Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET.

Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.

Expression of Carboxypeptidase A3 and Tryptase as Markers for Lymph Node Metastasis of Canine Cutaneous Mast Cell Tumors.

Detection of metastatic mast cell tumors (MCTs) in lymph nodes is a critical factor for treatment, prognosis, and clinical management. Presence/absence of mast cells in the lymph nodes cannot be used as a sole parameter to determine metastasis due to the inability to differentiate neoplastic from non-neoplastic/inflammatory mast cells. While cytologic and histopathologic classifications for assessment of metastatic MCTs based on the numbers and distribution of mast cells have been developed, inconsistency between the clinical interpretation of these grading schemes and actual metastatic status occurs. The aim of this study is to identify a novel diagnostic tool to accurately predict overt metastatic mast cell tumors in lymph nodes. We investigated the possibility of using RT-qPCR to detect mRNA expression of mast cell-specific genes in lymph nodes with different stages of MCT metastatic classification. We are able to establish a highly sensitive and discriminating RT-qPCR measuring Carboxy peptidase A3 (CPA3) and tryptase mRNA expression and identify the cut-off values with high sensitivity and specificity for overt metastatic MCTs in lymph nodes. An area of future interest would be to expand our analysis of the extent to which cut-off values for these markers in correctly identifying disease status, as well as predicting clinical outcomes and survival times. This would offer valuable information regarding the practical applicability of this technique and may enable us to improve our standards of detection metastasis, including possibility of molecular analysis of cytologic specimens obtained from suspicious nodes subjected to surgical excision.

Canine visceral hemangiosarcoma treated with surgery alone or surgery and doxorubicin: 37 cases (2005-2014).

The purpose of this retrospective study was to determine survival times and prognostic factors of dogs with visceral hemangiosarcoma (HSA) treated with surgery alone or surgery and doxorubicin. Medical records from 2 hospitals from 2005 to 2014 were searched for dogs with histopathologically confirmed visceral HSA. Data relevant to patient demographics, tumor characteristics, and outcomes were abstracted. The most common primary organ affected was the spleen; however, primary tumor location had no influence on prognosis. Twenty-three dogs were treated with surgery alone, while 14 dogs were treated with surgery and doxorubicin. There was a significant difference in survival times between dogs treated with surgery alone and with surgery followed by doxorubicin (66 days versus 274 days). Dogs with stage I tumors (196 days) had a longer median survival time (MST) than dogs with stage II (117 days) and stage III (23 days) disease. The overall MST was 179 days with a 1-year survival rate of 29.2%.

Hémangiosarcome viscéral canin traité par la chirurgie seule et la doxorubicine : 37 cas (2005­2014). Le but de cette étude rétrospective consistait à déterminer les temps de survie et les facteurs de pronostic des chiens atteints d'un hémangiosarcome (HSE) viscéral traités à l'aide de la chirurgie seule ou de la chirurgie et de la doxorubicine. Les dossiers médicaux de deux cliniques de 2005 à 2014 ont été fouillés pour trouver des chiens avec un HSE viscéral confirmé par histopathologie. Les données pertinentes pour les données démographiques du patient, les caractéristiques de la tumeur et les résultats ont été extraits des dossiers. L'organe primaire le plus couramment affecté était la rate. Cependant, l'emplacement primaire de la tumeur n'avait aucune influence sur le pronostic. Vingt-trois chiens ont été traités par la chirurgie seule, tandis que 14 chiens ont été traités par la chirurgie et la doxorubicine. Il y avait une différence importante dans les temps de survie entre les chiens traités par la chirurgie seule et la chirurgie suivie de la doxorubicine (66 jours contre 274 jours). Les chiens ayant des tumeurs de stade I (196 jours) avaient un temps de survie médian (TSM) plus long que les chiens atteints d'une maladie de stade II (117 jours) et de stade III (23 jours). Le TSM général était de 179 jours avec un taux de survie après 1 an de 29,2 %.(Traduit par Isabelle Vallières).

Tratamento quimioterápico das neoplasias mamárias em cadelas e gatas / Chemotherapeutic treatment of mammary neoplasms in female dogs and cats

A neoplasia mamária é um tumor freqüentemente observado na rotina da clínica veterinária. A ocorrência desta neoplasia está relacionada principalmente a fatores hormonais. O diagnóstico desta enfermidade é confirmado por biópsia excisional e exame histopatológico. Exame físico e radiografias torácicas devem ser realizados para pesquisa de metástase. Os tumores mamários devem ser avaliados quanto ao seu diâmetro, envolvimento de linfonodos regionais e presença de metástase. O tratamento de eleição é a excisão cirúrgica do tumor. A quimioterapia é um tratamento adjuvante, cuja finalidade é evitar recidivas locais e metástases, prolongando desta forma, a sobrevida do paciente. Para a escolha da droga quimioterápica, deve-se considerar: classificação histopatológica do tumor, classificação de acordo com o sistema TNM (tumor-nódulo-metástase), estado geral do animal e os efeitos colaterais que podem decorrer da aplicação dos fármacos, como mielossupressão e toxicidade gastrointestinal. Os principais quimioterápicos antineoplásicos empregados no tratamento das neoplasias mamárias são a doxorrubicina, a ciclofosfamida e o 5-Fluorouracil.

Mammary gland tumors are often observed in the practice of veterinary clinics. The occurrence of this tumor is specialy related to hormonal factors. The diagnosis is confirmed by excisional biopsy and histopathologic evaluation. Physical examination and chest radiographs should be taken to evaluate possible metastasis. Mammary gland tumors must be evaluated for tumor size, regional lymphnodes involvement and presence of metastasis. The treatment of choice is surgical excision of the tumor. Chemotherapy is an adjuvant treatment, whose goal is to avoid local recurrence and metastasis, extending this way, the patient's survival. To choice the chemotherapy drug, it must consider: tumor histopathologic classification, classification according to the TNM system (tumor-node-metastasis), animal's general health and the side effects that can occur from the use of the drugs, like myelossupression and gastrointestinal toxicity. The prime chemotherapy drugs used in the treatment of mammary gland tumors are doxorubicin, cyclophosphamide and 5-fluorouracil.