RESUMO
OBJECTIVE: To report outcomes in dogs with distal radial osteosarcoma (OSA) treated with metal endoprosthesis limb-sparing surgery and compare outcomes between 2 generations of endoprosthesis. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Forty-five dogs with distal radial OSA treated with endoprosthesis and chemotherapy. METHODS: Data of dogs treated with either first-generation endoprosthesis (GEN1) or second-generation endoprosthesis (GEN2) were sourced from medical records and radiographs. Surgical outcomes included postoperative lameness assessment and the presence, severity, and time to onset of complications. Oncologic outcomes included presence of local recurrence or metastasis, time to onset of local recurrence, metastasis-free interval (MFI), and survival time. Results for surgical and oncologic outcomes were compared between GEN1 and GEN2. RESULTS: Twenty-eight dogs received GEN1 and 17 dogs received GEN2. There were 39 complications (96%, 14 minor, 29 major) including infection (78%), implant-related complication (36%), and local recurrence (24%). Metastatic frequency was 67% and median MFI was 188 days (95% confidence interval [CI]: 126-250 days). Survival time ranged from 34 days to 6.1 years with a median of 289 days (95% CI: 207-371 days). There was no significant difference in complication severity, frequency, time to complication, MFI, or survival time between dogs receiving GEN1 and GEN2. CONCLUSION: There was no significant difference in outcomes between dogs receiving GEN1 and GEN2 for limb-sparing surgery of the radius. Metastatic frequency and survival time for metal endoprosthesis were similar to that of amputation with curative intent chemotherapy.
Assuntos
Neoplasias Ósseas/veterinária , Doenças do Cão/cirurgia , Recidiva Local de Neoplasia/veterinária , Osteossarcoma/veterinária , Complicações Pós-Operatórias/veterinária , Próteses e Implantes/veterinária , Animais , Neoplasias Ósseas/tratamento farmacológico , Cães , Metais , Osteossarcoma/cirurgia , Rádio (Anatomia)/cirurgia , Estudos RetrospectivosRESUMO
OBJECTIVE: To describe the frequency and extent of complications associated with lateral caudal axial pattern flaps used to cover large traumatic or excision skin defects on the dorsum, gluteal, and perineal region in 13 dogs. STUDY DESIGN: Case series. ANIMALS: Thirteen client-owned dogs. METHODS: Medical records from 8 institutions were reviewed for dogs treated with a lateral caudal axial pattern flap, including cases in which the procedure was combined with other reconstructive techniques. The flap length relative to the tail length, location of tail skin incision, size and cause of the defect, and short- and long-term complications were recorded. RESULTS: Thirteen dogs were included, 11 with tumors and 2 with traumatic skin loss. The mean estimated length of the flap relative to tail length was 51% (range 33-70%). Four dogs had wound complications. This included 2 dogs with minor postoperative wound complications (mild distal dehiscence) that did not require surgical revision and 2 dogs with major complications that required surgical revision. Two of these 4 dogs had distal flap necrosis, one was revised surgically and one was managed conservatively. In these 2 dogs, the flap length was estimated as 80% and 65% of the tail length, respectively. At 30 days, flaps in all dogs were completely healed. No long-term complications were recorded in any dog. For some dogs, the reconstruction was not obvious, with only the change in hair direction and color noticeable. CONCLUSION: Lateral caudal axial pattern flap is a reconstructive option for gluteal, dorsal, and perineal skin defects in dogs. Distal flap necrosis and dehiscence due to wound infection occurred in 4 dogs that required additional wound care but not always surgical revision.
Assuntos
Doenças do Cão/cirurgia , Cães/lesões , Retalhos Cirúrgicos/veterinária , Animais , Nádegas/cirurgia , Feminino , Masculino , Períneo/cirurgia , Complicações Pós-Operatórias/veterinária , Período Pós-Operatório , Estudos Retrospectivos , Pele/lesões , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/veterinária , Deiscência da Ferida Operatória/veterinária , Resultado do Tratamento , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/veterináriaRESUMO
BACKGROUND: Standard of care for dogs with high-grade lymphoma, multiagent chemotherapy, achieves good initial responses but long-term remissions are infrequent; previous studies using half-body irradiation suggest improved long-term outcomes. HYPOTHESIS: The addition of low-dose rate half-body irradiation would improve outcomes in dogs with B-cell lymphoma. ANIMALS: Client-owned dogs with stage III or higher, substage a, B-cell lymphoma that achieved complete remission after 4 doses of multiagent chemotherapy. METHODS: A case-controlled design comparing 2-year remission and survival rates between dogs treated with CHOP-based chemotherapy and those treated with chemotherapy and sequential low-dose rate half-body irradiation. RESULTS: Thirty-eight dogs were enrolled with 18 included in final analysis, 9 prospectively-enrolled dogs and 9 case-matched historical controls. The irradiation cohort's 2-year disease-free rate was 56% whereas median duration exceeded the 730-day study period compared with 0% and 261 days in the chemotherapy only group. Remission duration significantly differed between cohorts (P < .01), hazard ratio 0.218 (95% CI: 0.06-0.77). The irradiation cohort's 2-year survival rate was 78% with median overall survival duration exceeding the 730 day study period compared with 11% and 286 days in the chemotherapy only group. Overall survival time significantly differed between cohorts (P < .02), hazard ratio 0.173 (95% CI: 0.03-0.839). CONCLUSIONS AND CLINICAL IMPORTANCE: The improved long-term outcome achieved by dogs administered sequential low-dose rate half-body irradiation in this study is similar to previous observational studies. Where long-term remission is sought in dogs with B-cell lymphoma low-dose rate half-body irradiation could be considered in addition to standard chemotherapy.
Assuntos
Doenças do Cão , Linfoma de Células B , Linfoma não Hodgkin , Animais , Cães , Humanos , Doenças do Cão/tratamento farmacológico , Doenças do Cão/radioterapia , Irradiação Hemicorpórea/veterinária , Linfoma de Células B/tratamento farmacológico , Linfoma de Células B/radioterapia , Linfoma de Células B/veterinária , Linfoma não Hodgkin/veterinária , Estudos de Casos e ControlesRESUMO
Survival following amputation and administration of single-agent carboplatin for treatment of appendicular osteosarcoma (OSA) in dogs was retrospectively examined. Records of 155 dogs with appendicular OSA treated with amputation and single-agent carboplatin were included from 14 centers. Any carboplatin dosage, number of doses, and protocol schedule were eligible for inclusion. The median disease-free interval (DFI) was 256 days. The median overall survival time was 307 days. Similar prognostic survival factors were identified in this study as reported in prior studies of canine appendicular OSA. Median DFI and survival were comparable to those reported in the original Bergman et al publication. Carboplatin treatment improves the survival probability in dogs with appendicular OSA compared to amputation alone and remains an acceptable alternative to adjuvant treatment with cisplatin.
Assuntos
Amputação Cirúrgica/veterinária , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/cirurgia , Carboplatina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Osteossarcoma/tratamento farmacológico , Osteossarcoma/cirurgia , Animais , Antineoplásicos/toxicidade , Carboplatina/toxicidade , Cães , Feminino , Masculino , Estudos Retrospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
This paper describes in detail a combined dorsal and intraoral approach for maxillectomy for tumors involving tissues more caudal to the third premolar. The only intraoperative complication was that of blood loss, with six out of 20 dogs requiring a single unit of blood. Histopathologically clean margins were obtained in 14 of the 20 cases, with a recurrence rate of 50% in these dogs and a median time to recurrence of 24 months. This represents an improvement in outcome over previously reported studies, and the authors postulate this is due to the better exposure and access to the area afforded by the combined approach over the standard intraoral approach.