Gemignani Francesco, Mayhew Philipp D, Giuffrida Michelle A, Palaigos Jason, Runge Jeffrey J, Holt David E, Robertson Nicholas A, Seguin Bernard, Walker Meaghan, Singh Ameet, Liptak Julius M, Romanelli Giorgio, Martano Marina, Boston Sarah E, Lux Cassie, Busetto Roberto, Culp William T N, Skorupski Katherine A, Burton Jenna H
J Am Vet Med Assoc. 2018 Jun 1;252(11):1393-1402. doi: 10.2460/javma.252.11.1393.
OBJECTIVE To evaluate potential associations between surgical approach and complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma. DESIGN Retrospective case series. ANIMALS 107 client-owned cats. PROCEDURES Medical records of cats that underwent surgical excision of mammary adenocarcinoma by means of a unilateral or bilateral (staged or single-session) mastectomy at 9 hospitals between 1991 and 2014 were reviewed. Relevant clinicopathologic data and details of surgical and adjuvant treatments were recorded. Outcome data were obtained, including postoperative complications, progression-free survival time, and disease-specific survival time. RESULTS Complications occurred in 12 of 61 (19.7%) cats treated with unilateral mastectomy, 5 of 14 (35.7%) cats treated with staged bilateral mastectomy, and 13 of 32 (40.6%) cats treated with single-session bilateral mastectomy. Complications were significantly more likely to occur in cats undergoing bilateral versus unilateral mastectomy. Median progression-free survival time was longer for cats treated with bilateral mastectomy (542 days) than for cats treated with unilateral mastectomy (289 days). Significant risk factors for disease progression included unilateral mastectomy, tumor ulceration, lymph node metastasis, and tumors arising in the fourth mammary gland. Significant risk factors for disease-specific death included lymph node metastasis and development of regional or distant metastasis. Among cats that did not develop metastasis, unilateral mastectomy was a significant risk factor for disease-specific death. Treatment with chemotherapy was associated with a significantly decreased risk of disease-specific death. CONCLUSIONS AND CLINICAL RELEVANCE Results supported bilateral mastectomy for the treatment of mammary adenocarcinoma in cats to improve progression-free and disease-specific survival time. Performing bilateral mastectomy in a staged fashion may help to decrease the complication rate.
目的 评估乳腺腺癌猫的手术方式与并发症发生率、无进展生存时间和疾病特异性生存时间之间的潜在关联。 设计 回顾性病例系列。 动物 107 只客户拥有的猫。 程序 回顾了1991年至2014年间在9家医院接受单侧或双侧（分期或单次手术）乳房切除术切除乳腺腺癌的猫的病历。记录相关的临床病理数据以及手术和辅助治疗的细节。获取结局数据，包括术后并发症、无进展生存时间和疾病特异性生存时间。 结果 61只接受单侧乳房切除术的猫中有12只（19.7%）发生并发症，14只接受分期双侧乳房切除术的猫中有5只（35.7%）发生并发症，32只接受单次双侧乳房切除术的猫中有13只（40.6%）发生并发症。双侧乳房切除术的猫比单侧乳房切除术的猫更易发生并发症。接受双侧乳房切除术的猫的中位无进展生存时间（542天）比接受单侧乳房切除术的猫（289天）更长。疾病进展的显著危险因素包括单侧乳房切除术、肿瘤溃疡、淋巴结转移以及起源于第四乳腺的肿瘤。疾病特异性死亡的显著危险因素包括淋巴结转移以及局部或远处转移的发生。在未发生转移的猫中，单侧乳房切除术是疾病特异性死亡的显著危险因素。化疗与疾病特异性死亡风险显著降低相关。 结论及临床意义 结果支持对乳腺腺癌猫进行双侧乳房切除术以提高无进展和疾病特异性生存时间。分期进行双侧乳房切除术可能有助于降低并发症发生率。
