The impact on staging of no-palpable lymph node extirpation in single cutaneous mast cell tumor in dogs : a multicenter study
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Data di Pubblicazione:
2017
Citazione:
The impact on staging of no-palpable lymph node extirpation in single cutaneous mast cell tumor in dogs : a multicenter study / R. Ferrari, L. Marconato, P. Buracco, P. Boracchi, C. Giudice, S. Iussich, V. Grieco, L. Chiti, E. Favretto, D. Stefanello. ((Intervento presentato al 71. convegno Convegno Nazionale SISVet tenutosi a Napoli nel 2017.
Abstract:
Metastasis to regional lymph nodes (RLN) in cutaneous mast cell tumor (cMCT) in dogs were correlated
with contraction of survival time and high risk of spreading to distant sites. The extirpation of RLN in dogs
with cMCT has been suggested in presence of lymphoadenomegaly, suspected or certain cytological lymph
nodes metastasis.[1] On the contrary 29% of dogs with metastasizing grade II cMCT had normal size RLN
and 18% of cMCT at first presentation had RLN involvement.[2,3] In this study no palpable or normal size
regional lymph node extirpation was included in the surgical management of cMCT in dogs. The lymph
node status was assesed using a recent histologic classification[4] and possible correlations with tumour
variables were analized.
Ninety-three dogs with single MCT without distant metastasis that underwent wide surgical excision and no
palpable or normal size RLN extirpation were included. Data collected were: breed, age, weight, sex, site
and size of cMCT, ulceration, presentation (first vs recurrence), 3-tier and 2-tier histological grades,
histological margin status (clean vs dirty), RLN location, RLN histological status[4] and admission to adjuvant
oncological treatment. The association between nodal status and tumor variables was analyzed by a
generalized linear model with multinomial error.
Thirty-three (35.5%) lymph nodes were HN0, 14 (15%) were HN1, 26 (28%) were HN2 and 20 (21.5%) were
HN3. The presence of positive no palpable RLN was significantly associated with cMCT located in the genital
region and with cMCT larger than 3 cm.
Forty-four dogs received adjuvant chemotherapy. Mean and median follow-up time were 695 and 504
days, respectively (range, 10-2429). Loco-regional relapse with a positive lymph node was detected in 5
cases with a time ranged to 52 to 1071 days from surgery. Metastatic spread to spleen and liver was
identified in 5 dogs with a time ranged from 52 to 1071 days (3 out of this 5 dogs had also the loco-regional
relapse).
Lymphatic metastases play a crucial role in predicting a correct prognostication and recommendations for
adjuvant therapies. These results confirmed the high probability of lymph node metastasis even for no
palpable or normal size RLN for dogs with cMCT. No strong association were found to predict the lymph
node status. The relative low number of loco-regional and distant metastasis led to the hypothesis that
lymph node extirpation could also have a terapeutical value, but further prospective studies are needed.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Elenco autori:
R. Ferrari, L. Marconato, P. Buracco, P. Boracchi, C. Giudice, S. Iussich, V. Grieco, L. Chiti, E. Favretto, D. Stefanello
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