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Stefanello D, Gariboldi EM, Boracchi P, Ferrari R, Ubiali A, De Zani D, Zani DD, Grieco V, Giudice C, Recordati C, Caniatti M, Auletta L, Chiti LE. Weishaar's classification system for nodal metastasis in sentinel lymph nodes: Clinical outcome in 94 dogs with mast cell tumor. J Vet Intern Med 2024; 38:1675-1685. [PMID: 38426589 PMCID: PMC11099738 DOI: 10.1111/jvim.16997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The therapeutic role and prognostic relevance of lymphadenectomy in mast cell tumor (MCT) has historically been evaluated on regional rather than sentinel lymph nodes. HYPOTHESIS/OBJECTIVES To update information about the association of histological nodal (HN) classes with clinical outcome in dogs with MCT after tumor excision and extirpation of normal-sized sentinel nodes (SLN) guided by radiopharmaceutical. ANIMALS Ninety-four dogs with histologically-confirmed treatment-naïve MCT (71 cutaneous, 22 subcutaneous and 1 conjunctival MCT) were included if without: distant metastases, lymphadenomegaly, concurrent mixed cutaneous, and subcutaneous MCT. METHODS This was a monoistitutional cohort study. Tumors characteristics were retrieved and SLNs were classified according to Weishaar's system. Incidence of MCT-related events (local, nodal, distant relapse), de novo MCT or other tumors and death (MCT-related and non-MCT-related), were recorded. Incidence curves were compared among the HN classes. RESULTS Twenty-seven dogs had HN0, 19 HN1, 37 HN2, and 11 HN3 SLN. Thirteen (2 HN0, 4 HN2, and 7 HN3) received adjuvant chemotherapies. Kiupel high grade, increasing number of SLN and lymphocentrums were associated with higher HN classes. Five dogs died for MCT-related causes: 1 low-grade (HN0) and 1 subcutaneous (HN3) had a local relapse, 2 high-grade had distant relapse (HN3-HN0) and 1 dog developed disease progression from a de novo subcutaneous MCT. No nodal relapse was registered. Fourteen dogs developed de novo MCTs. CONCLUSION/DISCUSSION Low grade/low-risk MCT with nonpalpable and normal sized SLN have a favorable outcome independently from the HN. Result should be considered strictly related to the successful SLN detection guided pre- and intraoperative by radiopharmaceutical markers.
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Affiliation(s)
- Damiano Stefanello
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Elisa M. Gariboldi
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Patrizia Boracchi
- Dipartimento di Scienze Biomediche e ClinicheUniversità degli Studi di MilanoMilanoItaly
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Alessandra Ubiali
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Donatella De Zani
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Davide D. Zani
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Valeria Grieco
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Chiara Giudice
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Camilla Recordati
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Mario Caniatti
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Luigi Auletta
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Lavinia E. Chiti
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
- Clinic for Small Animals Surgery—Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Oblak ML, Lu HY, Ram AS, McKenna C. Comparative aspects of targeted sentinel lymph node mapping in veterinary and human medicine: opportunities for future research. Front Med (Lausanne) 2024; 11:1342456. [PMID: 38633313 PMCID: PMC11021648 DOI: 10.3389/fmed.2024.1342456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/29/2024] [Indexed: 04/19/2024] Open
Abstract
There is a significant overlap in the genetic, metabolic and epigenetic alterations between human and companion animal cancers, including those of the oral cavity, breast, bladder, skin, lungs and pancreas. In many cancer types, the identification and removal of affected lymph nodes are essential for accurate cancer management, including treatment and prognosis. Historically, lymphadenectomy and subsequent radical resection based on regional anatomy, palpation and lymph node aspirates were considered sufficient; however, modern approaches with sentinel lymph node mapping (SLN) mapping have increased the accuracy of surgical decision-making. Preoperative and intraoperative SLN mapping techniques in veterinary patients parallel those used in human medicine. While many of these techniques are highly successful, the main challenges with current methodologies are their sensitivity and specificity for the presence of cancer, which can be overcome via precision medicine and targeted SLN mapping agents. Given the large population of dogs and cats with cancer, the crossover of knowledge between species can help to deepen our understanding of many of these cancers and can be useful in evaluating new drugs and/or therapies. In this review, we discuss SLN mapping techniques in veterinary medicine and the concept of precision medicine as it relates to targeted SLN mapping imaging agents. The large number of companion animals affected by cancer is an underutilized resource to bridge the translational gap and we aim to provide a reference for the use of dogs and cats as a comparative model for human SLN mapping.
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Affiliation(s)
- Michelle L. Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Hui Yu Lu
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Ann S. Ram
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Charly McKenna
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Romańska M, Degórska B, Zabielska-Koczywąs KA. The Use of Sentinel Lymph Node Mapping for Canine Mast Cell Tumors. Animals (Basel) 2024; 14:1089. [PMID: 38612328 PMCID: PMC11010880 DOI: 10.3390/ani14071089] [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: 02/19/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Cancer is the leading cause of death in companion animals. The evaluation of locoregional lymph nodes, known as lymph node mapping, is a critical process in assessing the stage of various solid tumors, such as mast cell tumors (MCTs), anal gland anal sac adenocarcinoma, melanoma, and mammary gland adenocarcinoma. MCTs are among the most prevalent skin malignancies in dogs. Staging is used to describe the extent of neoplastic disease, provide a framework for rational treatment planning, and evaluate treatment results. The aim of this review is to present the current knowledge on sentinel lymph node (SLN) mapping in canine MCTs, its influence on treatment decisions and prognosis, as well as the advantages and limitations of different SLN techniques currently available in veterinary oncology. A search methodology was adopted using the PubMed, Scopus, and Google Scholar databases. Critical analyses of up-to-date research have shown that lymphoscintigraphy can achieve a lymph node detection rate of between 91 and 100%. This method is becoming increasingly recognized as the gold standard in both human and veterinary medicine. In addition, initial studies on a limited number of animals have shown that computed tomographic lymphography (CTL) is highly effective in the SLN mapping of MCTs, with detection rates between 90 and 100%. The first study on contrast-enhanced ultrasound (CEUS) also revealed that this advanced technique has up to a 95% detection rate in canine MCTs. These methods provide non-ionizing alternatives with high detection capabilities. Furthermore, combining computed tomography and near-infrared fluorescence (NIR/NIR-LND) lymphography is promising as each technique identifies different SLNs. Indirect lymphography with Lipiodol or Iohexol is technically feasible and may be also used to effectively detect SLNs. The integration of these mapping techniques into routine MCT staging is essential for enhancing the precision of MCT staging and potentially improving therapeutic outcomes. However, further clinical trials involving a larger number of animals are necessary to refine these procedures and fully evaluate the clinical benefits of each technique.
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Affiliation(s)
| | | | - Katarzyna A. Zabielska-Koczywąs
- Department of Small Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159c, 02-776 Warsaw, Poland; (M.R.); (B.D.)
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Gianni B, Franchi R, Mattolini M, Contiero B, Carozzi G, Nappi L, Cammarota R, Caleri E, Rossi F. CT features of cutaneous and subcutaneous canine mast cell tumors and utility of conventional and indirect lymphography to detect clinically unknown mast cell tumors and to map the sentinel lymph nodes. Vet Radiol Ultrasound 2024; 65:170-180. [PMID: 38339855 DOI: 10.1111/vru.13338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024] Open
Abstract
Computed tomography is frequently used to stage canine mast cell tumors (MCTs). The aims of this prospective, observational study were to describe the CT features of MCTs, to evaluate the performance of CT in detecting additional or incidental MCTs, to distinguish between cutaneous (cMCT) or subcutaneous (scMCT) MCTs, and to identify one or multiple sentinel lymph nodes (SLNs) by indirect CT lymphography (ICTL). Seventy-two dogs affected by 111 MCTs were included. The recorded parameters were: shape, size, attenuation (Hounsfield units [HU]), location (cutaneous or subcutaneous), and presence of fat stranding. The SLNs were compared with the regional lymph nodes and supplementary MCTs were registered. Mast cell tumors mostly appeared with well-defined margins (89%), round/oval shape (71%), homogeneous enhancement (90%) with a mean postcontrast density of 62.0 ± 23.4 HU and associated with fat stranding (43%). Cutaneous mast cell tumors were more frequently round (P = .003), whereas scMCTs were oval (P = .011) with a larger mean maximal diameter (2.91 ± 1.57 cm vs 1.46 ± 1.28 cm, P = .002) and more feeding vessels (77% vs 39% P = .044). Compared with histopathology, CT accuracy in differentiating cMCTs and sMCTs was 57%, with an interobserver agreement of 88% (three reviewers). Indirect CT lymphography showed the SLN in 82 of 85 (97%) cases, 32% of them not corresponding to the regional node. CT showed additional or incidental MCTs in 23 of 72 (32%) dogs. In conclusion, the common CT appearance of canine cMCTs and scMCTs is reported with some statistical differences between the two categories. CT is useful in identifying clinically undetected MCTs and SLNs, although it shows low accuracy in distinguishing between cMCT and scMCT.
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Affiliation(s)
- Beatrice Gianni
- Anicura Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
| | - Roberta Franchi
- Anicura Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
| | - Mirko Mattolini
- Anicura Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | | | - Luigia Nappi
- Anicura Centro Oncologico Veterinario, Sasso Marconi, Italy
| | | | | | - Federica Rossi
- Anicura Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
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Ercolin ACM, Uchôa AS, Aires LPN, Gomes DR, Tinto ST, Feliciano GSM, Feliciano MAR. Use of New Ultrasonography Methods for Detecting Neoplasms in Dogs and Cats: A Review. Animals (Basel) 2024; 14:312. [PMID: 38275771 PMCID: PMC10812759 DOI: 10.3390/ani14020312] [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: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
The aim of this literature review was to present the novel imaging modalities elastography and contrast-enhanced ultrasonography. We provided an overview of the concepts and applications of each technique for the investigation of neoplastic and metastatic tumors in dogs and cats. Studies on elastography are based on the elasticity and deformation of the evaluated tissue. The information obtained from the different types of elastography can aid in the detection and differentiation of malignant and benign structures. Descriptions of elastography studies in several organs and tissue in veterinary medicine reported that, in general, malignant tumors tend to be more rigid and, therefore, less deformable than benign lesions or in comparison to the healthy parenchyma. Contrast-enhanced ultrasonography is based on the intravenous injection of contrast media constituted by microbubbles. This imaging modality can be performed in nonsedated animals and provides information on the tissue perfusion, allowing the investigation of macro- and micro-circulation. Studies on different organs and tissues were performed in dogs and cats and revealed a tendency of malignant tumors to present faster transit of the contrast media (time to wash-in, peak and wash-out). These advanced techniques can be associated with other imaging modalities, aiding important information to the well-established exams of B-mode and Doppler ultrasonography. They can be used as screening tests, potentially representing an alternative to the invasive sampling methods required for cytological and histopathological analysis.
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Affiliation(s)
- Anna Carolina Mazeto Ercolin
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Alex Silveira Uchôa
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Luiz Paulo Nogueira Aires
- Department of Veterinary Clinic and Surgery, School of Agricultural and Veterinarian Sciences, Sao Paulo State University “Júlio de Mesquita Filho”, Sao Paulo 14884-900, Brazil;
| | - Diego Rodrigues Gomes
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Stefany Tagliatela Tinto
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Giovanna Serpa Maciel Feliciano
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
| | - Marcus Antônio Rossi Feliciano
- Laboratory of Veterinary, Faculty of Animal Science and Food Engineering, Sao Paulo University, Sao Paulo 13635-900, Brazil; (A.C.M.E.); (A.S.U.); (D.R.G.); (S.T.T.); (G.S.M.F.)
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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.
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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
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Chalfon C, Finotello R, Sabattini S, Gramer I, Morris JS, Aralla M, Morello EM, Ferraris E, Ramos S, Polton G, Schiavo L, Dobson J, Cola V, Marconato L. Patterns of nodal metastases, biological behaviour and prognosis of canine mast cell tumours of the pinna: A multi-institutional retrospective study. Vet Comp Oncol 2023; 21:332-338. [PMID: 36907653 DOI: 10.1111/vco.12893] [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: 01/05/2023] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
Canine cutaneous mast cell tumours (cMCTs) of the pinna have been associated with an aggressive biological behaviour, although data remain scarce. The knowledge acquired over the past years on histologic gradings, and the value of lymph node (LN) staging, may help in better characterizing this anatomical presentation. The first aim was to describe the frequency, location, and histologic appearance of LN metastases in cMCT of the pinna. A second aim was to evaluate prognosis. Medical records of dogs with cMCT of the pinna, that underwent tumour and sentinel (SLN) or regional LN (RLN) excision, were reviewed. The influence of potential prognostic variables on time to progression (TTP) and tumour-specific survival (TSS) was investigated. Thirty-nine dogs were included: 19 (48.7%) had Kiupel high-grade (K-HG) and 20 (51.3%) had low-grade (K-LG) MCTs. Eighteen (46.1%) dogs underwent SLN mapping: the superficial cervical LN was at least one of SLN in 17 (94.4%) cases. Twenty-two (56.4%) dogs had LN metastases; the superficial cervical LN was always involved. On multivariable analysis, only K-HG was associated with increased risk of progression (p = .043) and tumour-related death (p = .021). Median TTP and TSS were 270 and 370 days in K-HG, respectively; these were not reached in dogs with K-LG tumours (p < .01). cMCTs of the pinna are often K-HG and are also associated with a higher frequency of LN metastasis; however, we confirmed the independent prognostic value of histologic grading. A multimodal treatment may lead to favourable long-term outcome. Moreover, the superficial cervical LN is most often the SLN.
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Affiliation(s)
- Carmit Chalfon
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Riccardo Finotello
- Department of Small Animal Clinical Science, School of Veterinary Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Irina Gramer
- Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Joanna Siriol Morris
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Marina Aralla
- Pronto Soccorso Veterinario Laudenese, Oncology Service, Lodi, Italy
| | | | - Erica Ferraris
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Sofia Ramos
- North Downs Specialist Referrals, Bletchingley, UK
| | - Gerry Polton
- North Downs Specialist Referrals, Bletchingley, UK
| | - Luca Schiavo
- Department of Veterinary Medicine, Cambridge Veterinary School, University of Cambridge, Cambridge, UK
| | - Jane Dobson
- Department of Veterinary Medicine, Cambridge Veterinary School, University of Cambridge, Cambridge, UK
| | - Veronica Cola
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
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