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鸟类皮肤和口腔鳞状细胞癌的临床特征、治疗及预后

Clinical features, treatment, and outcomes of cutaneous and oral squamous cell carcinoma in avian species.

作者信息

Zehnder Ashley M, Swift Laura A, Sundaram Ash, Speer Brian L, Olsen Geoff P, Hawkins Michelle G, Paul-Murphy Joanne

出版信息

J Am Vet Med Assoc. 2018 Feb 1;252(3):309-315. doi: 10.2460/javma.252.3.309.

Abstract

OBJECTIVE To determine the clinical features, treatment, and outcomes of treatment for oral and cutaneous squamous cell carcinoma (SCC) in avian species. DESIGN Retrospective case series with nested cohort study. ANIMALS 87 client-owned birds of various species with histologically confirmed SCC of the skin or oral cavity. PROCEDURES Clinicians entered case information through an online survey tool. Data were collected regarding patient signalment, concurrent conditions, treatments, adverse effects, and clinical outcomes. Relationships were examined between complete excision and partial or complete response. Survival analysis was performed to compare outcomes among groupings of therapeutic approaches. RESULTS Only 7 of 64 (11%) birds for which full outcome data were available had complete remission of SCC; 53 (83%) had progressive disease, were euthanized, or died of the disease. The unadjusted OR for partial or complete response following complete tumor excision (vs other treatment approaches) was 6.9 (95% confidence interval [CI], 1.8 to 25.8). Risk of death was 62% lower (hazard ratio, 0.38; 95% CI, 0.19 to 0.77) for birds that underwent complete excision versus conservative treatment. Median survival time from initial evaluation for birds receiving complete excision was 628 days (95% CI, 210 to 1,008 days), compared with 171 days (95% CI, 89 to 286 days) for birds receiving monitoring with or without conservative treatment. Birds receiving any other additional treatment had a median survival time of 357 days (95% CI, 143 to 562 days). CONCLUSIONS AND CLINICAL RELEVANCE For birds with SCC, complete excision was the only treatment approach significantly associated with complete or partial response and increased survival time.

摘要

目的 确定鸟类口腔和皮肤鳞状细胞癌(SCC)的临床特征、治疗方法及治疗结果。 设计 带有嵌套队列研究的回顾性病例系列。 动物 87只由客户拥有的不同物种鸟类,其皮肤或口腔的SCC经组织学确诊。 方法 临床医生通过在线调查工具录入病例信息。收集有关患畜特征、并发疾病、治疗方法、不良反应及临床结果的数据。研究完全切除与部分或完全缓解之间的关系。进行生存分析以比较不同治疗方法分组的结果。 结果 在有完整结局数据的64只鸟中,只有7只(11%)SCC完全缓解;53只(83%)病情进展、实施安乐死或死于该病。完全肿瘤切除后部分或完全缓解的未调整比值比(与其他治疗方法相比)为6.9(95%置信区间[CI],1.8至25.8)。与保守治疗相比,接受完全切除的鸟死亡风险降低62%(风险比,0.38;95%CI,0.19至0.77)。接受完全切除的鸟从初次评估起的中位生存时间为628天(95%CI,210至1008天),而接受监测(无论是否进行保守治疗)的鸟为171天(95%CI,89至286天)。接受任何其他额外治疗的鸟中位生存时间为357天(95%CI,143至562天)。 结论及临床意义 对于患有SCC的鸟类,完全切除是唯一与部分或完全缓解及延长生存时间显著相关的治疗方法。

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