1
|
Pinheiro AV, Petrucci GN, Dourado A, Pires I. Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread. Animals (Basel) 2023; 13:3392. [PMID: 37958147 PMCID: PMC10648213 DOI: 10.3390/ani13213392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Throughout the course of oncological disease, the majority of patients require surgical, anaesthetic and analgesic intervention. However, during the perioperative period, anaesthetic agents and techniques, surgical tissue trauma, adjuvant drugs for local pain and inflammation and other non-pharmacological factors, such as blood transfusions, hydration, temperature and nutrition, may influence the prognosis of the disease. These factors significantly impact the oncologic patient's immune response, which is the primary barrier to tumour progress, promoting a window of vulnerability for its dissemination and recurrence. More research is required to ascertain which anaesthetics and techniques have immunoprotective and anti-tumour effects, which will contribute to developing novel anaesthetic strategies in veterinary medicine.
Collapse
Affiliation(s)
- Ana Vidal Pinheiro
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
| | - Gonçalo N. Petrucci
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Sciences, Vasco da Gama University School (EUVG), 3020-210 Coimbra, Portugal
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Amândio Dourado
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
| | - Isabel Pires
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| |
Collapse
|
2
|
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
|
3
|
Goldschmidt S, Stewart N, Ober C, Bell C, Wolf-Ringwall A, Kent M, Lawrence J. Contrast-enhanced and indirect computed tomography lymphangiography accurately identifies the cervical lymphocenter at risk for metastasis in pet dogs with spontaneously occurring oral neoplasia. PLoS One 2023; 18:e0282500. [PMID: 36862650 PMCID: PMC9980747 DOI: 10.1371/journal.pone.0282500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
For dogs with oral tumors, cervical lymph node (LN) metastasis alters treatment and prognosis. It is therefore prudent to make an accurate determination of the clinical presence (cN+ neck) or absence (cN0 neck) of metastasis prior to treatment. Currently, surgical LN extirpation with histopathology is the gold standard for a diagnosis of metastasis. Yet, recommendations to perform elective neck dissection (END) for staging are rare due to morbidity. Sentinel lymph node (SLN) mapping with indirect computed tomography lymphangiography (ICTL) followed by targeted biopsy (SLNB) is an alternative option to END. In this prospective study, SLN mapping followed by bilateral END of all mandibular LNs (MLNs) and medial retropharyngeal LNs (MRLNs) was performed in 39 dogs with spontaneously occurring oral neoplasia. A SLN was identified by ICTL in 38 (97%) dogs. Lymphatic drainage patterns were variable although most often the SLN was identified as a single ipsilateral MLN. In the 13 dogs (33%) with histopathologically confirmed LN metastasis, ICTL correctly identified the draining lymphocentrum in all (100%). Metastasis was confined to the SLN in 11 dogs (85%); 2 dogs (15%) had metastasis beyond the SLN ipsilaterally. Contrast enhanced CT features had good accuracy in predicting metastasis, with short axis measurements less than 10.5 mm most predictive. ICTL imaging features alone were unable to predict metastasis. Cytologic or histopathologic SLN sampling is recommended prior to treatment to inform clinical decision-making. This is the largest study to show potential clinical utility of minimally invasive ICTL for cervical LN evaluation in canine oral tumors.
Collapse
Affiliation(s)
- Stephanie Goldschmidt
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, United States of America
- * E-mail:
| | | | - Christopher Ober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, United States of America
| | - Cynthia Bell
- Specialty Oral pathology for Animals, Geneseo, Illinois, United States of America
| | - Amber Wolf-Ringwall
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, United States of America
| | - Michael Kent
- Department of Surgical and Radiologic Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
| | - Jessica Lawrence
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, United States of America
| |
Collapse
|
4
|
p-S6 as a Prognostic Biomarker in Canine Oral Squamous Cell Carcinoma. Biomolecules 2022; 12:biom12070935. [PMID: 35883491 PMCID: PMC9313205 DOI: 10.3390/biom12070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022] Open
Abstract
Scarce information exists on the role of mTOR pathway proteins and their association to aggressiveness and prognosis of patients with canine oral cancers. We aimed to investigate the activated form of mTOR and its downstream S6 protein in canine oral squamous cell carcinoma (OSCC), and to evaluate potential associations between protein expression and clinic-pathologic variables and survival. For that we analysed p-mTOR and p-S6 protein expression by immunohistochemistry in 61 canine OSCCs. Multivariate analysis was conducted to examine their role in patients’ cancer-specific survival (CSS). p-mTOR and p-S6 expression were present in almost all cases. High-expression of p-mTOR was observed in 44 (72.1%) cases using extent score and 52 (85.2%) cases using intensity score. For p-S6, high expression was observed in 53 (86.9%) cases using extent score and in 54 (88.5%) cases using intensity score. An independent prognostic value for p-S6 extension (p = 0.027), tumour stage (p = 0.013) and treatment (p = 0.0009) was found in patients’ CSS analysis. Our data suggest that p-mTOR and p-S6 proteins are commonly expressed in canine OSCC and p-S6 expression is correlated with poor CSS in dogs with OSCC. More studies should be performed to identify possible therapeutic targets related with mTOR pathway for these patients.
Collapse
|
5
|
Castejón-González AC, Reiter AM. Oral and Maxillofacial Tumor Management - From Biopsy to Surgical Removal. Vet Clin North Am Small Anim Pract 2021; 52:235-270. [PMID: 34838252 DOI: 10.1016/j.cvsm.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The main objective of oral and maxillofacial (OMF) tumor resection is to get local control of the disease. Many OMF tumors can be cured with wide or radical surgery, whereas others might only achieve temporary local control of the disease by removing infection and the source of pain, thereby improving the quality of life of the patient while keeping masticatory function. The standard of care on managing OMF tumors includes the diagnosis and identification of the local and distant extension of the disease to establish an appropriate treatment plan tailored for each patient. In this article, we provide a practical review of the current information related to staging, biopsy, and main surgical techniques for OMF tumor removal.
Collapse
Affiliation(s)
- Ana C Castejón-González
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
| | - Alexander M Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
6
|
Morrison-Esmail K, Harris C, Perry A. Pathology in Practice. J Am Vet Med Assoc 2021; 259:995-997. [PMID: 34647466 DOI: 10.2460/javma.259.9.995] [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]
|
7
|
Noguchi S, Hirano K, Tanimoto N, Shimada T, Akiyoshi H. SLUG is upregulated and induces epithelial mesenchymal transition in canine oral squamous cell carcinoma. Vet Comp Oncol 2021; 20:134-141. [PMID: 34310030 DOI: 10.1111/vco.12755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/11/2021] [Accepted: 07/22/2021] [Indexed: 12/13/2022]
Abstract
SLUG, encoded by the Snai2 gene, is known to play a role in epithelial-mesenchymal transition (EMT), which contributes to cell invasion and metastasis in some types of human carcinomas. However, the mechanisms and roles of EMT in canine squamous cell carcinoma (SCC) have not yet been elucidated. We have previously established canine oral SCC cell lines, including tonsillar SCC, and in this study, we evaluated the effects of SLUG on the phenotypes regarding EMT of canine SCC cells. First, immunohistochemical analysis revealed that SLUG is upregulated in canine oral SCC tissues compared to that in non-tumoural oral mucosa. Furthermore, gain-of-function and loss-of-function of SLUG revealed that SLUG partly contributed to migration and invasion of cells, as well as the upregulation of EMT markers such as vimentin and SNAIL. Thus, the current study suggests that SLUG promotes cell migration and invasion through EMT induction in canine oral SCC, as well as human cancers.
Collapse
Affiliation(s)
- Shunsuke Noguchi
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Kazuya Hirano
- Laboratory of Veterinary Radiology, College of Life, Environment, and Advanced Sciences, Osaka Prefecture University, Osaka, Japan
| | - Nanami Tanimoto
- Laboratory of Veterinary Radiology, College of Life, Environment, and Advanced Sciences, Osaka Prefecture University, Osaka, Japan
| | - Terumasa Shimada
- Veterinary Medical Center, Osaka Prefecture University, Osaka, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| |
Collapse
|
8
|
Guzu M, Rossetti D, Hennet PR. Locoregional Flap Reconstruction Following Oromaxillofacial Oncologic Surgery in Dogs and Cats: A Review and Decisional Algorithm. Front Vet Sci 2021; 8:685036. [PMID: 34095284 PMCID: PMC8175653 DOI: 10.3389/fvets.2021.685036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
Primary treatment of most oromaxillofacial tumors in dogs and cats is resective surgery. Management of malignant tumors may be very challenging as wide/radical free-margin surgical removal must be achieved while preserving vital functions. Removal of orofacial tumors may result in large defects exposing the oral cavity or creating a communication with the nasal, pharyngeal, or orbital cavities. Such defects require orofacial reconstruction in order to restore respiratory and manducatory functions. The veterinary surgeon must be familiar with reconstructive techniques in order to prevent the inability of closing the defect, which could lead to an insufficient resection. Small oral defects exposing the nasal cavity are best closed with local random mucosal flaps. Closure of large oral defects may be better achieved with a facial or major palatine-based axial-pattern flap. Small to moderate facial defects can be closed with local advancement or transposition skin flaps. Reconstruction of large facial defects often requires the use of locoregional axial pattern flaps such as the caudal auricular, the superficial temporal, or the facial (angularis oris) myocutaneous axial pattern flaps. Recent publications have shown that the facial (angularis oris) flap is a very versatile and reliable flap in orofacial reconstructive surgery. A surgical decision algorithm based on the size, nature, and location of the defect is proposed.
Collapse
Affiliation(s)
- Michel Guzu
- Dentistry and Oromaxillofacial Surgery Unit, Department of Surgery, ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, France
| | - Diego Rossetti
- Department of Surgery, CHV ADVETIA, Vélizy-Villacoublay, France
| | - Philippe R. Hennet
- Dentistry and Oromaxillofacial Surgery Unit, Department of Surgery, ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, France
| |
Collapse
|
9
|
Chiti LE, Stefanello D, Manfredi M, Zani DD, De Zani D, Boracchi P, Giudice C, Grieco V, Di Giancamillo M, Ferrari R. To map or not to map the cN0 neck: Impact of sentinel lymph node biopsy in canine head and neck tumours. Vet Comp Oncol 2021; 19:661-670. [PMID: 33886154 DOI: 10.1111/vco.12697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 12/24/2022]
Abstract
Tumour stage is a prognostic indicator for canine malignant head and neck tumours (MHNT). However, consensus is lacking on nodal staging in the absence of clinically apparent nodal disease (cN0 neck). This prospective observational study aims to determine the diagnostic accuracy of radiopharmaceutical and blue dye for sentinel lymph node biopsy (SLNB), to assess the correspondence between sentinel lymph node (SLN) and clinically expected regional lymph node (RLN) and the impact on staging of the procedure in dogs with MHNT and cN0 neck. Twenty-three dogs with MHNT and cN0 neck underwent tumour excision and SLNB guided by preoperative lymphoscintigraphy and intraoperative gamma-probe and blue dye. Diagnostic performances and detection rate were calculated. Correspondence between SLN and RLN, number of nodes excised, histopathological status of the SLN and complications related to the procedure were recorded. The mapping technique identified at least one SLN in 19/23 dogs, with a detection rate of 83%. The SLN did not correspond to the RLN in 52% of dogs. Multiple nodes were removed in 61% of dogs. At histopathology, eight (42%) dogs had SLN+, of which four differed from the RLN. Only minor self-limiting complications occurred in five (22%) dogs. Radiopharmaceutical and blue dye guidance is accurate (sensitivity 88.9%; specificity 100%) for SLNB in dogs with MHNT and cN0 and allowed the extirpation of unpredictable and/or multiple SLN with minimal morbidity. Incorporation of SLNB in the management of MHNT is desirable to correctly stage the cN0 neck, owing the unpredictability of the lymphatic drainage.
Collapse
Affiliation(s)
- Lavinia E Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Martina Manfredi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Davide D Zani
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Donatella De Zani
- 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
| | - Chiara Giudice
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Valeria Grieco
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
10
|
MOSCA A, GIBSON D, MASON SL, DOBSON J, GIULIANO A. A possible role of coarse fractionated radiotherapy in the management of gingival squamous cell carcinoma in dogs: A retrospective study of 21 cases from two referral centers in the UK. J Vet Med Sci 2021; 83:447-455. [PMID: 33487622 PMCID: PMC8025409 DOI: 10.1292/jvms.20-0191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 01/10/2021] [Indexed: 11/22/2022] Open
Abstract
Surgery with or without the addition of radiotherapy is the treatment of choice for canine oral squamous cell carcinoma (SCC). Fractionated radiotherapy alone is also effective in the long-term control of the disease, however coarse fractionated radiotherapy (CF-RT) for gingival SCC has not been extensively reported. The aim of this study was to describe side effects, clinical response, and median survival time (MST) of dogs with gingival SCC treated with CF-RT in the palliative and adjuvant setting. Twenty-one cases from two referral centres in the UK treated with CF-RT for gingival SCC between July 2013 and June 2019 were retrospectively evaluated. Of the 21 dogs, 11 developed mild acute adverse effects. Oral mucositis was the most common radiation induced toxicity. Three dogs developed chronic severe adverse effects (oro-nasal fistula, bone necrosis and gum recession). Overall clinical response rate was 77% in dogs receiving palliative treatment with MST of 365 days (60-1,095 days). MST was not reached for dogs treated in the adjuvant setting with a mean of 466 days (121-730 days). In cases of advanced gross disease CF-RT might have a role in short term palliation of clinical signs. However, it carries a significant risk of late toxicity for cases with unexpectedly long survival times and further investigations are required to identify an optimal CF-RT protocol. Randomized controlled trials are needed to confirm the role of CF-RT as adjuvant treatment of incompletely resected gingival SCC.
Collapse
Affiliation(s)
- Andrea MOSCA
- The Queen’s Veterinary School Hospital, Cambridge University Veterinary School, Madingley Rd, Cambridge CB3 0ES, UK
| | - Danielle GIBSON
- Southfields Veterinary Specialists, 1 Bramston Way, Basildon SS15 6TP, UK
| | - Sarah L. MASON
- Southfields Veterinary Specialists, 1 Bramston Way, Basildon SS15 6TP, UK
| | - Jane DOBSON
- The Queen’s Veterinary School Hospital, Cambridge University Veterinary School, Madingley Rd, Cambridge CB3 0ES, UK
| | - Antonio GIULIANO
- The Queen’s Veterinary School Hospital, Cambridge University Veterinary School, Madingley Rd, Cambridge CB3 0ES, UK
| |
Collapse
|
11
|
Sharma S, Boston SE, Skinner OT, Perry JA, Verstraete FJM, Lee DB, Van Stee LLL, Thompson C, Boylan M, McKee T, Bergman PJ. Survival time of juvenile dogs with oral squamous cell carcinoma treated with surgery alone: A Veterinary Society of Surgical Oncology retrospective study. Vet Surg 2021; 50:740-747. [PMID: 33772819 DOI: 10.1111/vsu.13625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/18/2020] [Accepted: 05/30/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To report the signalment, staging, surgical treatment, and survival time of juvenile dogs treated surgically for oral squamous cell carcinoma (OSCC). STUDY DESIGN Retrospective study. ANIMALS OR SAMPLE POPULATION Twenty-five dogs, <2 years of age with OSCC treated with surgery. METHODS Cases were solicited from the Veterinary Society of Surgical Oncology. Data retrieved included sex, breed, age, weight, clinical signs, tumor location, preoperative diagnostics and staging, histopathological diagnosis with margin evaluation, disease-free interval, and date and cause of death. A minimum follow-up time of 3 months was required for inclusion. RESULTS Eighteen dogs were <12 months of age, and seven were <24 months. Various breeds were represented, with a mean body weight of 22.3 ± 14.4 kg. No dogs had evidence of metastatic disease prior to surgery. All dogs underwent partial maxillectomy or mandibulectomy. Histological margins were complete in 24 dogs and incomplete in one. No dogs had evidence of metastatic disease or tumor recurrence. The median follow-up time was 1556 days (92 to 4234 days). All dogs were alive at the last follow-up except for one documented death, due to dilated cardiomyopathy. Median disease-specific survival time was not reached. CONCLUSION The prognosis after wide surgical excision of OSCC in juvenile dogs was excellent. CLINICAL SIGNIFICANCE OSCC in juvenile dogs can be effectively treated with surgery alone.
Collapse
Affiliation(s)
- Surabhi Sharma
- Small animal surgical oncology service, VCA Canada-Surgical Oncology, VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, Ontario, Canada
| | - Sarah E Boston
- Small animal surgical oncology service, VCA Canada-Surgical Oncology, VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, Ontario, Canada
| | - Owen T Skinner
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, Missouri, USA
| | - James A Perry
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Da Bin Lee
- WR Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California - Davis, Davis, CA
| | - Lucinda L L Van Stee
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Chris Thompson
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, Minnesota, USA
| | - Matthew Boylan
- Small animal surgical oncology service, VCA Canada-Surgical Oncology, VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, Ontario, Canada
| | - Talon McKee
- Department of clinical studies, VCA Clinical Studies, Los Angeles, California, USA
| | - Philip J Bergman
- Department of clinical studies, VCA Clinical Studies, Los Angeles, California, USA
| |
Collapse
|
12
|
Nemec A, Milevoj N, Lampreht Tratar U, Serša G, Čemažar M, Tozon N. Electroporation-Based Treatments in Small Animal Veterinary Oral and Maxillofacial Oncology. Front Vet Sci 2020; 7:575911. [PMID: 33134356 PMCID: PMC7550461 DOI: 10.3389/fvets.2020.575911] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022] Open
Abstract
Electroporation is a method of inducing an increase in permeability of the cell membrane through the application of an electric field and can be used as a delivery method for introducing molecules of interest (e.g., chemotherapeutics or plasmid DNA) into cells. Electroporation-based treatments (i.e., electrochemotherapy, gene electrotransfer, and their combinations) have been shown to be safe and effective in veterinary oncology, but they are currently mostly recommended for the treatment of those solid tumors for which clients have declined surgery and/or radiotherapy. Published data show that electroporation-based treatments are also safe, simple, fast and cost-effective treatment alternatives for selected oral and maxillofacial tumors, especially small squamous cell carcinoma and malignant melanoma tumors not involving the bone in dogs. In these patients, a good local response to treatment is expected to result in increased survival time with good quality of life. Despite emerging evidence of the clinical efficacy of electroporation-based treatments for oral and maxillofacial tumors, further investigation is needed to optimize treatment protocols, improve clinical data reporting and better understand the mechanisms of patients' response to the treatment.
Collapse
Affiliation(s)
- Ana Nemec
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Nina Milevoj
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Gregor Serša
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Maja Čemažar
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Nataša Tozon
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
13
|
Niemiec B, Gawor J, Nemec A, Clarke D, McLeod K, Tutt C, Gioso M, Steagall PV, Chandler M, Morgenegg G, Jouppi R. World Small Animal Veterinary Association Global Dental Guidelines. J Small Anim Pract 2020; 61:E36-E161. [PMID: 32715504 DOI: 10.1111/jsap.13132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.
Collapse
|
14
|
Congiusta M, Lawrence J, Rendahl A, Goldschmidt S. Variability in Recommendations for Cervical Lymph Node Pathology for Staging of Canine Oral Neoplasia: A Survey Study. Front Vet Sci 2020; 7:506. [PMID: 32903520 PMCID: PMC7438545 DOI: 10.3389/fvets.2020.00506] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/03/2020] [Indexed: 01/15/2023] Open
Abstract
There is no clear guideline regarding the indication for routine lymph node extirpation and pathologic evaluation during staging of canine oral tumors, despite a relatively high reported nodal metastatic rate for select tumor types. It is particularly unclear if clinicians recommend removal of lymph nodes only when there is confirmation of metastasis, defined as the N+ neck, or if elective neck dissection (END) is routinely recommended to confirm the true pathologic metastatic status of lymph nodes in the clinical N0 neck (no evidence of metastasis on clinical staging with diagnostic imaging or cytology). When clinicians are recommending END as a staging tool to confirm nodal status, there is also ambiguity regarding the surgical extent for subsequent histopathologic evaluation. The objective of this cross-sectional survey study was to determine the current recommendations given by practicing specialists regarding lymph node removal for dogs with oral tumors. Overall, 87 responses were obtained from 49 private practices (56%) and 38 academic institutions (44%). Respondents identified as oncologists (44%, N = 38), soft tissue surgeons (40%, N = 35), and dentists (16%, N = 14). Regardless of tumor type and stage, extirpation and histopathology were most commonly recommended in the clinical N+ neck only. The recommendation to routinely perform END in the N0 neck was significantly associated with tumor type. Bilateral removal of the mandibular and retropharyngeal lymph nodes was recommended more often for oral malignant melanoma (OMM) than for oral squamous cell carcinoma (OSCC; p ≤ 0.0039) or for oral fibrosarcoma (OFSA; p ≤ 0.0007). The likelihood of recommending END increased with increasing tumor size. Academic clinicians were significantly (p < 0.01) more likely to recommend END compared to private practitioners for canine T1-T3 OMM, T3 OSCC, T2 OFSA, and MCT. This study highlights the variability in recommendations for lymph node pathology for dogs with oral tumors. While tumor type and size influenced the decision to pursue END, it was not routinely recommended, even for tumor types with a known propensity for metastasis. Prospective studies are warranted to determine the potential diagnostic and therapeutic value of END in the N0 neck in veterinary patients such that a consensus approach can be made.
Collapse
Affiliation(s)
- Michael Congiusta
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States
| | - Jessica Lawrence
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.,Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Stephanie Goldschmidt
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| |
Collapse
|
15
|
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]
|
16
|
Arzi B, Verstraete FJM, Garcia TC, Lee M, Kim SE, Stover SM. Kinematic analysis of mandibular motion before and after mandibulectomy and mandibular reconstruction in dogs. Am J Vet Res 2019; 80:637-645. [PMID: 31246128 DOI: 10.2460/ajvr.80.7.637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate and quantify the kinematic behavior of canine mandibles before and after bilateral rostral or unilateral segmental mandibulectomy as well as after mandibular reconstruction with a locking reconstruction plate in ex vivo conditions. SAMPLE Head specimens from cadavers of 16 dogs (range in body weight, 30 to 35 kg). PROCEDURE Specimens were assigned to undergo unilateral segmental (n = 8) or bilateral rostral (8) mandibulectomy and then mandibular reconstruction by internal fixation with locking plates. Kinematic markers were attached to each specimen in a custom-built load frame. Markers were tracked in 3-D space during standardized loading conditions, and mandibular motions were quantified. Differences in mandibular range of motion among 3 experimental conditions (before mandibulectomy [ie, with mandibles intact], after mandibulectomy, and after reconstruction) were assessed by means of repeated-measures ANOVA. RESULTS Both unilateral segmental and bilateral rostral mandibulectomy resulted in significantly greater mandibular motion and instability, compared with results for intact mandibles. No significant differences in motion were detected between mandibles reconstructed after unilateral segmental mandibulectomy and intact mandibles. Similarly, the motion of mandibles reconstructed after rostral mandibulectomy was no different from that of intact mandibles, except in the lateral direction. CONCLUSIONS AND CLINICAL RELEVANCE Mandibular kinematics in head specimens from canine cadavers were significantly altered after unilateral segmental and bilateral rostral mandibulectomy. These alterations were corrected after mandibular reconstruction with locking reconstruction plates. Findings reinforced the clinical observations of the beneficial effect of reconstruction on mandibular function and the need for reconstructive surgery after mandibulectomy in dogs.
Collapse
|
17
|
Tuohy JL, Worley DR, Wustefeld-Janssens BG, Mickelson MA, Ehrhart NP, Seguin B. Bilateral caudal maxillectomy for resection of tumors crossing palatal midline and use of the angularis oris axial pattern flap for primary closure or dehiscence repair in two dogs. Vet Surg 2019; 48:1490-1499. [PMID: 31179557 DOI: 10.1111/vsu.13252] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/15/2019] [Accepted: 05/19/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the technique and outcomes for bilateral caudal maxillectomy for resection of large caudal maxillary tumors crossing palatal midline in two dogs. STUDY DESIGN Clinical case report. ANIMALS Two client-owned dogs. METHODS Two client-owned dogs with primary caudal maxillary tumors, a poorly differentiated sarcoma, and a multilobulated osteochondrosarcoma. Bilateral caudal maxillectomies were performed for curative-intent resection of these tumors. The angularis oris axial pattern flap was used for primary closure in one dog and for dehiscence repair in the other. RESULTS Both tumors were resected with complete histologic margins. The defects were closed with local buccal mucosal flaps, with or without a unilateral angularis oris flap. Esophagostomy tubes were placed at time of surgery to bypass oral feeding. Incisional dehiscence and subsequent oronasal fistula formation occurred as a postoperative complication in both dogs (3 and 10 days, respectively). Both were successfully repaired with a combination of local buccal mucosal flaps and the angularis oris flap. Both dogs had good functional outcome and quality of life after recovery from revision surgery. CONCLUSION Bilateral caudal maxillectomy allowed resection of caudal maxillary tumors crossing palatal midline, with good function and quality of life after recovery in 2 dogs. CLINICAL SIGNIFICANCE Good outcomes including complete resections are achievable with bilateral caudal maxillectomy despite complications. Local mucosal and axial pattern flaps can be used for dehiscence repair.
Collapse
Affiliation(s)
- Joanne L Tuohy
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Deanna R Worley
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Brandan G Wustefeld-Janssens
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Megan A Mickelson
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Nicole P Ehrhart
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Bernard Seguin
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| |
Collapse
|
18
|
Letters to the Editor. J Am Vet Med Assoc 2018; 253:699-702. [DOI: 10.2460/javma.253.6.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|