McSporran K D
Gribbles Veterinary, PO Box 12049, Penrose, Auckland 1642, New Zealand.
Vet Pathol. 2009 Sep;46(5):928-33. doi: 10.1354/vp.08-VP-0277-M-FL. Epub 2009 May 9.
Local recurrence of marginally excised subcutaneous soft tissue sarcomas is variable and difficult to predict. This study aimed to identify predictors of local recurrence after excisional biopsy. Medical records of 236 dogs from which tumors had been received between 2004 and 2007 were analyzed. Medium- to large-breed dogs, median age 10 years, were most commonly affected. A total of 139 tumors were graded histologically: 71 were grade 1 (51%); 59, grade 2 (42%); and 9, grade 3 (7%). Of these, 34 tumors (25%) were completely excised, and 104 (75%) were marginally excised. None of 30 completely excised tumors with follow-up information recurred. Three of 41 grade 1 tumors (7%), 14 of 41 grade 2 tumors (34%), and 3 out of 4 grade 3 tumors recurred after marginal excision. Kaplan-Meier survival curves were generated to evaluate survival and the tumor-free interval. The log-rank test and log-rank test for trend were used for comparisons. Tumor recurrence-free intervals for dogs with grade 1 and 2 tumors and for those with grade 1 and 3 tumors differed significantly (P = .0027 and .0001, respectively) and overall were inversely related to tumor grade (P = .0007). Kaplan-Meier survival curves, regardless of recurrence, for patients with grade 1, 2, or 3 tumors treated by marginal excision did not differ significantly, and none differed from the survival curves of patients treated by complete excision. In conclusion, histologic grade is a strong predictor for recurrence of marginally excised subcutaneous soft tissue sarcomas. Clean margins predict nonrecurrence. Tumor recurrence did not significantly reduce survival time.
边缘切除的皮下软组织肉瘤局部复发情况各异且难以预测。本研究旨在确定切除活检后局部复发的预测因素。分析了2004年至2007年间接收肿瘤的236只犬的病历。中型至大型犬最常受累,中位年龄为10岁。共139个肿瘤进行了组织学分级:71个为1级(51%);59个为2级(42%);9个为3级(7%)。其中,34个肿瘤(25%)被完整切除,104个(75%)为边缘切除。有随访信息的30个完整切除的肿瘤均未复发。41个1级肿瘤中有3个(7%)、41个2级肿瘤中有14个(34%)以及4个3级肿瘤中有3个在边缘切除后复发。生成了Kaplan-Meier生存曲线以评估生存率和无瘤间期。使用对数秩检验和趋势对数秩检验进行比较。1级和2级肿瘤犬以及1级和3级肿瘤犬的无瘤间期差异显著(分别为P = 0.0027和P = 0.0001),总体上与肿瘤分级呈负相关(P = 0.0007)。无论是否复发,边缘切除治疗的1级、2级或3级肿瘤患者的Kaplan-Meier生存曲线差异不显著,且均与完整切除治疗患者的生存曲线无差异。总之,组织学分级是边缘切除的皮下软组织肉瘤复发的有力预测因素。切缘阴性可预测无复发。肿瘤复发并未显著缩短生存时间。