Department of Veterinary Medical Sciences, University of Bologna, BO, Italy.
Small Animal Clinic Hofheim, Hofheim, Germany.
Vet Comp Oncol. 2020 Dec;18(4):778-786. doi: 10.1111/vco.12609. Epub 2020 Jun 1.
Localized histiocytic sarcoma may occur as a primary lesion in periarticular tissues of large appendicular joints. Treatment options for the primary lesion include radical surgical excision, radiation therapy (RT), or both, in combination with chemotherapy for potential systemic metastases. In an effort to better characterize the time to progression (TTP) following surgical vs non-surgical approaches for periarticular histiocytic sarcoma (PAHS), a contemporary European population of affected dogs was retrospectively surveyed. Medical records were queried for newly-diagnosed PAHS cases undergoing surgery (predominantly limb amputation) or RT followed by systemic chemotherapy. Of 49 dogs, 34 underwent RT and 15 underwent surgery. All dogs received adjuvant chemotherapy. There was no statistically significant difference in TTP or overall survival between groups. The median TTP was 336 days for the operated dogs and 217 days for the irradiated dogs (P = .117). The median overall survival time was 398 days for the operated dogs and 240 days for the irradiated dogs (P = .142). On multi-variable analysis, the variables significantly associated with an increased risk of both tumour progression and tumour-related death were regional lymph node and distant metastasis at admission. Survival and local control rates following RT may be comparable to radical resection. These data may better inform shared decision-making processes between multi-disciplinary care providers and owners.
局限性组织细胞肉瘤可能作为四肢大关节附肢组织的原发性病变发生。原发性病变的治疗选择包括根治性手术切除、放射治疗(RT)或两者联合,并结合化疗治疗潜在的全身转移。为了更好地描述关节周围组织细胞肉瘤(PAHS)手术与非手术治疗后的进展时间(TTP),对受影响的欧洲犬类进行了回顾性调查。对接受手术(主要为肢体截肢)或 RT 后接受全身化疗的新诊断为 PAHS 的病例进行了病历查询。49 只狗中,34 只接受了 RT,15 只接受了手术。所有狗都接受了辅助化疗。两组之间 TTP 或总生存率均无统计学差异。手术组的中位 TTP 为 336 天,放射组为 217 天(P =.117)。手术组的中位总生存时间为 398 天,放射组为 240 天(P =.142)。多变量分析显示,就诊时区域淋巴结和远处转移与肿瘤进展和肿瘤相关死亡的风险增加显著相关。RT 后的生存率和局部控制率可能与根治性切除相当。这些数据可能为多学科治疗提供者和主人之间的共同决策过程提供更好的信息。