Maritato Karl C, Schertel Eric R, Kennedy Shawn C, Dudley Robert, Lamm Catherine, Barnhart Matthew, Kass Phillip
MedVet, Fairfax, OH, USA
MedVet, Worthington, OH, USA.
J Feline Med Surg. 2014 Dec;16(12):979-84. doi: 10.1177/1098612X14530121. Epub 2014 Apr 7.
The purpose of this retrospective study of 20 client-owned cats was to describe the clinical signs, surgical interventions, histological features, stage and treatments of primary lung tumors removed by surgical excision, and to determine which factors significantly influence survival. Any cat that underwent surgical resection of a primary lung tumor between 2000 and 2007 was included in the study. Patient records were reviewed and signalment, clinical signs, preoperative diagnostics, surgical findings and histopathological results recorded. Histological reports were reviewed and scored using World Health Organization criteria. The Kaplan-Meier test was used to evaluate each potential prognostic factor with survival. Twenty cats met the inclusion criteria. The presence of clinical signs (such as dyspnea) at the time of diagnosis (P = 0.032), pleural effusion (P = 0.046), stage M1 (P = 0.015), and moderately and poorly differentiated tumors on histopathology (P = 0.011) were factors that were significantly correlated with reduced survival times. The median survival time of the 20 cats was 11 days. Cats presenting with no clinical signs had a median survival time of 578 days post-surgery vs 4 days post-surgery when presented with clinical signs. Cats staged T1N0M0 lived longer than cats at other stages (P = 0.044). Of the cats that survived to the time of suture removal, median survival time was 64 days. The results indicate that the presence of clinical signs, pleural effusion, moderately and poorly differentiated tumors on histopathology, evidence of metastasis and any stage beyond T1N0M0 are negative prognostic indicators for cats with primary lung tumors. The findings demonstrate that cats that presented with clinical signs, pleural effusion, any stage other than T1N0M0, or moderately and poorly differentiated tumors on histopathology had a poor prognosis. Therefore, extensive preoperative diagnostics, including computed tomography scans, should be performed before considering surgical intervention in these cats. These findings may be used to guide therapeutic decision-making in cats diagnosed with primary lung tumors.
这项对20只家养猫的回顾性研究旨在描述经手术切除的原发性肺肿瘤的临床症状、手术干预、组织学特征、分期及治疗方法,并确定哪些因素会显著影响生存情况。2000年至2007年间接受原发性肺肿瘤手术切除的任何猫都被纳入该研究。查阅了患者记录,并记录了信号、临床症状、术前诊断、手术发现及组织病理学结果。使用世界卫生组织标准对组织学报告进行审查和评分。采用Kaplan-Meier检验评估每个潜在预后因素与生存情况的关系。20只猫符合纳入标准。诊断时出现临床症状(如呼吸困难)(P = 0.032)、胸腔积液(P = 0.046)、M1期(P = 0.015)以及组织病理学上为中低分化肿瘤(P = 0.011)是与生存时间缩短显著相关的因素。这20只猫的中位生存时间为11天。无临床症状的猫术后中位生存时间为578天,而有临床症状的猫术后中位生存时间为4天。T1N0M0期的猫比其他分期的猫存活时间更长(P = 0.044)。在存活至拆线时的猫中,中位生存时间为64天。结果表明,临床症状的出现、胸腔积液、组织病理学上为中低分化肿瘤、转移证据以及T1N0M0期以外的任何分期都是原发性肺肿瘤猫的不良预后指标。研究结果表明,出现临床症状、胸腔积液、T1N0M0期以外的任何分期或组织病理学上为中低分化肿瘤的猫预后较差。因此,在考虑对这些猫进行手术干预之前,应进行包括计算机断层扫描在内的广泛术前诊断。这些发现可用于指导诊断为原发性肺肿瘤的猫的治疗决策。