对于接受切除手术且有明显转移性区域淋巴结的 Kiupel 分级高的皮肤肥大细胞瘤犬，淋巴结清扫术可改善预后。
Lymphadenectomy improves outcome in dogs with resected Kiupel high-grade cutaneous mast cell tumours and overtly metastatic regional lymph nodes.
机构信息
Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy.
Depertment of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK.
出版信息
J Small Anim Pract. 2022 Sep;63(9):661-669. doi: 10.1111/jsap.13525. Epub 2022 Jun 22.
INTRODUCTION
Historically, the prognosis for dogs with stage II Kiupel high-grade cutaneous mast cell tumours has been considered poor.
OBJECTIVES
The aim of this study was to explore the impact of lymphadenectomy on outcome in dogs with Kiupel high-grade cutaneous mast cell tumours and overt regional lymph node metastasis.
MATERIAL AND METHODS
Data from dogs with completely staged Kiupel high-grade cutaneous mast cell tumours with overt and/or certain regional lymph node metastasis undergoing excision of the primary tumours and adjuvant medical treatment were extracted. Dogs with a cytological diagnosis of regional lymph node metastasis that did not undergo lymphadenectomy were compared with dogs that underwent lymphadenectomy and had a histological diagnosis of overt lymph node metastasis.
RESULTS
Forty-nine dogs were included, 18 did not undergo lymphadenectomy while 31 underwent lymphadenectomy. Median time to progression was significantly shorter in dogs that did not undergo lymphadenectomy (150 days, 95% confidence interval: 129 to 170) compared to the other dogs (229 days, 95% confidence interval: 191 to 266). Median survival time was also shorter in dogs that did not undergo lymphadenectomy (250 days, 95% confidence interval: 191 to 308) compared to dogs that underwent lymphadenectomy (371 days, 95% confidence interval: 311 to 430). On multivariable analysis, lack of lymphadenectomy was associated with higher risk of overall tumour progression (hazard ratio: 2.05, 95% confidence interval: 1.02 to 4.13), nodal progression (hazard ratio: 3.4, 95% confidence interval: 1.65 to 7.02) and tumour-related death (hazard ratio 3.63, 95% confidence interval: 1.72 to 7.66), whereas tumour size was associated with higher risk of local recurrence (hazard ratio: 3.61, 95% confidence interval: 1.06 to 13).
CLINICAL SIGNIFICANCE
Regional lymphadenectomy may improve outcome in dogs with biologically aggressive cutaneous mast cell tumours.
简介
从历史上看，Kiupel 高级皮肤肥大细胞瘤 II 期犬的预后被认为较差。
目的
本研究旨在探讨淋巴结切除术对 Kiupel 高级皮肤肥大细胞瘤伴明显区域性淋巴结转移的犬的影响。
材料和方法
从接受原发肿瘤切除术和辅助药物治疗的完全分期 Kiupel 高级皮肤肥大细胞瘤，且伴有明显和/或特定区域性淋巴结转移的犬中提取数据。比较了细胞学诊断为区域性淋巴结转移但未行淋巴结切除术的犬与行淋巴结切除术且组织学诊断为明显淋巴结转移的犬。
结果
共纳入 49 只犬，其中 18 只未行淋巴结切除术，31 只行淋巴结切除术。未行淋巴结切除术的犬中位进展时间明显短于其他犬（150 天，95%置信区间：129 至 170）。未行淋巴结切除术的犬中位生存时间也较短（250 天，95%置信区间：191 至 308），而行淋巴结切除术的犬为 371 天（95%置信区间：311 至 430）。多变量分析显示，未行淋巴结切除术与总肿瘤进展（风险比：2.05，95%置信区间：1.02 至 4.13）、淋巴结进展（风险比：3.4，95%置信区间：1.65 至 7.02）和肿瘤相关死亡（风险比 3.63，95%置信区间：1.72 至 7.66）的风险增加相关，而肿瘤大小与局部复发的风险增加相关（风险比：3.61，95%置信区间：1.06 至 13）。
临床意义
区域性淋巴结切除术可能改善具有侵袭性生物学行为的皮肤肥大细胞瘤犬的预后。
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