一项对255只接受α-肾上腺素能受体拮抗剂或手术治疗的嗜铬细胞瘤犬长期生存情况的多中心回顾性分析（2010 - 2021年）
A Multicenter, Retrospective Analysis of Long-Term Survival in 255 Dogs With Pheochromocytoma Treated With Alpha-Adrenoreceptor Antagonists or Surgery (2010-2021).
作者信息
Steele Matthew M E, van den Berg Marit F, Galac Sara, Dordio Ana M, Threlfall Anna, Gomes Cláudia, Paul Amanda, Nolff Mirja, Sieber-Ruckstuhl Nadja, Benchekroun Ghita, Allerton Fergus, Mendoza Beatriz, Spence Susanna, Valiente Paula, Boag Alisdair, Fracassi Federico, Carranza Valencia Alejandra, Pena-Ramos Jorge, Lloyd-Bradley Ben, Seth Mayank, Fawsitt Jack, Yu Foo Fang, Heilmann Romy M, Silverstrini Paolo, Lyssens Aurélie, Vangrinsven Emilie, Casas-Acuna Clara, Hrovat Alenka, Arenas Carolina, Cervone Mario, Mooney Carmel T, Leal Rodolfo O, Piekos Karolina Maria, Olivares Gerard, Ruiz Guillame, Caulfield Sarah J, Keyte Sophie, Lamoureux Anaïs, Scudder Christopher J, Gostelow Ruth
机构信息
ChesterGates Veterinary Specialists, Chester, UK.
Clinical Science and Services, Royal Veterinary College, London, UK.
出版信息
J Vet Intern Med. 2025 Sep-Oct;39(5):e70220. doi: 10.1111/jvim.70220.
BACKGROUND
The survival of dogs with pheochromocytoma (PCC) treated with adrenoreceptor antagonists has not been described or compared to surgically managed cases.
HYPOTHESIS/OBJECTIVES: The objective of this study is to evaluate the survival of medically and surgically managed dogs with PCC and investigate factors associated with survival.
ANIMALS
Two hundred fifty-five dogs with PCC, treated with alpha-adrenoreceptor antagonists (AA) without adrenalectomy (Group 1, n = 75), adrenalectomy +/- AA (Group 2, n = 128), or neither treatment (Group 3, n = 52).
METHODS
Retrospective, multicenter review of medical records. Median overall survival time (OST) for Groups 1 and 2 combined was calculated using Kaplan-Meier estimates, and then compared between Group 1 and Group 2 using Log-Rank testing. Cox proportional hazard analysis identified factors associated with survival in Groups 1 and 2 individually and combined.
RESULTS
Median OST for all cases was 854 (95% CI: 572-1136) days. Median OST was lower in Group 1 (247 days, 95% CI: 76-418 days) than in Group 2 (927 days, 95% CI: 587-1267 days; p < 0.001). In Group 2, 88/92 dogs (97.8%) that received presurgical AA treatment survived to discharge compared to 23/27 (85.2%) that did not receive AA pretreatment (p = 0.03). Lack of clinical signs at presentation was associated with increased survival in both groups combined (HR 0.5; 95% CI 0.3-0.9; p = 0.02) and in Group 2 alone (HR 0.3; 95% CI 0.1-0.7; p = 0.01).
CONCLUSIONS AND CLINICAL IMPORTANCE
Dogs with PCC treated with adrenalectomy have longer survival compared to those managed with AA without adrenalectomy.
背景
用肾上腺素能受体拮抗剂治疗的嗜铬细胞瘤（PCC）犬的存活率尚未被描述，也未与手术治疗的病例进行比较。
假设/目标：本研究的目的是评估药物治疗和手术治疗的PCC犬的存活率，并调查与存活相关的因素。
动物
255只患有PCC的犬，用α-肾上腺素能受体拮抗剂（AA）治疗且未行肾上腺切除术（第1组，n = 75），行肾上腺切除术±AA（第2组，n = 128），或未接受任何治疗（第3组，n = 52）。
方法
对病历进行回顾性多中心研究。使用Kaplan-Meier估计法计算第1组和第2组合并后的中位总生存时间（OST），然后使用对数秩检验比较第1组和第2组。Cox比例风险分析分别确定第1组和第2组以及两组合并后与存活相关的因素。
结果
所有病例的中位OST为854（95%CI：572 - 1136）天。第1组的中位OST（247天，95%CI：76 - 418天）低于第2组（927天，95%CI：587 - 1267天；p < 0.001）。在第2组中，接受术前AA治疗的92只犬中有88只（97.8%）存活至出院，而未接受AA预处理的27只犬中有23只（85.2%）存活至出院（p = 0.03）。就诊时无临床症状与两组合并（HR 0.5；95%CI 0.3 - 0.9；p = 0.02）以及仅第2组（HR 0.3；95%CI 0.1 - 0.7；p = 0.01）的存活时间延长相关。
结论及临床意义
与未行肾上腺切除术而用AA治疗的犬相比，行肾上腺切除术治疗的PCC犬存活时间更长。
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