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在接受口腔恶性黑色素瘤治疗的犬中,以治愈为目的的切除与边缘性切除作为初次治疗的效果差异,以及辅助 CSPG4-DNA 电疫苗接种的影响:一项针对 155 例病例的回顾性研究。

Difference in outcome between curative intent vs marginal excision as a first treatment in dogs with oral malignant melanoma and the impact of adjuvant CSPG4-DNA electrovaccination: A retrospective study on 155 cases.

机构信息

Department of Veterinary Sciences, University of Torino, Torino, Italy.

Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy.

出版信息

Vet Comp Oncol. 2021 Dec;19(4):651-660. doi: 10.1111/vco.12690. Epub 2021 Mar 22.

Abstract

Canine oral malignant melanoma is locally invasive and highly metastatic. At present, the best option for local control is en bloc excision followed by radiation if excision margins are incomplete. Adjuvantly, the role of chemotherapy is dubious while immunotherapy appears encouraging. This retrospective study evaluated 155 dogs with oral malignant melanomas (24 stage I, 54 stage II, 66 stage III and 11 stage IV) managed in a single institution. The aim was to evaluate the differences in median survival time (MST) and disease-free interval (DFI) between dogs which, at presentation, were treated surgically with a curative intent (group 1) vs those marginally excised only (group 2). MST in group 1 was longer than in group 2 (594 vs 458 days), but no significant difference was found (P = .57); a statistical difference was, however, found for DFI (232 vs 183 days, P = .008). In the subpopulation of vaccinated dogs, the impact of adjuvant anti-CSPG4 DNA electrovaccination was then evaluated (curative intent, group 3, vs marginal, group 4); a significant difference for both MST (1333 vs 470 days, respectively, P = .03) and DFI (324 vs 184 days, respectively, P = .008) was found. Progressive disease was significantly more common in dogs undergoing marginal excision than curative intent excision for both the overall population (P = .03) and the vaccinated dogs (P = .02). This study pointed out that, after staging, wide excision together with adjuvant immunotherapy was an effective approach for canine oral malignant melanoma.

摘要

犬口腔恶性黑色素瘤具有局部侵袭性和高度转移性。目前,局部控制的最佳选择是整块切除,如果切除边缘不完整则进行放疗。辅助化疗的作用值得怀疑,而免疫疗法似乎令人鼓舞。这项回顾性研究评估了在一家机构接受治疗的 155 只患有口腔恶性黑色素瘤(24 只 I 期、54 只 II 期、66 只 III 期和 11 只 IV 期)的狗。目的是评估在呈现时接受根治性手术治疗的狗(组 1)与仅边缘切除的狗(组 2)之间的中位生存时间(MST)和无病间隔(DFI)的差异。组 1 的 MST 长于组 2(594 与 458 天),但差异无统计学意义(P=.57);然而,DFI 存在统计学差异(232 与 183 天,P=.008)。在接种疫苗的亚群中,然后评估辅助抗 CSPG4 DNA 电疫苗接种的影响(根治性意图,组 3,与边缘性,组 4);MST(分别为 1333 和 470 天,P=.03)和 DFI(分别为 324 和 184 天,P=.008)均有显著差异。对于总人群(P=.03)和接种疫苗的狗(P=.02),与根治性切除相比,边缘切除后疾病进展更为常见。这项研究表明,在分期后,广泛切除联合辅助免疫疗法是犬口腔恶性黑色素瘤的有效治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b73e/9290641/9f007013930f/VCO-19-651-g004.jpg

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