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手术部位感染对犬附肢骨肉瘤根治性治疗中肢体截肢术后生存的影响:一项外科肿瘤学兽医协会的回顾性研究。

Effect of surgical site infection on survival after limb amputation in the curative-intent treatment of canine appendicular osteosarcoma: a Veterinary Society of Surgical Oncology retrospective study.

作者信息

Hans Eric C, Pinard Chris, van Nimwegen S A, Kirpensteijn Jolle, Singh Ameet, MacEachern Steven, Naber Steven, Dudley Robert M

机构信息

MedVet Medical and Cancer Center for Pets, Worthington, Ohio.

Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

Vet Surg. 2018 Nov;47(8):E88-E96. doi: 10.1111/vsu.13105. Epub 2018 Oct 10.

DOI:10.1111/vsu.13105
PMID:30303552
Abstract

OBJECTIVE

To determine the influence of surgical site infection (SSI) on the median disease-free interval (DFI) and median survival time (MST) in dogs after amputation in the curative-intent treatment of appendicular osteosarcoma (OSA).

STUDY DESIGN

Multi-institutional retrospective cohort study.

ANIMALS

Fifteen dogs with OSA and SSI, and 134 dogs with OSA and no SSI.

METHODS

Medical records were reviewed, and dogs were included if the following criteria were met: histologic confirmation of OSA, no evidence of metastasis, ≥1 chemotherapy treatment, and available follow-up data. We used the definition of SSI from the Centers for Disease Control and Prevention. Kaplan-Meier estimates of median DFI and MST for the SSI and non-SSI groups were compared by log-rank test. Univariate and multivariate Cox proportional hazard regression analysis was evaluated for associations with DFI and survival.

RESULTS

The median DFI and MST of all OSA dogs were 236 days (95% CI, 181-283) and 283 days (95% CI 237-355), respectively. The median DFI of dogs with SSI (292 days) did not differ from that of dogs without SSI (224 days, P = .156). The MST of dogs with SSI (292 days) did not differ from that of dogs without SSI (280 days, P = .417). Failure to complete chemotherapy was associated with decreased DFI and survival (P < .001). Adjustments for chemotherapy completion found no effect of SSI on survival.

CONCLUSION

SSI did not influence the survival of dogs with appendicular OSA treated with amputation and curative-intent treatment.

CLINICAL SIGNIFICANCE

The extended survival associated with SSI after limb-spare surgery for OSA does not appear to be present after amputation. Interactions between the canine immune system and OSA warrant additional study.

摘要

目的

确定手术部位感染(SSI)对肢体骨肉瘤(OSA)根治性治疗截肢术后犬的无病间隔期(DFI)中位数和总生存时间(MST)中位数的影响。

研究设计

多机构回顾性队列研究。

动物

15只患有OSA和SSI的犬,以及134只患有OSA但无SSI的犬。

方法

查阅病历,符合以下标准的犬纳入研究:OSA组织学确诊、无转移证据、≥1次化疗治疗以及有可用的随访数据。我们采用疾病控制与预防中心对SSI的定义。通过对数秩检验比较SSI组和非SSI组DFI中位数和MST中位数的Kaplan-Meier估计值。对与DFI和生存的相关性进行单因素和多因素Cox比例风险回归分析。

结果

所有OSA犬的DFI中位数和MST中位数分别为236天(95%CI,181 - 283)和283天(95%CI 237 - 355)。患有SSI的犬的DFI中位数(292天)与未患SSI的犬(224天,P = 0.156)无差异。患有SSI的犬的MST中位数(292天)与未患SSI的犬(280天,P = 0.417)无差异。未完成化疗与DFI缩短和生存率降低相关(P < 0.001)。对化疗完成情况进行调整后发现SSI对生存无影响。

结论

SSI不影响接受截肢和根治性治疗的肢体OSA犬的生存。

临床意义

OSA保肢手术后与SSI相关的生存期延长在截肢后似乎不存在。犬免疫系统与OSA之间的相互作用值得进一步研究。

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