Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14850, USA.
Open Vet J. 2021 Jan-Mar;11(1):144-153. doi: 10.4314/ovj.v11i1.21. Epub 2021 Feb 23.
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer in dogs. Despite this, relatively few reports of this disease exist pertaining to prognostic factors and outcome.
To evaluate factors associated with survival in dogs with all subtypes of HCC diagnosed on histopathology.
A retrospective single institutional study was carried out on 94 client-owned dogs with a histopathologic diagnosis of HCC between 2007 and 2018 obtained by biopsy (21/94) or attempted definitive resection (73/94). Signalment, preoperative features, surgical findings, and postoperative outcomes were recorded. Associations between survival to discharge data were collected and univariable logistical regression was carried out. Kaplan-Meier survival analysis was carried out to identify negative risk factors for long-term prognosis.
The median survival time (MST) for all patients was 707 days (95% CI = 551-842). MST was not significantly different ( > 0.05) between patients who had suspected versus incidentally diagnosed HCC (695 775 days), between complete versus incomplete surgical margins (668 834 days), or between patients with massive subtype versus nodular/diffuse subtype (707 747 days). Logistical regression identified an association with the excision of the right medial lobe and risk of perioperative death (OR = 9.2, CI 1.5-55.9, = 0.016). An American Society of Anesthesiologists score ≥4, disease present within the quadrate lobe, and elevated blood urea nitrogen, potassium or gamma-glutamyltransferase were identified as negative prognosticators during multivariable Cox regression. Preoperative imaging (ultrasound or CT) agreed with the surgical location in 91% of the cases. Preoperative cytology was consistent with a diagnosis of HCC in 15/32 (46.9%) cases.
Type of diagnosis (incidental vs presumed), completeness of excision, and subtype were not associated with MST in this study. Preoperative identification of tumors within the central division may be related to a less favorable outcome. Results of preoperative cytology were not highly sensitive for identifying a malignancy.
肝细胞癌（HCC）是犬原发性肝癌中最常见的形式。尽管如此，关于这种疾病的预后因素和结果的报告相对较少。
评估组织病理学诊断为所有亚型 HCC 的犬生存相关因素。
对 2007 年至 2018 年间通过活检（21/94）或尝试明确切除（73/94）获得组织病理学诊断为 HCC 的 94 只患犬进行回顾性单机构研究。记录了犬的一般情况、术前特征、手术发现和术后结果。收集了与存活至出院数据的相关性，并进行了单变量逻辑回归分析。进行 Kaplan-Meier 生存分析以确定对长期预后的不利风险因素。
所有患者的中位生存时间（MST）为 707 天（95%CI=551-842）。疑似 HCC 与偶然诊断 HCC 之间（695-775 天）、完全切除与不完全切除之间（668-834 天）以及巨块型与结节/弥漫型之间（707-747 天）的 MST 差异无统计学意义（>0.05）。逻辑回归确定与右内侧叶切除和围手术期死亡风险相关（OR=9.2，CI 1.5-55.9，=0.016）。多变量 Cox 回归分析确定美国麻醉师协会评分≥4、疾病位于方叶、血尿素氮、钾或γ-谷氨酰转移酶升高为负预后因素。术前影像学（超声或 CT）在 91%的病例中与手术部位一致。术前细胞学检查与 HCC 诊断一致的有 15/32（46.9%）例。
在本研究中，诊断类型（偶然发现与推测）、切除的完整性和亚型与 MST 无关。术前识别中央部肿瘤可能与预后较差相关。术前细胞学检查对识别恶性肿瘤的敏感性不高。
