Gothenburg Animal Hospital Evidensia/Göteborgs Djursjukhus Evidensia, Produktvägen 5, 435 33, Mölnlycke, Sweden.
Acta Vet Scand. 2023 Mar 11;65(1):12. doi: 10.1186/s13028-023-00674-1.
Mammary gland tumours are the most frequent tumours in intact female dogs and surgery remains the main treatment modality. Surgery is traditionally performed according to the lymphatic drainage of the mammary glands, but robust evidence is still lacking on what surgical dose is the smallest and results in the best outcome. The objective of the study was to investigate whether choice of surgical dose influences treatment outcome in dogs with mammary tumours and to identify current gaps in research that need to be filled in future studies for identifying the smallest surgical dose with the best possible outcome. Articles for entrance into the study were identified in online databases. Information regarding outcome following use of different surgical doses was extracted for analysis. Also, known prognostic factors were mapped for each study to discuss their impact on treatment outcome. Twelve articles were identified and included. Surgical dose applied ranged from lumpectomy to radical mastectomy. Radical mastectomy was most often analysed [11/12 (92%) articles]. Less invasive surgical doses were used less often in decreasing order of invasiveness. Outcomes analysed were most often survival time [7/12 (58%) articles], frequency of recurrences [5/12 (50%) studies] and time to recurrence [5/12 (42%) studies)]. No studies demonstrated any significant association between surgical dose and outcome. Gaps in the research could be categorised as data that was not available for extraction, for example known prognostic factors. Other factors related to study design were also identified, for example small groups of dogs included into the study. No studies showed a clear benefit of choosing one surgical dose over the other. Choice of surgical dose should be based on known prognostic factors and risks for complications rather than on lymphatic drainage. In future studies all prognostic factors should be included when investigating how choice of surgical dose influences treatment outcome.
乳腺肿瘤是未绝育雌性犬中最常见的肿瘤，手术仍然是主要的治疗方式。手术传统上是根据乳腺的淋巴引流进行的，但仍然缺乏强有力的证据来证明哪种手术剂量最小，结果最好。本研究的目的是调查手术剂量的选择是否会影响乳腺肿瘤犬的治疗结果，并确定当前研究中的空白点，以便在未来的研究中确定具有最佳结果的最小手术剂量。通过在线数据库确定进入研究的文章。提取分析了不同手术剂量使用后的结果信息。此外，还为每个研究映射了已知的预后因素，以讨论它们对治疗结果的影响。确定并纳入了 12 篇文章。应用的手术剂量范围从肿瘤切除术到根治性乳房切除术。根治性乳房切除术最常被分析[11/12（92%）文章]。侵袭性越来越小的手术剂量使用频率越来越低。分析的结果最常是生存时间[7/12（58%）文章]、复发频率[5/12（50%）研究]和复发时间[5/12（42%）研究]。没有研究表明手术剂量与结果之间存在任何显著关联。研究中的空白可以分为无法提取的数据，例如已知的预后因素。还确定了与研究设计相关的其他因素，例如纳入研究的狗的数量较少。没有研究表明选择一种手术剂量优于另一种手术剂量有明显的益处。手术剂量的选择应基于已知的预后因素和并发症风险，而不是基于淋巴引流。在未来的研究中，在调查手术剂量选择如何影响治疗结果时，应纳入所有预后因素。
