miller MA, Munday JS, Roccabianca P, Salas EN, Schulman FY, Laufer-Amorim R, Asakawa MG, Craig L, Dervisis N, Esplin DG, George JW, Hauck M, Kagawa Y, Kiupel M, Linder K, Meichner K, Marconato L, Oblak ML, Santos RL, Simpson RM, Tvedten H, Whitley D. International Guidelines for Veterinary Tumor Pathology: A Call to Action. Vet Pathol 2021; 58:766-794. [PMID: 34282984 DOI: 10.1177/03009858211013712] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Standardization of tumor assessment lays the foundation for validation of grading systems, permits reproducibility of oncologic studies among investigators, and increases confidence in the significance of study results. Currently, there is minimal methodological standardization for assessing tumors in veterinary medicine, with few attempts to validate published protocols and grading schemes. The current article attempts to address these shortcomings by providing standard guidelines for tumor assessment parameters and protocols for evaluating specific tumor types. More detailed information is available in the Supplemental Files, the intention of which is 2-fold: publication as part of this commentary, but more importantly, these will be available as "living documents" on a website (www.vetcancerprotocols.org), which will be updated as new information is presented in the peer-reviewed literature. Our hope is that veterinary pathologists will agree that this initiative is needed, and will contribute to and utilize this information for routine diagnostic work and oncologic studies. Journal editors and reviewers can utilize checklists to ensure publications include sufficient detail and standardized methods of tumor assessment. To maintain the relevance of the guidelines and protocols, it is critical that the information is periodically updated and revised as new studies are published and validated with the intent of providing a repository of this information. Our hope is that this initiative (a continuation of efforts published in this journal in 2011) will facilitate collaboration and reproducibility between pathologists and institutions, increase case numbers, and strengthen clinical research findings, thus ensuring continued progress in veterinary oncologic pathology and improving patient care.
Collapse
Affiliation(s)
| | | | | | - Christof A Bertram
- Freie Universität Berlin, Berlin, Germany.,University of Veterinary Medicine, Vienna, Austria
| | | | | | | | | | | | | | | | | | | | - Pompei Bolfa
- Ross University, Basseterre, Saint Kitts and Nevis
| | - John Cullen
- North Carolina State University, Raleigh, NC, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Nick Dervisis
- VA-MD College of Veterinary Medicine, Blacksburg, VA, USA
| | | | | | | | | | | | - Keith Linder
- North Carolina State University, Raleigh, NC, USA
| | | | | | | | - Renato L Santos
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - R Mark Simpson
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Harold Tvedten
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | |
Collapse
|
15
|
Del Magno S, Morello E, Iussich S, Gola C, Dalpozzo B, Annoni M, Martano M, Massari F, Giacobino D, Piras LA, Stefanello D, Buracco P. Evaluation of the neoplastic infiltration of the skin overlying canine subcutaneous soft tissue sarcomas: An explorative study. Vet Comp Oncol 2021; 19:304-310. [PMID: 33423367 DOI: 10.1111/vco.12676] [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: 08/12/2020] [Revised: 12/17/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
Studies regarding the neoplastic infiltration of the skin overlying canine subcutaneous soft tissue sarcoma (sSTS) are lacking. In case of the absence of tumor infiltration, there would be the possibility of leaving this unaffected skin in place, thus simplifying surgery. The aim of the study was to investigate whether the skin overlying sSTSs is infiltrated by neoplastic cells. Dogs with sSTSs treated surgically were prospectively enrolled. After excision, the skin was dissected from the tumor along the natural surgical plane of cleavage and histologically evaluated. Twenty-nine dogs with an sSTS were included (22 grade I, 6 grade II, and 1 grade III). The sSTS-overlying skin was not tumor-infiltrated in 14/29 cases (48.3%). A higher frequency of infiltration was observed in higher grade sSTSs (grades II and III, 100%; P = .006); nevertheless, 8/22 grade I sSTSs (36%) also showed cutaneous infiltration. This infiltration involved the dermis of the skin directly in contact with the tumor (multifocal in 11 and diffuse in four cases). Although the cutaneous tumor infiltration is less frequent in grade I sSTSs and a wide excision may still be the safest treatment for any sSTS for a greater possibility of local control, this study opens the possibility to a less aggressive cutaneous excision, but still with a local curative intent, as only the skin directly in contact with the sSTS has been proven to be tumor-infiltrated. Additional studies are warranted to confirm that excision of only this skin may guarantee a complete local control, especially in lower-grade sSTSs.
Collapse
Affiliation(s)
- Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Emanuela Morello
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Selina Iussich
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Cecilia Gola
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Boris Dalpozzo
- Clinica Veterinaria dell'Orologio, Sasso Marconi, Bologna, Italy
| | | | - Marina Martano
- Department of Veterinary-Medical Sciences, University of Parma, Parma, Italy
| | | | - Davide Giacobino
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Lisa Adele Piras
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | | | - Paolo Buracco
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| |
Collapse
|
16
|
Chiti LE, Ferrari R, Boracchi P, Morello E, Marconato L, Roccabianca P, Avallone G, Iussich S, Giordano A, Ferraris EI, Agnoli C, Dondi F, Giacobino D, Godizzi F, Stefanello D. Prognostic impact of clinical, haematological, and histopathological variables in 102 canine cutaneous perivascular wall tumours. Vet Comp Oncol 2021; 19:275-283. [PMID: 33386693 DOI: 10.1111/vco.12673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/22/2020] [Accepted: 12/27/2020] [Indexed: 12/21/2022]
Abstract
Identification of prognostic factors for perivascular wall tumours (PWTs) is desirable to accurately predict prognosis and guide treatment. 100 and two dogs with surgically excised PWTs without distant metastasis were retrospectively enrolled in this multi-institutional study, and the impact of pre-treatment leukocyte parameters, clinical and histopathological variables on local recurrence (LR) and overall-survival time (OST) were evaluated. Increasing values of white blood cell count (WBCC), neutrophil count (NC) and neutrophil-to-lymphocyte ratio (NLR) were significantly correlated with the hazard of LR in univariate analysis. WBCC and NC remained prognostic when adjusted for margins, grade, tumour size, location and skin ulceration, but lost their significance when adjusted for mitotic index and necrosis, whilst NLR remained prognostic only when close margins where categorised as infiltrated. Castrated males had a higher hazard of LR than intact males in univariate analysis, but significance was lost in multivariate models. Ulcerated PWTs and those located on the distal extremities had a higher hazard of LR both in univariate and multivariate analysis. Histological grade, necrosis, mitotic count, and infiltrated margins were all associated with LR both in univariate and multivariate analysis. Boxer breed, older age, ulceration, grade III, necrosis >50% and higher mitotic count were correlated with shorter OST, although breed and age lost their significance in multivariate analysis. Prognostication of surgically excised PWTs should be based on both clinical and histopathological variables. If validated in further studies, leukocyte counts and NLR may aid the clinician in identifying dogs at higher risk of LR before treatment.
Collapse
Affiliation(s)
- Lavinia E Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Patrizia 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
| | - Emanuela Morello
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - Laura Marconato
- Dipartimento di Scienze Mediche Veterinarie (DIMEVET), Università degli Studi di Bologna, Ozzano dell'Emilia, Italy
| | - Paola Roccabianca
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giancarlo Avallone
- Dipartimento di Scienze Mediche Veterinarie (DIMEVET), Università degli Studi di Bologna, Ozzano dell'Emilia, Italy
| | - Selina Iussich
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - Alessia Giordano
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Erica I Ferraris
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - Chiara Agnoli
- Dipartimento di Scienze Mediche Veterinarie (DIMEVET), Università degli Studi di Bologna, Ozzano dell'Emilia, Italy
| | - Francesco Dondi
- Dipartimento di Scienze Mediche Veterinarie (DIMEVET), Università degli Studi di Bologna, Ozzano dell'Emilia, Italy
| | - Davide Giacobino
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Turin, Italy
| | - Francesco Godizzi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
17
|
Itoh T, Kojimoto A, Uchida K, Chambers J, Shii H. Long-term postsurgical outcomes of mast cell tumors resected with a margin proportional to the tumor diameter in 23 dogs. J Vet Med Sci 2020; 83:230-233. [PMID: 33342962 PMCID: PMC7972896 DOI: 10.1292/jvms.20-0281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We evaluated the postsurgical outcomes of cutaneous or subcutaneous mast cell tumors
(MCTs, n=25) in 23 dogs, resected with lateral surgical margins proportional to the widest
tumor diameter, including at least one facial plane. The tumor diameter range was 0.3–2.6
cm (median: 0.9 cm), and all were histologically diagnosed as Kiupel’s low-grade MCT.
Resection was histologically complete in 20, close (deep margin) in three, and incomplete
(deep margin) in two. No dogs developed local recurrence at the site of initial surgery
during follow-up of 161–2,219 days (median: 976 days). These results suggest that
resection of low-grade, relatively small MCTs with surgical margins proportional to the
tumor diameter is a practical procedure with high success rates.
Collapse
Affiliation(s)
- Teruo Itoh
- Aoba Animal Hospital, 92-1 Aoba, Miyazaki, Miyazaki 880-0842, Japan.,Division of Animal Medical Research, Hassen-kai, 2-27 Onozaki, Saito, Miyazaki 881-0012, Japan
| | - Atsuko Kojimoto
- Aoba Animal Hospital, 92-1 Aoba, Miyazaki, Miyazaki 880-0842, Japan.,Division of Animal Medical Research, Hassen-kai, 2-27 Onozaki, Saito, Miyazaki 881-0012, Japan
| | - Kazuyuki Uchida
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Yayoi 1-1, Bunkyo-ku, Tokyo 113-8657, Japan
| | - James Chambers
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Yayoi 1-1, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hiroki Shii
- Division of Animal Medical Research, Hassen-kai, 2-27 Onozaki, Saito, Miyazaki 881-0012, Japan
| |
Collapse
|
18
|
Saunders H, Thomson MJ, O'Connell K, Bridges JP, Chau L. Evaluation of a modified proportional margin approach for complete surgical excision of canine cutaneous mast cell tumours and its association with clinical outcome. Vet Comp Oncol 2020; 19:604-615. [PMID: 32558125 DOI: 10.1111/vco.12630] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 12/27/2022]
Abstract
Canine cutaneous mast cell tumours (MCTs) represent a common neoplasm in veterinary practice. Several reported techniques are available to guide surgical excision. Our study examined one hundred cutaneous MCTs that were excised surgically using a modified proportional margin approach. A 2 cm lateral margin upper limit was applied for any tumour diameter that exceeded this size with a deep surgical margin of one fascial plane applied. A retrospective, cross-sectional study with follow-up was used to determine the clinical utility of this excision technique. Associations between explanatory variables of tumour size and grade were compared with outcomes of complete excision and size of histologic tumour-free margins (HTFM) using the appropriate Pearson's χ2 and Fisher's exact tests. Follow-up data evaluated tumour recurrence and patient survival. Ninety-five percent of MCTs (95/100) were completely excised. No significant association in the achievement of complete excision between low- and high-grade MCTs (P = .48) was noted. Tumour size was not associated with the rate of complete excision (P = .06). Tumour grade and size did not influence the size of the HTFM (P = .94 and P = .14, respectively). Overall, a recurrence rate of 3% (3/100 tumours) and de novo MCT development rate of 7.7% (5/65 dogs) was noted, with median follow-up period of 593 days (range 180-1460 days). Post-operative metastases were seen in 4.6% of dogs (3/65). Therefore, a modified proportional margin approach with 2 cm lateral margin upper limit is a suitable technique to guide surgical excision of canine cutaneous MCTs.
Collapse
Affiliation(s)
- Harvey Saunders
- Department of Oncology, Animal Referral Hospital Brisbane, Sinnamon Park, Queensland, Australia
| | - Maurine J Thomson
- Department of Oncology, Animal Referral Hospital Brisbane, Sinnamon Park, Queensland, Australia
| | - Kathleen O'Connell
- Department of Oncology, Animal Referral Hospital Brisbane, Sinnamon Park, Queensland, Australia
| | - Janis P Bridges
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - Lincoln Chau
- Department of Oncology, Animal Referral Hospital Brisbane, Sinnamon Park, Queensland, Australia
| |
Collapse
|
19
|
Bray J. Histologic margins and the residual tumour classification scheme. Vet Comp Oncol 2020; 18:445-446. [PMID: 32378307 DOI: 10.1111/vco.12607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/30/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Jonathan Bray
- Fitzpatrick Referrals Oncology and Soft Tissue, Guildford, UK
| |
Collapse
|