Boston Sarah E, Lu Xiaomin, Culp William T N, Montinaro Vincenzo, Romanelli Giorgio, Dudley Robert M, Liptak Julius M, Mestrinho Lisa A, Buracco Paolo
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.
J Am Vet Med Assoc. 2014 Aug 15;245(4):401-7. doi: 10.2460/javma.245.4.401.
To determine prognostic factors for and compare outcome among dogs with oral malignant melanoma following excision with or without various systemic adjuvant therapies.
Retrospective case series.
151 dogs with naturally occurring oral malignant melanomas treated by excision with or without adjuvant therapies from 2001 to 2012.
Case accrual was solicited from Veterinary Society of Surgical Oncology members via an email list service. Information collected from case records included signalment, tumor staging, tumor characteristics, type of surgical excision, histologic diagnosis, adjuvant therapy, and survival time.
The overall median survival time was 346 days. Results of multivariate analysis indicated that tumor size, patient age, and intralesional excision (vs marginal, wide, or radical excision) were considered poor prognostic indicators. All other demographic and clinical variables were not significantly associated with survival time after adjusting for the aforementioned 3 variables. A clear survival benefit was not evident with any systemic adjuvant therapy, including vaccination against melanoma or chemotherapy; however, the number of dogs in each treatment group was small. Ninety-eight dogs received no postoperative adjuvant therapy, and there was no difference in survival time between dogs that did (335 days) and did not (352 days) receive systemic adjuvant therapy.
For dogs with oral malignant melanoma, increasing tumor size and age were negative prognostic factors. Complete excision of all macroscopic tumor burden improved survival time. Long-term survival was possible following surgery alone. Although systemic adjuvant therapy was not found to improve survival time, this could have been due to type II error.
确定接受或未接受各种全身辅助治疗的口腔恶性黑色素瘤犬的预后因素,并比较其预后情况。
回顾性病例系列研究。
2001年至2012年期间,151只患有自然发生的口腔恶性黑色素瘤的犬,接受了手术切除,部分接受或未接受辅助治疗。
通过电子邮件列表服务向兽医外科肿瘤学会成员征集病例。从病例记录中收集的信息包括信号、肿瘤分期、肿瘤特征、手术切除类型、组织学诊断、辅助治疗和生存时间。
总体中位生存时间为346天。多变量分析结果表明,肿瘤大小、患者年龄和病灶内切除(相对于边缘、广泛或根治性切除)被认为是不良预后指标。在对上述3个变量进行调整后,所有其他人口统计学和临床变量与生存时间均无显著相关性。包括黑色素瘤疫苗接种或化疗在内的任何全身辅助治疗均未显示出明显的生存获益;然而,每个治疗组中的犬只数量较少。98只犬未接受术后辅助治疗,接受(335天)和未接受(352天)全身辅助治疗的犬只在生存时间上没有差异。
对于患有口腔恶性黑色素瘤的犬,肿瘤大小增加和年龄增长是负面预后因素。完全切除所有肉眼可见的肿瘤负荷可延长生存时间。仅手术治疗后也有可能实现长期生存。虽然未发现全身辅助治疗能改善生存时间,但这可能是由于II类错误所致。