Bray J P
Veterinary Teaching Hospital, Institute for Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North 4442, New Zealand.
J Small Anim Pract. 2016 Oct;57(10):510-519. doi: 10.1111/jsap.12556. Epub 2016 Sep 14.
Soft tissue sarcomas are derived from tissues of mesenchymal origin. Although local recurrence following surgical resection is the characteristic challenge in their management, 40% dogs with high-grade tumours may also develop metastatic disease, despite successful local control. Soft tissue sarcoma is a complex disease and there are many uncertainties regarding the biology and optimal clinical management. There are currently no diagnostic tests that can reliably predict the amount of surgical margin required for a particular tumour, so there can be a mismatch between treatment and disease. Historically, the tendency has been to always recommend wide excision margins but this is not fully supported by recent evidence. A selection bias for less aggressive soft tissue sarcomas in primary care practice can account for good outcomes that are achieved despite narrow surgical excision margins. On the other hand, inappropriately conservative treatment will adversely affect outcomes for patients with more aggressive disease. This review provides an update on the current understanding of management of canine soft tissue sarcomas.
软组织肉瘤起源于间充质组织。尽管手术切除后局部复发是其治疗中的典型挑战,但40%的患有高级别肿瘤的犬只即便局部控制成功,仍可能发生转移性疾病。软组织肉瘤是一种复杂的疾病,在生物学特性和最佳临床治疗方面存在许多不确定性。目前尚无诊断测试能够可靠地预测特定肿瘤所需的手术切缘量,因此治疗与疾病之间可能存在不匹配的情况。从历史上看,一直倾向于始终推荐广泛的切除切缘,但最近的证据并未完全支持这一点。初级保健实践中对侵袭性较小的软组织肉瘤存在选择偏倚,这可以解释为何尽管手术切除切缘狭窄仍能取得良好的治疗效果。另一方面,不恰当的保守治疗会对侵袭性更强的疾病患者的治疗效果产生不利影响。本综述提供了关于犬软组织肉瘤治疗现状的最新认识。