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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.
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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
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2
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Brown GK, Finlay JR, Straw RC, Ziea JY, Leung B, O'Connell K, Thomson MJ, Campbell JE, Jones PD, Reddell P. Treatment of multiple synchronous canine mast cell tumours using intratumoural tigilanol tiglate. Front Vet Sci 2022; 9:1003165. [PMID: 36387404 PMCID: PMC9643212 DOI: 10.3389/fvets.2022.1003165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/30/2022] [Indexed: 02/16/2024] Open
Abstract
Mast cell tumours (MCTs) are common canine skin neoplasia. While they generally occur as single tumours, multiple synchronous MCTs (msMCTs) of de novo/non-metastatic origin are reported in a proportion of the patient population. Where there is no evidence of metastasis or lymphatic spread, MCTs are effectively controlled by surgery and other local therapies. However, treatment of de novo msMCTs can be more challenging, especially when they occur in surgically difficult locations. Here, we report the use of tigilanol tiglate, a novel small molecule registered as a veterinary pharmaceutical for the local treatment of non-metastatic MCTs, in the treatment of patients with msMCTs presenting at three Australian specialist referral centres. We also present a meta-analysis of the literature to provide a better understanding of the prevalence of canine msMCTs. Notably, nine patients with a total of 32 MCTs were treated during the study. A complete response was recorded in 26 (81%) of the individual MCTs on Day 28 after a single tigilanol tiglate injection. Of the 6 initially non-responsive MCTs, one achieved a complete response after a further tigilanol tiglate treatment. A complete response was reported at 6 months in all 22 of the tumours that were evaluable and that had recorded a complete response at Day 84. For the literature meta-analysis, 22 studies were found with prevalence estimates of msMCTs ranging from 3 to 40%; when combined, these studies yielded 3,745 patients with a prevalence of 13% (95% CI 10; 16). Overall, the results demonstrate the utility of intratumoural tigilanol tiglate as an option for the treatment of multiple MCTs where multiple surgical resections would have been required.
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Affiliation(s)
| | | | - Rodney C. Straw
- Brisbane Veterinary Specialist Centre, The Australian Animal Cancer Foundation, Albany Creek, QLD, Australia
| | - Joy Y. Ziea
- Brisbane Veterinary Specialist Centre, The Australian Animal Cancer Foundation, Albany Creek, QLD, Australia
| | - Becky Leung
- Brisbane Veterinary Specialist Centre, The Australian Animal Cancer Foundation, Albany Creek, QLD, Australia
| | | | | | | | | | - Paul Reddell
- QBiotics Group Limited, Yungaburra, QLD, Australia
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3
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Mickelson MA. Updated Concepts in Oncologic Surgery: Apocrine Gland Anal Sac Adenocarcinoma and Mast Cell Tumors. Vet Clin North Am Small Anim Pract 2022; 52:549-580. [DOI: 10.1016/j.cvsm.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Ridder T, Reddell P, Jones P, Brown G, Campbell J. Tigilanol Tiglate-Mediated Margins: A Comparison With Surgical Margins in Successful Treatment of Canine Mast Cell Tumours. Front Vet Sci 2021; 8:764800. [PMID: 34977208 PMCID: PMC8715915 DOI: 10.3389/fvets.2021.764800] [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: 08/26/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
Tigilanol tiglate (TT) is a novel small molecule registered as a veterinary pharmaceutical for intratumoural treatment of canine mast cell tumours (MCTs). The drug has a multifactorial mode of action resulting in rapid destruction of the treated tumour by haemorrhagic necrosis and subsequent slough of the necrotic tumour to reveal a tissue deficit that is left to heal by second intention with minimal to no veterinary intervention. Here we introduce the concept of TT-mediated margins, the calculated margin of tissue loss analogous to surgically applied margins to help clinicians conceptualise tissue deficits formed following tumour destruction by TT relative to surgical excision. We used data from 51 dogs that were recurrence-free 12 months after a single administered TT dose into a single target MCT <10 cm3 in volume in a randomised, controlled clinical trial in the USA. We calculated TT-mediated margins based on length of the longest axis of (i) the tumour prior to treatment and (ii) the maximum tissue deficit formed 7–14 days after TT treatment. We compared these TT-mediated margins for each tumour to two surgical approaches to MCT excision in general practise: modified proportional margins (with 2 cm upper limit) and 3 cm fixed margins. For most dogs, TT-mediated margins were less than half the length of the margins calculated for the two surgical approaches in removing the same tumour. There was a trend for TT-mediated margins to increase with increasing tumour volume. Nonetheless, even for the larger tumours in this study (>2 cm3 volume), 50% of TT-mediated margins were less than half the length of the two surgical margins. Eighteen cases were lower limb MCTs, sites often surgically challenging in veterinary practise. On these lower limbs, TT-mediated margins were less than half the length of the corresponding proportional margins in 56% of cases and larger than proportional margins in only two cases. This study suggests that, in many cases, smaller and more targeted margins could be expected when treating MCTs <10 cm3 volume with TT compared with surgical excision. TT-mediated margins are a novel approach to conceptualise tissue deficits after intratumoural TT treatment.
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Freytag JO, Queiroz MR, Govoni VM, Pereira IVA, Pulz LH, de Francisco Strefezzi R, Queiroga FL, Cogliati B. Prognostic value of immunohistochemical markers in canine cutaneous mast cell tumours: A systematic review and meta-analysis. Vet Comp Oncol 2021; 19:529-540. [PMID: 33724647 DOI: 10.1111/vco.12692] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/26/2021] [Accepted: 03/13/2021] [Indexed: 12/29/2022]
Abstract
Histological grading systems remain cornerstones in the prognosis of canine cutaneous mast cell tumours (MCTs), but the distinct biological behaviour of each tumour often necessitates the use of complementary markers. Although a plethora of immunohistochemical markers have been proposed as prognostic factors, few are presently applied in routine diagnosis. This systematic review and meta-analysis was designed to establish which immunohistochemical markers have verifiable prognostic value for cutaneous MCTs in dogs. A Boolean search of five databases identified 200 articles for screening, of which 73 were selected for full-text assessment and 24 ultimately included in the systematic review. Odds Ratio (OR) was adopted as the summary measure for subsequent meta-analysis but only 15 articles, relating to the immunomarkers Ki-67 (9), KIT (5), and BAX (2), provided either a value for OR or sufficient data to calculate this statistic. Meta-analysis verified that canine cutaneous MCTs with elevated expression of Ki-67 or BAX, as well aberrant immuno-expression of KIT, showed an increased odds of death, with respective OR values of 11.2 (95% CI 6.3-20.0; p < .01), 9.9 (95% CI 1.3-73.6; p = .03), and 4.1 (95% CI 1.1-15.3; p = .03). Despite KIT, Ki67, and BAX arise as suitable prognostic factor for canine MCTs, this study highlighted the lack of important clinical and statistical data in many published articles, rendering it impossible to complete the meta-analysis of several potentially valuable immunohistochemical markers.
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Affiliation(s)
- Jennifer Ostrand Freytag
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Mariana Ramos Queiroz
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Verônica Mollica Govoni
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Isabel Veloso Alves Pereira
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Lidia Hildebrand Pulz
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, Brazil
| | - Ricardo de Francisco Strefezzi
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, Brazil
| | - Felisbina Luisa Queiroga
- Center for Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Cogliati
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
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Karbe GT, Davis E, Runge JJ, Brown DC, Holt DE. Evaluation of scar revision after inadequate primary excision of cutaneous mast cell tumors in 85 dogs (2000-2013). Vet Surg 2021; 50:807-815. [PMID: 33666268 DOI: 10.1111/vsu.13619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/25/2021] [Accepted: 02/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the frequency of residual tumor, and factors associated with local recurrence and disease progression in dogs with incompletely excised mast cell tumors (MCT) following scar revision surgery. STUDY DESIGN Retrospective study. ANIMALS Eighty-five dogs. METHODS Medical records from January 2000 to April 2013 were reviewed. Dogs with scar revision surgery after incomplete primary MCT excision were included. Recorded were signalment; initial tumor size, location and grade; time interval between primary excision and scar revision surgery; presence of MCT in the resected scar; local recurrence, lymph node metastasis, systemic metastasis, and cause of death. RESULTS Eighty six tumors in 85 dogs were studied. Residual MCT was found in 23 (27%) resected scars. Seven (8%) scars with residual MCT had incomplete or narrow margins. Follow-up was available for 68 dogs (69 tumors; median 403 days; range 4-2939). Local recurrence was reported in three (4%) dogs at 212, 555, and 993 days. Disease progressed in 10 dogs (14.5%) with regional or systemic metastasis at a median of 207 days (64-1583). Margin status and presence of MCT in the resected scar were not associated with local recurrence or disease progression. Lymph node metastasis (p = .004), locoregional recurrence (p = .013), and disease progression (p = .001) were significantly more likely in Grade III tumors. CONCLUSION Twenty-seven percent of resected scars contained residual MCT, but recurrence was uncommon after surgical revision. CLINICAL SIGNIFICANCE Clinicians should primarily consider tumor grade when estimating the likelihood of local recurrence and disease progression and determining the need for ancillary treatment of MCT after scar resection.
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Affiliation(s)
- Georga T Karbe
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Elizabeth Davis
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Jeffrey J Runge
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Dorothy C Brown
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - David E Holt
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
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Abrams BE, Putterman AB, Ruple A, Wavreille V, Selmic LE. Variability in tumor margin reporting for soft tissue sarcoma and cutaneous mast cell tumors in dogs: A systematic review. Vet Surg 2020; 50:259-272. [DOI: 10.1111/vsu.13539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 10/01/2020] [Accepted: 10/17/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Brittany E. Abrams
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
| | - Allison B. Putterman
- Department of Veterinary Clinical Medicine College of Veterinary Medicine, University of Illinois at Urbana‐Champaign Urbana Illinois
| | - Audrey Ruple
- Department of Comparative Pathobiology College of Veterinary Medicine, Purdue University West Lafayette, Indiana
| | - Vincent Wavreille
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
| | - Laura E. Selmic
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
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Oliveira MT, Campos M, Lamego L, Magalhães D, Menezes R, Oliveira R, Patanita F, Ferreira DA. Canine and Feline Cutaneous Mast Cell Tumor: A Comprehensive Review of Treatments and Outcomes. Top Companion Anim Med 2020; 41:100472. [PMID: 32891740 DOI: 10.1016/j.tcam.2020.100472] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/19/2022]
Abstract
Mast cell tumor (MCT) or mastocytoma is one of the most frequent malignant cutaneous tumors in the dog, and the second most frequent in the cat. Several mast cell tumor therapeutic approaches have been proposed in the past years for dogs and cats, resulting in very distinct outcomes. The current comprehensive literature review presents a critical approach to the scientific information published about the MCTs treatments and the subsequent prognosis and survival times, in dogs and in cats diagnosed with MCTs. A systematic review of the literature following the Cochrane principles and methodology was performed. The authors resorted to MEDLINE, Scopus, Google Scholar and Web of Science databases to select the 133 publications with evidence-based treatments for MCTs in companion animals. Results of the review suggest that the recommended treatment, prognosis and survival times for dogs and cats with MCTs depends at all times on the clinical staging, histological grade and location of the tumor.
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Affiliation(s)
- Maria Teresa Oliveira
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal; Departamento de Medicina Veterinária, Escola de Ciências e Tecnologia, Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal.
| | - Marco Campos
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - Luís Lamego
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - Diogo Magalhães
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - Rui Menezes
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - Renato Oliveira
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - Francisco Patanita
- Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
| | - David A Ferreira
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal; Departamento de Medicina Veterinária, Escola de Ciências e Tecnologia, Universidade de Évora, Pólo da Mitra, Núcleo da Mitra, 7000 Évora, Portugal
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9
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Chu ML, Hayes GM, Henry JG, Oblak ML. Comparison of lateral surgical margins of up to two centimeters with margins of three centimeters for achieving tumor-free histologic margins following excision of grade I or II cutaneous mast cell tumors in dogs. J Am Vet Med Assoc 2020; 256:567-572. [PMID: 32068517 DOI: 10.2460/javma.256.5.567] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether conservative lateral surgical margins (equal to tumor diameter for tumors < 2 cm in diameter or 2 cm for larger tumors) were noninferior to wide (3-cm) lateral surgical margins for achieving tumor-free histologic margins following excision of grade I and II cutaneous mast cell tumors (MCTs) in dogs. ANIMALS 83 grade I and II MCTs excised with a deep surgical fascial margin and requisite lateral surgical margins from 68 dogs from 2007 to 2017. Tumors representing scar revision or local recurrence were excluded. PROCEDURES A pathology department database was searched to identify qualifying MCTs, and medical records were cross-referenced to obtain data regarding patients and tumors. Outcome (complete vs incomplete excision as histologically determined) was compared between conservative- and wide-margin groups. A noninferiority margin of ≥ 0.9 was used for the risk ratio (probability of complete excision for the conservative- vs wide-margin group), implying that noninferiority would be established if the data indicated that the true risk of complete excision with the conservative-margin approach was at worst 90% of that for the wide-margin approach. RESULTS The proportion of excised MCTs with tumor-free histologic margins was similar between the conservative- (43/46 [93%]) and wide- (34/37 [92%]) margin groups. There were no differences in tumor diameter or location between treatment groups. The risk ratio (1.02; 95% confidence interval, 0.89 to 1.19) met the criterion for noninferiority. CONCLUSIONS AND CLINICAL RELEVANCE The conservative-margin approach appeared to be noninferior to the wide-margin approach for achieving tumor-free histologic margins in the dogs of this study, and its use could potentially reduce the risk of postoperative complications. (J Am Vet Med Assoc 2020;256:567-572.
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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.
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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
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De Ridder TR, Campbell JE, Burke-Schwarz C, Clegg D, Elliot EL, Geller S, Kozak W, Pittenger ST, Pruitt JB, Riehl J, White J, Wiest ML, Johannes CM, Morton J, Jones PD, Schmidt PF, Gordon V, Reddell P. Randomized controlled clinical study evaluating the efficacy and safety of intratumoral treatment of canine mast cell tumors with tigilanol tiglate (EBC-46). J Vet Intern Med 2020; 35:415-429. [PMID: 32542733 PMCID: PMC7848366 DOI: 10.1111/jvim.15806] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate the efficacy and safety of tigilanol tiglate (TT) for local intratumoral treatment of mast cell tumors (MCTs) in dogs. Methods A randomized controlled clinical study in 2 phases involving 123 dogs with cytologically diagnosed MCT. Phase 1 compared 81 TT‐treated dogs with 42 control dogs; phase 2 allowed TT treatment of control dogs and retreatment of dogs that failed to achieve tumor resolution after TT treatment in phase 1. Tigilanol tiglate (1 mg/mL) was injected intratumorally with dose based on tumor volume. Concomitant medications were used to minimize potential for MCT degranulation. Modified response evaluation criteria in solid tumors were used to evaluate treatment response at 28 and 84 days. Adverse events and quality of life were also assessed. Results A single TT treatment resulted in 75% complete response (CR) (95% confidence interval [CI] = 61‐86) by 28 days, with no recurrence in 93% (95% CI = 82‐97) of dogs by 84 days. Eight TT‐treated dogs that did not achieve CR in phase 1 achieved CR after retreatment, increasing the overall CR to 88% (95% CI = 77‐93). Control dogs had 5% CR (95% CI = 1‐17) at 28 days. Wound formation after tumor slough and wound size relative to tumor volume were strongly associated with efficacy. Adverse events typically were low grade, transient, and directly associated with TT's mode of action. Conclusions Tigilanol tiglate is efficacious and well tolerated, providing a new option for the local treatment of MCTs in dogs.
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Affiliation(s)
| | | | | | - David Clegg
- Liverpool Animal Health Clinic, Liverpool, New York, USA
| | - Emily L Elliot
- Chippens Hill Veterinary Hospital, Bristol, Connecticut, USA
| | - Samuel Geller
- Quakertown Veterinary Clinic, Quakertown, Pennsylvania, USA
| | - Wendy Kozak
- Franklin Lakes Animal Hospital, Franklin Lakes, New Jersey, USA
| | | | | | - Jocelyn Riehl
- Paradise Animal Hospital, Catonsville, Maryland, USA
| | - Julie White
- Animal Hospital of Seminole, Seminole, Florida, USA
| | - Melissa L Wiest
- Bradford Park Veterinary Hospital, Springfield, Missouri, USA
| | - Chad M Johannes
- College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - John Morton
- Jemora Consulting, Geelong, Victoria, Australia
| | - Pamela D Jones
- QBiotics Group Limited, Yungaburra, Queensland, Australia
| | | | | | - Paul Reddell
- QBiotics Group Limited, Yungaburra, Queensland, Australia
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12
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Pecceu E, Serra Varela JC, Handel I, Piccinelli C, Milne E, Lawrence J. Ultrasound is a poor predictor of early or overt liver or spleen metastasis in dogs with high-risk mast cell tumours. Vet Comp Oncol 2020; 18:389-401. [PMID: 31863546 DOI: 10.1111/vco.12563] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Abstract
Conflicting evidence exists regarding the importance of routine abdominal ultrasound (US) with hepatic and splenic fine needle aspiration (FNA) cytology during staging of canine mast cell tumours (MCT). The objective of this study was to correlate ultrasonographic and cytologic findings in dogs with strictly defined high-risk MCTs and to determine the influence on outcome. Our hypothesis was that US poorly predicts visceral metastasis in high-risk MCTs and that early metastasis is associated with improved outcome when compared to overt metastasis. US of liver and spleen correlated to cytologic results, categorized as no metastasis, early metastasis or overt metastasis. Of 82 dogs prospectively enrolled, 18% had early visceral metastasis and 7% had overt metastasis on cytology; 67% with visceral metastasis had regional LN metastasis. US was a poor predictor of metastasis with sensitivity, specificity, positive predictive value and negative predictive value for the spleen of 67%, 68%, 21% and 94%, respectively and for the liver of 29%, 93%, 56% and 82%, respectively. Median time to progression (TTP) for dogs with no metastasis, early metastasis and overt metastasis was not reached, 305 and 69 days, respectively (P < .001). Median survival time (MST) for the 3 groups were not reached, 322 and 81 days, respectively (P < .001). High Patnaik or Kiupel grade, early metastasis, overt metastasis and adequate local control were significantly associated with outcome. Early visceral metastasis was associated with poorer outcome compared to dogs without metastasis, however, a subset of dogs experienced long-term control.
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Affiliation(s)
- Evi Pecceu
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Juan Carlos Serra Varela
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Chiara Piccinelli
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Elspeth Milne
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Jessica Lawrence
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
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Liptak JM. Histologic margins and the residual tumour classification scheme: Is it time to use a validated scheme in human oncology to standardise margin assessment in veterinary oncology? Vet Comp Oncol 2019; 18:25-35. [DOI: 10.1111/vco.12555] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 12/12/2022]
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14
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Mendez SE, Drobatz KJ, Duda LE, White P, Kubicek L, Sorenmo KU. Treating the locoregional lymph nodes with radiation and/or surgery significantly improves outcome in dogs with high-grade mast cell tumours. Vet Comp Oncol 2019; 18:239-246. [PMID: 31509648 DOI: 10.1111/vco.12541] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 08/15/2019] [Accepted: 09/03/2019] [Indexed: 11/30/2022]
Abstract
High-grade canine mast cell tumours (HG-MCT) have a high rate of locoregional relapse. In this study, dogs with HG-MCT treated with radiation therapy (RT) were retrospectively evaluated to determine the benefit associated with treating the locoregional lymph nodes (LNs). Forty-two dogs were included. Variables assessed for association with overall survival (OS) and progression-free survival (PFS) included WHO stage, tumour location and size, LN irradiation (prophylactic, therapeutic or none), LN treatment (yes or no), LN status at RT (metastatic or nonmetastatic) and RT intent (definitive vs palliative). Lower-stage disease at irradiation was significantly associated with prolonged median PFS (425 vs 125 days for stage 0 vs 1-4), and OS (615 vs 314 days for stage 0 vs 1-4). Having any LN treatment and definitive RT were both significantly associated with prolonged OS. In order to evaluate the role of LN irradiation, dogs were divided into subgroups: (a) stage 0 at irradiation with no LN treatment (n = 14), (b) stage 0 at irradiation with prophylactic LN irradiation (n = 6), (c) stage 0 at irradiation but previously stage 2 (n = 5) and (d) stage >0 at irradiation (n = 17). Prophylactic LN irradiation significantly prolonged PFS (>2381 vs 197 days; group B vs A). Interestingly, dogs that were stage 2 and had LN treatment (C) had prolonged OS vs dogs with negative LNs and no LN treatment (A) (1908 vs 284 days; P = .012). This study confirms that prophylactic and therapeutic LN irradiation in dogs with HG-MCT is beneficial and improves outcome.
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Affiliation(s)
- Susan E Mendez
- University of Pennsylvania, Department of Clinical Sciences & Advanced Medicine, Philadelphia, PA
| | - Kenneth J Drobatz
- University of Pennsylvania, Department of Clinical Sciences & Advanced Medicine, Philadelphia, PA
| | - Lilian E Duda
- University of Pennsylvania, Department of Clinical Sciences & Advanced Medicine, Philadelphia, PA.,University of Pennsylvania, Penn Vet Cancer Center, Philadelphia, Pennsylvania
| | | | | | - Karin U Sorenmo
- University of Pennsylvania, Penn Vet Cancer Center, Philadelphia, Pennsylvania.,University of Pennsylvania, Department of Biomedical Sciences, Philadelphia, Pennsylvania
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15
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Milovancev M, Townsend KL, Tuohy JL, Gorman E, Bracha S, Curran KM, Russell DS. Long-term outcomes of dogs undergoing surgical resection of mast cell tumors and soft tissue sarcomas: A prospective 2-year-long study. Vet Surg 2019; 49:96-105. [PMID: 31044443 DOI: 10.1111/vsu.13225] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 03/19/2019] [Accepted: 04/14/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Report clinical outcomes of dogs with surgically excised mast cell tumors (MCT) and soft tissue sarcomas (STS). STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Fifty-three dogs with 52 MCT (50 low grade, 2 high grade) and 19 STS (12 grade I, 6 grade II, 1 grade III). METHODS All dogs were examined at 3, 6, 12, 18, and 24 months postoperatively, with cytologic or histopathologic evaluation of suspected local recurrences. Dogs euthanized because of study tumor-related causes underwent necropsy. RESULTS Median intraoperative margins were 20 mm and 30 mm wide for MCT and STS, respectively, with 1 fascial plane resected en bloc. The narrowest histologic tumor-free margins measured <1 mm in 21 of 52 (40%) MCT and 7 of 19 (37%) STS. All dogs were followed for 24 months. Two of 50 (4%) low-grade MCT were diagnosed, with local recurrence 181 and 265 days postoperatively. Two of 36 (6%) dogs with low-grade MCT developed visceral metastasis 181 and 730 days postoperatively. One of 2 dogs with high-grade MCT developed local recurrence 115 days postoperatively. No local recurrence or metastasis was diagnosed after excision of 19 STS. CONCLUSION Local recurrence rates among predominantly low- to intermediate-grade MCT and STS were low, despite a high prevalence of histologic tumor-free margins <1 mm. Surgical recommendations for high-grade tumors cannot be extrapolated from this population. CLINICAL SIGNIFICANCE Surgeons should seek to achieve microscopically complete excision for MCT and STS while minimizing patient morbidity and considering limitations of histopathology in predicting outcomes.
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Affiliation(s)
- Milan Milovancev
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Katy L Townsend
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Joanne L Tuohy
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Elena Gorman
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Shay Bracha
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Kaitlin M Curran
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
| | - Duncan S Russell
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
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16
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Upchurch DA, Klocke EE, Henningson JN. Amount of skin shrinkage affecting tumor versus grossly normal marginal skin of dogs for cutaneous mast cell tumors excised with curative intent. Am J Vet Res 2018; 79:779-786. [DOI: 10.2460/ajvr.79.7.779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Reagan JK, Selmic LE, Fallon C, Driskell EA, Garrett LD. Evaluation of information presented within mast cell tumour histopathology reports in the United States: 2012-2015. Vet Med Sci 2018; 4:252-262. [PMID: 29877634 PMCID: PMC6090413 DOI: 10.1002/vms3.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
For canine mast cell tumour (MCT), histopathology reports are one of the main factors considered in the decision-making process regarding need and type of adjunctive therapy. However, considerable variation exists in types of information reported, especially relating to surgical margins. The purpose of this study was to describe and evaluate how information is presented within canine MCT histopathology reports across the United States. The reports were collected from medical and surgical oncologists from 4 geographic regions of the USA: Midwest, Northeast, South and West. All reports were obtained between January 1st 2012 and May 1st 2015. Inclusion criteria required that the final diagnosis was MCT, a microscopic description was present, and it was not a scar revision. Three hundred and sixty-eight reports were collected from 26 contributors. While the majority of the reports contained a clinical history (85.9%), information for certain prognostic indicators such as location and mass size was lacking. Grading with both Patnaik and Kiupel systems were described in 76.5% of reports with a single system being used in 7.1% and 15.2% of reports, respectively. Subcutaneous MCT were assigned a grading scheme in 67.2% of reports with 33.3% stating appropriate limitations. Surgical margins were reported in 92% of the reports with 77.2% describing deep and lateral margins separately. Tissue composing the deep margin was only described in 10.9% of the reports. The present results indicate reporting of MCT has variability across pathologists with inconsistencies present in the reporting of clinical history, margin evaluation and subcutaneous MCT grading.
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Affiliation(s)
- Jennifer K. Reagan
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Laura E. Selmic
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Caroline Fallon
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
- Department of PathobiologyCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Elizabeth A. Driskell
- Department of Clinical SciencesCollege of Veterinary MedicineAuburn UniversityAuburnAlabama
| | - Laura D. Garrett
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
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18
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Ilyinskaya GV, Mukhina EV, Soboleva AV, Matveeva OV, Chumakov PM. Oncolytic Sendai Virus Therapy of Canine Mast Cell Tumors (A Pilot Study). Front Vet Sci 2018; 5:116. [PMID: 29915788 PMCID: PMC5995045 DOI: 10.3389/fvets.2018.00116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 05/15/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Canine mastocytomas (mast cell tumors) represent a common malignancy among many dog breeds. A typical treatment strategy for canine mastocytomas includes surgery, chemo- and radio-therapy, although in many cases the therapy fails and the disease progression resumes. New treatment approaches are needed. Aims: The goal of this pilot study was to examine safety and efficacy of oncolytic Sendai virus therapy administered to canine patients with cutaneous or subcutaneous mastocytomas. Materials and Methods: Six canine patients, with variable grades and stages of the disease, received virus therapy, either as a monotherapy, or in combination with surgery. The therapy included two or more virus applications administered weekly or biweekly. Each application of Sendai virus (107-108.6 EID50) consisted of multiple individual 0.01-0.1 ml injections delivered intratumorally, intradermally around a tumor, and under a tumor bed. Results: The treatment was well tolerated, with minor transitory side effects. Of the six dogs, two did not receive surgery or any other treatment besides the virus injections. The other four animals underwent radical or debulking surgeries, and in three of them the subsequent administration of Sendai virus completely cleared locally recurrent or/and remaining tumor masses. Five dogs demonstrated a complete response to the treatment, the animals remained disease free during the time of observation (2-3 years). One dog responded only partially to the virotherapy; its after-surgical recurrent tumor and some, but not all, metastases were cleared. This dog had the most advanced stage of the disease with multiple enlarged lymph nodes and cutaneous metastases. Conclusion: The results of the pilot study suggest that Sendai virus injections could be safe and efficient for the treatment of dogs affected by mastocytomas.They also suggest the need of further studies for finding optimal schemes and schedules for this kind of therapy.
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Affiliation(s)
- Galina V. Ilyinskaya
- Engelhardt Institute of Molecular Biology, Moscow, Russia
- Blokhin Cancer Research Center, Moscow, Russia
| | - Elena V. Mukhina
- Veterinary Clinic of Herzen Oncology Research Institute, Moscow, Russia
| | - Alesya V. Soboleva
- Engelhardt Institute of Molecular Biology, Moscow, Russia
- Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Moscow, Russia
| | | | - Peter M. Chumakov
- Engelhardt Institute of Molecular Biology, Moscow, Russia
- Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Moscow, Russia
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19
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Russell D, Townsend K, Gorman E, Bracha S, Curran K, Milovancev M. Characterizing Microscopical Invasion Patterns in Canine Mast Cell Tumours and Soft Tissue Sarcomas. J Comp Pathol 2017; 157:231-240. [DOI: 10.1016/j.jcpa.2017.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 02/06/2023]
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20
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Dores C, Milovancev M, Russell D. Comparison of histologic margin status in low-grade cutaneous and subcutaneous canine mast cell tumours examined by radial and tangential sections. Vet Comp Oncol 2017; 16:125-130. [DOI: 10.1111/vco.12321] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/04/2017] [Accepted: 04/20/2017] [Indexed: 12/12/2022]
Affiliation(s)
- C.B. Dores
- Department of Biomedical Sciences; Oregon State University; Corvallis Oregon
| | - M. Milovancev
- Department of Clinical Sciences; Oregon State University; Corvallis Oregon
| | - D.S. Russell
- Department of Biomedical Sciences; Oregon State University; Corvallis Oregon
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21
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Milovancev M, Townsend KL, Gorman E, Bracha S, Curran K, Russell DS. Shaved margin histopathology and imprint cytology for assessment of excision in canine mast cell tumors and soft tissue sarcomas. Vet Surg 2017; 46:879-885. [DOI: 10.1111/vsu.12668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/07/2017] [Accepted: 02/25/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Milan Milovancev
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Kaitlin L. Townsend
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Elena Gorman
- Department of Biomedical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Shay Bracha
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Katie Curran
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Duncan S. Russell
- Department of Biomedical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
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22
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Milovancev M, Russell DS. Surgical margins in the veterinary cancer patient. Vet Comp Oncol 2017; 15:1136-1157. [PMID: 28194921 DOI: 10.1111/vco.12284] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 12/14/2022]
Abstract
In veterinary oncologic specimens, histopathology is the gold standard for determining adequacy of excision. Despite limitations of this technique, the pathologist's interpretation of margin status significantly impacts patient management, including indications for adjuvant therapy. This article aims to summarize peer-reviewed literature as it relates to histologic margin evaluation in veterinary cancer patients. The value of histologic tumour-free margins and technical factors influencing histopathologic margin outcomes are also discussed. We review alternative strategies for determining excisional status, and discuss how an evolving understanding of tumour biology might inform clinical and research perspectives on surgical margins. In doing so, we aim to provide context and a stimulus for future investigations into this important yet incompletely understood topic.
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Affiliation(s)
- M Milovancev
- Department of Veterinary Clinical Sciences, Oregon State University, Corvallis, OR, 97331, USA
| | - D S Russell
- Department of Biomedical Sciences, Oregon State University, Corvallis, OR, 97331, USA
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23
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Steffey MA. Principles and Applications of Surgical Oncology in Exotic Animals. Vet Clin North Am Exot Anim Pract 2016; 20:235-254. [PMID: 27890291 DOI: 10.1016/j.cvex.2016.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The diagnosis and treatment of cancer in exotic species is a rapidly evolving area of veterinary medicine. In general, surgical excision remains pivotal in cancer treatment, although optimal outcomes are achieved when a coherent and thorough diagnostic and therapeutic plan is created prior to surgery. While surgical cure is not always achieveable, multimodal treatment plans can offer a variety of options, and palliative procedures may be used to improve quality of life. Treatment goals, whether curative intent or palliative intent, should be identified before surgery, and practitioners should endeavor to adhere to surgical principles in order to attain the best outcomes.
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Affiliation(s)
- Michele A Steffey
- Surgical Oncology, University of California-Davis, School of Veterinary Medicine, 1 Shields Avenue, Davis, CA 95616, USA.
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24
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Hergt F, von Bomhard W, Kent MS, Hirschberger J. Use of a 2-tier histologic grading system for canine cutaneous mast cell tumors on cytology specimens. Vet Clin Pathol 2016; 45:477-83. [DOI: 10.1111/vcp.12387] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Franziska Hergt
- Clinic of Small Animal Internal Medicine; Center of Clinical Veterinary Medicine; LMU Munich; Munich Germany
| | | | - Michael S. Kent
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California Davis; Davis CA USA
| | - Johannes Hirschberger
- Clinic of Small Animal Internal Medicine; Center of Clinical Veterinary Medicine; LMU Munich; Munich Germany
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25
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Camus MS, Priest HL, Koehler JW, Driskell EA, Rakich PM, Ilha MR, Krimer PM. Cytologic Criteria for Mast Cell Tumor Grading in Dogs With Evaluation of Clinical Outcome. Vet Pathol 2016; 53:1117-1123. [DOI: 10.1177/0300985816638721] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 2-tiered histologic grading scheme for canine cutaneous mast cell tumors (MCTs) is based on morphologic characteristics of neoplastic cells, including karyomegaly, multinucleation, nuclear pleomorphism, and mitotic figures. Aspirates from MCTs may provide the same information more quickly, inexpensively, and less invasively. This study used these criteria to develop a cytologic grading scheme for canine MCTs to predict outcome. Three anatomic pathologists graded histologic samples from 152 canine MCTs. Three clinical pathologists evaluated aspirates from these masses using similar criteria. A cytologic grading scheme was created based on correlation with histologic grade and evaluated with a kappa statistic. Survival was evaluated with Kaplan-Meier survival curves. Cox proportional hazards regression was used to estimate hazard ratios for tumor grades and individual grading components. Simple logistic regression tested for relationships between risk factors and mortality. The cytologic grading scheme that best correlated with histology (kappa = 0.725 ± 0.085) classified a tumor as high grade if it was poorly granulated or had at least 2 of 4 findings: mitotic figures, binucleated or multinucleated cells, nuclear pleomorphism, or >50% anisokaryosis. The cytologic grading scheme had 88% sensitivity and 94% specificity relative to histologic grading. Dogs with histologic and cytologic high grade MCTs were 39 times and 25 times more likely to die within the 2-year follow-up period, respectively, than dogs with low grade MCTs. High tumor grade was associated with increased probability of additional tumors or tumor regrowth. This study concluded that cytologic grade is a useful predictor for treatment planning and prognostication.
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Affiliation(s)
- M. S. Camus
- Department of Pathology, University of Georgia, Athens, GA, USA
| | - H. L. Priest
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | - J. W. Koehler
- Department of Pathobiology, Auburn University, Auburn, AL, USA
| | - E. A. Driskell
- Department of Pathobiology, University of Illinois, Urbana, IL, USA
| | - P. M. Rakich
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, GA, USA
| | - M. R. Ilha
- Tifton Veterinary Diagnostic and Investigational Laboratory, University of Georgia, Athens, GA, USA
| | - P. M. Krimer
- Athens Veterinary Diagnostic Laboratory, University of Georgia, Athens, GA, USA
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26
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Sledge DG, Webster J, Kiupel M. Canine cutaneous mast cell tumors: A combined clinical and pathologic approach to diagnosis, prognosis, and treatment selection. Vet J 2016; 215:43-54. [PMID: 27372911 DOI: 10.1016/j.tvjl.2016.06.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/25/2016] [Accepted: 06/12/2016] [Indexed: 12/20/2022]
Abstract
In view of the varied biologic behavior and the costs of treatment for canine cutaneous mast cell tumors, development of appropriate treatment plans for individual affected dogs can be difficult, but decisions regarding treatment should be made using a systematic, evidence-based approach. This manuscript reviews the current state of diagnostics and prognostication of canine cutaneous mast cell tumors, and suggests a combined approach based on clinical and pathologic assessment for decision making regarding treatment choices. The current state of histologic grading, evaluation of proliferation indices, evaluation of mutations in the c-kit gene and KIT expression, evaluation of excision and clinical staging are examined. On the basis of the current understanding of prognostication and treatment response, algorithms for selection of local and systemic therapy are presented.
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Affiliation(s)
- Dodd G Sledge
- Diagnostic Center for Population and Animal Health, Michigan State University, 4125 Beaumont Road, Lansing, MI 48910, USA.
| | - Joshua Webster
- Genentech, 1 DNA Way, South San Francisco, CA 94080, USA
| | - Matti Kiupel
- Diagnostic Center for Population and Animal Health, Michigan State University, 4125 Beaumont Road, Lansing, MI 48910, USA
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27
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Bartholf DeWitt S, Eward WC, Eward CA, Lazarides AL, Whitley MJ, Ferrer JM, Brigman BE, Kirsch DG, Berg J. A Novel Imaging System Distinguishes Neoplastic from Normal Tissue During Resection of Soft Tissue Sarcomas and Mast Cell Tumors in Dogs. Vet Surg 2016; 45:715-22. [PMID: 27281113 DOI: 10.1111/vsu.12487] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MCT). STUDY DESIGN Non-randomized prospective clinical trial. ANIMALS 12 dogs with STS and 7 dogs with MCT. METHODS A fluorescent imaging agent that is activated by proteases in vivo was administered to the dogs 4-6 or 24-26 hours before tumor resection. During surgery, a handheld imaging device was used to measure fluorescence intensity within the cancerous portion of the resected specimen and determine an intensity threshold for subsequent identification of cancer. Selected areas within the resected specimen and tumor bed were then imaged, and biopsies (n=101) were obtained from areas that did or did not have a fluorescence intensity exceeding the threshold. Results of intraoperative fluorescence and histology were compared. RESULTS The imaging system correctly distinguished cancer from normal tissue in 93/101 biopsies (92%). Using histology as the reference, the sensitivity and specificity of the imaging system for identification of cancer in biopsies were 92% and 92%, respectively. There were 10/19 (53%) dogs which exhibited transient facial erythema soon after injection of the imaging agent which responded to but was not consistently prevented by intravenous diphenhydramine. CONCLUSION A fluorescence-based imaging system designed for intraoperative use can distinguish canine soft tissue sarcoma (STS) and mast cell tumor (MCT) tissue from normal tissue with a high degree of accuracy. The system has potential to assist surgeons in assessing the adequacy of tumor resections during surgery, potentially reducing the risk of local tumor recurrence. Although responsive to antihistamines, the risk of hypersensitivity needs to be considered in light of the potential benefits of this imaging system in dogs.
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Affiliation(s)
| | | | - Cindy A Eward
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina
| | | | | | | | | | | | - John Berg
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
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28
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Jeyakumar S, Smith AN, Schleis SE, Cattley RC, Tillson DM, Henderson RA. Effect of histologic processing on dimensions of skin samples obtained from cat cadavers. Am J Vet Res 2015; 76:939-45. [DOI: 10.2460/ajvr.76.11.939] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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29
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Risselada M, Mathews KG, Griffith E. Surgically planned versus histologically measured lateral tumor margins for resection of cutaneous and subcutaneous mast cell tumors in dogs: 46 cases (2010–2013). J Am Vet Med Assoc 2015; 247:184-9. [DOI: 10.2460/javma.247.2.184] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Abstract
Surgical oncology is experiencing rapid transition in veterinary medicine. Mast cell tumors and soft tissue sarcomas are two of the most common neoplasms in small animal patients. Clinicians should be familiar with the need for staging and the procedures involved in treating patients with these tumors. Clinicians should be comfortable with available adjuvant therapies and when to use them in certain patients.
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Affiliation(s)
- Brad M Matz
- Surgical Oncology, Department of Clinical Sciences, Auburn University, 1220 Wire Road, Auburn, AL 36849-5540, USA.
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31
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Smith J, Kiupel M, Farrelly J, Cohen R, Olmsted G, Kirpensteijn J, Brocks B, Post G. Recurrence rates and clinical outcome for dogs with grade II mast cell tumours with a low AgNOR count and Ki67 index treated with surgery alone. Vet Comp Oncol 2015; 15:36-45. [PMID: 25643820 DOI: 10.1111/vco.12140] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 12/02/2014] [Accepted: 12/18/2014] [Indexed: 12/27/2022]
Abstract
Grade II mast cell tumours (MCT) are tumours with variable biologic behaviour. Multiple factors have been associated with outcome, including proliferation markers. The purpose of this study was to determine if extent of surgical excision affects recurrence rate in dogs with grade II MCT with low proliferation activity, determined by Ki67 and argyrophilic nucleolar organising regions (AgNOR). Eighty-six dogs with cutaneous MCT were evaluated. All dogs had surgical excision of their MCT with a low Ki67 index and combined AgNORxKi67 (Ag67) values. Twenty-three (27%) dogs developed local or distant recurrence during the median follow-up time. Of these dogs, six (7%) had local recurrence, one had complete and five had incomplete histologic margins. This difference in recurrence rates between dogs with complete and incomplete histologic margins was not significant. On the basis of this study, ancillary therapy may not be necessary for patients with incompletely excised grade II MCT with low proliferation activity.
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Affiliation(s)
- J Smith
- Department of Medical Oncology, Chicago Veterinary Cancer Center, Chicago, IL, USA
| | - M Kiupel
- Diagnostic Center for Population and Animal Health, Michigan State University, East Lansing, MI, USA
| | - J Farrelly
- Department of Medical Oncology, The Veterinary Cancer Center, Norwalk, CT, USA
| | - R Cohen
- Department of Science Research, Cornell University, Ithaca, NY, USA
| | - G Olmsted
- Department of Medical Oncology, The Veterinary Cancer Center, Norwalk, CT, USA
| | - J Kirpensteijn
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands
| | - B Brocks
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands
| | - G Post
- Department of Medical Oncology, The Veterinary Cancer Center, Norwalk, CT, USA
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32
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Garrett LD. Canine mast cell tumors: diagnosis, treatment, and prognosis. VETERINARY MEDICINE-RESEARCH AND REPORTS 2014; 5:49-58. [PMID: 32670846 PMCID: PMC7337164 DOI: 10.2147/vmrr.s41005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/23/2014] [Indexed: 11/25/2022]
Abstract
Mast cell tumors (MCTs) are the most common malignant skin cancer in dogs, and significant variability exists in their biological behavior. Most MCTs are cured with appropriate local therapy, but a subset shows malignant behavior with the potential to spread to lymph nodes, liver, spleen, and other areas and to thus become a systemic cancer. Because of this variable behavior, it is difficult to predict how any individual tumor is going to behave. The variability thus creates uncertainty in deciding what a particular dog’s prognosis is, whether staging tests to assess for metastasis are needed, and even what treatments will be necessary for best outcome. In addition to controversies over the potential for development of systemic disease, or diffuse metastasis, controversies also exist over what treatment is needed to best attain local control of these tumors. This article will briefly discuss the diagnosis of MCTs in dogs and will summarize the literature in regards to the controversial topics surrounding the more aggressive form of this disease, with recommendations made based on published studies.
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Affiliation(s)
- Laura D Garrett
- Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, IL, USA
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Pratschke KM, Atherton MJ, Sillito JA, Lamm CG. Evaluation of a modified proportional margins approach for surgical resection of mast cell tumors in dogs: 40 cases (2008-2012). J Am Vet Med Assoc 2014; 243:1436-41. [PMID: 24171373 DOI: 10.2460/javma.243.10.1436] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate a modified proportional margins approach to resection of mast cell tumors (MCTs) in dogs. DESIGN Retrospective case series. ANIMALS 40 dogs with subcutaneous and cutaneous MCTs undergoing curative intent surgery. PROCEDURES Medical records were searched to identify dogs with a cytologically or histologically confirmed diagnosis of MCT that had not previously been treated surgically and that had undergone full oncological staging. In those dogs, tumors were resected with lateral margins equivalent to the widest measured diameter of the tumor and a minimum depth of 1 well-defined fascial plane deep to the tumor. Surgical margins were evaluated histologically. Cutaneous tumors were graded by use of the Patnaik system and the 2-tier system described by Kiupel et al. The prognosis for subcutaneous tumors was assessed in accordance with published recommendations. Follow-up information on dog health status was obtained through clinical examination, the dog owners, and the referring veterinarians. RESULTS The 40 dogs had 47 tumors. Forty-one (87%) tumors were cutaneous, and 6 (13%) were subcutaneous. On the basis of the Patnaik system, 21 (51%) cutaneous tumors were considered grade I, 18 (44%) were considered grade II, and 2 (5%) were considered grade III. On the basis of the Kiupel system, 37 (90%) cutaneous tumors were considered low grade, and 4 (10%) were considered high grade. The prognosis for the 6 subcutaneous tumors was classified as likely resulting in a shorter (2) or longer (4) survival time. Forty tumors were deemed to have been excised with clear margins and 7 with incomplete margins. Local recurrence was not recorded for any dog but was suspected for 1 (2%) tumor, although not confirmed. Interval from tumor excision to follow-up ranged from 30 to 1,140 days (median, 420 days). CONCLUSIONS AND CLINICAL RELEVANCE The modified proportional margins system resulted in satisfactory local disease control in dogs with MCTs.
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Affiliation(s)
- Kathryn M Pratschke
- School of Veterinary Medicine, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, G61 1QH, Scotland
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Schwab TM, Popovitch C, DeBiasio J, Goldschmidt M. Clinical Outcome for MCTs of Canine Pinnae Treated with Surgical Excision (2004–2008). J Am Anim Hosp Assoc 2014; 50:187-91. [DOI: 10.5326/jaaha-ms-6039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Canine mast cell tumors (MCTs) are the most common cutaneous neoplasm in the dog. It has been suggested that MCT in certain locations may behave in a more biologically aggressive fashion than MCTs located in others; however, no published data are available for MCTs of canine pinnae treated with surgical excision. A retrospective study of 28 animals with surgical excision of MCTs of pinnae was completed with a medical record review and follow-up questionnaire to the operating veterinarian. The effect of tumor grade, clean or dirty excision, cartilage penetration, and mitotic index (MI) on local recurrence and survival time (ST) was evaluated. There was local recurrence in one dog with a grade 2 MCT and in seven of eight dogs with grade 3 MCTs. The median ST of animals with grade 1 and 2 MCTs was not reached, whereas the median ST of animals with grade 3 MCTs was 10 mo. There was no statistical association between histologically clean and dirty margins and either local recurrence or ST. A prolonged disease free interval without local recurrence may be achieved with local excision of grade 1 and 2 MCTs. Animals with grade 3 MCTs had a uniformly poor outcome with short times to local recurrence and death.
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Affiliation(s)
- Timothy M. Schwab
- Department of Surgery (T.S., C.P.) and Department of Internal Medicine (J.D.), Metropolitan Veterinary Associates, Norristown, PA; and Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA (M.G.)
| | - Catherine Popovitch
- Department of Surgery (T.S., C.P.) and Department of Internal Medicine (J.D.), Metropolitan Veterinary Associates, Norristown, PA; and Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA (M.G.)
| | - John DeBiasio
- Department of Surgery (T.S., C.P.) and Department of Internal Medicine (J.D.), Metropolitan Veterinary Associates, Norristown, PA; and Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA (M.G.)
| | - Michael Goldschmidt
- Department of Surgery (T.S., C.P.) and Department of Internal Medicine (J.D.), Metropolitan Veterinary Associates, Norristown, PA; and Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA (M.G.)
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Scarpa F, Sabattini S, Bettini G. Cytological grading of canine cutaneous mast cell tumours. Vet Comp Oncol 2014; 14:245-51. [DOI: 10.1111/vco.12090] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/07/2014] [Accepted: 03/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Filippo Scarpa
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Dell'Emilia Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Dell'Emilia Italy
| | - Giuliano Bettini
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Dell'Emilia Italy
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Sabattini S, Scarpa F, Berlato D, Bettini G. Histologic grading of canine mast cell tumor: is 2 better than 3? Vet Pathol 2014; 52:70-3. [PMID: 24513799 DOI: 10.1177/0300985814521638] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mast cell tumor (MCT) is a common canine cutaneous neoplasm with variable biological behavior. A 2-tier histologic grading system was recently proposed by Kiupel et al to reduce interobserver variation and eliminate prognostic uncertainty of the Patnaik system. This study compared the ability of these 2 grading systems to predict survival in a cohort of dogs with MCTs. However, surgical margins were unknown, and the risk of developing new/metastatic MCTs was not studied. Histologic grade was assessed according to both systems for 137 surgically resected cutaneous MCTs. The relationship between grade and survival was evaluated. According to the Patnaik system, 18 MCTs (13.1%) were classified as grade I, 83 (60.6%) as grade II, and 36 (26.3%) as grade III. Grade III was associated with a poorer prognosis (P < .001), but no significant difference between grades I and II was detected. Grading according to the Patnaik system was based on consensus grading among 3 pathologists, and interobserver variability was not considered. All grade I MCTs were low grade in the Kiupel system, and all grade III were high grade. Among grade II, 71 (85.6%) were low grade, and 12 (14.4%) were high grade, with a 1-year survival probability of 94% and 46%, respectively (P < .001). The 2-tier system had a high prognostic value and was able to correctly predict the negative outcomes of some grade II MCTs. Data also confirm that histologic grading cannot predict biological behavior of each MCT and should be supplemented with molecular methods for more accurate prognostication.
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Affiliation(s)
- S Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Italy Contributed equally to this work
| | - F Scarpa
- Department of Veterinary Medical Sciences, University of Bologna, Italy Contributed equally to this work
| | | | - G Bettini
- Department of Veterinary Medical Sciences, University of Bologna, Italy
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Shiomitsu K, Sajo E, Rubin C, Sehgal I. The radiosensitizing effect of the aurora kinase inhibitors, ENMD-2076, on canine mast cell tumours in vitro. Vet Comp Oncol 2013; 14:13-27. [PMID: 23763774 DOI: 10.1111/vco.12046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
ENMD-2076 is an aurora kinase inhibitor that also has multi-target tyrosine kinase inhibitor properties. In this study, the mRNA and the protein expression of aurora-A and aurora-B were evaluated in three canine mast cell tumour cell lines. Dose-dependent cytotoxicity was seen in the cells treated, and it affected the cell cycle with cells in the G2/M phase being selectively killed. The cells were also evaluated for radiosensitivity with/without ENMD-2076, and radiosensitization was seen after 3 Gy and 6 Gy exposures with ENMD-2076 for 48 h. Protein expression of caspase-3 was gradually increased, and the expression intensity was highest at 24 h post irradiation in cells without ENMD-2076 treatment, which indicates that radiation exposure with ENMD-2076-induced cell death faster than radiation treatment alone. Our study results suggest the potential usefulness of treating canine mast cell tumours with aurora kinase inhibitors alone or in conjunction with radiation therapy.
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Affiliation(s)
- K Shiomitsu
- Department of Veterinary Clinical Sciences, Cancer Treatment Unit, Louisiana State University, Baton Rouge, LA, USA
| | - E Sajo
- Department of Physics, Medical Physics Program, University of Massachusetts Lowell, Lowell, MA, USA
| | - C Rubin
- Department of Veterinary Clinical Sciences, Cancer Treatment Unit, Louisiana State University, Baton Rouge, LA, USA
| | - I Sehgal
- Department of Comparative Biomedical Sciences, Louisiana State University, Baton Rouge, LA, USA
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Donnelly L, Mullin C, Balko J, Goldschmidt M, Krick E, Hume C, Brown DC, Sorenmo K. Evaluation of histological grade and histologically tumour-free margins as predictors of local recurrence in completely excised canine mast cell tumours. Vet Comp Oncol 2013; 13:70-6. [DOI: 10.1111/vco.12021] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/04/2013] [Accepted: 01/08/2013] [Indexed: 11/27/2022]
Affiliation(s)
- L. Donnelly
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - C. Mullin
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - J. Balko
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - M. Goldschmidt
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - E. Krick
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - C. Hume
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - D. C. Brown
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
| | - K. Sorenmo
- School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital; University of Pennsylvania; Philadelphia PA USA
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Regan RC, Rassnick KM, Malone EK, McDonough SP. A prospective evaluation of the impact of second-opinion histopathology on diagnostic testing, cost and treatment in dogs and cats with cancer. Vet Comp Oncol 2013; 13:106-16. [DOI: 10.1111/vco.12023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/20/2013] [Accepted: 01/22/2013] [Indexed: 11/27/2022]
Affiliation(s)
- R. C. Regan
- Department of Clinical Sciences, College of VeterinaryMedicine; Cornell University; Ithaca NY USA
- Department of Small Animal Medicine and Surgery; University of Georgia; Athens GA USA
| | - K. M. Rassnick
- Department of Clinical Sciences, College of VeterinaryMedicine; Cornell University; Ithaca NY USA
- Department of Oncology; Veterinary Medical Center of Central New York; Syracuse NY USA
| | - E. K. Malone
- Department of Clinical Sciences, College of VeterinaryMedicine; Cornell University; Ithaca NY USA
- Department of Oncology MedVet Medical & Cancer Center for Pets; Columbus OH USA
| | - S. P. McDonough
- Department of Clinical Sciences, College of VeterinaryMedicine; Cornell University; Ithaca NY USA
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Blackwood L, Murphy S, Buracco P, De Vos JP, De Fornel-Thibaud P, Hirschberger J, Kessler M, Pastor J, Ponce F, Savary-Bataille K, Argyle DJ. European consensus document on mast cell tumours in dogs and cats. Vet Comp Oncol 2012; 10:e1-e29. [DOI: 10.1111/j.1476-5829.2012.00341.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- L. Blackwood
- Small Animal Teaching Hospital, The Leahurst Campus; University of Liverpool Chester High Road; Neston Wirral CH64 7TE UK
| | - S. Murphy
- The Animal Health Trust; Suffolk CB8 7UU UK
| | - P. Buracco
- Department of Animal Pathology, School of Veterinary Medicine; University of Turin; Grugliasco (TO) Italy
| | - J. P. De Vos
- “De Ottenhorst” Veterinary Oncology Referral Centre; Terneuzen The Netherlands
| | - P. De Fornel-Thibaud
- DESV Internal Medicine, Centre de Cancérologie Vétérinaire; Maisons-Alfort France
| | - J. Hirschberger
- Medizinische Kleintierklinik Clinic for Small Animal Medicine, Center for Clinical Veterinary Medicine; Ludwig-Maximilians-Universität München Veterinärstr; München Germany
| | | | - J. Pastor
- Patología Médica Facultad de Veterinaria; Universidad Autónoma de Barcelona; Bellaterra Spain
| | - F. Ponce
- VetAgro Sup; Université Lyon 1; Lyon France
| | | | - D. J. Argyle
- Royal (Dick) School of Veterinary Studies and Roslin Institute; Easter Bush Midlothian EH25 9RG UK
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Rowland P. Requests clarification on study of surgical removal of mast cell tumors. J Am Vet Med Assoc 2011; 239:297; author reply 297. [PMID: 21801039 DOI: 10.2460/javma.239.3.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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